Lymphoma Of Gastrointestinal Tract Research Articles

Primary Intestinal T-cell Lymphomas – A Case Series from a Tertiary Center in South India

Abstract Background: Gastrointestinal tract (GIT) is the most common site for extranodal lymphomas, however, primary T-cell lymphomas of GIT are a rare occurrence. The aim of this study is to highlight the diverse clinical presentation and disease course of intestinal T-cell lymphomas, as per the 2019 World Health Organization classification of tumors of the digestive system. Materials and Methods: Out of 77 primary gastrointestinal lymphoma cases diagnosed over a 10-year period (2013–2023), there were five patients with primary intestinal T-cell lymphomas and their demographics, presentation, and clinical course were scrutinized. Results: The male-to-female ratio was 2:3 and the median age was 63.8 years. Involvement of the ileum and ileocecal region was seen in three patients, and jejunal and colonic involvement in one each. All patients presented with advanced stages of disease and progressed rapidly despite aggressive chemotherapy. Conclusion: Intestinal T-cell lymphomas are rare with diverse presentations and dismal prognoses despite the availability of chemotherapeutic regimens. It also reflects the need for pathologists to recognize the disease for appropriate patient management and prognostication. Collaborative studies will help to further characterize the disease for personalized treatment.

Primary Gastrointestinal Lymphoma: Clinicopathological Study: 10 Years Experience in a Tertiary Care Center in Southern India

Background: The gastrointestinal tract (GIT) is a common site for extranodal lymphomas, accounting for 10%–15% of all non-Hodgkin lymphoma cases and 30%–40% of extranodal lymphomas. Regarding the incidence of the various histological subtypes and areas of involvement, there is a lot of heterogeneity in the literature. This study looked into the anatomical distribution, histological subtypes, and locations of primary gastrointestinal tract lymphomas (PGL) that were seen at a tertiary referral hospital in Southern India. Materials and Methods: A retrospective analysis of 96 individuals who had been diagnosed with PGL over the course of 10 years (2012–2022) was done. We carried out an audit of the clinicopathological profile of patients with PGL diagnosed over a period of 10 years. All lymphomas were classified according to the World Health Organization’s 2008 classification. Results: Of the 96 patients with PGL, 74 (77%) were male. The most common site for PGL was the stomach (50%), followed by the terminal ileum (14.58%). The most common histological subtype was diffuse large B cell lymphoma (DLBCL), which was seen in 85.42% of the patients. The most common symptom was abdominal pain (51.04%). Rituximab–cyclophosphamide–doxorubicin–vincristine–prednisolone was the most commonly used treatment regimen (56.3%). Conclusion: In this large single-center retrospective study, we found that the pattern of distribution of PGLs in India is comparable to the Western literature in that the stomach is the most prevalent site of PGL and DLBCL is the most common histological subtype.

1187 A Study of Outcomes in Patients with Gastrointestinal Tract Lymphomas Who Require Inadvertent Surgery

Abstract Aim Patients may present with acute surgical symptoms from their lymphoma. We aimed to study postoperative outcomes and 3-year overall survival in patients who had inadvertent surgery as primary management of their gastrointestinal tract lymphomas. Method Suitable patients were identified using electronic records from January 2013 to December 2022. Demographics, clinicopathological characteristics and survival outcomes of these patients were collected retrospectively. Results A total of 25 patients were identified. The most common clinical symptom was abdominal pain (n = 18, 72%) with demonstration of an obstruction (n = 16, 64%) or perforation (n = 4, 16%) by a mass on CT scan. Small bowel was the most common site, followed by colon and stomach (55%, 24% and 21% respectively) Diffuse large B-cell lymphoma was the most common subtype (66.7%). Immunohistochemistry revealed B-lymphocyte antigen CD20 to be positive in most patients (n = 17, 68%) and Ki 67% to be high (>70%) in a third (n = 8, 32%). Upon discharge, two thirds of patients were well enough to have systemic chemotherapy (n = 19, 76%). Two patients died from surgical complications while the rest succumbed to disease progression (n = 10, 76%). The overall 3-year survival rate was 56%. Conclusions Patients with gastrointestinal tract lymphoma who do not die in the postoperative period after inadvertent surgery are likely to be alive at 3 years with the use of systemic chemotherapy.

