non-Hodgkin lymphoma

非霍奇金淋巴瘤
  • 文章类型: Case Reports
    血管免疫母细胞性T细胞淋巴瘤(AITL)是一种罕见的非霍奇金淋巴瘤(NHL)。我们介绍了一例60岁的女性,她因疲劳而去急诊科(ED)就诊,反复发烧,减肥,和腺病六个月。实验室检查结果显示贫血,淋巴细胞增多,嗜酸性粒细胞增多,血小板增多症,胆汁淤积,低蛋白血症,和低蛋白血症.腹盆腔计算机断层扫描(CT)显示多发腺病。在门诊进行的淋巴结活检结果尚无定论。稍后,入院期间,患者接受了正电子发射断层扫描-计算机断层扫描(PET-CT),显示一个整体切除的宫颈腺病簇。组织学证实了AITL的诊断。医疗团队开始化疗,但由于疾病进展而选择了独家对症治疗。患者在诊断后六个月死亡。AITL的波动和非特异性表现可能会阻碍和延迟明确的诊断,因此影响治疗和预后。
    Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of non-Hodgkin lymphoma (NHL). We present a case of a 60-year-old female who attended the emergency department (ED) with fatigue, recurrent fever, weight loss, and adenopathy for six months. Laboratory findings showed anemia, lymphocytosis, eosinophilia, thrombocytosis, cholestasis, hypoproteinemia, and hypoalbuminemia. Abdominopelvic computed tomography (CT) revealed multiple adenopathies. A lymph node biopsy yielded inconclusive results in the outpatient clinic. Later, during admission, the patient underwent a positron emission tomography-computed tomography (PET-CT), revealing a cervical adenopathy cluster that was excised en bloc. Histology confirmed the diagnosis of AITL. The medical team initiated chemotherapy but opted for exclusive symptomatic treatment due to disease progression. The patient died six months after diagnosis. The fluctuating and nonspecific presentation of AITL can hinder and delay definitive diagnosis, therefore impacting treatment and prognosis.
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  • 文章类型: Case Reports
    脾破裂和血肿是非霍奇金淋巴瘤(NHL)患者可能发生的重要并发症。了解这些相关并发症对于优化患者管理和提高患者预后至关重要。组织病理学和免疫组织化学分析对于诊断NHL和评估脾受累至关重要。在这项研究中,检察官办公室要求进行司法尸检,要求因医院摔倒而提出医疗事故索赔。在急诊室,一名72岁男子从轮床上摔下来,报告额头受伤。未报告其他症状。面部和脑部CT扫描未显示异常。出院后9天,患者出现腹痛。腹部CT显示脾破裂和腹膜积血。患者接受了开放性脾切除术,但出现了血液动力学休克的迹象,随后死亡。尸检的证据使我们能够诊断出脾受累的套细胞非霍奇金淋巴瘤,以前未知。进行组织病理学和免疫组织化学分析以评估脾破裂的诊断并估计其时机。结果强烈提示脾破裂与患者跌倒和先前存在的恶性肿瘤有关。此病例强调了在研究延迟性脾破裂时考虑潜在血液恶性肿瘤的重要性。脾脏样本的免疫组织化学研究允许评估脾血肿和破裂的时间。导致与创伤建立因果关系。
    Splenic rupture and hematoma are significant complications that can occur in patients with non-Hodgkin lymphoma (NHL). Understanding these associated complications is essential for optimal patient management and enhanced patient outcomes. Histopathological and immunohistochemical analyses are crucial in diagnosing NHL and assessing splenic involvement. In this study, a judicial autopsy had been requested by the Prosecutor\'s Office for a malpractice claim due to a fall in the hospital. In the Emergency Department, a 72-year-old man fell from a gurney and reported sustaining a wound to his forehead. No other symptoms were reported. A face and brain CT scan showed no abnormalities. Nine days after discharge, the patient presented with abdominal pain. An abdominal CT revealed splenic rupture and hemoperitoneum. The patient underwent open splenectomy but showed signs of hemodynamic shock and subsequently died. The evidence from the autopsy allowed us to diagnose mantle cell non-Hodgkin lymphoma with spleen involvement, previously unknown. Histopathological and immunohistochemical analyses were performed to assess the diagnosis of splenic rupture and estimate its timing. The findings strongly suggest that the splenic rupture was associated with the patient\'s fall and the pre-existing malignancy. This case highlights the importance of considering an underlying hematological malignancy when investigating delayed splenic rupture. An immunohistochemical study of spleen samples allowed the timing of splenic hematoma and rupture to be assessed, leading to the establishment of a causal relationship with trauma.
