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1.
Medicine (Baltimore) ; 99(38): e22062, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957327

RESUMO

RATIONALE: Primary central nervous system lymphoma (PCNSL) involving the choroid plexus is exceedingly rare. The differential diagnosis for choroid plexus enhancing lesions in addition to lymphoma includes infections, sarcoidosis, tuberculosis, papilloma, meningioma, subependymoma, and metastatic lesions. PATIENT CONCERNS: A 71-year-old man presented with 3 days of episodic memory loss and gait disturbance. Brain magnetic resonance imaging showed homogenously enhancing lesions with mildly restricted diffusion and T2 hypointensity in the lateral ventricles, as well as T2 hyperintensity and enhancement in the right hippocampus. His episodic memory loss was thought to be secondary to subclinical focal seizures, supported by EEG revealing right temporal lobe epileptiform discharges. DIAGNOSES: Large B-cell lymphoma, nongerminal center type was revealed on pathological examination. INTERVENTIONS: Stereotactic biopsy of his right thalamic lesion was performed. OUTCOMES: The patient underwent induction therapy with high-dose methotrexate, temozolomide, and rituximab, which resulted in complete resolution of the enhancing lesions. He then underwent conditioning chemotherapy with carmustine and thiotepa, followed by autologous stem cell transplantation. His PCNSL remains in remission 42 weeks after the onset of symptoms. LESSONS: We report a patient with multifocal PCNSL involving the choroid plexus, who presented with abnormal gait and episodic confusion and memory loss. PCNSL should be considered in the differential diagnosis of acute encephalopathy among immunocompetent older individuals who have choroid plexus enhancing lesions.


Assuntos
Neoplasias do Sistema Nervoso Central/diagnóstico , Linfoma não Hodgkin/diagnóstico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Neoplasias do Sistema Nervoso Central/terapia , Diagnóstico Diferencial , Eletroencefalografia , Transplante de Células-Tronco Hematopoéticas , Humanos , Linfoma não Hodgkin/terapia , Imagem por Ressonância Magnética , Masculino
2.
PLoS One ; 15(7): e0235786, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639975

RESUMO

In front-line treatment of diffuse large B-cell lymphoma (DLBCL), prior studies suggest that concordant but not discordant involvement of the bone marrow (BM) portends a poor prognosis. The prognostic impact of bone marrow infiltration (BMI) in recurrent or refractory DLBCL (r/rDLBCL) and transformed indolent lymphoma (r/rTRIL) patients is less clear. Thus, we examined the prognostic significance of the infiltration of bone marrow (BMI) by concordant, large B-cells (conBMI) and discordant, small B-cells (disBMI) in this patient group. We performed a single center retrospective analysis of the prognostic impact of BMI diagnosed before start of second-line treatment as well as multiple clinicopathologic variables in 82 patients with r/rDLBCL or r/rTRIL intended to treat with autologous SCT. Twenty-five of 82 patients (30.5%) had BMI. Out of these, 19 (76%) had conBMI and 6 (24%) had disBMI. In patients with conBMI but not disBMI, uni- and multivariate analysis revealed inferior progression free survival (PFS) and overall survival (OS) compared to patients without BMI (median PFS, 9.2 vs 17.45 months, log rank: p = 0.049; Hazard Ratio, 2.34 (Confidence Interval, 1.24-4.44), p = 0.009; median OS 14.72 vs 28.91 months, log rank: p = 0.017; Hazard Ratio, 2.76 (Confidence Interval, 1.43-5.31), p = 0.002). ConBMI was strongly associated with nonGCB subtype as classified by the Hans algorithm (82.4% vs 17.6%, p = 0.01). ConBMI comprised an independent predictor of poor prognosis in primary and secondary r/rDLBCL. Incorporating conBMI in the pretherapeutic risk assessment for r/rDLBCL and r/rTRIL patients may be useful for prognostication, for stratification in clinical trials, and to assess new therapies for this high-risk patient subset that might not benefit from SCT in second-line treatment.


