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Bhalala H, Faroun Y, Liao W. A Rare Case of Rapid Lymphadenopathy Progression in Hodgkin's Lymphoma: A Case Report. Cureus 2024; 16:e57954. [PMID: 38738058 PMCID: PMC11083759 DOI: 10.7759/cureus.57954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Hodgkin's lymphoma is a B-cell neoplasm that typically manifests with gradual lymphadenopathy progression over weeks to months. However, we present an exceptional case of Hodgkin's lymphoma marked by an unusually rapid development of lymphadenopathy within an hour. A 30-year-old male presented with a left neck swelling that occurred within an hour and then remained stable in size for three days, prompting an investigation revealing widespread lymphadenopathy consistent with Hodgkin's lymphoma. This case outlines the importance of recognizing and investigating unusual presentations of Hodgkin's lymphoma promptly, emphasizing the necessity for expedited diagnosis and intervention.
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Affiliation(s)
- Harsh Bhalala
- Internal Medicine, St. Luke's University Health Network, Bethlehem, USA
| | - Yacoub Faroun
- Department of Oncology, St. Luke's University Hospital-Bethlehem Campus, Bethlehem, USA
| | - Wenxin Liao
- Internal Medicine, St. Luke's University Health Network, Bethlehem, USA
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2
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Matos Sousa R, Nogueira C, Vilela MJ, Neves Correia F, Silva Araújo C, Ribeiro M, Capela C. A Rare First Presentation of Hodgkin's Lymphoma: Symptomatic Pericardial Effusion. Cureus 2023; 15:e46731. [PMID: 38022304 PMCID: PMC10631307 DOI: 10.7759/cureus.46731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Symptomatic pericardial effusion occurring as the initial manifestation of Hodgkin's lymphoma is exceedingly uncommon, and there are limited documented instances in the available literature. Pericardial effusion can present various differential diagnoses, and among these, malignancy is an important yet less frequently encountered cause. A heightened level of suspicion is crucial for establishing an accurate diagnosis, particularly when the patient's clinical course deviates from the anticipated trajectory. Through this case, we aim to emphasize the significance of considering lymphoproliferative diseases as a pertinent possibility in the differential diagnosis of pericardial effusion. Additionally, we underscore the importance of promptly reaching a diagnosis, as it can help prevent severe complications and enhance the patient's prognosis.
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Affiliation(s)
- Rita Matos Sousa
- Internal Medicine, Hospital de Braga, Braga, PRT
- Clinical Sciences, Escola de Medicina da Universidade do Minho, Braga, PRT
| | | | | | | | | | | | - Carlos Capela
- Internal Medicine, Hospital de Braga, Braga, PRT
- Clinical Sciences, Escola de Medicina da Universidade do Minho, Braga, PRT
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3
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Serum Procalcitonin Levels in Newly Diagnosed Hodgkin Lymphoma: Correlation with Other Inflammatory Biomarkers. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101331. [PMID: 36295492 PMCID: PMC9609271 DOI: 10.3390/medicina58101331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/06/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022]
Abstract
Background and Objectives: Procalcitonin (PCT) is a useful biomarker for the diagnosis of sepsis. Inflammatory markers are elevated in patients with Hodgkin lymphoma (HL), and yet ongoing infection rarely coexists at diagnosis. PCT levels might be helpful in differentiating bacterial from disease-related inflammation. Materials and Methods: We evaluated serum PCT levels and other inflammation markers in newly diagnosed HL patients. Values < 0.50 ng/mL were considered normal (0.10−0.50 ng/mL: detectable, <0.10 ng/mL: undetectable), while values ≥ 0.50 ng/L were considered elevated. Results: Among 137 patients, 55 had B symptoms (40%), 77/130 (59%) had elevated Erythrocyte Sedimentation Rate (ESR) and 116 (85%) had elevated C-Reactive Protein (CRP) (median 38.1 mg/L (range; 2.97−328)). PCT levels were normal in most patients (undetectable 94/137 (68.5%) and detectable 41/137(30%)) with median value < 0.10 ng/mL (range; <0.10−15.90). Elevated PCT was recorded in only two patients (1.5%). Patients with PCT < 0.10 ng/mL had significantly lower median CRP (25.75; range (2.97−203.0)) compared to patients with PCT ≥ 0.1 ng/mL (median CRP 92.50 mg/L; range (3.34−328.0)). Almost all patients (40/41, 97.6%) with detectable PCT had elevated CRP. Conclusions: This is the first study showing that the inflammation characterizing HL is not associated with PCT elevations, although CRP levels are elevated in 85% of the patients. Normal PCT levels may rule out the possibility of occult infection, thus preventing extensive evaluation, which may delay treatment initiation.
