RESUMO
A 62-year-old man was initially diagnosed with stage IA follicular lymphoma grade 1 of the left tonsil. Shortly after radiotherapy he rapidly developed multiple painful acroosteolytic lesions and testicular involvement. The histological examination revealed a transformed lymphoma in the testis (DLCL) and follicular lymphoma in the acroosteolytic lesions. The clonal identity of lymphoma cells within the primary biopsy as well as in the two sites at relapse was shown by PCR and nucleotide sequence analysis of the lymphoma clone specific B-cell receptor rearrangement. Chemotherapy with six cycles of CHOP followed by high dose chemotherapy and autologous blood stem cell transplantation led to a complete clinical remission with disappearance of all osteolytic lesions.
Assuntos
Neoplasias Ósseas/diagnóstico , Linfoma Folicular/diagnóstico , Neoplasias Testiculares/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Terapia Combinada , Humanos , Linfoma Folicular/patologia , Linfoma Folicular/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Osteólise/etiologia , Transplante de Células-Tronco de Sangue Periférico , Recidiva , Indução de Remissão , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Transplante Autólogo , Resultado do TratamentoRESUMO
DNA sequences coding for simian virus 40 (SV40) large T antigen have been detected at different frequencies in human non-Hodgkin's lymphomas (NHL) by PCR techniques as well as immunohistochemistry. A highly sensitive quantitative real-time PCR specific for a sequence of SV40 large T antigen was established to test whether SV40 DNA is present in malignant lymphomas of German patients. Thirty-three lymph node samples obtained from 27 patients with NHL and 6 patients with Hodgkin's disease (HD) were tested in addition to 48 samples of peripheral blood mononuclear cells (PBMNC) from patients with NHL containing between 0.1% and >90% circulating lymphoma cells determined by PCR. Fourteen lymph nodes obtained from patients with other diseases than malignant lymphomas and 47 PBMNC samples from healthy volunteers served as controls. All samples from patients with malignant lymphomas and all controls were negative for SV40 DNA by quantitative real-time. In contrast, EBV-DNA could be detected in 29 of 46 DNA preparations isolated from lymph nodes (63%) and in 20 of 47 DNA preparations from PBMNC. EBV-positive samples contained between 5 and 80,000 EBV copies per 100,000 cells. Our results do not support the hypothesis that SV40 plays a major role in the etiology of malignant lymphomas and, in addition, they exclude a clonal SV 40 infection of malignant lymphoma cells in all samples investigated.