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Guo Z, Hu L, Chen Q, Hu J, Liu J, Hu W. Synchronous pulmonary MALT lymphoma and squamous cell lung cancer: a case report. World J Surg Oncol 2023; 21:182. [PMID: 37337168 DOI: 10.1186/s12957-023-03069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023] Open
Abstract
Pulmonary B-cell lymphoma in the extranodal marginal zone of mucosa-associated lymphoid tissue (MALT), a rare tumor originating from bronchial mucosa-associated lymphoid tissue, is the major histologic type of primary pulmonary lymphoma. Combined lung squamous cell carcinoma with pulmonary MALT lymphoma is rare. A 63-year-old male patient presented to the hospital because of a dry cough, and chest CT showed soft tissue density nodules in the upper lobe of the right lung, the boundary was visible lobulation and spiculation, and the middle lobe of the right lung showed patchy shadow, moderate enhancement, associated with bronchial traction. After a multidisciplinary diagnosis and treatment (MDT) discussion, surgical resection was done for the patient, and postoperative pathological results showed pulmonary MALT lymphoma combined with lung squamous carcinoma. For complex pulmonary multiple lesions, judgment needs to be made after MDT discussion, and timely intervention is required for lesions suspicious of malignancy. There are no uniform recommendations for the management of mixed tumors of the lung, and an individualized treatment plan needs to be developed based on the patient's actual condition.
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Affiliation(s)
- Zixin Guo
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China
- Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, People's Republic of China
| | - Liwen Hu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China
- Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, People's Republic of China
| | - Qiongrong Chen
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China
| | - Junwei Hu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China
- Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, People's Republic of China
| | - Jun Liu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China
- Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, People's Republic of China
| | - Weidong Hu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
- Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, People's Republic of China.
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2
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Lin H, Zhou K, Peng Z, Liang L, Cao J, Mei J. Surgery and chemotherapy cannot improve the survival of patients with early-stage mucosa-associated lymphoid tissue derived primary pulmonary lymphoma. Front Oncol 2022; 12:965727. [PMID: 36081547 PMCID: PMC9446888 DOI: 10.3389/fonc.2022.965727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background To date, there is no treatment consensus on mucosa-associated lymphoid tissue (MALT) derived primary pulmonary lymphoma (PPL). Methods We identified patients with early-stage MALT-type PPL from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program database. The patients were divided into four groups according to treatment modalities: None of surgery or chemotherapy (None) group, Surgery alone group, Chemotherapy alone (Chemo alone) group, and Surgery plus chemotherapy (Surgery + chemo) group. Overall survival (OS) and cancer-specific survival (CSS) were study endpoints. We performed Cox regression analyses, propensity score-matched analyses (PSM) and Kaplan-Meier (KM) survival curves to compare the survival among different groups. Results A total of 953 patients were included in our analysis with 302, 403, 175, and 73 cases in the None, Surgery alone, Chemo alone, and Surgery + chemo groups, respectively. In this cohort, the estimated 3-year, 5-year and 10-year OS rates were 86.95%, 78.91%, and 55.89%, respectively. Meanwhile, the estimated 3-year, 5-year and 10-year CSS rates were 96.71%, 93.73%, and 86.84%, respectively. Multivariate Cox regression analyses demonstrated that increasing age, tumors located in the lower lobe, and stage II were significant predictors of poorer OS while increasing age and tumors located in the bilateral lungs were associated with lower CSS. After PSM analyses, the KM survival curves showed no significant differences in OS or CSS among the four groups. Conclusion Early-stage MALT-type PPL is indolent in nature. Neither surgery, chemotherapy nor a combination of surgery and chemotherapy can improve OS and CSS, suggesting that “watch and wait” may be a reasonable alternative.
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Affiliation(s)
- Huahang Lin
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Ke Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Zhiyu Peng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Linchuan Liang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Jie Cao
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
| | - Jiandong Mei
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China
- *Correspondence: Jiandong Mei,
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Yin X, Xu A, Huang Z, Fan F, Wang Y, Chen L, Cui G, Hu Y, Sun C. The relationship among primary anatomic subsite and risk and distribution of second malignant neoplasms in patients with stage I/II diffuse large B-cell lymphoma: An analysis of the surveillance, epidemiology, and end results database. Transl Oncol 2021; 14:101106. [PMID: 33932917 PMCID: PMC8102996 DOI: 10.1016/j.tranon.2021.101106] [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: 12/08/2020] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 12/30/2022] Open
Abstract
Diffuse large B-cell lymphoma(DLBCL) involving different primary extranodal sites have distinct clinicopathological characteristics and prognosis. Patients with extranodal DLBCL have an increased risk of SMN than the US general population(SIR, 1.18; 95% CI, 1.11–1.26). The risk of SMN significantly differs according to the location of DLBCL, age, sex and latency. Different anatomical sites tend to develop different types of second tumors. The strategies for cancer surveillance after extranodal DLBCL diagnosis may need to be individualized according to the subsite of extranodal DLBCL.
Background Recent studies have reported that diffuse large B-cell lymphoma (DLBCL) involving different primary extranodal sites have distinct clinicopathological characteristics and prognosis. However, the risk of secondary malignant neoplasms (SMNs) in DLBCL survivors with different primary extranodal sites are unknown. Methods A total of 40,714 patients diagnosed with stage I/II DLBCL were included from the Surveillance, Epidemiology, and End Results (SEER) database from 1983 to 2015.The standardized incidence ratio (SIR) and absolute excess risk (AER) were used to assess the risk of SMNs. Results The results show that the risk of SMN was significantly higher in extranodal DLBCL than in the US general population (SIR, 1.18; 95% CI, 1.11–1.26), and the risk of developing SMN remains significantly elevated with increased latency. Moreover, there were multiple site-specific risk patterns. There was a 22%, 44%, 66%, 123% and 151% increased risk of SMN 10 years after primary gastrointestinal tract, head/neck, skeletal, lung and liver/pancreas DLBCL diagnosis, respectively. There was a significant decrease risk of SMN with increasing age at diagnosis for primary gastrointestinal tract and skeletal DLBCL. In addition, DLBCL patients with primary sites in the gastrointestinal tract, thyroid and liver/pancreas had the highest incidences of secondary stomach cancer, second thyroid cancer, and second hepatobiliary cancer, respectively, which indicated that the initial site of DLBCL may predict the type of SMN. Conclusions The strategies for cancer surveillance after extranodal DLBCL diagnosis may need to be individualized according to the subsite of extranodal DLBCL.
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Affiliation(s)
- Xuejiao Yin
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Aoshuang Xu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenli Huang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengjuan Fan
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yajun Wang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Chen
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guohui Cui
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Sun
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China
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He H, Tan F, Xue Q, Liu L, Peng Y, Bai G, Zhang M, Gao S. Clinicopathological characteristics and prognostic factors of primary pulmonary lymphoma. J Thorac Dis 2021; 13:1106-1117. [PMID: 33717584 PMCID: PMC7947551 DOI: 10.21037/jtd-20-3159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Primary pulmonary lymphoma (PPL) is a rare extranodal lymphoma originating from the lung, accounting for 0.5–1.0% of primary lung malignant tumors. Previous case reports or cohort studies included a limited sample size; therefore, the understanding of the disease remains inadequate, and clinical data regarding PPL are limited. Methods Patients with PPL diagnosed histologically and radiologically between January 2000 and December 2019 at our center were retrospectively analyzed. Results In total, 90 consecutive cases were included in this research. Forty-seven (52.2%) patients were female, and the median age was 54 years old. Non-Hodgkin’s lymphoma (PPNHL) was the most common type of PPL (71/90, 78.9%), and mucosa-associated lymphoid tissue (MALT) lymphoma was the most common pathological subtype of PPNHL (56.3%) followed by diffuse large B-cell lymphoma (DLBCL) (32.4%). Thirty-nine (43.3%) patients underwent surgical treatment, and the others received chemotherapy alone or combined with radiotherapy. The estimated 5-year overall survival (OS) rates of MALT lymphoma and non-MALT lymphoma were 68.9% and 65.9%, respectively. Univariate analysis of PPL showed that clinicopathological features that significantly correlated with worse OS were age over 60 years (P=0.006<0.05), elevated LDH (P=0.029<0.05) and β2-MG (P=0.048<0.05) levels, clinical stage II2E and greater (P=0.015<0.05), and nonsurgical treatment (P=0.046<0.05). Age (P=0.013<0.05) was an independent prognostic factor for the 5-year OS of patients through multivariate analysis. Conclusions Age over 60 years old, elevated LDH and β2-MG levels, clinical stage II2E disease or higher, and nonsurgical treatment were associated with poor prognosis in patients with PPL. Age can be used as a potential independent prognostic factor for PPL.
