A Case of Primary Pulmonary Diffuse Large B-Cell Lymphoma Diagnosed by Transbronchial Biopsy

A 76-year-old man took a chest X-ray for his medical checkup and an abnormal shadow was detected in the right lower lung field. For more detailed examination, he was referred to our hospital. Chest computed tomography showed a 20-mm nodule with relatively regular margins in the right lower lobe. A compact proliferation of circular to polygonal cells with a high nucleus-cytoplasm ratio was evident in a transbronchial lung biopsy. Based on pathological findings, a mature large B-cell lymphoma was diagnosed. Thoracoscopic right lower lobectomy and mediastinal lymphadenectomy were performed. The post-surgical pathological examination showed that the tumor consisted of diffuse to compact proliferation of medium to large atypical lymphocyte-like cells. Immunohistochemical staining yielded positive results for B-cell lineage markers. Five months after surgical resection, neither local recurrence nor accumulation in remote organs was observed on gallium scintigraphy. The diagnosis of primary pulmonary diffuse large B-cell lymphoma was established.     

Lymphoma of the breast: A clinicopathologic analysis of 51 cases with a specific emphasis on patients with a history of breast carcinoma

We herein report our experience with 51 breast lymphoma (BL) cases from 46 patients with a specific focus on patients with a history of breast carcinoma. The overall most common subtype was diffuse large B-cell lymphoma, followed by MALT lymphoma and follicular lymphoma. Eleven of 46 (24%) patients had either previous history of or concurrent breast carcinoma. There was no significant difference in clinicopathologic characteristics between patients with primary and secondary BL. On follow-up, patients with secondary BL had a worse disease-free survival with no difference in overall survival between the two groups.     

Primary Lymphoma of the Liver: Report of a Case

(Received for publication on Sept. 11, 1998; accepted on Nov. 11, 1999)     

Ectopic Primary B Cell Lymphoma of the Thyroid Presenting as an Anterior Mediastinal Mass. A Case Report

Ectopic thyroid tumours arising in the mediastinum without connection to the cervical thyroid gland are very rare. Follicular adenoma, papillary carcinoma and follicular carcinoma in the mediastinum has been reported, but primary ectopic thyroid B cell lymphoma has not been reported previously. We report mediastinal primary ectopic thyroid large B cell lymphoma in an 80-year-old man. Differential diagnosis from primary mediastinal large B cell lymphoma and clinicopathologic features are discussed.     

Comparisons of Surgery and/or Chemotherapy in the Treatment of Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma

Background/Aims: To investigate the clinical features, imaging characteristics, treatment, and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.Methods: We retrospectively analysed the clinical, imaging, and follow-up data of 13 patients (median age, 59 years; range, 21–67 years) with primary pulmonary MALT lymphoma.Results: The main clinical manifestations were chest discomfort (six patients), cough (two), fever (two), chest pain (one), and no obvious symptoms (two). Six patients underwent surgery; three had postoperative chemotherapy; four had chemotherapy alone; and three only had symptomatic and supportive treatment. The follow-up duration was one to 11 years, with one patient lost to follow-up. Two patients died (two years and 11 years post-diagnosis). As of this report, the remaining 10 patients were alive with no disease progression.Conclusions: Pulmonary MALT lymphoma has atypical clinical manifestations and non-specific imaging changes, and the diagnosis depends on a pathological examination. For patients with confined lesions for which conventional biopsy cannot be performed, surgical excision plays an important role in clarifying the diagnosis and obtaining good therapeutic results and a good prognosis.     

