Author of

• 13754

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  P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 13786

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    P1.08-032 - Primary Pulmonary Lymphoma: Clinical Analysis of 34 Cases (ID 635)

    09:30 - 09:30  |  Author(s): T. Feldman
    • Abstract

    Background:
    Primary pulmonary lymphoma (PPL) accounts for only 0.5% of all primary lung cancers and 10% of all extranodal lymphomas. Though the majority are non-Hodgkin lymphomas (NHL), PPL can easily be misdiagnosed or missed due to their nonspecific clinical features and imaging findings. Our goal was to investigate the clinical characteristics, treatment and prognosis of PPL.
    
    Methods:
    We reviewed the clinical data of 34 patients diagnosed with PPL at our cancer center from 2005 to 2013. Initial diagnosis at our institution and minimum 24 month follow up were required. Kaplan-Meier method was used for survival analysis.
    
    Results:
    A total of 34 patients were identified. Median age at diagnosis was 55 years (range: 35-84), 53% were males and 47% females. 61% were current or former smokers. 14 patients (41%) had an autoimmune disorder (8 patients had Hashimoto’s hypothyroidism, 4 rheumatoid arthritis and 1 DM type 1). 32% had family history of cancer and 27% of autoimmune disorders. The major clinical manifestations were: cough (53%), weight loss (41%), incidental finding on chest x-ray (29%) and only 11% presented with B symptoms. Regarding tumor characteristics, 41% of the patients were stage I, 18% stage II, 6% stage III and 35% stage IV. Marginal zone B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma were the most prevalent subtypes, representing 97% of the cases. Patients were more likely to have upper lobe lesions (50%) vs. middle (29%) or lower lobe (21%) lesions. Regarding treatment, 15 patients (44%) were treated with surgery, 79% with chemotherapy (44% CHOP vs. 35% Rituximab monotherapy) and 24% with radiation (+/- chemotherapy or surgery). Overall median survival was 67.5 months (95%CI: 48.0-87.2) Factors associated with poor prognosis were: bilateral lung disease, presence of B symptoms and pleural involvement.
    
    Conclusion:
    PPL is a rare type of primary lung malignancy with an equal gender distribution. It is usually seen in middle-aged patients with history of autoimmune disorders and carries a good overall survival. The high incidence of misdiagnosis in PPL is associated with the lack of specific clinical features, making preoperative diagnosis difficult with most of the patients requiring lung tissue biopsy and immunohistochemistry studies.