Synchronous Primary Pleural Mucosa-Associated Lymphoid Tissue Lymphoma and Pulmonary Squamous Cell Carcinoma in a Patient With Asbestos Exposure: A Case Report

Our plain-English summary of Synchronous Primary Pleural Mucosa-Associated Lymphoid Tissue Lymphoma and Pulmonary Squamous Cell Carcinoma in a Patient With Asbestos Exposure: A Case Report, by R. Irie, T. Kawai, N. Nakamura, et al (Curēus, 2025).

The study

• Authors: R. Irie, T. Kawai, N. Nakamura, M. Okui, H. Orikasa
• Journal: Curēus
• Published: 2025;17(9):e93467
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Primary pleural extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) is extremely rare. We report the case of a Japanese man in his 70s who had a history of asbestos exposure and known bilateral pleural plaques and presented with dyspnea. Imaging studies revealed a pulmonary mass in the left lower lobe, and a biopsy confirmed squamous cell carcinoma of the lung. Positron emission tomography-computed tomography (PET-CT) incidentally revealed increased radiotracer uptake in the pleura between the third and fourth left ribs. The pleural mass was diagnosed as primary pleural MALT lymphoma on biopsy. To the best of our knowledge, this is the first reported case of the synchronous occurrence of primary pleural MALT lymphoma and pulmonary squamous cell carcinoma in a patient with a documented history of asbestos exposure.

Copyright © 2025, Irie et al.

In plain English

This case report described a Japanese man in his 70s who smoked and had about 50 years of work exposure to asbestos in shipbuilding and building pipe installation. The fiber type is not named. He had known pleural plaques on both sides and was admitted with shortness of breath on exertion. CT showed a mass of about 68 mm in the lower left lung, and a biopsy confirmed squamous cell carcinoma. PET-CT also showed activity in a pleural lesion of about 58 by 15 mm between the left third and fourth ribs. Scans over 12 years showed that spot tending to grow. Doctors suspected spread of the lung cancer or mesothelioma. A biopsy instead showed a low-grade B-cell lymphoma, diagnosed as primary pleural MALT lymphoma, not mesothelioma. No asbestos bodies were seen in the lung biopsy. The authors concluded that, to their knowledge, this was the first reported case of the two cancers occurring together in a patient with smoking and asbestos exposure. They said asbestos's role in primary pleural MALT lymphoma remains uncertain because it is so rare.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient), with a table of previously published cases of primary pleural MALT lymphoma
• Who was studied: One man in his 70s (listed as 74 years old in Table 1, nationality Japan) with a history of smoking, bilateral pleural plaques and benign prostatic hyperplasia
• Exposure: Occupational asbestos exposure in shipbuilding and building pipe installations for about 50 years. No fiber type is named. The patient also had a history of smoking.
• Main results:
  • Chest CT showed a mass of approximately 68 mm in the left lower lobe of the lung, and a transbronchial lung biopsy confirmed squamous cell carcinoma
  • PET-CT showed a pleural lesion of approximately 58 by 15 mm between the left third and fourth ribs. It was confined to the visceral pleura and was not connected to the lung mass.
  • On imaging over 12 years, the lesion in the left third/fourth intercostal space, where a pleural plaque had been seen, tended to increase in size
  • The pleural biopsy showed low-grade B-cell lymphoma, diagnosed as primary pleural MALT lymphoma, with no metastatic squamous cell carcinoma or malignant mesothelioma
  • No asbestos bodies were found in the lung biopsy on iron staining
  • Genetic testing (FISH) of the pleural tumor found no MALT1 break-apart signal
  • The lung cancer was stage IV with spread to the liver. Systemic chemotherapy was started, and the patient was alive three months later.
• The authors' conclusion: The authors concluded that, to the best of their knowledge, this was the first reported case of synchronous primary pleural MALT lymphoma and lung squamous cell carcinoma in a patient with smoking and asbestos exposure. They suggested a possible link between asbestos-related chronic pleural inflammation and the lymphoma, and said more cases are needed to clarify any association.
• Limitations the authors state:
  • Because primary pleural MALT lymphoma is so rare, the authors stated that the role of asbestos exposure in it remains uncertain
  • For this patient's lung cancer, no asbestos bodies were found in the biopsy and the patient smoked. The authors said only that an asbestos contribution cannot be excluded.

Topics

Medical terms in this study, explained in our Lexicon: Squamous Cell Carcinoma, Asbestos Exposure, Bilateral, Pleural Plaques, Dyspnea, Biopsy, PET-CT, Pleura.

Related studies

• Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type arising in the pleura with pleural fibrous plaques in a lathe worker — S. Nakatsuka, T. Nagano, et al. (2012)
• Chrysotile fibers in tissue adjacent to laryngeal squamous cell carcinoma in cases with a history of occupational asbestos exposure — S.K. Wronkiewicz, V.L. Roggli, et al. (2020)
• Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors — S. Hendry, R. Salgado, et al. (2017)
• Primary pleural squamous cell carcinoma misdiagnosed as localized mesothelioma: a case report and review of the literature — X.M. Lin, C. Chi, et al. (2013)
• A case of primary lung squamous cell carcinoma mimicking malignant mesothelioma producing granulocyte colony stimulating factor with chemotherapy (cisplatin and gemcitabine)-associated thrombotic thrombocytopenic purpura (TTP); An autopsy case report — Y. Suzuki, K. Kanazawa, et al. (2019)
• Pseudomesotheliomatous Primary Squamous Cell Lung Carcinoma: The First Case Reported in Turkey and a Review of the Literature — N. Katgi, M. Unlu, et al. (2018)

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