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Duffy P, Ecklund K. MR features of primary bone lymphoma in children. Pediatr Radiol 2023; 53:2400-2410. [PMID: 37770576 DOI: 10.1007/s00247-023-05772-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Primary lymphoma of bone is an uncommon non-Hodgkin lymphoma. Magnetic resonance imaging (MRI) features of primary lymphoma of bone in children are not well described. OBJECTIVE To identify typical MRI characteristics of pediatric primary lymphoma of bone at diagnosis and following treatment. MATERIALS AND METHODS Two pediatric radiologists retrospectively reviewed all imaging studies of 10 patients with biopsy-proven primary lymphoma of bone at presentation and after treatment. Anatomic location, number of sites, location within bone (epiphyseal, metaphyseal, diaphyseal), T1-weighted imaging margins, soft tissue mass, T2-weighted imaging appearance and enhancement pattern (homogeneous, heterogeneous, infarct-like), soft tissue edema, cortical disruption, and regional lymph nodes as seen on MRI as well as radiographic and positron emission tomography (PET) findings were recorded. Pathologic results, treatment plans, and outcomes at follow-up as detailed in the medical record were tabulated. RESULTS Of 10 patients, age at diagnosis 8-17 years, median 15 years, 4 (40%) had multifocal disease. MRI revealed 20 total lesions in the 10 patients with femoral lesions most common, being present in 7 (70%) of patients. Eight (80%) patients had at least one lesion around the knee. Eight (80%) patients had 1 or more lesions involving an epiphysis and 5 (50%) had at least 1 lesion confined to the epiphysis. Seven (70%) showed infarct-like appearance on T2-weighted imaging; 7 (88%) of the 8 patients with post-contrast imaging had infarct-like enhancement. Six (60%) had sharp T1 margins, 3 (30%) had cortical disruption, 8 (80%) had at least mild soft tissue edema, and 1 (10%) had soft tissue mass. Three (30%) had at least 1 PET-positive regional lymph node. At follow-up (range 1-108 months, median 4.3 months), all had residual osseous abnormality on MRI with 6 (60%) maintaining an infarct-like or combination of infarct-like and T2 hyperintense appearance. CONCLUSION Our results in this series of pediatric primary lymphoma of bone identified several frequent MR imaging features. Multifocality, epiphyseal involvement (especially about the knee), infarct-like enhancement pattern, sharp T1 margins, and surrounding soft tissue edema should raise suspicion for primary lymphoma of bone. Following treatment, residual osseous abnormality is expected on MRI.
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Affiliation(s)
- Patrick Duffy
- Boston Children's Hospital, Department of Radiology, Harvard Medical School, Boston, MA, USA.
| | - Kirsten Ecklund
- Boston Children's Hospital, Department of Radiology, Harvard Medical School, Boston, MA, USA
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Bhakta P, Youssef A, Bigham L, Mallick J, Bhargava P, Rawas F, Weaver D, Hunzeker ZE, Dong J, Willis M, Qiu S, Nawgiri R, Iguh CCC, Lyapichev KA. Proposal of Diagnostic Approach of Periodontal Primary Non Hodgkin Lymphoma of Bone with Flow Cytometry as an Essential Diagnostic Component. Head Neck Pathol 2022; 16:1091-1102. [PMID: 35802244 PMCID: PMC9729681 DOI: 10.1007/s12105-022-01469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/16/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary bone lymphoma is a rare type of lymphoid neoplasm with favorable prognosis, where Primary Non Hodgkin Lymphoma of bone (PB-NHL) is most common with the subtype. Amongst PB-NHL, diffuse large Bcell lymphoma represents the majority of cases. The mandible is a very uncommon site of involvement, presenting as a painful bone mass with high suspicion of osteomyelitis. METHODS We report the case of a 45-year-old male with no significant past medical history who was admitted to the hospital with a large right jaw mass and pain after recent tooth removal. The original tissue biopsy was not diagnostic, and cultures were found to be negative for microorganisms. Due to enlargement of the mass, a fine needle aspiration (FNA) was done. At the time of rapid onsite evaluation of the FNA, atypical lymphoid cells were seen, and material was obtained for flow cytometry (FC) evaluation. This revealed an aberrant clonal B-cell population. The consequent immunohistochemical evaluation of original material supported the diagnosis of PB-NHL. After chemotherapy patient improved. RESULTS After an extensive English language literature review, we identified and summarized the clinical presentations, diagnostic procedures, histopathologic features, treatment methods, and outcomes of forty-two cases of periodontal PB-NHL. Based on our findings, we propose a set of clinical features at initial presentation to increase the clinical suspicion of periodontal PB-NHL for practitioners. CONCLUSION Based on our institution's experience and the literature review conclusions, we propose the University of Texas Medical Branch diagnostic approach for PB-NHL and suggest that FNA and FC should be utilized as the essential diagnostic component. The fast and efficient diagnosis of PB-NHL can facilitate the correct treatment and sufficiently improve patient care.
