scholarly journals Not Always (and Only) Heart Failure—A Case Report of Primary Pleural Lymphoma in an Elderly Patient

2021 ◽  
Vol 11 (1) ◽  
pp. 32-36
Author(s):  
Tiago Rabadão ◽  
Leonor Naia ◽  
Filipa Ferreira ◽  
Mariana Teixeira ◽  
Marcelo Aveiro ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Clinical Case ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Therapeutic Approaches ◽  
Fluid Analysis ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Immunosuppressed Patients ◽  
Pleural Involvement

Pleural involvement in Non-Hodgkin Lymphoma (NHL) is well documented, but primary pleural lymphomas are extremely rare, occurring mostly in immunosuppressed patients or associated with chronic pleural inflammation. Nevertheless, the pathogenesis and therapeutic approaches to counteract primary pleural lymphomas are still matter of debate. The authors present the clinical case of an 81-year-old female with respiratory and constitutional symptoms. A valvular heart disease and bilateral pleural effusion were known. The study carried out showed a large right pleural effusion; the fluid analysis was compatible with Diffuse Large B-cell Lymphoma (DLBCL), and two lymphomatous masses with pleural origin were found at the ipsilateral hemithorax. Primary pleural lymphoma was considered and chemotherapy was initiated with a good response and evolution. The authors report this remarkable clinical case because of its rarity, its excellent clinical evolution and the absence of an immunodeficiency context.

scholarly journals Elevated Adenosine Deaminase in Pleural Effusion - A Case of Non-Hodgkin Lymphoma Misdiagnosis

2020 ◽  
Author(s):  
Tiago Seco ◽  
Ana Margarida Cerqueira ◽  
Ana Luís Ferreira ◽  
Ana Costa ◽  
Carlos Fernandes ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bodily Fluids ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Previous Diagnosis ◽  
Pleural Involvement

Despite a recent decline, tuberculosis (TB) infection is still a frequent diagnosis in Portugal. Adenosine deaminase (ADA) measurement has become an important tool in the timely diagnosis of this infection. However, ADA elevation in bodily fluids is not pathognomonic of TB infection. We present the case of a 70-year-old woman, undergoing treatment for pleural TB, diagnosed based on elevated ADA levels in a pleural effusion. Due to worsening symptoms she was readmitted, and the previous diagnosis was reconsidered. Thoracocentesis was repeated and cytometry analysis of the fluid was performed, showing the presence of diffuse large B cell lymphoma (DLBCL). DLBCL is the most frequently occurring non-Hodgkin lymphoma (NHL). Pleural involvement is rare in the initial stages. ADA elevation >250 U/l should raise suspicion of malignancy, especially in association with markedly elevated LDH levels. The purpose of this case report is to highlight that in the absence of microbiologic or histologic confirmation, a presumptive TB diagnosis should not be lightly made, and alternative diagnoses should be systematically ruled out.

Dysregulated CARD11 signaling in the development of diffuse large B cell lymphoma

2020 ◽  
Vol 7 (3) ◽  
pp. 90-103
Author(s):  
Tyler A. Jones ◽  
Shelby M. Hutcherson ◽  
Jacquelyn R. Bedsaul ◽  
Joel L. Pomerantz
Keyword(s):  
Signal Transduction ◽  
Signaling Pathways ◽  
Lymphocyte Proliferation ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Therapeutic Approaches ◽  
Antigen Receptor Signaling ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

CARD11 is a crucial scaffold protein that controls antigen-induced activation of lymphocytes. Upon antigen receptor signaling, CARD11 engages several signaling pathways, leading to the activation of NF-κB, mTOR, and JNK. CARD11 mutations are frequently found in patients with non-Hodgkin lymphoma and their ability to induce aberrant lymphocyte proliferation may be enhanced by mutations in regulators of CARD11 signal transduction. Here we describe how dysregulated CARD11 activity can promote lymphomagenesis through branched signaling pathways whose components and intermediates provide targets for novel diagnostic and therapeutic approaches. Statement of novelty: This review discusses how gain-of-function CARD11 mutations promote lymphomagenesis by engaging branching signaling pathways and how these different pathways provide multiple targets for therapies.

