RESUMO
Most cases of intravascular large cell lymphoma are of B-cell phenotype, with a few cases of T-cell lineage and rare cases with histiocytic features described. A definitive natural killer (NK) cell variant has not been recognized. This report is the first to describe the clinical, histologic, immunophenotypic, and molecular features of 2 cases of intravascular lymphoma with an NK cell phenotype (CD3epsilon+, CD2+, CD7+, CD56+, T-cell intracytoplasmic antigen-1+, perforin+, granzyme B+, CD20-, CD4-, CD5-, CD8-, T-cell receptor [TCR]betaF1-). Molecular studies for TCR gene rearrangements revealed a germline configuration. A 41-year-old man had erythematous plaque-like subcutaneous lesions of the lower extremities in which biopsy revealed Epstein-Barr virus-positive intravascular lymphoma. Following chemotherapy and stem cell transplantation, he was alive with no evidence of disease at 1 year. A 47-year-old woman had myalgias, arthralgias, weakness, fever, altered mental status, and pancytopenia. Bone marrow biopsy demonstrated intravascular lymphoma. Therapy was initiated; however, her condition deteriorated rapidly, and she died. Autopsy revealed involvement of multiple organs, including brain, kidneys, ovaries, and bone marrow. These cases represent the first documented examples of an NK cell variant of intravascular lymphoma.
Assuntos
Células Matadoras Naturais/metabolismo , Células Matadoras Naturais/patologia , Linfoma Difuso de Grandes Células B/metabolismo , Linfoma Difuso de Grandes Células B/patologia , Adulto , Antígenos CD/análise , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Feminino , Rearranjo Gênico , Genes Codificadores dos Receptores de Linfócitos T , Humanos , Imuno-Histoquímica , Imunofenotipagem , Linfoma Difuso de Grandes Células B/genética , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Pele/irrigação sanguínea , Pele/patologiaRESUMO
BACKGROUND: Pulmonary carcinoid tumors are rare, low-grade neuroendocrine malignancies which comprise 1-2% of all lung neoplasms. Approximately 80% of carcinoid tumors occur in the central airways and present clinically as obstructive pneumonia or hemoptysis. Experience with F18 FDG PET to image pulmonary carcinoid tumors is limited. CASE REPORT: A 67 year old woman presented with two episodes of hemoptysis within one month. A whole body FDG PET scan was performed in addition to a contrast enhanced chest CT, a whole body In111 octreotide scan, and quantitative lung perfusion scan during the diagnostic evaluation. An endobronchial lesion was discovered and the patient underwent a successful resection of the right middle and lower lobes. The histopathology of the lesion was consistent with a typical carcinoid tumor. CONCLUSIONS: We describe multimodality imaging findings along with the histopathology and a review of the literature, focusing on the role of FDG PET in the management of patients with bronchial carcinoid tumors.
Assuntos
Tumor Carcinoide/diagnóstico por imagem , Fluordesoxiglucose F18 , Neoplasias Pulmonares/diagnóstico por imagem , Compostos Radiofarmacêuticos , Idoso , Tumor Carcinoide/patologia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Perfusão , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios XRESUMO
The concept of mucosa-associated lymphoid tissue (MALT) lymphomas was introduced by Isaacson and Wright [Cancer 1983; 52:1410-1416] in 1983. After more than 20 years of clinical research MALT lymphomas are now recognized as a distinct subtype of non-Hodgkin's lymphoma (NHL) with unique pathogenic, histological, and clinical features. Although this subtype of NHL occurs frequently, optimal management remains elusive. This manuscript reviews features of the clinical presentation, diagnosis, pathology, molecular characteristics, and management of both gastric and non-gastric MALT lymphoma.