CTICasesExtranodal Marginal Zone Lymphoma with Extensive Pulmonary Involvement
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Imaging findings
PET-CT from 2009 shows FDG avidity and thickening of the stomach wall. Pulmonary findings at that time, though not initially emphasized, included poorly marginated, patchy, focal, non-segmental opacities (ranging from ground glass to consolidated), some with air bronchograms, and a single small cystic space. Follow-up imaging in 2013 demonstrates extensive progression of these findings, with widespread pulmonary parenchymal involvement by similar poorly marginated opacities and the previously noted cystic space persisting.
Key takeaways
Extranodal marginal zone lymphoma can extensively involve the pulmonary parenchyma, often presenting as poorly marginated ground-glass or consolidated opacities, sometimes with air bronchograms or cystic changes. Lung involvement may be overlooked initially if other sites (like GI tract) are more symptomatic. The findings can be diffuse and extensive, mimicking other inflammatory or infiltrative processes. A history of lymphoma in another extranodal site should raise suspicion for pulmonary involvement with similar findings.
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