Metody cytogenetyki molekularnej w różnicowaniu agresywnych B-NHL

2019 ◽  
Vol 50 (3) ◽  
pp. 109-115
Author(s):  
Beata Grygalewicz
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
World Health ◽  
High Grade ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Health Organization ◽  
Large B Cell

StreszczenieB-komórkowe agresywne chłoniaki nieziarnicze (B-cell non-Hodgkin lymphoma – B-NHL) to heterogenna grupa nowotworów układu chłonnego, wywodząca się z obwodowych limfocytów B. Aberracje cytogenetyczne towarzyszące B-NHL to najczęściej translokacje onkogenów takich jak MYC, BCL2, BCL6 w okolice genowych loci dla łańcuchów ciężkich lub lekkich immunoglobulin. W niektórych przypadkach dochodzi do wystąpienia kilku wymienionych aberracji jednocześnie, tak jak w przypadkach przebiegających z równoczesną translokacją genów MYC i BCL2 (double hit), niekiedy także z obecnością rearanżacji BCL6 (triple hit). Takie chłoniaki cechuje szczególnie agresywny przebieg kliniczny. Obecnie molekularna diagnostyka cytogenetyczna przy użyciu techniki fluorescencyjnej hybrydyzacji in situ (FISH) oraz, w niektórych przypadkach, aCGH jest niezbędnym narzędziem rozpoznawania, klasyfikowania i oceny stopnia zaawansowania agresywnych, nieziarniczych chłoniaków B-komórkowych. Technika mikromacierzy CGH (aCGH) była kluczowym elementem wyróżnienia prowizorycznej grupy chłoniaków Burkitt-like z aberracją chromosomu 11q (Burkitt-like lymphoma with 11q aberration – BLL, 11q) w najnowszej klasyfikacji nowotworów układu chłonnego Światowej Organizacji Zdrowia (World Health Organization – WHO) z 2016 r. Omówione zostaną sposoby różnicowania na poziomie cytogenetycznym takich chłoniaków jak: chłoniak Burkitta (Burkitt lymphoma – BL), chłoniak rozlany z dużych komórek B (diffuse large B-cell lymphoma – DLBCL) oraz 2 nowych jednostek klasyfikacji WHO 2016, czyli chłoniaka z komórek B wysokiego stopnia złośliwości z obecnością translokacji MYC i BCL2 i/lub BCL6 (high-grade B-cell lymphoma HGBL, with MYC and BCL2 and/or BCL6 translocations) oraz chłoniaka BLL, 11q.

Mechanism and Treatment of Rituximab Resistance in Diffuse Large Bcell Lymphoma

2019 ◽  
Vol 19 (9) ◽  
pp. 681-687 ◽  
Author(s):  
Linqing Zou ◽  
Guoqi Song ◽  
Siyu Gu ◽  
Lingling Kong ◽  
Shiqi Sun ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Line Treatment ◽  
First Line ◽  
Chop Regimen ◽  
Non Hodgkin Lymphoma ◽  
Subtype B ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
First Line Treatment

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype B non-Hodgkin lymphoma in adults. After rituximab being introduced to treat DLBCL, the current first-line treatment is R-CHOP regimen. This regimen greatly improves patient's prognosis, however, relapsed or refractory cases are commonly seen, mainly due to the resistance to rituximab. Although a large number of experiments have been conducted to investigate rituximab resistance, the exac mechanisms and solutions are still unclear. This review mainly explores the possible mechanisms oft rituximab resistance and current new effective treatments for rituximab resistance in DLBCL.

scholarly journals Aggressive Lymphoma “Sarcoma Mimicker” Originating in the Gluteus and Adductor Muscles: A Case Report and Literature Review

2016 ◽  
Vol 9 ◽  
pp. CCRep.S39052 ◽  
Author(s):  
Sarah A. Elkourashy ◽  
Abdulqadir J. Nashwan ◽  
Syed I. Alam ◽  
Adham A. Ammar ◽  
Ahmed M. El Sayed ◽  
...  
Keyword(s):  
Case Report ◽  
B Cell ◽  
Multidisciplinary Team ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Adductor Muscles ◽  
Large B Cell

