Node Swelling Research Articles

1594P SARS-CoV-2 vaccines in cancer patients (pts), real-world data (RWD) from 1069 Belong.life users

The COVID-19 pandemic continues to have a serious impact on many people, including cancer pts. The US CDC and oncology groups (ASCO, ESMO, ACS) made recommendations as to what high risk groups should be vaccinated first which includes cancer pts. Users of Belong.life, a worldwide, free, and voluntary, digital health application for cancer pts, replied to a targeted survey including demographic & clinical questions related to the pts cancers, ongoing therapies and the Covid 19 vaccination characteristics, and interactions. In this prospective study, 1069 cancer pts, Belong.life users, voluntarily replied to a survey asking demographic and clinical questions related to their Covid 19 vaccination and cancer status characteristics. Most of the pts were North American based (91 %), with 6.3 % from Europe and 2.6% from the rest of the world. 72% were between 50-69 years of age, and 79.5% were females. Five most common diagnosis were Breast Cancer (35.2%), gynecological (14.4%), gastrointestinal (13.3%), lung cancers (9.7%) and genitourinary (7%). 59% of the pts received chemotherapy,14.2% immunotherapy and 32.8% had radiotherapy over the past 12 months prior to receive the Covid 19 vaccination, which consisted of mRNA vaccines in 82.2% (Pfizer 46.2%, Moderna 36%). 4.9% of the pts refused vaccination. 82.3% of the pts had none (39.3%) or mild (43%) side-effects (S/E) and only 2.4% reported severe S/E. Most S/E lasted 1-3 days (89.4%) consisting mainly of sore arm (42.5%), headache (23.3%), fatigue (21.1%), and temperature (18.5%). Swollen lymph-nodes and allergic reactions were only reported in 0.7% (each). 49% of the pts were vaccinated while actively engaged on treatment, and in 96% there was no delay, interruption, or stoppage of the anticancer therapy. This is the first large report on Real word data voluntarily obtained from 1069 Belong.life users undergoing anticancer treatment with 90% of them receiving a Covid 19 vaccination. The large majority of pts had none or mild S/E (82.3%), and those were short lived (1-3 days in 89.4%) while only in 2% it was graded as severe. In 96% of the pts their ongoing anticancer therapy did not necessitate to be delayed, interrupted, or stopped.

Caseating Tuberculous Lymphadenitis- A Case Report

Introduction: Tuberculosis lymphadenitis (or tuberculous adenitis) is the most common type of infection with tuberculosis that occurs outside of the respiratory system. Tuberculosis lymphadenitis is a chronic condition caused by Mycobacterium tuberculosis in the granulomatous inflammation of the lymph node caused by caseated necrosis. The number of people who contact tuberculosis is estimated at 8 million per year, and about 3 million people die from tuberculosis in the world.
 Presentation of Case: In this case report we delineate the case of a female patient, 26-year-old, she had some pain and lymph node swelling in her right submandibular region since from 4 months and was diagnosed as right Caseating Tuberculous Lymphadenitis, associated with the cervical (neck) region, who was immunocompetent and HIV test negative, with a history of recurring fever, weight loss, loss of appetite for the last 4 months. On physical examination, she had swelling approximately 3×3 cm in the right submandibular region and a hard mass and painful sensation were noticed in her right submandibular region. On Fine needle aspiration cytology of submandibular lymph node reveals Caseating Tuberculous Lymphadenitis. this is extremely rare in immunocompetent individuals.

