Primary pulmonary lymphoma

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.