Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

EXPRESSION OF PTEN AND CASPASE-3 AND THEIR CLINICOPATHOLOGICAL SIGNIFICANCE IN PRIMARY GASTRIC MALIGNANT LYMPHOMA

Objective To investigate the expression of PTEN and Caspase-3 in malignant lymphoma of the stomach and explore their role in progression of primary gastric malignant lymphoma. Methods Formalin-fixed paraffin embedded tissues from 56 cases of primary gastric malignant lymphoma and their adjacent non-tumor mucosa were evaluated for PTEN and Caspase-3 protein ex-pression by streptavidin-biotin-complex (SABC) immunohistochemistry. Their expression was compared with clinical tumor parameters with the relationship between PTEN and Caspase-3 expression concerned as well. Results The positive rate of PTEN expression in primary gastric lymphomas(50.0%, 28/56) was significantly lower than that in adjacent non-tumor gastric mucosa(96.4%, 27/28)(P < 0.05). Meanwhile,43 of 56(76.8%)gastric lymphomas indicated Caspase-3 expression, less than that in adjacent non-tumor mucosa (93.5%, 29/31) (P < 0.05). The expression of PTEN was negatively correlated with invasion and lymph node metastasis of gastric lymphoma(P < 0.05), while the Caspase-3 expression was negatively associated with the latter one(P < 0.05). Additionally, the PTEN expression was posi-tively correlated with Caspase-3 expression in the primary gastric malignant lymphoma(P < 0.05). Conclusions The down-regulated expression of PTEN and Caspase-3 played an important role in progression of primary malignant gastric lymphoma. PTEN, as a molecular marker of pathobiological behaviors of tumor, contributes to tumor progression by increasing cell mobility and angiogenesis, as well as decreasing cell adhesion and apoptosis.

Value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas using automated biopsy gun

AIM: To evaluate the value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas.METHODS: From January 1999 to October 2004, CT-guided core-needle biopsies were performed in 80 patients with suspected malignant lymphoma. Biopsies were performed with an 18-20 G biopsy-cut (CR Bard, Inc., Covington, GA,USA) needle driven by a spring-loaded Bard biopsy gun.RESULTS: A definite diagnosis and accurate histological subtype were obtained in 61 patients with a success rate of 76.25% (61/80). Surgical sampling was performed in 19 patients (23.75%) with non-diagnostic core-needle biopsies. The success rate of CT-guided core-needle biopsy varied with the histopathologic subtypes in our group.The relatively high success rates of core-needle biopsy were noted in diffuse large B-cell non-Hodgkin's lymphoma (NHL, 88.89%) and peripheral T-cell NHL (90%). However,the success rates were relatively low in anaplastic large cell (T/null cell) lymphoma (ALCL, 44.44%) and Hodgkin's disease (HD, 28.57%) in our group.CONCLUSION: CT-guided core-needle biopsy is a reliable means of diagnosing and classifying malignant lymphomas,and can be widely applied in the management of patients with suspected malignant lymphoma.

Clinical Analysis of 10 AIDS Patients with Malignant Lymphoma

Objective This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma. Methods A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathological examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed. Results The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3 cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma （DLBCL）, and 3 patients were pathologically diagnosed with Burkitt＇s lymphoma. Up to 8 patients had CD4 cell counts below 200/μL, and 2 patients had a level of more than 200/μL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were not examined. Six patients underwent different chemotherapy and their prognoses were different. One patient with Burkitt＇s lymphoma alternatively took CODOXM and IVAC for 3 turns after VP chemotherapy; 1 patient with liver metastasis took R-CHOP 5 times, then changed therapy regimen to R-MINE and MINE. One patient with adrenal DLBCL took CHOP 6 times. Three patients with DLBCL took CHOP 1 or 2 times. Four patients gave up treatment. Various infections and side effects occurred, including bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAARI, and 4 did not. Six patients died, whereas 3 patients got improved; and 1 patient was discharged. Conclusions AIDS patients with malignant lymphoma had various clinical manifestations, were immunocompromised, and had multiple metastases when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional complications occurred. HAART failed to improve patient prognosis, and the overall prognosis was poor.

