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Pan C, Ma X, Yao Y, Wang C. EBV-Positive Intravascular Large B-Cell Lymphoma of the Small Intestine: A Case Report and Literature Review. Int J Surg Pathol 2024; 32:586-593. [PMID: 37431259 DOI: 10.1177/10668969231183637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare lymphoma that affects the brain, skin, and bone marrow. We describe the case of a 75-year-old man who was admitted to the hospital after 4 h of stomach aches. A thorough physical examination indicated stomach discomfort and skin discoloration. Laboratory tests revealed thrombocytopenia and elevated lactate dehydrogenase levels. A computed tomography scan of the abdomen revealed that the small intestine wall was thickened, edematous, and necrotic. The necrotic small bowel was surgically removed, revealing many little round, homogenous, and unusual cells in the mesenteric vein. In-situ hybridization revealed that these cells were positive for PAX5, CD20, CD79a, CD10, and BCL2, as well as Epstein-Barr virus-encoded small RNA. After 1 week of hospitalization without treatment, the patient was diagnosed with IVLBCL and died of multiple organ dysfunction syndrome. IVLBCL is a rare illness that affects the small intestine and possibly the gastrointestinal system. It has an insidious start, a fast development, and a dismal prognosis. Knowing its clinicopathologic traits helps in understanding the illness, making an early diagnosis, and preventing rapid worsening.
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Affiliation(s)
- Chenglong Pan
- Department of Pathology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Xiaoling Ma
- Department of Pathology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Yanfei Yao
- Department of Pathology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Chunyan Wang
- Department of Pathology, Kunming Medical University First Affiliated Hospital, Kunming, China
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Wang J, Alhaj Moustafa M, Kuhlman JJ, Seegobin K, Jiang L, Gupta V, Tun HW. Intravascular Large B Cell Lymphoma with CNS Involvement Successfully Treated with High-Dose Methotrexate and High-Dose Ara-C Based CNS-Directed Chemoimmunotherapy Alternating with Anthracycline Based Chemoimmunotherapy. Blood Lymphat Cancer 2022; 12:47-54. [PMID: 35642208 PMCID: PMC9148600 DOI: 10.2147/blctt.s362736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/18/2022] [Indexed: 01/14/2023] Open
Abstract
Intravascular large B cell lymphoma (IVL) is a rare subtype of diffuse large B cell lymphoma confined to small blood vessels with a predilection for CNS involvement. The prognosis of IVL with CNS involvement (CNS-IVL) is extremely poor. The optimal treatment for CNS-IVL is not well defined. Thus, we report three patients with CNS-IVL successfully treated with a CNS-centric approach consisting of high-dose methotrexate (HDMTX) and high-dose Ara-C (HiDAC) based CNS-directed chemoimmunotherapy (CIT) alternating with anthracycline-based CIT. Our rationale for intensifying the CNS-directed therapy is the presence of intracerebral bleeding in two of our patients which would result in extravasation of lymphoma cells into the cerebral parenchyma with the development of CNS lymphoma. All three patients have achieved excellent therapeutic outcomes. Two patients with intracerebral bleeding have been in complete remission (CR) for about 11 years and 4 years. One patient was successfully induced into CR about 10 months ago and currently is in CR. This unique therapeutic approach should be further explored for CNS-IVL.
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Affiliation(s)
- Jing Wang
- Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Muhamad Alhaj Moustafa
- Division of Hematology and Medical Oncology, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Justin J Kuhlman
- Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Karan Seegobin
- Division of Hematology and Medical Oncology, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Liuyan Jiang
- Department of Pathology and Laboratory Medicine, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Vivek Gupta
- Department of Radiology, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Han W Tun
- Division of Hematology and Medical Oncology, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
- Correspondence: Han W Tun, Mayo Clinic Florida Division of Hematology/Oncology, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA, Tel +1 904-953-2000, Email
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CUTANEOUS B-CELL LYMPHOMAS: UPDATE ON DIAGNOSIS, RISK-STRATIFICATION, AND MANAGEMENT. Presse Med 2022; 51:104109. [PMID: 35026390 DOI: 10.1016/j.lpm.2022.104109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/27/2021] [Indexed: 12/18/2022] Open
Abstract
PCBCLs are a group of Non-Hodgkin's B-cell lymphomas originating in and usually confined to the skin, representing approximately one fourth of primary cutaneous lymphomas (PCL). Their current classification system has been the result of the joint World Health Organization (WHO) - European Organization for Research and Treatment of Cancer (EORTC) consensus in 2018. To date, several types of PCBCLs have been described in the scientific literature, with different clinical presentation and prognosis. Primary cutaneous follicle-center lymphoma (PCFCL) and primary cutaneous marginal zone lymphoma (PCMZL) are the most common forms, with a typical indolent course. On the contrary, primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is less common, yet more aggressive, with a reported 5-year overall survival of approximatively 50%. In this review, we outline the PCBCLs defining diagnostic criteria, report the features of the less common subtypes and summarize the noteworthy therapeutical options currently available in this field.
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Barker JL, Swarup O, Puliyayil A. Intravascular large B-cell lymphoma: representative cases and approach to diagnosis. BMJ Case Rep 2021; 14:e244069. [PMID: 34728502 PMCID: PMC8565548 DOI: 10.1136/bcr-2021-244069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2021] [Indexed: 12/14/2022] Open
Abstract
Intravascular large B-cell lymphoma (ILBCL) is a subtype of non-Hodgkin's large B-cell lymphoma that is characterised by neoplastic lymphocyte proliferation within the lumen of small blood vessels, which may occur without an extracellular tumour mass or peripheral blood involvement. This report highlights some of the diagnostic issues for ILBCL, and how it can be approached. The two cases described below highlight two significantly different presentations, one with predominately neurological phenomena, and the other with fever of unknown origin for investigation. Both patients were managed with chemotherapy and intercalated intrathecal chemotherapy, with good clinical outcomes, without further evidence of clinical relapse. These cases along with a review of the literature highlight the key learning points in the difficulties in the diagnosis of this condition, and the appropriate use of random skin biopsy in patient suspected of having ILBCL, such as those with constitutional symptoms with otherwise negative malignancy screening, and unexplained neurological phenomena, especially if recurrent in nature.
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Affiliation(s)
- James Llewellyn Barker
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Medicine, Albury Wodonga Health, Albury, NSW, Australia
- Border Medical Oncology and Haematology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
| | - Oshi Swarup
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Medicine, Albury Wodonga Health, Albury, NSW, Australia
| | - Anish Puliyayil
- Border Medical Oncology and Haematology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
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5
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Free radical induced activity of an anthracycline analogue and its Mn II complex on biological targets through in situ electrochemical generation of semiquinone. Heliyon 2021; 7:e07746. [PMID: 34458604 PMCID: PMC8379465 DOI: 10.1016/j.heliyon.2021.e07746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
Cytotoxicity by anthracycline antibiotics is attributed to several pathways. Important among them are formation of free-radical intermediates. However, their generation makes anthracyclines cardiotoxic which is a concern on their use as anticancer agents. Hence, any change in redox behavior that address cardiotoxicity is welcome. Modulation of redox behavior raises the fear that cytotoxicity could be compromised. Regarding the generation of free radical intermediates on anthracyclines, a lot depends on the surrounding environment (oxic or anoxic), polarity and pH of the medium. In case of anthracyclines, one-electron reduction to semiquinone or two-electron reduction to quinone-dianion are crucial both for cytotoxicity and for cardiotoxic side effects. The disproportion-comproportionation equilibria at play between quinone-dianion, free quinone and semiquinone control biological activity. Whatever is the form of reduction, semiquinones are generated as a consequence of the presence of anthracyclines and these interact with a biological target. Alizarin, a simpler anthracycline analogue and its MnII complex were subjected to electrochemical reduction to realize what happens when anthracyclines are reduced by compounds present in cells as members of the electron transport chain. Glassy carbon electrode maintained at the pre-determined reduction potential of a compound was used for reduction of the compounds. Nucleobases and calf thymus DNA that were maintained in immediate vicinity of such radical generation were used as biological targets. Changes due to the generated species under aerated/de-aerated conditions on nucleobases and on DNA helps one to realize the process by which alizarin and its MnII complex might affect DNA. The study reveals alizarin was more effective on nucleobases than the complex in the free radical pathway. Difference in damage caused by alizarin and the MnII complex on DNA is comparatively less than that observed on nucleobases; the complex makes up for any inefficacy in the free radical pathway by its other attributes.
