Non-Hodgkin's lymphoma very rarely involves the esophagus, occurring in less than 1% of patients with gastrointestinal lymphoma. A few cases of mucosa-associated lymphoid tissue (MALT) lymphoma of the esophagus have been reported in the English literature. To our knowledge, there has been no report of MALT lymphoma of the esophagus coexistent with bronchus-associated lymphoid tissue lymphoma (BALT) of the lung. This report details the radiological and clinical findings of this first concurrent case.
Aged ; Bronchi/pathology ; Esophageal Neoplasms/*pathology/radiography ; Humans ; Lung Neoplasms/*pathology/radiography ; Lymphoma/*pathology/radiography ; Lymphoma, Mucosa-Associated Lymphoid Tissue/*pathology/radiography ; Male ; Neoplasms, Multiple Primary/*pathology/radiography

The authors present a case of histologically proven bronchus-associated lymphoid tissue (BALT) lymphoma of the lung in a patient with primary Sjogren's syn-drome that manifested on thin-section CT scan as a mosaic pattern of inhomoge-neous attenuation due to mixed small airway and infiltrative abnormalities
Adult ; Case Report ; Female ; Human ; Lung Neoplasms/complications/*radiography ; Lymphoid Tissue/radiography ; Lymphoma, Non-Hodgkin/complications/*radiography ; Sjogren's Syndrome/complications/radiography ; Tomography, X-Ray Computed/*methods

The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.
Alcoholism/complications ; Diagnosis, Differential ; Esophageal Neoplasms/pathology* ; Esophageal Neoplasms/radiography ; Esophageal Neoplasms/ultrasonography ; Esophagoscopy ; Gastritis/complications ; Helicobacter Infections/complications ; Hemangioma, Cavernous/diagnosis ; Human ; Incidental Findings ; Lymphoma, Mucosa-Associated Lymphoid Tissue/pathology* ; Lymphoma, Mucosa-Associated Lymphoid Tissue/radiography ; Lymphoma, Mucosa-Associated Lymphoid Tissue/ultrasonography ; Male ; Middle Aged ; Mucous Membrane/pathology ; Neoplasm Invasiveness ; Smoking ; Thyroiditis, Autoimmune/complications

Gastric pseudolymphoma can be defined as a benign proliferation of lymphoid tissue and is also called the lymphoid hyperplasia or reactive lymphoreticular hyperplasia of the stomach. This lesion has been described in the orbital area, skin, salivary glands, mediastinum and other organs. The etiology of this disease is unknown but chronic inflammation and ulceration have been proposed as the etiologic mechanism in many cases. Most patients exhibit chronic, nonspecific, mild symptoms with the vast majority having symptoms for more than 1 year before undergoing diagnosis and treatment. Unfortunately, upper GI radiography rarely clarifies the diagnosis and gastroacopy is ineffective in establishing the diagnosis of pseudolpnphoma. Therefare, gastric resection is the only sure way to diagnose gastric pseudolympboma, as well as providing curitive therapy in most cases because of its possible malignant potential. There is no typical gross appearance of gastric pseudolymphoma and histologic diagoosis is essential. Smaller tumor size, infiltration with small, round mature lymphoeytos and various inflammatory cells, and formation of a true lymphoid germinal center favor a diagnosis of pseudolymphoma, We report 3 cases of histopathologically confirmed gastric pseudolymphoma after gastrectomy, which were initially suspected to be gastric lymphoma and early gastric cancer
Diagnosis ; Gastrectomy ; Germinal Center ; Humans ; Hyperplasia ; Inflammation ; Lymphoid Tissue ; Lymphoma ; Mediastinum ; Orbit ; Pseudolymphoma* ; Radiography ; Salivary Glands ; Skin ; Stomach ; Stomach Neoplasms ; Ulcer

Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) represents distinct clinicopathologic features and remains localized for prolonged periods. We report a case of low grade B cell lymphoma of bronchus-associated lymphoid tissue (BALT). A 60-year-old female had a long-standing cough, sputum and intermittent fever for 10 years. In 1984, the chest radiography showed increased hazy density in both upper lungs. Although she had been treated by antituberculous medication under clinical diagnosis, there was no improvement. In 1995, open lung biopsy was carried out. Histologically, it showed massive nodular or diffuse infiltration of centrocyte-like cells in bronchus and parenchyme with pleural invasion. On immunohistochemical stain, they were positive for LN-2 and L26 and negative for UCHL-1, LN-1 and LN-3. In polymerase chain reaction (PCR), Ig heavy chain gene rearrangement was detected. The patient was well for 6 months after the biopsy.
Biopsy ; Bronchi ; Cough ; Diagnosis ; Female ; Fever ; Gene Rearrangement ; Humans ; Lung ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell ; Middle Aged ; Polymerase Chain Reaction ; Radiography ; Sputum ; Thorax

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
B-Lymphocytes* ; Cough ; Dyspnea ; Fever ; Glass ; Humans ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pneumonia* ; Radiography, Thoracic ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.
B-Lymphocytes* ; Cough ; Dyspnea ; Fever ; Glass ; Humans ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pneumonia* ; Radiography, Thoracic ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare disorder and it is a characteristic subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma that is classified as marginal zone lymphoma. We report here on a patient with rheumatoid arthritis who developed BALT lymphoma. She had no pulmonary symptoms and the pulmonary nodules were incidentally detected by routine chest radiography. Chest CT showed a 2.8cm sized ill-defined focal consolidation of homogenous attenuation in the posterobasal segment of the right lower lobe. The histological diagnosis from the wedge resection specimen revealed low grade B cell lymphoma of BALT. To the best of our knowledge, this case is the first to report BALT lymphoma that developed in a Korean patient with rheumatoid arthritis. BALT lymphoma should be included in the differential diagnosis of the pulmonary nodules in patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; B-Lymphocytes ; Diagnosis ; Diagnosis, Differential ; Humans ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Radiography ; Thorax ; Tomography, X-Ray Computed

OBJECTIVE: To investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). MATERIALS AND METHODS: From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. RESULTS: A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. CONCLUSION: Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT.
Adult ; Biopsy ; Bronchi/pathology ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Immunohistochemistry ; Lymphoid Tissue/pathology ; Lymphoma, B-Cell, Marginal Zone/pathology/*radiography/radionuclide imaging ; Male ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.
Aged ; Biopsy ; Bone Marrow ; Cough ; Diagnosis ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Tract ; Helicobacter pylori ; Humans ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiography, Thoracic ; Solitary Pulmonary Nodule* ; Stomach ; Tomography, X-Ray Computed