Subject(s)
Clinical Laboratory Techniques , Education, Medical , Infections/blood , Infections/diagnosis , Adult , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Burkitt lymphoma is a high-grade B cell lymphoma which accounts for less than 1% of all adult cases of non-Hodgkin lymphoma. Rare instances of Burkitt lymphoma developing secondary to prior irradiation have been described in the literature. CASE PRESENTATION: We report a case of a 90-year-old white woman with a recent history of irradiation for Hodgkin lymphoma, who presented with primary Burkitt lymphoma of the supraglottic larynx. She underwent emergency awake tracheostomy with biopsy. A histopathological examination confirmed non-Hodgkin, B cell lymphoma of Burkitt type. Given her age and poor functional status, she underwent treatment with palliative radiotherapy. CONCLUSIONS: A literature review was performed to clarify the clinical characteristics of radiation-induced Burkitt lymphoma in the head and neck, as well as its diagnosis and management. The present case represents the second case of radiation-induced Burkitt lymphoma in the head and neck in the reported literature, and the first in the supraglottic larynx. It highlights the need to maintain a broad differential in the assessment of malignancies of the larynx, particularly in patients with a prior history of radiation treatment.
Subject(s)
Burkitt Lymphoma/pathology , Hodgkin Disease/radiotherapy , Laryngeal Neoplasms/pathology , Larynx/pathology , Neoplasms, Radiation-Induced/pathology , Aged, 80 and over , Burkitt Lymphoma/therapy , Fatal Outcome , Female , Humans , Laryngeal Neoplasms/diagnostic imaging , Neoplasms, Radiation-Induced/therapy , Tomography, X-Ray ComputedSubject(s)
Central Nervous System Neoplasms/diagnosis , Epstein-Barr Virus Infections/diagnosis , Killer Cells, Natural/pathology , Leukemia, Prolymphocytic, T-Cell/diagnosis , Antineoplastic Agents/therapeutic use , Central Nervous System Neoplasms/cerebrospinal fluid , Central Nervous System Neoplasms/drug therapy , Central Nervous System Neoplasms/pathology , Epstein-Barr Virus Infections/cerebrospinal fluid , Epstein-Barr Virus Infections/drug therapy , Epstein-Barr Virus Infections/pathology , Fatal Outcome , Herpesvirus 4, Human/pathogenicity , Herpesvirus 4, Human/physiology , Humans , Killer Cells, Natural/drug effects , Killer Cells, Natural/metabolism , Leukemia, Prolymphocytic, T-Cell/cerebrospinal fluid , Leukemia, Prolymphocytic, T-Cell/drug therapy , Leukemia, Prolymphocytic, T-Cell/pathology , Magnetic Resonance Imaging , Male , Middle Aged , Recurrence , Spine/drug effects , Spine/innervation , Spine/pathology , T-Lymphocytes/drug effects , T-Lymphocytes/metabolism , T-Lymphocytes/pathologySubject(s)
Anemia, Refractory, with Excess of Blasts/drug therapy , Antimetabolites, Antineoplastic/adverse effects , Azacitidine/adverse effects , Mastocytosis, Systemic/chemically induced , Aged , Anemia, Refractory, with Excess of Blasts/pathology , Antimetabolites, Antineoplastic/therapeutic use , Azacitidine/therapeutic use , Fatal Outcome , Humans , Male , Mastocytosis, Systemic/pathologySubject(s)
Bone Marrow/pathology , Leukemia, Mast-Cell/diagnosis , Leukemia, Myeloid/diagnosis , Mast Cells/pathology , Mastocytosis, Systemic/diagnosis , Adult , Clone Cells/pathology , Diagnosis, Differential , Diagnostic Errors , Disease Progression , Fatal Outcome , Female , Humans , Infections/etiology , Karyotyping , Leukemia, Mast-Cell/blood , Leukemia, Mast-Cell/genetics , Leukemia, Mast-Cell/pathology , Leukemia, Myeloid/blood , Leukemia, Myeloid/complications , Leukemia, Myeloid/genetics , Leukemia, Myeloid/pathology , Male , Mastocytosis, Systemic/blood , Mastocytosis, Systemic/complications , Mastocytosis, Systemic/genetics , Mastocytosis, Systemic/pathology , Middle Aged , Myelodysplastic Syndromes/diagnosis , Myelopoiesis , Neoplastic Stem Cells/pathology , Staining and Labeling , Urticaria/etiologyABSTRACT
A recent phase III trial comparing granulocyte colony-stimulating factor (G-CSF)-stimulated bone marrow (G-BM) and G-CSF-mobilized peripheral blood (G-PB) in matched sibling allograft recipients showed that G-BM produced a similar hematologic recovery but a reduced incidence of extensive chronic graft-versus-host disease, indicating differences in the cell populations infused. As a first step toward identifying these differences, we treated a group of healthy adult humans with 4 daily doses of G-CSF 10 microg/kg and monitored the effects on various hematopoietic and immune cell types in the PB and BM over 12 days. G-CSF treatment caused rapid and large but transient increases in the number of circulating CD34+ cells, colony-forming cells, and long-term culture-initiating cells and in the short-term repopulating activity detectable in nonobese diabetic/severe combined immunodeficiency/beta2-microglobulin-null mice. Similar but generally less marked changes occurred in the same cell populations in the BM. G-CSF also caused transient perturbations in some immune cell types in both PB and BM: these included a greater increase in the frequency of naive B cells and CD123+ dendritic cells in the BM. The rapidity of the effects of G-CSF on the early progenitor activity of the BM provides a rationale for the apparent equivalence in rates of hematologic recovery obtained with G-BM and G-PB allotransplants. Accompanying effects on immune cell populations are consistent with a greater ability of G-BM to promote tolerance in allogeneic recipients, and this could contribute to a lower rate of chronic graft-versus-host disease.
