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2.
World Neurosurg ; 133: 49-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31562973

RESUMO

BACKGROUND: Subdural lymphomas are a rare subtype of primary central nervous system lymphomas that can radiographically mimic epidural blood and pose a diagnostic challenge. They can complicate treatment if not preemptively identified. METHODS: We present a case report of a subdural lymphoma that mimicked a compressive subdural hematoma, and we review the PubMed database for similar cases. RESULTS: A 77-year-old woman presented with a transient left facial droop and what appeared to be a subdural hematoma on computed tomography scan. The patient underwent surgery, during which grossly abnormal solid epicortical adherent tissue was noted instead of the expected appearance of a subdural hematoma. An intraoperative biopsy was suggestive of lymphoma, and the surgery was converted to a craniectomy. Pathology confirmed the diagnosis of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. The patient underwent radiotherapy with no complications or recurrence. Magnetic resonance imaging demonstrated complete resolution of the mass at 3 months after treatment, at which time the patient underwent a synthetic cranioplasty. Seven case reports of primary dural lymphomas mimicking subdural blood were found, with variable pathologic subclassifications. CONCLUSIONS: Although rare, a primary dural lymphoma can be mistaken for a subdural hematoma on computed tomography scan. The most common subtype is low-grade extranodal marginal zone lymphomas. It is important to keep these diseases in the differential diagnosis, especially when there is incongruence between imaging and the clinical picture, as earlier detection correlates to a stronger therapeutic response.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Paralisia Facial/diagnóstico por imagem , Hematoma Subdural/diagnóstico por imagem , Linfoma de Células B/diagnóstico por imagem , Idoso , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/cirurgia , Craniotomia , Diagnóstico Diferencial , Paralisia Facial/etiologia , Paralisia Facial/cirurgia , Feminino , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/cirurgia , Imagem por Ressonância Magnética , Espaço Subdural/diagnóstico por imagem , Espaço Subdural/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
BMJ Case Rep ; 12(5)2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31151968

RESUMO

Severe combined immunodeficiency (SCID) is an extremely rare disease caused by a disruption in the forkhead box N1 (FOXN1) gene, with an incidence of <1 per 1 000 000 live births. We report a boy aged 4 months who presented with a history of fever for 3 weeks and enlarged lymph nodes. The fever was associated with dry cough and runny nose. On physical examination, we noted oral thrush, generalised lymphadenopathy, nail dystrophy and alopecia. Flow cytometry of lymph node biopsy showed high-grade B-cell lymphoma. In addition, Epstein-Barr virus (EBV) infection was documented by PCR. The diagnosis of SCID was made by genetic testing, which revealed a homozygous variant of the FOXN1 gene. The variant was confirmed with Sanger sequencing. Management of EBV infection and lymphoma was initiated; unfortunately, the patient passed away on day 45 of hospitalisation.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Fatores de Transcrição Forkhead/deficiência , Linfoma de Células B/complicações , Imunodeficiência Combinada Severa/complicações , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/diagnóstico , Evolução Fatal , Fatores de Transcrição Forkhead/genética , Herpesvirus Humano 4 , Humanos , Lactente , Masculino , Imunodeficiência Combinada Severa/diagnóstico , Imunodeficiência Combinada Severa/genética
6.
J Stroke Cerebrovasc Dis ; 28(9): e132-e134, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31239223

RESUMO

Intravascular lymphomatosis (IVL) is a rare subtype of large B-cell lymphoma that follows an aggressive course with rapidly progressive neurological involvement and potentially fatal outcome.1 We report on a 64-year-old man with progressive myelopathy at T6-T7 and recurrent cerebral infarctions. This case is illustrative of the clinical course that is seen in IVL. It aims to present a timeline of imaging findings that demonstrate the progression of disease and characteristic pathology findings. We emphasize the importance of IVL on the differential diagnosis of spinal cord infarction.


Assuntos
Isquemia Encefálica/etiologia , Infarto/etiologia , Linfoma de Células B/complicações , Medula Espinal/irrigação sanguínea , Acidente Vascular Cerebral/etiologia , Neoplasias Vasculares/complicações , Biópsia , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/patologia , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Progressão da Doença , Evolução Fatal , Humanos , Infarto/diagnóstico por imagem , Infarto/patologia , Linfoma de Células B/diagnóstico por imagem , Linfoma de Células B/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recidiva , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/patologia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia
7.
PLoS One ; 14(5): e0217161, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31120924

