Assuntos
Linfonodos/patologia , Linfócitos/patologia , Linfoma de Células B/diagnóstico , Linfoma Folicular/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma de Célula do Manto/diagnóstico , Linfoma de Células T/diagnóstico , Adulto , Biópsia por Agulha Fina/métodos , Criança , Diagnóstico Diferencial , Citometria de Fluxo/métodos , Histiócitos/imunologia , Histiócitos/patologia , Humanos , Imunofenotipagem , Linfonodos/cirurgia , Linfócitos/classificação , Linfócitos/imunologia , Linfoma de Células B/imunologia , Linfoma de Células B/patologia , Linfoma de Células B/cirurgia , Linfoma Folicular/imunologia , Linfoma Folicular/patologia , Linfoma Folicular/cirurgia , Linfoma Imunoblástico de Células Grandes/imunologia , Linfoma Imunoblástico de Células Grandes/patologia , Linfoma Imunoblástico de Células Grandes/cirurgia , Linfoma de Célula do Manto/imunologia , Linfoma de Célula do Manto/patologia , Linfoma de Célula do Manto/cirurgia , Linfoma de Células T/imunologia , Linfoma de Células T/patologia , Linfoma de Células T/cirurgia , Plasmócitos/imunologia , Plasmócitos/patologiaRESUMO
A 46-year-old woman presenting to the Department of Hematology with swelling of the mandibular lymph nodes was diagnosed with angioimmunoblastic T-cell lymphoma (AITL) in June 2013. The patient went into complete remission in December 2013 with chemotherapy; however, she was re-evaluated because of mental confusion during May 2014. In addition to the memory disturbances, elevated cerebrospinal fluid cell count and protein were noted. Fluid attenuated inversion recovery cranial magnetic resonance imaging revealed multiple hyperintense areas in both the mammillary bodies and thalamus accompanied by contrast-enhancing in some areas. The diagnosis of recurrent AITL was made based on the brain biopsy. AITL recurrence in the cranium should be considered in patients exhibiting central nervous system symptoms although such recurrences have not been reported previously.
Assuntos
Neoplasias Encefálicas/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma de Células T/diagnóstico , Recidiva Local de Neoplasia , Indução de Remissão , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Terapia Combinada , Feminino , Humanos , Linfoma Imunoblástico de Células Grandes/diagnóstico por imagem , Linfoma Imunoblástico de Células Grandes/patologia , Linfoma Imunoblástico de Células Grandes/terapia , Linfoma de Células T/diagnóstico por imagem , Linfoma de Células T/patologia , Linfoma de Células T/terapia , Imageamento por Ressonância Magnética , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Radioterapia , Resultado do TratamentoRESUMO
Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma arising most frequently in the oral cavity of HIV-infected patients. Rare cases of PBL have been reported in extra-oral sites, as well as in HIV-negative patients. Cardiac involvement by lymphoma is very rare. The most common primary cardiac lymphoma is diffuse large B-cell lymphoma. We report an unusual case of PBL in a 49-year-old, HIV-positive man presenting with a large intracardiac mass and bilateral pleural effusions. Histological examination of the cardiac mass biopsy and cytological evaluation of the pleural fluid demonstrated large lymphoma cells with plasmablastic differentiation. By immunohistochemistry, the large lymphoma cells expressed CD30, CD45, CD138, MUM1, and kappa light chain, were weakly positive for EMA, and were negative for T-cell and B-cell markers, lambda light chain, and human herpes virus 8 (HHV8). In situ hybridization for Epstein Barr Virus-encoded RNA (EBER) was negative in large lymphoma cells. To our knowledge, in the English literature, this is the second reported case of PBL with cardiac origin and the first reported case of PBL that presents as a combination of intracardiac mass and pleural effusions.