Identifying multiple swollen lymph nodes on preoperative computed tomography is associated with poor prognosis along with pathological extensive nodal metastasis in locally advanced gastric cancer

BackgroundAdvanced gastric cancer with extensive lymph node (LN) metastasis is associated with poor outcomes even after R0 gastrectomy. Although multi-detector row computed tomography (MDCT) is the basis of preoperative LN staging, the diagnostic accuracy of pathologically extensive LN metastasis detection by MDCT remains unsatisfactory. MethodsWe retrospectively evaluated diagnostic accuracy for pN2/3 disease by size and number of depicted LNs on MDCT in a single-center cohort of 421 patients with pT2-4 gastric carcinoma. The positive predictive value (PPV) was determined based on the number and short-axis diameter (SAD) of identified LNs, and oncological outcomes were also evaluated according to clinical LN status and pN categories. ResultsThe PPV for detecting pN2/3 disease rose with the SAD value cut-off for one LN, reaching 84.6% at 10 mm with no further increase at 15 mm. However, the SAD cut-off value plateaued at 8 mm (91.3%) when at least two measurable LNs were identified on MDCT. Patients with two measurable LNs with SAD≥8 mm had significantly poorer 5-year overall and recurrence-free survival than patients with fewer than two measurable LNs in the pN2-3 disease. On multivariate analysis, two measurable LNs with SAD≥8 mm was an independent prognostic factor for overall and relapse-free survivals. ConclusionLocally advanced gastric cancer with two measurable LNs with SAD≥8 mm on preoperative MDCT is highly associated with pN2/3 disease and poorer outcomes with upfront surgery. This criterion might be a reasonable indicator for identifying candidates for neoadjuvant treatment of advanced gastric cancer.

Sarcoid-like reaction in a HER2-positive breast cancer patient: A case report.

Introduction and importanceSarcoid-like reaction is a systemic granulomatous reaction that may develop in the lymph nodes and organs of cancer patients. Distinguishing a sarcoid-like reaction from metastasis is difficult. Accurate diagnosis of this reaction is key to preventing overtreatment.Case presentationA 51-year-old woman presented with a lump in her left breast and swollen lymph nodes in her left axilla and infraclavicular fossa. A core biopsy was performed, leading to the diagnosis of grade 2 infiltrating ductal carcinoma, clinical stage T2N3M0 with estrogen and progesterone receptor negativity and human epidermal growth factor receptor-2 positivity. After neoadjuvant therapy, the tumor in her left breast reduced in size, but the lymph nodes remained swollen. Mastectomy and axillary lymph node dissections were performed. In the pathological findings, epithelioid cell granuloma was observed in the lymph nodes. Based on these findings, lymph node swelling was attributed to a sarcoid-like reaction.Clinical discussionSLRs have been reported in 4–14% of cancer patients. Although there are various imaging modalities for detecting swollen lymph nodes, the differential diagnosis of cancer metastasis is often difficult.ConclusionHistological evaluation of swollen lymph nodes is required to prevent overtreatment; especially in cases where the tumor size is reduced by chemotherapy, but the lymph nodes remain swollen.

A PECULIAR CASE OF ISOLATED METASTATIC INGUINAL LYMPHADENOPATHY IN A YOUNG LADY – A CASE REPORT

Lymphadenopathy refers to the swelling of lymph nodes which can be secondary to bacterial, viral or fungal infections, autoimmune disease and malignancy. Lymphadenopathy can be localized or diffuse. About 75% of most lymphadenopathies are localized, and about 50% of those occur in the head and neck regions . Inguinal lymphadenopathy (3) occurs at the groin region and most common causes include infections of leg or foot, STDs, non Hodgkin's lymphoma, tuberculosis and pelvic malignancies. One of the rare causes includes distant metastasis of nasopharyngeal carcinoma (NPC) which is present in our case. Nasopharyngeal cancer is an uncommon squamous cell carcinoma in the head and neck region, in most parts of the world. It has a high propensity for lymphatic spread and is known for regional metastases with occult primary at presentation . The incidence of distant (1) metastasis at presentation ranges from 4.4 to 6%. The most common sites of metastasis are bone (70%–80%) followed by liver (30%), lungs (18%) and distant lymph nodes (axillary, mediastinal, pelvic and inguinal, in that order) . About 98% of them are discovered within 3 (2) years of treatment. As it is a highly chemo and radio-sensitive tumor, radiotherapy with concurrent chemotherapy is the mainstay in the management of local and advanced diseases. Here we are presenting a peculiar case of previously treated NPC presenting as isolated left inguinal metastatic lymphadenopathy in a young lady

Mycobacterial lymphadenitis without granuloma formation in a patient with anti-interferon-gamma antibodies.