Assuntos
Medula Óssea/patologia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma não Hodgkin/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Linfócitos B/patologia , Feminino , Humanos , Linfoma Difuso de Grandes Células B/patologia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
3.
J Endod ; 46(9): 1330-1336, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32565334

RESUMO

Non-Hodgkin lymphomas (NHLs) are malignant neoplasms of the lymphatic system, typically occurring in the fifth through seventh decades of life. Tumors develop from abnormal lymphocyte proliferation and accumulation. Although a majority of NHLs occur in nodal regions, 40% of cases appear in extranodal sites involving the stomach, spleen, Waldeyer's ring, central nervous system, lung, skin, and bone. Extranodal NHL presents a diagnostic challenge because it may mimic endodontic disease when occurring in intraosseous and soft tissue sites. This case report presents misdiagnosis of a diffuse large B-cell lymphoma (DLBCL) of the anterior maxilla in a 72-year-old man with a history of Waldenstrom's macroglobulinemia, where the lesion was thought to be associated with a necrotic pulp and a chronic apical abscess on tooth #7. Clinical findings of a facial sinus tract, a nonresponsive pulp, large periapical radiolucency, and history of trauma were in support of this diagnosis for tooth #7. On encountering vital pulpal tissues during cavity access of tooth #7, a cone-beam computed tomography scan and lesion biopsy were obtained. Through immunohistochemistry and histologic analysis, a diagnosis of DLBCL was made. During evaluation of lesions with suspected endodontic etiology, the clinician should consider all factors of the patient's health history, hereditary risk, and comprehensive clinical testing to attain a differential diagnosis. A nonodontogenic etiology of disease should always be considered unless ruled out otherwise. Atypical presentation or testing may prompt the need for biopsy and interspecialty assessment.


Assuntos
Linfoma não Hodgkin/diagnóstico , Maxila , Abscesso , Adulto , Idoso , Biópsia , Diagnóstico Diferencial , Humanos , Masculino
4.
Medicine (Baltimore) ; 99(26): e20861, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590786

RESUMO

RATIONALE: Primary non-Hodgkin lymphoma (NHL) of the testes is rare, representing about 9% of testicular neoplasms and 1% to 2% of non-Hodgkin lymphomas. PATIENT CONCERNS: A previously healthy 47-month-old boy came to our institution for 3 months unilateral testicular swelling without tenderness. After preliminary examination, inguinal orchiectomy was performed to resect the right scrotal mass. The histopathological diagnosis of high-grade lymphoma was rendered and paraffin blocks were sent for immunophenotyping. DIAGNOSIS: The final diagnosis by histopathological combined with immunohistochemical staining revealed primary testicular T-cell lymphoblastic lymphoma (St Jude Children's Research Hospital Staging System, stage I). INTERVENTIONS: The patient was treated with right inguinal orchidectomy followed by chemotherapy (SMCC-2011 protocol modified based on the BFM-90/95 regimen from Germany) without prophylactic radiotherapy to the contralateral testis. OUTCOMES: After 36 months of follow-up, the patient is now disease-free without any complication. LESSONS: T-lymphoblastic lymphoma should be considered in the differential diagnosis of testicular masses in children. Intensive chemotherapy may improve the prognosis of such patients.


Assuntos
Linfoma não Hodgkin/diagnóstico , Neoplasias Testiculares/diagnóstico , Pré-Escolar , China , Humanos , Linfoma não Hodgkin/patologia , Masculino , Orquiectomia/métodos , Neoplasias Testiculares/patologia , Resultado do Tratamento
5.
Ann Hematol ; 99(6): 1293-1302, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32296914

RESUMO

Cell-free DNA (cfDNA) can be released from tumor cells during proliferation and apoptosis; thus, a fraction of the cfDNA in patients with cancer is tumor-derived. However, the prognostic value of cfDNA in aggressive non-Hodgkin lymphoma (NHL) has not been determined. Between March 2017 and April 2019, plasma cfDNA was obtained from 158 patients with aggressive NHL who were registered in a prospective Samsung Medical Center lymphoma cohort (diffuse large B cell lymphoma (DLBCL), n = 51; T cell lymphoma (TCL), n = 51; NK/T cell lymphoma (NKTCL), n = 56). The concentration of cfDNA was estimated in longitudinal samples collected from patients with NHL before and during various chemotherapy regimens. In pretreatment samples, the median cfDNA concentration of all patients with aggressive lymphoma was 13.7 ng/dl (range 1.7-1792), which was significantly higher than that of healthy volunteers (median 7.4 ng, range 3.7-14.4, p < 0.001), and advanced stages showed a higher cfDNA level than earlier stages. Multivariate analysis identified high cfDNA as an independent factor for event-free survival that predicted poor prognosis in DLBCL (hazard ratio [HR] = 5.33, 95% confidence interval [CI] = 1.72-16.52, p = 0.003) and TCL (HR = 2.82, 95% CI = 1.10-7.20, p = 0.030). NKTCL patients with a high level of cfDNA had worse overall survival (HR = 4.71, 95% CI = 1.09-20.35, p = 0.037) compared with those with a low level of cfDNA. In this study, our results suggest the usefulness of pretreatment cfDNA as a prognostic marker for patients with DLBCL, TCL, and NKTCL.