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Minish JM, Kelkar AH, Mehta AR, Gaffar M, Dang NH. Intravascular Large B-Cell Lymphoma Presenting as Acute Axonal Polyneuropathy: A Case Report and Literature Review. J Investig Med High Impact Case Rep 2021; 8:2324709620959997. [PMID: 32935589 PMCID: PMC7498961 DOI: 10.1177/2324709620959997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Intravascular large B-cell lymphoma (ILBL) is a rare and difficult to diagnose
subtype of large B-cell lymphoma. The most common locations of presentation are
in the central nervous system and the skin, but there are reports of other organ
involvement. Due to the indolence, nonspecific symptoms, and rarity of the
disease, this form of lymphoma is most often diagnosed postmortem. In this
article, we describe a case of ILBL that presented as a rapidly progressive
acute axonal polyneuropathy. Acute axonal polyneuropathy is a common disease
process with a wide differential diagnosis, but there is limited literature on
its prevalence as the presenting symptom of ILBL. This patient was treated with
R-EPOCH and intrathecal methotrexate with significant improvement in his
polyneuropathy after 1 cycle, and complete remission after 6 cycles. Data on
chemotherapy regimens and their success rates for this disease are lacking.
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Affiliation(s)
- Jordan M Minish
- University of Florida, University of Florida Health Shands Hospital, Gainesville, FL, USA
| | - Amar H Kelkar
- University of Florida, University of Florida Health Shands Hospital, Gainesville, FL, USA
| | - Amol R Mehta
- University of Florida, University of Florida Health Shands Hospital, Gainesville, FL, USA
| | - Maira Gaffar
- University of Florida, University of Florida Health Shands Hospital, Gainesville, FL, USA
| | - Nam H Dang
- University of Florida, University of Florida Health Shands Hospital, Gainesville, FL, USA
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Shimada K, Kiyoi H. Current progress and future perspectives of research on intravascular large B-cell lymphoma. Cancer Sci 2021; 112:3953-3961. [PMID: 34327781 PMCID: PMC8486207 DOI: 10.1111/cas.15091] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/12/2021] [Accepted: 07/25/2021] [Indexed: 12/30/2022] Open
Abstract
Intravascular large B‐cell lymphoma is a rare disease of the large B cells characterized by selective growth in the lumina of small vessels in systemic organs. Since first reported in 1959, the difficulty of obtaining sufficient tumor cells from biopsy specimens has hampered the elucidation of its underlying biology. Recent progress using xenograft models and plasma cell‐free DNA has uncovered genetic features that are similar to those of activated B‐cell type diffuse large B‐cell lymphoma, including MYD88 and CD79B mutations and frequent alterations in immune check point‐related genes such as PD‐L1 and PD‐L2. Given the improvement in clinical outcomes and a higher risk of secondary central nervous system (CNS) involvement in the rituximab era, a phase 2 trial of R‐CHOP combined with high‐dose methotrexate and intrathecal chemotherapy as a CNS‐oriented therapy has been conducted. This trial, the PRIMEUR‐IVL study, has displayed good progression‐free survival and a low cumulative incidence of secondary CNS involvement. Long‐term follow‐up within this trial is still ongoing. Further understanding of the pathophysiology of the disease and improvements in clinical outcomes are still needed.
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Affiliation(s)
- Kazuyuki Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Edahiro Y, Takaku T, Suzuki M, Fukuda Y, Harada S, Kinoshita S, Inano T, Shirane S, Hamano Y, Kondo A, Komatsu N. Intravascular large B-cell lymphoma as a recurrence of primary central nervous system lymphoma after chemotherapy: A case report. Leuk Res Rep 2021; 15:100249. [PMID: 34136342 PMCID: PMC8178116 DOI: 10.1016/j.lrr.2021.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/09/2021] [Accepted: 05/14/2021] [Indexed: 11/24/2022] Open
Abstract
We report about a 48-year-old woman diagnosed with primary central nervous system lymphoma (PCNSL). After chemotherapy and autologous stem cell transplantation, she presented with a continuous high-grade fever. Positron emission tomography-computed tomography revealed prominent hepatosplenomegaly and high diffuse uptake of 18F-fluorodeoxyglucose in the liver, spleen, and lungs. Intravascular large B-cell lymphoma (IVLBCL) was diagnosed using random skin biopsy. There were no symptoms of IVLBCL at the time of diagnosis of PCNSL. The histopathological features of PCNSL and IVLBCL were nearly similar. These findings suggest that IVLBCL was the recurrence of PCNSL rather than a separate entity.
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Affiliation(s)
- Yoko Edahiro
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Mario Suzuki
- Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Yasutaka Fukuda
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Sakiko Harada
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Shintaro Kinoshita
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Tadaaki Inano
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Shuichi Shirane
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Yasuharu Hamano
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan
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Morigi A, Stefoni V, Argnani L, Broccoli A, Zinzani PL. Intravascular Large B-cell Lymphoma Successfully Treated with Autologous Transplantation. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:e678-e679. [PMID: 33972187 DOI: 10.1016/j.clml.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/03/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Alice Morigi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Vittorio Stefoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Lisa Argnani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy.
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10
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Turin CG, Ting K, Bradshaw A, Dunham SR, Nunez-Wallace K, Patel SM, Dangayach P, Holdener S, Lin WC. Central nervous system intravascular lymphoma leading to rapidly progressive dementia. Proc (Bayl Univ Med Cent) 2021; 34:373-375. [PMID: 33953465 DOI: 10.1080/08998280.2020.1866943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Intravascular lymphoma is an uncommon subtype of B-cell lymphoma with neoplastic cells limited to the lumen of small blood vessels. We report a case of a 52-year-old man who presented with constitutional symptoms and rapidly progressive dementia. He was found to have diffuse leptomeningeal and faint parenchymal enhancement on magnetic resonance imaging and was subsequently diagnosed with intravascular lymphoma following a brain biopsy. He responded remarkably well to systemic and intrathecal chemotherapy. The diagnosis and treatment of intravascular lymphoma have been guided by a few case reports and are largely based on expert opinion.
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Affiliation(s)
- Christie G Turin
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kevin Ting
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Anthony Bradshaw
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - S Richard Dunham
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | | | - Shital M Patel
- Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Priti Dangayach
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Stephanie Holdener
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Weei-Chin Lin
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Division of Hematology-Oncology, Department of Medicine, Baylor College of Medicine, Houston, Texas
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11
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Ong YC, Kao HW, Chuang WY, Hung YS, Lin TL, Chang H, Kuo MC. Intravascular Large B-cell lymphoma: A case series and review of literatures. Biomed J 2020; 44:479-488. [PMID: 32344119 PMCID: PMC8514799 DOI: 10.1016/j.bj.2020.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/04/2019] [Accepted: 04/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma with uncommon clinical presentations and poor prognosis. The purpose of this study is to report the clinical features and outcome of IVLBCL in a single institution of Taiwan. Methods Ten patients with IVLBCL diagnosed from June 2006 to January 2018 were retrospectively reviewed. Results The median age was 61 (range 39–88) years. The most common presentation was fever (90%), cytopenia (90%), and confusion (50%). For all patients, the median progression free survival (PFS) and overall survival (OS) were 12.6 (95% confidence interval [CI] 0.0–76.1) and 18.8 (95% CI 0–59.3) months, respectively. Six patients received rituximab combined chemotherapy, and the other one patient was treated with chemotherapy alone. Six of seven (85.7%) patients achieved complete response after chemotherapy. The median PFS and OS for six patients who completed treatment were not reached. Three-year PFS and OS rates were 80% and 75%, respectively. Conclusion Our study showed that patients might achieve durable remission after rituximab-based chemotherapy. The outcome of IVLBCL patients may further improve if early diagnosis and prompt treatment were made.
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Affiliation(s)
- Yuen-Chin Ong
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Hsiao-Wen Kao
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Wen-Yu Chuang
- School of Medicine, Chang Gung University, Taiwan; Division of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Yu-Shin Hung
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Medicine, Chang Gung University, Taiwan
| | - Tung-Liang Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Hung Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; Center of Hemophilia and Coagulation Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Ming-Chung Kuo
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Medicine, Chang Gung University, Taiwan.