Adult Burkitt's lymphoma presenting as ileocecal intussusception

Most lymphomas of gastrointestinal tract arise mainly in stomach but can affect small bowel. Burkitt’s lymphoma stands for 9% of the cases of primary small intestine lymphoma and clinical presentations may vary. Case report of a 58-years old man presenting an acute abdomen secondary to intestinal obstruction with tomography revealing an ileocecal mass suspicious for intussusception. Surgery was performed and an invaginating mass from ileum-to-cecum lead to a laparoscopic right colectomy. Histopathological analysis established the diagnosis of ileocecal Burkitt’s lymphoma. Post-operative period was uneventful and the patient was referred to oncohematology and started early chemotherapy. Clinical situations of intestinal intussusception or small-bowel masses presenting with obstruction should rise the suspicion for malignancy and the surgeon must be aware of this clinical entity to proceed with an oncologically safe surgery. Intestinal perforation may indicates surgery as it leads to peritoneal tumor spread and indicates a worse prognosis. Laparoscopic surgery approaches must be seriously considered in selected cases. In intestinal lymphoma, early refer to oncohematology for evaluation and treatment is essential and establishes a better prognosis.

Primary Extranodal Non-Hodgkin’s Lymphoma: An Observational Study at a Tertiary Care Teaching Centre in Northern India

Introduction: Extranodal Non-Hodgkin’s Lymphoma (NHL) constitutes approximately one fourth of all NHL. The data regarding extranodal NHL from India is however limited. Aim: To evaluate the epidemiological and histomorphological patterns of extranodal NHL in a tertiary care institute in Northern India. Materials and Methods: The retrospective observational study was conducted on data of biopsy sections retrieved from the archives for a period of four years (January 2016 to December 2019), 130 extranodal NHL cases (90 males, 40 females) that were analysed for histological features and immunohistochemical subtype. All statistical analysis was done by Statistical Package for Social Sciences (SPSS) software. The values were represented in number, percentage, mean and ratio. Results: Total of 362 cases of NHL were reported. Out of which, 130 (36%) cases were of extranodal NHL. Male to female ratio being was 2.25:1. Mean age of presentation was 38.5 years. Paediatric cases constituted (32/130; 24.6%) cases. Head and neck was the most common site (52/130; 40%) followed by Gastrointestinal Tract (GIT) (21/130; 16.2%) and central nervous system (13/130; 10%). Amongst the paediatric cases, head and neck (11/32; 34.4%) was the most common site, followed by GIT (8/32; 25%). Amongst head and neck lymphomas, nasal cavity and Waldeyer Ring were the most common sites followed by orbit and oral cavity. Common sites among the GIT lymphomas were stomach, small intestine and large intestine. The B-cell NHL constituted 81/130 (62.3%), T-cell NHL 20/130 (15.4%) and NHL (Unclassified) were 29/130 (22.3%). Amongst B-cell type NHL, Diffuse Large B Cell Lymphoma (DLBCL) was the most common subtype. Conclusion: Extranodal NHL diagnosis is challenging due to morphological similarities with non haematopoietic tumours. Lineage determination by Immunohistochemistry (IHC) serves as the key to diagnosis. In our population, head and neck was the most common site, with B-cell NHL being the most common subtype.

A Study on Dermatomyositis and the Relation to Malignancy.

The idiopathic inflammatory myopathies (IIM) are a group of heterogeneous systemic diseases which include as main subtypes: polymyositis (PM), dermatomyositis (DM) and inclusion body myositis (IBM). The key feature of IIMs is the muscle weakness, accompanied by a characteristic skin rash in DM patients. The overall risk for malignancy in IIM is higher compared to the age-and sex-matched general population. Most epidemiologic studies have included only PM and DM patients and reported consistently higher rates of malignancy in DM. Most common types of cancer in DM are adenocarcinoma of the lung, ovary or gastrointestinal tract, melanoma and non-Hodgkins lymphoma. The highest risk for malignancy is seen in the first year after DM diagnosis. Multiple disease features have been linked to the development of cancer in DM. These include: older age, male sex, skin necrosis, Gottron sign, heliotrope rash, dysphagia, low complement C4, lymphocytosis, poor response to corticosteroids and rapid disease progression. Our study included 23 patients with DM, divided into two groups based on the association of malignancy, in order to compare clinical and demographic features, laboratory markers and analyze characteristic of cancer development.

