Abstract
We describe a 73-year-old patient with symptoms of chest pain, hemoptysis, malaise and weight loss for two years. Airspace consolidations with air bronchograms in right middle and both lower lobes were observed radiologically. For fiberoptic bronchoscopy was nondiagnostic, transthoracic true-cut needle biopsy was performed under CT guidence. Histological examination of lung biopsy revealed replacement of normal lung parenchyma with diffuse infiltration of monotonous cells with scanty cytoplasma and little nuclear irregularity. In immunohistochemical examination it was detected that the LCA and B cell markers of the cells were stained positive for CD20 and CD79; whereas epithelial markers were stained negative for cytokeratin and EMA, and T cell markers were stained negative for CD3. The histopathological features were reported to be compatible with primary pulmonary BALT (bronchus-associated lymphoid tissue) lymphoma or baltoma. We recommend that baltoma should be included in differential diagnosis of patients with slow-progressing pulmonary symptoms and airspace consolidation. Transthoracic true-cut needle biopsy under CT guidence might provide sufficient tissue in peripheral lung lesions for immunologic studies.
Keywords: lymphoma, lung