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12
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Shimada K, Yamaguchi M, Atsuta Y, Matsue K, Sato K, Kusumoto S, Nagai H, Takizawa J, Fukuhara N, Nagafuji K, Miyazaki K, Ohtsuka E, Okamoto M, Sugita Y, Uchida T, Kayukawa S, Wake A, Ennishi D, Kondo Y, Izumi T, Kin Y, Tsukasaki K, Hashimoto D, Yuge M, Yanagisawa A, Kuwatsuka Y, Shimada S, Masaki Y, Niitsu N, Kiyoi H, Suzuki R, Tokunaga T, Nakamura S, Kinoshita T. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone combined with high-dose methotrexate plus intrathecal chemotherapy for newly diagnosed intravascular large B-cell lymphoma (PRIMEUR-IVL): a multicentre, single-arm, phase 2 trial. Lancet Oncol 2020; 21:593-602. [PMID: 32171071 DOI: 10.1016/s1470-2045(20)30059-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Intravascular large B-cell lymphoma (IVLBCL) is a rare disease for which there is no available standard treatment. We aimed to ascertain the safety and activity of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) with high-dose methotrexate and intrathecal chemotherapy as CNS-oriented therapy for patients with previously untreated IVLBCL. METHODS PRIMEUR-IVL is a multicentre, single-arm, phase 2 trial at 22 hospitals in Japan. Eligible patients had untreated histologically confirmed IVLBCL, were aged 20-79 years, had an Eastern Cooperative Group performance status of 0-3, and had no apparent CNS involvement at diagnosis. Patients received three cycles of R-CHOP (rituximab 375 mg/m2 intravenously on day 1 [except cycle one, which was on day 8]; cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 [maximum 2·0 mg] intravenously on day 1 of cycle one and day 2 of cycles two and three; and prednisolone 100 mg/day orally on days 1-5 of cycle one and days 2-6 of cycles two and three) followed by two cycles of rituximab with high-dose methotrexate (3·5 g/m2 intravenously on day 2 of cycles four and five) every 2 weeks and three additional cycles of R-CHOP. Intrathecal chemotherapy (methotrexate 15 mg, cytarabine 40 mg, and prednisolone 10 mg) was administered four times during the R-CHOP phase. The primary endpoint was 2-year progression-free survival. Efficacy analyses were done in all enrolled patients; safety analyses were done in all enrolled and treated patients. The trial is registered in the UMIN Clinical Trials Registry (UMIN000005707) and the Japan Registry of Clinical Trials (jRCTs041180165); the trial is ongoing for long-term follow-up. FINDINGS Between June 16, 2011, and July 21, 2016, 38 patients were enrolled, of whom 37 were eligible; one patient was excluded because of a history of testicular lymphoma. Median follow-up was 3·9 years (IQR 2·5-5·5). 2-year progression-free survival was 76% (95% CI 58-87). The most frequent adverse events of grade 3-4 were neutropenia and leucocytopenia, which were reported in all 38 (100%) patients. Serious adverse events were hypokalaemia, febrile neutropenia with hypotension, hypertension, and intracerebral haemorrhage (reported in one [3%] patient each). No treatment-related deaths occurred during protocol treatment. INTERPRETATION R-CHOP combined with rituximab and high-dose methotrexate plus intrathecal chemotherapy is a safe and active treatment for patients with IVLBCL without apparent CNS involvement at diagnosis, and this regimen warrants future investigation. FUNDING The Japan Agency for Medical Research and Development, the Center for Supporting Hematology-Oncology Trials, and the National Cancer Center.
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Affiliation(s)
- Kazuyuki Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Motoko Yamaguchi
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Kosei Matsue
- Division of Hematology/Oncology, Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Keijiro Sato
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Eiichi Ohtsuka
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Masataka Okamoto
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yasumasa Sugita
- Department of Hematology, Oami Municipal Hospital, Oamishirasato, Japan
| | - Toshiki Uchida
- Department of Hematology and Oncology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Satoshi Kayukawa
- Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yukio Kondo
- Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Tohru Izumi
- Division of Hematology, Tochigi Cancer Center, Utsunomiya, Japan
| | - Yoshihiro Kin
- Department of Hematology, Daini Osaka Police Hospital, Osaka, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Daigo Hashimoto
- Department of Hematology, Hokkaido University Faculty of Medicine, Graduate School of Medicine, Sapporo, Japan
| | - Masaaki Yuge
- Division of Hematology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Atsumi Yanagisawa
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Yachiyo Kuwatsuka
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Satoko Shimada
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Nozomi Niitsu
- International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of HSCT Data Management and Biostatistics, Nagoya University School of Medicine, Nagoya, Japan
| | - Takashi Tokunaga
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Shigeo Nakamura
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Tomohiro Kinoshita
- Division of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
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13
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Lin CH, Shih YH, Wang R, Teng CL. Rituximab, cyclophosphamide, vincristine, and prednisolone with high-dose methotrexate as an effective regimen in a frail patient with intravascular large B-cell lymphoma. JOURNAL OF CANCER RESEARCH AND PRACTICE 2020. [DOI: 10.4103/jcrp.jcrp_17_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Primary lung intravascular large B-Cell lymphoma clinically mimicking sarcoidosis: A rare case report and review of literature. Respir Med Case Rep 2019; 29:100989. [PMID: 31921597 PMCID: PMC6948223 DOI: 10.1016/j.rmcr.2019.100989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/23/2019] [Accepted: 12/23/2019] [Indexed: 11/22/2022] Open
Abstract
We present a case of a 73-year-old male who initially presented with night sweats, intermittent fever, worsening dry cough and shortness of breath. CT scans revealed atelectasis and calcified mediastinal lymphadenopathy, raising a suspicion for sarcoidosis. Multiple lung biopsies were performed. Microscopically, atypical lymphocytes were identified within capillaries, small arteries and veins. These lymphocytes were large with prominent nucleoli. Immunohistochemical staining demonstrated tumor cells positive for CD20, CD79a, Pax-5, CD10 and Mum-1, while negative for CD3, cytokeratin, S100, and CD34. LDH serum level was increased (480 IU/L). Extra pulmonary lymphoma was not detected elsewhere in the patient. These findings support the diagnosis of primary lung intravascular large B cell lymphoma (IVLBCL). Literature review of 52 cases demonstrated occurrence of primary lung IVBCL in patients between the ages (35–85) with a slight male predominance (1.167:1). The most common clinical presentation was fever associated with dyspnea.
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15
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Intravascular large B-cell lymphoma: a chameleon with multiple faces and many masks. Blood 2018; 132:1561-1567. [DOI: 10.1182/blood-2017-04-737445] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/01/2018] [Indexed: 12/20/2022] Open
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16
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Abraham L, Kreipe H, Raab P, Hussein K. [Clinical and pathological characteristics of intravascular lymphomas]. DER PATHOLOGE 2018. [PMID: 29541829 DOI: 10.1007/s00292-018-0427-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Intravascular B‑cell lymphomas (IVL) are rare neoplasms that can manifest at any age (mean age ~62-63 years). About half of the cases are associated with Epstein-Barr virus. The most common sites of manifestation are the brain, skin, and bone marrow. The diagnosis is difficult due to unspecific clinical presentation and laboratory changes. FACS (fluorescence-activated cell sorting) and clonality analysis from peripheral blood and radiological findings are often not diagnostic. The most sensitive and most specific diagnostic method is the histopathological and immunohistochemical evaluation of a tissue biopsy. Because of the rarity of this disease, little is known about therapy and prognosis, whereby therapy is mainly similar to non-IVL lymphomas. The prognosis is poor; median survival after diagnosis is approximately one year.
