A Case of Pulmonary Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma with Ground-Glass Opacity (GGO) which Mimicked Pulmonary Cancer

Abstract

A 76-year-old woman was detected to have ground-glass opacity (GGO) from S¹⁺² to S⁶ of the left lung on a chest CT scan which was taken as preoperative examination for transverse colon cancer. During clinical observation, an enlargement of the GGO shadow along with appearance of solid component were noted. PET/CT scan showed an abnormal uptake of ¹⁸F-FDG to an area where coincided with the shadow. Pulmonary cancer was suspected, and a bronchoscopy was performed, but we could not gain definite diagnosis and performed surgery for the purposes of diagnosis and treatment. Although we diagnosed the left pulmonary S¹⁺² and S⁶ lesions to have formed a mass based on the preoperative imaging findings, intraoperative findings revealed that the left lung was completely segmented and there were no exposures of the lesions to the visceral pleura. We diagnosed the lesions as each independent lesion occurred multiply. Thoracoscopic segmentectomy of S¹⁺²⁺³ + S⁶, of the left lung was performed to remove the lesions. In the resected left pulmonary S¹⁺² and S⁶ involved in the resected specimen, there were many lesions over a wide area. The histopathological diagnosis was pulmonary MALT lymphoma. At one month after the operation, rituximab monotherapy was started in the Department of Hematological Medicine in our hospital to prevent recurrence. She is doing well without recurrence, as of 7 months after the surgery.