Assuntos
Ácidos Nucleicos Livres/sangue , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Coortes , Feminino , Humanos , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida/tendências , Adulto Jovem
7.
J Oncol Pharm Pract ; 26(1): 99-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30924740

RESUMO

OBJECTIVE: This study was conducted with the aim of making the contribution to a decision for treatment and determination of the modalities in patients diagnosed with non-Hodgkin lymphoma which increasingly become widespread in the geriatric population. MATERIALS AND METHODS: Ninety-one patients aged over 65 years diagnosed with lymphoma and treated in Bezmialem Vakif University Medical Faculty Hospital and Haseki Training and Research Hospital between 2008 and 2013 were retrospectively evaluated. Finally, 63 patients for whom data could be reached were included in the study. RESULTS: Examining the results, histological diagnoses of our patients were as follows: diffuse large B-cell lymphoma (50.8%), follicular lymphoma (23.8%), marginal zone lymphoma (12.7%), mantle cell lymphoma (4.8%), T-cell lymphoma (4.8%), lymphoplasmacytic lymphoma (1.6%) and small lymphocytic lymphoma (1.6%). Stages at the time of diagnosis were early stage by 33.3% and late stage by 66.7%. Of the patients, 36.5% had a low-intermediate and 63.5% a high-intermediate International Prognostic Index score. According to the Eastern Cooperative Oncology Group scoring, 34.9% of the patients have an Eastern Cooperative Oncology Group score of 2-4. Activities of daily living score of 33.3% patients was under 5. Looking at the responses to treatment, the complete response was found in 50.8%, partial response in 4.8%, stable disease in 1.6% and progressive disease in 9.5% of the patients. The mean follow-up duration of patients was found as 25.2 months and disease-free survival after remission as 20.2 months. CONCLUSION: We found that we have achieved a complete remission in more than half of our patients (50.8%). Based on this, treatment should aim remission in elderly patients.


Assuntos
Atividades Cotidianas , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Linfoma Folicular/diagnóstico , Linfoma Folicular/tratamento farmacológico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/tratamento farmacológico , Masculino , Indução de Remissão/métodos , Estudos Retrospectivos
8.
Eur Radiol ; 30(4): 2125-2137, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31858206

RESUMO

OBJECTIVES: To determine whether water kurtosis and diffusional metrics derived from diffusional kurtosis imaging (DKI) within primary central nervous system lymphomas (PCNSLs) and high-grade gliomas (HGGs) correlate with cellularity and/or nuclear-to-cytoplasmic (N/C) ratio. METHODS: Forty-four and 43 pathologically confirmed high-grade glioma and primary central nervous system lymphoma specimens between May 2013 and November 2016 were retrospectively reviewed. Diffusional metrics, kurtosis metrics, cellularity, and N/C ratios in PCNSLs and HGGs were compared using the Mann-Whitney U test (significant level, p < 0.007 [0.05/7]); Bonferroni correction). RESULTS: Mean kurtosis (MK), axial kurtosis (K//), and radial kurtosis (K⊥) in PCNSLs were 0.857 (0.693-0.924), 0.837 (0.660-0.941), and 0.834 (0.685-0.937), respectively; and 0.629 (0.524-0.716), 0.575 (0.511-0.689), and 0.675 (0.532-0.766), respectively, in HGGs (all p < 0.001). No significant differences in fractional anisotropy (FA), mean diffusion (MD), axial diffusion (λ//), and radial diffusion (λ⊥) were found between HGGs and PCNSLs. Cellularity was higher in PCNSLs than in HGGs (p = 0.125); whereas, the N/C ratio in PCNSLs was significantly higher than that in HGGs (p < 0.001). All DKI metrics (FA, MD, λ//, λ⊥, MK, K//, and K⊥) were significantly correlated with N/C ratio in PCNSLs with correlation coefficients being rho = 0.418, - 0.722, - 0.525, - 0.768, 0.704, 0.579, and 0.686, respectively. Cellularity in PCNSLs and HGGs did not correlate with any kurtosis or diffusional metrics. CONCLUSIONS: Difference of kurtosis parameters between PCNSLs and HGGs is correlated with their diverse N/C ratio. KEY POINTS: • DKI has considerable value in differentiating between PCNSLs and HGGs. • DKI can provide important information on nuclear-to-cytoplasmic ratio. • Difference of kurtosis parameters between PCNSLs and HGGs correlated well with their diverse N/C ratios.