Extranodal lymphoma (ENL) occurs in approximately 30%–40% of all patients with non-Hodgkin lymphoma and has been described in almost all organs and tissues. However, diffuse large B-cell lymphoma is the most common histological subtype of non-Hodgkin lymphoma, primarily arising in the retroperitoneal region. In this article, we report a rare case of an adult male diagnosed with primary diffuse large B-cell lymphoma of the gluteal and adductor muscles with aggressive bone involvement. All appropriate radiological and histopathological studies were done for diagnosis and staging. After discussion with the lymphoma multidisciplinary team, it was agreed to start on R-CHOP protocol (rituximab, cyclophosphamide, doxorubicin (Adriamycin), vincristine (Oncovin®), and prednisone) as the standard of care, which was later changed to R-CODOX-M/R-IVAC protocol (rituximab, cyclophosphamide, vincristine (Oncovin®), doxorubicin, and high-dose methotrexate alternating with rituximab, ifosfamide, etoposide, and high-dose cytarabine) due to inadequate response. Due to the refractory aggressive nature of the disease, subsequent decision of the multidisciplinary team was salvage chemotherapy and autologous stem cell transplant. The aim of this case report was to describe and evaluate the clinical presentation and important radiological features of extranodal lymphoma affecting the musculoskeletal system.

scholarly journals Molecular Sub-typing of Diffuse Large B-cell Lymphoma

2021 ◽  
Author(s):  
Thomas Drago
Keyword(s):  
B Cell ◽  
Germinal Center ◽  
Cell Lymphoma ◽  
Rapid Development ◽  
B Cell Lymphoma ◽  
The United States ◽  
Cellular Level ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common form of Non-Hodgkin Lymphoma (NHL) in adults. Affecting nearly 7 out of every 100,000 people in the United States annually, this hematogenous neoplasm is known for its aggressiveness and rapid development. Being the most common NHL, it has been divided into several subgroups based on pathogenesis and treatment methods. In particular, subtypes such as germinal center, activated B-cell-like, and primary mediastinal diffuse large B-cell lymphomas  have been divided by their uniqueness of pathology at the cellular level. Knowing the numerous cytokines, inflammatory markers, and other microcellular processes that these lymphomas disrupt can help target an effective therapeutic at the disease.

scholarly journals Intravascular Lymphoma in Patient With Celiac Disease With Multi Glandular Involvement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A938-A939
Author(s):  
Mustafa Alam ◽  
Mohamad Hosam Horani
Keyword(s):  
Celiac Disease ◽  
B Cell ◽  
Cell Lymphoma ◽  
Case Reports ◽  
B Cell Lymphoma ◽  
Diagnostic Challenge ◽  
Pituitary Microadenoma ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
History Of

Abstract Case Presentation: The patient is a 60 year old male with a past medical history of celiac disease, paroxysmal Afib, iron deficiency, and CAD who presented with lightheadedness, dizziness, and fatigue. Notable workup revealed that the patient had Afib with RVR, a TSH of 0.189, Free t4 0.51an LDH of 2726, hemoglobin of 8.7, AST of 155, ALT of 19, WBC of 4.5, and serum iron of 20. The patient’s cardizem dose was adjusted and repeat transthoracic echocardiogram was unremarkable compared to history. The patient presented again with complaints of abdominal distension, postural dizziness, occasional night sweats, and fevers. Repeat workups revealed pancytopenia, proteinuria, hypotension, and anasarca most pronounced in the lower extremity and scrotum. Ultimately, a kidney biopsy revealed an intravascular B cell non-Hodgkin lymphoma (IVBCL). Notable repeat labs include a CRP of 44 and a failed ACTH stimulation test. A brain MRI revealed a 6mm pituitary microadenoma. The patient placed on an R-CHOP regiment and is scheduled for repeat MRI to rule out pituitary involvement. Discussion: IVBCL’s are a rare form of diffuse B cell lymphoma and remain a diagnostic challenge due to the variety of involved systems including skin, CNS, and endocrine. IVBCL is also known to not produce a mass or lymphadenopathy. Celiac disease is a known risk factor for non-Hodgkin’s lymphoma. A literature search reveals a few case reports with common themes of increased LDH and inflammatory markers, anemia, and hepatic and renal dysfunction. Postural hypotension can also be a presenting symptom due to IVBCL’s ability to infiltrate neurovascular tissue to cause autonomic neuropathy. However, in this case, the patient’s history of primary adrenal insufficiency makes this unlikely. Hypothyroidism secondary to pituitary and thyroid involvement was suspected due to TSH level suppressed enough for central hypothyroidism. Repeated MRI showed resolution of Pituitary Microadenoma post Chemo therapy. Sylvain Raoul Simeni Njonnou, Bruno Couturier, Yannick Gombeir, Sylvain Verbanck, France Devuyst, Georges El Hachem, Ivan Theate, Anne-Laure Trepant, Virginie De Wilde, Frédéric-Alain Vandergheynst, “Pituitary Gland and Neurological Involvement in a Case of Hemophagocytic Syndrome Revealing an Intravascular Large B-Cell Lymphoma”, Case Reports in Hematology, vol. 2019, 6 pages, 2019. https://doi.org/10.1155/2019/9625075 Catassi C, Fabiani E, Corrao G, et al. Risk of Non-Hodgkin Lymphoma in Celiac Disease. JAMA. 2002;287(11):1413 Khan MS, McCubbin M, Nand S. Intravascular Large B-Cell Lymphoma: A Difficult Diagnostic Challenge. J Investig Med High Impact Case Rep. 2014 Mar 6;2(1):2324709614526702. Pearce C, Hope S, Butchart J. Intravascular lymphoma presenting with postural hypotension. BMJ Case Rep. Published 2018 Jan 29.