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Affiliation(s)
- L Abraham
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland
| | - H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland
| | - P Raab
- Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - K Hussein
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
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17
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Zhang Y, Bi L, Qiu Y, Zhao T, Cao M, Ding J, Meng F, Cai H. Primary pulmonary intravascular large B-cell lymphoma: A report of three cases and literature review. Oncol Lett 2018; 15:3610-3613. [PMID: 29467882 PMCID: PMC5796294 DOI: 10.3892/ol.2018.7753] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 12/22/2017] [Indexed: 01/18/2023] Open
Abstract
The present study aimed to investigate the clinicopathological features of primary intravascular large B-cell lymphoma (IVLBCL) of the lung. The clinical and histopathological data of three patients, and the literature was reviewed. The Ethics Committees of Drum Tower Hospital approved the current study based on the three cases. Fever and respiratory symptoms were the main presenting symptoms. Serum lactate dehydrogenase and C-reactive protein were significantly increased. Diffuse ground glass opacities or nodular consolidations were seen on high resolution computed tomography. Lung biopsy revealed lymphoma cells in the lumen of small blood vessels. Tumor cells expressed cluster of differentiation 20 and melanoma associated antigen (mutated) 1. Primary pulmonary IVLBCL is extremely rare and its prognosis is poor. Full recognition of its clinical character and improvement of the diagnostic awareness may help to reduce missed diagnosis, and facilitate appropriate treatment.
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Affiliation(s)
- Yingwei Zhang
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Lintao Bi
- Department of Oncology and Hematology, China-Japan Union Hospital Affiliated to Jilin University, Changchun, Jilin 130031, P.R. China
| | - Yuying Qiu
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Tingting Zhao
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Mengshu Cao
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Jingjing Ding
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Fanqing Meng
- Department of Pathology, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - Hourong Cai
- Department of Respiratory Diseases, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
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18
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Rajyaguru DJ, Bhaskar C, Borgert AJ, Smith A, Parsons B. Intravascular large B-cell lymphoma in the United States (US): a population-based study using Surveillance, Epidemiology, and End Results program and National Cancer Database. Leuk Lymphoma 2017; 58:1-9. [PMID: 28278725 DOI: 10.1080/10428194.2017.1287363] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A population-based study of intravascular large B-cell lymphoma (IVLBCL) in the US was conducted to determine incidence, demographic and clinical characteristics, prognostic factors, and survival compared with diffuse large B-cell lymphoma not otherwise specified (DLBCL NOS). In the years 2000-2013, the age-adjusted incidence rate of IVLBCL was 0.095 (case/1,000,000). The incidence of IVLBCL increased significantly from 2000 to 2013 (annual percentage change = 9.84, p = 0.002). We identified 344 patients with IVLBCL. The median age at diagnosis was 70 years. The median 1, 3, and 5-year OS rates for IVLBCL were 66.2, 51.8, and 46.3%, respectively. After propensity matching, the 5-year overall survival of IVLBCL was comparable to DLBCL NOS (46.4 versus 46.5%, p = 0.53). On multivariate analysis advanced age, advanced stage and having Medicaid or Medicare insurance predicted worse OS, whereas female gender and use of radiation therapy predicted better OS.
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Affiliation(s)
| | | | | | - Angela Smith
- b Gundersen Lutheran Medical Foundation , La Crosse , WI , USA
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19
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Brunet V, Marouan S, Routy JP, Hashem MA, Bernier V, Simard R, Petrella T, Lamarre L, Théorêt G, Carrier C, Knecht H, Fleury I, Pavic M. Retrospective study of intravascular large B-cell lymphoma cases diagnosed in Quebec: A retrospective study of 29 case reports. Medicine (Baltimore) 2017; 96:e5985. [PMID: 28151891 PMCID: PMC5293454 DOI: 10.1097/md.0000000000005985] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Intravascular large B-cell lymphoma (IVL) is an extremely rare malignancy, mainly studied through European and Asian series. Due to the low incidence of this condition, our understanding of the clinical presentation as well as the management of IVL relies on a limited number of patients.We report the largest North American study to date on IVL with 29 cases from Quebec hospital diagnosed between 1990 and 2016. The aim of our study is to describe the clinical presentations, diagnostic and staging procedures, therapeutic management and clinical outcomes of IVL patients in our population and compare the disease phenotype to European and Asian series reported.In our cohort, all patients had stage IV IVL at diagnosis, with a median age of 66.7 years (range 47.2-90.8). Clinical presentation was characterized by constitutional symptoms (100%), poor ECOG-PS (100% ≥ 2), cytopenias (93% anemia), and elevated lactate dehydrogenase (97%) and C-reactive protein (96%). Our cohort presented with mainly cutaneous and neurological symptoms. However, neurological involvement (75.9%) was predominant and no "cutaneous variant" was observed; this differs from European literature, where "classical" IVL is reported with mainly cutaneous involvement. Two of our Caucasian patients presented "Asian variant" IVL; this observation is not unusual, as cases of "classical" IVL have been reported in Asians and "Asian variant" IVL has been reported in Europeans. All patients were classified according to their immunophenotypic features in 3 different subgroups (CD5 or CD5CD10, CD5CD10, CD5CD10) with no difference in outcome. Finally, 62% of our cohort received anthracycline-based chemotherapy and 53% of them achieved a complete response. After a median follow-up of 328 days, OS at 3 years was 42.7% for the entire cohort and 47.4% for the cases with in vivo diagnosis. CONCLUSION Unlike European studies on "classical" IVL, our study showed that the French Canadian presentation of this subtype of IVL is more frequently observed with neurological rather than cutaneous involvement. Finally, an early diagnosis is of primary importance since almost a quarter of patients receive a post-mortem diagnosis. A prompt diagnosis allows the introduction of an early treatment, associated with a CR in 53% of patients.
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Affiliation(s)
- Vanessa Brunet
- Department of Hematology-Oncology at Sherbrooke University Hospital Center, CIUSSS Estrie, University of Sherbrooke, Sherbrooke
| | - Sofia Marouan
- Department of Pathology at Sherbrooke University Hospital Center, CIUSSS Estrie, University of Sherbrooke, Sherbrooke
| | - Jean-Pierre Routy
- Department of Hematology-Oncology at McGill University Health Centre, CIUSSS Centre-Ouest-de-l’Île-de-Montréal, McGill University, Montreal
| | - Mohamed Amin Hashem
- Department of Pathology at Laval University Hospital Center, CIUSSS Capitale Nationale, University Laval, Quebec
| | - Vincent Bernier
- Department of Pathology at Laval University Hospital Center, CIUSSS Capitale Nationale, University Laval, Quebec
| | - Raynald Simard
- Department of Hematology-Oncology at Chicoutimi Hospital, CIUSSS Saguenay-Lac-Saint-Jean, University of Sherbrooke, Chicoutimi
| | - Tony Petrella
- Department of Pathology at Montreal University Hospital Center, CIUSSS Est-de-l’Île-de-Montréal, University of Montreal, Montreal
| | - Louis Lamarre
- Department of Pathology at Charles-Lemoyne Hospital, CIUSSS Montérégie-Centre, University of Sherbrooke, Longueuil
| | - Gilles Théorêt
- Department of Pathology at Cité-de-la-Santé Hospital, CIUSSS Laval, Laval
| | - Christian Carrier
- Department of Hematology-Oncology at Montreal University Hospital Center in Trois-Rivières, CIUSSS Mauricie-et-du-Centre-du-Québec, Trois-Rivieres
| | - Hans Knecht
- Department of Hematology-Oncology at McGill University Health Centre, CIUSSS Centre-Ouest-de-l’Île-de-Montréal, McGill University, Montreal
| | - Isabelle Fleury
- Department of Hematology-Oncology at Maisonneuve-Rosemont Hospital, CIUSSS Est-de-l’Île-de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Michel Pavic
- Department of Hematology-Oncology at Sherbrooke University Hospital Center, CIUSSS Estrie, University of Sherbrooke, Sherbrooke
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20
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The Value of 18F-FDG PET/CT in Diagnostic Procedure of Intravascular Large B-Cell Lymphoma Presenting Fever of Unknown Origin and Pulmonary Hypertension as an Initial Manifestation. Clin Nucl Med 2017; 41:506-7. [PMID: 26914573 DOI: 10.1097/rlu.0000000000001188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A 57-year-old man presented with fever of unknown origin and pulmonary hypertension. An F-FDG PET/CT scan was performed to evaluate the source of fever, which showed diffuse, homogeneously increased FDG uptake in both lungs, which prompted the transbronchial lung biopsy. The pathological examination from biopsy specimen demonstrated intravascular large B-cell lymphoma.