Assuntos
Biópsia/métodos , Neoplasias Encefálicas/diagnóstico , Neoplasias do Sistema Nervoso Central/diagnóstico , Imagem de Difusão por Ressonância Magnética/métodos , Glioma/diagnóstico , Linfoma não Hodgkin/diagnóstico , Estadiamento de Neoplasias/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
9.
Blood Cancer J ; 9(12): 97, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31796726

RESUMO

Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative therapy for relapsed/refractory and high-risk non-Hodgkin lymphoma (NHL). However, no large studies have evaluated allo-HCT utilization in elderly NHL patients (≥65 years). Using the CIBMTR registry, we report a time-trend analysis of 727 NHL patients (≥65 years) undergoing the first allo-HCT from 2000 to 2015 in the United States (US). Study cohorts were divided by time period: 2000-2005 (N = 76) vs. 2006-2010 (N = 238) vs. 2011-2015 (N = 413). Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), relapse/progression (R/P), and non-relapse mortality (NRM). Median age at transplant, use of reduced-intensity conditioning, and graft source remained stable, while use of unrelated donors increased in the most current era. The 1-year probabilities of NRM from 2000 to 2005 vs. 2006-2010 vs. 2011-2015 were 24% vs. 19% vs. 21%, respectively (p = 0.67). Four-year probability of R/P was similar among the three cohorts: 48% (2000-2005), 40% (2006-2010), and 40% (2011-2015) (p = 0.39). The 4-year probabilities of PFS and OS (2000-2005 vs. 2006-2010 vs. 2011-2015) showed significantly improved outcomes in more recent time periods: 17% vs. 31% vs. 30% (p = 0.02) and 21% vs. 42% vs. 44% (p < 0.001), respectively. Utilization of allo-HCT increased in elderly NHL patients in the US since 2000 with improving survival outcomes.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma não Hodgkin/terapia , Idoso , Idoso de 80 Anos ou mais , Resistencia a Medicamentos Antineoplásicos , Feminino , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/mortalidade , Masculino , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Recidiva , Transplante Homólogo , Resultado do Tratamento
10.
Zhonghua Bing Li Xue Za Zhi ; 48(11): 861-866, 2019 Nov 08.
Artigo em Chinês | MEDLINE | ID: mdl-31775435

RESUMO

Objective: To assess clinical features and treatment outcomes in immunocompetent patients with primary central nervous system lymphoma (PCNSL). Methods: Sixty-two patients with PCNSL who attended Guangdong General Hospital between January 1998 and January 2012 were included. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous was assessed via the Cox proportional hazard model. Results: The median age of the patient cohort was 56 years, and the male to female ratio was 1.14∶1.00. The common presentations were increased intracranial pressure symptoms and neuron damage. Performance status of 54 (54/62, 87.1%) patients were the international prognostic index (IPI) 0-2. Diffuse large B-cell lymphoma (57/62, 91.9%) was most common, and the rest were T-cell lymphoma (4/62,6.4%) and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (1/62, 1.6%). In the series, 32 patients (32/62, 51.6%) had multiple lesions. Involvement of deep structures was found in 30 (30/62, 48.4%) patients. An elevated serum LDH level was detected in 19 (19/62, 30.6%) patients and the Ki-67 index was ≥90% in 38 (38/62, 61.3%) patients. Univariate analysis showed patients who were female, age<60 years, had WHO Eastern Cooperative Oncology Group performance status grade 0-2, single lesion, absence of deep structures involvement and normal LDH level showed better 2-year survival rate and longer median survival time. Significance was only seen in the normal LDH level group. Multivariate Cox regression analysis revealed that radical surgery only and Rituximab+ high-dose of methotrexate+ whole brain radiation therapy (WBRT) were independent prognostic indicators in PCNSL patients (P<0.05). Conclusions: PCNSL is a rare but aggressive tumor with poor prognosis. Patients treated with high-dose of methotrexate combining with rituximab, followed by WBRT have a better prognosis and longer survival time, and thus these could probably be a promising treatment.


