SUMMARY
Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare indolent non-Hodgkin lymphoma (NHL). It is a primary pulmonary marginal zone lymphoma originating from the BALT. Diagnosis is often delayed due to nonspecific symptoms, wide variability and low specificity of radiological patterns, and difficulties in getting representative biopsies.1 There are several treatment options: active surveillance, local therapy (surgery or radiotherapy), or systemic therapy ((chemo)immunotherapy, immunomodulating, or targeted therapy). 1–3 In this retrospective analysis, 30 patients diagnosed with primary BALT lymphoma were enrolled. The median time to diagnosis was six months (IQR 1.5 – 15.5 months). Median follow-up time was 67.3 months (IQR 30.6 – 106.1). Our review shows that the watch-and-wait approach is a valid option for a newly diagnosed BALT lymphoma, as we see no negative impact on outcome in our small case series. There is no evidence that postponing the start of systemic therapy holds a risk for transformation, which would mean an inferior outcome. Treatment must be guided primarily by symptomatology and not only by radiologic alterations.
(BELG J HEMATOL 2024;15(7):286–97)
