MINI-REVIEW Large Cell Lymphoma Complicating Persistent Polyclonal B
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Synchronous Diagnosis of Multiple Myeloma, Breast Cancer, and Monoclonal B-Cell Lymphocytosis on Initial Presentation
Hindawi Publishing Corporation Case Reports in Oncological Medicine Volume 2016, Article ID 7953745, 4 pages http://dx.doi.org/10.1155/2016/7953745 Case Report Synchronous Diagnosis of Multiple Myeloma, Breast Cancer, and Monoclonal B-Cell Lymphocytosis on Initial Presentation A. Vennepureddy,1 V. Motilal Nehru,1 Y. Liu,2 F. Mohammad,3 andJ.P.Atallah3 1 Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA 2Department of Pathology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA 3Division of Hematology and Oncology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA Correspondence should be addressed to A. Vennepureddy; [email protected] Received 20 December 2015; Accepted 24 April 2016 Academic Editor: Su Ming Tan Copyright © 2016 A. Vennepureddy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The cooccurrence of more than one oncologic illness in a patient can present a diagnostic challenge. Here we report an unusual case of concomitant existence of multiple myeloma, breast cancer, and monoclonal B-cell lymphocytosis on initial presentation. The challenge was to accurately diagnose each disease and stage in order to maximize the therapeutic regimen to achieve cure/remission. Successful management of the patient and increased life expectancy can be achieved by multidisciplinary management and patient- oriented approach in multiple primary malignant synchronous tumors. 1. Introduction different patterns of MPMs should be considered. Thera- peutically, a multidisciplinary and patient-oriented approach Multiple primary malignant tumors (MPMTs) are rarely should be considered. -
Follicular Lymphoma
Follicular Lymphoma What is follicular lymphoma? Let us explain it to you. www.anticancerfund.org www.esmo.org ESMO/ACF Patient Guide Series based on the ESMO Clinical Practice Guidelines FOLLICULAR LYMPHOMA: A GUIDE FOR PATIENTS PATIENT INFORMATION BASED ON ESMO CLINICAL PRACTICE GUIDELINES This guide for patients has been prepared by the Anticancer Fund as a service to patients, to help patients and their relatives better understand the nature of follicular lymphoma and appreciate the best treatment choices available according to the subtype of follicular lymphoma. We recommend that patients ask their doctors about what tests or types of treatments are needed for their type and stage of disease. The medical information described in this document is based on the clinical practice guidelines of the European Society for Medical Oncology (ESMO) for the management of newly diagnosed and relapsed follicular lymphoma. This guide for patients has been produced in collaboration with ESMO and is disseminated with the permission of ESMO. It has been written by a medical doctor and reviewed by two oncologists from ESMO including the lead author of the clinical practice guidelines for professionals, as well as two oncology nurses from the European Oncology Nursing Society (EONS). It has also been reviewed by patient representatives from ESMO’s Cancer Patient Working Group. More information about the Anticancer Fund: www.anticancerfund.org More information about the European Society for Medical Oncology: www.esmo.org For words marked with an asterisk, a definition is provided at the end of the document. Follicular Lymphoma: a guide for patients - Information based on ESMO Clinical Practice Guidelines – v.2014.1 Page 1 This document is provided by the Anticancer Fund with the permission of ESMO. -
Monoclonal B-Cell Lymphocytosis Is Characterized by Mutations in CLL Putative Driver Genes and Clonal Heterogeneity Many Years Before Disease Progression