Assuntos
Linfoma Plasmablástico/patologia , Linfócitos B/citologia , Linfócitos B/virologia , Diagnóstico Diferencial , Herpesvirus Humano 8 , Humanos , Imuno-Histoquímica/métodos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/virologia , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/virologia , Masculino , Pessoa de Meia-Idade , Linfoma Plasmablástico/virologia , Derrame Pleural/diagnóstico , Derrame Pleural/patologiaAssuntos
Soropositividade para HIV/complicações , Linfoma Imunoblástico de Células Grandes/complicações , Soropositividade para HIV/diagnóstico , Soropositividade para HIV/tratamento farmacológico , Soropositividade para HIV/mortalidade , Humanos , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/mortalidade , Linfoma Imunoblástico de Células Grandes/terapiaAssuntos
Herpesvirus Humano 4/isolamento & purificação , Infiltração Leucêmica/etiologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma Imunoblástico de Células Grandes/patologia , Linfoma Imunoblástico de Células Grandes/virologia , Seio Maxilar/patologia , Feminino , Infecções por HIV/diagnóstico , Humanos , Infiltração Leucêmica/diagnóstico , Infiltração Leucêmica/patologia , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/virologia , Linfoma Imunoblástico de Células Grandes/complicações , Linfoma Imunoblástico de Células Grandes/diagnóstico , Pessoa de Meia-IdadeRESUMO
The serum immunoglobulin free light chain (FLC) assay quantitates free kappa (κ) and lambda (λ) light chains. FLC elevations in patients with diffuse large B-cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and chronic lymphocytic leukemia (CLL) are associated with an inferior survival. These increases in FLC can be monoclonal (as in myeloma) or polyclonal. The goal was to estimate the frequency of these elevations within distinct types of B-cell and T-cell non-Hodgkin lymphoma (NHL) and whether the FLC measurements are associated with event-free survival (EFS). We studied serum for FLC abnormalities using normal laboratory reference ranges to define an elevated κ or λ FLC. Elevations were further classified as polyclonal or monoclonal. Four hundred ninety-two patients were studied: 453 B-cell and 34 T-cell NHL patients. Twenty-nine % (142/453) of patients had an elevated FLC of which 10% were monoclonal elevations. Within B-cell NHL, FLC abnormalities were most common in lymphoplasmacytic (79%), mantle cell (68%), and lymphomas of mucosa associated lymphoid tissue (31%); they were least common in follicular (15%). The hazard ratio (HR) for EFS in all patients was 1.41 (95% CI; 1.11-1.81); in all B-cell NHL the HR was 1.44 (95% CI 1.11-1.96); in all T-cell NHL the HR was 1.17 (95% CI 0.55-2.49). FLC abnormalities predicted an inferior OS (HR = 2.75, 95% CI: 1.93-3.90, P < 0.0001). The serum FLC assay is useful for prognosis in both B-cell and T-cell types of NHL. In B-cell NHL further discrimination between a monoclonal and polyclonal elevation may be helpful and should be analyzed in prospective clinical trials.
Assuntos
Cadeias kappa de Imunoglobulina/sangue , Cadeias lambda de Imunoglobulina/sangue , Linfoma de Células B/sangue , Linfoma Folicular/sangue , Linfoma Imunoblástico de Células Grandes/sangue , Linfoma de Célula do Manto/sangue , Linfoma de Células T/sangue , Idoso , Linfócitos B/imunologia , Linfócitos B/metabolismo , Linfócitos B/patologia , Células Clonais , Feminino , Humanos , Linfoma de Células B/diagnóstico , Linfoma de Células B/mortalidade , Linfoma de Células B/patologia , Linfoma Folicular/diagnóstico , Linfoma Folicular/mortalidade , Linfoma Folicular/patologia , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/mortalidade , Linfoma Imunoblástico de Células Grandes/patologia , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/mortalidade , Linfoma de Célula do Manto/patologia , Linfoma de Células T/diagnóstico , Linfoma de Células T/mortalidade , Linfoma de Células T/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , Linfócitos T/imunologia , Linfócitos T/metabolismo , Linfócitos T/patologiaAssuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Maxila/patologia , Boca/patologia , Humanos , Linfoma Difuso de Grandes Células B/imunologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma Imunoblástico de Células Grandes/imunologia , Linfoma Imunoblástico de Células Grandes/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Plasmablastic lymphoma (PL) is a relatively new category of lymphoma, which has been considered to be found predominantly in the oral cavity and has a strong association with HIV. CASE: We report a case of extraoral/mesenteric PL detected using cytological examination of ascitic fluid assisted by flow cytometric (FC) analysis. The cells were positive for CD38, CD138, CD10, CD45 and CD56 and negative for CD3, CD19, CD20 and CD79a, with cytoplasmic lambda light-chain restriction. We also reviewed 67 cases of extraoral PL from the available literature and found them to be less often associated with HIV (than oral PL), occurring mostly in males aged 30-60 years, with the most common extraoral site being the anorectal region. CONCLUSION: A high index of suspicion at the level of the cytopathologist is imperative for identifying lymphoma cells in a body fluid. A rare entity like PL can also be diagnosed on cytology assisted by ancillary techniques (like FC), without the need for a biopsy. We also suggest that the minimum panel to diagnose PLs should include CD138, MUM-1, Ki-67, ALK-1, CD3, immunoglobulin light-chains, CD20 and PAX5.
