BACKGROUND Central nervous system(CNS)lesions and peripheral neuropathy are rare among patients with non-Hodgkin’s lymphoma(NHL).Lymphomatous infiltration or local oppression usually accounts for CNS or peripheral ne...BACKGROUND Central nervous system(CNS)lesions and peripheral neuropathy are rare among patients with non-Hodgkin’s lymphoma(NHL).Lymphomatous infiltration or local oppression usually accounts for CNS or peripheral nerve lesions.The incidence of peripheral neuropathy was 5%.Guillain-Barrésyndrome(GBS)is rare and may occur in less than 0.3%of patients with NHL.Hemophagocytic syndrome(HPS)is a rare complication of NHL.It has been reported that 1%of patients with hematological malignancies develop HPS.Diffuse large B-cell lymphoma(DLBCL)combined with GBS has been reported in 10 cases.CASE SUMMARY We report the case of a 53-year-old man who was initially hospitalized because of abnormal feelings in the lower limbs and urinary incontinence.He was finally diagnosed with DLBCL combined with GBS and HPS after 16 d,which was earlier than previously reported.Immunoglobulin pulse therapy,dexamethasone,and etoposide were immediately administered.The neurological symptoms did not improve,but cytopenia was relieved.However,GBS-related clinical symptoms were relieved partially after one cycle of rituximab-cyclophosphamide,hydroxydaunorubicin,vincristine,and prednisone(R-CHOP)chemotherapy and disappeared after six cycles of R-CHOP.CONCLUSION GBS and HPS heralding the diagnosis of Epstein-Barr virus DLBCL are rare.Herein,we report a rare case of DLBCL combined with GBS and HPS,and share our clinical experience.Traditional therapies may be effective if GBS occurs before lymphoma is diagnosed.Rapid diagnosis and treatment of DLBCL are crucial.展开更多
BACKGROUND Antisynthetase syndrome(ASS)is characterized by the presence of antisynthetase antibodies coupled with clinical findings such as fever,polymyositis-dermatomyositis and interstitial lung disease.It is,howeve...BACKGROUND Antisynthetase syndrome(ASS)is characterized by the presence of antisynthetase antibodies coupled with clinical findings such as fever,polymyositis-dermatomyositis and interstitial lung disease.It is,however,rare to observe ASS association with B cell lymphoma presenting severe pneumonia as the first clinical manifestation.CASE SUMMARY We evaluated a 59-year-old male patient who presented with cough with sputum,shortness of breath and fever for 13 d.A chest computed tomography radiograph revealed bilateral diffuse ground-glass infiltrates in both upper fields,left lingual lobe and right middle lobe.Initially,the patient was diagnosed with severe community-acquired pneumonia and respiratory failure.He was empirically treated with broad-spectrum antibiotics,without improvement.Further analysis showed an ASS panel with anti-PL7 antibodies.Besides,electromyography evaluation demonstrated a manifestation of myogenic damage,while deltoid muscle biopsy showed irregular muscle fiber bundles especially abnormal lymphocyte infiltration.In addition,bone marrow biopsy revealed high invasive B cell lymphoma.Thus,the patient was diagnosed with a relatively rare anti–PL7 antibody positive ASS associated with B cell lymphoma.CONCLUSION This case highlights that rapidly progressive lung lesions and acute hypoxemic respiratory failure associated with heliotrope rash and extremely high lactate dehydrogenase level should be considered as the characteristics of non-infectious diseases,especially ASS and B cell lymphoma.展开更多
目的对艾滋病相关弥漫大B细胞淋巴瘤(diffuse large B-cell lymphom,DLBCL)患者的临床实验室特征进行分析,为临床诊治提供依据。方法回顾性分析云南省传染病医院2017年1月至2022年12月期间确诊为艾滋病相关DLBCL患者不同临床分期、国际...目的对艾滋病相关弥漫大B细胞淋巴瘤(diffuse large B-cell lymphom,DLBCL)患者的临床实验室特征进行分析,为临床诊治提供依据。方法回顾性分析云南省传染病医院2017年1月至2022年12月期间确诊为艾滋病相关DLBCL患者不同临床分期、国际预后指数(international prognostic index,IPI)评分和病理亚型等临床相关实验室指标。根据D-二聚体(D-dimer,D-D)和纤维蛋白原(fibrinogen,FIB)水平进行分组,对不同D-D和FIB水平组进行生存分析,同时分析存活组与死亡组化疗前后D-D和FIB水平变化。结果70例艾滋病相关DLBCL患者中男性占77.1%;5年生存率为60.0%,存活组的平均生存时间远高于死亡组(P<0.05)。Ann Arbor临床分期Ⅰ、Ⅱ期患者的D-D、红细胞分布宽度(red blood cell distribution width,RDW)均低于III、IV期患者,血红蛋白(hemoglobin,HGB)、白蛋白(albumin,ALB)水平均高于III、IV期患者(P均<0.05);在IPI评分中,IPI为4~5分患者的FIB和D-D水平均高于IPI为0~3分患者,而IPI为4~5分患者的HGB和ALB水平均低于IPI为0~3分患者(P均<0.05)。血浆高水平FIB和D-D组的患者与低水平组的5年无进展生存期并无显著差异(P>0.05);多次化疗后,2组患者血浆FIB水平相对稳定,而生存组D-D水平从第2次化疗后有下降趋势(P<0.05)。结论在艾滋病相关DLBCL患者诊断初期,可以由实验室常规检测指标推测患者临床状态。展开更多