A previously healthy 49-year-old Japanese woman presented with cervical lymph node swelling and tenderness. Lymph node biopsy revealed reactive lymphadenitis without granulomas. No malignant cells were found, and no acid-fast positive bacilli were identified by Ziehl–Neelsen staining. She was treated unsuccessfully with various antibiotics, and it was very challenging to reach a diagnosis. 18F-Fluorodeoxyglucose (18F-FDG) uptake in bones was evaluated using positron emission tomography-computed tomography (PET-CT), and disseminated mycobacterial infection was suspected. The interferon-gamma (IFN-γ) release assays QuantiFERON (QFT) and T-SPOT were used to diagnose tuberculosis infection. On testing, a difference in mitogen response was found between these assays. The response was low for QFT but adequate for T-SPOT, suggesting the presence of anti-IFN-γ antibodies. This difference depended on whether the patient’s plasma (including anti-IFN-γ antibodies) was used within the assay system. Mycobacterium abscessus was isolated from lymph node cultures, and plasma anti-IFN-γ antibodies were confirmed. The patient was diagnosed with disseminated M. abscessus infection with underlying adult-onset immunodeficiency caused by anti-IFN-γ antibodies. Granulomas are a pathological hallmark of mycobacterial infection, but may not fully form in immunodeficient patients. Clinicians should be aware of the possibility of mycobacterial infection without granuloma formation due to anti-IFN-γ antibodies.

Primary lymphoepithelioma-like carcinoma of the esophagus with metastatic lymph node and gastric cancer.

Upper gastrointestinal lymphoepithelioma-like carcinoma (LELC) is a rare disease-especially esophageal LELC (ELELC). Here, we report a surgically treated case of ELELC with gastric carcinoma. The patient was a 68-year-old asymptomatic Japanese man. Endoscopy revealed a submucosal-like protruding tumor located in the anterior wall of the esophagus 31-33cm from the upper incisors and a slightly ulcerative lesion at the antrum of stomach. Histopathological diagnosis from biopsy of the esophageal lesion revealed a poorly differentiated squamous cell carcinoma; the stomach lesion was found to be well-differentiated tubular adenocarcinoma. CT showed a swollen lymph node along the left recurrent nerve. On the basis of a diagnosis of esophageal and gastric cancer, we performed esophagectomy with three-field lymph node dissection and partial gastrectomy. Histopathology of the resected esophageal tumor revealed solid nests of cancer cells, with substantial infiltration of lymphoid cells into the stroma. There were poorly differentiated cancer cells with large nuclei in the lymph node. In situ hybridization for Epstein-Barr virus showed no nuclear signal in the tumor cells. Immunohistochemistry gave a diagnosis of ELELC.

The additional diagnostic impact of positron emission tomography–computed tomography for lymph node metastasis from colorectal cancer: A prospective lymph node level analysis