RESUMO

Emerging evidences indicate that hepatitis B virus (HBV) infection is associated with non-Hodgkin lymphoma (NHL), but the mechanisms of HBV-induction lymphomagenesis remain unclear. In this report, retrospective analysis of the prevalence of hepatitis B surface antigen (HBsAg) among NHL cases demonstrated significantly higher HBsAg carrier rate among B-cell NHL cases than controls (other cancers except primary liver cancer) (adjusted odds ratio, 1.56; 95% confidence interval, 1.13-2.16). Furthermore, cells with an immortalization potential existed in the peripheral blood of 4 patients with chronic HBV infection. Characterization of these cells showed their immunophenotypes similar to that of the majority of HBsAg-positive B-cell NHL patients. Immunoglobulin (Ig) gene rearrangements confirmed the clonal Ig gene rearrangements. Cytogenetic analysis revealed abnormal karyotypes of these cells with an immortalization potential. Compared with cells with an immortalization potential that we previously found in B-cell NHL patients by the same way, these cells showed many similar features. In conclusion, cells with an immortalization potential existed in the part of patients with chronic HBV infection before lymphoma development and showed some malignant features. They may be the cellular basis of HBV-associated lymphomagenesis.


Assuntos
Linfócitos B/patologia , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Linfoma de Células B/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Linfócitos B/virologia , Estudos de Casos e Controles , Técnicas de Cultura de Células , Transformação Celular Viral , Células Cultivadas , China/epidemiologia , Células Clonais , Feminino , Hepatite B/transmissão , Humanos , Linfoma de Células B/virologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto Jovem
8.
Int J Hematol ; 110(1): 77-85, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31127456

RESUMO

This multicenter phase II study (UMIN000008145) aims to investigate the efficacy and safety of six cycles of combination therapy (RBD) comprising rituximab, bendamustine, and dexamethasone (DEX) for relapsed or refractory (RR) indolent B-cell non-Hodgkin lymphoma (B-NHL) and mantle cell lymphoma (MCL). Although the initial study protocol comprised 20 mg/body DEX on days 1 and 2, and 10 mg/body on days 3-5 [high-dose (HD-) DEX group], the dose of DEX was later decreased to 8 mg/body on days 1 and 2 [low-dose (LD-) DEX group] due to frequent cytomegalovirus (CMV) antigenemia and recurrent retinitis. We enrolled 33 patients, and LD-DEX and HD-DEX were administered in 15 and 18 patients, respectively. The overall response and the 3-year progression-free survival rates were 88% and 75.5%, respectively. The leading adverse event was myelosuppression. Incidence of grade 3-4 leukocytopenia, neutropenia, and lymphocytopenia was 55%, 67%, and 91%, respectively. The most frequent nonhematological adverse events were CMV antigenemia and rash (33% and 30%, respectively). Incidence of CMV antigenemia over 10/100,000 white blood cells was significantly lower with LD-DEX than that with HD-DEX (P = 0.0127). In conclusion, RBD showed significant effectiveness for RR indolent B-NHL and MCL.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma de Células B/tratamento farmacológico , Linfoma de Célula do Manto/tratamento farmacológico , Terapia de Salvação/métodos , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cloridrato de Bendamustina/administração & dosagem , Infecções por Citomegalovirus/etiologia , Dexametasona/administração & dosagem , Dexametasona/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Leucopenia/etiologia , Linfoma de Células B/complicações , Linfoma de Célula do Manto/complicações , Masculino , Pessoa de Meia-Idade , Neutropenia/etiologia , Rituximab/administração & dosagem , Terapia de Salvação/efeitos adversos , Adulto Jovem
14.
Dermatol Online J ; 25(12)2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-32045164

RESUMO

Elephantiasis nostras verrucosa is a progressively debilitating and disfiguring disease commonly presenting with verrucous, cobblestone-like papules, nodules, or plaques with nonpitting edema in the lower extremities. Histopathology is marked by hyperkeratosis and dermal or subcutaneous fibrosis as a result of chronic lymphedema. Risk factors include obesity, recurrent cellulitis, chronic venous insufficiency, congestive heart failure, scleroderma, radiation, trauma, and tumors. We report a 72-year-old man who presented to the dermatology clinic for an 11-year history of edematous legs, occasionally associated with ulcerations. The findings developed within a year of intrapelvic non-Hodgkin lymphoma and progressed gradually over 10 years after lymphoma remission. Physical examination revealed atypical features including compressible cysts and pitting edema extending from the lower legs to the thighs bilaterally. The patient was noncompliant for the recommended compressive devices and the condition progressively worsened over the course of 7 months of follow-up. Early interdisciplinary management using compressive devices and a lymphatic pump are recommended. Underlying causative factors should be assessed with regular follow-up to optimize treatment outcomes.


