Linfoma primario difuso de células B grandes de mucosa gingival, en paciente VIH y EBV negativos / Primary gingival diffuse large b-cell lymphoma in HIV/EBR negative patient abstract

El linfoma difuso de células B grandes (LDCBG) es el linfoma más frecuente. La presentación clínica puede ser nodal o extranodal y sus síntomas dependen de la localización tumoral; en la mayoría de los casos están asociados a algún tipo de inmunodeficiencia. Referiremos un caso de LDCBG de presentación atípica en una localización muy infrecuente. Es importante tener en cuenta estas situaciones, ya que pueden simular otros procesos patológicos, retrasando así su correcto diagnóstico y por lo tanto un adecuado tratamiento. (AU)

Diffuse large cell lymphoma B (LDCBG) is the most common type of lymphoma. It´s clinical presentation can be nodal or extranodal and it's symptoms depend where the tumor is located and whether is associated or not with an immunodeficiency disease. We present an atypical presentation of a LDCBG in a very unusual location. It´s important to consider these kind of appearance, as they can mimic other oral pathological processes, delaying their correct diagnosis and therefore an appropriate treatment. (AU)

Classification of non-Hodgkin lymphoma in Central and South America: a review of 1028 cases.

The distribution of non-Hodgkin lymphoma (NHL) subtypes differs around the world but a systematic study of Latin America has not been done. Therefore, we evaluated the relative frequencies of NHL subtypes in Central and South America (CSA). Five expert hematopathologists classified consecutive cases of NHL from 5 CSA countries using the WHO classification and compared them to 400 cases from North America (NA). Among the 1028 CSA cases, the proportions of B- and T-cell NHL and the sex distribution were similar to NA. However, the median age of B-cell NHL in CSA (59 years) was significantly lower than in NA (66 years; P < .0001). The distribution of high-grade (52.9%) and low-grade (47.1%) mature B-cell NHL in CSA was also significantly different from NA (37.5% and 62.5%; P < .0001). Diffuse large B-cell lymphoma was more common in CSA (40%) than in NA (29.2%; P < .0001), whereas the frequency of follicular lymphoma was similar in Argentina (34.1%) and NA (33.8%), and higher than the rest of CSA (17%; P < .001). Extranodal NK/T-cell NHL was also more common in CSA (P < .0001). Our study provides new objective evidence that the distribution of NHL subtypes varies significantly by geographic region and should prompt epidemiologic studies to explain these differences.

VIH y Linfoma, una reflexión necesaria: reposte de serie de casos / HIV and LIMPHOMA, a necessary reflection: Case Series Report

La relación entre el deterioro de la función inmunológica y el desarrollo de linfoma es bien conocido en los pacientes con algún grado de inmunosupresión, en los que se observan linfomas con mayor frecuencia que en la población en general, por lo tanto no es sorprendente la asociación entre el virus de inmunodeficiencia humana (VIH) y el desarrollo de este tipo de neoplasia, con - siderándose como definitoria de enferme- dad avanzada. Los linfomas no Hodgkin (LNH) constituyen la segunda neoplasia más frecuente asociada a la infección por VIH, identificándose dos formas anatomo- clínicas principales: Los LNH Sistémicos y los Linfomas primarios del sistema nervioso central (LPSNC), estos últimos se han reducido considerablemente desde la intro - ducción del tratamiento antirretroviral de gran actividad (TARGA). Aunque no se considera definitorio de enfer - medad avanzada, otras neoplasias relacio - nadas con VIH son Enfermedad de Hodgkin y leucemias. Se presenta a continuación una serie de 4 casos clínicos de pacientes con VIH, atendidos en el Centro de Atención integral pediátrico/ Hospital Nacional Doctor Mario Catarino Rivas (HNMCR), en el año 2013, donde se puede observar la variedad de presentación de los linfomas y su relación con el estado inmunológico y virológico...(AU)

Lymphoma subtype incidence rates in children and adolescents: first report from Brazil.

