BALT lymphoma

BALT lymphoma is an abbreviated term for bronchus-associated lymphoid tissue lymphoma. These neoplasms fall under the broader umbrella of mucosa associated lymphoid tissue (MALT) lymphomas. It is sometimes considered a type of primary pulmonary lymphoma.

Up to half of patients can be asymptomatic and tumours are often discovered incidentally.

BALT lymphoma represents a low-grade B-lymphocyte lymphoma composed of monotonous small lymphocytes with focal plasmacytoid features. They are composed of sub-epithelial lymphoid follicles distributed along distal bronchi and bronchioles.

Associations

The tumours can have a number of associations which include 1:

HRCT Chest

Appearances can be quite variable. Described features include:

  • solitary, well-delineated soft-tissue masses: most BALT lymphoma cases
  • less common imaging features include
    • multiple unilateral or bilateral nodules
    • diffuse infiltrates along bronchovascular bundles and interlobular septa
    • extensive lobar infiltrates mimicking consolidation (pneumonia) with air bronchograms or areas of ground-glass attenuation
    • bubble-like radiolucencies 6
  • hilar and mediastinal lymphadenopathy: not a prominent radiologic finding with nodal involvement present at pathologic analysis in 30% of cases 3

Most tend to be slow growing lesions. The disease is often localised at the time of diagnosis and responds favourably to treatment.

Lymphoma
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Article Information

rID: 11116
Systems: Chest, Haematology
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • BALToma
  • Bronchus associated lymphoid tissue lymphoma
  • MALT lymphoma of lung
  • BALT lymphomas

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