Secondary pulmonary lymphoma

Last revised by Dr Bruno Di Muzio on 16 Jun 2020

Secondary pulmonary lymphomas refer to pulmonary involvement with lymphoma when the condition is not limited to the lung and has mediastinal lymph node involvement or evidence of extrathoracic dissemination for at least three months after the initial diagnosis. This is a more common form of pulmonary lymphoma.

The incidence of involvement of the lung at initial presentation is reported to be 12% of patients with Hodgkin’s disease and 4% of those with non-Hodgkin’s lymphoma 1. With non-Hodgkin lymphoma, pulmonary involvement may occur in ~30% (range 25-40%) as a site of relapse after treatment 1,4.

The pathogenesis of secondary pulmonary lymphoma can be rather variable and depends on the type of primary lymphoma 5.  While all forms of lymphoma may secondarily involve the lungs, the mature B-cell neoplasms may be the most frequent 5.

On histopathology, secondary pulmonary lymphoma and primary pulmonary lymphoma show identical morphological features 5.

Radiographic appearances can be variable and can mimic that of primary pulmonary lymphoma 4. It may have a lymphangitic, nodular and/or alveolar pattern.

Individual features are non-specific but reported manifestations include:

In some cases, pleural effusion may be present.

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Cases and figures

  • Case 1
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  • Case 1: on 18-FDG PET/CT
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  • Case 3
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  • Case 4: lymphagitic carcinomatosis
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