Thalassemia major terminating in a non-Hodgkin B-cell lymphoma: report of a case.

A large noncleaved diffuse follicular center cell lymphoma occurring in an 11-year-old child with homozygous beta thalassemia is described. The possible relationship between numerous blood transfusions during a 10-year period and the occurrence of a B-cell lymphoma is discussed.     

Primary brain malignant non-Hodgkin lymphoma: report of a case treated with chemotherapy in combination with radiotherapy

Primary brain lymphomas are usually treated with surgery in combination with radiotherapy, whereas only a few cases have been treated with chemotherapy. We describe a case of a 68-year-old man with an immunoblastic primary cerebral lymphoma first treated with surgery and radiotherapy and subsequently with chemotherapy consisting of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP). In this case immunological study of the peripheral blood and cerebrospinal fluid (CSF) lymphocytes confirmed that a primary brain lymphoma may be an intrinsic cerebral neoplasm with different forms of spreading within the central nervous system (CNS). The period of survival of our patient is equivalent to that of patients treated with radiotherapy alone or in combination with surgery. This suggests the need for further investigation in this field.     

Bronchoesophageal fistula in a patient with non-Hodgkin’s lymphoma

Bronchoesophageal fistula secondary to lymphoma is a very rare condition, usually associated with chemo-radiotherapy. We report a case of a patient with a non-Hodgkin's lymphoma (NHL) who, after chemotherapy, developed an oesophago-tracheal fistula. Initially it was treated conservatively but due to the lack of response, a stent was inserted. After nearly one year without success, surgery was considered. Right thoracotomy oesophagectomy and closure of the tracheal defect with an intercostal muscle flap and pericardial patch was performed. This was followed by laparoscopic creation of a gastric tube, which was successfully anastomosed to the cervical oesophagus through a cervicotomy. Unlike oesophageal cancer, NHL can have a good prognosis, so curative treatment of the fistula can be considered. Conservative treatment must always be the first option, leaving stenting or surgery for when the problem persists.     

Bilateral primary orbital non-Hodgkin's lymphoma in a patient with scleroderma: a case report

Orbital presentation of non-Hodgkin's Lymphoma (NHL) is uncommon but occurs both as the only site of disease and as a site of recurrence. Primary orbital NHLs are usually low-grade, and mostly extranodal marginal zone/mucosa associated lymphoid tissue B-cell neoplasms. They are commonly associated with chronic inflammatory conditions. The issue of bilaterality in orbital lymphoma is not very common. The onset of malignant lymphoproliferation may precede, follow, or exist simultaneously with scleroderma. Different treatment modalities were applied in orbital NHL such as surgery, radiation therapy, chemotherapy or both. We report a 57-year-old man with scleroderma presenting with eyelid hernias who had biopsy-proven marginal zone NHL, successfully treated with radiotherapy and combined chemotherapy, and also review the literature.     

Fatal intra-alveolar hemorrhage after rituximab in a patient with non-Hodgkin lymphoma

A 65-year-old male developed progressive dry cough and digital clubbing after starting rituximab-CHOP chemotherapy for non-Hodgkin lymphoma. A lung biopsy showed loose non-necrotic granulomas in a background of mild fibrosis and rare eosinophils, compatible with a drug-induced hypersensitivity pneumonia. Associated manifestations of this hypersensitivity reaction were a high eosinophil count, elevated serum levels of immunoglobulin E, and a skin rash consistent with pigmented purpuric dermatitis (Schamberg disease). Corticosteroids were marginally efficacious in treating this reaction. Few similar reactions have since been described, 2 of them ultimately fatal, but none was associated with pulmonary hemorrhage. A 2.5:1 ratio between the interstitial alveolar T4/T8 lymphocytes in our case is similar to the findings in methotrexate-induced pneumonitis and farmer lung disease. This report documents the serologic and immunohistologic findings associated with a pulmonary interstitial reaction to rituximab. A review of the pertinent literature is provided. The possible pathogenetic mechanisms, including the role of cytokines, cytotoxic T-lymphocytes and CD 20 positive T-cells in relation to the administration of rituximab are discussed.     