We conducted a prospective study to determine the diagnostic performance of positron emission tomography-computed tomography (PET-CT) for lymph node metastasis in colorectal cancer patients. We enrolled patients scheduled to receive curative surgery with lymph node dissection for colorectal adenocarcinoma who underwent contrast-enhanced abdominopelvic CT and PET-CT before surgery and who had primary lesions of cT2 or deeper. A radiologist determined the fluorodeoxyglucose uptake and the standardized uptake value (SUV) and metabolic volume (MV) to diagnose metastasis in cases with enlarged lymph nodes (≥7 mm long in minor diameter) on contrast-enhanced CT. Two gastrointestinal surgeons intraoperatively identified target lymph nodes to assess the association between images and pathological findings. The diagnostic performance (i.e., sensitivity, specificity, and positive and negative predictive values) for lymph node metastasis was determined using multilevel logistic modeling. A total of 205 colorectal cancer patients were enrolled from February 2018 to April 2020 and 194 patients were analyzed in this study. The sensitivity, specificity, and positive and negative predictive values of PET-CT were 15.3% (13.4%-17.5%), 100.0% (99.0%-100.0%), 100.0% (51.2%-100.0%), and 98.7% (98.5%-99.0%), respectively. PET-CT is a useful modality for determining the presence of metastasis in swollen lymph nodes on contrast-enhanced CT in colorectal cancer patients.

A case of Francisella tularensis meningitis in a 64-year-old man treated with quinolones

We report a French case of tularemic meningitis – the second to be thoroughly described – and discuss the existing literature.The patient is a 64-year-old man with no medical history, who developed fever, cutaneous symptoms, and swollen lymph nodes within a week after a hunt. He was then diagnosed with meningitis caused by Francisella tularensis subsp. holarctica.Healing was quickly achieved ad integrum within 3 weeks with a course of ciprofloxacin.We discuss the existing literature about this specific issue, and try to shine a light on the superior efficacy and lesser toxicity of quinolones compared to the historical treatment.

COVID-19 Vaccines Complicate Mammograms.

In a small number of people, an unexpected side effect of the COVID-19 vaccine has emerged: swollen lymph nodes on the same side of the body as the shot was given. For women who undergo breast screening soon after vaccination, such swelling can show up on a mammogram, so clinicians may need to take extra steps to educate patients about this possibility and assess the need for follow-up testing.

P44-9 A case of recurrent gastric cancer with drug-induced immune thrombocytopenia caused by trastuzumab

A 57-year-old woman was referred to the gastroenterology department of our hospital for management of chronic hepatitis B. Abdominal ultrasonography was performed and revealed swelling of the para-aortic lymph nodes. She underwent CT-guided needle biopsy and was diagnosed as having adenocarcinoma, which was positive for HER2. She had undergone total gastrectomy for gastric cancer (T1aN2M0, Stage 2A) 13 years earlier, and pathological examination of the resected specimen showed that the gastric cancer was HER2-positive (3+). Thus, she was diagnosed as having recurrence of HER2-positive gastric cancer in the para-aortic lymph nodes. Trastuzumab with S-1 plus oxaliplatin therapy was started. On day 1 of the first course, an infusion reaction due to trastuzumab occurred. Purpura appeared on the whole body from day 2. On the same day, oral administration of S-1 was stopped at her request. Hematuria appeared on day 3, and she visited our hospital on day 7. The platelet count was 1000/μL, so she was urgently hospitalized. Although platelets were transfused, the platelet count did not improve and bone marrow aspiration showed an increase in polynuclear megakaryocytes. We therefore suspected idiopathic thrombocytopenic purpura. Oral administration of prednisolone 1 mg/kg was started and rapidly improved the thrombocytopenia, suggesting a diagnosis of drug-induced immune idiopathic thrombocytopenia (DITP) rather than idiopathic thrombocytopenic purpura. Oxaliplatin was initially considered to be the causative agent of DITP, and S-1 monotherapy was started. No recurrence of thrombocytopenia was observed with S-1 monotherapy. Subsequently, she was started on S-1 plus trastuzumab therapy. On day 2, purpura appeared again, and the platelet count decreased remarkably. It appeared that DITP was caused by trastuzumab. The platelet count again rapidly improved after starting oral prednisolone. Here, we report this rare case of DITP due to trastuzumab with a review of the literature.