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4
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A Real-World Study of Combined Modality Therapy for Early-Stage Hodgkin Lymphoma: Too Little Treatment Impacts Outcome. Blood Adv 2022; 6:4241-4250. [PMID: 35617689 PMCID: PMC9327542 DOI: 10.1182/bloodadvances.2022007363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022] Open
Abstract
In the real-world setting, CMT led to improved outcomes for patients with PET2-positive and unfavorable disease. Similar to clinical trials, favorable, non-bulky, and PET2-negative subgroups had comparable survival outcomes with chemotherapy-alone.
Multiple clinical trials have assessed de-escalation strategies from combined modality therapy (CMT) to chemotherapy-alone for the treatment of early-stage classical Hodgkin lymphoma (cHL), confirming similar outcomes. The application of these data to the real-world is limited, however. We conducted a retrospective, multicenter cohort study comparing CMT vs chemotherapy-alone in patients with early-stage cHL (stage IA-IIB) treated between January 2010 and December 2020. Positron emission tomography (PET) scans after chemotherapy cycle 2 (PET2) were independently reviewed by a nuclear radiologist (Deauville score ≥4, positive; ≤3, negative). Patient outcomes were compared by using an intention-to-treat analysis. Among 125 patients (CMT, n = 63; chemotherapy-alone, n = 62) with a median follow-up of 59.8 months (95% CI, 48.6-71.0), no differences in overall survival were observed (5-year overall survival, CMT 98.0% vs chemotherapy-alone 95.1%; log-rank test, P = .38). However, there was reduced progression-free survival (PFS) with chemotherapy-alone among all patients (2-year PFS, CMT 95.1% vs chemotherapy-alone 75.3%; log-rank test, P = .005) and in those with bulky (n = 43; log-rank test, P < .001), unfavorable (n = 81; log-rank test, P = .002), or PET2-positive (n = 15; log-rank test, P = .02) disease. No significant differences in PFS were seen for patients with non-bulky (log-rank test, P = .35), favorable (log-rank test, P = .62), or PET2-negative (log-rank test, P = .19) disease. Based on our real-world experience, CMT seems beneficial for patients with early-stage cHL, especially those with PET2-positive and unfavorable disease. Chemotherapy-alone regimens can lead to comparable outcomes for patients with favorable, non-bulky, or PET2-negative disease. We conclude that although results seen in clinical trials are replicated in certain patient subgroups, other subgroups not fitting trial criteria do poorly when radiotherapy is excluded.
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Weinstein R, Parikh-Das AM, Salonga R, Schuemie M, Ryan PB, Atillasoy E, Hermanowski-Vosatka A, Eichenbaum G, Berlin JA. A systematic assessment of the epidemiologic literature regarding an association between acetaminophen exposure and cancer. Regul Toxicol Pharmacol 2021; 127:105043. [PMID: 34517075 DOI: 10.1016/j.yrtph.2021.105043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 08/02/2021] [Accepted: 09/03/2021] [Indexed: 01/05/2023]
Abstract
Introduced in the 1950s, acetaminophen is one of the most widely used antipyretics and analgesics worldwide. In 1999, the International Agency for Research on Cancer (IARC) reviewed the epidemiologic studies of acetaminophen and the data were judged to be "inadequate" to conclude that it is carcinogenic. In 2019 the California Office of Environmental Health Hazard Assessment initiated a review process on the carcinogenic hazard potential of acetaminophen. To inform this review process, the authors performed a comprehensive literature search and identified 136 epidemiologic studies, which for most cancer types suggest no alteration in risk associated with acetaminophen use. For 3 cancer types, renal cell, liver, and some forms of lymphohematopoietic, some studies suggest an increased risk; however, multiple factors unique to acetaminophen need to be considered to determine if these results are real and clinically meaningful. The objective of this publication is to analyze the results of these epidemiologic studies using a framework that accounts for the inherent challenge of evaluating acetaminophen, including, broad population-wide use in multiple disease states, challenges with exposure measurement, protopathic bias, channeling bias, and recall bias. When evaluated using this framework, the data do not support a causal association between acetaminophen use and cancer.