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  • 文章类型: Case Reports
    伯基特淋巴瘤(BL)是一种侵袭性非霍奇金淋巴瘤,其特征是8号染色体MYC基因易位。它表现在三种临床类型:免疫缺陷相关,零星(非地方性),和地方性(非洲),流行病学和临床行为各有不同。治疗通常涉及临床试验或强化化疗方案如R-CODOX-M/IVAC的登记。作者介绍了一例治疗后复发的BL病例。
    一名13岁女性患者出现左侧顶枕区逐渐进行性肿胀。检查显示生命体征正常,格拉斯哥昏迷评分,具有血清阴性调查结果。切除了神经节下软组织肿瘤,显示组织病理学特征,提示一个小的圆形蓝色细胞肿瘤。化疗后,患者头皮区域复发,诊断为BL。
    虽然头皮区域的BL报告很少,已在各个身体位置记录了病例。治疗策略,包括化疗和手术,在控制疾病和改善症状方面显示出有希望的结果。
    BL的复发是罕见的,强调在治疗后监测患者的警惕性的重要性。作者报告了一名13岁女性反复发作的BL病例,强调在管理这种侵袭性恶性肿瘤方面需要持续的研究和监测.
    UNASSIGNED: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma characterized by chromosome 8 MYC gene translocation. It manifests in three clinical types: immunodeficiency-related, sporadic (nonendemic), and endemic (African), each differing in epidemiology and clinical behavior. Treatment typically involves enrollment in clinical trials or intensive chemotherapy regimens like R-CODOX-M/IVAC. The authors present a case of recurrent BL following treatment.
    UNASSIGNED: A 13-year-old female presented with a gradually progressive swelling in the left parieto-occipital region. Examination revealed normal vital signs and a Glasgow coma scale, with seronegative findings on investigations. An excision of a subganglion soft tissue tumor was performed, revealing histopathological features suggestive of a small round blue cell tumor. After chemotherapy, the patient experienced a recurrence in the scalp region, diagnosed as BL.
    UNASSIGNED: While scarce reports exist on BL in the scalp region, cases have been documented in various body locations. Treatment strategies, including chemotherapy and surgery, have shown promising results in managing the disease and improving symptoms.
    UNASSIGNED: The recurrence of BL is rare, highlighting the importance of vigilance in monitoring patients post-treatment. The authors report a case of recurrent BL in a 13-year-old female, emphasizing the need for continued research and surveillance in managing this aggressive malignancy.
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  • 文章类型: Journal Article
    目的:免疫功能紊乱是非霍奇金淋巴瘤(NHL)发生发展的危险因素之一,炎症可能与它的病因有关。在开始化疗之前,关于细胞因子水平对淋巴瘤神经行为功能的影响的数据很少。因此,我们旨在通过评估细胞因子和脂肪因子水平及其与神经行为改变的相关性来探讨NHL的风险.