原发性胃肠道淋巴瘤的诊断与治疗

目的探讨原发性胃肠道淋巴瘤的诊治经验。方法回顾性分析12例原发性胃肠道淋巴瘤,均行剖腹探查,其中行根治性切除7例,姑息性手术3例,肿块活检术2例。结果胃淋巴瘤5例,肠淋巴瘤7例。病理分类:弥漫性非何杰金氏淋巴瘤9例,粘膜相关性淋巴瘤2例,高度恶性淋巴瘤1例。Ann Arbor临床分期:ⅡE期3例,ⅢE期7例,ⅣE期2例。平均随访18(6~72)月,6例存活,死亡6例。结论内镜和消化道造影是淋巴瘤主要诊断手段,手术切除为主的综合治疗为最佳治疗方案。     

A Successful Right Axillary Artery Graft to Repair a Ruptured Axillary Artery Due to the Involvement of Lymphoma: Report of a Case

Diffuse large B-cell lymphoma is a very common, highly invasive lymphoma, which typically presents as a rapidly enlarging symptomatic mass with local compression of vessels or airways, and often is involved with the peripheral nerves and the destruction of bone. Vascular invasion is extremely rare. We herein describe the case of a successfully treated 42-year-old man who presented with massive bleeding due to a rupture of the axillary artery and vein involvement due to lymphoma. Received: December 29, 2001 / Accepted: May 7, 2002 Reprint requests to: Y. ünlü, Atatürk Mah. Universite Loj, 38/8, 25170 Erzurum, Turkey     

Diffuse Large B-cell Lymphoma in the Ampulla of Vater Causing Obstructive Jaundice: Report of a Case

We report a case of diffuse large B-cell lymphoma (DLBCL) in the ampulla of Vater, causing painless obstructive jaundice in a 78-year-old woman. Duodenal endoscopy revealed a mass in the ampulla of Vater and narrowing of the second portion of the duodenum, although diagnosing DLBCL from an endoscopic biopsy was impossible because there were several kinds of leukocytes in the infiltrate. We performed pylorus-preserving pancreatoduodenectomy to establish a histological diagnosis, relieve the obstructive jaundice, and remove the narrowed second portion of the duodenum. Histological and immunohistochemical examination of the surgically resected specimen confirmed a diagnosis of DLBCL. Chemotherapy is the mainstay of treatment for DLBCL; however, surgery still plays an important role when the histological diagnosis cannot be established preoperatively and when complications are not amenable to nonsurgical therapy.     

原发性甲状腺淋巴瘤诊治分析

目的　提高原发性甲状腺淋巴瘤的诊断、治疗及预后水平。方法　回顾性分析 1980～ 2 0 0 3年本院收治的 11例原发性甲状腺淋巴瘤 ,分析其临床表现、病理分型、诊断、治疗方案及预后。结果　滤泡性淋巴瘤 7例 ,淋巴浆细胞性淋巴瘤 2例 ,弥漫性大B细胞淋巴瘤 2例。原发性甲状腺淋巴瘤复发及死亡率 ,综合治疗者明显低于单纯手术及手术加放疗者 ,滤泡性淋巴瘤低于淋巴浆细胞性淋巴瘤和弥漫性大B细胞淋巴瘤。结论　原发性甲状腺淋巴瘤的预后与病理类型、治疗方案密切相关 ,综合治疗效果最佳。     

阴茎原发性外周T细胞淋巴瘤(附1例报道及文献复习)

目的:报道1例阴茎原发性外周T细胞淋巴瘤并文献复习。方法:运用组织学、细胞化学和免疫组织化学技术对1例阴茎外周T细胞淋巴瘤进行光镜观察和免疫标记并结合文献就该类肿瘤的临床病理特征进行探讨。结果:患者为老年男性,临床上以阴茎肿胀为首发症状,并龟头糜烂溃疡和腹股沟淋巴结肿大。病理组织学表现为表皮溃疡,肿瘤细胞血管呈浸润性生长伴肿瘤性坏死,肿瘤细胞多形性,核分裂多见,并血管增生。免疫组织化学显示肿瘤细胞CD43和CD3强阳性,CKpan,CD20,CD79 a,CD30、CD56和CD34阴性。临床按外周T细胞淋巴瘤行化疗有效。结论:阴茎原发性外周T细胞淋巴瘤是一种罕见的恶性肿瘤,诊断依赖于病理检查和免疫组化标记,并需要与低分化鳞状细胞癌和其他类型淋巴瘤鉴别。     