Clinicopathological study of gastrointestinal Lymphomas and their survival in the patients referred to Yazd hospitals during 2011 to 2016

Introdution: Malignant lymphoma is divided into two subgroups of Hodgkin's and non-Hodgkin's, and 40% of them occur in areas other than the lymph node, the most common being the digestive tract. According to studies, in recent years the prevalence of non-Hodgkin's lymphomas has increased over the past. Therefore, in this study, we investigated the gastrointestinal lymphoma and the survival rate of the patients with this disease based on clinicopathologic characteristics.
 Methods: This study was an analytic-cross sectional study. The study population included 97 patients with various types of gastrointestinal lymphoma referring to 3 hospitals in Yazd during 2011-2011. Sampling was done by census. Referring to pathology department of hospitals, all cases related to gastrointestinal tract lymphoma extracted and the information (age, sex, year of diagnosis, type of lymphoma, location of lymphoma, treatment method and survival rate) using the checklist was recorded. The data were analyzed by SPSS18 software and patients' survival was assessed using Kaplan-Meier curves and Log-Rank test.
 Results: The results of the study showed that out of 97 patients, 69 patients (71.1%) were male and 28 (28.9%) were female. The mean age of the patients was 49.28±21.5. The most common site of lymphoma was stomach (45.4%), the most common type of treatment, surgical+ chemotherapy (53.6%), and the most common type of lymphoma, B cell lymphoma (50%). The mean survival time was 48 months and there was a significant relationship between mean survival time according to type of treatment.
 Conclusion: According to the results, it can be concluded that the appropriate treatment for patients with gastrointestinal lymphomas is surgical+chemotherapy combination therapy.

Practical Approach to the Histologic Diagnosis of Gastrointestinal Lymphomas Through the First-line Marker Battery of CD20, CD3, CD30, and Epstein-Barr Virus-encoded RNAs.

The gastrointestinal (GI) tract is a prevalent site for extranodal lymphomas. Some subtypes of GI tract lymphomas are aggressive and have dismal clinical outcomes. Therefore, prompt histopathologic detection of such types can be very important. We thus introduce a practical approach in the histopathologic diagnosis of GI lymphomas according to the revised World Health Organization (WHO) classification. When lymphocyte proliferation is found in the GI tract, a stepwise approach can help narrow down the differential diagnoses. When considering subtype incidence, macroscopic findings, and microscopic patterns, applying a first-line marker battery of CD20, CD3, CD30, and Epstein-Barr virus-encoded RNAs can effectively narrow down the top differential diagnoses at the initial step. Generally, the most common subtype among GI tract lymphomas is B-cell non-Hodgkin lymphoma identified by CD20 expression, followed by T-cell and NK-cell non-Hodgkin lymphomas identified by the CD3 expression, and some subtypes are defined by Epstein-Barr virus infection or CD30 expression. Macroscopically, lymphomas present as various gross types, such as large masses, small lesions, superficial and shallow lesions, polyp-like or polyposis-like features, or ulcer/necrosis/perforation. Microscopically, large pleomorphic cells or small to medium-sized tumor cells grow with various architectures and tumor microenvironments. Incorporation of macroscopic and microscopic features and the stepwise immunophenotyping may be a practical approach to the differential diagnosis of aggressive lymphoma, indolent/low-grade lymphoma, or benign to indolent lymphoproliferative disease. Exceptions always exist; this approach focuses on the relatively prevalent circumstances of lymphomatous lesions initially encountered in the GI tract.