Assuntos
Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/terapia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/terapia , Protocolos de Quimioterapia Combinada Antineoplásica , Feminino , Humanos , Linfoma Difuso de Grandes Células B , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
11.
Adv Anat Pathol ; 26(6): 371-389, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31567129

RESUMO

Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ∼5% of all non-Hodgkin lymphomas (NHLs) and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of mediastinal lymph nodes, thymus, and/or mediastinal organs (heart, lung, pleura, pericardium) by NHL without evidence of systemic disease at presentation. The clinical scenario is variable and depends on the lymphoma subtype. The radiologic presentation is also variable ranging from a mediastinal mass with or without superior vena cava syndrome, a pleural or a cardiac mass associated with effusion, or as an effusion only. The diagnosis of PM-NHLs can only be established by microscopic evaluation, and therefore, general pathologists should be aware of these tumors and familiar with their diagnostic approach. The most common anterior mediastinal NHLs (90% to 95%) are primary mediastinal (PM) large B-cell lymphoma and T-lymphoblastic lymphoma. Thymic marginal zone lymphoma and mediastinal gray zone lymphoma are very rare. The remainder PM-NHLs involving middle or posterior mediastinum include diffuse large B-cell lymphoma (DLBCL) and rare cases of T-cell lymphoma, including anaplastic large cell lymphoma and breast implant-associated anaplastic large cell lymphoma extending to the anterior mediastinum. Primary pleural and cardiac NHLs are mostly DLBCLs. Other rare subtypes of PM-NHLs include DLBCL associated with chronic inflammation/pyothorax-associated lymphoma, fibrin-associated DLBCL (both Epstein-Barr virus positive), and pleural and/or pericardial primary effusion lymphoma (human herpesvirus-8 positive/Epstein-Barr virus positive). We review the historical aspects, epidemiology, clinicoradiologic features, histopathology, immunohistochemistry, differential diagnosis, and relevant cytogenetic and molecular features of the remaining mediastinal B-cell lymphomas, including primary thymic marginal zone lymphoma of the mucosa-associated lymphoid tissue type, other PM small B-cell lymphomas, PM plasmacytoma, and the most relevant PM T-cell lymphomas.


Assuntos
Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/patologia , Neoplasias do Mediastino/patologia , Neoplasias do Timo/patologia , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/patologia , Humanos , Linfonodos/patologia , Neoplasias do Mediastino/diagnóstico , Neoplasias do Timo/diagnóstico
12.
Adv Anat Pathol ; 26(6): 346-370, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31567132

RESUMO

Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ~5% of all NHLs and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of mediastinal lymph nodes, thymus, and/or mediastinal organs (heart, lung, pleura, pericardium) by NHL without evidence of systemic disease at presentation. The clinical scenario is variable and depends on the lymphoma subtype. The radiologic presentation is also variable ranging from a mediastinal mass with or without superior vena cava syndrome, a pleural or a cardiac mass associated with an effusion, or as an effusion only. The diagnosis of PM-NHLs can only be established by microscopic evaluation, and therefore, general pathologists should be aware of these tumors and familiar with their diagnostic approach. The most common anterior mediastinal NHLs (90% to 95%) are primary mediastinal large B-cell lymphoma and T lymphoblastic lymphoma. Thymic marginal zone lymphoma and mediastinal gray zone lymphoma are very rare. The remainder PM-NHLs involving middle or posterior mediastinum include diffuse large B-cell lymphoma (DLBCL) and rare cases of T-cell lymphoma, including anaplastic large cell lymphoma and breast implant-associated anaplastic large cell lymphoma extending to the anterior mediastinum. Primary pleural and cardiac NHLs are mostly DLBCLs. Other rare subtypes of PM-NHLs include DLBCL associated with chronic inflammation/pyothorax-associated lymphoma, fibrin-associated DLBCL (both EBV), and pleural and/or pericardial primary effusion lymphoma (HHV-8/EBV). We review the historical aspects, epidemiology, clinico-radiologic features, histopathology, immunohistochemistry, differential diagnosis, and relevant cytogenetic and molecular features of PM (thymic) LBCL, PM "nonthymic" DLBCL, BCL, unclassifiable, with features intermediate between DLBCL and classic Hodgkin lymphoma (mediastinal gray zone lymphoma), DLBCL associated with chronic inflammation (pyothorax-associated lymphoma), fibrin-associated DLBCL, and primary effusion lymphoma. This review represents the first part of 2 manuscripts covering PM-NHLs.