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21
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Autologous hematopoietic stem cell transplantation for intravascular large B-cell lymphoma: the European Society for Blood and Marrow Transplantation experience. Bone Marrow Transplant 2016; 52:650-652. [PMID: 27991887 DOI: 10.1038/bmt.2016.339] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Das P, Jain CK, Roychoudhury S, Majumder HK, Das S. Design, Synthesis andin vitroAnticancer Activity of a Cu(II) Complex of Carminic Acid: A Novel Small Molecule Inhibitor of Human DNA Topoisomerase I and Topoisomerase II. ChemistrySelect 2016. [DOI: 10.1002/slct.201601152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Piyal Das
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata- 700032 INDIA
- Environmental Engineering Section; MECON Limited; Ranchi - 834 002 INDIA
| | - Chetan Kumar Jain
- Cancer Biology and Inflammatory Disorder Division; CSIR-Indian Institute of Chemical Biology; Kolkata- 700032 INDIA
- Infectious Diseases and Immunology Division; CSIR-Indian Institute of Chemical Biology; Kolkata- 700032 INDIA
| | - Susanta Roychoudhury
- Cancer Biology and Inflammatory Disorder Division; CSIR-Indian Institute of Chemical Biology; Kolkata- 700032 INDIA
| | - Hemanta Kumar Majumder
- Infectious Diseases and Immunology Division; CSIR-Indian Institute of Chemical Biology; Kolkata- 700032 INDIA
| | - Saurabh Das
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata- 700032 INDIA
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23
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Shimada K, Shimada S, Sugimoto K, Nakatochi M, Suguro M, Hirakawa A, Hocking TD, Takeuchi I, Tokunaga T, Takagi Y, Sakamoto A, Aoki T, Naoe T, Nakamura S, Hayakawa F, Seto M, Tomita A, Kiyoi H. Development and analysis of patient-derived xenograft mouse models in intravascular large B-cell lymphoma. Leukemia 2016; 30:1568-79. [PMID: 27001523 DOI: 10.1038/leu.2016.67] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/11/2016] [Accepted: 03/04/2016] [Indexed: 12/31/2022]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a distinct disease entity with the peculiar characteristic that tumor cells proliferate within vessels. Despite recent advances in understanding the disease from clinical aspects, the underlying pathogenesis remains unknown. Here we demonstrate analyses of IVLBCL biology using four xenograft mouse models established from primary IVLBCL samples. In all four models, the main characteristic of IVLBCL tumor cell proliferation within vessels was retained. Time-lapse engraftment analyses revealed that the tumor cells initially engrafted and proliferated in the sinusoids and vessels in the liver and then engrafted and proliferated in multiple organs. Intriguingly, serial passage of tumor cells from the adrenal gland of a transplanted mouse developed from primary patient bone marrow cells into a second mouse showed that the tumor cells mainly distributed into the adrenal gland in the second mouse, implying the existence of clonal selection and/or evolution at engraftment of a specific organ. Gene expression profiling analyses demonstrated that the gene set associated with cell migration was enriched for normal peripheral blood B cells, indicating that inhibition of cell migration might be involved in IVLBCL pathogenesis. In conclusion, the mouse xenograft models described here are essential tools for uncovering IVLBCL biology.
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Affiliation(s)
- K Shimada
- Institute for Advanced Research, Nagoya University, Nagoya, Japan.,Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Shimada
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - K Sugimoto
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Fujii Memorial Research Institute, Otsuka Pharmaceutical Co., Ltd, Otsu, Japan
| | - M Nakatochi
- Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Suguro
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - A Hirakawa
- Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T D Hocking
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - I Takeuchi
- Department of Computer Science/Scientific and Engineering Simulation, Nagoya Institute of Technology, Nagoya, Japan
| | - T Tokunaga
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Hematology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Y Takagi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - A Sakamoto
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Aoki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Hematology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - S Nakamura
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - F Hayakawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Seto
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - A Tomita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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24
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Mandal B, Singha S, Dey SK, Mazumdar S, Mondal TK, Karmakar P, Kumar S, Das S. Synthesis, crystal structure from PXRD of a MnII(purp)2complex, interaction with DNA at different temperatures and pH and lack of stimulated ROS formation by the complex. RSC Adv 2016. [DOI: 10.1039/c6ra09387f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
MnII(purpurin)2crystal structure done from PXRD is the second report on hydroxy-9,10-anthraquinone with a 3d-transition metal. DNA binding of complex is better and ROS generation less than purpurin. Complex maintains biological activity of purpurin.
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Affiliation(s)
- Bitapi Mandal
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata-700032
- India
| | - Soumen Singha
- Department of Physics
- Jadavpur University
- Kolkata-700032
- India
| | | | - Swagata Mazumdar
- Department of Life Science and Biotechnology
- Jadavpur University
- Kolkata-700032
- India
| | - Tapan Kumar Mondal
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata-700032
- India
| | - Parimal Karmakar
- Department of Life Science and Biotechnology
- Jadavpur University
- Kolkata-700032
- India
| | - Sanjay Kumar
- Department of Physics
- Jadavpur University
- Kolkata-700032
- India
| | - Saurabh Das
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata-700032
- India
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25
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Abe H, Kamimura K, Kawai H, Kamimura H, Domori K, Kobayashi Y, Nomoto M, Aoyagi Y. Diagnostic imaging of hepatic lymphoma. Clin Res Hepatol Gastroenterol 2015; 39:435-42. [PMID: 25541481 DOI: 10.1016/j.clinre.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/10/2014] [Accepted: 11/03/2014] [Indexed: 02/06/2023]
Abstract
Hepatic lymphoma is a rare disease with poor prognosis because of delayed diagnosis. The disease comprises primary, metastatic, and intravascular hepatic lymphomas. The pathological characteristics of lymphomas differ contributing to difficulty in early diagnosis. Early diagnosis and appropriate treatment result in improved prognosis; therefore, diagnostic radiology and its development with various contrast agents are critical for improving disease outcomes. Herein, we review hepatic lymphomas and summarize the results of imaging studies in correlation with pathological characteristics. The information provided will help physicians in early diagnosis and thereby improving prognosis.
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Affiliation(s)
- Hiroyuki Abe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan.
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Koji Domori
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Yuji Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Minoru Nomoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Yutaka Aoyagi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
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28
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Sagüés M, Paredes V, Altés J, Fernández de Sevilla A. [Ictus cerebellopontine as first manifestation of an intravascular diffuse large B cell lymphoma involving at the kidney]. Med Clin (Barc) 2015; 144:48-9. [PMID: 24698716 DOI: 10.1016/j.medcli.2014.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 02/07/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Miguel Sagüés
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España.
| | - Viviana Paredes
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Jordi Altés
- Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Alberto Fernández de Sevilla
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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29
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Das P, Bhattacharya D, Karmakar P, Das S. Influence of ionic strength on the interaction of THA and its Cu(ii) complex with DNA helps to explain studies on various breast cancer cells. RSC Adv 2015. [DOI: 10.1039/c5ra07805a] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpurin, a structural analogue of anthracycline anticancer drugs, was used to understand how environmental changes affect its biophysical interactions with DNA and along with its Cu(ii) complex, the activity it shows on breast cancer cells.
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Affiliation(s)
- Piyal Das
- Department of Chemistry
- Jadavpur University
- Kolkata – 700 032
- India
| | - Debalina Bhattacharya
- Department of Life Science and Biotechnology
- Jadavpur University
- Kolkata – 700 032
- India
| | - Parimal Karmakar
- Department of Life Science and Biotechnology
- Jadavpur University
- Kolkata – 700 032
- India
| | - Saurabh Das
- Department of Chemistry
- Jadavpur University
- Kolkata – 700 032
- India
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30
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Bailly P, Diraison P, Coustans M, Lamotte N, Breuilly C. [Intravascular large B-cell lymphoma revealed by a cerebral infarct and a mesenteric ischemia]. Presse Med 2014; 44:244-7. [PMID: 25542708 DOI: 10.1016/j.lpm.2014.09.015] [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] [Received: 07/02/2014] [Revised: 08/28/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Pierre Bailly
- Centre hospitalier de Cornouaille, service de neurologie, 29107 Quimper cedex, France.
| | - Philippe Diraison
- Centre hospitalier de Cornouaille, service de neurologie, 29107 Quimper cedex, France
| | - Marc Coustans
- Centre hospitalier de Cornouaille, service de neurologie, 29107 Quimper cedex, France
| | - Nadège Lamotte
- Centre hospitalier de Cornouaille, service de neurologie, 29107 Quimper cedex, France
| | - Christophe Breuilly
- Centre hospitalier de Cornouaille, service de neurologie, 29107 Quimper cedex, France
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31
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Cheah CY, Seymour JF, Dickinson M. Ongoing challenge of optimal patient selection for CNS prophylaxis in patients with non-Hodgkin lymphoma. Int J Hematol Oncol 2014. [DOI: 10.2217/ijh.14.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
SUMMARY CNS relapse is a devastating and frequently lethal complication in patients with lymphoma, and selecting patients to receive CNS-directed prophylaxis is a common and frequently challenging decision for the clinician. Histologic subtype, anatomic location, molecular and clinical risk factors may all be used to stratify patients for CNS risk. In this paper we focus on these issues and attempt to provide practical guidance for the clinician in selecting which patients with lymphoma may benefit from CNS prophylaxis.