2634 Small Bowel Lymphoma Presenting With Perforation: A Case Report

INTRODUCTION: Lymphoma account for only 1 to 4 % of neoplasms in the gastrointestinal tract (GIT), with the stomach being the most common location (68 to 75%) and the small bowel as the second most common (30 %). Among the possible presentations of GIT lymphomas, small bowel perforation is one of the most lethal and rare. Here we present a case of a patient that had a perforated jejunum secondary to lymphoma. CASE DESCRIPTION/METHODS: 57 year old female with history of diabetes, presented with 2 days of severe abdominal pain and vomiting. Physical exam revealed peritoneal signs and absent bowel sounds. CT showed multifocal small bowel thickening, pneumoperitoneum and extraluminal contrast indicating perforation. The patient was rushed to have explorative laparotomy which revealed multiple masses along the small bowel and had resection of a perforated jejunum. Pathology revealed lymphoma. Immunohistochemical staining was positive for CD20 and CD5, and was negative for Bcl-6 and CD10. FISH analysis was negative for translocation t(11,14), t(14,18), and MYC. The patient’s wounds healed and she was eventually treated with cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) along with rituximab for 6 cycles and Intrathecal (IT) chemotherapy. DISCUSSION: The WHO classify small bowel lymphomas (SBL) into B-cell subtypes (90 % of cases), T-Cell subtypes and Hodgkins Lymphoma.The most common symptoms are abdominal pain (70% of cases), ileus, and weight loss. Perforation was only found in approximately 16% of cases. CT may show polypoid lesions, multiple masses, and small bowel thickening. Usually, SBL is surgically resected for both diagnosis and treatment. Historically, endoscopy has been difficult because of the location. However, with the advent of capsule endoscopy and double balloon techniques, endoscopy can potentially avoid invasive surgeries. Our patient had an acute abdomen and therefore underwent surgical evaluation. Presence of CD20 and CD5, indicated a CD5 positive B-Cell lymphoma. FISH did not show any genetic rearrangements for Cyclin D- t(11,14), a marker for Mantle cell lymphoma, nor Myc and Bcl, markers for Burkitt’s and Follicular cell lymphomas, leading to the diagnosis of DLBCL. Localized tumors undergo surgical resection followed by radiation. TNM stage IIIE or higher is treated with combination chemotherapy, CHOP and rituximab, as was our patient. SBL is a rare entity; this case provides some insight and we hope such knowledge can only improve the management of patients to come.

3140 An Unfortunate Triad: GI Bleed Due to Refractory DLBCL Complicated by Occlusive Thrombus of the Inferior Vena Cava

INTRODUCTION: Ileal ulcers are circumscribed, inflammatory and necrotic erosive lesions on the mucosal surface of the ileum and can have specific etiologies such as Crohn's disease, NSAID-intake, intestinal tuberculosis and eosinophilic enteritis. Here, we report a symptomatic terminal ileal ulcer caused by a diffuse large B-cell lymphoma (DLBCL). CASE DESCRIPTION/METHODS: A 71 year-old male with a history of gastrointestinal bleeds (GIB) due to ulcers presented with weight loss and small bowel obstruction due to a terminal ileum mass and was diagnosed with an EBV-negative DLBCL after a right hemicolectomy. In the setting of refractory disease (RCHOP, Ibrutinib and Lenalidomide on trial, salvage with DHAX) he presented again with an active GIB with hematemesis and dark stools, an EGD was normal but a colonoscopy showed a lymphoma of the terminal ileum (TI). Clinical examination showed no abnormalities. Initial work up showed mild anemia and elevated creatinine (1.68). A CT abdomen and pelvis showed a progressive disease with new circumferential thickening of the small bowel in the right abdomen. A PET showed a progressive lymphadenopathy throughout the abdomen and pelvis. The GIB was managed with IV pantoprazole and sucralfate. A biopsy of the terminal ileum mass showed a recurrent DLBCL. The patient was considered for a regeneron trial but developed nearly occlusive deep vein thrombosis (DVT) that extended into his inferior vena cava (IVC) and led to a DVT in his left subclavian vein, so that he no longer was a candidate for trial. Given the active GIB, he was planned for the placement of an IVC filter, however, the occlusive thrombus in the IVC prevented the procedure. The goals of best supportive care were discussed with the patient. DISCUSSION: The gastrointestinal (GI) tract is the most common extranodal site involved by lymphomas. While GI tract involvement is usually secondary during progression of the disease, primary GI tract lymphoma is relatively rare. Diffuse large B-cell lymphomas are the most common lymphomas affecting the GI tract. GI lymphomas present with unspecific clinical features and are therefore difficult to distinguish from other conditions. The diagnosis is made by pathology. In this case, a biopsy was obtained from the TI mass confirming the diagnosis of refractory DLBCL with GI involvement. This patient developed an unfortunate combination of multiple complications interacting with the respective treatments.