Leukemia (2014) 28, 2395–2424 © 2014 Macmillan Publishers Limited All rights reserved 0887-6924/14 www.nature.com/leu LETTERS TO THE EDITOR Monoclonal B-cell lymphocytosis is characterized by mutations in CLL putative driver genes and clonal heterogeneity many years before disease progression Leukemia (2014) 28, 2395–2398; doi:10.1038/leu.2014.226 (Beckton Dickinson) and data analyzed using Cell Quest software. On the basis of FACS (fluorescence-activated cell sorting) analysis, we observed after enrichment an average of 91% of CD19+ cells Monoclonal B-cell lymphocytosis (MBL) is defined as an asympto- (range 76–99%) and 91% of the CD19+ fraction were CD19+/CD5+ matic expansion of clonal B cells with less than 5 × 109/L cells in the cells (range 66–99%). We used the values of the CD19+/CD5+ peripheral blood and without other manifestations of chronic fraction to calculate the leukemic B-cell fraction and reduce any lymphocytic leukemia (CLL; for example, lymphadenopathy, cyto- significant contamination of non-clonal B cells in each biopsy. DNA penias, constitutional symptoms).1 Approximately 1% of the MBL was extracted from the clonal B cells and non-clonal (that is, T cells) cohort develops CLL per year. Evidence suggests that nearly all CLL cells using the Gentra Puregene Cell Kit (Qiagen, Hilden, Germany). 2 fi fi cases are preceded by an MBL state. Our understanding of the Extracted DNAs were ngerprinted to con rm the relationship genetic basis, clonal architecture and evolution in CLL pathogenesis between samples of the same MBL individual and to rule out sample has undergone significant improvements in the last few years.3–8 In cross-contamination between individuals. -
Follicular Lymphoma with Leukemic Phase at Diagnosis: a Series Of
Leukemia Research 37 (2013) 1116–1119 Contents lists available at SciVerse ScienceDirect Leukemia Research journa l homepage: www.elsevier.com/locate/leukres Follicular lymphoma with leukemic phase at diagnosis: A series of seven cases and review of the literature a c c c c Brady E. Beltran , Pilar Quinones˜ , Domingo Morales , Jose C. Alva , Roberto N. Miranda , d e e b,∗ Gary Lu , Bijal D. Shah , Eduardo M. Sotomayor , Jorge J. Castillo a Department of Oncology and Radiotherapy, Edgardo Rebagliati Martins Hospital, Lima, Peru b Division of Hematology and Oncology, Rhode Island Hospital, Brown University Alpert Medical School, Providence, RI, USA c Department of Pathology, Edgardo Rebaglati Martins Hospital, Lima, Peru d Department of Hematopathology, MD Anderson Cancer Center, Houston, TX, USA e Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA a r t i c l e i n f o a b s t r a c t Article history: Follicular lymphoma (FL) is a prevalent type of non-Hodgkin lymphoma in the United States and Europe. Received 23 April 2013 Although, FL typically presents with nodal involvement, extranodal sites are less common, and leukemic Received in revised form 25 May 2013 phase at diagnosis is rare. There is mounting evidence that leukemic presentation portends a worse Accepted 26 May 2013 prognosis in patients with FL. We describe 7 patients with a pathological diagnosis of FL who presented Available online 20 June 2013 with a leukemic phase. We compared our cases with 24 additional cases reported in the literature. Based on our results, patients who present with leukemic FL tend to have higher risk disease. -
Occult B-Lymphoproliferative Disorders Andy Rawstron
Occult B-lymphoproliferative Disorders Andy Rawstron To cite this version: Andy Rawstron. Occult B-lymphoproliferative Disorders. Histopathology, Wiley, 2011, 58 (1), pp.81. 10.1111/j.1365-2559.2010.03702.x. hal-00610748 HAL Id: hal-00610748 https://hal.archives-ouvertes.fr/hal-00610748 Submitted on 24 Jul 2011 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Histopathology Occult B-lymphoproliferative Disorders ForJournal: Histopathology Peer Review Manuscript ID: HISTOP-09-10-0521 Wiley - Manuscript type: Review Date Submitted by the 21-Sep-2010 Author: Complete List of Authors: Rawstron, Andy; St. James's Institute of Oncology, HMDS Chronic Lymphocytic Leukaemia, Non-Hodgkin Lymphoma, Keywords: Monoclonal B-cell Lymphocytosis Published on behalf of the British Division of the International Academy of Pathology Page 1 of 22 Histopathology Occult B-lymphoproliferative Disorders Andy C. Rawstron 1,2 Andy C. Rawstron, PhD Consultant Clinical Scientist HMDS, St. James's Institute of Oncology, Bexley Wing, Beckett Street, Leeds LS9 7TF, UK and HYMS, University of York, YO10 5DD, UK. Contact details: tel +44 113 206 8104, fax +44 113 206 7883, email: [email protected] Peer Review Published on behalf of the British Division of the International Academy of Pathology Histopathology Page 2 of 22 Abstract The term Monoclonal B-lymphocytosis (MBL) was recently introduced to identify individuals with a population of monoclonal B-cells in the absence of other features that are diagnostic of a B-lymphoproliferative disorder. -