scholarly journals Primary pituitary diffuse large B-cell lymphoma with somatotroph hyperplasia and acromegaly: case report

2017 ◽  
Vol 126 (5) ◽  
pp. 1725-1730 ◽  
Author(s):  
Vijay M. Ravindra ◽  
Amol Raheja ◽  
Heather Corn ◽  
Meghan Driscoll ◽  
Corrine Welt ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Common Type ◽  
Histopathological Diagnosis ◽  
Sellar Lesions ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Persistent Elevation ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma and comprises approximately 30% of all lymphomas. Patients typically present with a nonpainful mass in the neck, groin, or abdomen associated with constitutional symptoms. In this report, however, the authors describe a rare case of a 61-year-old woman with hyperprolactinemia, hypothyroidism, and acromegaly (elevation of insulin-like growth factor-1 [IGF-1]) with elevated growth hormone–releasing hormone (GHRH) in whom an MRI demonstrated diffuse enlargement of the pituitary gland. Despite medical treatment, the patient had persistent elevation of IGF-1. She underwent a transsphenoidal biopsy, which yielded a diagnosis of DLBCL with an activated B-cell immunophenotype with somatotroph hyperplasia. After stereo-tactic radiation therapy in combination with chemotherapy, she is currently in remission from her lymphoma and has normalized IGF-1 levels without medical therapy, 8 months after her histopathological diagnosis. This is the only reported case of its kind and displays the importance of a broad differential diagnosis, multidisciplinary evaluation, and critical intraoperative decision-making when treating atypical sellar lesions.

A case of primary breast diffuse large B cell lymphoma

2021 ◽  
Vol 148 (12) ◽  
pp. 102-107
Author(s):  
Trinh Le Huy ◽  
Tran Dinh Anh
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Painless Mass ◽  
Large B Cell

Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin’s lymphoma with limited data. We here report a case of primary breast diffuse large B-cell lymphoma mimicking breast cancer. A 52-year-old woman had a painless mass in her right breast. Fine needle aspiration cytology and core biopsy were performed which suggested malignant features but could not confirm the specific subtype. Excisional biopsy then was conducted revealing non-Hodgkin lymphoma, which was subsequently confirmed with histopathology and diagnosed as diffuse large B-cell lymphoma (DLBCL). A chest computed tomography scan revealed a 3.5 cm sized breast mass with skin thickening and modest lymphadenopathy in the ipsilateral axilla. The patient received six courses of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab) chemotherapy, then whole breast radiation (30Gy in 15 fractions). At 12 months of follow-up, the patient survives with no evidence of disease. No morbidities occurred in this patient during the follow-up period. We briefly review the current practice pattern in patients with primary breast diffuse large B-cell lymphoma.

Sign in / Sign up

Export Citation Format

Share Document