Study on concordance of specific cytological diagnosis with histology in a teaching hospital

Background: Fine-needle aspiration cytology (FNAC), a cheap screening technique, has helped reduce the diagnostic turnaround time of palpable swellings from different anatomical sites. In light of the technique increasingly being used as a definitive diagnostic tool, it is thus important to evaluate its accuracy in making specific diagnosis beyond just being a screening tool. Objective: To determine the concordance rate between cytological and histological diagnosis Materials and Methods: Cytology and corresponding histology reports for lesions from patients with maxillofacial, lymph node, and abdominal swellings, where both were available, were compared for the concordance of specific cytological diagnosis with final histological diagnosis. Results: In the 10-year (2006–2015) studied, there were 177 complete cases in which specific diagnoses were made on cytology; of these, 135 (75.3%) were in concordance with histological diagnoses. Concordance for intra-abdominal, maxillofacial, and lymph node aspirates was 90.2%, 85.5%, and 62.9%, respectively. Cytological concordance of specific diagnosis for benign and malignant lesions was 70.7% and 79.5%, respectively. Concordances for lymphomas, carcinomas, and sarcomas were 84.1%, 68.2%, and 66.7%, respectively. The specific cytologic diagnosis was enhanced by preaspirate ultrasound scan while the absence of immunocytochemistry hampered accuracy in specific diagnosis of nodal non-Hodgkin's and Hodgkin's lymphoma (66.7% and 42.9%), respectively. Conclusion: This study concludes that FNAC is a simple technique with fairly reliable utility in proffering specific diagnosis on suitable lesions. However, in developing countries where repertoire of antibodies for immunocytochemistry may be limited, the accuracy will be improved by good clinical history and preaspirate ultrasound where necessary.

The prevalence of extra-salivary gland complications in immunoglobulin G4-related sialadenitis.

To estimate the prevalence of extra-glandular lesions in patients with immunoglobulin G4-related sialadenitis (IgG4-RS). Six electronic databases (PubMed, EMBASE, Science Direct, Scopus, Web of Science, and China National Knowledge Infrastructure) were systematically searched from the date of inception of each database to March 2021. The Strengthening the Reporting of Observational Studies in Epidemiology statement was used to conduct methodological quality assessment, and a random-effect meta-analysis model was applied to estimate the prevalence. Publication bias was visually assessed using a funnel plot and calculated via Begg's and Egger's tests. The Stata 15software was used to perform data analysis. A total of 43 articles comprising 1,864 patients with IgG4-RS were considered to be eligible for this study. The pooled prevalence of extra-salivary gland lesions in IgG4-RS was 76.53% with a confidence interval (CI) of (69.39%, 83.04%). A higher prevalence was associated with studies published before or during 2015 (84.38%, CI [74.23%, 92.58%]) than those published after 2015 (68.55%, CI [58.44%, 77.88%]). Lacrimal gland involvement (54.68%, CI [45.61%, 63.60%]) and lymph node swelling (56.96%, CI [48.16%, 65.56%]) were the most frequent lesions. Extra-glandular lesions were common in patients with IgG4-RS. More high-quality prospective studies with less heterogeneity are required to determine the accurate prevalence.

مسح تثقيفي حول التوعية بالتهاب اللوزتين في محافظة بابل

Tonsillitis is an infection or inflammation of the tonsils. Tonsillitis classified as acute, chronic (recurrent) and complication. Most often it is caused by a virus, but it may also be caused by the same bacteria that cause strep throat. According to numbers that data shows, the virus is more common, about 77.49% than bacterial which about 71.45% then fungal about 9.6%. The principal symptom of tonsillitis is a sore throat fever, swollen lymph nodes, nasal congestion, difficulty in swallowing and headache may also occur, according to if symptoms of tonsillitis are known or not, data show that they know about (119 of people) (79.3) this result is greater than unknown which was about 31 (20.7).

Neck Masses: Clinico-Radio-Pathological Evaluation.