Non-Hodgkin's Lymphoma Questions and Answers
Non-Hodgkin's Lymphoma Questions and Answers What is Non-Hodgkin's Lymphoma? Non-Hodgkin’s lymphoma (NHL) is a cancer of the lymphocytes, a type of white blood cell. When lymphocytes become cancerous (malignant), they multiply and become tumors. Lymphocytes are normally found in the blood stream and lymph nodes. Lymph nodes are found throughout the body and are identified by their location. They are a part of the body’s immune system, which includes the lymphatic system, spleen and lymphocytes. Some lymph nodes can be found just by feeling them in the neck, groin or under the arms. Some cannot be felt, but they can be seen on X-rays. NHL is the fifth most common cancer in the United States. Men are at slightly higher risk than women. It is more common in adults than children. The average age at diagnosis is 45 to 55 years. The cause of NHL remains unknown. What Are the Types and Symptoms of Non-Hodgkin’s Lymphoma? There are more than 30 different types of NHL. The specific types of NHL are associated with different symptoms. Low-grade or indolent NHL is usually associated with painless swelling of lymph nodes (usually in the neck or over the collarbone), but patients are otherwise healthy. The swelling may go away for a while, but then return. If the low-grade NHL has spread outside of the lymph nodes, such as to the stomach, there may be discomfort in the affected area. Low-grade lymphomas grow slowly. Examples of low-grade NHLs include: Marginal zone lymphomas. -
Non-Hodgkin Lymphoma Booklet
Understanding Non-Hodgkin Lymphoma A Guide for Patients, Survivors, and Loved Ones October 2017 Lymphoma Research Foundation (LRF) Helpline and Clinical Trials Information Service CONTACT THE LRF HELPLINE Trained staff are available to answer questions and provide support to patients, caregivers and healthcare professionals in any language. Our support services include: • Information on lymphoma, treatment options, side effect management and current research fi ndings • Financial assistance for eligible patients and referrals for additional fi nancial, legal and insurance help • Clinical trial searches based on patient’s diagnosis and treatment history • Support through LRF’s Lymphoma Support Network, a national one-to one volunteer patient peer program Monday through Friday, Toll-Free (800) 500-9976 or email [email protected] Understanding Non-Hodgkin Lymphoma A Guide For Patients, Survivors, and Loved Ones October 2017 This guide is an educational resource compiled by the Lymphoma Research Foundation to provide general information on adult non- Hodgkin lymphoma. Publication of this information is not intended to replace individualized medical care or the advice of a patient’s doctor. Patients are strongly encouraged to talk to their doctors for complete information on how their disease should be diagnosed, treated, and followed. Before starting treatment, patients should discuss the potential benefits and side effects of cancer therapies with their physician. Contact the Lymphoma Research Foundation Helpline: (800) 500-9976 [email protected] Website: www.lymphoma.org Email: [email protected] This patient guide is supported through unrestricted educational grants from: © 2017 Lymphoma Research Foundation. Information contained herein is the property of the Lymphoma Research Foundation (LRF). -
Hodgkin Lymphoma