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Affiliation(s)
- Pooja Bhakta
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX USA
| | - Ayman Youssef
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX USA
| | - Lindsay Bigham
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Jayati Mallick
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Peeyush Bhargava
- Department of Radiology, University of Texas Medical Branch, Galveston, TX USA
| | - Faisal Rawas
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Dylan Weaver
- Department of Radiology, University of Texas Medical Branch, Galveston, TX USA
| | - Zachary E. Hunzeker
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX USA
| | - Jianli Dong
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Maurice Willis
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX USA
| | - Suimin Qiu
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Ranjana Nawgiri
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
| | | | - Kirill A. Lyapichev
- Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555 USA
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Gante J, Georg S, Robez JMG, Dubuc A, Lauwers F. Primary extra-nodal non-Hodgkin's lymphoma affecting mandibular bone: a case report. Pan Afr Med J 2022; 41:231. [PMID: 35721648 PMCID: PMC9167483 DOI: 10.11604/pamj.2022.41.231.33778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
Non-Hodgkin's lymphoma (NHL) is the second most common non-epithelial malignant tumor in the cervicofacial region. Among aggressive NHL, the most common histological type is diffuse large B cell lymphoma (DLBCL). A 44-year-old man presented himself at the oral surgery consultation for the development of isolated dental mobilities associated with mandibular osteolytic lesion. The extraoral examination showed nothing. The neurological examination did not reveal dysesthesia or hypoesthesia. The endo-buccal examination showed an erythematous gum, mobility stage 3 of teeth #42 to 35 with positive pulp sensitivity tests on teeth #34 to 47 and no increased probing depth. The X-rays found homogeneous rounded monogeodic osteolytic lesion extending from teeth #42 to 35 with thinning of the cortical layer. The anatomopathological results of a partial biopsy of the parasymphyseal region found a diffuse large B cell lymphoma of GC phenotype. The patient was referred to the department of oncohematology and treatment was only medical with R-CHOP 21 type immunochemotherapy for 6 cycles. Primary intraosseous localization of non-Hodgkin's lymphoma is rare. The clinical and radiological signs of this malignant tumor pathology are not specific and make its positive diagnosis particularly difficult. In case of uncertainty, an appropriate radiological examination combined with a partial biopsy is essential.