Neck masses are defined as any swelling or enlargement of the structures in between the inferior border of mandible and clavicle and are a common clinical finding that can be encountered in patients of all age groups. There are many potential causes of neck masses so it is important to proceed in affordable, easy available and cost effective diagnostic technique for the proper and early diagnosis of neck masses. As there is very few study data available over clinico-radio-pathological analysis of neck masses, that's why this study is done. The present study has been carried out on 200 patients with clinically palpable neck masses presenting at ENT department in a tertiary care hospital. Neck swellings were classified into four main headings i.e. Lymph node swelling, Thyroid swelling, Salivary gland swellings and Skin and soft tissue swelling. After taking detailed history followed by complete General, Local and ENT examination, FNAC was done followed by USG. We came to the conclusion that neck masses have very variable presentations, and FNAC is a riskless, easy and fast tool which can be used in forming a diagnosis and appropriate management of neck masses.

Targeting T-Cell Receptor Signaling Pathway in Angioimmunoblastic T-Cell Lymphoma

[Backgrounds] Angioimmunoblastic T-cell lymphoma (AITL) belongs to nodal T-cell lymphoma with T follicular helper (TFH) phenotype. Both the G17V RHOA mutation and the loss-of-function TET2 mutation have been identified in 70% of AITLs. We previously demonstrated that G17V mutant RHOA augmented T-cell receptor (TCR) signaling though binding to VAV1, an essential component of the T-cell signaling pathway (Leukemia, in press). However, it remains elusive whether inhibition of TCR pathway serves as an effective treatment in AITL. [Methods] Activation of VAV1 and PLCgamma1 in response to TCR stimulation was examined in Jurkat cells inducibly expressing wild-type and G17V mutant RHOA under the treatment with dasatinib, a multi-kinase inhibitor. Nuclear factor of activated T cell (NFAT) activity was similarly examined in Jurkat cells transiently transfected with wild-type and G17V mutant RHOA. Mice expressing G17V RHOA under CD2 promoter (G17VRHOA mice) were crossed with MxCre Tet2f/f mice and pIpC was given to the offspring 4 weeks after birth to obtain Tet2-/- and Tet2-/-G17VRHOA mice. Whole transcriptome analysis was performed for CD4+ T cells purified from the spleen of tumor developed mice. Serum cytokines were examined by BD Cytometric Beads Assay. Cells derived from tumors developed in Tet2-/-G17VRHOA mice were transplanted into nude mice. Dasatinib was orally given at 5 mg/kg/day for 14 days. [Results] The G17V mutant RHOA enhanced phosphorylation of VAV1 and PLCgamma1, and NFAT reporter activity in Jurkat cells. The phosphorylation and the NFAT activity were efficiently blocked by dasatinib at 10 nM. Approximately 70% of Tet2-/-G17VRHOA mice died around 40 wo, while 14% of Tet2-/- and none of G17VRHOA mice died at the same age (p<0.05). All the moribund Tet2-/-G17VRHOA mice presented splenomegaly and lymphadenopathy. The lymph nodes and the spleens showed diffuse infiltration of tumor cells expressing TFH markers, i.e., CD4, PD1, and ICOS. The aberrant increase of high endothelial venules was observed in the swollen lymph nodes, mimicking human AITL. Whole transcriptome analysis followed by gene-set enrichment analysis revealed enrichment of Il-2/STAT5, Il-6/JAK-STAT3, and TNFα/NFκB signaling pathways in Tet2-/-G17VRHOA CD4+ spleen cells. The serum concentrations of Il-2, Il6, and TNFα in Tet2-/-G17VRHOA were significantly higher than control at the same age (p<0.05). The CD4+ cells in the enlarged spleen and the swollen lymph nodes in Tet2-/-G17VRHOA mice at 40 wo showed oligoclonal rearrangement of TCR genes. Nude mice transplanted with tumor-derived cells showed splenomegaly and lymphadenopathy preceded by elevation ofthe serum concentrations of Il-2, Il-6 and TNFα (before vs. after the transplantation, 4.33±0.14 vs. 4.80±0.37, 5.85±2.96 vs. 34.92±15.49, and 7.68±2.08 vs. 45.70±33.72, p<0.01, respectively). Mice given with dasatinib starting at 10 days after the transplantation showed higher overall survival compared to the vehicle control (p<0.05, Figure 1). The serum concentrations of Il-2, Il-6, and TNFα were decreased in dasatinib group (before vs. after the dasatinib treatment, 4.85±0.40 vs. 4.28±0.18, 38.23±18.74 vs. 10.01±7.38, and 48.37±34.6 vs. 18.67±12.37, p<0.05, respectively).Discussions and Conclusion: The combination of G17V mutantRHOAexpression and Tet2 deletion led to development of AITL-like tumors in mice, which were hughly effectively treated by dasatinib. This model may also be useful to examine novel treatment strategies for AITL, other than dasatinib. [Display omitted] DisclosuresChiba:Nippon Shinyaku: Honoraria, Research Funding.

