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1.
Intern Med ; 59(1): 61-65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31902909

RESUMO

We herein report a case with the rare combination of mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the stomach, autoimmune gastritis (AIG), autoimmune thyroiditis, autoimmune hemolytic anemia (AIHA), and systemic lupus erythematosus. A 68-year-old woman was diagnosed with gastric MALT lymphoma associated with Helicobacter pylori (H. pylori) infection and AIG. Complete remission of the MALT lymphoma was achieved by H. pylori eradication and radiotherapy. Three years after the diagnosis of MALT lymphoma, the patient developed AIHA and anti-nuclear and anti-Smith autoantibody-positive lupus serositis, which were successfully managed with prednisolone administration.


Assuntos
Anemia Hemolítica/complicações , Gastrite/complicações , Lúpus Eritematoso Sistêmico/complicações , Linfoma de Zona Marginal Tipo Células B/complicações , Tireoidite/complicações , Anemia Hemolítica/diagnóstico , Doenças Autoimunes , Biópsia , Endoscopia Gastrointestinal , Feminino , Mucosa Gástrica/patologia , Gastrite/diagnóstico , Gastrite/imunologia , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Pessoa de Meia-Idade , Radiografia Torácica , Tireoidite/diagnóstico
2.
Korean J Gastroenterol ; 74(6): 304-313, 2019 Dec 25.
Artigo em Coreano | MEDLINE | ID: mdl-31870136

RESUMO

The stomach is the most common primary site of an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type, which is characterized by an indolent clinical course. A diagnosis of gastric MALT lymphoma requires an endoscopic biopsy that should be confirmed by an experienced pathologist. Gastric MALT lymphoma shows a variable endoscopic appearance, including erosion, erythema, discoloration, atrophy, ulcer, and subepithelial lesion. The distribution is often multifocal. Therefore, clinical suspicion and multiple biopsies are essential for an accurate diagnosis. Gastric MALT lymphoma is almost invariably associated with a Helicobacter pylori (H. pylori) infection. H. pylori eradication therapy is the mainstay of treatment, which must be delivered to all patients regardless of the H. pylori infection status or stage. For patients who have failed to achieve remission following eradication therapy, radiotherapy or chemotherapy can be considered. Radiotherapy is an effective treatment modality for a localized stage and shows excellent outcomes. In the presence of disseminated or advanced disease, chemotherapy and/or immunotherapy with the anti-CD20 monoclonal antibody, rituximab, can be applied. Treatment should be individualized according to the stage and symptoms, as well as the patients' preference. Given that the clinical course of gastric MALT lymphoma is usually indolent, watchful waiting may be an adequate strategy in selected cases where scheduled follow-up is guaranteed.


Assuntos
Linfoma de Zona Marginal Tipo Células B/diagnóstico , Antibacterianos/uso terapêutico , Endoscopia do Sistema Digestório , Mucosa Gástrica/patologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Humanos , Linfoma de Zona Marginal Tipo Células B/complicações , Linfoma de Zona Marginal Tipo Células B/terapia , Radiação Ionizante , Rituximab/uso terapêutico
4.
Am J Case Rep ; 20: 1476-1481, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31588119

RESUMO

BACKGROUND Angioedema is a vascular reaction of the soft tissues or mucosa, with localized increased permeability of blood vessels. Patients with late-onset angioedema without urticaria have an increased risk of non-Hodgkin lymphoma. We present a case of late-onset angioedema that demonstrates that it is sometimes necessary to treat an indolent malignancy to address the symptoms of a secondary condition. CASE REPORT A 68-year-old man presented to the Emergency Department with distressing swelling of his tongue and lips. No urticaria was observed and the remainder of the physical examination was unremarkable. The patient's past medical history included chronic thrombocytopenia for the last 1.5 years, which had been asymptomatic. Routine laboratory testing revealed pancytopenia. The patient was referred to the Oncology Department, where he was diagnosed with splenic marginal zone lymphoma. A careful review of the patient's past medical history revealed 3 episodes of soft tissue swelling of the lower limbs and 2 episodes of unexplained colicky abdominal pain. The patient was started on maintenance therapy of danazol, which prevented further episodes of angioedema. He later underwent splenectomy to improve his pancytopenia and to treat his lymphoma. In the postoperative period, the patient discontinued the danazol therapy. Three months after the splenectomy, he was asymptomatic and had not had any further angioedema episodes, and his laboratory values showed he was in remission. CONCLUSIONS In this case, late-onset angioedema with recurrent episodes of soft tissue swelling was associated with underlying hematologic malignancy. The patient's angioedema resolved when the malignancy was treated.