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Affiliation(s)
| | | | | | | | | | - Evren Atillasoy
- Johnson & Johnson Consumer Products US, Fort Washington, PA, USA
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Verhagen MV, Menezes LJ, Neriman D, Watson TA, Punwani S, Taylor SA, Shankar A, Daw S, Humphries PD. 18F-FDG PET/MRI for Staging and Interim Response Assessment in Pediatric and Adolescent Hodgkin Lymphoma: A Prospective Study with 18F-FDG PET/CT as the Reference Standard. J Nucl Med 2021; 62:1524-1530. [PMID: 33608429 DOI: 10.2967/jnumed.120.260059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
Treatment regimens for pediatric Hodgkin lymphoma (HL) depend on accurate staging and treatment response assessment, based on accurate disease distribution and metabolic activity depiction. With the aim of radiation dose reduction, we compared the diagnostic performance of 18F-FDG PET/MRI with a 18F-FDG PET/CT reference standard for staging and response assessment. Methods: Twenty-four patients (mean age, 15.4 y; range, 8-19.5 y) with histologically proven HL were prospectively and consecutively recruited in 2015 and 2016, undergoing both 18F-FDG PET/CT and 18F-FDG PET/MRI at initial staging (n = 24) and at response assessment (n = 21). The diagnostic accuracy of 18F-FDG PET/MRI for both nodal and extranodal disease was compared with that of 18F-FDG PET/CT, which was considered the reference standard. Discrepancies were retrospectively classified as perceptual or technical errors, and 18F-FDG PET/MRI and 18F-FDG PET/CT were corrected by removing perceptual error. Agreement with Ann Arbor staging and Deauville grading was also assessed. Results: For nodal and extranodal sites combined, corrected staging 18F-FDG PET/MRI sensitivity was 100% (95% CI, 96.7%-100%) and specificity was 99.5% (95% CI, 98.3%-99.9%). Corrected response-assessment 18F-FDG PET/MRI sensitivity was 83.3% (95% CI, 36.5%-99.1%) and specificity was 100% (95% CI, 99.2%-100%). Modified Ann Arbor staging agreement between 18F-FDG PET/CT and 18F-FDG PET/MRI was perfect (κ = 1.0, P = 0.000). Deauville grading agreement between 18F-FDG PET/MRI and 18F-FDG PET/CT was excellent (κ = 0.835, P = 0.000). Conclusion: 18F-FDG PET/MRI is a promising alternative to 18F-FDG PET/CT for staging and response assessment in children with HL.