Assuntos
Linfoma não Hodgkin/patologia , Neoplasias do Mediastino/patologia , Mediastino/patologia , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/patologia , Humanos , Linfonodos/patologia , Linfoma não Hodgkin/diagnóstico , Neoplasias do Mediastino/diagnóstico
13.
Pediatr Hematol Oncol ; 36(8): 504-509, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31566047

RESUMO

Non-Hodgkin's lymphomas (NHL) are common malignant tumors in children and adolescents. Among them diffuse large B-cell lymphomas (DLBCL) are relatively rare as compared to non-cleaved small cell lymphoma (mostly Burkitt's-BL) and lymphoblastic lymphoma (LL). While BL has abdominal or cervical site predilection, LL (mostly T-cell) tends to have mediastinal involvement. However, diffuse large B-cell lymphomas may involve abdomen, peripheral lymph nodes, skin, bone, other rare sites. Ureteral NHLs are extremely rare in children; however, many cases have been reported in adults. In adults the histopathology is usually follicular lymphoma. Only one case of unilateral ureter DLBCL has been reported in an adolescent in the past. Here we report a case of bilateral ureteral DLBCL to highlight the unusual presentation of NHLs and that it should be considered in the differential diagnosis of acute renal insufficiency.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma não Hodgkin/diagnóstico , Ureter/patologia , Criança , Humanos , Linfoma não Hodgkin/patologia , Masculino
14.
Ann Hematol ; 98(11): 2561-2567, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31515574

RESUMO

Overt central nervous system (CNS) involvement in aggressive non-Hodgkin's lymphoma (NHL) is rare at diagnosis. Much effort is put to identify risk factors for occult CNS involvement, and the risk assessment of CNS relapse. Prophylactic treatment carries risk of adverse events and its efficacy is not clear. Detection of cerebrospinal fluid molecular gene rearrangement (GRR) as a method to detect occult disease has been studied in acute leukemia and primary CNS lymphoma. To date, the capacity of a positive GRR in newly diagnosed NHL patients to predict CNS relapse has not been addressed. We retrospectively studied the prognostic value of GRR in cerebrospinal fluid samples of 148 newly diagnosed patients with high grade NHL. We demonstrate that positive GRR at diagnosis does not affect PFS or OS and did not predict CNS relapse. However, although numbers were small, repeated positive samples (≥ 2) correlated with a higher risk for CNS relapse (p = 0.048), possibly stressing the need for an aggressive preventive approach.


Assuntos
Neoplasias do Sistema Nervoso Central , Rearranjo Gênico , Linfoma não Hodgkin , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/genética , Neoplasias do Sistema Nervoso Central/patologia , Feminino , Humanos , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/genética , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
Hautarzt ; 70(10): 815-830, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31511903

RESUMO

Cutaneous lymphomas comprise different subgroups with distinct biological behavior. Mycosis fungoides, the most common cutaneous lymphoma, presents with patches, plaques, tumors and erythroderma. Therapeutic options depend on stage and comprise local skin-directed treatment in early stages, while later stages and Sézary syndrome require systemic therapies including bexarotene, interferon or brentuximab vedotin. While the rare CD4-positive lymphoproliferation and acral CD8-positive lymphoma present with an invariably indolent course, cutaneous peripheral T­cell lymphomas exhibit an aggressive clinical behavior. Among the subgroup of cutaneous B­cell lymphomas, primary cutaneous marginal zone lymphoma and follicle center cell lymphoma belong to indolent entities with almost unrestricted overall survival, whereas cutaneous large B­cell lymphoma presents with a significant risk of systemic dissemination and is associated with high lethality.