Primary Small Bowel Diffuse Large B-Cell Lymphoma: Excellent Endoscopic Appearance

Primary gastrointestinal tract lymphoma is a rare entity and its occurrence primarily in the small intestine is even more uncommon. A 37-year-old female presented with abdominal pain ongoing for 3 months associated with nausea and vomiting. The pain was diffuse, radiating to back and it limited her oral intake. She endorsed night sweats and chills but did not report exposure to any sick contacts. She was HIV positive (CD4 count: 46 cells/mm3). CT abdomen and pelvis showed diffuse irregular small bowel wall thickening and submucosal edema, retroperitoneal and diffuse mesenteric lymphadenopathy. Endoscopy revealed multiple hard, friable nodules ranging from 5mm to 2 cm starting at the second portion of the duodenum and extending into the visualized jejunum (Image 1 and 2). Pathology confirmed the diagnosis of DLBCL (Image 3). Bone Marrow biopsy showed no evidence of lymphoma. The patient was started on chemotherapy with dose-adjusted rituximab with etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. Primary gastrointestinal lymphomas are quite uncommon and constitute 5-10% of all gastrointestinal tumors. [1] In the small intestine, most commonly affected region is ileum followed by jejunum, duodenum (6-8%) and then other sites. [2] HIV, is a known risk factor for lymphoma [3]. With the involvement of small intestine, the symptoms are quite non-specific. [1] Diagnosis is made via biopsy. Endoscopy is used to identify suspicious lesions preceded by radiographical evaluation. In some rare cases, it can present as multiple lymphomatous polyposis (MLP). [3] No guidelines exist for treatment of DLBCL of the small intestine. Historically, in HIV patients chemotherapy combined with ART remains the first step in the management of aggressive lymphomas. [4] Radiotherapy, as a mono treatment modality, has not been shown to be beneficial in DLBCL of the small intestine. [1,2]2555_A Figure 1. Nodules seen endoscopically in the duodenum.2555_B Figure 2. Friable nodules seen in the small bowel2555_C Figure 3. Malignant lymphocytes with moderately abundant cytoplasm, and the nuclei are round to ovoid with prominent nucleoli and occasional mitoses. H&E Stain, 400x

Su1988 - Gastrointestinal Tract Lymphoma Receiving Chemotherapy: Does Prophylactic Parenteral Nutrition and Bowel Rest Reduce Risk of Perforation?

Su1988 - Gastrointestinal Tract Lymphoma Receiving Chemotherapy: Does Prophylactic Parenteral Nutrition and Bowel Rest Reduce Risk of Perforation?

Primer Gastrointestinal Sistem Lenfoması Tanısı Alan Olgularımızın Retrospektif Değerlendirilmesi

Primer Gastrointestinal Sistem Lenfoması Tanısı Alan Olgularımızın Retrospektif Değerlendirilmesi

A Case of Primary Ileocecal Lymphoma

Primary lymphoma in gastrointestinal tract is not very common. Ileocecal region is the commonest site for primary lymphoma and diffuse large B cell lymphoma (DLBCL) is the most prevalent subtype. The clinical presentation in this condition is pain in right lower quadrant region and this can very confusing since many diseases can also cause this problem like infection and inflammatory disease. In this paper, we report a case of primary lymphoma subtype DLBCL in ileocecal region that come to emergency department with ileus obstruction. Abdominal computerized tomography (CT) scan and colonoscopy revealed tumour in ileocecal region ascendens colon. Hemicolectomy was performed and the specimen was sent to pathology which revealed non-Hodgkin lymphoma with subtype DLBCL CD20 (+). The patient had undergone of Rituximab, Cyclophosphamide, Doxorubicine, Vincristin, and Prednison (RCHOP) chemotherapy regimen and had complete remission.