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Affiliation(s)
- Chan Yoon Cheah
- Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - John F Seymour
- Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Michael Dickinson
- Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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32
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Panda AK, Malik S. CNS intravascular lymphoma: an underappreciated cause of rapidly progressive dementia. BMJ Case Rep 2014; 2014:bcr-2014-203772. [PMID: 24722717 DOI: 10.1136/bcr-2014-203772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Intravascular lymphoma is a rare subtype of extranodal large cell non-Hodgkin's lymphoma that is usually seen in the elderly. It can occasionally present with neurological symptoms in the form of dementia, focal neurological deficit and seizure. Diagnosis is difficult because of non-specific clinical manifestation. We report a case of a 38-year-old woman presenting with rapidly progressive dementia and seizure. MRI of the brain showed bilateral diffuse involvement of cortex and subcortical white matter. Brain biopsy disclosed the aetiological confirmation of intravascular B-cell lymphoma. The patient was treated with monthly cyclophosphamide, doxorubicin, vincristine and prednisolone regimen, but unfortunately, she died after two chemotherapy cycles. So, high index of suspicion is warranted to diagnose and treat the condition early to have a better outcome.
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Affiliation(s)
- Akhila Kumar Panda
- Department of Neurology, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India
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33
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Mahasneh T, Harrington Z, Williamson J, Alkhawaja D, Duflou J, Shin JS. Intravascular large B-cell lymphoma complicated by invasive pulmonary aspergillosis: a rare presentation. Respirol Case Rep 2014; 2:67-9. [PMID: 25473570 PMCID: PMC4184509 DOI: 10.1002/rcr2.51] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/09/2013] [Accepted: 12/14/2013] [Indexed: 11/25/2022] Open
Abstract
We describe a patient with persisting fevers, a progressive pulmonary infiltrate, and high levels of serum lactate dehydrogenase. No underlying cause for these changes was found prior to her death despite extensive investigations. Postmortem tissue revealed invasive pulmonary aspergillosis and subsequent brain examination revealed vascular changes in keeping with intravascular large B-cell lymphoma (IVLBCL). On review, subtle yet extensive lymphomatous infiltrates involved the vasculature of multiple other organs, including the lungs. Aspergillosis is a relatively rare presenting feature of lymphoproliferative disorders, and IVLBCL is a rare subtype of diffuse large B-cell non-Hodgkin's lymphoma with, to our knowledge, very few case reports to date. Lymphoma should be considered in patients presenting with pneumonitis with bilateral lung infiltrates on imaging, with a high serum level of lactate dehydrogenase.
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Affiliation(s)
- Tamadur Mahasneh
- Department of Anatomical Pathology, School of Medicine, University of Western Sydney Sydney, New South Wales, Australia
| | - Zinta Harrington
- Department of Respiratory Medicine, Liverpool Hospital, University of New South Wales Sydney, New South Wales, Australia
| | - Jonathan Williamson
- Department of Respiratory Medicine, Liverpool Hospital, University of New South Wales Sydney, New South Wales, Australia
| | - Darweesh Alkhawaja
- Department of Surgery, Nepean Hospital, University of Sydney Sydney, New South Wales, Australia
| | - Jo Duflou
- Department of Forensic Medicine, University of Sydney Sydney, New South Wales, Australia
| | - Joo-Shik Shin
- Department of Anatomical Pathology, School of Medicine, University of Western Sydney Sydney, New South Wales, Australia
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34
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Das P, Jain CK, Dey SK, Saha R, Chowdhury AD, Roychoudhury S, Kumar S, Majumder HK, Das S. Synthesis, crystal structure, DNA interaction and in vitro anticancer activity of a Cu(ii) complex of purpurin: dual poison for human DNA topoisomerase I and II. RSC Adv 2014. [DOI: 10.1039/c4ra07127a] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although generation of reactive oxygen species (ROS) by anthracycline anticancer drugs is essential for anti-tumor activity, they make these drugs cardiotoxic.
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Affiliation(s)
- Piyal Das
- Department of Chemistry
- Jadavpur University
- Kolkata-700032, India
| | - Chetan Kumar Jain
- Cancer Biology & Inflammatory Disorder Division
- Indian Institute of Chemical Biology
- Kolkata-700032, India
- Infectious Diseases and Immunology Division
- Indian Institute of Chemical Biology
| | - Sanjoy K. Dey
- Department of Physics
- Jadavpur University
- Kolkata-700032, India
| | - Rajat Saha
- Department of Physics
- Jadavpur University
- Kolkata-700032, India
| | | | - Susanta Roychoudhury
- Cancer Biology & Inflammatory Disorder Division
- Indian Institute of Chemical Biology
- Kolkata-700032, India
| | - Sanjay Kumar
- Department of Physics
- Jadavpur University
- Kolkata-700032, India
| | - Hemanta Kumar Majumder
- Infectious Diseases and Immunology Division
- Indian Institute of Chemical Biology
- Kolkata-700032, India
| | - Saurabh Das
- Department of Chemistry
- Jadavpur University
- Kolkata-700032, India
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35
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Abe H, Kamimura K, Mamizu M, Shibazaki Y, Ishiguro T, Katada SI, Nishiyama YK, Takahashi Y, Hatano YY, Mizuno KI, Watanabe Y, Nagashima A, Takizawa J, Takeuchi M, Kawai H, Nomoto M, Sone H, Nishizawa M, Aoyagi Y. Early diagnosis of hepatic intravascular lymphoma: a case report and literature review. Intern Med 2014; 53:587-93. [PMID: 24633029 DOI: 10.2169/internalmedicine.53.1812] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatic intravascular large B-cell lymphoma (IVL) is a rare disease entity that involves invasion into various organs. Due to the aggressive behavior and poor prognosis of the disease and the difficulty in making an early diagnosis, some cases are diagnosed at autopsy. Early suspicion and the use of imaging studies and liver biopsies are key for diagnosing IVL; however, no reports have described the results of imaging studies due to the limited number of cases. We herein report the results of imaging studies of hepatic IVL, including the findings PET-CT, dynamic-CT, EOB-MRI and CEUS. These results may help physicians to make an early diagnosis and improve the prognosis.
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Affiliation(s)
- Hiroyuki Abe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan
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36
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Hong JY, Kim HJ, Ko YH, Choi JY, Jung CW, Kim SJ, Kim WS. Clinical features and treatment outcomes of intravascular large B-cell lymphoma: a single-center experience in Korea. Acta Haematol 2014; 131:18-27. [PMID: 24021554 DOI: 10.1159/000351060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 03/24/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical features and treatment outcomes of intravascular large B-cell lymphoma (IVLBCL) have rarely been reviewed due to its rarity and pathologic obscurity. METHODS We analyzed 20 patients who were pathologically diagnosed with IVLBCL at the Samsung Medical Center. RESULTS Initial manifestations were nonspecific, such as fever with cytopenia, elevated serum lactate dehydrogenase and hypoalbuminemia. Hemophagocytosis was frequent and bone marrow was the most common site of pathologic diagnosis in our series. Hepatosplenomegaly, pleural effusion and ground-glass opacity in the lungs were also commonly found, and positron emission tomography imaging showed increased (18)F-fluorodeoxyglucose uptake in the involved organs. All patients received CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) or rituximab-CHOP. The median overall survival (OS) was 38.9 months (95% confidence interval 6.7-71.1). Rituximab-containing chemotherapy compared to chemotherapy alone resulted in higher 3-year OS (71.4 and 25.0%; p = 0.027). Patients with hemophagocytosis had a poorer 3-year OS compared to patients without hemophagocytosis (29.6 and 75%; p = 0.046). Prognostic factor analysis showed the association of pleural effusion with worse OS (p = 0.002). CONCLUSIONS Treatment with rituximab-containing chemotherapy can improve the treatment outcome of IVLBCL. Pleural effusion may be a poor prognostic factor in patients with IVLBCL.