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Affiliation(s)
- Martijn V Verhagen
- Department of Radiology, University College London Hospital, London, United Kingdom.,Department of Radiology, Great Ormond Street Hospital, London, United Kingdom
| | - Leon J Menezes
- UCL Institute of Nuclear Medicine, University College London Hospital, London, United Kingdom.,NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Deena Neriman
- UCL Institute of Nuclear Medicine, University College London Hospital, London, United Kingdom
| | - Tom A Watson
- Department of Radiology, Great Ormond Street Hospital, London, United Kingdom
| | - Shonit Punwani
- Department of Radiology, University College London Hospital, London, United Kingdom
| | - Stuart A Taylor
- Department of Radiology, University College London Hospital, London, United Kingdom.,Centre for Medical Imaging, CBH, London, United Kingdom; and
| | - Ananth Shankar
- Centre for Medical Imaging, CBH, London, United Kingdom; and.,Department of Pediatrics, University College London Hospital, London, United Kingdom
| | - Stephen Daw
- Department of Pediatrics, University College London Hospital, London, United Kingdom
| | - Paul D Humphries
- Department of Radiology, University College London Hospital, London, United Kingdom; .,Department of Radiology, Great Ormond Street Hospital, London, United Kingdom
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Longjohn MN, Hudson JABJ, Smith NC, Rise ML, Moorehead PC, Christian SL. Deciphering the messages carried by extracellular vesicles in hematological malignancies. Blood Rev 2020; 46:100734. [PMID: 32736879 DOI: 10.1016/j.blre.2020.100734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/10/2020] [Accepted: 07/08/2020] [Indexed: 12/15/2022]
Abstract
Extracellular vesicles (EVs) are nanosized membrane-bound particles released from all living cells examined thus far. EVs can transfer information in the form of proteins, nucleic acids, and lipids from donor cells to recipient cells. Here we summarize recent advances in understanding the role(s) EVs play in hematological malignancies (HM) and outline potential prognostic and diagnostic strategies using EVs. EVs have been shown to promote proliferation and angiogenesis, and alter the bone marrow microenvironment to favour the growth and survival of diverse HM. They also promote evasion of anti-cancer immune responses and increase multi-drug resistance. Using knowledge of EV biology, including HM-specific packaging of cargo, EV based diagnostics and therapeutic approaches show substantial clinical promise. However, while EVs may represent a new paradigm to solve many of the challenges in treating and/or diagnosing HM, much work is needed before they can be used clinically to improve patient outcomes.
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Affiliation(s)
| | - Jo-Anna B J Hudson
- Discipline of Pediatrics, Memorial University of Newfoundland, Canada; University of Ottawa, Children's Hospital of Eastern Ontario, Canada
| | - Nicole C Smith
- Department of Ocean Sciences, Memorial University of Newfoundland, Canada
| | - Matthew L Rise
- Department of Ocean Sciences, Memorial University of Newfoundland, Canada
| | - Paul C Moorehead
- Discipline of Pediatrics, Memorial University of Newfoundland, Canada
| | - Sherri L Christian
- Department of Biochemistry, Memorial University of Newfoundland, Canada.
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Ma L, Varma S, Niranjan-Azadi A. Hodgkin lymphoma presenting as alcohol-induced back pain. BMJ Case Rep 2019; 12:12/11/e228440. [DOI: 10.1136/bcr-2018-228440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 32-year-old Chinese man without significant medical history presented with a 2-month history of worsening lumbosacral back pain radiating to the groin and left lower extremity. He also described a shooting pain in the sciatic nerve distribution that began with and was exacerbated by alcohol consumption, a rare but known symptom of Hodgkin lymphoma (HL). On exam, an anterior chest wall mass was noted. Radiographic evaluation of an anterior mediastinal mass showed osseous erosion into the manubrium. MRI of the lumbar spine showed diffuse osseous disease of the lower thoracic and lumbar spine with extension into the right sacroiliac joint and S2 neural foramen without vertebral body collapse or stenosis. Tissue biopsy revealed nodular sclerosis HL, stage IVB IPS2. The patient was primary refractory to ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) therapy. Salvage ICE (ifosfamide, carboplatin, etoposide) chemotherapy was used and then followed by non-myeloablative haploidentical bone marrow transplant was performed on 5 March 2019.
