Case Of Extranodal Lymphoma Research Articles

Histopathological patterns and immunophenotyping of feline lymphomas and incidence in Metropolitan Bangkok, Thailand.

Feline lymphomas are categorized based on the location of tumor cells, with anatomical classifications including alimentary, mediastinal, multicentric, and extranodal forms. Accurate diagnosis and classification of feline lymphoma are paramount for enhancing treatment and prognosis. T-cell lymphomas are CD3 positive, while B-cell lymphomas exhibit positive forCD20, CD79α, and paired box 5 (PAX5). The aims of this study were (1) to classify feline lymphoma in each anatomical subtype using the World Health Organization (WHO) classification to provide information on epidemiological findings; (2) to investigate the expression and detection of B-cell lymphoma, various antibodies will be used, with the addition of PAX5, for clearer results; and (3) to gather more extensive information about feline lymphoma in Thailand, particularly in the Bangkok area. From 2011 to 2023, 86 sample tissues were submitted for routine pathological examination at the Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University. Immunohistochemistry (IHC) was performed to detect an immunophenotype of PAX5, CD79α, CD20 (B-cell lineage), and CD3 (T-cell lineage). Eighty-six formalin-fixed, paraffin-embedded lymphoma tissues were prepared on silane-coated slides. After IHC, all cases were classified according to the WHO classification. The most common form of lymphoma in this study was extranodal lymphoma at 37.2% (32/86), followed by multicentric lymphoma at 31.3% (27/74), mediastinal lymphoma at 17.4% (15/86), and alimentary lymphoma at 14% (12/86). Most extranodal lymphoma cases were in the nasal region. From the anatomical form, multicentric and extranodal lymphomas were predominantly diffuse large B-cell high-grade, while mediastinal lymphomas were small low-grade B-cell lymphomas. Alimentary lymphomas occur in various types, with most being the B-cell type. This study indicates that extranodal lymphoma and extranodal lymphoma are the most frequent presentations found in cats in Bangkok. Mediastinal and alimentary lymphomas still occur. The utilization of various B-cell markers in combination could aid pathologists in distinguishing between various stages of B-cell maturation, assessing tumor cell heterogeneity, and determining the phenotype in scenarios where there is a loss of common B-cell markers diffuse large B-cell lymphomas is the most prevalent subtype of feline lymphoma. Significantly, relying solely on immunochemistry with one parameter may not be sufficient for a definitive diagnosis of B-cell lymphoma, as another parameter may also be necessary.

Imaging of extranodal lymphomas in the head and neck: A case series and review of the literature

Extranodal lymphomas (ENLs) are relatively rare malignancies of the head and neck. Clinical presentation varies greatly depending on location, pattern of nodal involvement, and histologic subtype. The most frequently involved sites include the palatine tonsils and nasal cavity/paranasal sinuses, and over half of patients have concurrent nodal disease. Most are non-Hodgkin’s lymphomas of B-cell lineage. While the clinical presentation may mimic other pathologies of the head and neck, various radiographic features and patterns may help raise suspicion for ENL as a differential consideration. This is of critical importance given that the management and treatment of lymphomas differ significantly from other pathologies of the head and neck. In this case series, three cases of ENL in the head and neck are described, with an emphasis on radiographic findings. A review of epidemiology and treatment paradigms is also provided.

Primary extranodal lymphomas - spectrum of distribution and morphology with immunophenotyping: A 3-year institutional study

Background: Malignant lymphomas arising in extranodal sites are intriguing. The histological types of lymphomas vary from one site to another. This study is undertaken to diagnose and categorize extranodal lymphomas using histochemistry and immunohistochemistry (IHC). Materials and Methods: Formalin processed paraffin blocks and hematoxylin and eosin stained sections were used for routine histology. IHC was done in all cases. Results: We have encountered 31 cases of extra nodal lymphomas over a period of 3 years. The tumors occurred at different sites, including brain, nasopharynx, nose, gastrointestinal tract, thyroid, bone, testis, breast, lung, vagina, and skin. Majority of the cases were B-cell lymphomas, while four cases were T-cell lymphomas. Among the B-cell lymphomas diffuse large B-cell lymphoma was the most common variant. Conclusion: This study reiterates the key role of IHC particularly when the differential diagnosis includes an undifferentiated epithelial malignancy and a high-grade lymphoma in the extranodal sites as the treatment modalities and prognosis are different.