Mogamulizumab Monotherapy in the Treatment of Relapsed/Refractory Peripheral T-Cell Lymphoma or Cutaneous T-Cell Lymphoma Patients in Single-Institution Experience

Objectives; T-cell lymphomas generally have a poor outcome with shorter long-term survival compared with B-cell lymphomas. CC chemokine receptor 4 (CCR4) is highly expressed by aggressive peripheral T-cell lymphoma, not otherwise specified (PTCLs), particularly adult T-cell leukemia/lymphoma (ATL) and cutaneous T-cell lymphomas (CTCLs). Mogamulizumab is a humanized immunoglobulin G1 monoclonal antibody that targets CCR4. In phase II study, Mogamulizumab has been shown to high clinical efficacy and low toxicity. However, its efficacy has not been well evaluated in the clinical setting. We retrospectively analyzed the efficacy and safety of Mogamulizumab of against relapsed/refractory non- ATL T-cell lymphomas.Methods; Fourteen patients with relapsed/ refractory CCR4 positive PTCLs or CTCL were treated with weekly Mogamulizumab (1.0 mg/kg) alone at Iwate Prefectural Central Hospital between January 2015 and June 2017. CCR4 expression was determined by immunohistochemistry by a central laboratory center (SRL, Tokyo, Japan). In the first line, most patients receive commonly anthracycline-containing induction chemotherapy regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). The patients had received a median of one previous chemotherapy regime (range 1-3).We retrospectively evaluated (1) the best overall response, (2) progression-free survival (PFS), (3) overall survival (OS), (4) the best response according to disease site(peripheral blood; PB, lymph nodes; LN and skin) and (5) safety. Response assessments were performed after eighth mogamulizumab infusions according to the 1999 IWG criteria guidelines for response assessments for NHL (IWG-NHL). Treatment efficacy in patients with CTCL was evaluated by using a Global Response Score. Treatment was discontinued if progressive disease (PD) was evident.For safety evaluations, adverse events (AEs) were graded according to the National Cancer Institute Common Terminology Criteria for AEs, version 4.0.Results; The median age was 69 years old (range 48-85). Eight patients are male. The diagnosis comprised PTCLs (n=12) and CTCL (n=2). The median follow up periods and median number of Mogamulizumab infusion were 293 days (range 49- 681) and 8 courses (range 2- 9). (1) Complete remission (CR) was achieved in two patients (16.7%) and partial remission in one patients (8.3%), stable disease (SD) in two patients (16.7%), respectively. And (2) median PFS was 88 days and (3) median OS was 475 days. Peripheral blood, lymph node and skin lesion were affected in two, ten, and six patients, respectively. (4) In PB, complete response (CR) was obtained in all two patients (100%) and two patients were achieved CR in skin lesion (33.3%). In LN, only one of ten patient manifested CR(10.0%). This patient's tumor burden is low. (5) With regard to safety issues, hematological AEs were frequently observed, and lymphocytopenia occurred in 62.5% of patients. However, the AEs were controllable and tolerated. Non-hematological AEs, including fever, infusion reactions and skin trouble , were frequently observed (37.5%, 25.0%, and 37.5%, respectively). Grade 3/4 non-hematological AEs were scarcely observed.Conclusions; Although Mogamulizumab monotherapy is effective with highly safety, the patients who had swollen lymph node may need combination chemotherapy with mogamulizumab. The number of patients was small in this retrospective analysis, further investigation are required. DisclosuresNo relevant conflicts of interest to declare.