Assuntos
Angioedema/etiologia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Neoplasias Esplênicas/diagnóstico , Idoso , Humanos , Linfoma de Zona Marginal Tipo Células B/cirurgia , Masculino , Esplenectomia , Neoplasias Esplênicas/cirurgia
5.
Adv Clin Exp Med ; 28(8): 1119-1124, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31414733

RESUMO

Although gastrointestinal (GI) tract is the most common extranodal site involved in non-Hodgkin lymphoma (NHL), primary gastrointestinal NHL (gNHL) is a rare problem which concerns about 10-15% of NHL patients and 30-40% of extranodal NHL patients. Lymphoid neoplasms may consist of mature B, T and (less commonly) extranodal NK/T cells. The most common diagnoses are diffuse large B-cell lymphoma and marginal zone lymphoma (MALT), but many other lymphomas may be found in the GI tract. There are a few well-known risk factors of gNHL and some of them affect treatment. The most frequent sites of occurrence are the stomach followed by small intestine and ileocecal region. In the last 2 decades, there has been a rapid development in the diagnosis, staging and management of GI lymphoma, but still some of such lymphomas, especially T-cell ones, are a therapeutic challenge. In this review, we present clinical and pathological features of GI lymphomas. We also describe the current status in diagnosis and treatment.


Assuntos
Neoplasias Gastrointestinais , Linfoma de Zona Marginal Tipo Células B , Linfoma Difuso de Grandes Células B , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/terapia , Humanos , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/terapia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/terapia
6.
Nihon Shokakibyo Gakkai Zasshi ; 116(8): 660-667, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31406071

RESUMO

An 82-year-old man with abdominal pain was admitted to our hospital. Laboratory tests revealed the following:white blood cells, 14300/µl;serum hemoglobin level, 12.9g/dl;serum C-reactive protein level, 0.38mg/dl;and negative anti-Helicobacter pylori immunoglobulin G test. Abdominal computed tomography revealed a tumor in the appendix along with multiple swollen lymph nodes. Colonoscopy revealed a submucosal tumor (SMT) of approximately 30mm in diameter with central ulceration. However, a tumor tissue specimen could not be obtained for biopsy;thus, the tumor could not be diagnosed. In esophagogastroduodenoscopy, abnormalities or gastric mucosal atrophy was not observed. A rapid urease test yielded negative results. Hence, endoscopic ultrasound-guided fine needle aspiration for the SMT was recommended;however, the patient preferred to undergo a definitive surgery to establish exact diagnosis. Therefore, right hemicolectomy and lymph node dissection (D3) were performed. Histopathologically, the resected tumor specimen showed atypical lymphocytes. Additionally, immunohistochemical evaluation demonstrated positive staining of the tumor cells for CD20 and BCL2 and negative staining for CD34, CD4, CD10, and BCL6. The tumor was finally diagnosed as a stage II2 mucosa-associated lymphoid tissue lymphoma (Lugano classification). Postoperatively, the patient received chemotherapy with four cycles of rituximab based on his age and activities of daily living.


Assuntos
Apendicite/diagnóstico , Apêndice , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Atividades Cotidianas , Idoso de 80 Anos ou mais , Helicobacter pylori , Humanos , Masculino
7.
Presse Med ; 48(7-8 Pt 1): 859-870, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31447331