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Affiliation(s)
- Huayu He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Peng
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangyu Bai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Moyan Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Treatment and outcomes of primary mediastinal B cell lymphoma: a three-decade monocentric experience with 151 patients. Ann Hematol 2020; 100:2261-2268. [PMID: 33305333 PMCID: PMC8357719 DOI: 10.1007/s00277-020-04364-0] [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: 06/10/2020] [Accepted: 11/30/2020] [Indexed: 01/07/2023]
Abstract
Primary mediastinal B cell lymphoma is a rare entity and often should be promptly treated as a hematological emergency: The initial treatment decision is crucial for the management of this disease. An observational retrospective study was conducted with the aim to improve information on treatment and outcomes of primary mediastinal B cell lymphoma in real practice. After 12 cycles of MACOP-B regimen (methotrexate, doxorubicin, cyclophosphamide, vincristine, bleomycin , and prednisone) with or without rituximab, 120 patients out of 151 (79.5%) achieved a complete response and 12 (7.9%) a partial response leading to a global response of 87.4%. The 21-year overall survival is 82.6%; progression-free and disease-free survivals are 69.3% and 86.4%, respectively. Regarding the role of radiotherapy (RT), patients with a negative PET scan after MACOP-B did not undergo RT: One out of these 48 (2.1%) showed a relapse at 11 months. All relapsed/refractory patients who achieved a response with checkpoint inhibitors are still in continuous complete response with a median follow-up of 14 months. Data that we have gathered over a 30-year experience in the treatment of primary mediastinal B cell lymphoma patients clearly indicate that a third-generation chemotherapy regimen such as MACOP-B is feasible and easily deliverable on an outpatient basis. Regarding the unmet medical need of relapsed/refractory patients, new encouraging results occurred with the advent of the checkpoint inhibitors.
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Xie X, Zhang L, Wu M, Kang Z, Yan H, Zhang X, Shen W, Dong M. A retrospective study on the clinical characteristics and radiological features of primary pulmonary lymphoma. Transl Cancer Res 2020; 9:1969-1977. [PMID: 35117543 PMCID: PMC8798910 DOI: 10.21037/tcr.2020.02.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022]
Abstract
Background The retrospective study was mainly performed to determine the clinical symptoms and radiological characteristics of primary pulmonary lymphoma (PPL) to improve the recognition and diagnosis of the disease. Methods Between June 2007 and June 2019, the clinical data and radiological images of the 16 patients with PPL confirmed by pathology were retrospectively analyzed. Results Among the 16 patients with PPL (6 males and 10 females, aged 32 to 72 years, with a median age of 55.13 years), 9 patients were mucosa-associated lymphoid tissue lymphoma (MALT) and 7 patients were diffuse large B-cell lymphoma (DLBCL); all of the patients did not suffer from autoimmune disease [such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or Sjogren’s syndrome (SSS)]; and 11 patients had a long-term smoking history from 10 to 40 years. The common clinical symptoms were as follows: chest discomfort (n=8), cough (n=10), chest pain (n=7), fever (n=6), apnea (n=1), fatigue (n=4) and weight loss (n=3), however, 6 cases did not show clear symptoms at the time of diagnosis. Blood tests revealed anemia (n=6), thrombocytopenia (n=2), lactate dehydrogenase (LDH) level (n=7), C-reactive protein (CRP) (n=9), erythrocyte sedimentation rate (ESR) (n=8) and no tumor-related indexes were detected abnormal. The chest radiological images showed a total of 8 cases with multiple masses, 2 cases with different types of nodes, 4 cases with patchy infiltration or consolidation shadow, with or without an air bronchogram, and 2 cases with a mixed manifestation. All the lesions were only involved in unilateral lung (13 right, 3 left), none of them located on bilateral lung fields. At the time of admission, the patients were misdiagnosed as lung cancer (n=9), pneumonia (n=5), tuberculosis (n=1), and diffuse interstitial lung disease (n=1). Then final pathological diagnosis was confirmed by surgery (n=9), percutaneous lung biopsy (n=5), and bronchoscopic biopsy (n=2). Conclusions PPL is a rare disease, though clinical symptoms and radiological characteristics are not typical, they serve as significant clues for the diagnosis and differential diagnosis. Accurate diagnosis mainly depends on histopathological examination, however, conducting a retrospectively study could improve and enrich our knowledge to the disease and reduce inappropriate treatments.
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Affiliation(s)
- Xiaodong Xie
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Lei Zhang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Mengjie Wu
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Zheng Kang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Hongwei Yan
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Xiuming Zhang
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Wenrong Shen
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Min Dong
- Departments of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
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Aussedat G, Traverse-Glehen A, Stamatoullas A, Molina T, Safar V, Laurent C, Michot JM, Hirsch P, Nicolas-Virelizier E, Lamure S, Regny C, Picquenot JM, Ledoux-Pilon A, Tas P, Chassagne-Clément C, Manson G, Lemal R, Fontaine J, Le Cann M, Salles G, Ghesquières H, Copie-Bergman C, Sarkozy C. Composite and sequential lymphoma between classical Hodgkin lymphoma and primary mediastinal lymphoma/diffuse large B-cell lymphoma, a clinico-pathological series of 25 cases. Br J Haematol 2020; 189:244-256. [PMID: 32030731 DOI: 10.1111/bjh.16331] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/30/2019] [Indexed: 01/12/2023]
Abstract
Composite and sequential lymphomas involving both classical Hodgkin lymphoma (CHL) and primary mediastinal B-cell lymphoma (PMBCL) are rare phenomena. Beyond the relevant biological interest raised by these cases, treatments and outcome data are poorly covered in the recent literature. This retrospective analysis describes the pathological and clinical characteristics of 10 composite and 15 sequential cases included after a central pathological review. At diagnosis, 70% of the composite lymphomas presented a disseminated and extranodal disease. Among the 15 sequential lymphomas, 12 were CHL at first occurrence and three were PMBCL. Based on their clinical evolution, these sequential lymphomas could be divided into early (i.e., diagnosis of second lymphoma within a year) and late [(i.e., a second lymphoma occurrence occurring after a long period of complete remission]). All composite cases were alive in complete remission after a median follow-up of 34 months. If the early sequential lymphoma presented a particularly poor outcome with a median overall survival shorter than one year, the late cases were efficiently salvaged. Further molecular studies are needed to describe the underlying biology of these rare diseases, possibly representing the extreme of tumour cell plasticity found in grey-zone lymphoma.
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Affiliation(s)
- Guillaume Aussedat
- Department of Haematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France.,INSERM Unité Mixte de Recherche (UMR)-S1052, Centre National de la Recherche UMR 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France-Equipe Labellisée Ligue Contre le Cancer - Université Claude Bernard Lyon 1, Pierre Bénite cedex, France
| | - Alexandra Traverse-Glehen
- INSERM Unité Mixte de Recherche (UMR)-S1052, Centre National de la Recherche UMR 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France-Equipe Labellisée Ligue Contre le Cancer - Université Claude Bernard Lyon 1, Pierre Bénite cedex, France.,Pathology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France
| | | | - Thierry Molina
- Pathology Department, Necker Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Violaine Safar
- Department of Haematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France
| | - Camille Laurent
- Pathology Department, Centre de Recherche en Cancerologie de Toulouse-Purpan, Institut Universitaire du Cancer-Oncopole de Toulouse, CHU Toulouse, INSERM U.1037, Toulouse, France
| | - Jean-Marie Michot
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, INSERM U1170, Villejuif, France
| | - Pierre Hirsch
- Department of Haematology, Centre de Recherche Saint-Antoine CRSA, Sorbonne Université, Inserm, AP-HP, Hôpital Saint Antoine, Paris, France
| | | | - Sylvain Lamure
- Department of Haematology, CHU Montpellier, Montpellier, France
| | - Caroline Regny
- Department of Haematology, CHU Grenoble, Grenoble, France
| | | | | | - Patrick Tas
- Pathology Department, CHU Rennes, Rennes, France
| | | | | | - Richard Lemal
- Histocompatibility Unit, CHU, Université Clermont Auvergne, EA7453 CHELTER, CIC1405, Clermont Ferrand, France
| | - Juliette Fontaine
- Pathology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France
| | - Marie Le Cann
- Department of Hematology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Gilles Salles
- Department of Haematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France.,INSERM Unité Mixte de Recherche (UMR)-S1052, Centre National de la Recherche UMR 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France-Equipe Labellisée Ligue Contre le Cancer - Université Claude Bernard Lyon 1, Pierre Bénite cedex, France
| | - Hervé Ghesquières
- Department of Haematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France.,INSERM Unité Mixte de Recherche (UMR)-S1052, Centre National de la Recherche UMR 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France-Equipe Labellisée Ligue Contre le Cancer - Université Claude Bernard Lyon 1, Pierre Bénite cedex, France
| | - Christiane Copie-Bergman
- Pathology Department, CHU Henri Mondor, APHP, INSERM U955, Université Paris-Est, Créteil, France
| | - Clémentine Sarkozy
- Department of Haematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite cedex, France.,INSERM Unité Mixte de Recherche (UMR)-S1052, Centre National de la Recherche UMR 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France-Equipe Labellisée Ligue Contre le Cancer - Université Claude Bernard Lyon 1, Pierre Bénite cedex, France
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Takyar J, Raut M, Borse R, Balakumaran A, Sehgal M. Relapsed/refractory primary mediastinal large B-cell lymphoma: a structured review of epidemiology, treatment guidelines and real-world treatment practices. Expert Rev Hematol 2020; 13:275-287. [DOI: 10.1080/17474086.2020.1716725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Koç ZP, Kara PÖ, Özge C, Yaldız M. F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Images of Severe Primary Lung Lymphoma. Indian J Nucl Med 2020; 35:80-81. [PMID: 31949381 PMCID: PMC6958965 DOI: 10.4103/ijnm.ijnm_61_19] [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: 03/10/2019] [Revised: 03/26/2019] [Accepted: 04/28/2019] [Indexed: 11/04/2022] Open
Abstract
Primary lung lymphoma is one of the rarest forms of lymphoma and pulmonary space-occupying lesions. This case report represents the F-18 fluorodeoxyglucose positron emission tomography/computed tomography images of the most severe form of the primary pulmonary lymphoma reported in the literature.
