1/70. Beta-HCG aberrant expression in primary mediastinal large B-cell lymphoma.We report on a primary mediastinal large B-cell lymphoma with aberrant expression of beta-human chorionic gonadotropin (beta-hCG). The patient, a 33-year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. The neoplastic elements expressed CD45, CD20, CD79a and, partially, CD30, whereas they were negative for CD3, epithelial membrane antigen and cytokeratins. Surprisingly, they displayed a clear-cut positivity for beta-hCG. The remaining oncofetal markers applied (PLAP and alpha1-fetoprotein) were negative. Electron microscopy demonstrated the presence of numerous nuclear pockets and the lack of intercellular junctions. dna analysis by polymerase chain reaction showed clonal rearrangement of Ig heavy-chain genes. The patient responded promptly to the administration of MACOP-B. To the best of our knowledge, this is the first example of B-cell lymphoma showing positivity for beta-hCG; a similar aberrant expression was previously observed only in three Japanese patients with human T-cell lymphotropic virus type I adult T-cell lymphoma/leukemia. Because primary mediastinal large B-cell lymphoma has in the past been frequently confused with germ cell tumors, pathologists should be aware of possible beta-hCG expression by lymphomatous cells to avoid the risk of misdiagnosis.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
2/70. Primary cutaneous B-cell lymphoma: an association of chronic hepatitis c infection.Primary cutaneous B-cell lymphoma is a low-grade malignancy, distinct from other lymphomas in terms of biological activity and response to treatment. We describe a 77-year-old woman with a five-year history of chronic hepatitis c infection who developed a lower-limb lesion over a period of 3 months which was diagnosed as a high-grade cutaneous B-cell lymphoma. Despite a lack of definitive evidence implicating hepatitis c virus (HCV) in the aetiology of lymphomas, there is considerable research which establishes a strong association between these two diseases. On the basis of published research and the demonstration of HCV rna in the lymphomatous tissue, we consider this to be a rare case of primary cutaneous lymphoma in association with hepatitis c.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
3/70. Kaposi's sarcoma-associated herpesvirus-positive primary effusion lymphoma arising in the subarachnoid space.Primary effusion lymphoma (PEL) is a rare and distinctive type of B-cell non-Hodgkin's lymphoma (NHL) that occurs primarily, although not exclusively, in patients with AIDS. It usually develops as a lymphomatous effusion in the absence of a tumor mass, characteristically contains the Kaposi's sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8), usually also contains the Epstein-Barr virus (EBV), displays a characteristic cytomorphology bridging immunoblastic and anaplastic large cell lymphoma, often expresses an indeterminate immunophenotype, and a B-cell genotype. Thus far, PEL has been limited almost entirely to the pleural, peritoneal, and pericardial cavities. We describe a NHL occurring in a gay man with AIDS that is typical of PEL in that it arose in a body cavity or space without an associated tumor mass, displays the cytomorphology typical of PEL, is a clonal B-cell neoplasm, and contains KSHV as well as EBV. This case is singularly distinctive in that it is the first case of PEL reported to arise in the subarachnoid space. This unique case further supports the strong association between KSHV and malignant lymphoma arising in body cavities and growing as an effusion.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
4/70. Primary hepatic diffuse large B-cell lymphoma in a patient with chronic hepatitis c.Epidemiological and experimental data suggest that the hepatitis c virus infection might be associated with the development of distinct types of non-Hodgkin's lymphomas. Here, we report a case of a patient with chronic hepatitis c and type II mixed cryoglobulinemia, who developed a primary hepatic non-Hodgkin's B-cell lymphoma. A diffuse, large B-cell lymphoma was diagnosed based on morphological, immunophenotypical and molecular genetic findings. hepatitis c virus replication, as evaluated by strand-specific reverse transcriptase-polymerase chain reaction, was detected in the nonneoplastic liver, but not in the lymphomatous tissue. High grade non-Hodgkin's lymphomas, although rare complications, have to be considered as part of the spectrum of hepatitis c virus-related hepatic lesions.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
5/70. Early peripheral lymph node involvement of human herpesvirus 8-associated, body cavity-based lymphoma in a human immunodeficiency virus-negative patient.Human herpesvirus 8 (HHV-8), or Kaposi sarcoma-associated herpesvirus, is a gamma herpesvirus first detected in a specimen of Kaposi sarcoma from a human immunodeficiency virus (hiv)-positive patient. Human herpesvirus 8 is also found in an unusual clinicopathologic form of body cavity-based B-cell lymphoma, which has been named primary effusion lymphoma (PEL) and occurs primarily in hiv-positive patients. PEL is characterized by the formation of lymphomatous effusions, without obvious lymphadenopathy, tumor masses, or bone marrow involvement. Only a few cases of PEL in hiv-seronegative patients have been reported. We describe a case of an HHV-8-associated lymphoma, with ascites, pleural effusion, and axillary lymphadenopathy in an hiv-negative patient. The patient was a 68-year-old Jewish man of North African extraction, with a previous history of coronary bypass surgery and multiple blood transfusions. The pleural fluid contained large atypical lymphoid cells and was suggestive of lymphoma but could not provide a conclusive diagnosis of PEL. The lymph node contained groups of large anaplastic lymphoid cells. polymerase chain reaction for HHV-8 performed on the lymph node specimen was positive, establishing the diagnosis of PEL. polymerase chain reaction for Epstein-Barr virus was negative. Results of a gallium scan were normal. The patient did not respond to combination chemotherapy with cyclophosphamide, doxorubicin, vincristine sulfate, and prednisone and progressively developed, massive intra-abdominal solid tumor formation. To our knowledge, this is the first report of a case of PEL that demonstrates peripheral lymph node involvement at diagnosis and the first report of PEL in an Israeli patient.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