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Affiliation(s)
- Jung Yong Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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37
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Gan LP, Ooi WS, Lee HY, Ng WH. A case of large B-cell intravascular lymphoma in the brain. Surg Neurol Int 2013; 4:99. [PMID: 23956942 PMCID: PMC3740612 DOI: 10.4103/2152-7806.115709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 05/29/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Intravascular lymphoma is a rare and fatal disease that can have central nervous system (CNS) manifestations. It is usually a diagnosis made postmortem. This is partly due to its varied presentation, which lends itself to the complexity of diagnosis. CASE DESCRIPTION We report a rare case of intravascular lymphoma in the brain found antemortem. CONCLUSION Review of the literature shows that a timely diagnostic tissue biopsy together with aggressive combination chemotherapy treatment can improve patient outcome.
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Affiliation(s)
- Lee Ping Gan
- Department of Neurosurgery, National Neuroscience Institute, Singapore
| | - Wei Seong Ooi
- Department of Medical Oncology, National Cancer Centre, Singapore
| | - Hwei Yee Lee
- Department of Histopathology, Tan Tock Seng Hospital, Singapore
| | - Wai Hoe Ng
- Department of Neurosurgery, National Neuroscience Institute, Singapore
- Department of Neurosurgery, Duke-NUS Graduate Medical School, Singapore
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38
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Abstract
We describe three cases of intravascular lymphoma B with different clinical presentation: one case of a cutaneous variant and two cases with surrenal and cutaneous localisation. All patients are in complete remission after chemotherapy alone or after chemotherapy and autologous stem cells transplantation. The review of the literature as well as our cases specify the interest of an aggressive chemotherapy with autologous of peripheral stem cells if it was possible.
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39
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Wakim JJ, Levenson BM, Mathews D, Naina HV. Management of an unusual case of intravascular large B-cell lymphoma of the penis, prostate, and bones with CNS relapse. J Clin Oncol 2013; 31:e288-90. [PMID: 23650410 DOI: 10.1200/jco.2012.46.6003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Jad J Wakim
- Division of Hematology and Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
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40
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Franz M, Alfidja A, Molucon Chabrot C, Hermet E, Montoriol PF, Rosset E, Boyer L, Chabrot P. [Lymphoma and arteries: peri- or intravascular?]. ACTA ACUST UNITED AC 2013; 38:162-71. [PMID: 23473620 DOI: 10.1016/j.jmv.2013.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 01/13/2013] [Indexed: 12/24/2022]
Abstract
PURPOSE Lymphoma is a polymorphous disease that does not spare arteries. Arterial involvement may be perivascular or intravascular, with different prognostic and therapeutic implications. PATIENTS AND METHODS We present here one case of perivascular lymphoma and another case of intravascular lymphoma in order to highlight the specific features of each type. RESULTS The first patient was a woman who presented a pseudo-aneurysmal anterior iliac artery due to a non-Hodgkin lymphoma with subsequent bilateral pyelocalyceal distension. The second patient was a man who developed intravascular lymphomatosis expressed by an aneurysm of the common femoral then the primitive iliac artery. CONCLUSION The distinction between perivascular and intravascular arterial involvement is based on a range of features and is essential for an optimal care of patients with lymphoma.
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MESH Headings
- Aged
- Aneurysm/etiology
- Aneurysm/pathology
- Aneurysm, False/etiology
- Aneurysm, False/pathology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Aorta, Abdominal/pathology
- Arterial Occlusive Diseases/etiology
- Arteritis/diagnosis
- Diagnosis, Differential
- Female
- Femoral Artery/pathology
- Fourth Ventricle/pathology
- Humans
- Hydrocephalus/etiology
- Iliac Artery/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Positron-Emission Tomography
- Recurrence
- Renal Artery Obstruction/complications
- Sarcoma/diagnosis
- Thrombosis/etiology
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Affiliation(s)
- M Franz
- Service de Radiologie B, Pôle de Radiologie, CHU Gabriel-Montpied, 58 rue Montalembert, BP 69, 63003 Clermont-Ferrand cedex 1, France.
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41
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Kloesel B, Vaidya R, Howard MT, Thompson CA. A unifying diagnosis for pancytopenia, fever, hypoglycemia, and lactic acidosis. Am J Hematol 2013; 88:78-81. [PMID: 22460726 DOI: 10.1002/ajh.23178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 02/15/2012] [Accepted: 02/22/2012] [Indexed: 12/17/2022]
Affiliation(s)
- Benjamin Kloesel
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55904, USA
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42
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Intravascular CNS lymphoma: Successful therapy using high-dose methotrexate-based polychemotherapy. Exp Hematol Oncol 2012; 1:37. [PMID: 23217063 PMCID: PMC3533508 DOI: 10.1186/2162-3619-1-37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 11/24/2012] [Indexed: 11/10/2022] Open
Abstract
Intravascular diffuse large B-cell lymphoma limited to the CNS (cIVL) is a very rare malignant disorder characterized by a selective accumulation of neoplastic lymphocytes (usually B cells) within the lumen of CNS blood vessels but not in the brain parenchyma. In the past, treatment of cIVL with anthracycline-based regimens was unsatisfactory with very short survival times. In the case of cIVL presented here, high-dose methotrexate-based polychemotherapy according to the Bonn protocol plus rituximab therapy was successful and led to a complete clinical and MRI remission which is ongoing 29 months after diagnosis.
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43
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Tirado CA, Chen W, García R, Kohlman KA, Rao N. Genomic profiling using array comparative genomic hybridization define distinct subtypes of diffuse large B-cell lymphoma: a review of the literature. J Hematol Oncol 2012; 5:54. [PMID: 22967872 PMCID: PMC3479011 DOI: 10.1186/1756-8722-5-54] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/31/2012] [Indexed: 11/13/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin Lymphoma comprising of greater than 30% of adult non-Hodgkin Lymphomas. DLBCL represents a diverse set of lymphomas, defined as diffuse proliferation of large B lymphoid cells. Numerous cytogenetic studies including karyotypes and fluorescent in situ hybridization (FISH), as well as morphological, biological, clinical, microarray and sequencing technologies have attempted to categorize DLBCL into morphological variants, molecular and immunophenotypic subgroups, as well as distinct disease entities. Despite such efforts, most lymphoma remains undistinguishable and falls into DLBCL, not otherwise specified (DLBCL-NOS). The advent of microarray-based studies (chromosome, RNA, gene expression, etc) has provided a plethora of high-resolution data that could potentially facilitate the finer classification of DLBCL. This review covers the microarray data currently published for DLBCL. We will focus on these types of data; 1) array based CGH; 2) classical CGH; and 3) gene expression profiling studies. The aims of this review were three-fold: (1) to catalog chromosome loci that are present in at least 20% or more of distinct DLBCL subtypes; a detailed list of gains and losses for different subtypes was generated in a table form to illustrate specific chromosome loci affected in selected subtypes; (2) to determine common and distinct copy number alterations among the different subtypes and based on this information, characteristic and similar chromosome loci for the different subtypes were depicted in two separate chromosome ideograms; and, (3) to list re-classified subtypes and those that remained indistinguishable after review of the microarray data. To the best of our knowledge, this is the first effort to compile and review available literatures on microarray analysis data and their practical utility in classifying DLBCL subtypes. Although conventional cytogenetic methods such as Karyotypes and FISH have played a major role in classification schemes of lymphomas, better classification models are clearly needed to further understanding the biology, disease outcome and therapeutic management of DLBCL. In summary, microarray data reviewed here can provide better subtype specific classifications models for DLBCL.
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Affiliation(s)
- Carlos A Tirado
- Department of Pathology & Laboratory Medicine UCLA - David Geffen UCLA, School of Medicine, Los Angeles, USA.