Misleading lymphomas of the oral cavity - An institutional review

Context: Non-Hodgkin's lymphoma involves the lymph nodes, as well as extranodal organs and tissues. Sometimes within the oral cavity, they present with nonspecific signs and symptoms, which may result in wrong diagnosis and delay in appropriate treatment. The aim of this article is to present cases of extranodal lymphoma that clinically and histologically misled the diagnosis. Materials and Methods: A retrospective search at the Department of Oral Pathology and Microbiology, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, India, was carried out for cases diagnosed as orthokeratinized odontogenic cyst from 1985 to 2013 (a 28-year period). Eight cases of extranodal lymphoma in the head and neck region were reviewed. Results: All the cases were HIV negative except one. The cases were clinically or histologically diagnosed as either a periapical lesion or carcinoma. Histologically, some of them resembled a round cell lesion or poorly differentiated carcinoma. Immunohistochemical analysis showed they belonged to the B-cell neoplasm category. Conclusion: The varied presentation of these extranodal lymphomas may mislead the clinician and pathologist initially during the diagnosis.

Primary Diffuse Large B Cell Lymphoma of the Bladder

Primary malignant lymphoma of the urinary bladder is a rare disease, and it accounts for only 0.2% of all the cases of extranodal lymphoma. The prognosis of primary bladder lymphoma has been favorable, with many patients being alive an d well several years after treatment. We report here on a case of primary diffuse large B cell lymphoma of the urinary bladder in a 75-year-old man patient who presented with a one-month history of persistent dysuria. The abdominal CT revealed a mass at the posterior wall of the urinary bladder. The tissue obtained by transurethral cystoscopy showed an atypical lymphoid pro- liferation, which was consistent with diffuse large B cell lymphoma. The patient received systemic chemo- therapy of rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) and he

Cases of extranodal lymphoma in the head and neck region

18544 Background: Primary extranodal lymphomas of the head and neck region constitute 10–20% of all NHLs. Since they are frequently encountered as localised disease, radiotherapy accounts for the important part in the treatment although other modalities are also available. Cases with the diagnosis of primary extranodal lymphomas of the head and neck region, who administered to our clinic were evaluated retrospectively and presented here. Materials and Methods: Total 13 patients who administered to the Radiation Oncology Clinic of Kartal Education and Research Hospital between years 2000 and 2005, with the diagnosis of primary extranodal lymphoma of the head and neck region were enrolled into the study. All information was gathered from the patients‘ files and evaluated in the electronic environment. Results: Median age was 61 (36–80). Nine patients (69%) were female, and 4 patients (41%) were male. Primary site was found to be tonsil in 8 cases (61%), nasopharynx in 4 cases (30%), and thyroid in one case (7%). Of the 13 cases, 5 (38%) had stage 1, 4 (30%) stage II, 3 (23%) stage III, and 1 (9%) stage IV diseases. Histological type was diffuse large B-cell lymphoma in 8 patients (7 originating from tonsil, 1 from thyroid), T-cell lymphoma in 2 patients (originating from nasopharynx), poorly differentiated histiocytic lymphoma in 1 patient (originating from nasopharynx), and diffuse mixed large B-cell and small B-cell lymphoma in 1 patient. Therapeutic approach was CT+RT in 7 cases, CT+RT+surgery in 3 cases, CT+ surgery in 1 case, RT+ surgery in 1 case, and CT alone in 1 case. Total 44 Gy RT was performed in 22 fractions to involved fields and regional lymph nodes by using cobalt 60 machine. Median 4 cycles of CT that consisted of CHOP were performed to the patients. Of the 13 patients 10 are still under control with no medical problem. One patient with stage 4 disease was lost under treatment after 3 cycles of CT. One case with nasopharyngeal lymphoma was referred due to progression after 2 series of CT, and died 1 month after palliative RT. One case with stage IB tonsil lymphoma received 2 cycles of CT+ RT+ 2 cycles of CT, and died of other medical reason during her 12th month follow up period. Conclusion: Primary extranodal lymphomas of the head and neck region constitute a heterogeneous group of patients, and RT represents an important part of the treatment. No significant financial relationships to disclose.

Fine-needle aspiration cytology of extranodal lymphoma.

