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Lymphoma of bronchus‐associated lymphoid tissue resembling middle lobe syndrome
Author(s) -
Chida Kingo,
Sato Atsuhiko,
Sato Jun,
Ide Kyohtaro,
Shirai Masahiro,
Iwata Masatoshi,
Nakamura Hirotoshi
Publication year - 1999
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1046/j.1440-1843.1999.00173.x
Subject(s) - medicine , pathology , lymphoma , respiratory tract , bronchus , lung , differential diagnosis , hyperplasia , biopsy , lymphatic system , lesion , respiratory system , respiratory disease , anatomy
We describe three cases of lymphoma of bronchus‐associated lymphoid tissue (BALT). All three patients had long histories of right middle lobe and/or lingula infiltrates on chest radiographs that were compatible with chronic respiratory tract infection. On histological and immunological examination of lung biopsy specimens in the three cases, a lymphoepithelial lesion was identifiable. Phenotyping of the infiltrating lymphocytes showed predominantly B cells, but the lymphocytes were negative for CD10. In two of the cases, rearrangement of the immunoglobulin heavy chain genes was positive, while rearrangements of the bcl‐2 and T cell receptor genes were negative. Each patient had a long history of a productive cough, ranging from 5 to 7 years. Thus, the differential diagnosis of BALToma must be considered when serial chest radiographs show progression over years in the right middle lobe and/or lingula. Furthermore, because BALToma arises from BALT itself and hyperplasia of BALT is dependent on prolonged antigenic stimulation, the onset of these BALTomas may have been related to chronic respiratory tract infections.