Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma With Spontaneous Regression After Computed Tomography-guided Needle Biopsy: A Case Report And Summary Of 8 Reported Cases
Fukushima, K., Hirosako, S., Tenjin, Y., Mukasa, Y., Kojima, K., Saeki, S., Okamoto, S., Ichiyasu, H., Fujii, K., Kikukawa, Y., Kawanaka, K., & Kohrogi, H. (2016). pulmonary Mucosa-associated Lymphoid Tissue Lymphoma with spontaneous Regression after Computed Tomography-guided Needle Biopsy: A Case report and Summary of 8 reported Cases. Internal medicine (Tokyo, Japan), 55(24), 3655–3660. https://doi.org/10.2169/internalmedicine.55.6874
View Original Source →Abstract
A 72-year-old woman was admitted to our hospital with a solitary right lung nodule. She had no symptoms and no abnormal physical findings except for bladder cancer. Tumor markers were mildly elevated but no other abnormal laboratory data were found. The nodule was diagnosed to be pulmonary mucosa-associated lymphoid tissue lymphoma on computed tomography-guided needle biopsy. Thereafter, she first underwent surgery for bladder cancer. The lung nodule was found to have slightly increased at three months and then disappeared at 15 months after the biopsy. The notable clinical course of this rare disease suggests the effectiveness of a non-interventional treatment strategy.
Case Details
Disease Location
Pulmonary (right lung)
Personal Characteristics
72 -year-old female past history of chronic gastritis, surgery for a uterine m-year-old malea, and fever and diarrhea after the ingestion of sho-saiko-to she had a 20-pack-year history of smoking no unusual family history she had repeatedly undergone tranurethral resections of bladder tumors for 15 years and a total cystectomy with an ileal conduit was planned because a cancerous tumor had progressed
Clinical Characteristics
Pulmonary mucosa-associated lymphoid tissue lymphoma (malt) presented with an abnormal shadow of the right lung and no symptoms a total cystectomy with an ileal conduit was planned because a cancerous tumor had progressed before the operation, chest CT revealed a solitary nodule in the right lower obe of the lung, the lung nodule had remained undiagnosed by bronchofiberoscopy at her previous hospatientical physical exam revealed a surgical scar on the abdomen lab investigation revealed that carcinoembryonic antigen (CEA) was 5.8 ng/ml, and cytokeratin 19 fragment was 3.8 ng/ml chest x-ray and chest CT showed a nodule measuring 12mm diameter localized in the right lower lobe CT-guided needle biopsy of the nodule was performed h&e staining showed the proliferation of small lymphocytes with little atypia ihc staining showed most cells in the lymphatic follicles were clusters of differentiation CD20+ presence of a lymphoepithelial lesion was confirmed by immunostaining of cytokeratin, which indicated the infiltration of lymphocytes into the epithelium of the gland duct gene rearrangement of the igh chain was detected pulmonary malt lymphoma was diagnosed the lymphoma was asymptomatic and localized, bladder cancer surgery was initially performed and lymphoma was observed until the patient recovered from surgery
Remission Characteristics
The lung nodule increased slightly on the CT image 3 months after the biopsy but subsequently became unclear on a chest x-ray 9 months after the biopsy, and then it completely disappeared on the CT image 15 months after the biopsy to date, there has been no recurrence in the lung or any other sites as of 40 months after the initial biopsy
Treatment & Mechanisms
Proposed Remission Mechanisms
Invasive procedure i.e. Needle biopsy, may have triggered a direct regional immune reaction or, the trauma due to the baldder surgery may have activated the patient's systemic immunity
Clinical Treatment
Total cystectomy with and ileal conduit (bladder cancer surgery) guided needle biopsy
Non-Clinical Treatment
None reported