Pulmonary MALT lymphoma: Imaging findings in 18 cases and the associated pathological correlations

Background: Pulmonary MALT lymphoma is a rare disease that is easily misdiagnosed. The objective of this study was to improve the understanding of pulmonary MALT lymphoma for clinicians. Methods: The computed tomography (CT) scans of 18 patients (13 males and 5 females), aged 41-70 years (mean=55.6 years), with histologically proven pulmonary MALT lymphoma were retrospectively reviewed by two radiologists, and pulmo-nary imaging findings were described. Correlations between the pulmonary abnormalities and histopathological findings in 13 patients were retrospectively reviewed. Results: Elementary lesions were characterized by masses or mass-like areas of consolidation (15/18), nodules (5/ 18), air bronchograms (16/18), airway dilatation (7/18), cavitation (5/18), airways passing through the lesion (8/18), CT angiogram signs (12/14) and vessels passing through the lesion (12/14). Additional findings included multiple cysts (n = 1), pleural effusion (n = 1) and atelectasis (n = 1). Pulmonary abnormalities were correlated with patho-logical appearance. Pathological examination confirmed lymphomatous infiltration with a bronchovascular distribution but no vessel or airway destruction, which appeared on CT as the vessels/airways passed through lesions naturally. Conclusions: We herein demonstrated the imaging findings for 18 cases of pulmonary MALT lymphomas by analyzing the corresponding pathologies. We also discovered that vessels/airways could pass through pulmonary MALT lym-phoma lesions, which may be helpful for diagnosis. This disease should be considered when chest CT imaging shows multiple/single masses or nodules or mass-like areas of consolidation together with vessels/airways passing through lesions.