Lymphoma In Immunocompetent Patient Research Articles

Plasmablastic lymphoma of the sphenoid bone in an immunocompetent patient: A diagnostic challenge.

Plasmablastic lymphoma is a rare type of highly aggressive B-cell non-Hodgkin lymphoma that usually occurs in immunocompromised patients and involves chiefly extra-nodal sites such as the oral cavity, jaw, gastrointestinal tract, soft tissue, bone, and skin. People above the age of 50 years are more commonly affected, with male predominance having a survival rate of 8 to 15 months. Here, we describe the case of a 48-year-old man who had an isolated plasmablastic lymphoma of the right sphenoid bone without any immunodeficiency. Plasmablastic lymphoma in immunocompetent patients at rare sites is a diagnostic challenge for both clinicians and pathologists because of vague clinical and histomorphology findings. This rare case report reemphasizes the utility of complete assimilation of clinical, histopathological, and immunohistochemical findings in such rare cases.

Primary CNS lymphoma in Immunocompetent patients: Appearances on Conventional and Advanced Imaging with Review of literature.

Primary central nervous system lymphoma (PCNSL) constitutes about 3% of all primary brain tumors and nearly 1 to 3% of all Non Hodgkin Lymphomas. In the recent years the incidence of primary CNS lymphoma is increasing in immunocompetent patients. As PCNSL are chemosensitive as well as radiosensitive, its early and accurate diagnosis is imperative for optimal management. Contrast enhanced Magnetic Resonance Imaging (MRI) is the recommended imaging modality for PCNSL; however, contrast enhanced Computed Tomography (CE-CT) is done in cases where MRI is contraindicated. Advanced imaging techniques like DWI (diffusion weighted imaging), MRS (MR Spectroscopy), MR perfusion, DTI (Diffusion tensor imaging) are important in diagnosis and help in its differentiation from other tumors.

An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients.

Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients.

Epidemiology and Outcome of Primary Cerebral Lymphoma in Immunocompetent Patients: A Monocentric Study

Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3% to 4% of brain tumors. The most common histological type is diffuse large B-cell lymphoma. Survival is improved by combining immunotherapy with chemotherapy. This is a descriptive retrospective study conducted at the Casablanca hematology center over a period of 9 years. The aim of this study was to report our experience by studying the clinical, paraclinical, therapeutic and evolutionary profile of patients with primary cerebral lymphoma. We present a study of 22 patients with PCL. The clinical, radiological and histological findings are shown along with the results of treatment. Patients were aged 25 - 75 years (mean 47 years) with a male predominance (77%). Computed tomography (CT) scans were performed on 16 patients (73%) and Brain magnetic resonance imaging for 16 patients (73%). Typically, lesions were multiple, isodense, and showed uniform enhancement with contrast medium. Immunocytochemical studies demonstrated 21 B-cell and 1 mantle-cell lymphomas. All patients received chemotherapy through high-dose MTX with whole brain radiotherapy (WBRT). After a median follow-up of 19 months, 54% are in complete remission, 32% have died, and 14% are lost to follow-up. Overall survival at 24 months and 36 months were 72% and 52%. The event-free survival at 24 months and 36 months were 60% and 48%. This study was to investigate the clinical features of PCNSL, and evaluate the efficacy of high-dose methotrexate (MTX)-based chemotherapy for immunocompetent Moroccan patients with PCNSL.

A series of four cases on plasmablastic lymphoma: A rare Epstein–Barr virus-positive lymphoma in immunocompetent patients with varied presentation

Plasmablastic lymphoma (PBL) is a rare and aggressive type of non-Hodgkin lymphoma (NHL) which is typically seen in the setting of an immunocompromised state, classically associated with human immunodeficiency virus infection. It is often also associated with Epstein–Barr virus infection. It has an immunophenotype of a terminally differentiated B lymphocyte. The diagnosis of PBL is challenging due to complex overlap with myeloma and other B-cell NHL having a plasmablastic morphology. In the past few years, there are an increasing number of cases being identified in patients with no known immunocompromised state. We hereby report a case series of four such cases in immunocompetent patients with different sites of involvement and varied presentation to add to the literature.