BACKGROUND: Lymphoma is the third most common pediatric malignancy. The purpose of this study was to analyze the incidence rates of lymphoma in children and adolescents in Brazil. METHODS: All cases of Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), and Burkitt lymphoma (BL) were extracted from 14 population-based cancer registries (PBCRs) from 2000 to 2005, and included children and adolescents 0-19 years old. Analyses included age-adjusted incidence rates (AAIRs) and age-specific incidence rates (ASIRs) by each PBCR. A social exclusion index (SEI) was built and used as proxy for socioeconomic status (SES) levels. Correlations between SES and incidence rates were investigated using Spearman's test. RESULTS: The median incidence of lymphoma was 22.7/million. AAIRs of lymphomas varied from 12.9 (Salvador) to 34.5 per million (São Paulo). Median AAIR was 8.8/million, 9.8/million, and 2.9/million for NHL, HL, and BL, respectively. In all PBCRs except that of Recife, AAIR was slightly higher in males than females. The median ASIR was highest for HL (18.5/million) at 15-19 years for both genders. For NHL there were two peaks for ASIR: 11.1/million (1-4 years of age) and 13.2/million (15-19 years of age). The median ASIR for BL was highest among children aged 1-4 years (4.7/million) and in males. Higher SEI correlated with higher incidence of HL (P = 0.06), whereas rates of NHL and BL did not correlate with SEI. Borderline different incidence rates were observed in HL correlated with cities with higher SEIs. CONCLUSION: Incidence rates of lymphomas in Brazil do not differ compared to rates reported worldwide, although SES differences deserve further investigation.

Non-Hodgkin lymphoma in Chile: a review of 207 consecutive adult cases by a panel of five expert hematopathologists.

The distribution of subtypes of non-Hodgkin lymphoma (NHL) in Latin America is not well known. This Chilean study included 207 consecutive cases of NHL diagnosed at five cancer centers in the capital, Santiago, and one center in Viña del Mar. All cases were reviewed and classified independently by five expert hematopathologists according to the 2001 World Health Organization classification of NHL. A consensus diagnosis of NHL was reached in 195 of the 207 cases (94%). B-cell lymphomas constituted 88% of NHL, and diffuse large B-cell lymphoma (DLBCL, 38.5%) and follicular lymphoma (25.1%) were the most common subtypes. There was a high frequency of marginal zone B-cell lymphoma (10.3%), as well as of extranodal natural killer (NK)/T-cell lymphoma, nasal type (2.6%) and adult T-cell leukemia/lymphoma (0.5%). Extranodal presentation was seen in 74 of the 195 cases (38%) and the most common extranodal presentation was in the stomach (37.6%). The most common gastric lymphoma was DLBCL (54.5%) followed by mucosa-associated lymphoid tissue (MALT) lymphoma (41%). Overall, the frequency of NHL subtypes in Chile is between that reported in Western and Eastern countries, which is probably a reflection of the admixture of ethnicities as well as the environment and socioeconomic status of its population.

Lymphoma subtype incidence rates in children and adolescents: first report from Brazil

Lymphoma is the third most common pediatric malignancy. The purpose of this study was to analyze the incidence rates of lymphoma in children and adolescents in Brazil. All cases of Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), and Burkitt lymphoma (BL) were extracted from 14 population-based cancer registries (PBCRs) from 2000 to 2005, and included children and adolescents 0-19 years old. Analyses included age-adjusted incidence rates (AAIRs) and age-specific incidence rates (ASIRs) by each PBCR. A social exclusion index (SEI) was built and used as proxy for socioeconomic status (SES) levels. Correlations between SES and incidence rates were investigated using Spearman's test. The median incidence of lymphoma was 22.7/million. AAIRs of lymphomas varied from 12.9 (Salvador) to 34.5 per million (São Paulo). Median AAIR was 8.8/million, 9.8/million, and 2.9/million for NHL, HL, and BL, respectively. In all PBCRs except that of Recife, AAIR was slightly higher in males than females. The median ASIR was highest for HL (18.5/million) at 15-19 years for both genders. For NHL there were two peaks for ASIR: 11.1/million (1-4 years of age) and 13.2/million (15-19 years of age). The median ASIR for BL was highest among children aged 1-4 years (4.7/million) and in males. Higher SEI correlated with higher incidence of HL (P = 0.06), whereas rates of NHL and BL did not correlate with SEI. Borderline different incidence rates were observed in HL correlated with cities with higher SEIs. Incidence rates of lymphomas in Brazil do not differ compared to rates reported worldwide, although SES differences deserve further investigation

