Case Of Lymphoma Research Articles

A case of lung adenocarcinoma and follicular lymphoma in the same lesion

A case of lung adenocarcinoma and follicular lymphoma in the same lesion

Distinguishing lymphoma from benign lymph node diseases in fever of unknown origin using PET/CT radiomics.

A considerable portion of patients with fever of unknown origin (FUO) present concomitant lymphadenopathy. Diseases within the spectrum of FUO accompanied by lymphadenopathy include lymphoma, infections, and rheumatic diseases. Particularly, lymphoma has emerged as the most prevalent etiology of FUO with associated lymphadenopathy. Distinguishing between benign and malignant lymph node lesions is a major challenge for physicians and an urgent clinical concern for patients. However, conventional imaging techniques, including PET/CT, often have difficulty accurately distinguishing between malignant and benign lymph node lesions. This study utilizes PET/CT radiomics to differentiate between lymphoma and benign lymph node lesions in patients with FUO, aiming to improve diagnostic accuracy. Data were collected from 204 patients who underwent 18F-FDG PET/CT examinations for FUO, including 114 lymphoma patients and 90 patients with benign lymph node lesions. Patients were randomly divided into training and testing groups at a ratio of 7:3. A total of 15 effective features were obtained by the least absolute shrinkage and selection operator (LASSO) algorithm. Machine learning models were constructed using logistic regression (LR), support vector machine (SVM), random forest (RF), and k-nearest neighbors (KNN) algorithms. In the training group, the area under the curve (AUC) values for predicting lymphoma and benign cases by LR, SVM, RF, and KNN models were 0.936, 0.930, 0.998, and 0.938, respectively. There were statistically significant differences in AUC between the RF and other models (all P < 0.001). In the testing group, the AUC values for the four models were 0.860, 0.866, 0.915, and 0.891, respectively, with no statistically significant differences observed among them (all P > 0.05). The decision curve analysis (DCA) curves of the RF model outperformed those of the other three models in both the training and testing groups. PET/CT radiomics demonstrated promising performance in discriminating lymphoma from benign lymph node lesions in patients with FUO, with the RF model showing the best performance.

A Rare Case of Diffuse Large B-cell Lymphoma in the Breast: Diagnostic Insights and Treatment Approaches

A Rare Case of Diffuse Large B-cell Lymphoma in the Breast: Diagnostic Insights and Treatment Approaches

A rare case of splenic marginal zone lymphoma with MYD88 mutation transformed into diffuse large B-cell lymphoma: case report and literature review.

In indolent lymphomas, histological transformation (HT) often results in a poor prognosis and presents a significant challenge in the management of these lymphomas. Previous studies have indicated that MYD88 mutations are associated with transformation in certain haematologic malignancies. We report a rare case of splenic marginal zone lymphoma (SMZL) harbouring an MYD88 mutation, which was transformed into diffuse large B-cell lymphoma (DLBCL) and accompanied by newly emerging genetic abnormalities. The role of the MYD88 gene in SMZL is currently unclear. Through this case, we reviewed relevant studies, which indicated that MYD88 mutations, along with other genetic anomalies, may play a significant role in this process. In the future, it is essential to collect more of these rare cases for further research.

Histopathological assessment of AIDS-defining malignancies in the gastrointestinal tract presenting with acute abdomen: Improving diagnostic timeliness and patient care.

While a large number of cases in an HIV setting may be attributed to infections, there has also been a rise in HIV- associated malignancies such as Kaposi sarcoma and aggressive B-cell lymphoma. To describe the clinicopathological features of cases with acute abdomen secondary to AIDS-defining malignancy in the gatrointestinal tract. This is a retrospective analysis of all cases presenting with acute abdomen and histologically diagnosed AIDS-defining malignancies of the gastrointestinal tract over a period of 8 years in our centre. Clinicopathological characteristics were retrieved from the laboratory information system. Archived haematoxylin and eosin-stained sections and immunohistochemical stains were reap- praised. A total of 13 cases, which consisted of 5 males and 8 females, with an average age of 35 years formed the study sample. All the patients were HIV-positive on antiretroviral therapy, and presented with acute abdomen. Intraoperatively, there were five intussusceptions, three strictures, three perforated tumours and two luminal occlusions. Histopathology confirmed five cases of Kaposi sarcoma and eight cases of high-grade B-cell lymphomas. Two patients with high-grade B-cell lymphomas died after surgical intervention. Expedited histopathological assessment of bowel resection in HIV-infected patients could improve clinical outcomes with early treatment.

