BACKGROUND Granulocyte colony-stimulating factor(G-CSF)is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow.We report a rare case of aggressi...BACKGROUND Granulocyte colony-stimulating factor(G-CSF)is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow.We report a rare case of aggressive G-CSFproducing squamous cell carcinoma of the tongue exhibiting fluorine-18 deoxyglucose(FDG)accumulation in primary lesion,metastatic lymph nodes,spleen,and bone marrow on positron emission tomography–computed tomography(PET/CT).CASE SUMMARY We report a 58-year-old female with a rapid enlarged lingual mass with partial necrosis.Blood test results from the initial examination revealed a leukocyte count of 21380/μL.On PET/CT,extensive FDG accumulation was observed in the tongue and bilateral cervical lymph nodes,with elevated FDG accumulation in the spleen and bone marrow although no distant metastases were observed.We performed partial glossectomy and bilateral neck dissection.Immunohistochemical staining with G-CSF antibodies on biopsy specimen and resected samples revealed that both specimens were G-CSF positive.This is a rare case of G-CSF producing tongue carcinoma with elevated FDG accumulation in the spleen and bone marrow.CONCLUSION In patients with the tongue cancer and hyperleukocytosis,where FDG accumulations in the spleen and bone marrow are observed using PET/CT and when these accumulations are not caused by metastasis,G-CSF-producing tumors,with associated poor prognosis,should be considered.展开更多
Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extr...Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extranodal non-Hodgkin’s lymphoma (NHL) with initial mandibular symptoms in our department. At initial treatment of dental clinics, dentists had diagnosed as dental or gingival diseases and had performed dental treatment. Neurological disorder to involvement of the inferior alveolar nerve was present in 80.0% of our cases. On dental or panoramic radiography a specific radiolucent lesion in the mandible was not detected, except for dental lesions. On CT, NHL of the mandible region has no widening and no clear destruction but a slit-like the cortex bone destruction pattern with keeping in shape of the mandibular body (62.5% of CT-examined cases), and extraosseous soft tissue mass are clearer on MRI (100.0% of MRI-examined cases). Histopathologically, 80.0% of our cases were diagnosed as diffuse large B cell lymphoma (DLBCL). One case as B-cell lymphoblastic lymphoma and one case as B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma were Stage IV (Ann Arbor staging system) and had poor prognosis. The disease-specific survival rate was 77.8% at 5 years. If unexplained non-specific symptoms such as swelling of the jaw, pain, neurological disorder of the inferior alveolar nerve, tooth mobility are observed, oral surgeons and dentists should not perform dental treatments. CT and MRI show disease specific appearance to be able to give a definitive diasnosis as NHL. PET/CT is useful for scaninng of whole body. A deep bone biopsy is preferred for suspected malignant lymphoma.展开更多
文摘BACKGROUND Granulocyte colony-stimulating factor(G-CSF)is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow.We report a rare case of aggressive G-CSFproducing squamous cell carcinoma of the tongue exhibiting fluorine-18 deoxyglucose(FDG)accumulation in primary lesion,metastatic lymph nodes,spleen,and bone marrow on positron emission tomography–computed tomography(PET/CT).CASE SUMMARY We report a 58-year-old female with a rapid enlarged lingual mass with partial necrosis.Blood test results from the initial examination revealed a leukocyte count of 21380/μL.On PET/CT,extensive FDG accumulation was observed in the tongue and bilateral cervical lymph nodes,with elevated FDG accumulation in the spleen and bone marrow although no distant metastases were observed.We performed partial glossectomy and bilateral neck dissection.Immunohistochemical staining with G-CSF antibodies on biopsy specimen and resected samples revealed that both specimens were G-CSF positive.This is a rare case of G-CSF producing tongue carcinoma with elevated FDG accumulation in the spleen and bone marrow.CONCLUSION In patients with the tongue cancer and hyperleukocytosis,where FDG accumulations in the spleen and bone marrow are observed using PET/CT and when these accumulations are not caused by metastasis,G-CSF-producing tumors,with associated poor prognosis,should be considered.
文摘Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extranodal non-Hodgkin’s lymphoma (NHL) with initial mandibular symptoms in our department. At initial treatment of dental clinics, dentists had diagnosed as dental or gingival diseases and had performed dental treatment. Neurological disorder to involvement of the inferior alveolar nerve was present in 80.0% of our cases. On dental or panoramic radiography a specific radiolucent lesion in the mandible was not detected, except for dental lesions. On CT, NHL of the mandible region has no widening and no clear destruction but a slit-like the cortex bone destruction pattern with keeping in shape of the mandibular body (62.5% of CT-examined cases), and extraosseous soft tissue mass are clearer on MRI (100.0% of MRI-examined cases). Histopathologically, 80.0% of our cases were diagnosed as diffuse large B cell lymphoma (DLBCL). One case as B-cell lymphoblastic lymphoma and one case as B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma were Stage IV (Ann Arbor staging system) and had poor prognosis. The disease-specific survival rate was 77.8% at 5 years. If unexplained non-specific symptoms such as swelling of the jaw, pain, neurological disorder of the inferior alveolar nerve, tooth mobility are observed, oral surgeons and dentists should not perform dental treatments. CT and MRI show disease specific appearance to be able to give a definitive diasnosis as NHL. PET/CT is useful for scaninng of whole body. A deep bone biopsy is preferred for suspected malignant lymphoma.