Safe and successful birth following pelvic radiotherapy for rectal mucosa-associated lymphoid tissue lymphoma: a case report

BackgroundMucosa-associated lymphoid tissue lymphomas can occur in various parts of the body, and half of mucosa-associated lymphoid tissue lymphomas occur in the gastrointestinal tract. Gastric mucosa-associated lymphoid tissue lymphoma is the most common lymphoma of the gastrointestinal tract and primary rectal mucosa-associated lymphoid tissue lymphoma is very rare. Because of the high radiosensitivity of mucosa-associated lymphoid tissue lymphomas, this condition can be controlled with radiotherapy of approximately 30 Gy alone. However, ovarian dysfunction as an adverse event of radiotherapy for pelvic lesions can become a problem in girls and women. We report a case of a 28-year-old woman with rectal mucosa-associated lymphoid tissue lymphoma who safely gave birth to a baby following 30.6 Gy radiotherapy to her whole rectum.Case presentationA 28-year-old Japanese woman became aware of bloody stools and was diagnosed as having Lugano I rectal mucosa-associated lymphoid tissue lymphoma. She was referred to our institute and initiated on radiotherapy. However, she expressed a desire to bear children. We used horizontally opposed pair fields for radiotherapy to minimize the irradiation to her endometrium and ovary. A total dose of 30.6 Gy was given in 17 fractions of 1.8 Gy by 10-Megavolt X-ray linear accelerator. As a result, one-third of her uterus and half of her ovary were outside the irradiation field. After approximately 1 year of treatment, positive pregnancy was confirmed and finally she safely gave birth to a baby girl without congenital abnormalities.ConclusionsThis report provides hope for girls and women who have undergone irradiation for pelvic mucosa-associated lymphoid tissue lymphomas and who desire to bear children.

Gastrointestinal Lymphoma in Southwest China: Subtype Distribution of 1,010 Cases Using the WHO (2008) Classification in a Single Institution

The gastrointestinal tract (GIT) is the most common anatomic site of extranodal non-Hodgkin lymphoma (NHL) involvement. The classification criteria of lymphoma have changed in recent decades, and few large-sample studies regarding subtype analysis of lymphoma have been performed in this site. Aim: Therefore, the present study was conducted to analyze the histological subtype distribution of the GIT. Method: All patients in a single institution with a diagnosis of primary NHL in the GIT were enrolled between January 2007 and April 2014. The patients were categorized according to the WHO (2008) classification of tumors of hematopoietic and lymphoid tissue. Result: A total of 1,010 eligible cases diagnosed as NHL were collected in this study. The male:female ratio was 1.7:1 and the median age was 55 years. The percent of patients with lymphoma involvement in the stomach was 52% (n = 522), and the remaining 48% (n = 484) had intestinal tract involvement. Histologically, diffuse large B cell lymphoma (DLBCL) was the most common subtype in all of the GIT lymphoma cases, and was also the most common subtype in cases involving the stomach (78%) and the intestinal tract (53%). The incidence of DLBCL and mucosa-associated lymphoid tissue lymphoma in the stomach was significantly higher than the incident in the intestinal tract (p < 0.01). T and NK cell lymphoma was significantly more common in the intestinal tract than in the stomach (p < 0.01). Extranodal NK/T cell lymphoma nasal type (ENKTL-N) was the most common subtype of T and NK cell lineage lymphoma in GIT and was also the second most common intestinal tract-involved lymphoma. Conclusion: DLBCL was the most frequent lymphoma in the stomach and in the intestinal tract. T and NK cell lineage lymphoma had a higher occurrence in the intestinal tract than in the stomach. ENKTL-N was the most frequent subtype of lymphoma derived from NK/T cell lineage, and was the second most common lymphoma among all intestinal tract lymphomas.