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9
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Jain S, Gupta A, Nagalla S. A Mediastinal Mass in a Young Man. JAMA 2018; 319:2432-2433. [PMID: 29922807 DOI: 10.1001/jama.2018.7107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Snigdha Jain
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Arjun Gupta
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Srikanth Nagalla
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
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10
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Björkholm M, Weibull CE, Eloranta S, Smedby KE, Glimelius I, Dickman PW. Greater attention should be paid to developing therapies for elderly patients with Hodgkin lymphoma-A population-based study from Sweden. Eur J Haematol 2018; 101:106-114. [PMID: 29727497 DOI: 10.1111/ejh.13090] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Forty percent of Hodgkin lymphoma (HL) patients are older than 50 years at diagnosis, a fact which is not commonly recognized. Older patients do significantly worse than younger patients and are rarely included in clinical trials. METHODS Using data from Swedish Cancer and Lymphoma Registries, we estimated relative survival ratios (RSRs) for 7997 HL patients (diagnosed 1973-2013; 45% ≥50 years). RESULTS The 1-year RSRs (95% confidence interval; CI) for males aged 45-59, 60-69, 70-80, and 81 years and over, diagnosed in 2013, were 0.95 (0.91-0.97), 0.88 (0.81-0.92), 0.74 (0.63-0.81), and 0.52 (0.35-0.67), respectively. The corresponding 1-year RSRs for females were 0.97 (0.94-0.98), 0.91 (0.85-0.95), 0.82 (0.73-0.88), and 0.66 (0.50-0.77). No improvements in 1-year of 5-year relative survival from 2000 to 2013 were observed for patients aged 45-59 or 60-69 but there were modest improvements for patients aged 70 years and older. Importantly, we saw no changes in the distribution of disease or patient characteristics between 2000 and 2013. CONCLUSIONS Elderly patients constitute a large group with clearly unmet medical needs. Our findings motivate a more active approach to including elderly patients in clinical trials. Our study provides a baseline for outcome comparison after the broader introduction of targeted drugs.
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Affiliation(s)
- Magnus Björkholm
- Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Caroline E Weibull
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Eloranta
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Ingrid Glimelius
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden.,Department of Immunology, Genetics and Pathology, Clinical and Experimental Oncology, Uppsala University and Uppsala Akademiska Hospital, Uppsala, Sweden
| | - Paul W Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Kuwahara K, Kudo K, Yashima-Abo A, Katayama K, Kojima K, Tone K, Ito E, Nakazawa A, Iwafuchi H, Kurose A. Classic Hodgkin lymphoma with osseous involvement mimicking Langerhans cell histiocytosis in a child. Hum Pathol 2018; 77:147-151. [PMID: 29307624 DOI: 10.1016/j.humpath.2017.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/28/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023]
Abstract
Hodgkin lymphoma (HL) commonly presents superficial lymphadenopathy. In addition, HL cells can arise in various organs including the liver and spleen as an extranodal lymphoma. HL in bone is unusual at the initial diagnosis, although some cases show late-stage localization of lymphoma cells to bone. We report the rare case of a young patient with cranial bone classic HL, presumably originating from the skull without any involvement of lymph nodes. As the main clinical manifestation was only tumor mass in the skull without osteoscopic pain, the tentative diagnosis of Langerhans cell histiocytosis was histologically confirmed by an excisional biopsy. Before the final pathological diagnosis as classic HL, we noticed several small lesions in extranodal regions through systemic surveys, suggesting that the cranial lesion appeared antecedent to those lesions. This is a rare and instructive case of cranial bone HL for which a histological diagnosis has been meticulously made.
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Affiliation(s)
- Kazuhiko Kuwahara
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan; Division of Immunology, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan.
| | - Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Akiko Yashima-Abo
- Department of Pathology, School of Medicine, Iwate Medical University, Shiwa-gun, 028-3694, Japan
| | - Kosuke Katayama
- Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Keiko Kojima
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Kiyoshi Tone
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Etsuro Ito
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama 330-8777, Japan
| | - Hideto Iwafuchi
- Department of Pathology, Shizuoka Children's Hospital, Shizuoka 420-8660, Japan
| | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
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Jehanno N, Cassou-Mounat T, Vincent-Salomon A, Luporsi M, Bedoui M, Kuhnowski F. PET/CT imaging in management of concomitant Hodgkin lymphoma and tuberculosis - a problem solver tool. Clin Case Rep 2017; 6:232-234. [PMID: 29375875 PMCID: PMC5771937 DOI: 10.1002/ccr3.1248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/18/2017] [Accepted: 09/26/2017] [Indexed: 12/19/2022] Open
Abstract
Infectious lymph nodes mimicking lymphoma is challenging for accurate staging. Although 18F-FDG is a nonspecific tracer accumulating not only in tumor cells but also in inflammatory tissues, the metabolic features and uptake kinetics give valuable information: 18F-FDG PET/CT appears as a useful problem solver tool in ambiguous situation.
