scholarly journals The diagnostic challenge of adenocarcinoma in pulmonary nodular lymphoid hyperplasia

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110393
Author(s):  
Anita Savić Vuković ◽  
Melita Kukuljan ◽  
Morana Dinter ◽  
Ksenija Jurinović ◽  
Nives Jonjić
Keyword(s):  
Lymphoid Tissue ◽  
Marginal Zone ◽  
Plasma Cells ◽  
Radiological Finding ◽  
Lymphoid Hyperplasia ◽  
Lymphoproliferative Diseases ◽  
Diagnostic Challenge ◽  
Immunoglobulin G4 ◽  
Nodular Lymphoid Hyperplasia ◽  
Immunohistochemical Analyses

Pulmonary nodular lymphoid hyperplasia is a rare, nonneoplastic lymphoproliferative disorder mostly manifesting as one or more nodules or localized lung infiltrates. The lesion comprises reactive germinal centers with well-preserved mantle zones and sheets of interfollicular mature plasma cells, lymphocytes, histiocytes, and neutrophils. The radiological finding is not specific, and the diagnosis of pulmonary nodular lymphoid hyperplasia relies generally on pathohistological and immunohistochemical analyses. The most important differential diagnoses are extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and immunoglobulin G4–related sclerosing disease. Nonetheless, we present a case of pulmonary nodular lymphoid hyperplasia in a 69-year-old woman with the diagnostic challenge of cytological atypia in alveolar spaces inside the lymphoid tissue, coexisting with the diagnosis of adenocarcinoma of the lepidic pattern. Therefore, this case highlights the importance of identifying these rare benign and reactive lymphoproliferative diseases given the risk of developing not only lymphoma but also carcinoma.

scholarly journals Pulmonary Nodular Lymphoid Hyperplasia

2019 ◽  
Vol 143 (9) ◽  
pp. 1149-1153 ◽  
Author(s):  
Maggie Yell ◽  
Flavia G. Rosado
Keyword(s):  
Lymphoid Tissue ◽  
Lymphoproliferative Disorder ◽  
Marginal Zone ◽  
Correct Diagnosis ◽  
Lymphoid Hyperplasia ◽  
Marginal Zone Lymphoma ◽  
Lung Mass ◽  
Immunoglobulin G4 ◽  
Nodular Lymphoid Hyperplasia ◽  
Histopathologic Diagnosis

Pulmonary nodular lymphoid hyperplasia is an uncommon reactive lymphoproliferative disorder that presents as an asymptomatic lung mass. The histopathologic diagnosis of pulmonary nodular lymphoid hyperplasia may be challenging because of its morphologic overlap with other diseases, such as extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and immunoglobulin G4–related sclerosing disease. Despite the similarities, there are distinctive morphologic and phenotypic features that allow for the correct diagnosis in the majority of cases. This review aims to discuss the clinicopathologic features of pulmonary nodular lymphoid hyperplasia and contrast them with its histopathologic mimickers.

scholarly journals Immunoglobulin G4 Sclerosing Cholangitis: An Unusual Cause of Obstructive Jaundice—Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Pragya Shrestha ◽  
Brian Le ◽  
Brent Wagner ◽  
William Pompella ◽  
Paras Karmacharya
Keyword(s):  
Sclerosing Cholangitis ◽  
Plasma Cells ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Disease Process ◽  
High Serum ◽  
Diagnostic Challenge ◽  
Obliterative Phlebitis ◽  
Immunoglobulin G4 ◽  
Serum Igg4