Richter Syndrome With Follicular Colonization of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Cells Mimicking Follicular Lymphoma

Follicular colonization is occasionally observed in marginal zone lymphoma. In rare cases, it has also been associated with mantle cell lymphoma. Chronic lymphocytic leukemia typically involves nodal or extranodal tissues as diffuse proliferation by complete effacement of the normal architecture. The involvement of chronic lymphocytic leukemia may be less frequently limited to the interfollicular areas. Here, we report a case of Richter syndrome of the small intestine that was initially diagnosed as follicular lymphoma of the gastrointestinal tract because of a partial follicular growth pattern in addition to a mainly diffuse proliferation pattern. The follicular pattern mimicking follicular lymphoma was shown to be composed of reactive follicles with follicular colonization of the original chronic lymphocytic leukemia cells. As the prognoses of Richter syndrome and follicular lymphoma of gastrointestinal tract are quite different, clinicians must carefully diagnose these conditions to avoid a misdiagnosis.

High prevalence of oncogenic MYD88 and CD79B mutations in diffuse large B-cell lymphomas presenting at immune-privileged sites

Activating mutations in CD79 and MYD88 have recently been found in a subset of diffuse large B-cell lymphoma (DLBCL), identifying B-cell receptor and MYD88 signalling as potential therapeutic targets for personalized treatment. Here, we report the prevalence of CD79B and MYD88 mutations and their relation to established clinical, phenotypic and molecular parameters in a large panel of DLBCLs. We show that these mutations often coexist and demonstrate that their presence is almost mutually exclusive with translocations of BCL2, BCL6 and cMYC, or Epstein–Bar virus infection. Intriguingly, MYD88 mutations were by far most prevalent in immune-privileged site-associated DLBCL (IP-DLBCL), presenting in central nervous system (75%) or testis (71%) and relatively uncommon in nodal (17%) and gastrointestinal tract lymphomas (11%). Our results suggest that MYD88 and CD79B mutations are important drivers of IP-DLBCLs and endow lymphoma-initiating cells with tissue-specific homing properties or a growth advantage in these barrier-protected tissues.

Pattern and Trends of Cancer in Odisha, India: A Retrospective Study

The burden of cancer is growing globally and is one of the top leading causes of death. Information on cancer patterns are essential for effective planning of cancer control interventions. There is limited published information available on pattern of cancer for the state of Odisha, India. The present study was an attempt to explore the pattern and trend of cancer in Odisha. To fulfill the objectives retrospective data available from 2001-2011 at Acharya Harihar Regional Cancer Center (AHRCC), Cuttack, Odisha, were analyzed. Medical records of cancer patients were reviewed and relevant information on diagnosis, primary site and demographic data were retrieved. Data were entered and analyzed using SPSS 16.0 (SPSS Inc.). A total of 74,861 cancer inpatients were registered at AHRCC for the years 2001-2011. The proportion of females outnumbered males with female:male ratio 1.1:1. The number of female cases increased four folds and that of males three fold over the period studied. Malignancies such as oral cancer (16.93%), acute lymphocytic leukemia/non Hodgkins lymphoma (14.09%) and cancer of gastrointestinal tract (21.07%) are leading cancers among males and carcinomas of breast (28.94%), cervix (23.66%) and ovary (16.11%) were leading among females. Findings from this study indicate an overall increase in cancer reporting which could be regarded as proxy measure for overall cancer situation in Odisha. There is scope and need for integrating other government hospitals, existing private health service providers and research institutions across the state for better planning of cancer control program.

Non-Hodgkin malignant lymphoma of gastrointestinal tract detected by ultrasonography

Introduction: The gastrointestinal tract is the most frequent location for primary extra-nodal non-Hodgkin lymphomas. Primary NHLs located in the gastrointestinal tract account for only 1–4% of gastrointestinal malignancies. The complaints are very varied and often atypical depending on the different locations, which makes the diagnosis difficult.