Hodgkin Lymphoma Erica, Hodgkin lymphoma survivor Revised 2016 Publication Update Hodgkin Lymphoma The Leukemia & Lymphoma Society wants you to have the most up-to-date information about blood cancer treatment. See below for important new information that was not available at the time this publication was printed. In May 2017, the Food and Drug Administration (FDA) approved nivolumab (Opdivo®) for the treatment of adult patients with classical Hodgkin lymphoma (HL) that has relapsed or progressed after 3 or more lines of systemic therapy that includes autologous hematopoietic stem cell transplantation (HSCT). It is also approved for the treatment of adult patients with classical HL that has relapsed or progressed after autologous HSCT and brentuximab vedotin. These indications are approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. In March 2017, the Food and Drug Administration (FDA) approved pembrolizumab (Keytruda®) for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma (cHL), or who have relapsed after 3 or more prior lines of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. For more information, contact an Information Specialist at (800) 955-4572 or [email protected]. Information Specialists: 800.955.4572 I www.LLS.org PS57 A Message from Louis J. DeGennaro, PhD President and CEO of The Leukemia & Lymphoma Society The Leukemia & Lymphoma Society (LLS) is the world’s largest voluntary health organization dedicated to finding cures for blood cancer patients. -
Lymphoproliferative Disorders
Lymphoproliferative disorders Dr. Mansour Aljabry Definition Lymphoproliferative disorders Several clinical conditions in which lymphocytes are produced in excessive quantities ( Lymphocytosis) Lymphoma Malignant lymphoid mass involving the lymphoid tissues (± other tissues e.g : skin ,GIT ,CNS …) Lymphoid leukemia Malignant proliferation of lymphoid cells in Bone marrow and peripheral blood (± other tissues e.g : lymph nods ,spleen , skin ,GIT ,CNS …) Lymphoproliferative disorders Autoimmune Infection Malignant Lymphocytosis 1- Viral infection : •Infectious mononucleosis ,cytomegalovirus ,rubella, hepatitis, adenoviruses, varicella…. 2- Some bacterial infection: (Pertussis ,brucellosis …) 3-Immune : SLE , Allergic drug reactions 4- Other conditions:, splenectomy, dermatitis ,hyperthyroidism metastatic carcinoma….) 5- Chronic lymphocytic leukemia (CLL) 6-Other lymphomas: Mantle cell lymphoma ,Hodgkin lymphoma… Infectious mononucleosis An acute, infectious disease, caused by Epstein-Barr virus and characterized by • fever • swollen lymph nodes (painful) • Sore throat, • atypical lymphocyte • Affect young people ( usually) Malignant Lymphoproliferative Disorders ALL CLL Lymphomas MM naïve B-lymphocytes Plasma Lymphoid cells progenitor T-lymphocytes AML Myeloproliferative disorders Hematopoietic Myeloid Neutrophils stem cell progenitor Eosinophils Basophils Monocytes Platelets Red cells Malignant Lymphoproliferative disorders Immature Mature ALL Lymphoma Lymphoid leukemia CLL Hairy cell leukemia Non Hodgkin lymphoma Hodgkin lymphoma T- prolymphocytic -
Understanding Chronic Lymphocytic Leukemia/ Small Lymphocytic Lymphoma
Understanding Chronic Lymphocytic Leukemia/ Small Lymphocytic Lymphoma Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are forms of non-Hodgkin lymphoma (NHL) that arise from B lymphocytes. CLL and SLL are essentially the same disease, with the only difference being the location where the cancer primarily occurs. When most of the cancer cells are located in the bloodstream and the bone marrow, the disease is referred to as CLL, although the lymph nodes and spleen are often involved. When the cancer cells are located mostly in the lymph nodes and are less frequent in the blood, the disease is called SLL. Many patients with CLL/SLL do not have any obvious symptoms of the disease. Their doctors might detect the disease during routine blood tests and/or a physical examination. For others, the disease is detected when symptoms occur and the patient goes to the doctor because he or she is worried, uncomfortable, or does not feel well. CLL/SLL may cause different symptoms depending on the location of the tumor in the body, including fatigue (extreme tiredness), shortness of breath, anemia (low red blood cell count), bruising easily, night sweats, weight loss, frequent infections. Other symptoms can include a swollen abdomen and feeling full even after eating only a small amount. However, many patients with CLL/SLL will live for years without symptoms. TREATMENT OPTIONS • Chlorambucil (Leukeran) and obinutuzumab (Gazyva) • Venetoclax (Venclexta) and obinutuzumab (Gazyva) Treatment is based on the severity of associated symptoms Occasionally patients might also be treated with chemotherapy, as well as the rate of cancer growth. -