RESUMO

Non-follicular small cell lymphomas include several entities whose clinical and pathological descriptions have been refined in the last 20 years. MALT lymphoma, developed at the expense of lymphoid tissue associated with the mucosa, is usually localized to a given organ, but can also disseminate. Some patients with MALT lymphoma can be treated by eradicating the associated infectious agent, whereas local treatment should be preferred for other cases ; disseminated forms and relapsed patients are eligible for anti-CD20 antibodies associated with cytotoxic agents. Patients with mantle cell lymphoma have benefited from many advances, including the use of cytarabine and bendamustine, anti-CD20 antibodies, intensive treatments (autograft) and recently targeted therapy (ibrutinib, inhibitor or the Bruton tyrosine kinase). Patients with splenic nodal marginal zone lymphomas should be evaluated for different options, of which immunochemotherapy remains important. For all these entities, the implementation of treatments may be delayed by several years for certain groups of patients. Although considered as incurable, the prognosis of these pathologies has improved significantly and the majority of patients will be able to live for many years with often treatment-free intervals.


Assuntos
Linfoma de Zona Marginal Tipo Células B , Fatores Etários , Idade de Início , Anticorpos Monoclonais/uso terapêutico , Diagnóstico Diferencial , Humanos , Imunoterapia/métodos , Imunoterapia/tendências , Linfoma de Zona Marginal Tipo Células B/classificação , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Linfoma de Zona Marginal Tipo Células B/terapia , Terapia de Alvo Molecular/métodos , Terapia de Alvo Molecular/tendências , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/terapia , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Prognóstico , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/epidemiologia , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/terapia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapia
8.
Dermatol Clin ; 37(4): 443-454, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31466585

RESUMO

Primary cutaneous B-cell lymphomas are a group of diseases with indolent and aggressive behavior. The goal of the initial workup is to evaluate for systemic involvement, provide adequate staging, and guide therapy. Histopathological studies are a critical part of the workup for classification of these lymphomas because they are similar to their nodal counterparts. There are limited data for treatment guidelines, and thus, therapy differs among institutions. Overall, localized therapies are preferred for indolent types and chemotherapy or immunotherapy for the aggressive forms.


Assuntos
Antineoplásicos/uso terapêutico , Procedimentos Cirúrgicos Dermatológicos , Linfoma de Células B/terapia , Neoplasias Cutâneas/terapia , Administração Cutânea , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bexaroteno/uso terapêutico , Borrelia burgdorferi , Ciclofosfamida/uso terapêutico , Procedimentos Cirúrgicos de Citorredução , Gerenciamento Clínico , Doxorrubicina/análogos & derivados , Doxorrubicina/uso terapêutico , Humanos , Injeções Intralesionais , Doença de Lyme/tratamento farmacológico , Linfoma de Células B/diagnóstico , Linfoma de Células B/patologia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/microbiologia , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/terapia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/terapia , Mecloretamina/uso terapêutico , Polietilenoglicóis/uso terapêutico , Prednisona/uso terapêutico , Rituximab/uso terapêutico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Vincristina/uso terapêutico
9.
Dermatol Online J ; 25(7)2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31450275

RESUMO

Epidermotropic B cell lymphoma represents a rare form of marginal zone lymphoma presenting as a disseminated skin rash resembling pityriasis rosea. To date there are 8 reported cases. In addition to the widespread nature of the skin rash, there is a proclivity for spleen and bone marrow involvement raising consideration regarding its categorization as a systemic lymphoma. We present an 89-year-old man with epidermotropic B cell lymphoma, who presented with a pityriasis rosea-like skin rash. An initial diagnosis of diffuse large cell B cell lymphoma was made based on the extent of dermal-based large cell infiltration. However, after recognizing the epidermotropic component and the distinctive clinical presentation, a diagnosis of epidermotropic B cell lymphoma was rendered. There was minimal bone marrow involvement based only on flow cytometric analysis, but there was no apparent bone marrow or splenic involvement on routine light microscopic assessment. Remission was = achieved with single agent rituximab chemotherapy and the patient remained symptom free. The neoplastic CD20 positive epidermotropic B lymphocytes expressed CXCR3. Similar to the prior reported cases by the authors, the neoplastic cells expressed CXCR3, a chemokine whose organ and tissue specific ligands could contribute to its relatively indolent clinicalcourse.


