INCIDENTAL FINDING OF PULMONARY MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA

TOPIC: Lung Cancer TYPE: Medical Student/Resident Case Reports INTRODUCTION: Primary pulmonary lymphomas (PPLs) comprise 1% of lung neoplasias, with mucosa associated lymphoid tissue (MALT) lymphoma making up approximately 80% these lesions. Pulmonary MALT is a rare extranodal marginal zone B-cell that typically indolent in nature. Clinical manifestations include fever, malaise, cough, dyspnea, and chest pain, although 30% patients can be asymptomatic. We present case an incidental discovery diagnosis lymphoma. CASE PRESENTATION: 72-year-old male lifelong non-smoker medical history hypertension presented to pulmonology clinic due central left lower perihilar ground glass density seen on CT performed for coronary calcium scoring. He denied symptoms, his physical examination laboratory values were normal. Follow-up contrast showed persistent 3.5 cm ground-glass lesion the superior segment lobe. Navigational bronchoscopy biopsy bronchoalveolar lavage was performed. The pathology revealed bronchial dense atypical infiltrate predominance CD20 positive CD5 negative B lymphocytes. These findings consistent lymphoproliferative disorder FDG PET-CT demonstrated moderate uptake lobe nodule no other significant elsewhere body. patient evaluated by oncology undergoing active surveillance repeat anticipated 3 months. DISCUSSION: Onset PPL occurs around 50-60 years age rate smoking not higher than general population. chronic antigen stimulation, but unlike lymphomas, they have yet been infection. They are often cytogenetic abnormalities, 42% cases having translocation t(11;18)(q21;q21). Diagnosis made biopsy, usually bronchoscopic versus guided. Pathology immunohistochemistry infiltrates expanding follicle zones cells. Treatment options chemotherapy, radiation therapy, immunotherapy, surgical management, or expectant approach limited disease. Overall five-year survival greater 80%. CONCLUSIONS: pathogenesis well understood. Due its occurrence, there studies treatment therefore true consensus regarding best strategies. With slow growth rates, watch wait plan may suitable isolated lesions has shown negatively affect overall survival. However, better understanding pathophysiology optimal requires further studies. REFERENCE #1: Sanguedolce F, et al. lymphoma: A review update. Cancers. 2021; 13(3): 415. #2: Borie R. mucosa-associated revisited. Eur Respir J. 2016;47(4):1244-60 #3: Yan W. Watch-and-wait immediate immunotherapy/immunochemotherapy phase IE primary lymphoma? multicenter retrospective study. Annals Hematology. 100(3): 709-714. DISCLOSURES: No relevant relationships Nicole Bernskoetter, source=Web Response Speaker/Speaker's Bureau relationship Astra Zeneca, GSK Please note: $1001 - $5000 Daniel Gerardi, Response, value=Honoraria Simrina Sabharwal,