    方法:本病例对照研究纳入62名受试者(年龄性别匹配:31例和31名对照)。使用蒙特利尔认知评估问卷(MoCA)和患者健康问卷(PHQ-9)进行神经行为评估。使用EORTC核心生活质量问卷(EORTCQLQ-C30)评估生活质量。在患者入组后和第一周期化疗前进行问卷评估和样本收集。
    结果:NHL患者和健康对照组的平均年龄分别为51.9±11.8和50±10.9岁,分别。NHL患者的IL-6(0.77±0.11)和TNF-α(1.47±1.31)水平明显高于对照组(分别为0.55±0.4和0.66±0.89),p值<0.005。此外,NHL患者的脂联素(0.31±0.24)和网膜素(0.46±0.1)水平明显低于对照组(分别为0.42±0.13和0.53±0.11),p值<0.005。与健康对照相比,在NHL患者中观察到较低的MoCA和EORTCQLQC-30评分和较高的PHQ-9评分。
    结论:我们的结果表明脂联素,网膜素IL-6和TNF-α可用作NHL风险的预诊断标志物。在NHL患者中观察到的神经行为变化可能会改变生活质量。
    OBJECTIVE: Immune dysfunction is one of the risk factors which plays an important role in the development of non-Hodgkin lymphoma (NHL), and inflammation may be involved in its etiology. Minimal data is available on the effect of cytokine levels on neurobehavioral function in lymphoma before the initiation of chemotherapy. Therefore, we aimed to explore the risk of NHL by assessment of cytokine and adipokine levels and their correlation with neurobehavioral changes.
    METHODS: This case-control study enrolled 62 subjects (age-sex matched: 31 cases and 31 controls). Neurobehavioral assessment was done using Montreal Cognitive Assessment questionnaire (MoCA) and Patient Health Questionnaire (PHQ-9). EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was used to assess quality of life. Questionnaire assessment and sample collection were done after the patient enrolment and before first cycle of chemotherapy.
    RESULTS: Mean age of NHL patients and healthy controls was 51.9 ± 11.8 and 50 ± 10.9 years, respectively. NHL patients showed significantly higher levels of IL-6 (0.77 ± 0.11) and TNF- α (1.47 ± 1.31) than controls (0.55 ± 0.4 and 0.66 ± 0.89, respectively) with p-value<0.005. Also, NHL patients showed significantly lower levels of adiponectin (0.31 ± 0.24) and omentin (0.46 ± 0.1) than controls (0.42 ± 0.13 and 0.53 ± 0.11, respectively) with p-value<0.005. Lower MoCA and EORTC QLQ C-30 scores and higher PHQ-9 scores were observed in NHL patients in comparison to healthy control.
    CONCLUSIONS: Our results showed that adiponectin, omentin IL-6 and TNF-α may be used as pre-diagnostic markers of NHL risk. Neurobehavioral changes observed in NHL patients may alter the quality of life.
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  • 文章类型: Case Reports
    神经节神经瘤是一种罕见的良性神经母细胞瘤,起源于周围神经系统的交感神经节细胞。它通常是在成像研究期间偶然发现的,主要影响儿童和年轻人。
    方法:我们介绍一例21岁女性非霍奇金淋巴瘤患者,在影像学检查中偶然发现腹部肿块,最初在初次诊断的情况下被误认为是淋巴瘤。淋巴瘤化疗后,群众对治疗没有反应,所以手术切除了肿块,组织病理学检查证实了节细胞神经瘤的诊断。患者对淋巴瘤的治疗反应良好,并且保持良好状态,没有复发的迹象。
    据我们所知,这是第一例描述腹内节细胞神经瘤与非霍奇金淋巴瘤之间的关联的病例.
    结论:该病例强调了在评估淋巴瘤患者腹部肿块时,将神经节细胞神经瘤作为鉴别诊断的重要性。
    UNASSIGNED: Ganglioneuroma is a rare benign neuroblastic tumor originating from sympathetic ganglion cells in the peripheral nervous system. It is often incidentally discovered during imaging studies and primarily affects children and young adults.
