Primary pulmonary lymphoma (PPL) is a rare extranodal malignancy primarily characterized by mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma (DLBCL). This commentary examines the population-based study conducted by Li et al., which evaluates survival outcomes between pulmonary MALT lymphoma and pulmonary DLBCL, while also proposing a prognostic nomogram for DLBCL. The study establishes that histological subtype is the primary determinant of prognosis, with MALT lymphoma demonstrating significantly better survival rates than DLBCL, even after adjusting for baseline and treatment factors. Furthermore, it underscores the limited prognostic utility of American Joint Committee on Cancer (AJCC) staging in pulmonary DLBCL, highlighting the necessity for biologically informed prognostic models that integrate molecular, immunological, and clinical variables. Despite the inherent limitations of registry-based research utilizing the Surveillance, Epidemiology, and End Results (SEER) database, this study provides crucial evidence supporting precise histological classification and enhanced risk stratification in PPL.
Hongmei Yu (2026) studied this question.