Assuntos
Linfoma de Células B/terapia , Linfoma não Hodgkin/terapia , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/terapia , Micose Fungoide/diagnóstico , Micose Fungoide/terapia , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Doença de Hodgkin/mortalidade , Doença de Hodgkin/terapia , Humanos , Linfoma , Linfoma de Células B/mortalidade , Linfoma de Células B/patologia , Linfoma de Zona Marginal Tipo Células B/mortalidade , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/terapia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/mortalidade , Linfoma Cutâneo de Células T/mortalidade , Micose Fungoide/mortalidade , Síndrome de Sézary/mortalidade , Neoplasias Cutâneas/mortalidade , Taxa de Sobrevida
16.
Pathol Res Pract ; 215(11): 152615, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31562020

RESUMO

OBJECTIVE: To explore the clinical value of immunoglobulin (Ig) and T cell receptor (TCR) gene rearrangement in the diagnosis of non-Hodgkin lymphoma. METHODS: Using the standardized BIOMED-2 multiplex PCR strategy to detect IgH, IgK and TCR in 272 cases of mature B-cell lymphoma, 55 cases of mature T-cell lymphoma, 21 cases of extranodal NK/ T-cell lymphoma, nasal type, and 20 cases of lymphoid tissue reactive hyperplasia. RESULTS: Among all mature B-cell lymphomas, the sensitivity of Ig gene rearrangement was 91.18% (248/272), IgH and IgK gene rearrangement was 76.47% (208/272) and 75.00% (204/272), respectively, meanwhile the sensitivity of TCRγ rearrangement was 3.68% (10/272). In the 55 cases of mature T-cell lymphoma, the sensitivity of the detection of TCRγ was 76.36% (44/55), at the same time the sensitivity of Ig gene rearrangement was 14.55% (8/55), IgH and IgK gene rearrangement was 7.27% (4/55) and 12.73% (7/55), respectively. In 21 cases of extranodal NK/T cell lymphoma, nasal type, and 20 cases of reactive lymphoid hyperplasia, no gene rearrangement was found in the samples of IgH, IgK and TCR. The sensitivity of gene rearrangement in Ig/TCR in B and T-cell lymphoma was significantly different from that in the control group (P < 0.05). CONCLUSION: The Ig/TCR gene rearrangement of BIOMED-2 multiplex PCR strategy has important auxiliary value in the diagnosis of B/T-cell non-Hodgkin lymphoma respectively, however, a few B-cell lymphomas may company TCR gene rearrangement as well as a few T-cell lymphomas may accompany Ig gene rearrangement, it must be comprehensively judged with the combination of morphology, immunohistochemistry and clinical features.


Assuntos
Cadeias Pesadas de Imunoglobulinas/genética , Cadeias kappa de Imunoglobulina/genética , Linfoma não Hodgkin/diagnóstico , Reação em Cadeia da Polimerase Multiplex/métodos , Receptores de Antígenos de Linfócitos T gama-delta/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China , Feminino , Rearranjo Gênico , Genes de Imunoglobulinas , Humanos , Linfoma não Hodgkin/genética , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
17.
Rev. cuba. hematol. inmunol. hemoter ; 35(3): e1068, jul.-set. 2019. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1093281

RESUMO

Introducción: Los linfomas no-Hodgkin pueden infiltrar el sistema nervioso central y producir síntomas neurológicos, lo cual incrementa la mortalidad. El diagnóstico de esta infiltración se puede realizar mediante el estudio del líquido cefalorraquídeo por la técnica de citometría de flujo, con una mayor sensibilidad que la citología convencional. Objetivo: Estimar la supervivencia global de pacientes con Linfoma no-Hodgkin y síntomas neurológicos según el inmunofenotipo celular del líquido cefalorraquídeo. Métodos: Se realizó un estudio analítico y prospectivo en 15 pacientes con diagnóstico confirmado de linfoma no-Hodgkin y síntomas neurológicos, con citología negativa del líquido cefalorraquídeo, tratados en el servicio de oncología del Instituto Nacional de Oncología y Radiobiología, durante los años 2017 y 2018. El inmunofenotipo fue caracterizado mediante citometría de flujo multiparamétrica. Resultados: El 60,0 por ciento de los pacientes fue del sexo femenino y el 53,4 por ciento mayor de 60 años. Hubo una mortalidad del 26,7 por ciento. Se realizaron 17 inmunofenotipos, el 58,9 por ciento fue normal, el 23,4 por ciento reactivo y el 17,7 por ciento sospechoso de malignidad. La supervivencia global fue mayor en pacientes con líquido cefalorraquídeo con inmunofenotipo normal (HR. 0.04). Conclusiones: La citometría de flujo pudo discriminar células sospechosas de malignidad, en pacientes cuyas citologías fueron negativas. La presencia en el líquido cefalorraquídeo de células atípicas, de pleocitosis y de un índice de linfocito-monocito alto se asoció con una supervivencia global menor(AU)