Assuntos
Linfoma de Zona Marginal Tipo Células B/diagnóstico , Pele/patologia , Idoso , Idoso de 80 Anos ou mais , Erros de Diagnóstico , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Linfoma de Zona Marginal Tipo Células B/patologia , Masculino , Pessoa de Meia-Idade , Receptores CXCR3/análise , Indução de Remissão , Neoplasias Esplênicas/diagnóstico
10.
Blood ; 134(10): 798-801, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31292118

RESUMO

Marginal zone lymphomas (MZLs) are indolent nonfollicular B-cell lymphomas (INFLs) and have heterogeneous clinical behavior. Recently, time to progression of disease at 24 months (POD24) was identified to stratify overall survival (OS) in follicular non-Hodgkin lymphoma and in INFL. Here, we examined the ability of POD24 to predict subsequent OS in a large, international cohort of MZL as part of the NF10 prospective international registry headed by Fondazione Italiana Linfomi (FIL). POD24 was only calculated for MZL patients requiring immediate therapy and was defined as experiencing lymphoma progression within 24 months from diagnosis. Among the 1325 patients enrolled in the NF10 study, we identified 321 patients with MZL for whom immediate therapy was planned right after lymphoma diagnosis. Overall, POD24 was confirmed in 59 patients (18%). Three-year OS for patients with POD24 was 53% with a hazard ratio of 19.5 (95% confidence interval, 8.4-45) compared with patients without POD24 (3-year OS, 95%). Association of POD24 with OS was confirmed for the subgroup of splenic and extranodal MZLs. Assessment of POD24 stratifies subsequent outcome in MZL and identifies a high-risk population. This trial was registered at www.clinicaltrials.gov as #NCT02904577.


Assuntos
Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/mortalidade , Linfoma de Zona Marginal Tipo Células B/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Linfoma de Zona Marginal Tipo Células B/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Análise de Sobrevida , Fatores de Tempo
11.
J UOEH ; 41(2): 225-230, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31292368

RESUMO

Case 1: A 81-year-old man was admitted to our hospital because of a mass shadow on chest x-ray examination. Chest computed tomography (CT) showed a 1.5 cm nodule in the middle lobe of the right lung. We suspected a primary lung cancer and performed video-assisted right middle lobectomy. Histopathological examination showed a white, elastic, hard and solid 30 × 10 × 10 mm nodule with infiltration of small-to-medium-sized lymphocytes that were positive for CD20 and CD79a, and negative for CD10 and Cyclin D1 in immunohistochemical staining. We diagnosed mucosa-associated lymphoid tissue (MALT) lymphoma. Case 2: A 67-year-old woman was admitted to our hospital because of a mass shadow in the right upper lobe on chest x-ray and chest CT. As the lesion had not grow in 1 year, the patient strongly wanted it resected, therefore we performed wedge resetion of the right upper lobe via video-assisted thoracic surgery. Histopathological examination showed a white, elastic, hard and solid 25 × 25 × 16 mm nodule with infiltration of small-to-medium-sized lymphocytes that had positive staining of CD20 and CD79a, and negative staining of CD10 and Cyclin D1. We diagnosed MALT lymphoma. Primary lung MALT lymphoma shows a variety of shadows on chest CT, similar to lung cancer and other inflammatory diseases. Local therapies such as surgery and radiation therapy are effective against early stage MALT lymphoma, but there is no consensus of a standard surgery.


Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/cirurgia , Radiografia Torácica , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Antígenos CD20/análise , Biomarcadores Tumorais/análise , Antígenos CD79/análise , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/patologia , Excisão de Linfonodo , Linfoma de Zona Marginal Tipo Células B/patologia , Masculino , Pneumonectomia/métodos , Toracoscopia
13.
Medicina (B Aires) ; 79(3): 208-211, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31284257

RESUMO

The lymphomas of mucosa-associated lymphoid tissue (MALT), are uncommon entities, of low grade of malignancy with very infrequent or no lymph node involvement. They represent about 80% of the primary pulmonary lymphomas. The synchronous appearance with lung adenocarcinoma is an extremely rare finding. We present the case of an ex-smoker 68-year-old man, in whom, in the follow-up of a pulmonary nodule, a second pulmonary nodule was found. The surgical biopsy confirmed the diagnosis of both neoplasms.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Adenocarcinoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/cirurgia , Idoso , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/cirurgia , Masculino , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Tomografia Computadorizada por Raios X
14.
Int J Surg Oncol ; 2019: 2912361, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31186956