Assuntos
Elefantíase/etiologia , Perna (Membro)/patologia , Linfoma de Células B/complicações , Idoso , Elefantíase/diagnóstico por imagem , Elefantíase/patologia , Humanos , Perna (Membro)/diagnóstico por imagem , Masculino , Cooperação do Paciente , Ultrassonografia
15.
BMJ Case Rep ; 11(1)2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30567252

RESUMO

Among lung malignancies, primary pulmonary lymphoma is rare and many of them are indolent B-cell lymphomas. We describe a case of primary pulmonary indolent B-cell lymphoma with plasmacytic differentiation, which exacerbated with the manifestation of macroglobulinaemia and was successfully treated using chemotherapy. The patient subsequently developed pulmonary cysts and thrombocytopaenia due to autoimmune pathology and was successfully treated using prednisolone. This case suggests that in indolent B-cell lymphoma with plasmacytic differentiation, immunoglobulin M level should be carefully followed even if it is within the normal range at lymphoma onset. Additionally, new cystic pulmonary infiltrates that develop during the post-treatment follow-up of an indolent pulmonary B-cell lymphoma may indicate pulmonary lymphoma recurrence, but there is also a possibility of an immunological complication.


Assuntos
Antineoplásicos/efeitos adversos , Cistos/induzido quimicamente , Pneumopatias/induzido quimicamente , Neoplasias Pulmonares/tratamento farmacológico , Linfoma de Células B/tratamento farmacológico , Púrpura Trombocitopênica Idiopática/induzido quimicamente , Idoso , Diferenciação Celular , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Linfoma de Células B/complicações , Linfoma de Células B/patologia , Masculino , Plasmócitos , Macroglobulinemia de Waldenstrom/etiologia
16.
Mymensingh Med J ; 27(4): 888-893, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30487511

RESUMO

Lymphomas are group of malignant neoplasm having origins from lymphoreticular cells. B cell Non Hodgkin Lymphoma (BNHL) of sphenoid sinus as primary site for lymphomas are very rare and whenever involves comes usually with ocular manifestations. The proximity of the lesion to optic nerve and cavernous sinus present a high risk of developing unilateral ophthalmoplegia or even blindness. The vast majority of cases of localized sphenoid sinus lymphomas are usually curable to surgery, chemotherapy alone or combination of both, sometimes radiotherapy. Here we report a case of 58 years old male attended at Bangabandhu Sheikh Mujib Medical University (BSMMU) on 9th February 2017 at 9:00 AM having headache and gradually developing ptosis in left eye over 15 days. MRI of brain revealed homogeneously enhancing lesion occupying sphenoid sinus, clivus extending towards left cavernous sinus. Gross total resection of tumor was achieved by endoscopic endonasal approach. Histopathology revealed non-Hodgkin lymphoma and immunohistochemically it was positive for CD 20, CD 45, CD 79 and BCL 2, strongly compatible with diffuse large B cell lymphoma. Treatment with R-CHOP regimen following surgery resulted in initiation of improvement of the condition of the patient. Primary B cell Non-Hodgkin Lymphoma (PBNHL) of the sphenoid sinus is a rare entity which can be perplexing and misleading for a surgeon until the histopathological proof is in hand. Early diagnosis with strong suspicion of sphenoid lymphoma in mind during workouts and timely management, close monitoring and follow ups have high potential for cure and longer disease-free survival of the BNHL patients.


Assuntos
Seio Cavernoso , Linfoma de Células B , Linfoma não Hodgkin , Seio Esfenoidal , Seio Cavernoso/patologia , Fossa Craniana Posterior , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologia , Seio Esfenoidal/patologia
18.
BMC Nephrol ; 19(1): 224, 2018 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-30200898

RESUMO

BACKGROUND: Paraneoplastic glomerulonephritis is rare in haematological malignancies and tends to manifest as minimal change disease, membranous glomerulonephritis or membranoproliferative glomerulonephritis. We present the first report of immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in a patient with asymptomatic low grade B-cell lymphoma. CASE PRESENTATION: A 53 year old gentleman presented with nephrotic range proteinuria (urine protein creatinine ratio of 662 mg/mmol) on a background of type 2 diabetes mellitus (glycosylated haemoglobin: < 6%), hypertension, obesity (body mass index: 47.6 kg/m2) and degenerative spine disease. Bone marrow biopsy diagnosed a low grade B-cell lymphoma and renal biopsy was consistent with immunoglobulin A nephropathy. Lymphoma treatment with six cycles of cyclophosphamide/ rituximab/ prednisolone led to normalisation of urinary protein excretion (urine protein creatinine ratio: 14 mg/mmol at 26 months post-chemotherapy). CONCLUSION: Paraneoplastic immunoglobulin A nephropathy can occur with a broad range of haematological malignancies regardless of stage. This case illustrates the importance of meticulous haematological system work-up for patients presenting with immunoglobulin A nephropathy. Recognition of paraneoplastic immunoglobulin A nephropathy and early diagnosis of associated malignancy can be life-saving.