The utilization of cytology for intraoperative diagnosis of primary central nervous system lymphoma

To investigate the diagnostic value of intraoperative cytology and rapid immunocytochemistry in primary central nervous system lymphoma. 254 cases of lymphoma and 82 cases of non-lymphoma were collected from 2010 to 2023. Frozen section(FS) was using alone in 44 cases during 2010–2014, FS and intraoperative cytology(IC) were using in 251 cases during 2015 to 2022. Rapid immunocytochemical(RICC, CD20, GFAP) were using with FS + IC in 41 cases during 2021 to 2023. Method One: According to the results of archives, statistic the diagnostic accuracy of lymphoma during three time periods. Method Two: All cases were randomly renumbered, 4 neuropathologists compared the accuracy of independent histology and that of combining cytology. The archives showed the diagnostic accuracy of FS in PCNSL was 77.27%, FS + IC was 86.06%, FS + IC + RICC was 92.68%. The retrospective study demonstrated the diagnostic accuracy of FS was 79.76%, FS + IC was 87.33% and FS + IC + RICC was 92.68%. The positive predictive value, negative predictive value, sensitivity, specificity and accuracy of CD20 were 100%, 76.92%, 90.32%, 100% and 92.68%, respectively. The results of the paired χ2 test was no statistically significant difference (0.05 < P < 0.1) between FS + IC + RICC and immunohistochemical (IHC) diagnosis of paraffin sections. The integration of IC + RICC + FS diagnosis can significantly enhance the intraoperative diagnostic accuracy of PCNSL and rectify potential errors that may occurred when relying solely on FS diagnosis.

Significance of increased 18F-FDG uptake in determining pathological status in post-chemotherapy lymphoma cases involving head-neck region on PET-CT

BackgroundCurrently, all follow-up cases of lymphoma showing fluorodeoxyglucose (FDG) avid uptake on positron emission tomography/computed tomography (PET-CT) in head-neck region undergo biopsy for tissue confirmation of diagnosis. There are no consensus or practice guidelines in literature pertaining, whether to biopsy all such FDG avid lesions post-chemotherapy. Hence, this study was conducted to determine the significance of PET-CT (SUVmax 5.0 or above) in determining remission or pathological status in these patients. MethodsA retrospective cohort analysis conducted between July 2019 and May 2023 at our institute of 40 follow-up cases of lymphoma post-chemotherapy (Group A) showing FDG Uptake with SUVmax 5.0 or above on PET-CT in Waldeyer's Ring (WR) or neck, and 40 non- lymphoma cases (Group B) showing FDG Uptake with similar SUVmax in WR or neck. All cases in group A underwent tonsillectomy and results of histopathology were correlated with PET-CT findings. All cases in group B underwent thorough clinical correlation with respect to PET-CT findings. A Receiver Operating Characteristic (ROC) curve for SUVmax was plotted to statistically analyse this data. ResultsStatistical analysis of our observations by plotting a ROC curve for SUVmax revealed a sensitivity of 90% with 10% specificity and an insignificant p-value of 0.733. ConclusionWe propose that unnecessary biopsy in all cases with FDG avid uptake must not be encouraged unless accompanied by a suspicious holistic clinical picture of asymmetry, significant lymph node involvement with FDG avid uptake and counterpart finding on CT. A tissue confirmation in all such cases may result in unnecessary risk and increase the cost of therapy.

Treatment of atopic dermatitis with abrocitinib in real practice in Spain: efficacy and safety results from a 24-week multicenter study.