P884 Rare case of primary cardiac lymphoma in immunocompetent patient

Abstract Primary cardiac lymphoma is a rare tumour especially in immunocompetent person. It is invariably fatal unless diagnosed and treated early. Our patient was a 76 year old Chinese gentlemen, known case diabetes mellitus and hypertension, who presented with 3 months history of failure symptoms. He also had loss of appetite. His vital signs were stable. There was bibasal crepitation, raised JVP with normal heart sounds and bilateral pedal edema. Chest X-ray showed bilateral pleural effusion.He was admitted for stabilization of heart failure and started on diuretics. Echocardiography showed the LV ejection fraction was 50% with grade 1 diastolic dysfunction. There was a global pericardial effusion with effusion size 2.52cm maximum at posterior to LV. There was partial RA collapse .Patient was otherwise hemodynamically stable. Patient was observed closely and diuretics continued. Echocardiography on the third day of admission showed a suspicious looking mass in the right atrial (RA) and right ventricular (RV) wall near the AV groove. It become apparent after pericardial effusion became less. Patient was counselled and agreed for pericardial tapping but procedure had to be abandoned as effusion has reduced compared to before (<20mm). MRI cardiac showed an infiltrating mass around the right atrio-ventricular groove extending to the right ventricular free wall and around the pericardial lining around the ascending aorta and pulmonary trunks. There is inhomogenous signal in STIR with iso-intensity on T1 weighted images. First pass metabolism revealed some vascularity. There was a patchy myocardial enhancement on late gadolinium enhancement. pericardium was thickened with global pericardial effusion- 16mm. Large right pleural effusion seen and minimal left pleural effusion. Mediastinal lymphadenopathy was seen. The finding were suggestive of cardiac lymphoma with differential sarcoma. Subsequent day, patient develop acute ischemic stroke which was complicated by aspiration pneumonia and septic shock. Fortunately he recovered after 1 week of antibiotics and non-invasive ventilatory support. FDG PET- CT scan showed FDG-avid primary cardiac lymphoma with pericardial involvement and conglomerate of multiple group of mediastinal and supra clavicular lymph nodes . Bilateral hypermetabolic adrenal nodule were seen but unable to determine its relevance to the primary pathology(lymphoma). No marrow or other organ involvement. Stage is likely IIE. We were unable to harvest the lymph node because they were too deep. Patient"s family was counselled for cardiac biopsy but family did not want to take the risk as patient was bedridden and fragile. They were also not keen for any chemotherapy or invasive procedure. Once patient was out of infection, they requested to bring back patient to home. He was sent to nursing home for full time care but succumbed to another bout of aspiration pneumonia one week after discharge. Abstract P884 Figure. Echo, MRI, Pet CT scan

Serial case report: Primary central nervous system lymphoma in immunocompetent patients

Serial case report: Primary central nervous system lymphoma in immunocompetent patients

Treatment of Primary Central Nervous System Lymphoma in Immunocompetent Patients.

This review focuses on the findings of recent randomized prospective trials evaluating new therapeutic options for primary central nervous system lymphoma (PCNSL) in first-line treatment and on the most promising novel agents. The current standard treatment of newly diagnosed PCNSL has long been depending on high-dose methotrexate (HD-MTX)-based polychemotherapy followed by whole-brain radiotherapy (WBRT). Recent randomized trials have provided evidence that high-dose chemotherapy with autologous stem cell transplantation (ASCT) is a valuable alternative option to WBRT as consolidation after induction HD-MTX-based chemotherapy. For the elderly, cumulative studies confirm that chemotherapy alone as initial treatment is the best approach in this frail population in order to reduce chemoradiation neurotoxicity. If the role of rituximab needs to be further investigated, novel agents such as imids and ibrutinib have shown to be promising drugs to be incorporated in innovative combination treatment. The role of WBRT, at least at conventional dose, is declining in first-line treatment in favor of intensive consolidation chemotherapy with or without ASCT and possibly maintenance chemotherapy in the elderly. Despite their rarity, it has been shown that ambitious randomized trials in PCNSL are feasible thanks to collaborative networks.

