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Review
. 2023;62(1):95-102.
doi: 10.2169/internalmedicine.9310-21. Epub 2023 Jan 1.

Pulmonary Nodular Lymphoid Hyperplasia Evaluated with Bronchoalveolar Lavage Fluid Findings: A Case Report and Review of the Literature on Japanese Patients

Sakiko Moriyama  1 , Takashi Kido  1 , Noriho Sakamoto  1 , Mai Fuchigami  2 , Takatomo Tokito  1 , Daisuke Okuno  1 , Takuto Miyamura  1 , Shota Nakashima  1 , Atsuko Hara  1 , Hiroshi Ishimoto  1 , Yoshitaka Imaizumi  3 , Kazuto Tsuruda  2 , Katsunori Yanagihara  2 , Junya Fukuoka  4 , Hiroshi Mukae  1
Affiliations
Review

Pulmonary Nodular Lymphoid Hyperplasia Evaluated with Bronchoalveolar Lavage Fluid Findings: A Case Report and Review of the Literature on Japanese Patients

Sakiko Moriyama et al. Intern Med. 2023.

Abstract

Pulmonary nodular lymphoid hyperplasia (PNLH) is a very rare disease, and it is difficult to diagnose PNLH and distinguish it from mucosa-associated lymphoid tissue (MALT) lymphoma. In addition, information on bronchoalveolar lavage fluid (BALF) analyses is lacking. We herein report a 36-year-old Japanese woman diagnosed with PLNH by a surgical biopsy and analysis of BALF. The BALF showed an increase in B-cell marker-positive lymphocytes, normal patterns of B-cell clonality, mucosa-associated lymphoid tissue 1 gene, and immunoglobulin heavy chain at 14q32 translocations. We also reviewed Japanese cases of PNLH described in Japanese or English to explore the characteristics of such cases.

Keywords: bronchoalveolar lavage fluid; gene translocation; immunoglobulin heavy chain; mucosa-associated lymphoid tissue lymphoma; pulmonary nodular lymphoid hyperplasia.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Chest radiograph. Chest radiograph showing multiple ground-glass opacities in the bilateral lung fields.
Figure 2.
Figure 2.
Chest high-resolution computed tomography. Chest high-resolution computed tomography showing multiple ground-glass opacities, nodules, and cyst formation in the bilateral lung fields (A). Five years later, the findings had gradually worsened (B).
Figure 3.
Figure 3.
Pathological findings from the lung specimens. Low- (A) and high- (B, C) magnification photomicrographs of pathological specimens obtained during video-assisted thoracic surgery. Nodular lesions with fibrosis (A), lymphoid follicles with numerous germinal centers (B), and infiltration of plasma cells (C) were observed. Lymphoepithelial lesions were not observed.
Figure 4.
Figure 4.
Analyses of the bronchoalveolar lavage fluid (BALF) with molecular biology techniques. (A) Negative results (nonclonal peaks) in the VH (FR1)/JH region for immunoglobulin heavy chain gene rearrangement for the evaluation of B-cell clonality using polymerase chain reaction (PCR). (B) Fusion signals of mucosa-associated lymphoid tissue 1 evaluated by fluorescence in situ hybridization with lymphocytes in BALF, suggesting no translocation of the specific gene of mucosa-associated lymphoid tissue lymphoma.
See this image and copyright information in PMC

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