Palatine Tonsils Primary Presentation of Blastoid Variant of Mantle Cell Lymphoma: Case Report

Head and neck lymphomas can present with a wide range of symptoms. Timely and accurate diagnosis is often challenging. The blastoid variant of mantle cell lymphoma (MCL) accounts for less than one-third of all MCL cases. Isolated primary presentation on the palatine tonsils is rare, and prognosis and outcome are seemingly unfavorable. An 81-year-old man presented with persistent odynophagia, dysphagia, and obstructive hypertrophic palatine tonsils with purulent exudate. The signs and symptoms were non-responsive to antibiotic therapy, and the tonsils were biopsied. The cellular morphology, immunophenotype, and genotype supported a diagnosis of the blastoid variant of MCL. After staging, the patient underwent chemotherapy with Rituximab-Bendamustine (R-Benda). The patient is in clinical remission more than two years after therapy. We report an exceedingly rare case of blastoid MCL that is prone to be misdiagnosed as tonsillitis. We review the literature and discuss treatment options of this uncommon malignancy.     

An Unusual Case of Marginal Zone B-Cell Lymphoma Arising in the Breast - Its Diagnosis and the Role of Radiotherapy in its Management

BACKGROUND: Primary lymphoma of the breast accounts for 0.04-0.5% of all breast malignancies and approximately 1% of all extranodal lymphomas. For stage IE node-negative disease, involved field radiotherapy is recommended except for very young women in whom the risk of breast cancer is a concern. The rate of complete response for limited stage extranodal marginal B-cell lymphoma is in excess of 90%. CASE REPORT: We report the case of a 62-year-old lady who presented with a unilateral painless palpable right breast lump. She subsequently underwent a trucut biopsy of the lesion. The histology revealed a low-grade B-cell non-Hodgkin's lymphoma (NHL). Immunohistochemistry showed that more than 95% of the cells were B cells which were CD 20+/CD 45+ and BC L6+. This confirmed the diagnosis of marginal zone lymphoma. Staging work-up was negative for distant metastases. Serum alkaline phosphatase and lactate dehydrogenase were normal. The patient had no 'B' symptoms. Her final diagnosis was clinical stage IAE NHL, and she was referred for curative radiotherapy. CONCLUSION: Radiation treatment is a safe and extremely effective modality of treatment for early stage I marginal zone B-cell lymphomas of the breast.     

精囊原发性Burkitt淋巴瘤1例报告并文献复习

目的:报告精囊原发性Burkitt淋巴瘤(BL)的临床病理特征。方法:对1例精囊原发性BL的临床特征、组织学、免疫组织化学和原位分子杂交进行观察,并结合文献探讨其病理形态及鉴别诊断。结果:本例临床表现以尿频和排尿困难为特征,发病2个月后出现腹股沟淋巴结肿大。影像学显示病灶精囊呈低密度阴影,组织学呈弥漫单一性中等大小肿瘤细胞浸润性生长伴肿瘤性坏死,核分裂易见并有"星空"图象。免疫标记肿瘤细胞表达CD10、CD20、CD79α和Bcl-6,而CD3、CD5、CD23、MPO、Bcl-2、CyclinD1和TdT缺乏表达,肿瘤细胞Ki-67增殖指数>95%,原位杂交检测肿瘤细胞EBER阳性。结论:精囊原发性BL是一种非常罕见的高度恶性的肿瘤,病程进展快,诊断时应除外精囊外BL累及,确诊依赖病理组织学和实验室检查,并需要与精囊或前列腺发生的弥漫性大B细胞性淋巴瘤、淋巴母细胞淋巴瘤和小细胞癌鉴别。