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Ann Thorac Surg 2005;80:1248-1253
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Primary Pulmonary Lymphoma

Brian B. Graham, MD a , * , Douglas J. Mathisen, MD a , Eugene J. Mark, MD b , Ronald W. Takvorian, MD c

a Department of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts
b Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
c Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts

Accepted for publication April 5, 2005.

* Address reprint requests to Dr Graham, University of Colorado Health Sciences Center, Campus Box B-177, Denver, CO 80262 (Email: brian.graham{at}uchsc.edu).

BACKGROUND: Primary pulmonary lymphoma is a rare disease. The clinical characteristics, methods of treatment, and outcomes are not well elucidated.

METHODS: A retrospective review of primary pulmonary lymphoma cases at a single institution from 1990 to 2002 was performed.

RESULTS: Eighteen patients were included, with a mean follow-up of 2.9 years. Fourteen patients had mucosa-associated lymphoid tissue (MALT) lymphoma, 2 had large cell transformation of sheet cells in MALT lymphoma, and 1 each had Hodgkin's disease and follicular lymphoma. Computed tomography-guided biopsy was diagnostic in only two of eight attempts. Eleven patients had disease confined to the pulmonary parenchyma, and 7 had parenchymal disease as well as mediastinal lymphadenopathy. Treatment methods included observation only (n = 1), surgery only (n = 6), surgery plus chemotherapy (n = 8), surgery plus radiotherapy (n = 1), and surgery plus chemotherapy plus radiotherapy (n = 2). Kaplan-Meier estimate of median time to disease recurrence or death was 6 years. Only 1 patient died of disease-related causes. Patients who had bilateral disease were more likely to have recurrent disease or death (p = 0.03).

CONCLUSIONS: A wide range of treatments were used for patients with generally MALT lymphoma, resulting in good outcomes, and recurrent disease was well controlled.




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