Malignant lymphoma in the ileum diagnosed by double-balloon enteroscopy

A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant lymphoma. Double-balloon enteroscopy confirmed the diagnosis of a malignant lymphoma tumor which was surgically resected. The patient is still in complete remission now.

Clinical Analysis of 29 Cases with Primary Malignant Lymphoma of the Prostate

OBJECTIVE To summarize the clinical characteristics, pathology, treatment and prognosis of malignant lymphoma of the prostate. METHODS Clinical data from 29 patients with primary malignant lymphoma of the prostate were reviewed retrospectively. The median age was 66 years. Clinical signs and symptoms were due to lower urinary tract obstruction resulting from a diffusely enlarged prostate. Prostate biopsies revealed diffuse large B-cell non-Hodgkin＇s lymphoma. The therapeutic modalities included prostatectomy, radiotherapy and chemotherapy. RESULTS Extraprostatic involvement at various sites became evident in 19 of the 29 patients after diagnosis. Ten patients died from lymphoma with a median survival of 23 months （range, 2-30 months）. Seven patients were alive up to 60 months. CONCLUSION Malignant lymphoma involving the prostate was rare and has a rather poor prognosis. Prognosis related to the patient age, histologic type, and treatment or clinical stage of the disease at presentation.

COMBINATION CHEMOTHERAPY WITH COBDP IN MALIGNANT LYMPHOMA: AN ANALYSIS OF 64 CASES

From February 1986 to February 1989, 64 patients with malignant lymphoma were treated with COBDP regimen. Of these patients, there were 7 cases with Hodgkin's disease and 57 cases with non Hodgkin's lymphoma. Clinical staging showed 7 stage Ⅰ , 5 stage Ⅱ, 22 stage Ⅲ and 30 stage Ⅳ . The COBDP regimen was carried out as : Cyclophosphamide 600 mg iv on days 1,8; vincristine 2 mg iv on days 1,8; Pingyanymycin long im on days 1, 4, 8, 11; cis-dichlorodiamineplatinum 20 mg iv drip on day 1 - 5 and prednisone 10 mg po tid on day 1 -14. Treatment results showed 39% (25 cases) achieving complete remission (CR) , 52% (33 cases) partial remission (PR) , giving an over-all response rate of 91 % (CR+PR). There was a significant difference in the CR of the untreated patients (56%) and that of the treated ones (28%) (P< 0.05) .However, between two groups of patients, no statistical significance was observed in the median CR duration (> 12 months, vs >9 months) and the median surrivals of the CR patients (> 16. 5 months, vs > 15 months) (P< 0.05). The median survival after CR was significantly longer than that after PR (P<0. 05). The side effects were: anorexia, nausea; vomiting, alopecia and leucopenia without montality or pulmonary complication. The authors believe that COBDP regimen mayserve as the first line attack against walignant lymphomas.

Successful endoscopic hemostasis for gastric arterial bleeding due to invasion of malignant lymphoma

A 75-year-old male with malignant lymphoma (ML) accompanied with gastric lesion was treated with combination chemotherapy. The patient produced tarry stool on the 4th d, and emergency gastroscopy showed arterial bleeding from the lesion. Hemostasis was achieved by injecting pure ethanol and using hemostatic clips. There is only one previous report on endoscopic hemostasis being effective for bleeding due to lymphoma. Since gastric bleeding causes significant mortality, endoscopic hemostasis should be considered as first-line treatment for ML patients who were treated with chemotherapy.

Relevance on the diagnosis of malignant lymphoma of the salivary gland

Malignant lymphoma originates from the lymphohematopoietic system.It can occur in any lymphoid tissue.Malignant lymphoma of the salivary gland is rare,but its incidence has increased in recent years.Its clinical-presentations are nonspecific,and it is often manifested as a painless mass in a salivary gland,which can be accompanied by multiple swollen cervical lymph nodes.Confirmation of the diagnosis before an invasive procedure is difficult.Clinically,malignant lymphoma of the salivary gland tends to be misdiagnosed,leading to an inappropriate treatment plan and the ultimate delay in the optimal treatment of the disease.This article reviews the pathogenesis,clinical features,imaging findings,diagnosis,treatment and prognosis of malignant lymphoma of the salivary gland.