The assessment of lymphoproliferative disorders using fine-needle aspiration (FNA) cytology may be problematic particularly when organs other than lymph node are involved. In this report we have reviewed 26 consecutive FNA specimens from superficial extranodal sites which were reported as diagnostic or suggestive of malignant lymphoma. The aspirates were obtained from skin or subcutaneous tissue (ten cases), thyroid (five cases), salivary gland (five cases), breast (four cases), neck, and pharynx (one case each). Ancillary studies including immunocytochemistry, in situ hybridisation to detect immunoglobulin light chain mRNA expression, and polymerase chain reaction for analysis of immunoglobulin heavy chain gene rearrangement were performed in 20, 12, and 7 cases, respectively. Clinicopathologic correlation confirmed the diagnosis of lymphoma in 25/26 aspirates. Nine of the 14 patients whose initial presentation was with an extranodal mass were considered to have primary lymphomas of mucosa-associated lymphoid tissue (MALT) type. In contrast, ten of 11 patients with recurrent extranodal disease had primary nodal type lymphomas. There was one false-positive diagnosis, a neck mass misinterpreted cytologically as B-cell lymphoma which was ultimately shown to be a branchial cyst. FNA cytology supported by appropriate ancillary investigations provides accurate diagnosis in most cases of extranodal lymphoma.

Determination of Epstein-Barr virus association with B-cell lymphomas in Japan: study of 72 cases--in situ hybridization, polymerase chain reaction, immunohistochemical studies.

The association of Epstein-Barr virus (EBV) with B-cell lymphoma was examined in 72 human immunodeficiency virus-negative Japanese patients using the polymerase chain reaction (PCR) on DNA obtained from formalin-fixed paraffin-embedded tissues and an in situ hybridization (ISH) technique. EBV-encoded RNA 1 (EBER-1) was detected in 12 of 72 cases (17%); five of 33 cases (15%) of nodal B-cell lymphomas and seven of 39 cases (18%) of extranodal B-cell lymphomas. Three cases of post-bone marrow transplantation and one case of autoimmune disease (Evans syndrome) were included among seven EBER-1 positive extranodal lymphomas. A combined study of immunohistochemistry and EBER-1 revealed that some L26 positive cells were EBER-1 positive. A DNA band was also observed in 13 of 70 examined cases (19%) (four of 33 cases of nodal B-cell lymphomas (12%) and nine of 37 cases of extranodal B-lymphomas (24%)) in the PCR study using primers to detect the Bam HI-W fragment of EBV. In the immunohistochemical study using a monoclonal antibody to the latent membrane protein 1 (LMP-1) of the EBV, one of the EBV-encoded latent gene products, LMP-1, was expressed in six of 34 cases (18%) of extranodal B-lymphomas, but none of the cases with nodal B-cell lymphomas were shown to be LMP-1 positive. Oncoprotein bcl-2 was examined by immunohistochemistry and found to be expressed in seven cases of nodal lymphomas and three cases of extranodal lymphomas, and two of these nodal cases were EBER ISH positive. In EBV serology, only two cases of nodal and one case of extranodal EBER positive B-cell lymphomas revealed a reactivation pattern. In the PCR study using primers to detect the lymphocyte-determined membrane antigen (LYDMA), the same sized monoclonal bands were observed in case 36 in the PCR products from the nose and skin, suggesting the monoclonal proliferation of the tumor. These findings suggested a low incidence of EBV association with B-cell lymphomas unless patients were in an immunologically impaired condition such as post-organ transplantation or autoimmune diseases.

顎・口腔領域における非ホジキンリンパ腫の臨床的および病理組織学的検討

Eighteen primary cases of non-Hodgkin's lymphoma were examined clinically and histophathologically at our department from 1985 to 1994. The results were as follows:1) There were 7 cases of nodal lymphoma, 9 cases of extranodal lymphoma, and 2 cases of lymphoma in Waldeyer ring. According to the LSG classification, 72%(13 of 18 cases) were diffuse large cell type or diffuse mixed cell type. Immunophenotypic analysis of surface markers revealed that 86%(12 of 14 cases) were B cell type.2) The combination of CT with ultrasound examinations, and cytological examinations were valuable in the diagnosis of malignant lymphoma.3) Ten cases followed up for over 3 years were in stage I or II, and 6 of them were treated with irradiation and chemotherapy. The prognosis of T cell type was poor.

Immunohistochemical Detection of High Endothelial Venules in Extranodal B-Cell Lymphomas

The hypothesis that extranodal malignant lymphomas, such as thyroid, stomach, rectum, ileum and uterus, eventuate from long-standing inflammation is essentially tested using a monoclonal antibody (HECA-452) to an endothelial-associated antigen selectively expressed by the high endothelim of post-capillary venules (HEVs) normally present in lymph nodes, tonsils and mucosa-associated lymphoid tissues. The presence of HEVs was examined on freshly prepared specimens from 16 cases of extranodal lymphoma of the B-cell type (eight thyroid, three stomach, two rectum, one ileum, one uterus, one tonsil). Control cases included reactive lymph nodes, nodal lymphoma of T-cell type, epithelial neoplasia, bone and soft tissue sarcomas, glioblastoma, thyroid affected by chronic lymphocytic thyroiditis (CLTH), thyrotoxicosis (Grave's disease) or nodular goiter, and salivary gland affected by Sjogren's syndrome (SS). HECA+ HEVs were present in reactive lymph nodes, nodal lymphoma, and all but one case of thyroid, all cases of stomach and all cases of rectal lymphoma, together with all CLTH and SS, both known to be autoimmune diseases. No thyroid, ileal or uterine lymphoma cases had any HECA positive venules. HECA+ venules were present in extranodal lymphomas, either adjoining the lymphoid follicles observed in several cases or in the diffusely proliferating tumor cells. Previous studies have shown that HEVs appeared in association with long-standing inflammation. The present study therefore, suggested that extranodal lymphomas of the thyroid, stomach and rectum evolve in long-standing inflammation, forming HEVs.

