Korean J Hematol.  2007 Dec;42(4):439-444. 10.5045/kjh.2007.42.4.439.

A Case of Primary Tracheal Lymphoma of a 65-year-old Female: Extremely Rare Primary Localization of a Diffuse Large B-cell Lymphoma

Affiliations
  • 1Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. jyj822@hanmail.net
  • 2Department of Laboratory Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 4Department of Pathology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 5Department of Diagnostic Radiology, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 6Department of Internal Medicine, National Cancer Center, Goyang, Korea.

Abstract

Primary extranodal non-Hodgkin's lymphomas comprise approximately 10% of all non-Hodgkin's lymphomas. However, primary tracheal non-Hodgkin's lymphoma is extremely rare, being mainly mucosa-associated lymphoid tissue lymphoma. A 65-year-old female has dry cough for one year. She was diagnosed as diffuse large B-cell lymphoma via bronchoscopic-guided biopsy. She was treated with four cycles of the R-CHOP regimen and adjuvant radiotherapy. After completion of the combined treatment, the treatment response was complete remission, and the disease free survival was 26 months.

Keyword

Primary tracheal lymphoma; Diffuse large B-cell lymphoma; R-CHOP

MeSH Terms

Aged*
B-Lymphocytes*
Biopsy
Cough
Disease-Free Survival
Female*
Humans
Lymphoma*
Lymphoma, B-Cell*
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Non-Hodgkin
Radiotherapy, Adjuvant

Figure

  • Fig. 1 Serial bronchoscopic findings. (A) At 20cm from upper incisor, multi-lobulated, multi-lobulated tumor with vascularization was seen. the tumor obstructed the tracheal lumen by about 50%. (B, C) Comparing previous bronchoscopic finding. the size of tracheal lymphoma was marked decreased at about 5cm above carina. (B) After the patient received 2 cycles of combination chemotherapy with R-CHOP regimen. (C) After the patient received 4 cycles of combination chemotherapy with R-CHOP regimen. (D) Comparing previous bronchoscopic finding. Slight flat bilobulated nodule was more decreased at about 5cm above carina after additional RT was done.

  • Fig. 2 The chest CT shows a polypoid mass lesion in the Lt anterolateral aspect of the trachea.

  • Fig. 3 Pathologic findings. (A) Large, globular abnormal lymphocytes are observed (H&E stain, ×1,000). (B) Strongly stained tumor cell (CD20 stain, ×1,000).

  • Fig. 4 PET-CT shows a 1.5×1.0cm sized polypoid mass lesion in trachea.


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