Clinical features and outcomes of pulmonary lymphoma: A single center experience of 180 cases. (June 2019)

• Record Type: Journal Article
• Authors: Zhang, Mu-Chen; Zhou, Min; Song, Qi; Wang, Shuo; Shi, Qing; Wang, Li; Yan, Fu-hua; Qu, Jie-Ming; Zhao, Wei-Li
• Is Part Of: Lung cancer. Volume 132(2019)
• Page Start: 39
• Page End: 44
• Publication Date: 2019-06
• Subjects: PPL primary pulmonary lymphoma -- SPL secondary pulmonary lymphoma -- MALT mucosa-associated lymphoid tissue lymphoma -- DLBCL diffuse large B-cell lymphoma -- MCL mantle cell lymphoma -- FL follicular lymphoma -- BL burkitt lymphoma -- SLL small lymphocytic lymphoma -- ECOG PS eastern cooperative oncology group performance status -- IPI international prognostic index -- NCCN-IPI national comprehensive cancer network-IPI -- LDH lactate dehydrogenase -- ALB albumin -- β2-MG β2-microglobulin -- CRP C-reactive protein -- NSE neuron specific enolase -- CA carbohydrate antigen -- IL interleukin -- TNF tumor necrosis factor -- OS overall survival -- R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; Pulmonary lymphoma -- Primary -- Secondary -- Clinical features -- Prognosis; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2019.04.004
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Primary and secondary pulmonary lymphoma show distinct clinical features. Elevated interleukin -2R, -6, -10 are observed in secondary pulmonary lymphoma. β2-microglobulin independently predicts poor outcome of aggressive pulmonary lymphoma. Abstract: Background: Pulmonary lymphoma arises primarily from the lung, which is extremely rare, or be secondarily involved by lymphoma. The clinical features, management, and prognostic factors have not been clearly identified. Methods: Sixty-three patients with primary pulmonary lymphoma (PPL) and 117 patients with secondary pulmonary lymphoma (SPL) treated in our institution between June 2003 and December 2017 were retrospectively reviewed. Results: MALT (67%) was the most common pathological subtype of PPL, while DLBCL (48%) was the most common subtype of SPL. Compared to the patients with PPL, the presence of B symptoms, advanced disease stage, intermediate-high or high risks of IPI and NCCN-IPI, elevated inflammatory parameters, and elevated cytokine levels were all observed in patients with SPL. Consolidation was the most frequent radiological finding in PPL cases, while nodules were the most frequent finding in SPL. With a median follow-up of 35 months (range 2–176), the estimated 3-year OS rates were 95%, 100%, 70% and 50% in indolent PPL, indolent SPL, aggressive PPL, and aggressive SPL, respectively. In indolent pulmonary lymphoma, none of the prognostic factors we studied significantly influenced survival of the patients. In aggressive pulmonary lymphoma, univariate analysis showed that NCCN-IPI was related to OS in PPL. Multivariate analysis showed that β2-MG was an independent prognostic factor for OS in SPL. Conclusions: Primary and secondary pulmonary lymphoma differ in their clinical features and outcome. Furthermore, β2-MG is the independent prognostic factor for OS in patients with aggressive SPL.