Non-hodgkin's lymphomas in turkey

Between 1982 and 1986, 185 adult patients with non-Hodgkin's lymphoma (NHL) were studied at Cukurova University Hospital (CUH), Adana, Turkey. This constituted 13% of all malignant neoplasms diagnosed in the oncology clinic. The mean age for men was 45.5 years and 41 years for women. Fifty-four percent of the cases were nodal lymphoma and the remaining 46% were extranodal lymphoma. Sixty-six percent of the extranodal lymphoma cases were gastrointestinal lymphoma. The stomach was the most common localization (43%), followed by intestinal involvement (30%) and abdominal mass (27%). The mean age of the patients with gastric lymphoma was 49 years, and 36 years for patients with abdominal mass. The following conclusions were reached: (1) the relative frequency rate of NHL in South Turkey is higher than Turkey averages, but similar to other Middle East countries; (2) extranodal lymphomas account for more than 40% of all lymphomas; (3) gastric lymphoma is more prevalent than intestinal lymphoma in our region; and (4) compared with western gastric lymphomas, our patients were 10 years younger and had a higher incidence of small lymphocytic and immunoblastic lymphoma.

Biopsy pathology of acquired immune deficiency syndrome (AIDS).

Between January 1982 and May 1986 279 biopsy specimens from 82 patients with acquired immune deficiency syndrome (AIDS) were examined. A wide variety of infectious conditions were diagnosed, the commonest being Pneumocystis pneumonia (n = 36), cytomegalovirus (n = 21), a variety of fungi (n = 8), mycobacteria (n = 7). Kaposi's sarcoma was the commonest tumour (n = 40), and there were two cases of extranodal lymphoma. Striking features were the unusual sites of disease and the occasional paucity of organisms.

Non-Hodgkin's lymphomas in a southern prefecture in Japan: an analysis in 715 cases.

As of March 1978, the prognosis was confirmed in 715 non-Hodgkin's lymphoma cases reported during the 12-year period from 1965 through 1976 in the Prefecture of Kagoshima. Included were 222 cases of extranodal lymphoma. Patients with the initial tumor site in the gastrointestinal tract and Waldeyer's ring had a relatively good probability of survival. Among the patients with cutaneous lymphomas, those with the mycosis fungoides type had a poor survival rate. In Kagoshima Prefecture, the survival curve for cases of nodal lymphomas is characteristically much poorer than those reported in the medical literature. Of the nodal lymphomas, the nodular type was found in 128 cases and the five-year survival rate was 15%, while the diffuse type accounted for 365 cases and the five-year survival rate was 8%. The paracortex type, considered to be of T-cell origin, accounted for 55 cases and the five-year survival rate was 0%. These differences were statistically significant. Based on our data, the classification of nodular lymphomas into subtypes according to the degree of nodularity was found to be useful since it was related to clinical stage and survival. Rappaport's cellular classification of diffuse lymphoma is related to prognosis and was found to be useful, but problems still remain in determining T- and B-cell types by means of cellular morphology and thus further study is warranted.

A Case of extranodal lymphoma (reticulum cell sar coma) originated from uterine cervix

This paper presents an extremely rare case of extra nodal lymphoma of the uterine cervix in a 57year-old multiparous woman. The histology of this case should be classified into histiocytic malignant lymphoma (re ticulum cell sarcoma) by the Rappaport classification of malignant lymphomas. Cytology in this case was a poor ly differentiated reticulum cell sarcoma whose cells it was necessary to differentiate from those of lympho sarcoma.The patient was treated by external radiation therapy with the telecobalt unit up to 1, 000 rads, following a simple hysterectomy. Unfortunately, she died in a rapid course of two month duration after onset of the disease. Perhaps, her acute death may be explained by the fact that she had already been in the advanced stage in view of the clinical and laboratory findings, and also of the studies of the removed specimens.