1/8. Primary T-cell lymphoma of the thyroid.BACKGROUND: The routine use of immunocytochemical analysis has led to the recognition that many thyroid neoplasms previously diagnosed as anaplastic or small cell carcinomas are actually lymphomas of the thyroid. The great majority are B-cell lymphomas which can be associated with Hashimoto's thyroiditis. In spite of this, thyroid lymphomas are still not commonly recognized as a significant part of thyroid differential diagnosis. methods: A rare case of a primary T-cell lymphoma of the thyroid gland is presented along with general clinical history and physical findings which should make the practitioner suspicious of a thyroid lymphoma. The usefulness of radiology scans and fine-needle aspiration are discussed. RESULTS: Both prognosis and treatment options are very different for thyroid lymphomas and anaplastic carcinoma. CONCLUSIONS: cyclophosphamide/adriamycin/vincristine/prednisolone chemotherapy/radiotherapy regimens have proven to be very effective for most thyroid lymphomas.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Peripheral T-cell lymphoma presenting as ascites: a case report and review of the literature.Here we report an unusual case of T-cell lymphoma presenting as ascites. A 49-yr-old woman was admitted to the hospital for abdominal discomfort associated with increasing abdominal girth over the course of 3 mo. She also complained of nausea, vomiting, and diarrhea. On physical examination, a tense and distended abdomen and edema of the lower extremities were noted. Neither hepatosplenomegaly nor lymphadenopathy was found. A CT scan of the abdomen and pelvis showed a large abdominal/pelvic mass surrounding the small bowel and omentum and small nodes in the para-aortic and mesenteric regions. The cytospin prepared from the peritoneal fluid was hypercellular and composed of a population of monotonous, noncohesive cells with a high nuclear/cytoplasmic ratio and a single prominent central nucleolus. The cells were positive for leukocyte common antigen and Leu-22 (CD43) but negative for keratin, L26, UCHL-1, kappa, lambda, CD3, Ki-1 (CD30), S-100, and carcinoembryonic antigen. Morphologic and immunologic findings were suggestive of T-cell immunoblastic lymphoma. Peripheral T-cell lymphomas rarely present as ascites; this case demonstrates the value of effusion cytology in making this diagnosis.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
3/8. Peripheral T-cell lymphoma other than angioimmunoblastic T-cell lymphoma (AILD), with follicular dendritic cells proliferation and infection of B immunoblasts with Epstein Barr virus.We describe a case of peripheral T-cell lymphoma, unspecified (REAL) with co-existence of follicular dendritic cell (FDC) proliferation and EB virus-infection. A 55-year-old Japanese man complained of generalized lymphadenopathy and physical examination showed systemic lymphadenopathy, and hepatosplenomegaly. HTLV-1 antibody titers and gamma-globulin level were within normal limits. Histopathologic examination of the right cervical lymph node showed peripheral T-cell lymphoma, unspecified (REAL classification). A diffuse infiltration of lymphoma cells with abundant small venules were found throughout the lymph node. There were few arborizing venules. An irregular meshwork of FDCs was found by immunostaining with DRC-1 and CD21 in the area rich in venules, but not in the area of diffuse lymphoma cell-infiltration. EBER-1 rna-in situ hybridization showed positive signal on the nuclei of mainly non-neoplastic B immunoblasts. The present case, therefore, was regarded as a rare case of peripheral T-cell lymphoma, unspecified with FDC proliferation and EB virus infection.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
4/8. Enterotherapy associated T-cell lymphoma: a case report and literature review.T-cell lymphoma of the intestine is a form of extranodal, non-Hodgkins lymphoma. Enteropathy associated T-cell lymphoma (EATCL) is a unique form of T-cell lymphoma involving the gastrointestinal tract. This disorder is rare and there is no consensus on guidelines for diagnosis or treatment. CASE: This 47 year old patient presented to the hospital with increasing abdominal girth and swelling of the lower extremities over the four days prior to admission. He complained of dyspnea on exertion, anorexia, nausea and vomiting, 40 pound weight loss over half a year, accompanied by intermittent diarrhea. On physical examination, the patient was found to have anasarca, an abdominal fluid wave with shifting dullness, mild abdominal tenderness, marked pitting edema of the extremities, and necrotic toes. A small bowel follow through revealed an abnormality in the mid-jejunum and a colonoscopy revealed two erythematous lesions near the cecum. Subsequent esophagoduodenoscopy and enteroscopy identified multiple white patchy lesions in the proximal jejunum. Biopsies were consistent with a T-cell lymphoma. The patient underwent a partial small bowel resection. Biopsies of the jejunum had ulceration and necrosis with a lymphomatous infiltrate. The lymphocytes were found to be a monoclonal CD2 positive T-cell population. A bone marrow biopsy was unremarkable. Enteropathy associated T-cell lymphoma is a rare, and this may be the first reported case of EATCL presenting as anasarca. DISCUSSION: The etiology and pathophysiology of intestinal lymphomas, particularly enteropathy associated T-cell lymphoma, is reviewed. CONCLUSION: EATCL is a rare and unique form of lymphoma without an exact treatment regimen which carries a high mortality rate.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