IgG4-related sclerosing cholangitis (IgG4-SC) is one of the most common extra-pancreatic manifestation of IgG4-related disease (IgG4-RD) and is clinically distinct from primary sclerosing cholangitis (PSC). IgG4-RD is an increasingly recognized immune-mediated fibroinflammatory systemic disease, mostly affecting middle-aged and older male populations that can affect multiple organs. The presence of extra-biliary clinical manifestations of IgG4-RD, such as parotid and lacrimal swelling, lymphadenopathy, autoimmune pancreatitis, and retroperitoneal fibrosis, if present could provide important clues to diagnosis. High serum IgG4 levels, characteristic radiological (e.g., sausage-shaped pancreas or periaortitis) or biopsy findings (high percentage of IgG4+ plasma cells, lymphoplasmacytic infiltrate, storiform fibrosis, or obliterative phlebitis) in the setting of these features is diagnostic of this disease process. However, isolated IgG4-SC might be a diagnostic challenge, and the distinction is important as management of this disorder is vastly different from other causes of cholangitis such as PSC. Systemic corticosteroid therapy is the mainstay of therapy.

scholarly journals Bilateral Bronchiectasis as a Presentation Form of Pulmonary Marginal Zone B-Cell Lymphoma of Bronchus Associated Lymphoid Tissue

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Glenda Ernst ◽  
Carla Torres ◽  
Eduardo Borsini ◽  
Félix Vigovich ◽  
Daniel Downey ◽  
...  
Keyword(s):  
B Cell ◽  
Lymphoid Tissue ◽  
Marginal Zone ◽  
Cell Lymphoma ◽  
Radiological Finding ◽  
B Cell Lymphoma ◽  
Radiological Findings ◽  
Laboratory Findings ◽  
Pulmonary Lymphoma ◽  
Restrictive Pattern

The pulmonary marginal zone B-cell lymphoma of bronchus associated lymphoid tissue of the lung (BALT) is a rare illness that can remain without symptoms. Radiological findings of pulmonary lymphoma are heterogeneous. In literature, bronchiectasis is only described in one patient who also had besides adenomegalies. We reported on a 48-year-old female patient. She showed symptoms consistent with dyspnea with productive cough; there were crepitant sounds in the auscultation. Pulmonary functional test has shown a severe restrictive pattern with a low FVC and DLCO. CT scan showed bronchiectasis in the medium lobule without adenomegalies. Echocardiogram was normal, and the laboratory findings only showed leukocytosis. There were no findings in the bronchoscopy, but the lung biopsy showed a B-cell pulmonary lymphoma (positive to CD20 and CD79a in immunostaining). A wide variety of radiological manifestations has been previously described; however, we have presented this rare case, with bronchiectasis, as unique radiological finding.

Crystal-Storing Histiocytosis Complicating Primary Pulmonary Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue

2013 ◽  
Vol 137 (9) ◽  
pp. 1199-1204 ◽  
Author(s):  
Chen Zhang ◽  
Jeffrey L. Myers
Keyword(s):  
Lymphoid Tissue ◽  
Marginal Zone ◽  
Plasma Cells ◽  
Lung Nodule ◽  
Marginal Zone Lymphoma ◽  
Abundant Cytoplasm ◽  
Plasma Cell Disorder ◽  
Localized Disease ◽  
Eosinophilic Inclusions

Crystal-storing histiocytosis is an uncommon form of nonneoplastic histiocytic proliferation that in most patients complicates an underlying lymphoproliferative or plasma cell disorder. Lung is a common site of involvement in patients with localized disease. We present an illustrative example from a 54-year-old woman with an asymptomatic solitary lung nodule. The tumor was characterized by sheets of histiocytes with abundant cytoplasm expanded by distinctive eosinophilic inclusions. Focal necrosis was present. Aggregates of monocytoid lymphocytes and clusters of peribronchiolar plasma cells were overshadowed by the histiocytic infiltrate. Immunohistochemical stains showed CD68 staining in nonneoplastic histiocytes and CD20 staining in monocytoid lymphocytes. In situ hybridization studies showed κ light-chain restriction in plasma cells. These results, combined with the histologic findings, supported the diagnosis of crystal-storing histiocytosis complicating marginal zone lymphoma of mucosa-associated lymphoid tissue. We review the literature pertaining to pulmonary crystal-storing histiocytosis, highlighting the differential diagnosis for this rare phenomenon.