Abrocitinib, a selective JAK 1 inhibitor, was recently approved in Europe. Despite its approval, real-world data on its efficacy and safety in treating moderate-to-severe atopic dermatitis (AD) remains limited. This study aimed to evaluate the short-term effectiveness and safety of abrocitinib in a real-life setting for patients with moderate-to-severe AD. We conducted a retrospective multicenter study involving adult patients with moderate-to-severe AD who started abrocitinib treatment between May 1, 2023, and September 30, 2023, in 15 Spanish hospitals. Treatment doses were 100 or 200 mg daily, based on clinical assessment. Data collection included patient demographics, AD history, comorbidities, previous treatments, and disease severity indicators such as SCORing atopic dermatitis (SCORAD), Eczema Area and Severity Index (EASI), body surface area, and Peak Pruritus NRS scores at baseline, 4, 12, and 24 weeks. Quality of life was measured using the Dermatology Life Quality Index (DLQI), and safety was assessed by monitoring adverse reactions and various biochemical parameters. The cohort comprised 76 patients with an average age of 33.93 years; 57.89% were male. Before abrocitinib, 36.84% were naïve to advanced therapies. The baseline mean scores were SCORAD 47.04, EASI 21.79, and DLQI 15.01. At Week 24, there were significant improvements: EASI was reduced to 2.81, and 70.58% of the patients achieved EASI 75. However, 18.42% discontinued treatment mainly due to inefficacy or adverse effects. The safety profile was favorable, with 22.37% reporting mild adverse events (AEs) and one serious case of cutaneous lymphoma. This first Spanish series assessing abrocitinib in real-world conditions reveals a significant improvement in AD symptoms and quality of life in a range of severity and prior treatment failures. Abrocitinib was well-tolerated, with few serious AEs, highlighting its potential as an effective treatment option for AD.

Mucosa-Associated Lymphoid Tissue Lymphoma as a Rare Mimicker of Relapsing Polychondritis.

Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade B cell extranodal lymphoma characterized by clonal marginal zone lymphocyte proliferation. We report a case of MALT lymphoma with a relapsing polychondritis (RP)-like phenotype, manifesting as rapidly progressive tracheal stenosis requiring tracheotomy.

Helicobacter pylori a karcinom žaludku

Helicobacter pylori belongs to the most common bacterial infections worldwide; despite its decreasing prevalence during the past four decades (currently ~ 40–50%), it is more prevalent in developing countries compared to developed ones. Intensive research of chronic Helicobacter pylori infection clarified the pathogenesis of several gastric and extragastric diseases, including different cancers. This review pointed out the role of Helicobacter pylori in different gastric malignancies. Chronic Helicobacter pylori infection is an etiological factor in non-cardia gastric cancer and most cases of low-grade MALT lymphoma of the stomach. However, there is an inverse association of Helicobacter pylori infection with other gastric malignancies, like cardia gastric cancer or rare hereditary Gastric Adenocarcinoma and Proximal Polyposis of the Stomach syndrome (GAPPS). A crucial issue has not been definitely solved yet: whether early eradication of Helicobacter pylori could prevent sporadic gastric cancer in the future? There is moderate evidence that searching for and eradicating Helicobacter pylori reduces the incidence of gastric cancer and death from gastric cancer in healthy asymptomatic infected Asian individuals, although data cannot necessarily be extrapolated to European or US populations so far. Indication for the eradication of Helicobacter pylori must now be considered with caution, on an individual basis of personalized medicine.

GATA3 Immunohistochemical Staining in Classical Hodgkin Lymphoma and its Diagnostic Utility in Differential Diagnosis.

Classical Hodgkin lymphoma (CHL) is a common lymphoid neoplasm with a wide range of differential diagnosis. Although it has a specific immunophenotype, aberrant expression of antigens can cause problems at its diagnosis. In this study we evaluated the usefulness of GATA3 in differential diagnosis of classical Hodgkin lymphoma. One hundred CHL cases and a control group of 106 lymphoma cases, which include anaplastic large cell lymphoma (ALK (+) and (-)), EBV (+) large B cell lymphoma, T-cell/ histiocyte rich B cell lymphoma, primary mediastinal large B cell lymphoma, nodular lymphocyte predominant Hodgkin lymphoma and mediastinal grey zone lymphoma, were included in the study. GATA3 immunohistochemistry were applied to all cases and its nuclear expression was accepted as positive. Expression status of GATA3 was compared in between the CHL and the control group, as well as among each lymphoma subtype. In addition, whether the biopsy type effects its diagnostic performance is assessed. In CHLs relationship with EBV status and GATA3 expression is evaluated. GATA3 expression was significantly higher in CHL cases compared to the control group (p<0,001). When compared with the individual subgroups GATA3 is still found to be useful in differential diagnosis except for ALK (-) ALCL (p=0,678) and mediastinal gray zone lymphomas (p=0,327). GATA3 expression is significantly higher in EBV (-) CHLs (p=0,02). In core needle biopsies its diagnostic performance is limited (p=0,178). GATA3 is a useful marker for differentiating CHL from B-cell non-Hodgkin lymphomas but its efficiency is limited in ALK (-) ALCL and mediastinal grey zone lymphomas. Due to the heterogeneous reaction diagnostic value is limited in core needle biopsies.