Assuntos
Líquido Ascítico/patologia , Citodiagnóstico/métodos , Citometria de Fluxo/métodos , Linfoma Imunoblástico de Células Grandes/diagnóstico , Idoso , Humanos , MasculinoRESUMO
OBJECTIVE: To report two cases of laryngeal plasmablastic lymphoma, a rare and relatively recently described form of non-Hodgkin's lymphoma. It has not previously been described in the larynx, nor associated with upper airway obstruction. CASE REPORTS: We describe the clinicopathological features of two such cases in human immunodeficiency virus positive patients, and we discuss their unusual presentations and diagnostic features. CONCLUSION: When evaluating a laryngeal tumour, plasmablastic lymphoma and other non-Hodgkin's lymphomata should be considered as differential diagnoses, particularly in the setting of a high prevalence of human immunodeficiency virus infection. Biopsy with detailed histopathological and immunohistochemical evaluation is recommended to ensure correct diagnosis and optimal management.
Assuntos
Neoplasias Laríngeas/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Endoscopia , Feminino , Humanos , Neoplasias Laríngeas/terapia , Linfoma Imunoblástico de Células Grandes/terapia , Masculino , Pessoa de Meia-Idade , FotomicrografiaAssuntos
Artrite Psoriásica/tratamento farmacológico , Imunossupressores/efeitos adversos , Linfoma Difuso de Grandes Células B/imunologia , Linfoma Imunoblástico de Células Grandes/imunologia , Metotrexato/efeitos adversos , Idoso , Artrite Psoriásica/complicações , Artrite Psoriásica/imunologia , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/imunologia , Feminino , Herpesvirus Humano 4/isolamento & purificação , Humanos , Hospedeiro Imunocomprometido , Cadeias Leves de Imunoglobulina/análise , Imunofenotipagem , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/etiologia , Linfoma Difuso de Grandes Células B/virologia , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/etiologia , Linfoma Imunoblástico de Células Grandes/virologia , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Proteínas de Neoplasias/análise , Úlceras Orais/etiologia , Remissão EspontâneaAssuntos
Linfoma de Células T Periférico/patologia , Idoso , Biomarcadores Tumorais , Células Clonais/virologia , Células Dendríticas Foliculares/patologia , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/patologia , Feminino , Rearranjo Gênico do Linfócito T , Herpesvirus Humano 4/isolamento & purificação , Doença de Hodgkin/diagnóstico , Humanos , Hiperplasia , Imunofenotipagem , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/epidemiologia , Linfoma de Células T Periférico/genética , Linfoma de Células T Periférico/virologia , Prognóstico , Pseudolinfoma/diagnóstico , Esplenomegalia/etiologia , Vênulas/patologiaRESUMO
Lymphoblastic lymphoma is an uncommon subtype of lymphoid neoplasm in adults. Acute kidney injury at initial presentation due to lymphoblastic lymphoma infiltration of the kidneys has rarely been described. We report a 19-year-old woman who presented with acute kidney injury due to massive lymphomatous infiltration of the kidneys. The diagnosis of B-cell lymphoblastic lymphoma was established by immunohistochemical study of the biopsied kidney. The patient had an excellent response to the VDCLP protocol (vincristine, daunomycin, cyclophosphamide, asparaginase, and dexamethasone) with sustained remission. We recommend that lymphomatous infiltration be considered in patients presenting with unexplained acute kidney injury and enlarged kidneys.