Experiencia de linfomas cutáneos entre enero de 1995 y abril de 2008 en el Instituto Nacional de Cancerología / Experience with cutaneous lymphomas between January 1995 and April 2008 at the National Cancer Institute

Objetivos: Describir los diferentes linfomas cutáneos conforme a la clasificación WHO- EORTC, observados en el Instituto Nacional de Cancerología (INC) entre el 1° de enero de 1995 y abril de 2008. Métodos: Estudio retrospectivo, descriptivo, donde se incluyó a los pacientes con diagnóstico de linfoma cutáneo en el INC desde enero de 1995 hasta abril de 2008. La ubicación de las historias clínicas se realizó utilizando la base de datos del Departamento de Patología. El análisis estadístico se realizó mediante el programa Epi info 2008. Resultados: Se revisaron 252 historias y se incluyó a 160 pacientes en el estudio: 139 linfomas T (87%) y 21 linfomas B (13%). El linfoma más común fue la micosis fungoide (63% de los casos). Dentro de las variantes descritas de micosis fungoide (MF) llamó la atención la frecuencia de MF hipopigmentadas (13%). El grupo de enfermedades linfoproliferativas CD30+ fue el segundo en frecuencia dentro de los linfomas T. En el grupo de linfomas B los linfomas indolentes de excelente pronóstico se presentaron en un 5% de los casos. Conclusiones: Los linfomas cutáneos primarios son tumores raros. Predominan los linfomas de células T sobre los B. La mayoría de los casos son linfomas de bajo grado, y deben tratarse con terapias dirigidas a la piel. Dentro de cada categoría existen linfomas que van a progresar y comprometer órganos internos.

Objectives: To describe different cutaneous lymphomas in accordance with WHO-EORTC classification under observation at the National Cancer Institute (NCI) between January 1, 1995 and April, 2008. Methods: A descriptive, retrospective study was carried out which included patients diagnosed with cutaneous lymphoma at the NCI from January 1995 until April 2008. Clinical cases were taken from Pathology Department data base. Statistical analysis was performed with Epi 2008 info program. Results: A total of 252 case histories were reviewed, and 160 patients were included in the study: 139 T-cell lymphomas (87%) and 21 B-cell lymphomas (13%). The most common (63% of cases) was mycosis fungoides (MF). Among the variations of MF described, the frequency of hypopigmented MF (13%) stood out. The lymphoproliferative CD30+ disease group was the second most frequent among T-cell lymphomas. In the B-cell lymphoma group, the indolent lymphomas with excellent prognosis made up 5% of cases. Conclusions: Primary cutaneous lymphomas are rare tumors. T-cell lymphomas predominate over B-cell. Most cases are low grade lymphomas and should be treated with skin therapies. Within each category, lymphomas exist that will progress and compromise internal organs.

Classification of non-Hodgkin lymphomas in Guatemala according to the World Health Organization system.