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44
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Abstract
A rare type of diffuse large B-cell lymphoma, intravascular large B-cell lymphoma primarily affects the middle-aged to elderly population, with a slight predominance in men. By the time of presentation, most patients have advanced, disseminated disease, and often the diagnosis is made at autopsy. Patients may present with any of a myriad of symptoms, with any tissue potentially being infiltrated. Central nervous system and cutaneous involvement is common, as is the presence of B symptoms including fever, weight loss, and night sweats. Morphologically, growth of neoplastic cells is restricted to the lumen of small vessels. The cells are large, with 1 or more prominent nucleoli, scant cytoplasm, and frequent mitotic figures, and are commonly positive for cluster of differentiation markers 79a, 20, and 19, as well as MUM1/IRF4 and Bcl-2. Intravascular large B-cell lymphoma is aggressive, and without treatment is rapidly fatal.
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Affiliation(s)
- Dennis E Orwat
- Department of Pathology, Medical University of South Carolina, Charleston, 29425, USA
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45
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Geyer H, Karlin N, Palen B, Mesa R. Asian-variant intravascular lymphoma in the African race. Rare Tumors 2012; 4:e10. [PMID: 22532908 PMCID: PMC3325737 DOI: 10.4081/rt.2012.e10] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 12/12/2011] [Indexed: 01/28/2023] Open
Abstract
Intravascular Large B-cell lymphoma (IVLBCL) is an exceptionally rare form of non-Hodgkin lymphoma (NHL) distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laboratory data was notable for anemia, thrombocytopenia, elevated liver function tests, and hematuria. An extensive work-up for infectious, rheumatologic and malignant causes was negative. Her symptoms progressed and within two weeks, she was admitted for disseminated intravascular coagulation (DIC). Her course was complicated by diffuse pulmonary hemorrhage and ultimately, care was withdrawn. Autopsy identified widespread CD-20 positive intravascular large B-cell lymphoma with significant hepatosplenic involvement, characteristic of the Asian variant IVLBCL. This case uniquely highlights development of the Asian variant IVLBVL in a previously undescribed race. Identified by its intraluminal vascular growth pattern, IVLBCL generally spares lymphatic channels. Diagnosis and differentiation of this condition from other hematological malignancies via skin, visceral and bone marrow biopsy is imperative as anthracycline-containing chemotherapies may significantly improve clinical outcomes. This article outlines the common presentation, natural course, and treatment options of IVLBCL, along with the histopathology, immunohistochemistry, and chromosomal aberrations common to this condition.
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Affiliation(s)
- Holly Geyer
- Division of Hematology - Oncology, Mayo Clinic, Scottsdale, AZ, USA
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46
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Chroboczek T, Lazaro E, Greib C, Parrens M, Dilhuydi MS, Pellegrin JL, Viallard JF. [Intravascular large B cell lymphoma: a case series of three patients and update]. Rev Med Interne 2012; 33:250-8. [PMID: 22305635 DOI: 10.1016/j.revmed.2011.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 11/06/2011] [Accepted: 12/21/2011] [Indexed: 01/29/2023]
Abstract
PURPOSE Intravascular large B cell lymphoma (IVLBCL) is a rare and aggressive variant of non-Hodgkin's lymphoma, characterized by multifocal proliferation of lymphoma cells exclusively within small and medium blood vessels. IVLBCL can be systemic and quite polymorphic, which often makes it difficult to diagnose, thus delaying appropriate treatment. PATIENTS AND METHODS We report three patients of atypical IVLBCL, through the study of which we overview recent knowledge about IVLBCL. RESULTS The first patient initially presented with peripheral thrombocytopenia and splenic destruction of platelets, later completed with an interstitial pulmonary syndrome. The second patient, of African origin, we believe is the first case of a black patient with IVLBCL described in the medical literature. The third belongs to the rare group of occidental patients that present an IVLBCL associated with a hemophagocytic syndrome. CONCLUSION Intravascular large B cell lymphoma is a systemic and polymorphic disease. Awareness of this entitiy should allow rapid and appropriate management.
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Affiliation(s)
- T Chroboczek
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévèque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
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47
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Zhao S, Zhang L, Zhang M, Yao G, Zhang X, Zhao W, Ren W, Wang J, Zhang Q. Angioimmunoblastic T-cell lymphoma: the effect of initial treatment and microvascular density in 31 patients. Med Oncol 2011; 29:2311-6. [PMID: 22038726 DOI: 10.1007/s12032-011-0094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 10/13/2011] [Indexed: 01/19/2023]
Abstract
The objectives of this study are to explore the clinical features and treatment outcomes and to investigate the correlation between microvessel density (MVD) and survival in patients with angioimmunoblastic T-cell lymphoma (AITL). We retrospectively analyzed clinical and follow-up data of 31 patients treated in two hospitals during 1995-2009 histologically proven AITL. We also assessed MVD in the lump of 31 previously untreated patients using α-CD34 immunohistochemical staining. The median age of the 31 patients was 48 years, eighty percent of the patients were in an advanced stage. 67.7% of them had B symptoms, with the follow-up of 2-13 years, the 5-year overall survival rate was 25.8%. The response rates (RR) of CHOP group and COP (cyclophosphamide, vincristine and prednisolone) group are 76.5 and 75%, respectively, which is no significant difference (P=0.894). RR did not differ whether chemotherapy regimens contained anthracycline or not. The 3-year PFS rate for patients who received COP and CHOP regimen was 25.4 and 35.3% (P=0.562), while 5-year OS rates were 25.0 and 29.4%, respectively (P=0.667). The median PFS for patients with high MVD and low MVD were 15.1 and 30.0 months (P=0.048), while the median OS were 20 and 45 months, respectively (P=0.038). Patients who were sensitive to initial chemotherapy COP regimen have the similar therapeutic effect to CHOP regimen. Patients with high MVD measured in the microenvironment had worse PFS and OS than AITL patients with low expression.
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Affiliation(s)
- Shu Zhao
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150081, China
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48
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Müldür E, Chott A, Mirzaei S, Zojer N, Ludwig H. Patient with high-grade fever, night sweats, and hepatosplenomegaly. J Clin Oncol 2011; 29:e254-6. [PMID: 21220615 DOI: 10.1200/jco.2010.32.6330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
MESH Headings
- Adult
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Biopsy
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Female
- Fever/etiology
- Hepatomegaly/etiology
- Humans
- Immunohistochemistry
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/physiopathology
- Positron-Emission Tomography
- Prednisone/administration & dosage
- Rituximab
- Splenomegaly/etiology
- Sweating
- Treatment Outcome
- Vascular Neoplasms/complications
- Vascular Neoplasms/diagnosis
- Vascular Neoplasms/drug therapy
- Vascular Neoplasms/physiopathology
- Vincristine/administration & dosage
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49
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Passarin MG, Wen PY, Vattemi E, Buffone E, Ghimenton C, Bontempini L, Ottaviani S, Musso AM, Pedersini R. Intravascular lymphomatosis and intracerebral haemorrhage. Neurol Sci 2010; 31:793-7. [PMID: 20517703 DOI: 10.1007/s10072-010-0284-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Accepted: 04/07/2010] [Indexed: 11/27/2022]
Abstract
Intravascular lymphomatosis (IVL) is a rare, malignant B- or T-cell lymphoma with remarkable affinity for the endothelial cells of small vessels, particularly within the skin and central nervous system. It is a disease that mimics several neurological disorders, particularly those of cerebrovascular ischemic origin. The prognosis is generally poor, with a rapidly fatal outcome. As a result the diagnosis is often made at post-mortem. We report a rare case of a 73-year-old patient with IVL complicated by intracerebral haemorrhage. In literature two cases of systemic IVL complicated by intracerebral haemorrhage have been reported, but they presented initially with a disseminated intravascular coagulation (DIC). This is the first case of brain IVL complicated by intracerebral haemorrhage not associated to DIC. Increasing awareness of this disease as a differential diagnosis to a common clinical presentation may lead to more opportunities to evaluate new diagnostic and treatment approaches.
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Affiliation(s)
- Maria Grazia Passarin
- Division of Neurology, Department of Medicine, Bussolengo Hospital, Via Ospedale 2, Bussolengo, Verona, Italy.
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50
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Pless ML, Chen YB, Copen WA, Frosch MP. Case records of the Massachusetts General Hospital. Case 9-2010. A 37-year-old woman with paresthesias and ataxia. N Engl J Med 2010; 362:1129-38. [PMID: 20335590 DOI: 10.1056/nejmcpc0910092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Misha L Pless
- Department of Neurology, Massachusetts General Hospital, USA
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