Assuntos
Doenças Assintomáticas , Glomerulonefrite por IGA/diagnóstico , Glomerulosclerose Segmentar e Focal/diagnóstico , Linfoma de Células B/diagnóstico , Glomerulonefrite por IGA/complicações , Glomerulonefrite por IGA/urina , Glomerulosclerose Segmentar e Focal/complicações , Glomerulosclerose Segmentar e Focal/urina , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/urina , Masculino , Pessoa de Meia-Idade
19.
J Cancer Res Ther ; 14(Supplement): S694-S700, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30249889

RESUMO

Objective: The objective of this paper was to reveal hub pathways in primary mediastinal B-cell lymphoma (PMBL) based on multiple pathway crosstalk networks (PCNs) and give insight for its pathological mechanism. Materials and Methods: Based on gene expression data, pathway data and protein-protein interaction data, background PCN (BPCN) and tumor PCN (TPCN) of PMBL were constructed. The rank product algorithm was implemented to identify hub pathways of BPCN and TPCN. Finally, topological properties (degree, closeness, betweenness, and transitivity) of hub pathways were analyzed. Results: For BPCN, there were three hundred nodes and 42,239 edges, and the pathway pairs had great overlaps. TPCN was composed of 281 nodes and 12,700 cross-talks. A total of five hub pathways were identified, nonalcoholic fatty liver disease (NAFLD), tuberculosis, human T-lymphotropic virus type-I (HTLV-I) infection, hepatitis B, and Epstein-Barr virus infection. The topological properties for them were different from each other, further between PMBL and normal controls. Conclusion: We have identified five hub pathways for PMBL, such as NAFLD, HTLV-I infection, and Hepatitis B, which might be potential biomarkers for target therapy for PMBL.


Assuntos
Biomarcadores Tumorais/genética , Linfoma de Células B/genética , Neoplasias do Mediastino/genética , Mapas de Interação de Proteínas/genética , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/genética , Infecções por Vírus Epstein-Barr/virologia , Regulação Neoplásica da Expressão Gênica/genética , Redes Reguladoras de Genes/genética , Infecções por HTLV-I/complicações , Infecções por HTLV-I/genética , Infecções por HTLV-I/virologia , Hepatite B/complicações , Hepatite B/genética , Hepatite B/virologia , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/epidemiologia , Linfoma de Células B/virologia , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/epidemiologia , Neoplasias do Mediastino/virologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/virologia , Transdução de Sinais/genética , Tuberculose/complicações , Tuberculose/genética , Tuberculose/virologia
20.
BMJ Case Rep ; 20182018 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-30150351

RESUMO

A 49-year-old woman, known case of diffuse large B-cell lymphoma, presented with complaints of floater in both eyes since 3 days. On examination, visual acuity was 0.18 logMAR in both eyes. Indirect ophthalmoscopy revealed presence of vitreous clumps. Vitreous biopsy was done and the histopathological report suggested a diagnosis of ocular lymphoma. The patient was treated with weekly injections of intravitreal methotrexate in both eyes. The patient developed severe photophobia, watering, redness and diminution of vision in the both eyes 2 days following the fifth dose of intravitreal methotrexate. Severe limbitis with annular corneal epitheliopathy and corneal haze was noted on slit-lamp examination. The patient was started on topical lubricants, antibiotic, ciclosporin, loteprednol, folinic acid and oral folic acid. Complete resolution was noted at 2-week follow-up. The patient, however, refused further injections and was kept on close follow-up to look for recurrence of the disease.


Assuntos
Doenças da Córnea/induzido quimicamente , Epitélio Anterior/efeitos dos fármacos , Lubrificantes Oftálmicos/administração & dosagem , Linfoma de Células B/tratamento farmacológico , Metotrexato/efeitos adversos , Soluções Oftálmicas/administração & dosagem , Doenças da Córnea/tratamento farmacológico , Doenças da Córnea/patologia , Epitélio Anterior/patologia , Feminino , Humanos , Injeções Intravítreas , Linfoma de Células B/complicações , Linfoma de Células B/fisiopatologia , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Resultado do Tratamento , Acuidade Visual , Corpo Vítreo
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