5/8. T-cell lymphoblastic lymphoma presenting with a breast mass.Lymphomas secondarily involving the breast are uncommon, although they do represent the largest group of tumors metastatic to breast. A 20-year-old female with lymphoblastic lymphoma (LBL) presented here with 3 month history of weight loss, night sweats, fatigue and a mass in her left breast. Her physical examination revealed a left breast mass, lympadenopathy, bilateral pleural effusion and hepatomegaly. WBC count was 17,710/mm3 and LDH was mildly elevated. breast ultrasound showed a 1.7 cm mass in the inner lower quadrant of left breast. biopsy of the breast mass showed diffuse infiltration with small, round atypical cells which did not stain with CD20, CD43, CD34, cytokeratine and were positive for CD3. She was diagnosed as leukemic phase of a precursor T-cell LBL and treated with 6 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone), intrathecal methotrexate and cranial radiotherapy, achieving a complete response. She then was started on maintenance therapy. Four months later she returned with CNS involvement and was started on induction treatment. She had a very aggressive course of disease and died only 12 months after diagnosis. breast involvement is very rarely seen in precursor T-cell LBL/ALL and in this patient occurred secondarily as part of widespread disease.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
6/8. Body cavity-based presentation of natural killer cell lymphoma.We describe an unusual case of a 31-year-old Mexican woman who presented with pleural and peritoneal effusions involved by Epstein-Barr virus-positive non-Hodgkin's lymphoma of natural killer (NK)-cell lineage. The patient had no symptoms that could be related to her nasal region, and physical examination and radiologic studies showed no evidence of lymphadenopathy, organomegaly, or other extranodal masses. Thus, this case clinically mimicked body cavity-based lymphoma. Extranodal NK/T-cell lymphoma of nasal type is the current designation for these neoplasms in the recently proposed world health organization classification of lymphoid neoplasms. These tumors previously have been referred to many other names, including lethal midline granuloma, midline malignant reticulosis, polymorphic reticulosis, angiocentric immunoproliferative lesion, and angiocentric lymphoma. Nasal-type NK/T-cell lymphomas typically involve the nasal region, but may involve other extranodal sites, such as skin and gastrointestinal tract. The malignant cytologic features and the presence of azurophilic granules within the cell cytoplasm observed in Wright-Giemsa-stained cytocentrifuge preparations led to immunophenotypic and molecular genetic studies that were essential in establishing the correct diagnosis. As demonstrated in the case reported, extranodal NK/T-cell lymphomas of nasal-type can be clinically aggressive and may be associated with paraneoplastic phenomena.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
7/8. A rapidly fatal case of T-cell lymphoma presenting as idiopathic orbital inflammation.A 41-year-old Caucasian woman presented with a painful, red right eye with minimal systemic symptomatology, and was initially diagnosed with right idiopathic orbital inflammation. Ten days later, she developed abdominal and respiratory symptoms; this led to her demise within a further week. Post-mortem examination demonstrated widespread extranodal NK/T- cell lymphoma (nasal type), involving the right posterior orbit, lungs, uterus, left adrenal gland, pericardium and meninges. Thorough physical examination with early orbital biopsy should be considered to exclude underlying treatable pathology in managing patients with presumed idiopathic orbital inflammation.- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |
8/8. Primary CD56-positive NK/T-cell lymphoma of median nerve: a case report.Primary extranodal lymphomas of the central nervous system constitute 2% of all malignant lymphomas. The involvement of the peripheral nervous system is very rare. A solitary primary CD56-positive NK/T-cell lymphoma of the median nerve is described in a 70-year-old woman. On physical examination, a rubbery hard mass measuring 2.0 cm in diameter was palpated on the volar aspect of second to third finger of left hand. Excisional biopsy was performed. Under the fascia, a large fusiform tumor of the median nerve encapsulated with the epineurium was noted. Microscopically, the enlarged nerve showed extensive infiltration of atypical lymphoid cells. The lymphoid elements had abundant pale cytoplasm and large vesicular nuclei with peripheral prominent nuclei. The cells strongly expressed T-cell marker (UCHL-1) and natural killer cell marker (CD56). gene rearrangement study showed rearrangement of T cell receptor (TCR-gamma).- - - - - - - - - - ranking = 24.36381893934keywords = physical examination, physical (Clic here for more details about this article) |