Imaging features (CT, MRI, MRS, and PET/CT) of primary central nervous system lymphoma in immunocompetent patients

BackgroundBecause of the low incidence of primary central nervous system lymphoma (PCNSL) in non-HIV individuals and because of the lack of specific clinical manifestations and auxiliary examinations, the disease is easily missed or misdiagnosed.ObjectiveTo analyze the imaging features of PCNSL in non-HIV patients.MethodsThis was a retrospective study of patients with PCNSL treated between January 2001 and December 2011 at the Naval General Hospital (Beijing, China). All included patients were pathologically diagnosed with PCNSL. Specimens were obtained by stereotactic biopsy and diagnosed by pathological examination. Serological panel had to be negative for HIV.ResultsOut of the 118 patients, 73 (61.9%) were male and 45 (38.1%) were female. Median age was 54 (range 11–83) years. All patients had B cell lymphoma. The lesions showed slightly hyperintense shadows on computed tomography (CT) images, and mostly hyperintense T1 and iso- or hyperintense T2 signals on magnetic resonance imaging (MRI). Most lesions showed patchy enhancement after enhanced scanning, and some had the characteristic “butterfly sign” on enhanced MRI. The magnetic resonance spectroscopy of PCNSL manifested as increased Cho peak, moderately decreased NAA peak, and slightly decreased Cr peak. Positron emission computed tomography indicated high metabolism of 18F-FDG in PCNSL lesions.ConclusionMRI is important in the diagnosis of PCNSL. Understanding the imaging features of PCNSL will help improve its diagnosis in clinics.

Primary central nervous system lymphoma in immunocompetent patients: Spectrum of findings and differential characteristics

Primary central nervous system lymphomas (PCNSL) are rare and their management varies significantly from that of other malignant tumors involving the CNS. This article discusses how the imaging findings often suggest the diagnosis early in time. The typical findings in immunocompetent patients consist of one supratentorial intra-axial mass of homogeneous enhancement. Other findings that should be assessed include multifocality and incomplete ring enhancement. The differential diagnosis of PCNSL should mainly consider other malignant tumors of the CNS such as glioblastomas or metastases. PCNSLs tend to have less edema and less mass effect; they also tend to spare the adjacent cortex. Necrosis, hemorrhage, and calcification are rare in PCNSLs. Although the findings in the morphologic sequences are characteristic, they are not completely specific and atypical types can sometimes be found. Advanced imaging techniques such as diffusion-weighted images and, above all, perfusion-weighted images provide qualitative and quantitative data that play an important role in the differentiation of PCNSLs from other brain tumors.

Primary cerebral lymphoma in immuno-competent patient: report of 2 cases and literature review

Primary cerebral lymphoma is a form of non-Hodgkin lymphoma with a solitary localization in the brain, excepting other localizations involving the central nervous system. This is a rare cancer but with increasing incidence, it was predominantly observed in immunodepressed HIV-positive patients but since the advent of effective antiretroviral treatments, it has essentially been observed in immunocompetent patients. We report two cases of primary cerebral lymphoma observed in immunocompetent patients.

Primary sinonasal lymphoma in immunocompetent patients: A 10 years retrospective clinicopathological study.

Introduction:Sinonasal tumors occur in the nasal cavity or paranasal sinuses (PNS). These tumors are rare and lymphomas are even rarer. Lymphoma of the nose and PNS may mimic benign processes and may manifest either in an isolated fashion or in conjunction with systemic diseases. B-cell lymphomas, a more favorable diagnosis, account for the majority of cases, whereas T-cell and extranodal natural killer lymphoma are associated with rapid disease progression and death.Materials and Methods:All patients with sinonasal lymphomas who were nonreactive for HIV and were operated and treated in our hospital from 2006 to 2016 were included in the study. Histopathological diagnosis and immunohistochemistry using a panel of antibodies (CK, CD99, CD 15, CD30, CD45, Bcl 2, anaplastic lymphoma kinase-1, CD 16, CD 57 and ki-67) were reviewed and recorded.Results:Out of 153 malignant sinonasal tumors, 18 were diagnosed with lymphoma. Non-Hodgkins lymphoma constituted 88.8% of cases with the most common subtype being diffuse large B-cell lymphoma (n = 12, 66.6%). Maxillary sinus was the most frequently involved site (62%). The average age of presentation was 52 years with a slight male predominance. Computed tomography and magnetic resonance imaging scans were done in virtually all cases to assess the extent of the tumor as well as bony destruction. Average 5-year survival was 50%. Local recurrence was the most frequent cause of treatment failure.Conclusion:Malignant lymphomas constituted 11.7% of all malignancies of PNS. The association of diffuse large B-cell tumors with obstructive nasal mass and T-cell tumors with septal perforation, orbital extension and ophthalmological symptoms were more commonly seen.

Primary central nervous system lymphoma in immunocompetent patients: A regional cancer center experience.

