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• W4387248862 abstract "SESSION TITLE: Lung Cancer Case Report Posters 6 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 12:00 pm - 12:45 pm INTRODUCTION: Lymphomas in the lungs represent <1% of all pulmonary malignancies. Of those, the likelihood of Mucosa-associated lymphoid tissue (MALT) lymphoma presenting as a tracheal or endobronchial mass is even rarer (0.4 to 1.3%). There have only been two published cases that have utilized rigid bronchoscopy as initial treatment for MALT lymphoma per literature review. We present the third case of a MALT lymphoma being initially diagnosed with rigid bronchoscopy in a patient. CASE PRESENTATION: A 59-year-old male with a history of MALToma of the stomach, diagnosed 15 years ago, was referred to interventional pulmonology clinic for evaluation of near complete obstruction of the left main stem bronchus (LMSB). He had presented to his PCP for a 20-pound weight loss over three months with associated nocturnal sweating, dyspnea, and dry cough. Computed Tomogram (CT) chest displayed thickening of the lateral wall of the LMSB with near complete obstruction of the LMSB. Review of the old images showed slow progression of the lesion over two years. Given the size and location of the mass, rigid bronchoscopy was performed to core out the mass and to obtain diagnostic tissue. The endobronchial mass in the proximal left main stem bronchus was causing approximately 90% obstruction. Additionally, there were multiple polypoid lesions noted in the proximal and mid trachea that were debulked with cryotherapy and sent for histopathology. Endobronchial ultrasound (EBUS) was done to sample the hilar and mediastinal lymph nodes. All tissue obtained confirmed MALT lymphoma. His dyspnea and cough improved significantly and repeat CT imaging in 4 weeks displayed complete resolution of his obstructing mass. He was evaluated by hematology for further management. DISCUSSION: MALT lymphoma presenting as a tracheal and endobronchial obstructive lesion is extremely rare, with one case study of 75 patients displaying a prevalence of 1.3%. Patients are often asymptomatic, and the malignancy may be incidentally noted on routine imaging. Less commonly, symptoms are present and may include dyspnea and dry cough. Location of the mass and symptom severity should be considered when approaching the initial management in patients with obstructive endobronchial lesions. CONCLUSIONS: Generally, this type of malignancy requires flexible bronchoscopy with biopsy for histopathological diagnosis. However, rigid bronchoscopic debulking was considered the best approach for diagnosis and immediate management of respiratory symptoms in our patient. REFERENCE #1: Yu Lee-Mateus A, Garcia-Saucedo JC, Abia-Trujillo D, Khoor A, Fernandez-Bussy S. Endobronchial Extranodal Marginal Zone B-Cell Lymphoma with Plasmacytic Differentiation. Cureus. 2021 Feb 3;13(2):e13104. doi: 10.7759/cureus.13104. PMID: 33728124; PMCID: PMC7934969. REFERENCE #2: Zinzani PL, Magagnoli M, Galieni P, Martelli M, Poletti V, Zaja F, Molica S, Zaccaria A, Cantonetti AM, Gentilini P, Guardigni L, Gherlinzoni F, Ribersani M, Bendandi M, Albertini P, Tura S. Nongastrointestinal low-grade mucosa-associated lymphoid tissue lymphoma: analysis of 75 patients. J Clin Oncol. 1999 Apr;17(4):1254. doi: 10.1200/JCO.1999.17.4.1254. PMID: 10561186. REFERENCE #3: Huang, J. (n.d.). TRACHEA LYMPHOMA TREATED BY RIGID BRONCHOSCOPE: TWO CASES REPORTS. https://doi.org/https://www.wabipacademy.com/publications/abstracts/wcbip2014/80-trachea-lymphoma-treated-by-rigid-bronchoscope-two-cases-reports/file DISCLOSURES: No relevant relationships by Rabih Bechara No relevant relationships by Joshua Fowler No relevant relationships by Stanley Hoy Consultant relationship with COOK Medical Please note: June 2022 Added 03/30/2023 by Shaheen Islam, source=Web Response, value=Consulting fee" @default.
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• W4387248862 date "2023-10-01" @default.
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• W4387248862 title "UNUSUAL PRESENTATION OF EXTRANODAL MARGINAL ZONE LYMPHOMA AS OBSTRUCTIVE ENDOBRONCHIAL MASS" @default.
• W4387248862 doi "https://doi.org/10.1016/j.chest.2023.07.2899" @default.
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