The aim of this study is to report the relative frequencies of non-Hodgkin lymphoma (NHL) subtypes in Guatemala. A panel of five hematopathologists reviewed 226 consecutive biopsies and classified them according to the 2001 World Health Organization (WHO) classification. The 83 cases of diffuse large B-cell lymphoma (DLBCL) were further subclassified into germinal center B-cell-like (GCB) and non-GCB subtypes. Of the 226 cases, 194 (86%) were confirmed as NHL, including 169 (87%) B-cell and 25 (13%) T- or natural killer (NK)-cell NHL. The most common subtype was DLBCL (44.3%), and the most frequent subtype among T- and NK-cell NHL was extranodal NK/T-cell lymphoma, nasal type (7.8% of all NHL). A comparison of the frequencies of NHL subtypes between Guatemala and other parts of the world showed that Guatemala is most similar to the Middle East and Asia. However, there is no significant difference in the frequency of the DLBCL subtypes compared to North America and Europe.

Linfoma no Hodgkin en pacientes con SIDA: una reflexión necesaria / Non-Hodking lymphoma in AIDS patients: a necessary reflection

El linfoma no Hodgkin constituye una de las 3 afecciones malignas marcadoras de SIDA reconocidas actualmente. Tanto en Cuba, como en el resto del mundo, en la última década se ha observado su incremento en pacientes infectados por el virus de la inmunodeficiencia humana (VIH). Por las razones anteriormente planteadas, se realizó una revisión bibliográfica actualizada del tema en revistas de alto impacto internacional, para describir los principales elementos de esta enfermedad (clasificación, epidemiología, evolución y tratamiento) y brindar, de esta forma, una guía para el trabajo de los profesionales de la atención primaria en el seguimiento de estos pacientes en la comunidad.

Linfoma: epidemiología y clasificación actual. Trabajo de actualización / Lymphoma: epidemiology and current classification

La incidencia del linfoma no-Hodgkin (LNH) ha aumentado aproximadamente un 80 por ciento desde la década de 1970 y ahora es el quinto tipo de cáncer más común en los Estados Unidos. La incidencia de LNH es aproximadamente un 50 por ciento más alta en hombres que en mujeres y un 35 por ciento más alta en la raza blanca que en la raza negraq. Las tasas de incidencia de todos los subtipos de LNH ha aumentado, especialmente el subtipo de célula grande difusa y el inmunoblástico. El aumento de la incidencia de LNH es poco comprendido. Los factores de riesgo arrojan resultados contradictorios: algunos de estos factores son: la herencia, la distribución geográfica, el tabaco, el alcohol, las enfermedades auatoinmunes, el medio ambiente, la exposición ocupacional, las tareas domésticas. Futuros estudios epidemiológicos deberían incorporar la nueva clasificación de la Organización Mundial de la Salud, basada en estudios genotípicos y fenotípicos para mejorar el diagnóstico de LNH.

Linfoma: epidemiología y clasificación actual. Trabajo de actualización / Lymphoma: epidemiology and current classification

La incidencia del linfoma no-Hodgkin (LNH) ha aumentado aproximadamente un 80 por ciento desde la década de 1970 y ahora es el quinto tipo de cáncer más común en los Estados Unidos. La incidencia de LNH es aproximadamente un 50 por ciento más alta en hombres que en mujeres y un 35 por ciento más alta en la raza blanca que en la raza negraq. Las tasas de incidencia de todos los subtipos de LNH ha aumentado, especialmente el subtipo de célula grande difusa y el inmunoblástico. El aumento de la incidencia de LNH es poco comprendido. Los factores de riesgo arrojan resultados contradictorios: algunos de estos factores son: la herencia, la distribución geográfica, el tabaco, el alcohol, las enfermedades auatoinmunes, el medio ambiente, la exposición ocupacional, las tareas domésticas. Futuros estudios epidemiológicos deberían incorporar la nueva clasificación de la Organización Mundial de la Salud, basada en estudios genotípicos y fenotípicos para mejorar el diagnóstico de LNH.(AU)

Linfoma No Hodgkin (LNH) asociado a SIDA en la cavidad bucal: reporte de caso clínico / AIDS-related Non-Hodgkin lymphoma in the oral cavity: report of a clinical case