Background:Primary central nervous system lymphoma (PCNSL) is a rare form of aggressive extranodal non-Hodgkin's lymphoma which occurs in both immunocompromised and immunocompetent patients. It has an overall poor prognosis in spite of a multimodality treatment approach including chemotherapy and radiotherapy. This study attempts to further delineate the clinicopathological, immunohistochemical, and radiological profile of PCNSL at Kidwai Memorial Institute of Oncology, Karnataka, India.Materials and Methods:All the pathologically confirmed PCNSL cases between January 2010 and June 2016, at our center, were analyzed retrospectively. The influence of potential prognostic parameters on overall survival (OS) was investigated by log-rank test and Cox regression analysis.Results:Of the 26 PCNSL patients, 17 (65.3%) were males. Median age at diagnosis was 42.5 years. None of the patients had HIV or Epstein-Barr virus positivity and only four patients (15.4%) had B-symptoms. The most common location in the brain was cerebral hemispheres in 15 patients (57%) and 10 patients (38.5%) had multiple intracranial lesions. Histologically, all were diffuse large B-cell lymphomas, except one case of anaplastic large cell lymphoma. Immunohistochemically, 18 patients (69%) had MUM 1 positivity and 20 cases (77%) belonged to nongerminal center subtype. DeAngelis protocol was followed in 24 patients (92%), and among this cohort, Memorial Sloan Kettering Cancer Center Class 1 (n = 17) and Class 2 (n = 7) patients had a median OS of 25 months and 11 months, respectively.Conclusion:None of the potential prognostic factors had a statistically significant influence on OS in our patients. High-dose methotrexate combined with radiation is an effective therapeutic approach. However, further prospective studies with a large number of patients are needed to identify more effective primary chemotherapy regimens to further improve the treatment outcome.

MRI findings in primary brain lymphoma in immunocompetent patients

Background and objective: Primary brain lymphoma is an extranodal aggressive intracranial neoplasm of lymphocytic origin originating and confined to the brain parenchyma and meninges. It is rare in immune competent patients, but its incidence is increasing. This retrospective study was conducted to record the MRI features of primary brain lymphoma at the time of diagnosis in immunocompetent patients. Methods: Of the 450 patients diagnosed with the brain tumor during a period of five years from 2008 to 2013, the clinical features and MRI findings of 16 cases of pathologically proven to be non-Hodgkin’s lymphoma were studied. All the patients were tested negative for HIV and there was no history of immune suppression drugs or any other chronic illness. All the patients were examined with MRI observing the tumor location, multifocality, signal intensity in different sequences, enhancement patterns, peritumoral edema, the presence of hemorrhage and calcification. Results: Of the 16 patients, including the monofocal and multifocal cases, 30 lesions exhibited. The mean age at diagnosis was 53 years. Nine patients (56.25%) found to have a multifocal disease. In more than 75% of lesions, MRI was hypo to iso signal on T1 and T2. Mild to moderate perilesional edema, strong contrast enhancement and restricted diffusion were seen in all cases. The hemorrhagic tumor was noticed in four lesions (13.3%). No calcification and no leptomeningeal lesions were noted. The MRI images in post steroid therapy were studied within one month of treatment. Tumour regression was noticed in 21/30 (70%), stable in 3/30 (10%) and progressing in 6/30 (20%). Conclusion: MRI is a reliable imaging technique in the management of patients with primary brain lymphoma. Early accurate diagnosis is crucial to avoid the unnecessary operation and shift patients from extensive surgery to chemoradiotherapy.

Primary Central Nervous System Lymphoma in Immunocompetent Patients: A Literature Review and the Experiment

Primary Central Nervous System Lymphoma in Immunocompetent Patients: A Literature Review and the Experiment

EBV-dUTPase Modulates Host Immune Responses Potentially Altering the Tumor Microenvironment in EBV-associated Malignancies

