PRIMARY LYMPHOMA OF THE LUNG: AN APPRAISAL OF ITS NATURAL HISTORY AND A COMPARISON WITH OTHER LOCALIZED LYMPHOMAS.

SUMMARY AND CONCLUSIONS 1. Study of the Memorial Sloan-Kettering Cancer Center records and review of the literature revealed 77 cases of lymphosarcoma and 16 cases of reticulum cell sarcoma primary in the lung. Not one case of Hodgkin's disease could be accepted as primary in the lung. 2. The discovery of the disease is preceded by pulmonary symptoms lasting for months or years in about one half of the patients. In about one third of the patients, the disease is discovered on “routine” chest film. 3. The roentgenologic features of the disease are rather protean; they may mimic consolidation, inflammation, or carcinoma. 4. The diagnosis is difficult to make by bronchoscopy or sputum cytologic examinations, probably because bronchial obstruction and ulceration are not common. 5. Surgery and radiation therapy, either alone or in combination, effect a 45.2 per cent 5-year survival rate. 6. Local recurrences are frequent, regardless of the therapeutic modality employed initially. Fatal recurrences usually occur early; on the contrary those occurring late are usually controlled by radiation therapy. 7. Even though radiosensitive, these tumors should be treated initially by operation in view of the likelihood of repeated recurrences and the limited resistance of the lung to radiation. 8. Following adequate resection, “prophylactic” radiation therapy does not seem to be indicated. 9. The prognosis for localized lymphoma of the lung is better than that of the gastrointestinal tract and somewhat worse than that of the head and neck and bone. 10. It is suggested that the difference in survival of localized lymphoma in different regions is related to a variety of factors which lead to earlier diagnosis and therapy in some areas than in others.