GIANT LAMELLAR BODIES IN A PULMONARY MALT LYMPHOMA - A CASE-REPORT WITH ULTRASTRUCTURAL AND IMMUNOHISTOCHEMICAL STUDIES

A 35-year-old, African-American man presented with a 7-year history of a persistent, enlarging pulmonary infiltrate in the right middle lobe associated with three episodes of right-sided pneumonia, recent 12-lb weight loss, and progressive shortness of breath. The nature of the r ight middle lobe infiltrate was unclear, but recurrent aspiration pneu monia and carcinoma of lung were important considerations. Exploratory thoracotomy with partial lobectomies revealed a low-grade B-cell lymp homa of mucosa-associated lymphoid tissue (MALT). Clusters of giant la mellar bodies were a unique finding in this lymphoma. Results of ultra structural and immunohistochemical studies gave support to the views t hat these inclusions were derived from both products of cellular degen eration and surfactant. The pulmonary lymphoma subsequently spread to the gastric mucosa. The patient is alive with lymphoma 5 years after t he initial diagnosis was made.