While the use of long-term antiretroviral therapy (ART) has improved immune function and reduced the incidence of some malignancies in human immunodeficiency virus (HIV-1) infected patients, this is not the case for non-Hodgkin’s lymphoma, an AIDS-defining cancer, and Hodgkin lymphoma, a non-AIDS defining cancer. Epstein-Barr virus (EBV) is an independent factor that adversely affects risk and/or survival among patients with Diffuse Large B cell Lymphoma (DLBCL) or classical Hodgkin lymphoma in immunocompetent patients as well as in HIV-1 infected individuals on ART. While cells infected with EBV in EBV-associated malignancies generally express one type of the latency programs, a small number of cells in these tumors are expressing EBV genes associated with lytic replication of the virus, which suggests that products from lytic or abortive-lytic replication may contribute to lymphomagenesis. However, the potential roles of these proteins in lymphomagenesis remain unclear. In this study we demonstrate that the EBV deoxyuridine triphosphate nucleotidohydrolase (dUTPase), an early protein produced during abortive/lytic EBV replication, is expressed in nasopharyngeal carcinoma (NPC) tumors in a mouse model of NPC, an EBV associated malignancy. Furthermore, screening of sera from 4 cohorts of patients diagnosed with AIDS, DLBCL, NPC and breast cancer (BC) by ELISA revealed an increase in IgG antibodies to the EBV-dUTPase in a subset of patients with AIDS, DLBCL and NPC relative to the controls. Finally, using an in vitro model of EBV infection we demonstrate that the EBV-dUTPase also inhibits T-cell function thus, allowing the proliferation of EBV immortalized B-cells. Altogether, our data support the premise that the EBV-dUTPase can modulate host immune responses and potentially alter the tumor microenvironment by promoting the survival/proliferation of immortalized B-cells, which may lead to lymphomagenesis. Key Words: Epstein-Barr virus, dUTPase, lymphomagenesis

Primary cardiac diffuse large B-cell lymphoma in immunocompetent patients: clinical, histologic, immunophenotypic, and genotypic features of 3 cases.

Primary cardiac lymphoma (PCL) is a rare extranodal lymphoma that involves only the heart and/or pericardium. Primary cardiac lymphoma is much less common in immunocompetent patients compared with those who are immunosuppressed. Patients with PCL have variable clinical manifestations that may lead to misdiagnosis and delay in treatment. Modern radiologic imaging now allows for earlier detection of these tumors. This study describes the clinical, histologic/cytologic, immunophenotypic, and molecular genetic findings for 3 immunocompetent patients with primary cardiac diffuse large B-cell lymphoma. All 3 patients had different initial clinical presentations. The neoplastic cells in all 3 cases were large in size, morphologically resembling diffuse large B-cell lymphoma. Neoplastic cells in 2 cases had non-germinal center (GC)-like (non-GC-like) and 1 case had GC-like immunophenotype. Neoplastic cells in all 3 cases showed C-MYC and BCL2 immunohistochemical protein coexpression. Neoplastic cells in 1 case showed double-hit MYC and BCL2 gene rearrangements, whereas another 1 case showed MYC gene rearrangement without BCL2 gene rearrangement. Epstein-Barr virus-encoded RNA was negative in the neoplastic cells in all 3 cases. All 3 patients received rituximab-based chemotherapy. Two patients subsequently had disease relapse at other extranodal sites at 10 and 24 months, respectively, whereas 1 patient was alive without disease at 9 months after diagnosis. If there is sufficient diagnostic tissue in these rare tumors, molecular studies should ideally be performed for prognostication and further patient management.

Treatment Response and Outcomes in Post-transplantation Lymphoproliferative Disease vs Lymphoma in Immunocompetent Patients.

Posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation may carry a poorer prognosis than lymphoma in immunocompetent individuals, but comparative data are lacking. In a retrospective, single-center, case-control study, 21 cases of PTLD were identified in patients undergoing kidney transplantation since 2000, and compared to 42 nontransplanted controls cared for in the same institution and matched for age, prognostic index, and cerebral localization. Two-year and 5-year overall survival was 57% and 44%, respectively, in PTLD patients and 71% and 58% in controls (log-rank test P= .20). On multivariable analysis, overall survival was similar for PTLD and control patients (hazard ratio 1.71, 95% confidence interval 0.81 to 3.61, P= .16). Response rate to first-line chemotherapy was similar between the 2 groups. Death was due to progression of the disease in 46% vs 94% of PTLD and control patients, respectively (P< .01), or sepsis in 31% vs 0% (P= .03). Treatment-related mortality was significantly higher in PTLD (19%) than in controls (0%, P= .03). In conclusion, response to first-line chemotherapy and overall survival are similar in PTLD and control patients, whereas causes of death were significantly different. Better prevention and management of infectious complications could improve the results in PTLD patients.