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Affiliation(s)
- Julie Gante
- Department of Maxillo-Facial Surgery, University Hospital of Toulouse, Paul Sabatier University, Purpan, Toulouse, France
| | - Ségolène Georg
- Department of Maxillo-Facial Surgery, University Hospital of Toulouse, Paul Sabatier University, Purpan, Toulouse, France
| | | | - Antoine Dubuc
- Department of Maxillo-Facial Surgery, University Hospital of Toulouse, Paul Sabatier University, Purpan, Toulouse, France
| | - Frédéric Lauwers
- Department of Maxillo-Facial Surgery, University Hospital of Toulouse, Paul Sabatier University, Purpan, Toulouse, France
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Michi Y, Harada H, Oikawa Y, Okuyama K, Kugimoto T, Kuroshima T, Hirai H, Mochizuki Y, Shimamoto H, Tomioka H, Kachi H, Sakamoto JI, Kayamori K, Yoda T. Clinical manifestations of diffuse large B-cell lymphoma that exhibits initial symptoms in the maxilla and mandible: a single-center retrospective study. BMC Oral Health 2022; 22:20. [PMID: 35081952 PMCID: PMC8793180 DOI: 10.1186/s12903-022-02056-x] [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: 07/01/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphatic tumor; however, extranodal DLBCLs that exhibit initial symptoms in the maxilla and mandible are rare. Moreover, DLBCL is clinically classified as a moderate to highly malignant lymphatic tumor that can progress rapidly; therefore, early diagnosis is crucial. However, diagnosis is difficult as the disease causes a diverse range of clinical symptoms with no characteristic imaging findings. We conducted a clinical investigation to clarify the clinical characteristics of DLBCL that exhibits initial manifestation in the maxilla and mandible. METHODS Of the 2748 patients with malignant tumors of the oral and maxillofacial region examined at our hospital during a period of 11 years between January 2006 and December 2016, 27 primary cases diagnosed with DLBCL based on the chief complaint of symptoms in the gingiva and bone of the maxilla and mandible were enrolled in this study. Evaluations were based on sex, age, whether treatment was provided by a previous physician, symptoms, duration of disease until treatment was sought, clinical diagnosis, laboratory findings, and imaging results. RESULTS There were 15 cases that involved the maxilla and 12 that involved the mandible. The median duration of disease until treatment was sought was 60 d (3-450 d). All cases exhibited a tumor or a mass, and hypoesthesia of the chin was confirmed in eight cases wherein the mandible was involved. The clinical stages were stage I in eight cases, stage II in ten cases, and stage IV in nine cases. Serum lactate dehydrogenase (LDH) levels were elevated in 13 of 22 patients. The overall survival rate was 63%. CONCLUSIONS Symptoms associated with nontender swelling and numbness of the lip or chin in the absence of other findings such as dental infections should raise suspicions about DLBCL. Patients should be provided appropriate imaging and accurate biopsy assessments to improve prognosis.
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Affiliation(s)
- Yasuyuki Michi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Kohei Okuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takuma Kugimoto
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takeshi Kuroshima
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hideaki Hirai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yumi Mochizuki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hirofumi Tomioka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hirokazu Kachi
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Jun-Ichiro Sakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Larmie J, Vasilyeva D, Peters SM. Palatal swelling in an 84-year-old woman. J Am Dent Assoc 2021; 153:894-898. [PMID: 34489070 DOI: 10.1016/j.adaj.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/03/2021] [Accepted: 06/19/2021] [Indexed: 10/20/2022]
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Yoshino A, Ishida S, Nakamura S, Kita R, Seto M, Matsumoto S, Takeshita M, Kondo S. Use of Liquid-based Cytology and Cell Block Combined Technique for an Accurate Diagnosis of Oral Diffuse Large B Cell Lymphoma: A Case Report. Diagnostics (Basel) 2020; 10:diagnostics10100823. [PMID: 33066681 PMCID: PMC7602475 DOI: 10.3390/diagnostics10100823] [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: 09/09/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
Primary oral diffuse large B cell lymphoma (DLBCL) is rare and the differential diagnosis is difficult due to its low incidence and nonspecific symptoms, which resemble those of common oral diseases in the initial clinical setting. We aimed to discuss the value of making an accurate diagnosis using liquid-based cytology (LBC) and cell block (CB) for not only the morphological interpretation but also cytohistological assessment of oral DLBCL. LBC and CBs made from oral brushing materials were prepared on the first medical examination and a morphological analysis and immunohistochemical analysis of specific biomarkers were performed. The analysis of LBC preparations showed the presence of large-size lymphocytes with large irregular nuclei and prominent nucleoli, suggesting the existence of large B-cell lymphoma. A more detailed histological subclassification of the CB specimen was performed, which was classified as the activated B-cell (ABC) phenotype of DLBCL, by confirming the immunohistochemical expression of CD10−/ B-cell lymphoma 6 (BCL6)+/ multiple myeloma oncogene 1(MUM1)+, which is a significant risk factor in DLBCL. Our findings suggest that the combination of LBC and CB is a useful and informative tool for making an accurate molecular diagnosis of oral DLBCL in cases in which lymphomas are clinically suspected.