Assuntos
Injúria Renal Aguda/diagnóstico , Rim/patologia , Linfoma de Células B/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Injúria Renal Aguda/complicações , Injúria Renal Aguda/patologia , Movimento Celular/fisiologia , Diagnóstico Diferencial , Feminino , Humanos , Hipertrofia , Linfoma de Células B/complicações , Linfoma de Células B/patologia , Linfoma Imunoblástico de Células Grandes/complicações , Linfoma Imunoblástico de Células Grandes/patologia , Adulto JovemAssuntos
Imunoglobulina G/metabolismo , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/metabolismo , Neoplasias de Plasmócitos/diagnóstico , Neoplasias de Plasmócitos/metabolismo , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Imunofenotipagem , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
Plasmablastic lymphoma (PBL) is a unique type of diffuse proliferation of large neoplastic lymphoid cells most of which resemble B immunoblasts, but all tumor cells show the immunophenotype of plasma cells. It has a strong predilection for jaw and oral cavity in HIV-positive patients. Incidences of extraoral location of this tumor is increasingly being recognized especially in HIV-negative patients for example, stomach, jejunum, omentum, anorectum, lungs, testes, soft tissues, lymph nodes, bone marrow, skin, and central nervous system. We present a case of PBL found in cecum in an HIV-negative patient. It was accompanied by lung and lymph node involvement and presented as abdominal mass. This is only the second reported case of PBL originating in cecum.
Assuntos
Neoplasias do Ceco/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Plasmócitos/patologia , Idoso , Evolução Fatal , Feminino , Soronegatividade para HIV , Humanos , Tomografia Computadorizada por Raios XAssuntos
Linfoma de Células B/patologia , Linfoma Imunoblástico de Células Grandes/complicações , Linfoma Imunoblástico de Células Grandes/patologia , Polineuropatia Paraneoplásica/etiologia , Neoplasias Esplênicas/secundário , Idoso , Linfócitos B/patologia , Progressão da Doença , Hemangioma/diagnóstico , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Linfoma Imunoblástico de Células Grandes/diagnóstico , Masculino , Neurite (Inflamação)/diagnóstico , Neurite (Inflamação)/etiologia , Neurite (Inflamação)/patologia , Neoplasias Esplênicas/diagnóstico , Fatores de TempoRESUMO
Tumor necrosis factor-α-inducible protein-2 (TNFAIP2) is a protein upregulated in cultured cells treated with tumor necrosis factor α (TNF), but its expression in normal and neoplastic tissues remains largely unknown. Here, we use standard immunohistochemical techniques to demonstrate that TNFAIP2 is normally expressed by follicular dendritic cells, interdigitating dendritic cells, and macrophages but not by lymphoid cells in secondary lymphoid tissues. Consistent with this expression pattern, we found strong TNFAIP2 staining of tumor cells in 4 of 4 cases (100%) of follicular dendritic cell sarcoma and in 3 of 3 cases (100%) of histiocytic sarcoma. Although TNFAIP2 is not expressed by the small and intermediate-sized neoplastic B cells comprising follicular lymphoma, small lymphocytic lymphoma, mantle cell lymphoma, or marginal zone lymphoma, we observed strong TNFAIP2 staining of the large, neoplastic cells in 31 of 31 cases (100%) of classical Hodgkin lymphoma, in 12 of 12 cases (100%) of nodular lymphocyte-predominant Hodgkin lymphoma, and in 27 of 31 cases (87%) of primary mediastinal (thymic) large B-cell lymphoma. In contrast, TNFAIP2 was expressed by malignant cells in only 2 of 45 cases (4%) of diffuse large B-cell lymphoma, not otherwise specified, in 2 of 18 cases (11%) of Burkitt lymphoma, and in 1 of 19 cases (5%) of anaplastic large cell lymphoma. Further analysis indicates that TNFAIP2, as a single diagnostic marker, is more sensitive (sensitivity=87%) and specific (specificity=96%) than TRAF1, nuclear cRel, or CD23 for distinguishing the malignant B cells of primary mediastinal (thymic) large B-cell lymphoma from those of its morphologic and immunophenotypic mimic, diffuse large B-cell lymphoma, not otherwise specified. Thus, TNFAIP2 may serve as a useful new marker of dendritic and histiocytic sarcomas, the aberrant expression of which in the malignant cells of classical Hodgkin lymphoma and primary mediastinal (thymic) large B-cell lymphoma serves to distinguish these tumors from other large cell lymphomas in routine clinical practice.