Introduction: When non-Hodgkin lymphomas infiltrate the central nervous system increases mortality. The diagnosis of this infiltration can be made by the study of cerebrospinal fluid using flow cytometry, with a higher sensitivity than conventional cytology. Objective: To estimate the relationship between the cellular immunophenotype of the cerebrospinal fluid and the overall survival of patients with non-Hodgkin lymphoma and neurological symptoms. Methods: An analytical and prospective study was conducted in 15 patients with confirmed diagnosis of non-Hodgkin lymphoma and neurological symptoms, with negative cytology of the cerebrospinal fluid. Patients cared at Oncology Department of the National Institute of Oncology and Radiobiology, during the years 2017-2018. The immunophenotype was characterized by multiparametric flow cytometry. Results: 60.0 percent of the patients was female and 53.4 percent older than 60 years. There was an overall mortality of 26.7 percent 17 immunophenotypes were found, 58.9 percent of them was normal, 23.4 percent reactive and 17.7 percent suspected of malignancy. Overall survival advantage was obtained in patients with cerebrospinal fluid with normal immunophenotype (HR 0.04). Conclusions: Flow cytometry could discriminate cells suspected of malignancy, in patients whose cytologies were negative. The presence in the cerebrospinal fluid of atypical cells, pleocytosis and a high lymphocyte-monocyte index were associated with a lower overall survival(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/líquido cefalorraquidiano , Imunofenotipagem/métodos , Citometria de Fluxo/métodos , Análise de Sobrevida , Métodos de Análise/métodos , Doenças do Sistema Nervoso/complicações
18.
Contrast Media Mol Imaging ; 2019: 2641627, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31427906

RESUMO

Objectives: The aim of this study is to explore the textural features that may identify the morphological changes in the lymphoma region and predict the prognosis of patients with primary renal lymphoma (PRL) and primary adrenal lymphoma (PAL). Methods: This retrospective study comprised nineteen non-Hodgkin's lymphoma (NHL) patients undergoing 18F-FDG-PET/CT at West China Hospital from December 2013 to May 2017. 18F-FDG-PET images were reviewed independently by two board certificated radiologists of nuclear medicine, and the texture features were extracted from LifeX packages. The prognostic value of PET FDG-uptake parameters, patients' baseline characteristics, and textural parameters were analyzed using Kaplan-Meier analysis. Cox regression analysis was used to identify the independent prognostic factors among the imaging and clinical features. Results: The overall survival of included patients was 18.84 ± 13.40 (mean ± SD) months. Univariate Cox analyses found that the tumor stage, GLCM (gray-level co-occurrence matrix) entropy, GLZLM_GLNU (gray-level nonuniformity), and GLZLM_ZLNU (zone length nonuniformity), values were significant predictors for OS. Among them, GLRLM_RLNU ≥216.6 demonstrated association with worse OS at multivariate analysis (HR 9.016, 95% CI 1.041-78.112, p=0.046). Conclusions: The texture analysis of 18F-FDG-PET images could potentially serve as a noninvasive strategy to predict the overall survival of patients with PRL and PAL.


Assuntos
Linfoma não Hodgkin/diagnóstico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/mortalidade , Idoso , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/mortalidade , Linfoma não Hodgkin/diagnóstico por imagem , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
19.
Indian J Pathol Microbiol ; 62(3): 454-456, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361239

RESUMO

Simultaneously triple head and neck malignancies are extremely rare. We report a case who had epithelial and mesenchymal malignant tumor with lymphoid malignancy in head and neck area. A patient who is 74 year old male patient presented to the otorhinolaryngology department with severe breathing difficulty due to laryngeal mass. The result of laryngeal biopsy was invasive SCCs, so patient underwent total larygectomy and bilateral level 2,3,4 neck disection operation. Primary 3 different type head and neck tumors were observed with histopathological examination. These were orderly invasive SCCs in larynx, B-cell Non-Hodgkin's lymphoma in tongue root and one lymph node of left neck dissection material, Kaposi's sarcoma in one lymph node of right neck dissection material. Although synchronous head and neck tumors occurs very rare with laryngeal carcinoma, the neck dissection materials should be researched for synchronous tumors.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Laríngeas/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Sarcoma de Kaposi/diagnóstico , Idoso , Biópsia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/radioterapia , Laringe/patologia , Imagem por Ressonância Magnética , Masculino , Pescoço/patologia , Neoplasias Primárias Múltiplas/patologia , Língua/patologia , Resultado do Tratamento
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