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Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma associated with coeliac disease
  1. Emma McNally1,
  2. Lani Cronje1,
  3. Aurelie Fabre2 and
  4. Eddie Moloney3
  1. 1Respiratory Department, Tallaght University Hospital, Dublin, Ireland
  2. 2Histopathology Department, St Vincent's University Hospital, Dublin, Ireland
  3. 3Respiratory Department, Tallaght Hospital, Dublin, Ireland
  1. Correspondence to Dr Emma McNally; emcnall{at}tcd.ie

Abstract

Pulmonary mucosa-associated lymphoid tissue (pMALT) lymphomas are rare, representing <1% of lung malignancies. An association between pMALT and autoimmune conditions has been described, but there is a paucity of documented cases linked to coeliac disease. We present the case of a patient with a history of coeliac disease who presented with weight loss but no respiratory symptoms. CT revealed diffuse endobronchial opacities with associated bronchial dilation and pulmonary nodules. Bronchoscopy confirmed widespread polypoid endobronchial lesions. Histology demonstrated diffuse lymphoid infiltrate which stained positive for CD20. Clonality studies confirmed low grade B cell MALT lymphoma. She was treated with anti CD20 monoclonal antibody, rituximab. Prognosis of pMALT is good with 5-year survival >80%. Thus, an index of suspicion and early detection are vital. This case highlights that pMALT should be considered in patients with non-specific symptoms and coeliac disease. Bronchoscopy is a valuable diagnostic tool to be used in these cases.

  • Respiratory system
  • Haematology (incl blood transfusion)
  • Lung cancer (oncology)

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Footnotes

  • Contributors Dr EM and Dr LC prepared this report for publication including consenting the patient and conducting a review of the existing literature, along with preparing the manuscript. Professor AF was involved in this patient's care by reporting on the histology and preparing the slides for publication in this report. Professor EM was the overall treating Respiratory consultant who continues to look after this patient and who was involved in the editing and preparation of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.