Health-Related Quality of Life in Adults Treated with Blinatumomab Using the Acute Lymphoblastic Leukemia Symptom Scale

Health-Related Quality of Life in Adults Treated with Blinatumomab Using the Acute Lymphoblastic Leukemia Symptom Scale

A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy

Background: Recently, double cancer is no longer uncommon. It is Particularly difficult to determine whether swollen lymph nodes (LNs) indicate malignant lymphoma or metastasis of other carcinoma. We experienced a case of rectal carcinoma complicated with adult T-cell leukemia/lymphoma (ATLL). Case presentation: We encountered a 77-year-old woman who had visited a previous hospital due to bloody stool. Colonoscopy revealed a 10-cm tumor in the lower rectum. Given its pit pattern and surface and vessel pattern, she was suspected of having adenocarcinoma in situ. However, enhanced computed tomography (CT) showed LN swelling around the rectum, and her bilateral inguinal LNs were palpable. Colonoscopy and a biopsy performed at our hospital showed adenoma (Group 3) with no malignant findings. We performed an inguinal LN biopsy and diagnosed her with ATLL. We suspected the rectal mass either be rectal carcinoma or ATLL invasion. We performed chemotherapy for ATLL. The inguinal LNs became no longer palpable, but the rectal mass did not shrink, so we performed operative resection for diagnostic treatment. Thereafter, we diagnosed her with double cancer of rectal adenocarcinoma and ATLL. Conclusion: It is difficult to determine whether swollen LNs indicate malignant lymphoma or metastasis of other carcinoma without performing an LN biopsy. However, a diagnosis of metastasis or non-metastasis does not influence either the staging of the carcinoma or the treatment plan.

CORRELATION OF CYTOLOGY WITH THE HISTOPATHOLOGY IN BENIGN AND MALIGNANT LESIONS OF LYMPH NODES

Background &amp; Objectives: Lymph node swellings are one of the commonest clinical presentation of patients and it encompasses a wide spectrum ranging from benign lesions to a malignant lymphoma or a more obnoxious metastatic malignancy. The objective of the study was to study the role of FNAC in the evaluating lymph node swellings of cervical , axillary , supraclavicular in the body and to understand the various cytological patterns of FNAC in correlation with histopathology of lymph node swellings. Methods: Patients referred to the Department of Pathology, CAIMS ,karimnagar from cancer Hospital and its allied branches, for palpable lymph node swelling on whom FNAC procedure was performed were included in the study. FNAC diagnosis of patients was compared with histopathology in cases which underwent surgical excision and its diagnostic accuracy was studied. Results: Out of 280 cases which included in the study, lymph node biopsy was carried out in 150 cases, 4 cases were inconclusive. Most were in 31 to 40 years. Gender wise, there was female preponderance. Cervical group of lymph node were most affected. Benign /non neoplastic lymphadenopathies were diagnosed in 83 cases(55.5%) of cases. Metastatic deposits were diagnosed in 28 cases(18.6%) of cases. Lymphomas contributed to 39 cases(26%). On correlation of FNAC ndings with histopathology. The overall correlation rate was 97.33%. Interpretation &amp; Conclusion: FNAC of lymph nodes is an excellent rst line method to investigate the nature of lesions as it is economical and an easy alternative to open biopsy