    METHODS: We present a case report of a 21-year-old female diagnosed with non-Hodgkin lymphoma who had an abdominal mass incidentally detected during imaging, Initially mistaken for lymphoma in the setting of the primary diagnose. After the chemotherapy for the lymphoma, the mass did not response to the treatment, so the mass was surgically excised, and histopathological examination confirmed the diagnosis of ganglioneuroma. The patient responded well to treatment for lymphoma and remains in good condition without signs of recurrence.
    UNASSIGNED: To the best of our knowledge, this is the first case that describes an association between an intraabdominal ganglioneuroma and non-Hodgkin\'s lymphoma.
    CONCLUSIONS: This case highlights the importance of considering ganglioneuroma as a differential diagnosis when evaluating abdominal masses in patients with lymphoma.
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  • 文章类型: Case Reports
    我们描述了一例粘膜相关淋巴组织(MALT-ML)的胆囊结外边缘区B细胞淋巴瘤。MALT-ML是罕见的,临床表现缺乏特异性。已经报道了一些病例,并且没有描述特征成像特征。我们讨论了MRI诊断胆囊MALT-ML的挑战,尤其是在鉴别胆囊癌方面.我们在T2WI的胆囊内壁发现了一个“梳子状”的标志,这可能有助于诊断胆囊MALT-ML。
    We describe a case of gallbladder extra-nodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-ML). MALT-ML is rare, and its clinical manifestations are lack of specificity. A few cases have been reported, and no characteristic imaging features have been described. We discussed the challenges of MRI in diagnosing MALT-ML of gallbladder, especially in differentiating it from gallbladder cancer. We found a \"comb-like\" sign in the inner wall of gallbladder on T2WI, which may be helpful in diagnosing gallbladder MALT-ML.
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  • 文章类型: Journal Article
    背景:非细菌性血栓性心内膜炎(NBTE)是一种罕见的疾病,其特征是心脏瓣膜上有无菌植被,通常与风湿病有关,自身免疫性疾病,和晚期实体恶性肿瘤。相关临床病症的早期诊断和治疗是强制性的,虽然它们通常不会消除瓣膜植被,抗凝对预防栓塞事件至关重要。尽管变化,由于复发性栓塞事件和原发疾病的严重程度,NBTE的预后通常是不利的,典型的晚期癌症。
    方法:我们介绍了一例57岁男性患者,他在急诊科就诊,有5天的双侧数字水肿和颜色变化发作(从苍白到发紫)的病史。体格检查显示四肢远端有红细胞增多症,提示考虑继发性雷诺综合征。尽管有药物治疗,进行性手指缺血导致多个手指截肢。在病因调查期间,抗凝试验和自身免疫分析结果为阴性.进行了经食管超声心动图检查,显示二尖瓣前小叶上有不规则的高回声肿块,无瓣膜功能障碍,胸部计算机断层扫描增强扫描显示右气管旁淋巴结肿大。气管旁淋巴结经胸穿刺活检的组织病理学分析显示弥漫性大B细胞淋巴瘤。患者接受了积极的R-CHOP化疗,实现有利的完整响应。
    结论:这是一个特殊情况,涉及NBTE和雷诺现象的发生,作为先前健康的年轻人的最初副肿瘤表现。NBTE与淋巴组织增生相关的报道非常罕见,文献中描述的病例不到10例。据我们所知,这是首例与弥漫性大B细胞淋巴瘤特异性相关的NBTE病例.
    BACKGROUND: Non-bacterial thrombotic endocarditis (NBTE) is a rare condition marked by sterile vegetations on cardiac valves, often linked to rheumatologic diseases, autoimmune disorders, and advanced solid malignancies. An early diagnosis and treatment of the associated clinical condition are mandatory, although they do not usually eliminate valvular vegetations, making anticoagulation essential to prevent embolic events. Despite variability, the prognosis of NBTE is usually unfavorable due to recurrent embolic events and the severity of the primary condition, typically advanced cancer.