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Affiliation(s)
- Nina Jehanno
- Department of Nuclear Medicine Institut Curie Paris France
| | | | | | - Marie Luporsi
- Department of Nuclear Medicine Institut Curie Paris France
| | - Manel Bedoui
- Department of Hematology Institut Curie Paris France
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13
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Mauro FR, Galieni P, Tedeschi A, Laurenti L, Del Poeta G, Reda G, Motta M, Gozzetti A, Murru R, Caputo MD, Campanelli M, Frustaci AM, Innocenti I, Raponi S, Guarini A, Morabito F, Foà R, Gentile M. Factors predicting survival in chronic lymphocytic leukemia patients developing Richter syndrome transformation into Hodgkin lymphoma. Am J Hematol 2017; 92:529-535. [PMID: 28295527 DOI: 10.1002/ajh.24714] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 12/13/2022]
Abstract
We hereby report the clinical and biologic features of 33 of 4680 (0.7%) patients with chronic lymphocytic leukemia (CLL), managed at 10 Italian centers, who developed Hodgkin lymphoma (HL), a rare variant of Richter syndrome. The median age at CLL and at HL diagnosis were 61 years (range 41-80) and 70 years (range 46-82), respectively, with a median interval from CLL to the diagnosis of HL of 90 months (range 0-258). In 3 cases, CLL and HL were diagnosed simultaneously. Hl was characterized by advanced stage in 79% of cases, International Prognostic Score (IPS) ≥4 in 50%, extranodal involvement in 39%, B symptoms in 70%. Prior treatment for CLL had been received by 82% of patients and included fludarabine in 67%. Coexistence of CLL and HL was detected in the same bioptic tissue in 87% of cases. The most common administered treatment was the ABVD regimen given to 22 patients (66.6%). The complete response (CR) rate after ABVD was 68%, and was influenced by the IPS (P = .03) and interval from the last CLL treatment (P = .057). Survival from HL was also influenced by the IPS (P = .006) and time from the last CLL treatment (P = .047). The achievement of CR with ABVD was the only significant and independent factor predicting survival (P = .037). Taken together, our results show that the IPS and the interval from the prior CLL treatment influence the likelihood of achieving CR after ABVD, which is the most important factor predicting survival of patients with CLL developing HL.
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Affiliation(s)
- Francesca Romana Mauro
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
| | - Piero Galieni
- U.O.C. Ematologia e Trapianto di Cellule Staminali Emopoietiche, Ospedale Mazzoni; Ascoli Piceno
| | | | | | - Giovanni Del Poeta
- Hematology; Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata; Rome
| | - Gianluigi Reda
- Oncohematology Department; Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Milan
| | - Marina Motta
- Department of Hematology; ASST Spedali Civili; Brescia
| | | | - Roberta Murru
- UO Ematologia e CTMO Ospedale Oncologico A. Businco; Cagliari
| | - Maria Denise Caputo
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
| | - Melissa Campanelli
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
| | | | | | - Sara Raponi
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
| | - Anna Guarini
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
| | | | - Robin Foà
- Hematology; Department of Cellular Biotechnologies and Hematology, Sapienza University; Policlinico Umberto I Rome
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14
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MicroRNA-155 in serum-derived extracellular vesicles as a potential biomarker for hematologic malignancies - a short report. Cell Oncol (Dordr) 2016; 40:97-103. [DOI: 10.1007/s13402-016-0300-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 12/16/2022] Open
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