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Affiliation(s)
- Zehra Pınar Koç
- Department of Nuclear Medicine, Medical Faculty, Mersin University, Mersin, Turkey
| | - Pelin Özcan Kara
- Department of Nuclear Medicine, Medical Faculty, Mersin University, Mersin, Turkey
| | - Cengiz Özge
- Department of Respiratory Medicine, Medical Faculty, Mersin University, Mersin, Turkey
| | - Mehmet Yaldız
- Department of Pathology, Medical Faculty, Mersin University, Mersin, Turkey
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Primary Pulmonary Diffuse Large B-Cell Lymphoma Presenting as an Endobronchial Lesion: The Youngest Adult Patient in the Literature. CURRENT HEALTH SCIENCES JOURNAL 2019; 45:425-428. [PMID: 32110447 PMCID: PMC7014988 DOI: 10.12865/chsj.45.04.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/20/2019] [Indexed: 12/02/2022]
Abstract
A 20-year-old female patient was admitted to hospital with complaints of chest and back pain in September 2018. There was a cavitary lesion in the upper zone of the left lung in the chest X-ray. Thorax CT revealed an irregular contoured and shaped mass with 87x67x79 mm sizes, in the upper lobe of the left lung lying to paramediastinal area. Since there was a doubt about malignancy, positron emission tomography (PET) was performed; there was a cavitary lesion in the left upper lobe with high FDG uptake (SUVmax: 23.2). Bronchoscopic examination revealed an endobronchial lesion with nearly complete occlusion in the apicoposterior segment of the left upper lobe. Bronchoalveolar lavage (BAL) performed in this session for acid-fast bacilli (AFB) was negative. The patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) by histopathological and immunohistochemical evaluation of endobronchial biopsy specimens. Following the final diagnosis of Bronchus-Associated Lymphoid Tissue Lymphoma (BALTOMA), the patient was referred to the department of haematology, and chemotherapy was planned for therapy. Since DLBCL is extremely rare, and uncommonly presenting with an endobronchial lesion, we want to present this patient as the youngest adult case of primary endobronchial BALT lymphoma in the literature.
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Hashimoto Y, Omura H, Tokuyasu Y, Nakamoto S, Tanaka T. Successful Management of Primary Mediastinal Large B-cell Lymphoma during Pregnancy. Intern Med 2019; 58:3455-3459. [PMID: 31391392 PMCID: PMC6928502 DOI: 10.2169/internalmedicine.3129-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We experienced a pregnant woman with superior vena cava syndrome at 15 weeks of pregnancy who was diagnosed with primary mediastinal large B-cell lymphoma and given chemotherapy. In this case, the clinical courses of both the mother and infant were favorable without any serious complications because of close multidisciplinary cooperation. Based on a retrospective review of this case, the administration of CHOP-like regimens during the second and third trimesters appears relatively safe. Because pregnancy and continuation of pregnancy are rare in patients with hematopoietic malignancies, the accumulation of detailed information is important.
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Affiliation(s)
| | - Hiromi Omura
- Department of Hematology, Tottori Prefectural Central Hospital, Japan
| | - Yusuke Tokuyasu
- Department of Pathology, Tottori Prefectural Central Hospital, Japan
| | - Shu Nakamoto
- Department of Pathology, Tottori Prefectural Central Hospital, Japan
| | - Takayuki Tanaka
- Department of Hematology, Tottori Prefectural Central Hospital, Japan
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Cozzi D, Dini C, Mungai F, Puccini B, Rigacci L, Miele V. Primary pulmonary lymphoma: imaging findings in 30 cases. Radiol Med 2019; 124:1262-1269. [PMID: 31583557 DOI: 10.1007/s11547-019-01091-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/25/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To present our experience of cases of primary pulmonary lymphoma (PPL) found between January 2002 and July 2018, focusing on the radiological features and the differential diagnosis in order to contribute to the difficult role of the radiologist in the disease identification and to help the clinicians to reach the diagnosis. MATERIALS AND METHODS CT scans of 30 patients (14 men and 16 women, aged 58-86, mean age 72 years) with PPL were retrospectively reviewed. All patients had a histopathological confirmation of the disease: MALT lymphoma (23 patients, 76.6%); diffuse large B-cell lymphoma-DLBCL (seven patients, 23.4%). All the staging CT scans were evaluated by three experienced radiologists dedicated to thoracic disease in order to radiologically define the predominant pattern of presentation. RESULTS The following parenchymal patterns were observed: 11 patients with single/multiple nodules, five with masses/mass-like consolidations, 14 with consolidations with air bronchogram, 16 with ground-glass opacity, ten with angiogram sign, 22 with perilymphatic and/or peribronchovascular spread, 15 with associated lymphadenopathies, and 13 with pleural/chest wall involvement. The main characteristics of PPLs were the presence of consolidations and ground-glass opacities, with perilymphatic and/or bronchovascular spread. CONCLUSION All the characteristics of the work should alert the radiologist to consider lymphoma among the possible differential diagnoses, always correlating the results of the CT examination with appropriate clinical laboratory evaluations.
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Affiliation(s)
- Diletta Cozzi
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Catia Dini
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Francesco Mungai
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Benedetta Puccini
- Haematology Unit - Department of Oncology, University Hospital Careggi, Florence, Italy
| | - Luigi Rigacci
- Haematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy.
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Abstract
OBJECTIVE. The purpose of this article is to provide a primer for radiologists focused on integrating the radiologic, pathologic, and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL). CONCLUSION. PMLBCL is a unique subtype of lymphoma that poses diagnostic and therapeutic challenges to the fields of radiology and oncology. Knowledge of this distinctive clinical-pathologic entity and its associated imaging and clinical features is critical for radiologists.
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Zhang XY, Gu DM, Guo JJ, Su QQ, Chen YB. Primary Pulmonary Lymphoma: A Retrospective Analysis of 27 Cases in a Single Tertiary Hospital. Am J Med Sci 2019; 357:316-322. [PMID: 30904047 DOI: 10.1016/j.amjms.2019.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/20/2018] [Accepted: 01/18/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND The objective of this study was to improve the understanding of primary pulmonary lymphoma (PPL) for clinicians. METHODS We enrolled 27 patients diagnosed with PPL in the First Affiliated Hospital of Soochow University from January 2000 to December 2016. The clinical manifestations, imaging findings, pathologic features, treatments and prognosis of the patients were collected. RESULTS The male to female ratio was 1.5:1 and the average age was 54.6 ± 15.7 years old. Nine patients were asymptomatic. The main manifestations were cough, expectoration, bloody sputum and fever. The imaging findings presented as nodule, mass, pneumonia or consolidation. There were 2 cases of Hodgkin's lymphoma, 18 cases of non-Hodgkin's lymphoma and 7 cases of undifferentiated lymphoma. Non-Hodgkin's lymphoma cases were divided into T-cell lymphoma (n = 2), mucosa-associated lymphoid tissue lymphoma (MALT) (n = 11), diffuse large B-cell lymphoma (n = 3), small B-cell lymphoma (n = 1) and plasmacytoid B-cell lymphoma (n = 1). Ten MALT cases survived and 1 diffuse large B-cell lymphoma case has been in stable condition for 71 months after surgery and chemotherapy. The international prognostic index was related to the prognosis of PPL. CONCLUSIONS The clinical manifestations and imaging findings of PPL were nonspecific. The prognosis of MALT was better than other types of PPL. The International prognostic index can be used for predicting the prognosis of PPL.