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Affiliation(s)
- Aya Yoshino
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
| | - Shintaro Ishida
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
| | - Shinsuke Nakamura
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
| | - Ryosuke Kita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
| | - Mika Seto
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
| | - Shinji Matsumoto
- Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (S.M.); (M.T.)
| | - Morishige Takeshita
- Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (S.M.); (M.T.)
| | - Seiji Kondo
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (A.Y.); (S.I.); (S.N.); (R.K.); (M.S.)
- Correspondence: ; Tel.: +81-(92)-801-1011; Fax: +81-(92)-801-1044
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Karadwal A, Chatterjee S, Pathak K, Sabharwal R. Diffused mixed B-cell non-Hodgkin lymphoma of mandible. J Oral Maxillofac Pathol 2020; 24:S77-S81. [PMID: 32189910 PMCID: PMC7069130 DOI: 10.4103/jomfp.jomfp_310_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 09/06/2019] [Accepted: 01/16/2020] [Indexed: 12/29/2022] Open
Abstract
Lymphomas are the third-most common cancer of the oral cavity after squamous cell carcinomas and salivary gland tumors. It is characterized by proliferation of lymphoid cells and their precursor. Diffuse B-cell non-Hodgkin lymphoma is the most common histological type of lymphoma in the head-and-neck region and most commonly affects older men in their seventh decade of life.
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Affiliation(s)
- Asha Karadwal
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Shailja Chatterjee
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Kush Pathak
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Robin Sabharwal
- Department of Oral Pathology, MM College of Dental Sciences and Research, Ambala, Haryana, India
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Mortazavi H, Baharvan M, Rezaeifar K. Periapical lymphoma: Review of reported cases in the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:404-407. [PMID: 32035143 DOI: 10.1016/j.jormas.2020.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 11/25/2022]
Abstract
Oral lymphoma can resemble clinically to other pathologic entities such as periapical radiolucencies, or dental abscess. The aim of this study was to review the literature related to misdiagnosed periapical lymphomas and discuss their characteristics. In this review study, authenticated search engines and databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were surfed to find articles related to the topic by using related keywords. Out of more than 100 articles approximately, 50 were closely relevant to the title, and ultimately 43 well-documented English articles were chosen. Out of 45 reported cases, 63% were male and 37% were female with mean age of 41.22 years. The majority of such lesions have been detected in the mandible (61%) with a mandibular to maxillary involvement ratio of 1.58:1. The most frequent type of lymphoma was diffuse large B cell lymphoma (DLBCL) (53%). Noteworthy, 49% of periapical lymphoma has been misdiagnosed as pulpal pathology and treated through root canal therapy. The mean time lapse before making the correct diagnosis was 4.3 months. Although rare, periapical lymphoma should be ranked in the differential diagnosis of a periapical lesion especially when vitality pulp tests are positive.