Primary Cardiac Burrkit Lymphoma: Characteristics, Clinical Presentation and Outcome

Background:Primary cardiac lymphoma (PCL) is rare extranodal subtype of non-Hodgkin's lymphoma (NHL) .It is extremely rare in immunocompetent patients. PCL usually occurs in adults mean age of 62.1 years with male predominance. Primary cardiac Burkitts lymphoma (PCBL) is small subgroup of the PCL. Characteristics, presentation and the optimal management guideline of BL have not been clearly defined.Method:We performed PubMed searches using the particular terms including but not limited to primary, cardiac, burrkit's , lymphoma to identify reported adult cases of PCBL.Different Variables including demographic, immune status, clinical presentation, radiographic and other clinical variables were analyzed.Result:This is the largest study of PCBL up to now.We analyzed 10 cases of adult PCBL including 9 reported cases in literature and one case who presented to our facility.Majority of patients were older than 65 (7/10), which is consistent with other studies of Burrkit's lymphoma in immunocompetent patients particularly in sporadic type. This can be secondary to similarity of pathogenesis and oncogenesis of PCBL to sporadic type. Although age at presentation ranged from 30 to 85 years old, only (2/10) were younger than 40. .All reported PCBL in our analysis including the one who presented to our facility were HIV negative and immunocompetent state. Thus we propose that PCBL can be categorized as a subtype of sporadic BL (SBL) but interestingly PCBL was more common in older patients in contrast with SBL as is more common in younger individuals, with a peak incidence at age 30 in adults. Most of patients (7/10) were male, which is also consistent with other studies of majority of NHL subgroups including cardiac lymphoma. As expected all patients except one presented with cardiac symptoms. Dyspnea was the most prominent presenting symptom comparing to palpitation, syncope or chest pain. It is most likely secondary to large pericardial effusion, which was present in all patients, rather than the mass effect. Interestingly one case had no cardiac mass identified and PCBL was diagnosed with pericardial analysis. These demonstrate the importance of evaluation for and analysis of possible pericardial effusion in patients, who present with dyspneaAs noted, our analysis showed that all patient except the one who presented to our facility, presented with cardiac mass (9/10). Similar to other studies of cardiac lymphoma, right heart particularly right atrium was the most common location of the cardiac mass. Cardiac lymphoma should be highly considered in patient with right atrial mass.Interestingly, Outcomes and chemotherapy response were variable; 3/10 cases reported favorable response to chemotherapy , however two cases with variable burrkit type and other chromosomal abnormalities had poorer prognosis. Due to rarity and low number of the cases ,outcome analysis adjusted with treatment regimen was not performed in our study.Conclusion:There is no comprehensive treatment analysis study for burrkit lymphoma . Due to complexity of pathogenesis and different behavior of this type of lymphoma, an efficient and optimal diagnostic, treatment and management guidelines for Burrkit lymphoma and its subtypes need to be developed.Table 1AgeGender(Male : M, Female : F)Presenting SymptomMass Locationpericardial effusionDiagnosed byChromosomal abnormalitiesHIV statusReference79FDyspneaLeft Ventricle (LV)Positive (pos)Pericardial analysisvariant type-(8,22)(q24,q11), no c-mycnegative (neg)J. Kuroda et al.elderlyMNot available (NA)positive mass location NANANANAnegS. Fatimi et al61FDyspneaRight atrium (RA) +Right ventricle (RV)posExcisional biopsyvariant type- 49, XX, +X, t(8;14)(q24;q32), −14, +der(14)(3;8;14) (q27;q24;q32), +18, +20negPiero Maria Stefani et al.33MDyspneaRAposExcisional biopsyNAnegChang-Fu Peng et al.44FAbdominal DiscomfortRAposPericardial analysist(8;14)negDimitrios et al.77MDyspnealarge mass , location NAposAutopsy of masst(8;14)negTakai K. et al.70MDyspneaRAposExcisional biopsyt(8;14)negM.De Filippo et al.74MDyspneaRAposPericardial analysisNAnegSylvie et al.67Msyncopebi-atrial + LVposExcisional biopsyt(8;14)negFrancesco Santini et al.84MDyspneaNo massposPericardial analysist(8;14)negPresented to our facility DisclosuresNo relevant conflicts of interest to declare.

Multimodality imaging of primary CNS lymphoma in immunocompetent patients

Primary central nervous system lymphoma (PCNSL) belongs to the group of extranodal non-Hodgkin's lymphoma, and the management of the disease is radically different from other central nervous system neoplasms. Owing to its varied appearance on imaging, diagnosis of PCNSL can be challenging. The purpose of this pictorial review is to depict the brain findings of PCNSL during initial diagnosis in immunocompetent individuals. Multimodal imaging integrating advanced sequences can facilitate differentiation of PCNSL from other CNS neoplasms.