low grade b cell lymphoma | Pulmonary lymphoma

Pulmonary lymphoma

Pulmonary lymphomas are non-Hodgkin indolent lymphomas in the same way as:

Follicular lymphoma;
Lymphocytic lymphoma;
The lymphoma of the marginal zone;
Lymphoplasmocytaire lymphoma;
Cutaneous T-lymphoma;
Gastric lymphoma;
Spleen lymphoma.
Different types of pulmonary lymphomas
There are three main types of pulmonary lymphoma. All three are indolent lymphomas, i.e. low malignancy:

Primary pulmonary lymphomas are lymphomas that are born in the lymphoid tissue of the lung and in which no extra-pulmonary disease is found (either at the time of lymphoma diagnosis or within three months). They only touch the lungs. Primitive pulmonary lymphoma is sometimes developed in patients with disseminated lupus erythematosus or other pathologies such as multiple sclerosis or Sjögren's syndrome.
Secondary pulmonary lymphomas are either Hodgkin lymphomas or non-Hodgkin (NHL) ganglion "classic" lymphomas that have invaded the lung. They are divided into two categories:
Ganglion lymphomas having invaded the lung because of its immediate proximity (the cancerous lymph nodes located in the mediastinum will easily reach the lung): they are pulmonary lymphomas with lymphadenopathy Hilaire or mediastinal.
Ganglion lymphomas having reached the lung after spreading through blood and lymphatics from any other site.
Anatomy of the lungs

Primitive pulmonary lymphomas
Primary pulmonary lymphomas (LPP) are rare since they represent only 3-4% of the NHL ganglion, which, in themselves, account for about 30% of NHL cases (less than 1% of all NHL). Indeed, most of the extra-ganglion NHL develop in the digestive tract, while a large majority of primitive pulmonary lymphomas develop from the bronchi.

LPP are for people between 50 and 55 years of age, with men as affected as women. immunocompromised people (those who have just received an organ transplant or HIV-positive individuals) are more at risk than others.

Among the LPP are three sub-groups:

The primary pulmonary lymphomas with low-grade B-cell malignancies are the most common. They represent three-quarters of the cases and 9 times out of 10 these are MALT lymphomas.

The primary pulmonary lymphomas with high-grade B-cell malignancies are rarer (about 15%).

The granulomatosis papulosis is even rarer.

Low-grade B-cell primitive pulmonary lymphomas

In the most common case, that of a LPP in the form of lymphoma of MALT, no symptoms are found. The pathology is therefore discovered incidentally on the occasion of a chest X-ray. Medical Imaging Exams Show:

several pulmonary nodules;

Dilations of the bronchi or a bronchiolitis;

swollen lymph nodes at the hilum of the lung and/or mediastinum.

In 20% of cases, pulmonary testing can detect crackling rails. The prognosis is very good in this type of lymphoma since survival at 5 years is between 80 and 94%.

Note: Surgical ablation can be performed in localized forms.

Pulmonary Nodule

High-grade B-cell primitive pulmonary lymphomas

They appear especially in people aged sixty years. They coexist with MALT lymphoma in 50% of cases. Respiratory symptoms are found, as well as more general clinical signs (alteration of the general condition).

Medical imaging makes it possible to observe:

A pulmonary mass

a pleural effusion sometimes;

cavities;

swollen lymph nodes at the mediastinum.

It is necessary to distinguish between these high-grade B-cell primitive pulmonary lymphomas from primitive lung cancers (pulmonary adenocarcinomas). The prognosis is less good than for low-grade LPP.

Granulomatosis Papulosis

This is a rare disease that is most often associated with Epstein-Barr virus (responsible for infectious mononucleosis). It affects mostly people between 30 and 50 years of age. It is accompanied by various clinical signs such as fever, pulmonary disorders (pain, cough, difficulty breathing), ent, cutaneous (rash) and neurological conditions.

Medical Imaging shows:

Poorly limited multiple pulmonary nodules;

sometimes cavities;

Several pulmonary masses (especially at the base of the lungs).

Regardless of the results of medical imaging, only a biopsy will be able to diagnose with certainty, especially as there is a risk of confusion with tuberculosis, a pulmonary infarction or with metastases of other cancers. The prognosis is generally bad, patients rarely living more than 4 years, especially the younger ones.

Metastasis

Secondary pulmonary lymphomas

Secondary pulmonary lymphomas are a lung injury in a patient who was initially known to be carrying lymphoma that does not affect the lungs. So the tumor cells migrated to the lungs. This type of scenario is relatively common since 25 to 40% of patients develop secondary pulmonary lymphoma:

Secondary pulmonary lymphomas are linked to Hodgkin's lymphoma in only 10% of cases. Symptoms such as fever, night sweats, slimming and coughing will then be found. In medical imaging, nodules are observed, particularly at the upper lobes.

Secondary pulmonary lymphomas related to non-Hodgkin's lymphoma account for 1% of all NHL.

These are serious lymphomas that are difficult to treat in both cases.