Primary cutaneous B cell lymphoma: Clinical features, diagnosis and treatment

Primary cutaneous B cell lymphoma(PCBCL) is defined as B cell lymphomas that presents in the skin without any evidence of extra-cutaneous involvement at diagnosis. They are the second most common type of primary cutaneous lymphomas accounting for 25%-30%. Since the prognosis and treatment differ from systemic lymphomas involving the skin, differential diagnosis is very important. PCBCL is a heterogeneous group of disease comprising different B cell lymphomas with distinct treatment and prognosis. PCBCL is divided into 5 subclasses according to World Health Organization and European Organization of Research and Treatment of Cancer classification. Primary cutaneous marginal zone lymphoma and primary cutaneous follicle centerlymphoma are indolent forms and often confined to skin at presentation and during the course of the disease. But primary cutaneous diffuse large B cell lymphoma, leg type and intravascular large B cell lymphoma are more aggressive forms that may disseminate to extra-cutaneous tissues. There is not a treatment consensus since they are rare entities. Local therapies like radiotherapy, surgery or intralesional steroids are options for localized disease in indolent forms. More disseminated disease may be treated with a systemic therapy like single agent rituximab. However combination chemotherapies which are used in systemic lymphomas are also required for aggressive PCBCL. Although indolent forms have relatively better prognosis, early relapses and disseminated diseases are mostly observed in aggressive form with a consequent poor prognosis.

Primitive Breast Lymphoma about a Case: Literature Review

Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracycline-based chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history;nulliparous;followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration;a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy;the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.

mIgM-mediated splenic marginal zone B cells targeting of folic acid for immunological evasion

Folic acid is a fully oxidized synthetic folate with high bioavailability and stability which has been extensively prescribed to prevent congenital disabilities.Here we revealed the immunosuppressive effect of folic acid by targeting splenic marginal zone B(MZB)cells.Folic acid demonstrates avid binding with the Fc domain of immunoglobulin M(IgM),targeting IgM positive MZB cells in vivo to destabilize IgM-B cell receptor(BCR)complex and block immune responses.The induced anergy of MZB cells by folic acid provides an immunological escaping window for antigens.Covalent conjugation of folic acid with therapeutic proteins and antibodies induces immunological evasion to mitigate the production of anti-drug antibodies,which is a major obstacle to the long-term treatment of biologics by reducing curative effects and/or causing adverse reactions.Folic acid acts as a safe and effective immunosuppressant via IgM-mediated MZB cells targeting to boost the clinical outcomes of biologics by inhibiting the production of anti-drug antibodies,and also holds the potential to treat other indications that adverse immune responses need to be transiently shut off.

Evidence-Based Immunotherapeutic Effects of Herbal Compounds on Humoral Immunity:Ancient and New Approaches

The human immune system represents a dynamic multiscale system with high complexity in biology.Humoral immunity,as the main branch of adaptive immunity,is characterized by differentiated stages of the Blymphocytes,producing the final product of antibodies that has a diversity of the tuning mechanisms within genetic and epigenetic levels in confrontation with environmental exposures.Disorders because of disturbed humoral immunity are linked with dysregulation of feedback-regulated signaling and the dynamic of immune components that determine the overall response.Food products,mainly herbal components have a significant role in tailoring the immune system micro-ecosystem which can diversify the adaptive nature of humoral immunity.Herein,we review the current evidence-based approaches for the impact of medicinal herbs on humoral immunity signaling and antibody production with a focus on immunotherapeutic applications.