El riesgo de Linfoma No Hodgkin (LNH) en las personas con infección por el Virus de Inmunodeficiencia Humana (VIH) es cien veces mayor respecto al resto de la población. La incidencia de estas neoplasias en hombres jóvenes en la década de los 80 aumentó veinte veces producto de la infección por el VIH. No obstante, en los últimos años, el Síndrome de Inmunodeficiencia Adquirida (SIDA) es factor de riesgo condicionante de una discreta proporción de los casos de LNH. Estos linfomas suelen presentarse en su mayoría de células B con histología de alto grado, principalmente del subtipo difuso de células grandes, con compromiso extraganglionar frecuente y principalmente en el sistema nervioso central (SNC). En general, el entorno clínico y la respuesta al tratamiento de los pacientes con linfoma relacionado con el SIDA son muy diferentes a los de los pacientes seronegativos con linfomas. El individuo con linfoma agresivo que presenta infección por VIH se presenta generalmente con enfermedad en etapa avanzada que suele ser extraganglionar. Su curso clínico es más agresivo, la enfermedad es más extensa y menos sensible a la quimioterapia. Presentamos un caso clínico de Linfoma No Hodgkin en cavidad bucal en un paciente con las características antes mencionadas que acudió al Centro de Atención a Pacientes con Enfermedades Infectoectocontagiosas "Elsa La Corte" - CAPEI de la Facultad de Odontología de la Universidad Central de Venezuela, referido por el Centro de Hematooncología de la misma universidad, del cual destacamos el manejo interdisciplinario médico-odontológico del mismo.

Non-Hodgkin's Lymphoma's risk (NHL) in the persons with infection for the Human of Immunodeficiency Virus (HIV) is hundred times major with regard to the rest of the population. The incidence of these neoplasms in young men, in the decade of the 80 increased twenty times product of the infection for the HIV. Nevertheless, in the last years, the Acquired Immunodeficiency Syndrome (AIDS) is a cause of a discreet proportion of NHL's cases. These lymphomas are in the habit of appearing in the main of cells B with histology of high degree, principally of the diffuse subtype of big cells, with extranodal frequent compromise and principally in the nervous central system (NCS). In general, the clinical environment and the response to the treatment of the patients with lymphoma related to the AIDS are very different from those of the HIV_negative patient with lymphomas. The individual with aggressive lymphoma that presents infection for HIV appears generally with disease in advanced stage that is in the habit of being extranodal. The clinical course is more aggressive, the disease is more extensive and less sensitive to the chemotherapy.We present Non-Hodgkin's Lymphoma's clinical case in oral cavity in a patient with the characteristics before mentioned that came to the Center of Attention to Patients with Infectious and Contagious Diseases "Dra. Elsa La Corte" of the Faculty of Odontolgy of the Central University of Venezuela, refered by Hematooncology's Center of the same university.

Contribution of immunohistochemistry to small B-cell lymphoma classification.

Although the small B-cell lymphomas show major morphologic overlapping, they have been recently shown to be distinct entities with several biologic and clinical differences. Therefore, the utility of a panel of paraffin-reactive antibodies in differentiating these neoplasms was investigated. Using clinical data and morphologic criteria, 134 cases of small B-cell lymphomas were grouped as those with (1) one strongly suggested diagnosis, (2) differential diagnosis between two types of lymphomas, and (3) small B-cell lymphoma without hints for further subclassification. With a panel of antibodies including CD5, CD10, CD23, CD43, bcl-2, and cyclin D1, most but not all cases could be precisely categorized. This panel confirmed the diagnosis in 96.5% of the cases from group 1. In group 2 it confirmed one of the two diagnoses in 81.5% of the cases. In group 3 it established a definitive diagnosis in 55% of the cases. When all groups were considered, a correct diagnosis could be established for 88.1% of cases; for 6.7% of them the authors remained with two possible diagnosis, and the broad "small B-cell lymphoma" was the only diagnosis for 5.2% of cases. CD10 separated most follicular lymphomas from other small B-cell lymphoid neoplasms. CD23 separated small lymphocytic lymphoma/chronic lymphocytic leukemia. Cyclin D1 separated mantle cell lymphoma. The present study selected CD10, CD23, and cyclin D1 as a minimal panel for the classification of small B-cell lymphomas, yielding a final diagnosis in 88.1% of the cases.