Expression of the IRTA1 receptor identifies intraepithelial and subepithelial marginal zone B cells of the mucosa-associated lymphoid tissue (MALT)

Blood ◽  
2003 ◽  
Vol 102 (10) ◽  
pp. 3684-3692 ◽  
Author(s):  
Brunangelo Falini ◽  
Enrico Tiacci ◽  
Alessandra Pucciarini ◽  
Barbara Bigerna ◽  
Julia Kurth ◽  
...  
Keyword(s):  
B Cells ◽  
Lymph Nodes ◽  
B Cell ◽  
Cell Population ◽  
Lymphoid Tissue ◽  
Marginal Zone ◽  
Plasma Cells ◽  
Immunoglobulin Superfamily ◽  
Lymphoid Tissues ◽  
Marginal Zone B Cells

AbstractIRTA1 (immunoglobulin superfamily receptor translocation-associated 1) is a novel surface B-cell receptor related to Fc receptors, inhibitory receptor superfamily (IRS), and cell adhesion molecule (CAM) family members and we mapped for the first time its distribution in human lymphoid tissues, using newly generated specific antibodies. IRTA1 was selectively and consistently expressed by a B-cell population located underneath and within the tonsil epithelium and dome epithelium of Peyer patches (regarded as the anatomic equivalents of marginal zone). Similarly, in mucosa-associated lymphoid tissue (MALT) lymphomas IRTA1 was mainly expressed by tumor cells involved in lympho-epithelial lesions. In contrast, no or a low number of IRTA1+ cells was usually observed in the marginal zone of mesenteric lymph nodes and spleen. Interestingly, monocytoid B cells in reactive lymph nodes were strongly IRTA1+. Tonsil IRTA1+ cells expressed the memory B-cell marker CD27 but not mantle cell-, germinal center-, and plasma cell-associated molecules. Polymerase chain reaction (PCR) analysis of single tonsil IRTA1+ cells showed they represent a mixed B-cell population carrying mostly mutated, but also unmutated, IgV genes. The immunohistochemical finding in the tonsil epithelial areas of aggregates of IRTA1+ B cells closely adjacent to plasma cells surrounding small vessels suggests antigen-triggered in situ proliferation/differentiation of memory IRTA1+ cells into plasma cells. Collectively, these results suggest a role of IRTA1 in the immune function of B cells within epithelia. (Blood. 2003;102: 3684-3692)

scholarly journals Splenic Epstein-Barr Virus–Associated Inflammatory Pseudotumor

2017 ◽  
Vol 141 (5) ◽  
pp. 722-727 ◽  
Author(s):  
Chris Van Baeten ◽  
Jo Van Dorpe
Keyword(s):  
Dendritic Cell ◽  
Epstein Barr Virus ◽  
Inflammatory Pseudotumor ◽  
Plasma Cells ◽  
Follicular Dendritic Cell ◽  
Diagnostic Challenge ◽  
Immunoglobulin G4 ◽  
Barr Virus ◽  
Follicular Dendritic ◽  
Epstein Barr

Splenic inflammatory pseudotumor (IPT) is an uncommon lesion with an inflammatory morphologic aspect that often poses a diagnostic challenge. The etiology of IPT can be infectious, autoimmune, reactive, or neoplastic. Splenic Epstein-Barr virus (EBV)–associated IPTs form a subset of splenic IPTs in which there is a spindle cell component infected by EBV. The best characterized and most frequent subgroup of splenic EBV-associated IPT is IPT-like follicular dendritic cell tumor. This review also focusses on EBV-associated splenic IPTs without follicular dendritic cell marker expression. These lesions are less well characterized, making the differential diagnosis with other splenic lesions even more difficult. Recently, increased numbers of immunoglobulin G4–positive plasma cells and the presence of numerous granulomas have been reported in EBV-associated IPTs, and this can add to the difficulties in recognizing the neoplastic nature of these lesions. Herein, we also review the epidemiology, clinical features, histologic morphology, immunohistochemistry, electron microscopy, and pathogenesis of EBV-associated IPTs.

Sign in / Sign up

Export Citation Format

Share Document