RESUMO

This study examines survival time in patients with small bowel tumors and determines its contributing factors. In this retrospective analytical study, the medical records of 106 patients with small bowel cancer (from 2006 to 2011) were investigated. The patients' data were extracted, including age, gender, clinical presentation, location of tumor, histological type, grade of tumor, site of metastasis, and type of treatment. The Kaplan-Meier test was used to estimate the overall survival time and the Log-rank test to compare the survival curves. The Cox regression was also used to evaluate the effect of the confounding variables on survival time. This study was conducted on 106 patients with a median age of 60 years (Min: 7, Max: 87). The tumor types included adenocarcinoma (n=78, 73.6%), MALToma (n=22, 20.8%), neuroendocrine tumors (n=4, 3.8%), and sarcoma (n=2. 1.8%). Grade 3 adenocarcinomas had a significantly lower survival time (HR: 1.48, 95% CI: 0.46-2.86; P=.001). Combined therapy (chemotherapy and surgery) vs. single-therapy (only surgery) had no significant effects on the survival of the patients with MALToma (5 vs. 3 months, 95% CI: 1.89-5.26; P=.06). There were no significant differences between the survival time in adenocarcinoma and MALToma (12 vs. 20 months, 95% CI: 6.24-24.76; P=.49). Tumor grade was the only independent prognostic factor that affected survival in adenocarcinoma. The patients diagnosed with MALToma in the study also had a poor prognosis, and the type of treatment had no significant effect on their survival.


Assuntos
Adenocarcinoma/mortalidade , Neoplasias Intestinais/mortalidade , Intestino Delgado , Linfoma de Zona Marginal Tipo Células B/mortalidade , Tumores Neuroendócrinos/mortalidade , Sarcoma/mortalidade , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Seguimentos , Humanos , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/patologia , Neoplasias Intestinais/terapia , Estimativa de Kaplan-Meier , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/terapia , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/terapia , Prognóstico , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/patologia , Sarcoma/terapia , Análise de Sobrevida , Adulto Jovem
15.
Hematol Oncol ; 37 Suppl 1: 53-61, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187530

RESUMO

Pediatric-type follicular lymphoma (PTFL), pediatric nodal marginal zone lymphoma (pnMZL), and large B-cell lymphoma (LBCL) with IRF4 rearrangement have been introduced into the current World Health Organization (WHO) classification. They account for 5% to 10% of mature B-cell lymphomas in children and adolescents. Both PTFL and pnMZL predominantly affect male adolescents and usually present with localized lymphadenopathy in the head and neck region. The cells within the follicles of PTFL typically show high-grade cytology, IGH monoclonality and lack the t(14;18) chromosomal alteration. In contrast, pnMZL is characterized by progressive transformation of germinal center (PTGC)-like features and interfollicular proliferation of the cells with expansion of the marginal zones with diffuse areas. Watch and wait after complete resection seems an adequate therapy with chemotherapy restricted to incompletely resected disease. All children with PTFL and pnMZL reported, so far, survived. B-cell lymphomas presenting in the Waldeyer's ring are characterized by the expression of IRF4/MUM1 and often associated with IRF4 rearrangements. Because of the frequent diffuse component, treatment often follows current protocols for mature B-NHL. The prognosis is excellent.


Assuntos
Linfoma de Células B/diagnóstico , Adolescente , Fatores Etários , Biópsia , Criança , Terapia Combinada , Humanos , Imuno-Histoquímica , Fatores Reguladores de Interferon/genética , Fatores Reguladores de Interferon/metabolismo , Linfoma de Células B/epidemiologia , Linfoma de Células B/etiologia , Linfoma de Células B/terapia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Linfoma de Zona Marginal Tipo Células B/terapia , Linfoma Folicular/diagnóstico , Linfoma Folicular/epidemiologia , Linfoma Folicular/terapia , Técnicas de Diagnóstico Molecular , Gradação de Tumores , Estadiamento de Neoplasias , Resultado do Tratamento
17.
Int J Clin Oncol ; 24(12): 1620-1628, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31172332