Assuntos
Citocinas/metabolismo , Células Dendríticas/patologia , Doença de Hodgkin/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Neoplasias do Mediastino/diagnóstico , Biomarcadores Tumorais/metabolismo , Células Dendríticas/metabolismo , Diagnóstico Diferencial , Doença de Hodgkin/metabolismo , Humanos , Imuno-Histoquímica , Linfonodos/metabolismo , Linfonodos/patologia , Linfoma Folicular/diagnóstico , Linfoma Difuso de Grandes Células B/metabolismo , Linfoma Imunoblástico de Células Grandes/diagnóstico , Neoplasias do Mediastino/metabolismo , Baço/metabolismo , Baço/patologiaRESUMO
Plasmablastic lymphoma (PBL) is an aggressive variant of non-Hodgkin lymphoma initially reported in the oral cavity of HIV-positive individuals. Since its original description, several cases have been reported in patients who do not have HIV infection. However, despite its recognition as a distinct subtype of diffuse large B-cell lymphoma several years ago, comprehensive reviews of this entity are lacking. A MEDLINE search through June 2010 was performed to identify cases with a pathologic diagnosis of HIV-negative PBL based on morphology and minimal immunohistochemical criteria. Our study included a total of 76 cases. The median age was 57 years (range, 1 to 90 years) with a male-to-female ratio of 1.7. Seventy-four percent of cases did not have an apparent association with immunosuppression, 18% had a concurrent lymphoproliferative or autoimmune disorder and 9% developed PBL after solid organ transplantation. Oral involvement was observed in 21%, advanced stage in 60%, Epstein-Barr virus-encoded RNA expression was positive in 45% and Ki-67 expression of greater than or equal to 80% in 61% of the cases. Chemotherapy was documented in 43 patients, from which 43% received the cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)-like regimens. The median and the 2-year overall survival for the whole group were 9 months and 10%, respectively. Patients who had HIV-negative PBL have distinct clinicopathological characteristics, such as short overall survival and lower rates of oral involvement and Epstein-Barr virus-encoded RNA expression than the previously reported in HIV-positive patients.
Assuntos
Soronegatividade para HIV/imunologia , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/patologia , Boca/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/metabolismo , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Linfoma Imunoblástico de Células Grandes/tratamento farmacológico , Linfoma Imunoblástico de Células Grandes/mortalidade , Prednisona/uso terapêutico , Prognóstico , Análise de Sobrevida , Resultado do Tratamento , Vincristina/uso terapêuticoRESUMO
Oropharyngeal lymphomas are rare, typically high-grade neoplasms. We describe a case of plasmablastic lymphoma that originated in the oropharynx of a 40-year-old man who was positive for human immunodeficiency virus (HIV). The diagnosis was based on fine-needle aspiration cytology of the mass followed by histopathologic examination supplemented with immunophenotyping. The mass was excised, but the patient refused antiretroviral therapy, and he died within 6 months of the diagnosis. In HIV-positive patients, non-Hodgkin lymphomas frequently involve sites, including the oropharynx, that are unusual in patients without HIV.
Assuntos
Infecções por HIV/diagnóstico , Linfoma Relacionado a AIDS/patologia , Linfoma Imunoblástico de Células Grandes/patologia , Neoplasias Orofaríngeas/patologia , Adulto , Biópsia por Agulha , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Progressão da Doença , Evolução Fatal , Infecções por HIV/imunologia , Humanos , Imuno-Histoquímica , Linfoma Relacionado a AIDS/diagnóstico , Linfoma Relacionado a AIDS/cirurgia , Linfoma Imunoblástico de Células Grandes/diagnóstico , Linfoma Imunoblástico de Células Grandes/cirurgia , Masculino , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/cirurgia , Medição de Risco , Recusa do Paciente ao TratamentoRESUMO
Primary hepatic lymphoma is extremely rare. Although the utility of fluorodeoxyglucose (FDG)-positron emission tomography (PET) for imaging extranodal lymphoma has been reported, there is very little literature describing its use in primary hepatic lymphoma. This case report demonstrates the effect of FDG-PET/computed tomography (CT) in a case of unifocal primary hepatic lymphoma and its usefulness in the assessment of treatment response.