PRIMARY PULMONARY LYMPHOMA - CLINICAL REVIEW FROM A SINGLE INSTITUTION IN SINGAPORE

Primary pulmonary lymphoma is a rare and vexing subset of extranodal n on-Hodgkin's lymphoma. We report 11 cases and provide a brief literatu re review. We also highlight an unusual case of a relapsed peripheral T-cell primary lung lymphoma that underwent apparent spontaneous remis sion. Eleven cases of primary pulmonary lymphoma treated in our instit ution were studied for their clinical characteristics, behaviour, resp onse to treatment and clinical outcome. The median duration of follow up was 26 months. The mean age was in the 50s and the presenting sympt oms generally respiratory and non-specific. LDH levels did not correla te with either stage or grade of disease. Lower lobe involvement was m ost common and nodules and mass-like lesions the main radiologic featu re. Small lymphocytic lymphoma accounted for the majority of cases and were indolent in behaviour. Good symptom control and radiologic respo nse was achieved with chemotherapy in disseminated low grade lung lymp homas, Combination chemotherapy was effective in the aggressive lympho mas. In conclusion, Small lymphocytic lymphoma of the lung is an indol ent disease with a long symptom-free survival even after recurrence. O ur series confirms the clinical characteristics of primary pulmonary l ymphoma, The role of Ling Zhi in effecting the spontaneous remission i n the peripheral T-cell lymphoma is speculative.