RESUMO

BACKGROUND: Differentiation between primary ocular adnexal mucosa-associated lymphoid tissue (POA-MALT) lymphoma and reactive lymphoid hyperplasias sometimes may be difficult. We have examined the treatment-associated mortality of POA-MALT lymphoma after confirmed diagnosis and evaluated their proper treatments. PATIENTS AND METHODS: From 1991 through 2016, cases of POA-MALT lymphoma were retrospectively analyzed based on their pathological and molecular/immunological diagnoses. RESULTS: A total of 78 cases with POA-MALT lymphoma with a median age of 66 years were analyzed over median/mean observations of 6.4/7.1 years. Forty-four patients (56%) were diagnosed with IgH gene clonality and 10 patients (13%) were diagnosed with flow cytometric analysis in addition to the pathological decision. The rest (24 patients, 31%) were diagnosed employing pathological decisions of hemato-pathologists and clinical decisions. All patients, except cases of watchful waiting, achieved complete remission. After initial treatment, 68 patients (87%) presented disease-free during the observation period. As treatment, a radiotherapy-based strategy was followed with 15 patients (19%, group A). Immuno-chemotherapy was administered to 24 patients (31%, B). Surgical extraction only was selected for 36 patients (46%, C). Watchful waiting was selected with three patients (4%). Recurrence after the initial treatment was found in one patient (7%) out of A, in three patients (13%) out of B, and in six patients (17%) out of C, respectively. Progression-free survivals at 5 and 10 years were 100 and 100% in A, 95 and 75% in B, and 88 and 81% in C, respectively. The recurrence rates between the patients who were diagnosed with only pathological decision (n = 24) and the patients who were diagnosed with molecular and immunological procedures (n = 54) did not show any statistical differences. CONCLUSION: Our results indicate that radiotherapy-based treatment strategies for patients with POA-MALT lymphoma show a low rate of recurrence and may improve their prognosis even after the accurate diagnosis. However, contamination of the cases with reactive (polyclonal) lymphoid hyperplasia into those with MALT lymphoma should be carefully removed to avoid unnecessary treatment for malignancies that do not exist.


Assuntos
Neoplasias Oculares/diagnóstico , Neoplasias Oculares/terapia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias Oculares/mortalidade , Feminino , Humanos , Imunoterapia , Linfoma de Zona Marginal Tipo Células B/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Resultado do Tratamento
18.
Ann Hematol ; 98(8): 1981-1987, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31177299

RESUMO

Infection with Helicobacter pylori (H. pylori) is associated with an increased risk of gastric malignant lymphoma. The chronic inflammation of gastric mucosa by H. pylori infection induces lymphomagenesis. Although this chronic mucosal inflammation also results in atrophic gastritis, evidence supporting the possible significance of atrophic gastritis in gastric lymphomagenesis is scarce. Here, to evaluate the association between gastric mucosal atrophy and the risk of gastric lymphoma, we conducted a matched case-control study at Aichi Cancer Center focusing on the attribution of H. pylori infection status and pepsinogen (PG) serum levels. In total, 86 patients with gastric lymphoma (including 49 cases of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and 24 cases of diffuse large B cell lymphoma (DLBCL)) and 1720 non-cancer controls were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were assessed by conditional logistic regression analysis with adjustment for potential confounders. Results failed to show a statistically significant association between atrophic gastritis and the risk of gastric lymphoma. The adjusted ORs of positive atrophic gastritis relative to negative for overall gastric lymphoma, MALT lymphoma, DLBCL, and other lymphomas were 0.77 (95% CI 0.45-1.33), 0.65 (0.30-1.39), 1.03 (0.38-2.79), and 0.84 (0.22-3.29), respectively. In contrast, a positive association between overall gastric lymphoma and H. pylori infection was observed (OR = 2.14, 95% CI 1.30-3.54). A consistent association was observed for MALT lymphoma, DLBCL, and other lymphomas with ORs of 1.96 (1.00-3.86), 1.92 (0.74-4.95), and 5.80 (1.12-30.12), respectively. These findings suggest that H. pylori infection triggers gastric lymphoma but that epithelial changes due to atrophic gastritis do not inherently affect the development of gastric lymphoma.