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Affiliation(s)
- Xin-Yue Zhang
- Department of Respiratory Medicine, First People's Hospital of Yuhang District, Hangzhou, China
| | | | - Jing-Jing Guo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qing-Qing Su
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan-Bin Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Knežević S, Gajović Z, Petrović M. Primary mediastinal large B-cell lymphoma. PRAXIS MEDICA 2019. [DOI: 10.5937/pramed1901049k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Broccoli A, Zinzani PL. The unique biology and treatment of primary mediastinal B-cell lymphoma. Best Pract Res Clin Haematol 2018; 31:241-250. [DOI: 10.1016/j.beha.2018.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/11/2018] [Accepted: 07/02/2018] [Indexed: 01/03/2023]
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17
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Autologous stem cell transplantation for primary mediastinal B-cell lymphoma: long-term outcome and role of post-transplant radiotherapy. A report of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2018; 53:1001-1009. [PMID: 29463854 DOI: 10.1038/s41409-017-0063-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 08/22/2017] [Accepted: 09/17/2017] [Indexed: 11/08/2022]
Abstract
The purpose of this retrospective registry study was to investigate the outcome of autoSCT for primary mediastinal B-cell lymphoma (PMBCL) in the rituximab era, including the effects of eventual post-transplant radiotherapy (RT) consolidation. Patients with PMBCL aged between 18 and 70 years who were treated with a first autoSCT between 2000 and 2012 and registered with the EBMT were eligible. Eighty-six patients with confirmed PMBCL and the full data set required for this analysis were evaluable. Sixteen patients underwent autoSCT in remission after first-line therapy (CR/PR1), 44 patients were transplanted with chemosensitive relapsed or primary refractory disease (CR/PR >1), and 24 patients were chemorefractory at the time of autoSCT. With a median follow-up of 5 years, 3-year estimates of relapse incidence, progression-free survival, and overall survival were 6%, 94%, and 100% for CR/PR1; 31%, 64%, and 85% for CR/PR >1; and 52%, 39%, and 41% for REF, respectively. Whilst there was no significant benefit of post-transplant RT in the CR/PR >1 group, RT could completely prevent disease recurrence post d100 in the refractory group. In conclusion, autoSCT with or without consolidating RT is associated with excellent outcome in chemoimmunotherapy-sensitive PMBCL, whereas its benefits seem to be limited in chemoimmunotherapy-refractory disease.
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Aguiar-Bujanda D, Ros-Sanjuan L, Hernandez-Sosa M, Perera-Romero C. An unexpected diagnosis in a patient with new-onset pulmonary infiltrates during adjuvant therapy for breast cancer. Oxf Med Case Reports 2018; 2018:omx095. [PMID: 29479451 PMCID: PMC5806405 DOI: 10.1093/omcr/omx095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/17/2017] [Indexed: 11/22/2022] Open
Abstract
The differential diagnosis of new-onset pulmonary infiltrates during adjuvant therapy in a cancer patient is challenging. Opportunistic infections, pulmonary drug-induced toxicity and metastatic dissemination of the underlying cancer are the most common causes. However, although infrequent, the development of a second primary pulmonary neoplasia should be taken into account. We present the clinical case of a breast cancer patient who developed progressive pulmonary infiltrates during adjuvant therapy, who was finally diagnosed as having a second lung neoplasm of unexpected histology.
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Affiliation(s)
- David Aguiar-Bujanda
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
- Correspondence address. Department of Medical Oncology. Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria. Spain. Tel: +34-928-450400; Fax: +34-928-450079; E-mail:
| | - Laura Ros-Sanjuan
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Maria Hernandez-Sosa
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
| | - Carmen Perera-Romero
- Department of Nuclear Medicine, Hospital Universitario de Gran Canaria Dr Negrin, c/ Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain
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Dirweesh A, Bukhari S, Alvarez C, Khan M, Rimmer C, Shmuts R. Concurrent Primary Gastric and Pulmonary Diffuse Large B-Cell Lymphoma: A Case Report and Literature Review. Gastroenterology Res 2017; 10:311-314. [PMID: 29118873 PMCID: PMC5667698 DOI: 10.14740/gr860w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 06/12/2017] [Indexed: 12/15/2022] Open
Abstract
The primary pulmonary diffuse large B-cell lymphoma (PPDLBCL), a kind of non-Hodgkin’s lymphomas, itself is a rare entity. Its association with primary B-cell gastric lymphoma has not been established yet. Herein we present a case of PPDLBCL along with a literature review. This case is special and extremely rare as it has concurrent primary gastric B-cell lymphoma.
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Affiliation(s)
- Ahmed Dirweesh
- Department of Internal Medicine, Seton Hall University-Hackensack Meridian School of Medicine, Saint Francis Medical Center, Trenton, NJ, USA
| | - Sumera Bukhari
- Department of Internal Medicine, Seton Hall University-Hackensack Meridian School of Medicine, Saint Francis Medical Center, Trenton, NJ, USA
| | - Chikezie Alvarez
- Department of Internal Medicine, Seton Hall University-Hackensack Meridian School of Medicine, Saint Francis Medical Center, Trenton, NJ, USA
| | - Muhammad Khan
- Department of Internal Medicine, Seton Hall University-Hackensack Meridian School of Medicine, Saint Francis Medical Center, Trenton, NJ, USA
| | - Cheryl Rimmer
- Department of Pathology, Our Lady of Lourdes Hospital, Willingboro, NJ, USA
| | - Robert Shmuts
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Willingboro, NJ, USA
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Tamang TGL, Singh P, Garellek J, Malhotra S, Chandra AB, Solomon W. Prostatic Lymphoma Masquerading as Urinary Retention and Hematuria With Review of Literature. World J Oncol 2017; 8:132-135. [PMID: 29147449 PMCID: PMC5650011 DOI: 10.14740/wjon1055w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 11/25/2022] Open
Abstract
Lymphomas of prostate are very rare tumors. They are not commonly considered in the clinical and histological differential diagnosis of prostatic enlargement. We report a case of a 49-year-old man who presented to emergency department with several weeks of difficulty in urination, for which he was being treated for benign prostate hyperplasia with no improvement. Computerized tomography scan showed lobulated mass originating from the superior aspect of the prostate with right inguinal lymph node involvement and no distant organ metastatic disease. Prostatic biopsy revealed diffuse large B-cell lymphoma. The patient achieved complete remission after six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimen. Lymphomas of the prostate should be considered in differential diagnosis of the patient presenting with obstructive lower urinary tract symptoms especially in patients with normal prostatic-specific antigen level and previous history of lymphoma in other sites.
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Affiliation(s)
- Tsering Gyalpo Lama Tamang
- Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA.,Both first authors and contributed equally
| | - Prabhsimranjot Singh
- Department of Hematology/Oncology, Maimonides Medical, Center, Brooklyn, NY, USA.,Both first authors and contributed equally
| | - Jonathan Garellek
- Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Sonali Malhotra
- Department of Pediatric Endocrinology, Maimonides Medical Center, Brooklyn, NY, USA
| | | | - William Solomon
- Department of Hematology/Oncology, Maimonides Medical, Center, Brooklyn, NY, USA
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Saitoh Y, Ohnishi-Amemiya A, Asano M, Tanaka Y, Yoshizawa S, Fujimoto H, Itoh Y, Nakamura N, Ohyashiki K. Unique radiological features of two cases of primary pulmonary diffuse large B-cell lymphoma. Thorax 2017; 72:859-860. [PMID: 28710338 DOI: 10.1136/thoraxjnl-2017-210248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/25/2017] [Accepted: 05/29/2017] [Indexed: 11/03/2022]
Affiliation(s)
- Yuu Saitoh
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | | | - Michiyo Asano
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Yuko Tanaka
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | | | - Hiroaki Fujimoto
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Yoshikazu Itoh
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University, Isehara, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
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Zinzani PL, Broccoli A. Optimizing Outcomes in Primary Mediastinal B-cell Lymphoma. Hematol Oncol Clin North Am 2017; 30:1261-1275. [PMID: 27888880 DOI: 10.1016/j.hoc.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Primary mediastinal B-cell lymphoma is characterized by a high chance of cure, and cured patients have a long disease-free life-expectancy; however, prognosis is severe in the case of relapsed or refractory disease. The initial use of the most effective chemoimmunotherapy regimen is therefore crucial. Understanding who will benefit from postinduction radiotherapy is also of paramount importance; positron emission tomography may be a reliable guide for physicians in determining which patients will require consolidation. New drugs with mechanisms of action including the most relevant biologic features of the tumor may allow better disease control.