[Primary descending colon lymphoma: case communication]. / Linfoma primario de colon descendente: comunicación de un caso.

Primary colon lymphomas are very uncommon gastrointestinal tumors, more so in the descending colon. We would like to present this clinical entity with the case of a 33-year-old woman in order to inform them about the case of Primary colon lymphoma that was encountered and to review the literature. In her case, the diagnosis was suspected from the clinical symptoms, images and fiber endoscopy study. The diagnosis was confirmed by anatomopathology and inmunohistoquimic study. The woman was subjected to exploratory laparotomy and the final diagnosis was given to be high-grade MALT type Lymphoma B cells (Non-Hodgkins Lymphoma Big Cell) big cells) EII2.

Proliferation in non-Hodgkin's lymphomas and its prognostic value related to staging parameters.

In malignant lymphomas, cell kinetics has shown to be related with histologic type as well as with the clinical behaviour. The aim of our study was to investigate the relevance of cell proliferation parameters on overall survival in non-Hodgkin's lymphomas as well as their relationship with prognostic factors such as International Prognostic Index (IPI). We performed DNA-flow-cytometry (S-phase fraction and detection of DNA-aneuploidy) as well as cytologic examination and the AgNOR technique in material obtained by fine needle aspiration of lymph nodes at diagnosis. The majority of the patients were stage IV by Ann Arbor and intermediate risk by IPI (42/55). When analyzing all patients together, histologic type by the WHO classification, IPI and the presence of a DNA-aneuploid clone could not separate well patients with a different survival. For all patients, univariate Cox analysis revealed S-phase (SPF) and AgNOR parameters to be of prognostic value. In the multivariate analysis, however, only SPF remained in the final model. Yet, when stratifying for DNA-ploidy, only the total number of AgNORs/nucleus was an independent parameter. Looking only at the DNA-diploid cases, the AgNOR pattern remained the most important parameter, whereas for the DNA-aneuploid cases this was true for SPF. When studying patients with B large cell lymphoma separately, only DNA-ploidy was a prognostic factor. In summary, cell kinetic parameters reveal important prognostic information in NHL patients. Furthermore, DNA-aneuploidy seems to interfere with the analysis of the AgNOR pattern.

Envolvimento secundário pulmonar por linfomas e leucemias / Secondary lung involvement by lymphomas and leukemias

Estudamos o envolvimento secundário pulmonar por leucemias em estudo retrospectivo de 12 anos de autópsias. Descrevemos o padrão de infiltração pulmonar em 77 linfomas e 50 leucemias. Os linfomas apresentaram maior freqüência do padrão peribrônquico/ perivascular de infiltração. O padrão intersticial foi mais freqüente nas leucemias. Mais de um padrão de infiltração estavam presentes por paciente. Linfomas de Hodgkin apresentaram maior freqüência do padrão nodular em relação aos linfomas B e T. Linfomas T apresentaram maior freqüência de infiltração intersticial do que os linfomas B / We have studied the secondary lung involvement by lymphomas and leukemias in a retrospective 12-year autopsy study. We have described histological infiltration patterns in lymphomas and leukemias. Lymphomas showed peribronchial/perivascular infiltration pattern. Leukemias had more frequently interstitial pattern. More than one infiltration pattern was present per patient. Hodgkin lymphomas had increased frequency of nodular infiltration pattern than B or T cell lymphomas. T cell lymphomas had more frequent interstitial pattern than B cell lymphomas. Pleural and intrapulmonary lymphnode involvement was more frequent in lymphomas than in leukemias...