Primary non-Hodgkin lymphoma of the humerus following traumatic injury: case report

A case of primary non-Hodgkin lymphoma of the right humerus which occurred in a 21-year-old male patient after an impact to the right shoulder in a car accident in July 1983 is described. Seventeen years after the injury, due to a civil lawsuit, the biopsy material was revised. Immunohistochemical analysis showed CD20 and CD79a positivity on large pleomorphic cells, while small reactive lymphocytes were CD3, Bcl-2 and CD20 positive. Molecular analysis carried out with PCR revealed a monoclonal B-lymphocyte population. The diagnosis of diffuse large peripheral B cell lymphoma of the bone was confirmed. The present case concurs with the literature on primary bone lymphoma, in which the diagnostic problem, trauma-related presentation and an excellent prognosis of malignant tumour are emphasized.     

Total circulating B lymphocyte abnormalities in a primary cerebral localization of non-Hodgkin lymphoma: a case report

The authors describe a case of primary central nervous system lymphoma in a 43-year-old male. Interest in this rare form of B-lymphocyte non-Hodgkin's lymphoma is due to its increasing incidence in the last decade, especially in immunodeficient patients. Extraneural involvement was excluded by staging examinations: bilateral bone marrow biopsy from the posterior iliac crest, bipedal lymphography, abdominal CT scan, skeletal, thoracic and gastrointestinal X-rays, spinal puncture, ORL and clinical examination. The peripheral immunologic state was particularly interesting: there was a substantial decrease in total circulating B-lymphocytes at diagnosis (4.4% = 80/mmc; nv 13 +/- 4% = 287 +/- 130/mmc) and a further decrease after 2 and 4 months of therapy (0.16% = 2/mmc). Three months after completion of therapy, the B-lymphocyte level returned to the base level at diagnosis (7% = 88/mmc). At 10 months after diagnosis and 3 months after completion of chemotherapy, the patient is alive and in good health except for the after-effects of a left hemiparesis. The etiologic and possible pathogenic factors are considered.     

Primary non-Hodgkin lymphoma and invasive ductal carcinoma in the same breast: a rare case report

Primary lymphoma of the breast is an unusual clinical entity. The coexistence in the same breast of an invasive ductal carcinoma is even rarer. We report a 69-year-old woman referred for further evaluation of a palpable mass in her right breast. She was diagnosed and treated for simultaneous primary lymphoma and invasive ductal carcinoma. Primary breast lymphoma should always be considered in the differential diagnosis of breast masses. The presence of both malignancies presents a challenge in treatment decisions.     

Bevacizumab induced reversible thrombocytopenia in a patient with recurrent high-grade glioma: a case report

We report a case of bevacizumab (BEV)-induced thrombocytopenia in a 36-year-old woman treated with BEV as a single-agent for a recurrent high-grade glioma. The thrombocytopenia was both reversible and reproducible on multiple treatment cycles. The patient has improved clinically and by brain MR imaging with single-agent BEV for approximately 7 months to date. She did not have bleeding or thromboembolic complications. Treatment delays have been 1–2 weeks relative to a conventional plan of treatment, i.e., 10 mg/kg every 2 weeks. This is a rare complication that has not been previously reported.     

Primary bone non-Hodgkin lymphoma of unusual location in a patient with HIV infection

Non-Hodgkin lymphoma is one of the AIDS-defining diseases associated with HIV infection but presentation as a primary bone lymphoma is rare in HIV infected patients. We report the case of a large B-cell lymphoma with exceptional isolated location at the right fibula presenting in a 34-year-old woman infected by HIV. The patient was treated with CHOP-type chemotherapy followed by involved-field radiotherapy, obtaining sustained complete remission.     

双重打击淋巴瘤一例

患者 男性,48岁.因腹部发现肿物10d余,于2014年2月入我院.无发热、盗汗、体质量下降、中枢神经系统等症状.既往体健.查体：一般情况尚好,肝、脾、浅表淋巴结不大.白细胞计数8.5×109/L,血红蛋白154 g/L,血小板计数232×109/L,肝肾功能、心电图（ECG）正常,乳酸脱氢酶（LDH）225 U/L,β2微球蛋白（β2-MG） 1.5 mg/L.腹部彩色超声示：腹腔及腹膜后肿物直径＞ 10 cm.外科行剖腹探查术,术中见肿块巨大,与胃壁、胰腺、腹主动脉、下腔静脉等重要脏器联系紧密,取部分组织送检.     

