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Ren B, Chen Y, Bai X, Zheng J, Chang J, Jiang X, Xia Q, Zhang H. Case report: Clinicopathological and molecular characteristics of pediatric-type follicular lymphoma. Front Pediatr 2023; 11:1205384. [PMID: 37539011 PMCID: PMC10394512 DOI: 10.3389/fped.2023.1205384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023] Open
Abstract
Pediatric-type follicular lymphoma (PTFL) is a rare pediatric-type indolent B-cell lymphoma that clinicopathologically differs from adult lymphoma. Accurate diagnosis of PTFL, which is often challenging, is essential to avoid missed diagnosis, misdiagnosis, and overtreatment. To improve our understanding of PTFL, clinicopathological features, differential diagnosis, and molecular mutation characteristics of four patients of PTFL were analyzed using hematoxylin and eosin staining, immunohistochemistry, polymerase chain reaction, fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS). A relevant literature review was also performed. All four PTFL patients were male, with ages of 6, 18, 13, and 15 years, and had St. Jude stage I or III. Microscopic results showed that the structure of the lymph nodes was destroyed; the tumor follicles were enlarged and irregular; medium-large blastoid cells with a consistent shape were visible in tumor follicles, and the nucleus was round or oval; and the "starry sky" pattern was easily observed. Tumor cells expressed CD20, PAX-5, BCL6, and CD10. None of the tumor cells expressed BCL2, CD3, CD5, MUM1, and CyclinD1. CD21 showed dilated growth of a follicular dendritic cell network in tumor follicles. EBER genes were negative in all cases. FISH testing also showed negative BCL2 gene breaks and IRF4 gene breaks in all cases. NGS detected 12 related mutant genes, including KMT2D, CD79B, GNA13, MYD88, PCLO, TCF3, IRF8, MAP2K1, FOXO1, POLE, INPP5D, and FAT4. Two of the four patients had an IRF8 gene mutation, and one patient had a dual mutation of the MAP2K1 gene. Our study revealed the unique clinicopathological features and molecular mutational characteristics of PTFL, consolidated our understanding of PTFL, and identified other rare mutant genes, which may further contribute to the study of the molecular mechanism and differential diagnosis of PTFL.
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Affiliation(s)
- Beibei Ren
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Tumor Pathology and Artificial Intelligence Diagnosis, Zhengzhou, China
- Pathological Diagnostic Antibody Engineering Research Center of Henan Province, Zhengzhou, China
| | - Yu Chen
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Tumor Pathology and Artificial Intelligence Diagnosis, Zhengzhou, China
- Pathological Diagnostic Antibody Engineering Research Center of Henan Province, Zhengzhou, China
| | - Xuanye Bai
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Tumor Pathology and Artificial Intelligence Diagnosis, Zhengzhou, China
- Pathological Diagnostic Antibody Engineering Research Center of Henan Province, Zhengzhou, China
| | - Jiawen Zheng
- Department of Molecular Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Chang
- Medical Service Office, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangnan Jiang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qingxin Xia
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Tumor Pathology and Artificial Intelligence Diagnosis, Zhengzhou, China
- Pathological Diagnostic Antibody Engineering Research Center of Henan Province, Zhengzhou, China
| | - He Zhang
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- Henan Medical Key Laboratory of Tumor Pathology and Artificial Intelligence Diagnosis, Zhengzhou, China
- Pathological Diagnostic Antibody Engineering Research Center of Henan Province, Zhengzhou, China
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Ryoo HJ, Lim JS, Kim MC. Primary non-Hodgkin lymphoma of the parotid gland: a case report. Arch Craniofac Surg 2022; 23:125-129. [PMID: 35811344 PMCID: PMC9271651 DOI: 10.7181/acfs.2022.00136] [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: 02/28/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are non-specific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.
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Affiliation(s)
- Hyun Jung Ryoo
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin Soo Lim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Min Cheol Kim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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D'Arco F, Ugga L. Computed tomography and magnetic resonance imaging in pediatric salivary gland diseases: a guide to the differential diagnosis. Pediatr Radiol 2020; 50:1293-1307. [PMID: 32556808 DOI: 10.1007/s00247-020-04684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/09/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Salivary gland pathologies in children are frequent, particularly viral infections, but rarely need cross-sectional imaging. However, when a mass involves the salivary spaces (primarily or as a secondary invasion from other neck spaces) it may pose problems in the differential diagnosis and in immediate management. Infrequently, systemic autoimmune diseases can also involve the salivary parenchyma in children and correctly interpreting the constellation of findings in the whole body is critical for the diagnosis. Distinguishing between cystic and solid masses is the first step for radiologists in order to narrow down the diagnosis. Location and spatial extension are the most important elements differentiating cystic masses, while signal characteristics, internal structure and local invasion help in the differential diagnosis of solid masses.
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Affiliation(s)
- Felice D'Arco
- Department of Radiology, Neuroradiology Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences,, University of Naples "Federico II", Naples, Italy
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Zhang XY, Wang ZM. Relevance on the diagnosis of malignant lymphoma of the salivary gland. World J Clin Cases 2020; 8:2717-2726. [PMID: 32742982 PMCID: PMC7360714 DOI: 10.12998/wjcc.v8.i13.2717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/13/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
Malignant lymphoma originates from the lymphohematopoietic system. It can occur in any lymphoid tissue. Malignant lymphoma of the salivary gland is rare, but its incidence has increased in recent years. Its clinical- presentations are non-specific, and it is often manifested as a painless mass in a salivary gland, which can be accompanied by multiple swollen cervical lymph nodes. Confirmation of the diagnosis before an invasive procedure is difficult. Clinically, malignant lymphoma of the salivary gland tends to be misdiagnosed, leading to an inappropriate treatment plan and the ultimate delay in the optimal treatment of the disease. This article reviews the pathogenesis, clinical features, imaging findings, diagnosis, treatment and prognosis of malignant lymphoma of the salivary gland.
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Affiliation(s)
- Xin-Yue Zhang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zhi-Ming Wang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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