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Affiliation(s)
- H Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - M Baharvan
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - K Rezaeifar
- Department of Oral Medicine, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Abstract
RATIONALE Primary lymphoma of the bones (PLB) is a rare extranodal non-Hodgkin lymphoma (NHL) that is particularly rare in children. The clinical presentation and radiological features of PLB are often nonspecific, making clinical diagnosis challenging and misdiagnosis frequent. Here, we report 2 children with PLB focusing on clinical presentation, differential diagnosis, and treatment outcomes. PATIENTS CONCERNS A 9-year-old boy presented with left knee swelling and pain for 4 months after a fall. He was previously misdiagnosed with traumatic soft tissue injury. The second patient was an 11-year-old boy with a 6-month history of intermittent left knee pain. He was previously misdiagnosed with bone tuberculosis and chronic osteomyelitis. DIAGNOSES A 9-year-old boy showed an abnormal signal of the left tibia metaphysis, diaphysis, and epiphysis, and tibia with periosteal reactions and surrounding soft tissue swelling. Tumor biopsy and immunohistochemistry confirmed a diagnosis of B-cell lymphoblastic lymphoma.An 11-year-old boy showed a permeative lesion in the metaphysis and diaphysis of the left proximal tibia. Tumor biopsy and immunohistochemistry confirmed the diagnosis of diffuse large B-cell lymphoma. INTERVENTIONS Both patients were treated with 6 courses of NHL-Berlin-Frankfurt-Münster-95. OUTCOMES Both patients are in complete clinical remission with a follow-up of 27 and 18months after treatment, respectively. LESSONS PLB is a rare malignancy that is difficult to diagnose, particularly in children. Clinicians should increase the awareness of the disease and consider a differential diagnosis of bone lesions. Chemotherapy combined with radiotherapy is a favorable treatment for children with PLB. Early diagnosis and active treatment can improve patient prognosis.
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Affiliation(s)
- Haiqiang Suo
- Department of Bone and Joint, The First Hospital of Jilin
| | - Li Fu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University Changchun, Jilin, China
| | - Zhiwei Wang
- Department of Bone and Joint, The First Hospital of Jilin
| | - Hanguang Liang
- Department of Bone and Joint, The First Hospital of Jilin
| | - Zhe Xu
- Department of Bone and Joint, The First Hospital of Jilin
| | - Wei Feng
- Department of Bone and Joint, The First Hospital of Jilin
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Hao S, Sun Y, Hu C, Zhi Y, Xiao H, Li Y. Primary nasal diffuse large B-cell lymphoma with synchronous pulmonary involvement: A case report. Medicine (Baltimore) 2019; 98:e15439. [PMID: 31027146 PMCID: PMC6831417 DOI: 10.1097/md.0000000000015439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Diffuse large B-cell lymphoma (DLBCL) is the most commonly occurring type of non-Hodgkin's lymphoma, which may be found at various extranodal sites. The nose is not a common site for DLBCL as compared with natural killer/T-cell lymphoma, and synchronous pulmonary involvement is even rarer. We report a case of primary nasal DLBCL who presented with a mass in the left lower lobe, mimicking primary lung carcinoma. PATIENT CONCERNS A 62-year-old Chinese female visited the Ear-Nose-Throat Department of our hospital with nasal congestion and rhinorrhea for 2 months. DIAGNOSIS Computed tomography scan revealed a mass with soft tissue density in the left vestibule and nasal cavity. Histopathological examination revealed a large number of lymphoma cells, and immunohistochemistry confirmed the diagnosis of DLBCL. INTERVENTIONS The patient was treated with 6 cycles of R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisone, and rituximab). OUTCOMES The treatment was well tolerated and led to complete remission for the patient. There was no sign of relapse over the 3-year close follow-up LESSONS:: DLBCL can be present at various extranodal sites and clinicians irrespective of their specialty must be vigilant for the synchronous mode of presentation of such lesions. Immunohistochemical techniques play a vital role in the diagnosis, because clinical characteristics may be misleading.