Pyothorax-associated T-cell lymphoma: a case report

We present a case of pyothorax-associated T-cell lymphoma in which Epstein-Barr virus (EBV) genome is not detected in the tumor cells. An 80-year-old male came to our hospital because of a left chest pain. Chest computed tomography (CT) showed a mass at the lower-dorsal part of the pyothorax wall, which involved the adjacent chest wall. The surgical biopsy specimen showed a predominant infiltration of atypical lymphocytes. Results of immunohistochemical analysis were as follows: CD3+, CD4-, CD8+, CD20-, CD30-, CD45RO+ and CD79a-. We diagnosed this case as a type of peripheral T-cell lymphoma. In situ hybridization using EBV-encoded RNA-1 (EBER-1) did not reveal the positive signals in the nucleus of tumor cells. Polymerase chain reaction (PCR) analysis yielded a negative result for human herpesvirus 8 (HHV8). Radiation therapy at 54 Gy reduced the tumor size by 90%. Visual and hearing disturbances of unknown etiology developed just before the completion of radiotherapy. The symptoms progressively worsened and the patient became bedridden. He died of pneumonia 2 months after the completion of radiotherapy. Autopsy did not reveal abnormalities to which the neurological disturbances were attributable.     

T-cell lymphoma of the rectum in a patient with AIDS and hepatitis C: a case report and discussion

Primary T-cell non-Hodgkin's lymphoma (NHL) occurring in the context of acquired immune deficiency syndrome (AIDS) is uncommon. Here, we report and discuss such a case presenting in the rectum, and review relevant literature. Although typical in some respects, the case is, in other ways, somewhat unusual for an AIDS-related NHL (ARL); ARL tends to be B cell and advanced stage and our case was T cell and stage IE. In addition, the patient suffered from concomitant cirrhosis related to hepatitis C. Chemotherapeutic options for ARL were limited early in the AIDS epidemic due to poor tolerability. Although this has largely been mitigated by the advent of highly active antiretroviral therapy, our patient eventually suffered complications of chemotherapy, apparently related more to his liver disease than to either his lymphoma or AIDS, that ultimately brought about his demise.     

原发于女性生殖系统的非霍奇金淋巴瘤28例临床研究

目的：探讨原发于女性生殖系统的非霍奇金淋巴瘤(PFGSL)的临床特征、治疗方法及预后的影响因素。方法：回顾性分析28例PFGSL的临床资料,分析其临床分期、恶性程度、病理类型、治疗方法及其与预后的关系,运用SPSS10．0软件包分析其预后的影响因素。结果：28例PFGSL患者中位年龄44岁,病变多累及子宫、宫颈、卵巢和阴道等部位。B细胞来源20例,T细胞来源4例,来源不明4例。依国际工作分类(IWF),中度恶性占66．7％。按An Arbor分期,IE期和Ⅳ期各占42．9％。ⅡE期占10．7％,ⅢE期占3．6％。国际预后指数(IPI)低危10例,低中危9例,中高危3例,高危6例。全组患者中位生存期(MST)2年,5年生存率39．3％。治疗多采用综合治疗,各综合治疗模式对生存率的影响差异无显著性(P=0．2554)。发病部位、分期、IWF及IPI不同,其生存期差异有显著性。结论：PFGSL治疗应采用以化疗为主的综合治疗;发病部位、分期、IFW及IPI是预后的影响因素。     

Peripheral T cell lymphoma in a patient with common variable immunodeficiency disease: case report and literature review

This report documents the occurrence of a peripheral T cell lymphoma arising in the bone marrow and liver of a patient with common variable immunodeficiency disease. The T cell origin of this lymphoma was demonstrated by immunohistochemical phenotyping and gene rearrangement studies and was not associated with EBV infection of the lymphoma cells. The frequency and characteristics of lymphomas complicating CVID are reviewed.