目的探讨p53和c-Myc表达对弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)相关噬血细胞综合征患者的预后影响。方法回顾性分析2018年1月至2021年1月浙江大学医学院附属第一医院、台州市第一人民医院确诊的30例成人DLBCL相关...目的探讨p53和c-Myc表达对弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)相关噬血细胞综合征患者的预后影响。方法回顾性分析2018年1月至2021年1月浙江大学医学院附属第一医院、台州市第一人民医院确诊的30例成人DLBCL相关噬血细胞综合征患者的临床资料,采用免疫组织化学法检测p53、c-Myc表达,结合临床资料进行预后影响因素分析。结果p53和c-Myc均阳性表达占43.3%(13/30),p53和(或)c-Myc阴性表达占56.7%(17/30)。p53和c-Myc阳性组患者的纤维蛋白原显著低于p53和(或)c-Myc阴性组,血清铁蛋白、白细胞介素-10均显著高于p53和(或)c-Myc阴性组(P<0.05)。p53和c-Myc阳性组患者的12个月总生存率显著低于p53和(或)c-Myc阴性组(23.1%vs.82.4%,P<0.05)。结论免疫组织化学法检测p53、c-Myc表达能够预测DLBCL相关噬血细胞综合征患者的预后,p53和c-Myc均阳性表达的患者预后较差。展开更多
The relationships between lymphomas and their microenvironment appear to follow 3 major patterns:(1)an independent pattern;(2)a dependent pattern on deregulated interactions;and(3)a dependent pattern on regulated coex...The relationships between lymphomas and their microenvironment appear to follow 3 major patterns:(1)an independent pattern;(2)a dependent pattern on deregulated interactions;and(3)a dependent pattern on regulated coexistence.Typical examples of the third pattern are hepatitis C virus(HCV)-associated marginal zone lymphomas(MZLs)and mucosa-associated lymphoid tissue lymphomas.In these lymphomas,a regulated coexistence of the malignant cells and the microenvironmental factors usually occurs.At least initially,however,tumor development and cell growth largely depend on external signals from the microenvironment,such as viral antigens,cytokines,and cell-cell interactions.The association between HCV infection and B-cell lymphomas is not completely defined,although this association has been demonstrated by epidemiological studies.MZL and diffuse large B-cell lymphoma are the histotypes most frequently associated with HCV infection.Many mechanisms have been proposed for explaining HCV-induced lymphomagenesis;antigenic stimulation by HCV seems to be fundamental in establishing B-cell expansion as observed in mixed cryoglobulinemia and in B-cell lymphomas.Recently,antiviral treatment has been proved to be effective in the treatment of HCV-associated indolent lymphomas.Importantly,clinically responses were linked to the eradication of the HCV-RNA,providing a strong argument in favor of a causative link between HCV and lymphoproliferation.展开更多
文摘BACKGROUND Central nervous system(CNS)lesions and peripheral neuropathy are rare among patients with non-Hodgkin’s lymphoma(NHL).Lymphomatous infiltration or local oppression usually accounts for CNS or peripheral nerve lesions.The incidence of peripheral neuropathy was 5%.Guillain-Barrésyndrome(GBS)is rare and may occur in less than 0.3%of patients with NHL.Hemophagocytic syndrome(HPS)is a rare complication of NHL.It has been reported that 1%of patients with hematological malignancies develop HPS.Diffuse large B-cell lymphoma(DLBCL)combined with GBS has been reported in 10 cases.CASE SUMMARY We report the case of a 53-year-old man who was initially hospitalized because of abnormal feelings in the lower limbs and urinary incontinence.He was finally diagnosed with DLBCL combined with GBS and HPS after 16 d,which was earlier than previously reported.Immunoglobulin pulse therapy,dexamethasone,and etoposide were immediately administered.The neurological symptoms did not improve,but cytopenia was relieved.However,GBS-related clinical symptoms were relieved partially after one cycle of rituximab-cyclophosphamide,hydroxydaunorubicin,vincristine,and prednisone(R-CHOP)chemotherapy and disappeared after six cycles of R-CHOP.CONCLUSION GBS and HPS heralding the diagnosis of Epstein-Barr virus DLBCL are rare.Herein,we report a rare case of DLBCL combined with GBS and HPS,and share our clinical experience.Traditional therapies may be effective if GBS occurs before lymphoma is diagnosed.Rapid diagnosis and treatment of DLBCL are crucial.