6/70. Increased incidence of follicular lymphoma in the duodenum.The incidence of indolent lymphomas in the lymph nodes and extranodal regions is quite different. Follicular lymphoma (FL) is most common in the nodes, and it seems to be least common in the gastrointestinal (GI) tract, where mucosa-associated lymphoid tissue lymphoma arises most frequently. The authors report that the incidence of FL is unexpectedly high in the duodenum compared with other portions of the GI tract. FL was detected in only eight of 222 cases of GI lymphoma (3.6%). However, five cases of FL arose in the duodenum, which accounted for 38.5% of 13 duodenal lymphomas. Only in two patients did FL arise in either the stomach or the colorectum, and in the remaining patients FL was widespread with lymphomatous polyposis. Duodenal FL was composed of neoplastic follicles with small cleaved cells in dominance, and the immunophenotype of the lymphoma cells was CD10 , BCL-2 , CD20 , CD75 , CD79 , CD3-, CD5-, cyclin d1-, CD23-, and CD45RO-. All the patients were women age 37 to 66 years (average age, 52.4 yrs). In all patients the lymphoma was present around the ampulla of vater, and four of five patients showed multiple small-size polyps. Although lymphoma cell infiltration was confined to the submucosa in the four patients examined, the regional lymph nodes were involved partially in two patients without distant metastasis. All patients are alive at 2 to 50 months of follow up (average, 27 mos), which is comparable with the prognosis for indolent nodal lymphomas. These results suggest that the duodenum has a distinct background of histogenesis of the lymphomas and that biopsy specimens from the duodenum with multiple polyps should be examined carefully.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
7/70. recurrence of non-Hodgkin's lymphoma isolated to the right masticator and left psoas muscles.We present the clinical and magnetic resonance imaging findings of a patient who, following treatment for pancreatic non-Hodgkin's lymphoma (NHL), relapsed with apparently isolated involvement of the right masticator space and left psoas muscles. Non-Hodgkin's lymphoma arising from the masticator space muscles is very rare. In addition, simultaneous lymphomatous involvement of multiple discrete skeletal muscle sites, in the absence of disease elsewhere, has previously only been reported in the limb or limb girdle muscles. lymphoma should be considered as a cause of isolated enlarged skeletal muscles, even when involving such distant sites.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
8/70. Diffuse large B-cell lymphoma associated with skin, muscle and cranial nerve involvement.The present case, a 75-year-old man with extranodal B-cell lymphoma showed facial hemiplegia, paresthesia and cutaneous manifestations. He was initially diagnosed as having a facial paralysis of unknown etiology. One month after the original diagnosis, erythematous indurated plaques developed on his left cheek and nose. A skin biopsy from the plaque on his cheek showed dense infiltrates of large lymphocytes with irregularly shaped nuclei and prominent nucleoli in the dermis and subcutaneous tissue. The lymphocytes were positive for L26 and CD79a. A diagnosis of diffuse large B-cell lymphoma was made. A muscle biopsy from facial muscle in the area of the erythematous plaque showed massive destruction of the muscle tissues by the lymphomatous infiltrates. Furthermore, electrodiagnostic study showed peripheral cranial nerve palsies, involving the left facial and trigeminal nerves. We conclude that diffuse large B-cell lymphoma may develop symptoms such as facial hemiplegia and paresthesia prior to cutaneous manifestations. Diffuse large B-cell lymphoma must be considered as one of the important causes of palsies of cranial nerves at the peripheral level.- - - - - - - - - - ranking = 1keywords = lymphomatous (Clic here for more details about this article) |
9/70. Primary thyroid lymphoma: diagnosis of immunoglobulin heavy chain gene rearrangement with polymerase chain reaction in ultrasound-guided fine-needle aspiration.We present a case of primary thyroid lymphoma coexisting with Hashimoto's thyroiditis in a 75-year-old woman in whom B-cell lymphoma was substantiated based on the findings of immunophenotyping and polymerase chain reaction (PCR) gene rearrangement in specimens that had been obtained by ultrasound (US)-guided fine-needle aspiration biopsy (FNAB). The immunophenotyping technique showed A light chain restriction, and PCR-based assays showed a discrete narrow band, which was diagnostic for clonal B-cell proliferation. Analyses of PCR gene rearrangement in US-guided FNAB may be a useful ancillary technique to pathological findings for diagnosis of primary thyroid lymphoma, especially for differentiation between low-grade B-cell lymphomas and Hashimoto's thyroiditis.- - - - - - - - - - ranking = 0.10525423245584keywords = thyroiditis (Clic here for more details about this article) |
10/70. Temporary one-and-a-half ventricular repair to relieve lymphomatous obstruction of the pulmonary artery.Mediastinal lymphoma may infiltrate the conoarterial junction of the heart and cause life-threatening compression of the pulmonary artery. Partial debulking of the tumor along the left pulmonary artery and creation of a cavopulmonary anastomosis on the right pulmonary artery restored satisfactory perfusion of the lungs and unloading of the right ventricle in a 19-year-old woman. Remission of the tumor after chemotherapy allowed subsequent takedown of the cavopulmonary anastomosis.- - - - - - - - - - ranking = 4keywords = lymphomatous (Clic here for more details about this article) |
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