    METHODS: We present a case of a 57 years-old male who presented to the emergency department with a 5-day history of painful bilateral digital edema and color change episodes (from pallor to cyanosis). Physical examination revealed erythrocyanosis in the distal extremities, prompting consideration of secondary Raynaud syndrome. Despite medical therapy, progressive digital ischemia led to multiple finger amputations. During etiological investigation, anticoagulation tests and autoimmune analysis yielded negative results. A transesophageal echocardiogram was performed, revealing an irregular hyperechogenic mass on the anterior leaflet of the mitral valve without valve dysfunction, and a thoracic computed tomography scan with contrast showed an enlarged right paratracheal lymph node. Histopathological analysis from a transthoracic needle biopsy of the paratracheal lymph node revealed diffuse large B-cell lymphoma. The patient underwent aggressive R-CHOP chemotherapy, achieving a favorable complete response.
    CONCLUSIONS: This is a particular case involving the occurrence of NBTE and Raynaud phenomenon as the initial paraneoplastic manifestations in a previously healthy young man. Reports of NBTE associated with lymphoproliferative conditions are quite rare, with fewer than ten cases described in the literature. To our knowledge, this is the first case of NBTE specifically associated with diffuse large B-cell lymphoma.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    背景:多原发恶性肿瘤(MPMT)是一种罕见的癌症,特别是当实体瘤是第一和淋巴瘤是第二原发性恶性肿瘤。我们报告了一例由前列腺癌和直肠弥漫性大B细胞淋巴瘤(DLBCL)组成的非同步MPMT患者。
    方法:我们报告了一名被诊断为前列腺癌的77岁男性患者,他接受了放射治疗和一年的内分泌治疗,使用比卡鲁胺(每天50mg)和戈舍瑞林缓释植入物(1/28d)。七年后,发现直肠DLBCL伴肺转移。
    结论:虽然罕见,对前列腺癌合并DLBCL双原发癌的可能性有更深入的了解。
    BACKGROUND: Multiple primary malignant tumors (MPMTs) are rare type of cancer, especially when solid tumors are the first and lymphoma is the second primary malignancy. We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma (DLBCL).
    METHODS: We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide (50 mg per day) and an extended-release implant of goserelin (1/28 d). Seven years later, rectal DLBCL with lung metastases was found.
    CONCLUSIONS: Although rare, the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.
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  • 文章类型: Case Reports
    伯基特淋巴瘤,一种侵袭性的非霍奇金淋巴瘤,是成人患者回肠套叠的罕见原因。我们介绍了一个17岁的男性患者,儿童期有非霍奇金淋巴瘤病史,表现为急性腹痛,呕吐,和腹泻。CT和结肠镜检查结果显示回肠肠套叠伴有大的回盲部肿块,导致在组织病理学和免疫组织化学检查后诊断Burkitt淋巴瘤。该病例突出了伯基特淋巴瘤在成人引起肠套叠的罕见性,在儿童中更常见的情况。该病例还强调了在有急性腹部症状的非霍奇金淋巴瘤病史的患者中考虑Burkitt淋巴瘤的重要性。他成功接受了手术治疗,没有任何并发症。在后续行动中,他做得很好。
    Burkitt Lymphoma, an aggressive form of non-Hodgkin\'s lymphoma, is a rare cause of ileocolic intussusception in adult patients. We present the case of a 17-year-old male patient, with a history of non-Hodgkin\'s lymphoma in childhood, presenting with acute abdominal pain, vomiting, and diarrhea. CT and colonoscopy findings revealed ileocolic intussusception with a large ileocecal mass, leading to a diagnosis of Burkitt Lymphoma after histopathological and immunohistochemical examination. This case highlights the rarity of Burkitt Lymphoma causing intussusception in adults, a condition more commonly seen in children. The case also underscores the importance of considering Burkitt Lymphoma in patients with a history of non-Hodgkin\'s lymphoma presenting with acute abdominal symptoms. He was successfully treated with surgery without any complications. On follow-ups, he is doing well.
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