基金Supported by National Natural Science Foundation of China,No.81900020Natural Science Foundation of Zhejiang Province,China,No.LQ19H160020.
文摘BACKGROUND Antisynthetase syndrome(ASS)is characterized by the presence of antisynthetase antibodies coupled with clinical findings such as fever,polymyositis-dermatomyositis and interstitial lung disease.It is,however,rare to observe ASS association with B cell lymphoma presenting severe pneumonia as the first clinical manifestation.CASE SUMMARY We evaluated a 59-year-old male patient who presented with cough with sputum,shortness of breath and fever for 13 d.A chest computed tomography radiograph revealed bilateral diffuse ground-glass infiltrates in both upper fields,left lingual lobe and right middle lobe.Initially,the patient was diagnosed with severe community-acquired pneumonia and respiratory failure.He was empirically treated with broad-spectrum antibiotics,without improvement.Further analysis showed an ASS panel with anti-PL7 antibodies.Besides,electromyography evaluation demonstrated a manifestation of myogenic damage,while deltoid muscle biopsy showed irregular muscle fiber bundles especially abnormal lymphocyte infiltration.In addition,bone marrow biopsy revealed high invasive B cell lymphoma.Thus,the patient was diagnosed with a relatively rare anti–PL7 antibody positive ASS associated with B cell lymphoma.CONCLUSION This case highlights that rapidly progressive lung lesions and acute hypoxemic respiratory failure associated with heliotrope rash and extremely high lactate dehydrogenase level should be considered as the characteristics of non-infectious diseases,especially ASS and B cell lymphoma.
文摘目的探讨p53和c-Myc表达对弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)相关噬血细胞综合征患者的预后影响。方法回顾性分析2018年1月至2021年1月浙江大学医学院附属第一医院、台州市第一人民医院确诊的30例成人DLBCL相关噬血细胞综合征患者的临床资料,采用免疫组织化学法检测p53、c-Myc表达,结合临床资料进行预后影响因素分析。结果p53和c-Myc均阳性表达占43.3%(13/30),p53和(或)c-Myc阴性表达占56.7%(17/30)。p53和c-Myc阳性组患者的纤维蛋白原显著低于p53和(或)c-Myc阴性组,血清铁蛋白、白细胞介素-10均显著高于p53和(或)c-Myc阴性组(P<0.05)。p53和c-Myc阳性组患者的12个月总生存率显著低于p53和(或)c-Myc阴性组(23.1%vs.82.4%,P<0.05)。结论免疫组织化学法检测p53、c-Myc表达能够预测DLBCL相关噬血细胞综合征患者的预后,p53和c-Myc均阳性表达的患者预后较差。
基金Supported by An Institutional grant from Centro di Riferimento Oncologico Aviano for an intramural project"Agenti Infettivi e Tumori"to Carbone Aan Institutional grant from the Fondazione IRCSS Istituto Nazionale Tumori Milano"Validation of a new algorithm for HPV status assessment in head and neck carcinoma"to Gloghini A
文摘The relationships between lymphomas and their microenvironment appear to follow 3 major patterns:(1)an independent pattern;(2)a dependent pattern on deregulated interactions;and(3)a dependent pattern on regulated coexistence.Typical examples of the third pattern are hepatitis C virus(HCV)-associated marginal zone lymphomas(MZLs)and mucosa-associated lymphoid tissue lymphomas.In these lymphomas,a regulated coexistence of the malignant cells and the microenvironmental factors usually occurs.At least initially,however,tumor development and cell growth largely depend on external signals from the microenvironment,such as viral antigens,cytokines,and cell-cell interactions.The association between HCV infection and B-cell lymphomas is not completely defined,although this association has been demonstrated by epidemiological studies.MZL and diffuse large B-cell lymphoma are the histotypes most frequently associated with HCV infection.Many mechanisms have been proposed for explaining HCV-induced lymphomagenesis;antigenic stimulation by HCV seems to be fundamental in establishing B-cell expansion as observed in mixed cryoglobulinemia and in B-cell lymphomas.Recently,antiviral treatment has been proved to be effective in the treatment of HCV-associated indolent lymphomas.Importantly,clinically responses were linked to the eradication of the HCV-RNA,providing a strong argument in favor of a causative link between HCV and lymphoproliferation.