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology L. e A. Seràgnoli, University of Bologna, Via Massarenti, 9, Bologna 40138, Italy.
| | - Alessandro Broccoli
- Institute of Hematology L. e A. Seràgnoli, University of Bologna, Via Massarenti, 9, Bologna 40138, Italy
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Broccoli A, Casadei B, Stefoni V, Pellegrini C, Quirini F, Tonialini L, Morigi A, Marangon M, Argnani L, Zinzani PL. The treatment of primary mediastinal large B-cell lymphoma: a two decades monocentric experience with 98 patients. BMC Cancer 2017; 17:276. [PMID: 28415982 PMCID: PMC5392963 DOI: 10.1186/s12885-017-3269-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/05/2017] [Indexed: 01/14/2023] Open
Abstract
Background The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades. Methods Our single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only. Results Sixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented. Conclusions Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.
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Affiliation(s)
- Alessandro Broccoli
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy.
| | - Beatrice Casadei
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Vittorio Stefoni
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Cinzia Pellegrini
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Federica Quirini
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Lorenzo Tonialini
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Alice Morigi
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Miriam Marangon
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Lisa Argnani
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
| | - Pier Luigi Zinzani
- Institute of Haematology "L. e A. Seràgnoli", University of Bologna, Via Massarenti, 9 - 40138, Bologna, Italy
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Wei Z, Li J, Cheng Z, Yuan L, Liu P. A single center experience: rituximab plus cladribine is an effective and safe first-line therapy for unresectable bronchial-associated lymphoid tissue lymphoma. J Thorac Dis 2017; 9:1081-1092. [PMID: 28523163 DOI: 10.21037/jtd.2017.03.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Bronchial-associated lymphoid tissue (BALT) lymphoma is a relatively rare form of B-cell non-Hodgkin lymphoma (B-NHL). To date, the standard systemic treatment for this disease is still under debate, and few data are accessible for newly diagnosed unresectable BALT lymphoma presented with advanced disease. The combination of rituximab (R) and cladribine (2-CdA) has shown some activity in indolent B-NHL, but its usage has not been tested in disseminated BALT lymphoma so far. METHODS An observational retrospective study was performed on homogeneous data of 8 patients with biopsy-proven stage IV BALT lymphoma to assess the efficacy and the safety of R-2-CdA therapy. All but one of the patients received six courses of R-2-CdA regimen consisted of rituximab 375 mg/m2 IV day 1 and cladribine 0.1 mg/kg IV days 1-4 every 21 days; one patient completed 4 cycles and received additional R maintenance. RESULTS A high overall response rate (ORR) was observed (100%), with 2 patients (25%) achieved a complete remission (CR), the remaining (75%) a partial response. Improvement of pulmonary function was observed in all tested patients. Grade 3 and 4 toxicities were leukocytopenia and neutropenia in 3 patients (37.5%), diarrhea in one (12.5%). Estimated two-year progression-free survival (PFS) and 2-yr overall survival (OS) were 80.0% (95% CI, 20.3-96.7%) and 100%, respectively. CONCLUSIONS R-2-CdA therapy demonstrated high activity and tolerable toxicity in chemotherapy-naïve patients with unresectable BALT lymphoma of advanced stage. Although further large-scale study is needed for consolidation, R-2-CdA regimen could be a good first-line therapy option for patients with unresectable BALT lymphoma.
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Affiliation(s)
- Zheng Wei
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jing Li
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhixiang Cheng
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ling Yuan
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Peng Liu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Zhu Z, Liu W, Mamlouk O, O'Donnell JE, Sen D, Avezbakiyev B. Primary Pulmonary Diffuse Large B Cell Non-Hodgkin's Lymphoma: A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:286-290. [PMID: 28321110 PMCID: PMC5373819 DOI: 10.12659/ajcr.901528] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Patient: Female, 48 Final Diagnosis: Primary pulmonary DLBCL Symptoms: Cough • weigh loss Medication: R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) Clinical Procedure: Bone marrow biopsy • CT-guided lung biopsy Specialty: Oncology
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Affiliation(s)
- Ziqiang Zhu
- Department of Medicine, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Wei Liu
- Department of Medicine, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Omar Mamlouk
- Department of Medicine, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - James E O'Donnell
- Department of Pathology, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Debabrata Sen
- Department of Medicine, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Boris Avezbakiyev
- Division of Hematology/Oncology, The Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
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Brentuximab vedotin in relapsed primary mediastinal large B-cell lymphoma: results from a phase 2 clinical trial. Blood 2017; 129:2328-2330. [PMID: 28264798 DOI: 10.1182/blood-2017-01-764258] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
Primary pulmonary lymphomas represent a pathologically heterogeneous group of disorders that often share imaging features, which include peribronchovascular nodules and masses or areas of nonresolving consolidation. Primary mediastinal B-cell lymphoma is an extranodal non-Hodgkin lymphoma seen in younger patients that has imaging and pathologic features that demonstrate some degree of overlap with Hodgkin lymphoma. Primary lymphomas of the pleural space are rare and associated with concomitant viral infections.
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Du C, Gao F, Wen E, Liu X, Du L, Luo F. Successful Treatment of Coexistence of Diffused Large B Cell Lymphoma and Lung Adenocarcinoma, a Case Report. INT J GERONTOL 2016. [DOI: 10.1016/j.ijge.2016.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Zheng JX, Li XZ, Xiang RL, Gao Z. Synchronous primary pulmonary lymphoma presenting with pulmonary adenocarcinoma: A case report and literature review. Indian J Cancer 2016; 52 Suppl 1:e37-40. [PMID: 26548938 DOI: 10.4103/0019-509x.168955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The incidence of synchronous lung tumors is rare, as reported in various clinical series, ranging from 0.2% to 8%. Most reported cases of synchronous tumors were shown to have the same histologic types of lung cancer. Among possible combinations, squamous cell carcinoma was by far the most common. Primary pulmonary lymphoma (PPL) is very rare in clinics accounting for only 0.5-1% of primary lung tumors. There is no report about synchronous primary pulmonary adenocarcinoma presenting with lung lymphoma. It can be easily misdiagnosed or missed. Although the treatment of PPL and synchronous pulmonary tumors has controversial, surgery with/without postoperative adjuvant radio-chemotherapy are used for most patients in present. We describe a case of synchronous primary lung tumors presenting with lymphoma and adenocarcinoma, in which expression of the cell surface antigens were evaluated immunohistochemically. By taking into consideration of the reported experiences, the author discusses the clinical features, prognostic criteria and therapeutic management of synchronous lung cancer and PPL.
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Affiliation(s)
| | | | | | - Z Gao
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Nishii-Ito S, Izumi H, Touge H, Takeda K, Hosoda Y, Yamasaki A, Kuwamoto S, Shimizu E, Motokura T. Pulmonary intravascular large B-cell lymphoma successfully treated with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone immunochemotherapy: Report of a patient surviving for over 1 year. Mol Clin Oncol 2016; 5:689-692. [PMID: 28105347 PMCID: PMC5228415 DOI: 10.3892/mco.2016.1063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/05/2016] [Indexed: 12/01/2022] Open
Abstract
A 73-year-old man with a history of lethargy, fever and dyspnea was admitted to Tottori University Hospital. A computed tomography (CT) scan revealed splenomegaly and diffusely spreading ground-glass opacities (GGOs) in both lungs. A video-assisted thoracoscopic surgery (VATS)-guided lung biopsy revealed intravascular proliferation of large atypical lymphoid cells in the arteries, veins and alveolar walls. The patient was diagnosed with intravascular large B-cell lymphoma (IVLBCL); he received 6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) immunochemotherapy and has remained in complete remission for >1 year. Although IVLBCL is a rare disease, it should be considered in the differential diagnosis of pulmonary diffuse lesions that present with GGOs on CT scans.
