Tuberc Respir Dis.  2012 Jul;73(1):61-66. 10.4046/trd.2012.73.1.61.

A Case of Synchronous Lung Adenocarcinoma and Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Type

• Jung CY
• Kwon KY

• KMID: 2050676
• DOI: http://doi.org/10.4046/trd.2012.73.1.61

Abstract

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (extranodal MZL) is a distinct subgroup of non-Hodgkin's lymphoma. Pulmonary extranodal MZL is a rare entity and accounts for less than 0.5% of primary pulmonary malignancies. Only a few cases of simultaneous occurrence of lung cancer and pulmonary extranodal MZL have been reported. A 60-year-old woman was referred to our hospital with a pulmonary nodule. She was diagnosed with lung adenocarcinoma by percutaneous needle biopsy. The protrusions into the left main bronchus were found by accident while performing bronchoscopy during lung cancer evaluation. The bronchial lesions were diagnosed as extranodal MZL. Although the patient underwent surgical resection for the lung adenocarcinoma, the pulmonary extranodal MZL was left untreated; it was monitored during follow-up visits. To our knowledge, this is the first report of synchronous lung adenocarcinoma and primary extranodal MZL of the main bronchus.

Keyword

Lymphoma, B-Cell, Marginal Zone; Adenocarcinoma of Lung; Lung Neoplasms

MeSH Terms

Adenocarcinoma
Biopsy, Needle
Bronchi
Bronchoscopy
Female
Follow-Up Studies
Humans
Lung
Lung Neoplasms
Lymphoid Tissue
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Non-Hodgkin
Middle Aged
Adenocarcinoma
Lung Neoplasms

Figure

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  Figure 1 (A) Chest radiograph shows a nodule in the right upper lung. (B) Chest computed tomographic scan shows a 2.4×1.8 cm sized nodule in the anterior segment of the right upper lobe.

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  Figure 2 Fluorine 18-labeled fluorodeoxyglucose-positron emission tomography-computed tomographic scan shows a hypermetabolic nodule in the right upper lobe (SUVmax, 11.2).

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  Figure 3 Bronchoscopic findings show a few small variable-sized protrusions in the proximal left main bronchus.

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  Figure 4 The computed tomography-guided percutaneous needle biopsy specimens of the right lung nodule. (A) Lung tumor tissue shows non-mucinous adenocarcinoma with a lepdic and acinar growth pattern and stromal infiltration. Immunohistochemical stains were positive for (B) cytokeratin (CK) 7 and (C) thyroid transcription factor-1, and negative for (D) CK20 (A~D, ×200).

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  Figure 5 The bronchoscopic biopsy specimens of the left main bronchial lesions. (A) The bronchial mucosa shows diffuse proliferation of atypical lymphoid cells beneath the mucosal epithelium. The neoplastic lymphoid cells show diffuse strong positive for (B) CD20, but negative for (C) pan cytokeratin and (D) CD10 (A~D, ×200).

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