---
title: "Primary pulmonary MALT lymphoma presenting as a right hilar mass: CT and 18F-FDG PET/CT evaluation"
id: "pubmed-42826325"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42826325"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42826325/"
doi: "10.1097/MD.0000000000051002"
published_at: "2026-10-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Primary pulmonary MALT lymphoma presenting as a right hilar mass: CT and 18F-FDG PET/CT evaluation
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42826325
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42826325/)
- **DOI:** [10.1097/MD.0000000000051002](https://doi.org/10.1097%2FMD.0000000000051002)
- **Published At:** 2026-10-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- A 44-year-old asymptomatic male had an incidental lung lesion on screening; no respiratory symptoms or systemic B symptoms were reported. - Baseline chest **CT** showed a 3.9 × 3.5 cm right hilar soft-tissue mass compressing the right upper lobe bronchus with secondary post-obstructive consolidation but lacking an air bronchogram. An incidental 2.6 × 2.6 cm anterior mediastinal nodule was also seen. - Whole-body **18F-FDG PET/CT** demonstrated intense FDG uptake in the right hilar mass (SUVmax 7.1) and mild-to-moderate uptake in an adjacent regional lymph node (SUVmax 3.2). The anterior mediastinal nodule and the post-obstructive consolidation showed no FDG uptake. - Bronchoscopic transbronchial lung biopsy with histopathology and immunohistochemistry confirmed **primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma**. - The patient received localized radiotherapy targeting the FDG-avid right hilar mass and the regional hilar/posterior mediastinal lymph node: total dose 66 Gy delivered in 18 fractions over 3 weeks. - Two months after discharge, repeat chest CT showed marked reduction in the size of the hilar lesion and regional lymph nodes; the patient remained asymptomatic and laboratory parameters normalized. - The report highlights the diagnostic and staging value of combined CT and **18F-FDG PET/CT** for differentiating metabolically active lymphoma from coexisting benign mediastinal lesions and avoiding clinical overstaging. - The authors declared no conflicts of interest. - Source: Case report published in Medicine (Baltimore), PMID 42826325; DOI 10.1097/MD.0000000000051002.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine (900th Hospital), Fuzhou, China. * 2 College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China. * PMID: **42826325** * DOI: [ 10.1097/MD.0000000000051002 ](https://doi.org/10.1097/md.0000000000051002) Item in Clipboard Case Reports # Primary pulmonary mucosa-associated lymphoid tissue lymphoma presenting as a right hilar mass: A case report Liyuan Fu et al. Medicine (Baltimore). 2026. Show details Display options Display options Format Abstract PubMed PMID Medicine (Baltimore) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Medicine+%28Baltimore%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Medicine+%28Baltimore%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42826325/) . 2026 Oct 2;105(40):e51002. doi: 10.1097/MD.0000000000051002. ### Authors [Liyuan Fu](https://pubmed.ncbi.nlm.nih.gov/?term=Fu+L&cauthor_id=42826325)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-1 "Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine \(900th Hospital\), Fuzhou, China."), [Taipeng Zeng](https://pubmed.ncbi.nlm.nih.gov/?term=Zeng+T&cauthor_id=42826325)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-1 "Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine \(900th Hospital\), Fuzhou, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-2 "College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China."), [Chengkun Hong](https://pubmed.ncbi.nlm.nih.gov/?term=Hong+C&cauthor_id=42826325)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-1 "Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine \(900th Hospital\), Fuzhou, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-2 "College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China."), [Yuhang Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42826325)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-1 "Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine \(900th Hospital\), Fuzhou, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-2 "College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China."), [Hao Huang](https://pubmed.ncbi.nlm.nih.gov/?term=Huang+H&cauthor_id=42826325)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42826325/#short-view-affiliation-2 "College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.") ### Affiliations * 1 Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine (900th Hospital), Fuzhou, China. * 2 College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China. * PMID: **42826325** * DOI: [ 10.1097/MD.0000000000051002 ](https://doi.org/10.1097/md.0000000000051002) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Rationale:** Primary pulmonary lymphoma (PPL) is an extremely rare malignant lung tumor that is frequently misdiagnosed as pneumonia or lung cancer due to its atypical radiological and clinical presentation. The rationale of this report is to elucidate the diagnostic value of combining computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in evaluating a rare presentation of PPL. **Patient concerns:** A 44-year-old male was admitted after an incidental lung lesion was discovered during routine screening. He was completely asymptomatic, lacking respiratory or systemic "B symptoms." **Diagnoses:** A baseline chest CT identified a 3.9 × 3.5 cm soft-tissue mass in the right hilar region that compressed the right upper lobe bronchus, leading to secondary post-obstructive consolidation that lacked the characteristic air bronchogram sign. The CT also revealed an incidental 2.6 × 2.6 cm anterior mediastinal nodule. Subsequent whole-body 18F-FDG PET/CT demonstrated intense tracer uptake in the right hilar mass with a maximum standardized uptake value of 7.1 and mild-to-moderate uptake in an adjacent regional lymph node (maximum standardized uptake value of 3.2). The scan showed completely absent uptake in the anterior mediastinal nodule and the post-obstructive consolidation, arguing against metabolically active malignancy in those areas. Histopathological and immunohistochemical analysis from a bronchoscopic transbronchial lung biopsy confirmed primary pulmonary mucosa-associated lymphoid tissue lymphoma. **Interventions:** The patient underwent localized radiotherapy targeting the right hilar mass and the FDG-avid regional hilar/posterior mediastinal lymph node. A total dose of 66 Gy was delivered in 18 fractions over the course of 3 weeks. **Outcomes:** At the 2-month post-discharge follow-up, a repeat chest CT revealed a marked reduction in the size of both the hilar lesion and the regional lymph nodes. The patient remained completely asymptomatic, and his laboratory parameters normalized. **Lessons:** Differentiating PPL from central lung cancer and coexisting benign mediastinal abnormalities presents a significant clinical challenge, particularly when atypical radiological features mimic aggressive carcinomas. Whole-body 18F-FDG PET/CT serves as an invaluable, noninvasive modality for metabolic characterization, accurate loco-regional staging, and preventing clinical overstaging by effectively differentiating metabolically active lymphoma from concurrent benign lesions. **Keywords:** case report; computed tomography imaging; maximum standardized uptake value; primary pulmonary lymphoma. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, LLC. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors have no conflicts of interest to declare. ## References 1. 1. Wang X, Yang W, Zhou Q, et al. The role of 18F-FDG PET/CT in predicting the pathological response to neoadjuvant PD-1 blockade in combination with chemotherapy for resectable esophageal squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2022;49:4241–51. 2. 1. Antoine M, Vieira T, Fallet V, et al. Carcinomes sarcomatoïdes pulmonaires [Pulmonary sarcomatoid carcinoma]. Ann Pathol. 2016;36:44–54. 3. 1. Wei S, Li X, Qiu X, et al. Primary lung lymphoma involving the superior vena cava. World J Surg Oncol. 2012;10:131. 4. 1. Piña-Oviedo S, Weissferdt A, Kalhor N, Moran CA. Primary pulmonary lymphomas. Adv Anat Pathol. 2015;22:355–75. 5. 1. Zhang MC, Zhou M, Song Q, et al. Clinical features and outcomes of pulmonary lymphoma: a single center experience of 180 cases. Lung Cancer. 2019;132:39–44. 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