CLONAL PROLIFERATION AND LONG-TERM CULTURE OF MALIGNANT LYMPHOMA CELLS UNDER SERUM-FREE CULTURE CONDITIONS

We developed a serum-free culture system that promoted the growth of B cell colonies in peripheral blood, bone marrow, lymph nodes and cerebrospinal fluid (CSF) from 7 out of 8 patients with non-Hodgkin's lymphomas of B cell type. The culture cells were pretreated with or without galactose oxi-dase (GO) prior to plating. Colony growth was best supported with BCGF. A moderate increment was observed with rIL-3, as well as rIL-1β and even to a lesser degree, by rlL-2, while B cell stimulating factor-2 (rBCSF-2) and rlL-1β did not show significant activity. rGM-CSF and rG-CSF had little effect, while rM-CSF enhanced the formation of lymphoma colonies. The cells from different patients had different requirements for Staphylococcus aureus protein A and GO pretreatment. It reflected the differences in activation and differentiation status and surface properties of lymphoma cells from different patients. The cells from CSF of one patient were successfully maintained in serum-free culture medium supplemented with 10% BCGF or 5% PHA-LCM for more than 4 months. The long-term culture cells were EBV negative, phenotypically consistent with B cells and gene rearrangements for JH, Kappa and myc. This serum-free culture system allowed extensive analysis of the growth requirements for clonogenic precursors.

PRIMARY MALIGNANT LYMPHOMA OF THE LUNG: REPORT OF A CASE AND REFERENCE TO DIAGNOSTIC CRITERIA

Although pulmonary involvement ofmalignant lymphoma is quite common, primarymalignant lymphoma of the lung is rare. Two caseswere reported by Chinese literature in 1985. Thispaper describes a case of primary pulmonarymalignant lymphoma which has been remitted by

CLINICAL STUDY ON SERUM COPPER AND ZINC LEVELS AND COPPER/ZINC RATIO IN MALIGNANT LYMPHOMA

173 simultaneous determinations of serum copper levels (SCL), serum zinc levels (SZL) and copper/zinc ratio (CZR) were made by atomic absorption spectrophotometry in 51 previously untreated lymphoma patients. SCL and CZR were significantly higher in patients before treatment (mean value 22.97 μmol/L, 1.55, respectively) and in those who did not reach complete remission (mean 21.21 μmol/L, 1.36) as compared with the patients in complete remission (mean 16.36 μmol/L, 1.06) or normal controls (mean 15.67 μmol/L, 0.98). The mean value of SCL and CZR of patients in complete remission did not differ significantly from those of normal controls. Patients in stages HI and IV had higher SCL and CZR (mean 25.15 μmol/L, 1.79) than those in stage Ⅰ and Ⅱ (mean 19.30 μmol/L, 1.16). No significant difference in SZL was observed between the patient groups and normal controls. Thus, SCL and CZR may be used as prognostic indicators for monitoring disease activity and response to therapy in malignant lymphoma.

OKT_（10） POSITIVE CELLS IN PERIPHERAL BLOOD OF MULTIPLE MYELOMA AND MALIGNANT LYMPHOMA

patients with maligant lywioma and 18 patients with multiple myeloma were investigated for expression of OKT10 in Peripheral blood. A significant increasing of OKT10 positive cells was found in most of patients(26/3espectively) with Non_Hodgekin's lymphoma(NHL)and multiple myeloma(MM). The increasing of OKT10 positive cells is related to the degree of malignancy of patients with NHL from low_grade to high_grade.It is useful to judge prognosis of NHL.The presence of OKT10 positive cells was unrelated with treatment status and clinic phases. some of OKT10 positive cells belong to neoplastic precursors.

EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN IN CUTANEOUS MALIGNANT LYMPHOMAS AND LYMPHOID INFILTRATES

Paraffin-embedded tissue of skin biopsy specimens taken retrospectively from 24 patients with cutaneous malignant lymphomas (CML) and 8 patients with cutaneous lymphoid infiltrates (CLI) and other dennatoses were studied retrospectively with PCIO immunostaining. The results show a statistical significant difference among PCIO indices for cutaneous genuine histiocytic lymphoma (CGHL), cutaneous germinal center cell-derived lymphomas (CGCCL), cutaneous peripheral T-cell lymphomas (CPTL), non-mycosis fungoides (MF) and Sezary's syndrome (SS), and MF when compared with those for CLI. There is a linear relationship between PCIO index and square root of PCIO density, both of which seem to have a parallel relationship to the severity of malignancy in CML. The nuclear volume of the positive tumor cell or lymphocyte with PCIO immunostaining may be also useful in differentiating CML from CLI.

Establishment of a Human Malignant T Lymphoma Cell Line Carrying a Retrovirus-like Particles with RT Activity

We have established an IL-2 independent malignant lymphoma line (CM-1) from peripheral T lymphocytes donated by a femalc patient with nervous systcm disease, the binlogical characteristics of CM-1 cells was studied in this paper. Another T lymphocytes,such as peripheral T lymphocytes donated by a maIe patient with multiple sclerosis, could be transformed into a malignant lymphoma line by using filtered supernatant of the CM-1 cultured medium, thus the CM-2 cell line u'as estabIished. The CM-1 and CM-2 cells were transplanted by subcutaneous inoculation into nude mice, and could cause the occurrenceof typical maIignant lymphoma. The observation of eIectron micrographs suggested the existence of virions in the CM-1 and CM-2 cells, and these virions were similar toretrovirus in the ultra-structure characteristics. lt was found that this virus possesses reverse transcriptase activity. ResuIts obtained from serological assay, molecular hybridization and PCR excluded the existence of other human viruses, which were commonly usedin our laboratory. The unknown virus possesses strong transformation activity, and probably is a new retro virus. Meanwhile, the work on the clone and sequence analysis ofthis virus are being carried out.

Mucosa-associated lymphoid tissue lymphoma of the transverse colon: A case report

We herein present a case of a 75-year-old female with mucosa-associated lymphoid tissue （MALT） lymphoma of the transverse colon with the stage IE （Ann Arbor classification）. Colonoscopy revealed the tumor＇s appearance as a IIa plus Ⅱ c-like early colon cancer as defined according to the macroscopic classification of the Japanese Research Society for Cancer of Colon, Rectum and Anus, measuring less than 2 cm in diameter. Histologically, the tumor was diagnosed as MALT lymphoma because of the presence of lymphoepithelial lesions consisting of diffuse proliferation of atypical lymphocytes and glandular destruction. The majority of these lymphocytes immunohistochemically stained for the B-lymphocyte marker. The patient first underwent H pylori eradication therapy with Lansap. However, the tumor size gradually increased over the next 4 mo and the patient eventually underwent surgical resection. The operative procedure included a partial colectomy with dissection of the paracolic lymph nodes. The tumor measured 45 mm × 30 mm in diameter and histological examination showed that the lymphoma cells had infiltrated the muscle layer of the colon without nodal involvement. The patient has had no recurrence postoperatively without any chemotherapy.

Gallbladder Burkitt's lymphoma mimicking gallbladder cancer:A case report

BACKGROUND Malignant lymphoma is a rare form of gallbladder malignancy.Most of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas;however,Burkitt’s lymphoma of the gallbladder is extremely rare,and only two previous reports are available in the literature.Herein,we report a rare case of Burkitt’s lymphoma of the gallbladder mimicking gallbladder adenocarcinoma.CASE SUMMARY An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography(CT)performed for hypertension screening.His laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 receptor.Imaging examinations revealed two irregular and contrastenhanced masses extending into the gallbladder lumen,but these did not infiltrate the serosa.Moreover,a periportal lymph node had enlarged to 30 mm.Based on these findings,we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis,which was treated using bile duct resection with gallbladder bed resection and periportal lymph node dissection.However,the patient was finally diagnosed as having Burkitt’s lymphoma.Although the surgical margin was pathologically negative,recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after discharge.Thus,he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide,doxorubicin,vincristine,and prednisone.CONCLUSION Burkitt’s lymphoma can occur in the gallbladder.Biopsy can be useful in cases with findings suggestive of gallbladder malignant lymphoma.

HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS PERIPHERAL BLOOD STEM CELL SUPPORT IN CHILDREN WITH MALIGNANT DISEASES

Objective： To determine the potential effectiveness and toxicity of this therapy in children with advanced neuroblastoma or malignant lymphoma. Methods： Carboplatin （425 mg/m^2·d） and etoposide （338 regime-d） were given as a 24 h continuous IV infusion on days -7, -6, -5 and -4, and melphalam （70 mg/m^2·d） by bolus IV infusion at hour 0 of days -7, -6, and - 5（CEM）. Or busulphan was given as 1 mg/kg.6 h orally on days -6, -5, -4, and melphalam （140 mg/m^2） by IV bolus infusion on day-3（BM）. Treatment regimens followed by autologous PBSC infusion were performed in 19 children with neuroblastoma （n=12） or malignant lymphoma （n=7） for consolidation treatment. There were thirteen males and six females, with a median age of 6.4 years （raging 3.5-13 years）. Results： The median period of achieving ANC 〉0.5×10^9/L, WBC〉1.0×10^9/L, and platelet 〉20×10^9/L after infusion of PBSCs were 21 d, 17 d, and 33 d respectively. Stomatitis occurred in 16 children （86%）, and twelve had gastrointestinal toxicity （64%）. Complete remission （CR） was achieved in 14 （74%） children. Fifteen patients （79%） survived. Ten patients （53%） are alive in CR. These patients are alive for a median of 639 days and disease-free for 909 d after transplantation. Four cases （21%） relapsed, and four cases （21%） died. Conclusion： CEM or BM regimen followed by autologous PBSCT infusion is safe and feasible, and has significant effects in children with advanced neuroblastoma or malignant lymphoma.

THE APPLICATION OF IMMUNOHISTOCHEMISTRY IN THE DIFFERENTIAL DIAGNOSIS OF EXTRANODAL LYMPHOMA AND ANAPLASTIC CARCINOMA

Thirty-six cases originally diagnosed histologically as malignant lymphoma (ML) or anaplastic carcinoma were reexamined immunohistochemically by leukocyte common antigen (LCA) and epithelial membrane antigen (EMA). 5/18 cases originally diagnosed as ' anaplastic carcinoma'' and 'anaplastic carcinoma? (ML to be excluded)' , showed positive staining for LCA and negative for EMA; whereas 3 cases originally diagnosed as malignancy unclassified turned out to be ML, with the relevant assay performed.

Diffuse large B cell lymphoma originating from the maxillary sinus with skin metastases:A case report and review of literature

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common type of malignant lymphoma(ML),accounting for 30%-40%of cases of non-Hodgkin’s lymphoma(NHL)in adults.Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17%of all lymphomas.ML from the maxillary sinus(MS)is a particularly rare presentation,and is thus often difficult to diagnose.We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastasis.CASE SUMMARY An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve area.His medical history included splenectomy due to a traffic injury,an old right cerebral infarction from when he was 74-years-old,hypertension,and type 2 diabetes mellitus.A plain head computed tomography(CT)scan revealed a 3 cm×3.1 cm×3 cm sized left MS.On day 25,left diplopia and ptosis occurred,and a follow-up CT on day 31 revealed the growth of the left MS mass.Based on an MS biopsy on day 50,we established a definitive diagnosis of DLBCL,non-germinal center B-cell-like originating from the left MS.The patient was admitted on day 62 due to rapid deterioration of his condition,and a plain CT scan revealed the further growth of the left MS mass,as well as multiple systemic metastasis,including of the skin.A skin biopsy on day 70 was found to be the same as that of the left MS mass.We notified the patient and his family of the disease,and they opted for palliative care,considering on his condition and age.The patient died on day 80.CONCLUSION This case suggests the need for careful,detailed examination,and for careful follow-up,when encountering patients presenting with a mass.