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Affiliation(s)
- Shizuka Nishii-Ito
- Department of Hematology, Tottori University Hospital, Yonago, Tottori 683-8504, Japan; Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Hiroki Izumi
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Hirokazu Touge
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Kenichi Takeda
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Yuzuru Hosoda
- Department of Hematology, Tottori University Hospital, Yonago, Tottori 683-8504, Japan; Division of Clinical Laboratory Medicine, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Akira Yamasaki
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Satoshi Kuwamoto
- Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Eiji Shimizu
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Toru Motokura
- Department of Hematology, Tottori University Hospital, Yonago, Tottori 683-8504, Japan; Division of Clinical Laboratory Medicine, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
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Tanriverdi E, Acat M, Ozgul G, Abbasli K, Gul S, Yasar Z, Cortuk M, Fener NA, Akin H, Ozgul MA, Cetinkaya E. Primary pulmonary lymphoma: four different and unusual radiologic and clinical manifestations. Leuk Lymphoma 2016; 58:1231-1233. [PMID: 27658461 DOI: 10.1080/10428194.2016.1225210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Elif Tanriverdi
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Murat Acat
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Guler Ozgul
- c Department of Chest Diseases , Bağcılar Education and Research Hospital , İstanbul , Turkey
| | - Kenan Abbasli
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Sule Gul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Zehra Yasar
- d Department of Chest Diseases , Abant İzzet Baysal University Faculty of Medicine , Bolu , Turkey
| | - Mustafa Cortuk
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Neslihan Akanil Fener
- e Department of Pathology , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Hasan Akin
- f Department of Thoracic Surgery , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Akif Ozgul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Erdogan Cetinkaya
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
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Early Bronchus-Associated Lymphoid Tissue Lymphoma Diagnosed with Immunoglobulin Heavy Chain Molecular Testing. Can Respir J 2016; 2016:7056035. [PMID: 27445561 PMCID: PMC4904558 DOI: 10.1155/2016/7056035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 05/03/2015] [Indexed: 12/02/2022] Open
Abstract
When extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT), a low grade B-cell lymphoma, arises in the lung it is referred to as bronchus-associated lymphoid tissue (BALT) lymphoma. We describe a patient with a history of Sjögren's syndrome and rheumatoid arthritis with dyspnea and imaging consistent with lymphoid interstitial pneumonia (LIP). However, while histology and immunohistochemistry lacked definitive features of a lymphoma, immunoglobulin heavy chain (IgH) polymerase chain reaction testing demonstrated B-cell monoclonality, consistent with an early BALT lymphoma.
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Wang T, Zhang M, Sun J, Hao D, Qi Z, Lu F, Ji H, Liu W, Wang X, Wu D. A rare case of primary pulmonary diffuse large B cell lymphoma with CD5 positive expression. Open Med (Wars) 2016; 11:49-51. [PMID: 28352766 PMCID: PMC5329797 DOI: 10.1515/med-2016-0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 01/27/2016] [Indexed: 11/15/2022] Open
Abstract
Primary pulmonary diffuse large B-cell lymphoma (PPDLBCL) is extremely rare. Its clinical symptoms and signs are nonspe cific, and imaging features also have not yet been well-defined. Further description is important for the diagnosis and treatment of PPDLBCL. Herein, we reported a case of a patient who suffered from bilateral chest pain and dyspnea. Computed tomography (CT) of chest demonstrated bilateral lung mass, consolidations and reverse halo sign, while consolidations and reverse halo sign are uncommon according to previous reports. Tissue samples were taken by CT guided needle biopsy. The histological samples showed PPDLBCL. This case was special in view of positive expression of CD5. After the case was treated by cyclophosphamide pirarubicin vindesine dexamethasone (CHOP) chemotherapy for six courses, her clinical symptoms were partially alleviated, while CT showed progression disease. This case report highlights different imaging features and characteristics of molecular biology, and reviews study progress of PPDLBCL.
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Affiliation(s)
- Tao Wang
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China; Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Mingming Zhang
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China; Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Jianrong Sun
- Department of Hematology, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Dong Hao
- Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Zhijiang Qi
- Emergency Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Feng Lu
- Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Hong Ji
- Department of Pathology, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Weili Liu
- Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China
| | - Xiaozhi Wang
- Department of Critical Care Medicine, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China . Tel: 13561578530
| | - Dawei Wu
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan, 250012, China . Tel: 18560081001
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Cavalli F, Ceriani L, Zucca E. Functional Imaging Using 18-Fluorodeoxyglucose PET in the Management of Primary Mediastinal Large B-Cell Lymphoma: The Contributions of the International Extranodal Lymphoma Study Group. Am Soc Clin Oncol Educ Book 2016; 35:e368-75. [PMID: 27249743 DOI: 10.1200/edbk_159037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Primary mediastinal large B-cell lymphoma (PMLBCL) is recognized as a distinct disease entity. Treatment outcomes appear better than in other diffuse large B-cell lymphoma (DLBCL) types, partly because of their earlier stage at presentation and the younger age of most patients. If initial treatment fails, however, the results of salvage chemotherapy and myeloablative treatment are poor. The need to avoid relapses after initial therapy has led to controversy over the extent of front-line therapy, particularly whether consolidation radiotherapy to the mediastinum is always required and whether the 18-fluorodeoxyglucose ((18)F-FDG) uptake detected by PET-CT scan can be used to determine its requirements. Functional imaging using PET-CT generally allows distinguishing of residual mediastinal masses containing active lymphoma from those with only sclerotic material remaining. The International Extranodal Lymphoma Study Group (IELSG) conducted the prospective IELSG-26 study, which showed that a five-point visual scale can be used to define metabolic response after immunochemotherapy and that a cut point based on liver uptake discriminates effectively between high or low risk of failure, with 5-year progression-free survival (PFS) of 99% versus 68% and 5-year overall survival (OS) of 100% versus 83%. This study also showed that a baseline quantitative PET parameter, namely the total lesion glycolysis describing the metabolic tumor burden, can be a powerful predictor of PMLBCL outcomes and warrants further validation as a biomarker. The ongoing IELSG-37 randomized study addresses the need for consolidation mediastinal radiotherapy in patients in whom a complete metabolic response (CMR) can be seen on PET scans after standard immunochemotherapy.
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Affiliation(s)
- Franco Cavalli
- From the Oncology Institute of Southern Switzerland, Lymphoma Unit-Ospedale San Giovanni, Bellinzona, Switzerland
| | - Luca Ceriani
- From the Oncology Institute of Southern Switzerland, Lymphoma Unit-Ospedale San Giovanni, Bellinzona, Switzerland
| | - Emanuele Zucca
- From the Oncology Institute of Southern Switzerland, Lymphoma Unit-Ospedale San Giovanni, Bellinzona, Switzerland
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Abstract
Primary pulmonary diffuse large B-cell lymphoma (PPDLBCL) directly arising from lung tissue is extremely rare. It may usually be misdiagnosed as inflammation including pulmonary tuberculosis, even lung cancer, because its clinical symptoms and signs are often nonspecific. The final diagnosis usually depends on lung biopsy. Herein, we report a case of PPDLBCL and review of diagnosis of this disease, particularly in radiology. A 44-year-old man presented with cough, sputum, and intermittent chest pain for 4 weeks. Multiple radiological examinations showed an irregular mass in the right upper lobe with ground-glass opacities around it and air-filled bronchi in the consolidation. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography-magnetic resonance imaging (MRI) detected positive FDG uptake, and diffusion-weighted imaging indicated abnormal hyperintension in the lesion. Inflammation was suspected, but malignance cannot be excluded. Finally, ultrasound-guided fine-needle aspiration cytology was performed for histological examination and definitive diagnosis yielded lymphomatous cells infiltration in the right upper lobe. This report emphasizes the significance of multimodality radiological examinations. Multimodality imaging contributes to proper diagnosis, staging, and management of lymphomas.
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Affiliation(s)
- Huiting Xu
- From the Department of Radiology (HX, RW, XL), Affiliated Hospital of Xuzhou Medical College; and School of Medical Imaging (HX, KX, RW), Xuzhou Medical College, Xuzhou, China
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Sun ML, Shang B, Gao JH, Jiang SJ. Rare case of primary pleural lymphoma presenting with pleural effusion. Thorac Cancer 2015; 7:145-50. [PMID: 26813352 PMCID: PMC4718130 DOI: 10.1111/1759-7714.12256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/11/2014] [Indexed: 12/22/2022] Open
Abstract
Primary pleural lymphoma is rare and has been described in association with human immunodeficiency virus (HIV) infection or pyothorax. We report a rare case of primary pleural lymphoma in a 73-year-old man who presented with chest pain and no history of HIV infection or pyothorax. Chest imaging showed pleural thickening and pleural effusion. Thoracoscopic pleural biopsy was performed. Histopathological and immunohistochemical examinations conformed to that of a diffuse large B-cell lymphoma. Physicians should be aware of this rare location of primary lymphoma and implement thoracoscopy as soon as possible.