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Affiliation(s)
- Shuhong Hao
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yan Sun
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Chunmei Hu
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yunhui Zhi
- Department of Ultrasound, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Han Xiao
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yarong Li
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
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11
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Luo B, Gu YY, Wang XD, Chen G, Peng ZG. Identification of potential drugs for diffuse large b-cell lymphoma based on bioinformatics and Connectivity Map database. Pathol Res Pract 2018; 214:1854-1867. [PMID: 30244948 DOI: 10.1016/j.prp.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/28/2018] [Accepted: 09/14/2018] [Indexed: 12/17/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most main subtype in non-Hodgkin lymphoma. After chemotherapy, about 30% of patients with DLBCL develop resistance and relapse. This study was to identify potential therapeutic drugs for DLBCL using the bioinformatics method. The differentially expressed genes (DEGs) between DLBCL and non-cancer samples were downloaded from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO). Gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of DEGs were analyzed using the Database for Annotation, Visualization, and Integrated Discovery. The R software package (SubpathwayMiner) was used to perform pathway analysis on DEGs affected by drugs found in the Connectivity Map (CMap) database. Protein-protein interaction (PPI) networks of DEGs were constructed using the Search Tool for the Retrieval of Interacting Genes online database and Cytoscape software. In order to identify potential novel drugs for DLBCL, the DLBCL-related pathways and drug-affected pathways were integrated. The results showed that 1927 DEGs were identified from TCGA and GEO. We found 54 significant pathways of DLBCL using KEGG pathway analysis. By integrating pathways, we identified five overlapping pathways and 47 drugs that affected these pathways. The PPI network analysis results showed that the CDK2 is closely associated with three overlapping pathways (cell cycle, p53 signaling pathway, and small cell lung cancer). The further literature verification results showed that etoposide, rinotecan, methotrexate, resveratrol, and irinotecan have been used as classic clinical drugs for DLBCL. Anisomycin, naproxen, gossypol, vorinostat, emetine, mycophenolic acid and daunorubicin also act on DLBCL. It was found through bioinformatics analysis that paclitaxel in the drug-pathway network can be used as a potential novel drug for DLBCL.
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Affiliation(s)
- Bin Luo
- Department of Medical Oncology, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China
| | - Yong-Yao Gu
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China
| | - Xiao-Dong Wang
- The Ultrasonics Division of Radiology Department, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China
| | - Zhi-Gang Peng
- Department of Medical Oncology, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China.
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12
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Silva RNF, Mendonça EF, Batista AC, Alencar RDCG, Mesquita RA, Costa NL. T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: Report of the First Case in the Mandible. Head Neck Pathol 2018; 13:711-717. [PMID: 30019325 PMCID: PMC6854205 DOI: 10.1007/s12105-018-0948-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/12/2018] [Indexed: 12/29/2022]
Abstract
T-cell/histiocyte-rich large B-cell lymphoma (THRBCL) is an uncommon subtype of non-Hodgkin's lymphoma. It is a predominant nodal neoplasm; however, extranodal sites, such as the spleen, liver and bone marrow, can be involved at diagnosis. However, only one case of primary THRLBCL in the jaws have been reported. We herein describe a 29-year-old female patient who presented with a swelling of the right mandible that had grown rapidly over the previous 2 months. Periapical and panoramic radiographs showed a multilocular osteolytic lesion located in the mandibular periapical region of the canine and premolar teeth and molar region. Preoperative examination and incisional biopsy were performed. Immunohistochemistry was applied to confirm the diagnosis of THRBCL in the jaw. The treatment consisted of CHOP therapy and radiotherapy. After complete tumor remission following initial treatment, additional sites of the disease appeared in the lung, abdomen and long bones. The patient died within 2 months. THRLBCL is an uncommon and aggressive malignant neoplasm that can involve the jaws, mimicking a periapical disease.
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Affiliation(s)
- Ricardo Natã Fonseca Silva
- Department of Stomathology (Oral Pathology), School of Dentistry, Federal University of Goias, Goiânia, GO Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomathology (Oral Pathology), School of Dentistry, Federal University of Goias, Goiânia, GO Brazil ,Division of Head and Neck, Araújo Jorge Hospital, Association of Cancer Combat of Goiás, Goiânia, Brazil
| | - Aline Carvalho Batista
- Department of Stomathology (Oral Pathology), School of Dentistry, Federal University of Goias, Goiânia, GO Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG Brazil
| | - Nadia Lago Costa
- Department of Stomathology (Oral Pathology), School of Dentistry, Federal University of Goias, Goiânia, GO Brazil
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