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines® ) Non-Hodgkin’S Lymphomas Version 2.2015
NCCN Guidelines Index NHL Table of Contents Discussion NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines® ) Non-Hodgkin’s Lymphomas Version 2.2015 NCCN.org Continue Version 2.2015, 03/03/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN® . Peripheral T-Cell Lymphomas NCCN Guidelines Version 2.2015 NCCN Guidelines Index NHL Table of Contents Peripheral T-Cell Lymphomas Discussion DIAGNOSIS SUBTYPES ESSENTIAL: · Review of all slides with at least one paraffin block representative of the tumor should be done by a hematopathologist with expertise in the diagnosis of PTCL. Rebiopsy if consult material is nondiagnostic. · An FNA alone is not sufficient for the initial diagnosis of peripheral T-cell lymphoma. Subtypes included: · Adequate immunophenotyping to establish diagnosisa,b · Peripheral T-cell lymphoma (PTCL), NOS > IHC panel: CD20, CD3, CD10, BCL6, Ki-67, CD5, CD30, CD2, · Angioimmunoblastic T-cell lymphoma (AITL)d See Workup CD4, CD8, CD7, CD56, CD57 CD21, CD23, EBER-ISH, ALK · Anaplastic large cell lymphoma (ALCL), ALK positive (TCEL-2) or · ALCL, ALK negative > Cell surface marker analysis by flow cytometry: · Enteropathy-associated T-cell lymphoma (EATL) kappa/lambda, CD45, CD3, CD5, CD19, CD10, CD20, CD30, CD4, CD8, CD7, CD2; TCRαβ; TCRγ Subtypesnot included: · Primary cutaneous ALCL USEFUL UNDER CERTAIN CIRCUMSTANCES: · All other T-cell lymphomas · Molecular analysis to detect: antigen receptor gene rearrangements; t(2;5) and variants · Additional immunohistochemical studies to establish Extranodal NK/T-cell lymphoma, nasal type (See NKTL-1) lymphoma subtype:βγ F1, TCR-C M1, CD279/PD1, CXCL-13 · Cytogenetics to establish clonality · Assessment of HTLV-1c serology in at-risk populations. -
Hodgkin's Disease Variant of Richter's Syndrome in Chronic Lymphocytic Leukaemia Patients Previously Treated with Fludarabin
research paper Hodgkin’s disease variant of Richter’s syndrome in chronic lymphocytic leukaemia patients previously treated with fludarabine Dominic Fong,1 Alexandra Kaiser,2 Summary Gilbert Spizzo,1 Guenther Gastl,1 Alexandar Tzankov2 The transformation of chronic lymphocytic leukaemia (CLL) into large-cell 1Division of Haematology and Oncology and lymphoma (Richter’s syndrome, RS) is a well-documented phenomenon. 2Department of Pathology, Innsbruck Medical Only rarely does CLL transform into Hodgkin’s lymphoma (HL). To further University, Innsbruck, Austria analyse the clinico-pathological and genetic findings in the HL variant of RS, we performed a single-institution study in four patients, who developed HL within a mean of 107 months after diagnosis of CLL. All were treated with fludarabine. Three cases were Epstein–Barr virus (EBV)-associated mixed cellularity (MC) HL, the fourth was nodular sclerosis (NS) HL without EBV association. The sites involved by HL included supra- and infradiaphragmal lymph nodes and the tonsils; stage IV disease was also documented. All patients presented with CLL treatment-resistant lymphadenopathies and B- symptoms. In two of the MC cases, molecular analysis performed on CLL samples and microdissected Hodgkin and Reed–Sternberg cells (HRSC) suggested a clonal relationship, while in NS no indication of a clonal relationship was detected. In summary, HL can occur in CLL patients at any Received 15 December 2004; accepted for site, up to 17 years after initial diagnosis, especially after treatment with publication 1 February 2005 fludarabine. The majority present with B-symptoms and CLL treatment- Correspondence: A. Tzankov MD, Department resistant lymphadenopathy, are of the MC type, clonally related to CLL and of Pathology, Innsbruck Medical University, might be triggered by an EBV infection.