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Affiliation(s)
- Mei-Ling Sun
- Department of Respiratory Medicine Provincial Hospital Affiliated to Shandong University Jinan China
| | - Bin Shang
- Department of Thoracic Surgery Provincial Hospital Affiliated to Shandong University Jinan China
| | - Jian-Hua Gao
- Department of Respiratory Medicine Wendeng Central Hospital Weihai China
| | - Shu-Juan Jiang
- Department of Respiratory Medicine Provincial Hospital Affiliated to Shandong University Jinan China
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Zhu J, Wang Y, Gong L, Huang G. Diagnosis of primary pulmonary T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia via clinicopathological observation and molecular assay. Diagn Pathol 2014; 9:188. [PMID: 25273521 PMCID: PMC4207321 DOI: 10.1186/s13000-014-0188-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 09/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Primary pulmonary lymphoma (PPL) is rare and easily misdiagnosed because of the lack of typical clinical features. It most commonly involves elderly patients aged between 60 and 70 years, and pathological diagnosis depends mainly on chest surgery rather than bronchial mucosal biopsy. Via percutaneous needle aspiration biopsy of the lung of a 33-year-old woman, which had distinct tissue eosinophilia, we diagnosed a rare case of rapidly growing large B cell lymphoma. Methods Bronchial mucosal biopsy and computed tomography–guided percutaneous needle aspiration biopsy were performed to determine the nature of the lesion, and we identified its immunophenotype using immunohistochemistry. We used BIOMED-2 gene rearrangement PCR to determine lymphocyte clonality; laser microdissection was used to confirm the clonality of suspicious malignant lymphocytes. Results Morphologically, the lesion was composed of a large number of eosinophilic cells and a few lymphoid cells. Immunohistochemical staining revealed a few CD1α-positive cells, but they were S-100–negative. The small lymphoid cells predominantly expressed CD3; the large lymphoid cells expressed CD20 and some scattered large lymphoid cells expressed Pax5. However, molecular studies confirmed clonal immunoglobulin heavy chain (IGH)-D gene rearrangement in Pax5–positive large B lymphocytes. Conclusions This is the first recorded case of T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia of the lung. It highlights the unusual morphological features of PPL that might be mistaken for eosinophilic granuloma or parasitic infection. In addition, IGH and T cell receptor gene rearrangement play important roles in differentiating rare B cell lymphoma from lung space–occupying lesions with abundant eosinophils or T cell infiltration. Virtual Slides The virtual slide(s) for this article can be found here: http://med.motic.com/MoticGallery/Slides/AC5C9A6F-46EC-4C71-A448-1312F6900C65?user=2C69F0D6-A478-4A2B-ABF0-BB36763E8025
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Histopathological Difficulties in an Adolescent Lymphoma Patient. Pathol Oncol Res 2014; 21:213-7. [DOI: 10.1007/s12253-014-9810-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 06/04/2014] [Indexed: 02/06/2023]
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Albores J, Fishbein MC, Wang T. A 57-year-old woman with persistent cough and pulmonary nodules. Chest 2014; 145:1162-1165. [PMID: 24798842 DOI: 10.1378/chest.13-1950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jeffrey Albores
- Division of Pulmonary and Critical Care Medicine, Los Angeles, CA.
| | - Michael C Fishbein
- David Geffen School of Medicine at UCLA, and UCLA Pathology & Laboratory Medicine, Los Angeles, CA
| | - Tisha Wang
- Division of Pulmonary and Critical Care Medicine, Los Angeles, CA
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40
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Jiang AG, Gao XY, Lu HY. Diagnosis and management of a patient with primary pulmonary diffuse large B-cell lymphoma: A case report and review of the literature. Exp Ther Med 2014; 8:797-800. [PMID: 25120602 PMCID: PMC4113546 DOI: 10.3892/etm.2014.1797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/16/2014] [Indexed: 12/20/2022] Open
Abstract
Primary pulmonary lymphoma (PPL) is an uncommon type of non-Hodgkin's lymphoma. The majority of PPLs are of low-grade, mucosa-associated lymphoid tissue type. Primary pulmonary diffuse large B-cell lymphoma (DLBCL) is extremely rare, and prompt diagnosis may be challenging since its clinical symptoms and signs are nonspecific. Although the clinical features, diagnostic procedures, optimal management and prognostic factors of this disease have not yet been well defined, open thoracotomy and chest computed tomography (CT)-guided percutaneous biopsy are the preferred methods used in previous studies. In the present case report, the diagnosis and management of a patient with primary pulmonary DLBCL is reported. A 68-year-old patient was admitted to hospital in May 2013, with complaints of shortness of breath and intermittent wheezing and a cough associated with the production of small amounts of phlegm. Following admission, chest CT scans revealed a mass in the right middle lobe with ground-glass opacities at the lesion margins, as well as air bronchograms in the areas of consolidation. Bronchoscopy was performed and revealed an endobronchial lesion and partial stenosis in the distal end of the middle segment bronchus. Transbronchial needle aspiration (TBNA) of the right hilar lymph node, as well as endobronchial biopsy, was performed. The patient was diagnosed with primary pulmonary DLBCL by subsequent histopathological and immunohistochemical analysis of biopsy specimens collected via TBNA. Following the final diagnosis, standard treatment with CHOP chemotherapy resulted in significant clinical and radiological response and the patient remained in remission 8 months later. These results indicate that TBNA may be an effective method for the diagnosis of primary pulmonary DLBCL.
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Affiliation(s)
- Ai-Gui Jiang
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Xiao-Yan Gao
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Hui-Yu Lu
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
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Majid N, Kamal EB, Oncology B, Rachid A, Hassan IHE. Primary pulmonary lymphoma: About five cases and literature review. Lung India 2014; 31:53-5. [PMID: 24669084 PMCID: PMC3960812 DOI: 10.4103/0970-2113.125909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary pulmonary lymphoma is a very rare neoplasm that represents only 3-4% of extranodal non-Hodgkin lymphoma (NHL), less than 1% of NHL and only 0.5-1% of primary pulmonary malignancies. Primary pulmonary NHL is most commonly represented by marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma). The clinical characteristics, methods of treatment, and outcomes are not well-elucidated. We, therefore, reviewed the medical records of five Moroccan patients who were pathologically and clinically diagnosed as primary pulmonary lymphoma and treated in our institute of oncology.
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Affiliation(s)
- Noura Majid
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
| | - El Bakraoui Kamal
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
| | - Boukir Oncology
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
| | - Aassab Rachid
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
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42
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Wang Z, Li X, Chen J, Jin Z, Shi H, Zhang X, Pan J, Liu W, Yang N, Chen J. Value of Computed Tomography–guided Core Needle Biopsy in Diagnosis of Primary Pulmonary Lymphomas. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2012.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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43
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Zinzani PL, Pellegrini C, Gandolfi L, Casadei B, Derenzini E, Broccoli A, Quirini F, Argnani L, Pileri S, Celli M, Fanti S, Poletti V, Stefoni V, Baccarani M. Extranodal marginal zone B-cell lymphoma of the lung: experience with fludarabine and mitoxantrone-containing regimens. Hematol Oncol 2012; 31:183-8. [DOI: 10.1002/hon.2039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 10/08/2012] [Accepted: 11/07/2012] [Indexed: 11/09/2022]
Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Cinzia Pellegrini
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Letizia Gandolfi
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Beatrice Casadei
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Enrico Derenzini
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Alessandro Broccoli
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Federica Quirini
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Lisa Argnani
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Stefano Pileri
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Monica Celli
- Department of Nuclear Medicine; University of Bologna; Bologna Italy
| | - Stefano Fanti
- Department of Nuclear Medicine; University of Bologna; Bologna Italy
| | | | - Vittorio Stefoni
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Michele Baccarani
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
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Sergiacomi G, Gaspari E, Taglieri A, Meschini A, Gisone V, Cudillo L, Arcese W, Simonetti G. 3-Tesla MR spectroscopy in patients subjected to bone marrow transplantation: clinical correlations. Radiol Med 2012; 118:101-11. [PMID: 22327923 DOI: 10.1007/s11547-012-0796-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 07/06/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE This study evaluated the usefulness of 3-Tesla magnetic resonance (MR) spectroscopy in patients with non-Hodgkin's lymphoma (NHL) undergoing bone marrow transplantation (BMT). MATERIALS AND METHODS Twelve NHL patients who were candidates for BMT underwent three MR examinations of the lumbosacral spine: before ablative therapy for BMT, 15±4 days and 54±24 days after BMT. The MR study was supplemented by spectroscopic analysis. The lipid content was calculated and expressed as a percentage of lipid signal intensity relative to total signal intensity [fat fraction (FF)]. RESULTS In the first MR study, the FF was 62.5±7%, in the second it was 70.75±5% and in the third it was 75±1%. We observed a statistically significant difference between FF values calculated at the various MR studies (p=0.02) and between red blood cell count (p=0.017), platelet count (p=0.003) and haematocrit (p<0.001) at the three MR studies. FF had a statistically significant correlation with the number of circulating platelets (p<0.01) CONCLUSIONS MR spectroscopy of the bone marrow of NHL patients undergoing BMT is noninvasive and highly sensitive for characterising and monitoring bone marrow after BMT.
