BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and...BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and HGBL-not otherwise specific(HGBL-NOS),which are morphologically characteristic of HGBL but lack MYC,BCL-2,or BCL-6 rearrangements.HGBL is partially transformed by follicular lymphoma and other indolent lymphoma,with few cases of marginal zone lymphoma(MZL)transformation.HGBL often has a poor prognosis and intensive therapy is currently mainly advocated,but there is no good treatment for these patients who cannot tolerate chemotherapy.CASE SUMMARY We reported a case of MZL transformed into HGBL-NOS with TP53 mutation and terminal deoxynucleotidyl transferase expression.Gene analysis revealed the gene expression profile was identical in the pre-and post-transformed tissues,suggesting that the two diseases are homologous,not secondary tumors.The chemotherapy was ineffective and the side effect was severe,so we tried combination therapy including venetoclax and obinutuzumab.The patient tolerated treatment well,and reached partial response.The patient had recurrence of hepatocellular carcinoma and died of multifunctional organ failure.He survived for 12 months after diagnosis.CONCLUSION Venetoclax combined with obinutuzumab might improve the survival in some HGBL patients,who are unsuitable for chemotherapy.展开更多
Intraductal papilloma of the breast is relatively common,accounting for 5.3%of all benign breast diseases.[1]However,relapse readily occurs with pathological changes such as atypical ductal hyperplasia(ADH)and cancera...Intraductal papilloma of the breast is relatively common,accounting for 5.3%of all benign breast diseases.[1]However,relapse readily occurs with pathological changes such as atypical ductal hyperplasia(ADH)and canceration,and the rate of underestimation of biopsy diagnosis is high.[2,3]Therefore,specific considerations are required for the diagnosis and treatment methods of intraductal papilloma,and some clinical problems with these methods remain controversial.To standardize the diagnosis and treatment of intraductal papilloma of the breast and provide a reference for the clinical work of breast specialists,Chinese Society of Breast Surgery has determined the key clinical issues of the clinical practice guidelines for intraductal papilloma of the breast through a literature search and expert discussion.The relevant evidence was evaluated with reference to the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system,and the Clinical Practice Guidelines for Intraductal Papilloma:Chinese Society of Breast Surgery(CSBrS)practice guidelines 2021 was formulated to provide a reference for the clinical work of breast surgeons in China.展开更多
Ultrasound-guided vacuum-assisted breast biopsy(VABB)is a common technique in breast surgery.To standardize this technique,the Chinese Society of Breast Surgery(CSBrS)re-evaluated the quality of evidence for clinical ...Ultrasound-guided vacuum-assisted breast biopsy(VABB)is a common technique in breast surgery.To standardize this technique,the Chinese Society of Breast Surgery(CSBrS)re-evaluated the quality of evidence for clinical studies of VABB,referring to the grading of recommendations assessment,development,and evaluation,and developed the Clinical Practice Guidelines for Ultrasound-guided vacuum-assisted breast biopsy:CSBrS Practice Guidelines 2021,in accordance with the Expert Consensus and Operation Guidelines for Ultrasound-guided Vacuum-assisted Breast Biopsy Surgery(2017)combined with data from clinical practice in breast surgery in China,providing a reference for breast surgeons in China.展开更多
基金Supported by The Lishui Science and Technology Planing Projects,No.2020SJZC048.
文摘BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and HGBL-not otherwise specific(HGBL-NOS),which are morphologically characteristic of HGBL but lack MYC,BCL-2,or BCL-6 rearrangements.HGBL is partially transformed by follicular lymphoma and other indolent lymphoma,with few cases of marginal zone lymphoma(MZL)transformation.HGBL often has a poor prognosis and intensive therapy is currently mainly advocated,but there is no good treatment for these patients who cannot tolerate chemotherapy.CASE SUMMARY We reported a case of MZL transformed into HGBL-NOS with TP53 mutation and terminal deoxynucleotidyl transferase expression.Gene analysis revealed the gene expression profile was identical in the pre-and post-transformed tissues,suggesting that the two diseases are homologous,not secondary tumors.The chemotherapy was ineffective and the side effect was severe,so we tried combination therapy including venetoclax and obinutuzumab.The patient tolerated treatment well,and reached partial response.The patient had recurrence of hepatocellular carcinoma and died of multifunctional organ failure.He survived for 12 months after diagnosis.CONCLUSION Venetoclax combined with obinutuzumab might improve the survival in some HGBL patients,who are unsuitable for chemotherapy.
文摘Intraductal papilloma of the breast is relatively common,accounting for 5.3%of all benign breast diseases.[1]However,relapse readily occurs with pathological changes such as atypical ductal hyperplasia(ADH)and canceration,and the rate of underestimation of biopsy diagnosis is high.[2,3]Therefore,specific considerations are required for the diagnosis and treatment methods of intraductal papilloma,and some clinical problems with these methods remain controversial.To standardize the diagnosis and treatment of intraductal papilloma of the breast and provide a reference for the clinical work of breast specialists,Chinese Society of Breast Surgery has determined the key clinical issues of the clinical practice guidelines for intraductal papilloma of the breast through a literature search and expert discussion.The relevant evidence was evaluated with reference to the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system,and the Clinical Practice Guidelines for Intraductal Papilloma:Chinese Society of Breast Surgery(CSBrS)practice guidelines 2021 was formulated to provide a reference for the clinical work of breast surgeons in China.
文摘Ultrasound-guided vacuum-assisted breast biopsy(VABB)is a common technique in breast surgery.To standardize this technique,the Chinese Society of Breast Surgery(CSBrS)re-evaluated the quality of evidence for clinical studies of VABB,referring to the grading of recommendations assessment,development,and evaluation,and developed the Clinical Practice Guidelines for Ultrasound-guided vacuum-assisted breast biopsy:CSBrS Practice Guidelines 2021,in accordance with the Expert Consensus and Operation Guidelines for Ultrasound-guided Vacuum-assisted Breast Biopsy Surgery(2017)combined with data from clinical practice in breast surgery in China,providing a reference for breast surgeons in China.