Assuntos
Infecções por Helicobacter/diagnóstico , Helicobacter pylori/patogenicidade , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma não Hodgkin/diagnóstico , Neoplasias Gástricas/diagnóstico , Adulto , Idoso , Carcinogênese/patologia , Estudos de Casos e Controles , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite Atrófica/complicações , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/microbiologia , Gastrite Atrófica/patologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/fisiologia , Humanos , Japão , Modelos Logísticos , Linfoma de Zona Marginal Tipo Células B/etiologia , Linfoma de Zona Marginal Tipo Células B/microbiologia , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma Difuso de Grandes Células B/etiologia , Linfoma Difuso de Grandes Células B/microbiologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma não Hodgkin/etiologia , Linfoma não Hodgkin/microbiologia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pepsinogênio A/sangue , Fatores de Risco , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia
19.
Ophthalmic Plast Reconstr Surg ; 35(4): e92-e94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31219941

RESUMO

Langerhans cell histiocytosis (LCH) is a clonal neoplastic proliferation of Langerhans-type cells. Orbital LCH is infrequent, typically manifesting as an isolated lytic bony lesion with an adjacent soft tissue mass in a child. Isolated lacrimal gland involvement by LCH is extremely rare, with only 2 previously reported cases. The authors describe a 37-year-old woman with a 6-month history of painless right upper eyelid swelling and diffuse right lacrimal gland enlargement without bony changes on computed tomography scan. Excisional biopsy of the lacrimal gland demonstrated concurrent LCH, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, and increased IgG4-expressing plasma cells. Work-up was negative for systemic hematolymphoid malignancy and IgG4-related disease. This case illustrates the association between LCH, mucosa-associated lymphoid tissue lymphoma, and elevated IgG4 plasma cells in the lacrimal gland, and we review the emerging theories proposed to explain this phenomenon.


Assuntos
Histiocitose de Células de Langerhans/complicações , Imunoglobulina G/imunologia , Doenças do Aparelho Lacrimal/complicações , Aparelho Lacrimal/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/complicações , Plasmócitos/imunologia , Adulto , Biópsia , Feminino , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/imunologia , Humanos , Imunoglobulina G/metabolismo , Doenças do Aparelho Lacrimal/diagnóstico , Doenças do Aparelho Lacrimal/imunologia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/imunologia , Plasmócitos/patologia , Tomografia Computadorizada por Raios X
20.
Lupus ; 28(8): 923-936, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31215845

RESUMO

Sjögren syndrome is a systemic autoimmune disease that principally affects women between the fourth and sixth decades of life who present with sicca symptomatology caused by dryness of the main mucosal surfaces. The clinical spectrum of Sjögren syndrome extends from dryness to systemic involvement. Since 1978, Sjögren syndrome has been closely associated with an enhanced risk of lymphoma, one of the most severe complications a patient may develop. Primary Sjögren syndrome patients have a 10-44-fold greater risk of lymphoma than healthy individuals, higher than that reported for systemic lupus erythematosus and rheumatoid arthritis. The close link between lymphoma and Sjögren syndrome is clearly exemplified by the very specific type of lymphoma arising in Sjögren syndrome patients, mainly low-grade B-cell lymphomas (predominantly a marginal zone histological type) with primary extranodal involvement of the major salivary glands (overwhelmingly parotid), with a primordial role of cryoglobulinemic-related markers (both clinical and immunological). The most recent studies support a higher number of risk factors detected in an individual leads to a higher lymphoma risk. A close follow-up of high-risk groups with longitudinal assessments of all known risk factors, including cryoglobulin-related markers and EULAR Sjögren's syndrome disease activity index measurement in particular, is mandatory.


Assuntos
Biomarcadores Tumorais , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/etiologia , Síndrome de Sjogren/complicações , Progressão da Doença , Humanos , Fatores de Risco , Glândulas Salivares/patologia , Síndrome de Sjogren/epidemiologia , Síndrome de Sjogren/imunologia
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