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Affiliation(s)
- G Sergiacomi
- Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Fondazione Policlinico Universitario Tor Vergata, Viale Oxford 81, 00133, Roma, Italy.
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45
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Ogusa E, Tomita N, Ishii Y, Takasaki H, Hattori Y, Matsumoto C, Ishigatsubo Y. Clinical manifestations of primary pulmonary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in Japanese population. Hematol Oncol 2012; 31:18-21. [PMID: 22278757 DOI: 10.1002/hon.2008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We retrospectively analysed 16 cases of newly diagnosed pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma in the Japanese population. The disease was found on the basis of examination findings in 14 cases, and clinical manifestations in 2. According to the extensive staging procedure, four patients had concomitant gastric involvement. Primary treatment involved surgery alone in two patients; surgery followed by rituximab (R)-containing chemotherapy in two; R-containing chemotherapy alone in 11; and chemoradiotherapy without R in one. Over the median observation period of 28 months, disease progression was recorded in three patients, but all 16 patients were alive at the end of the observation period. One patient was treated with R alone and achieved partial remission; subsequent tentative surgery showed no evidence of residual lymphoma. It has been 72 months of progression-free survival after the diagnosis. Primary pulmonary MALT lymphoma exhibited an indolent clinical course. R has potential as a therapeutic agent in patients with pulmonary MALT lymphoma.
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Affiliation(s)
- Eriko Ogusa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
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Wróbel T, Dzietczenia J, Prochorec-Sobieszek M, Mazur G, Piwkowski P. Primary pulmonary diffuse large B-cell lymphoma. Am J Hematol 2012; 87:107-8. [PMID: 21815186 DOI: 10.1002/ajh.22116] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 06/11/2011] [Accepted: 06/20/2011] [Indexed: 11/07/2022]
Affiliation(s)
- Tomasz Wróbel
- Department of Haematology, Wrocław Medical University, Poland.
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47
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Marco S, Thariat J, Poudenx M, Butori C, Mouroux J, Fuzibet JG, Marquette CH, Peyrade F, Thyss A. [Six cases of pulmonary MALT lymphoma: a heterogeneous therapeutic management]. REVUE DE PNEUMOLOGIE CLINIQUE 2011; 67:174-178. [PMID: 21665083 DOI: 10.1016/j.pneumo.2010.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 05/02/2010] [Accepted: 05/10/2010] [Indexed: 05/30/2023]
Abstract
Pulmonary mucosa-associated lymphoid tissue lymphomas (PMALT) account for around 1% of lymphomas. Clinical and radiological presentations, and the treatment of six PMALT were collected from 1993 to 2008. All patients received chemotherapy before disease progression. Two patients had a lobectomy and one received thoracic radiotherapy. In 2008, all the patients were alive and three were in remission. A "watch and wait" strategy is widely accepted for stable, asymptomatic patients and patients with low tumour mass. Surgery may be proposed for symptomatic patients who have localised PMALT. When a chemotherapy treatment is to be suggested, chlorambucil-based chemotherapy is preferred. There may be room for rituximab alone or in combination, but this remains to be precisely defined. Several larger studies are currently ongoing to assess the role of monoclonal antibodies and chemotherapy in MALT lymphomas. Subgroup analysis should help us to define the optimal treatment for PMALT.
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MESH Headings
- Aged
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chemotherapy, Adjuvant
- Chlorambucil/administration & dosage
- Female
- Follow-Up Studies
- Humans
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/radiotherapy
- Lymphoma, B-Cell, Marginal Zone/surgery
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Pneumonectomy
- Radiotherapy, Adjuvant
- Retrospective Studies
- Rituximab
- Treatment Outcome
- Watchful Waiting
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Affiliation(s)
- S Marco
- Service d'hématologie et d'oncologie médicale, centre Antoine-Lacassagne, Nice cedex, France.
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48
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Oschlies I, Burkhardt B, Salaverria I, Rosenwald A, d'Amore ESG, Szczepanowski M, Koch K, Hansmann ML, Stein H, Möller P, Reiter A, Zimmermann M, Rosolen A, Siebert R, Jaffe ES, Klapper W. Clinical, pathological and genetic features of primary mediastinal large B-cell lymphomas and mediastinal gray zone lymphomas in children. Haematologica 2010; 96:262-8. [PMID: 20971819 DOI: 10.3324/haematol.2010.030809] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
UNLABELLED Background Primary mediastinal large B-cell lymphoma is a rare lymphoma accounting for no more than 3% of all B-cell lymphomas in children and adolescents. However, patients in this young age group with this lymphoma have the shortest event-free survival of patients with any B-cell lymphoma under current standard chemotherapy protocols. Lymphomas with features intermediate between primary mediastinal large B-cell lymphoma and classical Hodgkin's lymphoma (mediastinal gray zone lymphomas) have been acknowledged in the latest World Health Organization classification. Recent studies suggest that mediastinal gray zone lymphomas have an aggressive clinical course whereas patients, at least adult ones, with primary mediastinal large B-cell lymphoma might respond very well to chemotherapy in combination with anti-CD20 antibody. DESIGN AND METHODS We aimed to evaluate whether biological differences or so far unrecognized admixed mediastinal gray zone lymphomas might explain the relatively poor outcome of pediatric patients with apparent primary mediastinal large B-cell lymphoma. We, therefore, performed a retrospective histopathological, immunohistochemical and interphase cytogenetic analysis of 52 pediatric lymphomas. RESULTS The childhood primary mediastinal large B-cell lymphomas (n=44) showed a similar pattern of histology, immunophenotype and gains at 9p (59%) and 2p (41%) as adult cases, as determined from published data. We identified only four so far unrecognized cases of mediastinal gray zone lymphoma among 52 lymphomas registered in previous trials. Conclusions Mediastinal gray zone lymphoma is very rare in children and adolescents. It does, therefore, seem unlikely that these lymphomas account for the unsatisfactory clinical results with current therapy protocols in pediatric patients. These data have major implications for the design of future treatment protocols for mediastinal lymphomas in children and adolescents.
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Affiliation(s)
- Ilske Oschlies
- Department of Pathology, Hematopathology Section and Lymph Node Registry, Christian-Albrechts-University Kiel, University Hospital Schleswig-Holstein, Kiel, Germany
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Huang J, Lin T, Li Z, Xu R, Huang H, Jiang W. Primary pulmonary non-Hodgkin's lymphoma: a retrospective analysis of 29 cases in a Chinese population. Am J Hematol 2010; 85:523-5. [PMID: 20575021 PMCID: PMC7159398 DOI: 10.1002/ajh.21720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jiajia Huang
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
| | - Tongyu Lin
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhi‐Ming Li
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
| | - Ruihua Xu
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
| | - Huiqiang Huang
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
| | - Wenqi Jiang
- State Key Laboratory of Oncology in Southern China, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
- Department of Medical Oncology, Cancer Center, Sun Yat‐sen University, Guangzhou, Guangdong, People's Republic of China
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Ahn HK, Kim SJ, Yun J, Yi JH, Kim JH, Won YW, Kim K, Ko YH, Kim WS. Improved treatment outcome of primary mediastinal large B-cell lymphoma after introduction of rituximab in Korean patients. Int J Hematol 2010; 91:456-63. [PMID: 20198460 DOI: 10.1007/s12185-010-0536-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 02/05/2010] [Accepted: 02/08/2010] [Indexed: 12/13/2022]
Abstract
The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) improved the outcome of patients with diffuse large B-cell lymphoma (DLBCL). However, the impact of rituximab (R-CHOP) is still not determined in primary mediastinal large B-cell lymphoma (PMBCL), a subtype of DLBCL, especially in Asian patients. Thus, we analyzed the treatment outcome of PMBCL patients (n = 21) treated with R-CHOP and compared it with the historical group treated with CHOP (n = 14). The rate of complete response for R-CHOP was higher than that of CHOP (17/21, 81.0% vs. 8/14, 57.2%), although the difference was not statistically significant (P = 0.151). The number of patients with disease progression or relapse was higher in the CHOP group (6/14, 42.9%) than the R-CHOP group (2/21, 9.5%). Thus, patients treated with R-CHOP had higher 2-year progression-free survival (79.0%) than those treated with CHOP (50.0%, P = 0.043). Although the 2-year overall survival of the R-CHOP was also superior to that of the CHOP group (82.7% vs. 57.1%), this survival benefit did not reach statistical significance (P = 0.081). In conclusion, our comparison suggests that R-CHOP may increase response and reduce relapse resulting in prolongation of progression-free survival of patients with PMBCL.
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Affiliation(s)
- Hee Kyung Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea
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