Projection of the number of new lymphoma cases in the world.

Projection of the number of new lymphoma cases in the world.

A Rare Case of Signet Ring Cell Lymphoma and Review of the Literature

Signet ring cell lymphoma (SRCL) is a non-Hodgkin's lymphoma with a very rare variant. Although this morphology is frequently seen in follicular lymphoma, it can also be observed in the group of diffuse large B-cell lymphomas. A seventy-six year old woman with known diagnosis of gastric adenocarcinoma, tubular type, moderately differentiate presented with a lymphadenopathy with high FDG uptake (SUVmax: 21.3) in PET/CT during follow-up. A tru-cut biopsy was performed for histopathological diagnosis. Diffuse infiltrative singet ring neoplastic cells showed negativity for PanCK, CK7, CK20, S100, SMA, calretinin and vimentin. The panel was then expanded to include SRCL, a rare variant of lymphoma. Additional immunohistochemical evaluation revealed positivity for CD20, CD19, PAX-5 and Bcl-2. Ki-67 proliferation index was about 80%. CD3, CD30, Myc, Bcl-6, ALK, Cyclin-D1, CD23, CD10, CD21, and MUM-1 were negative. EBER was also negative by chromogen in situ hybridization (CISH). Based on these data, diffuse large B-cell lymphoma (DLBCL) was considered. We herein reported a case of signet ring cell lymphoma discussed its clinical and morphological features with regard to the literature.

Clinicopathological characteristics and genomic profiling in patients with transformed lymphoma: a monocentric retrospective study

Background Transformed lymphoma occurs when indolent lymphoma transforms into more aggressive lymphoma usually associated with poor prognosis. Methods In this study, we analysed the immunophenotypes, prognostic factors and outcomes of 35 patients with transformed lymphoma from among 306 marginal zone lymphoma (MZL), 544 follicular lymphoma (FL) and 871 chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) cases. In addition, we performed whole-exome sequencing study of seven transformed MZL (tMZL) cases. Results Our results demonstrate that the median time from indolent lymphoma diagnosis to transformed DLBCL was 35 months (range, 14–53 months). The 5-year overall survival (OS) and progression-free survival (PFS) rates after histological transformation (HT) were 50% and 26%, respectively. Kaplan–Meier survival analysis revealed that asynchronous HT and transformed CLL/SLL (tCLL/SLL) were significant adverse prognostic factors for OS after DLBCL HT. We identified mutations involvement in chromatin remodelling (CREBBP and EP300) and regulators of NF-κB signalling (TNFAIP3, BCL10, MYD88, CD79B and CARD11) were affected in tMZL. Conclusion Whole-exome sequencing and copy-number analysis revealed that tMZL derives from the divergent evolution of an ancestral common progenitor clone (CPC). Collectively, this study provides clinicopathological characteristics of three common types of transformed lymphomas and the genetic profile of tMZL with diagnostic and therapeutic implications.

Proportion and characteristics of Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma: A systematic review and meta-analysis.

While Helicobacter pylori (H. pylori) infection is common in patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, there are still individuals who test negative for it. The proportion and characteristics of these patients remain unclear. We conducted a systematic search of the PubMed, Embase, and Cochrane Library databases for relevant articles. Using a random effects model, we performed a meta-analysis to assess the pooled proportion of gastric MALT lymphoma patients with negative H. pylori tests. Additionally, we compared characteristics between gastric MALT lymphoma patients with and without H. pylori infection to examine clinical features in H. pylori-negative cases. A total of 50 studies involving 6033 patients were included. The overall proportion of gastric MALT lymphoma patients with negative H. pylori tests was 20.5% (95% confidence interval: 17.0%-24.6%). This rate exhibited an increasing trend over the years, particularly in non-Asian countries and in studies published after 2013, as well as in cases with sample sizes exceeding 100 participants, in male individuals, and among those with proximal or multiple lesions, non-superficial type morphology, submucosal invasion, and advanced clinical staging. Compared to H. pylori-positive patients, those who tested negative were more likely to be male, have proximal lesions, exhibit submucosal invasion, and present with an advanced clinical stage. This study provides comprehensive information on the proportion and characteristics of H. pylori-negative gastric MALT lymphoma cases, highlighting the need for future clinical attention to treatment and surveillance in this patient population.

