pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2024-34-4-522-532pulmo-4414Research ArticleОБЗОРЫREVIEWПоражения легких при лимфопролиферативных заболеванияхLung lesions in lymphoproliferative diseaseshttps://orcid.org/0000-0001-9928-926XГайнитдиноваВ. В.GainitdinovaV. V.

Гайнитдинова Вилия Вилевна – д. м. н., доцент, профессор кафедры пульмонологии Института клинической медицины имени Н.В. Склифосовского.

119991, Москва, ул. Трубецкая, 8, стр. 2

Тел.: (499) 248-53-83

Viliya V. Gaynitdinova - Doctor of Medicine, Professor, Department of Pulmonology, N.V. Sklifosovsky Institute of Clinical Medicine, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).

Trubetskaya ul. 8, build. 2, Moscow, 119991

Tel.: (499) 248-53-83

ivv_08@mail.ruhttps://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич – д. м. н., профессор, академик Российской академии наук, заведующий кафедрой пульмонологии Института клинической медицины имени Н.В. Склифосовского ФГАОУ ВО «ПМГМУ им. И.М. Сеченова» МЗ РФ (Сеченовский Университет), главный внештатный специалист-пульмонолог Министерства здравоохранения Российской Федерации; директор Национального медицинского исследовательского центра по профилю «Пульмонология».

119991, Москва, ул. Трубецкая, 8, стр. 2

Тел.: (499) 248-53-83

Sergey N. Avdeev - Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of the Department of Pulmonology, N.V.Sklifosovsky Institute of Clinical Medicine, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Chief Freelance Pulmonologist of the Ministry of Health of the Russian Federation; Director of the National Medical Research Center for Pulmonology.

Trubetskaya ul. 8, build. 2, Moscow, 119991

Tel.: (499) 248-53-83

serg_avdeev@list.ruФедеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation202418082024344522532Copyright © Гайнитдинова В.В., Авдеев С.Н., 20242024Гайнитдинова В.В., Авдеев С.Н.Gainitdinova V.V., Avdeev S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4414

Первичные лимфомы классифицируются в соответствии с общей системой классификации Всемирной организации здравоохранения. Несмотря на то, что более чем у 50 % пациентов с узловыми лимфомами отмечается поражение легких, первичные легочные лимфомы составляют < 0,5 % всех первичных новообразований легких. Кроме того, наиболее распространенная первичная лимфома легких – неходжкинская В-клеточная лимфома маргинальной зоны (MALT-лимфома) – составляет < 10 % экстранодальных лимфом. Лимфомы Ходжкина (ЛХ) лишь в редких случаях считаются первичными лимфомами легких, даже если легкие являются основным органом поражения. Более того, чаще всего при первичной легочной MALT-лимфоме по данным углубленного обследования выявляются другие экстранодальные участки (например, желудок, толстая кишка, щитовидная железа, костный мозг), которые могут быть идентифицированы как места субклинической клональной лимфоидной пролиферации. Вторичное поражение легких при лимфомах обнаруживается в 50 % случаев и встречается чаще, чем первичная легочная лимфома. Однако морфологически определить различие между первичной легочной лимфомой и вторичным поражением легких при лимфопролиферативных заболеваниях (ЛПЗ) сложно. Целью обзора явилось демонстрация данных о клинических и диагностических особенностях первичных и вторичных поражений легких при злокачественных ЛПЗ. Заключение. Поражения легких при ЛПЗ могут быть первичными и вторичными. Первичные поражения легких и плевры при ЛПЗ встречаются редко, в то время как лимфомы, вторично поражающие легкие, при аутопсии выявляются в 20 % случаев. В большинстве случаев диагноз основывается на результатах световой микроскопии, иммуно-гистохимических и молекулярных исследований.

Primary lymphomas are classified according to the WHO general classification system. Despite the fact that more than half of patients with nodular lymphomas have lung lesions, primary pulmonary lymphomas account for less than 0.5% of all primary lung neoplasms. In addition, the most common primary lung lymphoma, non-Hodgkin’s B-cell marginal zone lymphoma (MALT lymphoma), accounts for less than 10% of extranodal lymphomas. Hodgkin’s lymphomas (LH) are only rarely considered primary lung lymphomas, even if the lungs are the main affected organ. Moreover, in most cases of primary pulmonary MALT lymphoma, in-depth examination reveals other extranodal sites (for example, stomach, colon, thyroid gland, bone marrow) that can be identified as sites of subclinical clonal lymphoid proliferation. Secondary lung damage in lymphomas is found in half of the cases and is more common than primary pulmonary lymphoma. However, it is difficult to morphologically determine the difference between primary pulmonary lymphoma and secondary lung damage in malignant lymphoproliferative diseases (LPDs). The aim was to present an overview of the clinical and diagnostic features of primary and secondary lung lesions in malignant lymphoproliferative diseases. Conclusion. Lung lesions in lymphoproliferative diseases can be primary and secondary. Primary lung and pleural lesions in LPDs are rare, while lymphomas that secondary lung lesions are identified in 20% of the cases during autopsy. In most patients, the diagnosis is based on the results of light microscopy, immunohistochemical and molecular assays.

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The authors declare that there are no conflicts of interest present.