Infected Primary Bone Mantle Cell Lymphoma with Multiple Vertebral Involvement

Primary vertebral lymphoma is an exceedingly rare entity. We hereby report a case of a 67-year-old male who presented to our department with fever, weight loss, and progressively worsening lower back pain radiating to the right hip. Physical examination showed pain on percussion of the dorsal and lumbar spine and tenderness on palpation of the right upper thigh area. The radiographic findings revealed numerous vertebral lesions with a right psoas abscess extending to the right upper thigh. Intravenous antibiotic therapy was initiated and the patient underwent an incision and drainage of the psoas abscess with a favourable outcome. However, given the suspicious imaging findings of the osseous lesions suggestive of malignancy, a vertebral biopsy was performed and yielded histo-pathological findings consistent with bone mantle cell lymphoma. To the best of our knowledge, this is the first case of an infected primary bone mantle cell lymphoma with multiple vertebral involvement. The diagnosis is challenging and can be confused with other diseases.

A Case of Intravascular Large B-cell Lymphoma That Was Overlooked due to Nonspecific Symptoms During Combination Immunotherapy for Left Upper Lobe Lung Adenocarcinoma

A Case of Intravascular Large B-cell Lymphoma That Was Overlooked due to Nonspecific Symptoms During Combination Immunotherapy for Left Upper Lobe Lung Adenocarcinoma

Two Atypical Clinical Cases of a Rare Lymphoma: Peripheral T-Cell Lymphoma

Two Atypical Clinical Cases of a Rare Lymphoma: Peripheral T-Cell Lymphoma

Brown adipose tissue activation in paediatric and adolescent oncological (Hodgkin lymphoma or sarcoma) cases visualised on FDG PET/CT

Brown adipose tissue activation in paediatric and adolescent oncological (Hodgkin lymphoma or sarcoma) cases visualised on FDG PET/CT

The Value of Sysmex White Precursor Cell Channel in Distinguishing Circulating Large Blastoid Lymphoma Cells from Blasts

Abstract Background There are rare cases of lymphoma presenting with circulating large blastoid cells mimicking blasts. These abnormal cells usually are medium to large in size with high nucleus-to-cytoplasmic ratio, fine to slightly condensed chromatin, prominent nucleoli, and scant to moderate amount of cytoplasm. Distinguishing them from real blasts is challenging, and although flow cytometry provides a definitive answer, pathologists may feel compelled to offer a quick preliminary assessment to the clinical team, particularly during weekends when flow cytometry is not accessible. We have recently replaced the old CBC instrument with Sysmex XN-9100 which incorporates a new white precursor cell channel (WPC). WPC channel is triggered only when Sysmex differential channels (WDF+WNR) produce a combined flag of “blasts/abnormal lymphocytes?”. The WPC will then separate this into a specific flag for either cell type or remove the flag if it is normal. Our study aims to explore the effectiveness of the WPC Channel in distinguishing blastoid lymphoma cells from true blasts. Method Between October 2023 and January 2024, we identified four lymphoma cases exhibiting circulating large blastoid cells. For comparative analysis, we included the most recent seven cases of acute myeloid leukemia (AML) and one case of acute lymphoblastic leukemia (ALL), all featuring medium to large-sized blasts. We collected results from initial testing (WDF+WNR) and WPC reflex testing. The reference for our analysis included manual differentials assisted by CellaVision, pathologist reviews, and immunophenotyping results. Results Within four blastoid lymphoma cases, two were diagnosed as blastoid high-grade B-cell lymphomas, one as diffuse large B-cell lymphoma, and another as chronic lymphocytic leukemia with many blast-like cells observed on the cytospin slide (no smear available). Pathologists reviewed the smears and slides of all four cases, categorizing them as blasts or blast-like cells before flow was run. All cases were initially flagged with “Blasts/Abnormal Lymphocyte?” on Sysmex differential channels but were subsequently flagged only with abnormal lymphocytes after the WPC reflex. For comparison, in 7 AML and 1 ALL cases, the WPC channel flagged blasts in 7 out of the 8 cases following the reflex of initial “Blasts/Abnormal Lymphocyte?” flag. The only case flagged with abnormal lymphocytes but not blasts was a case of AML with monocytic differentiation, characterized by many promonocytes and rare blasts. Conclusion The WPC channel accurately characterized the challenging large blastoid lymphoma cells as abnormal lymphocytes in all four cases, where morphology characterization was difficult. The study’s limitation lies in its small sample size. We are actively accumulating additional cases with circulating blastoid lymphoma cells, alongside control leukemia cases, to further assess the efficacy of the WPC channel.