Psychotic manifestations of brain tumours are rare but described in the literature mostly along with other neurological defcits. Memory loss, diffculty in attention and concentration, depression, anxiety, and mood sym...Psychotic manifestations of brain tumours are rare but described in the literature mostly along with other neurological defcits. Memory loss, diffculty in attention and concentration, depression, anxiety, and mood symptoms are commonly described in brain tumours. A schizophrenia-like picture without a defcit in motor or sensory function may land the clinician into a diagnostic dilemma. Primary central nervous system lymphoma （PCNSL） is a highly malignant disease with high mortality and needs immediate attention. Our case which had a unique recurrence in the postoperative period with psychotic symptoms can be an eye-opener to be more vigilant about underlying clinical extension.展开更多
Objective: To gain more data for the diagnosis and treatment for primary hepatic lymphoma(PHL). Methods: A 32-year-old man was admitted due to fatigue, anorexia, loss of weight and fever. Physical examination was carr...Objective: To gain more data for the diagnosis and treatment for primary hepatic lymphoma(PHL). Methods: A 32-year-old man was admitted due to fatigue, anorexia, loss of weight and fever. Physical examination was carried out and bone marrow aspitation, blood culture, endoscopy of stomach and colon, chest X-ray, renal fumction and liver function test were all done. Results: Physical examination showed slight abdominal tenderness all edema of the legs, and the liver was unpalpable. Alpha- fetoprotein (AFP ) and carcinomoembryonic antigen (CEA ) were negative. Laboratory tests of rheumatic diseases such as ANA and ENA were all normal. Abdominal ultrasonography and computerized tomography showed diffuse low density or diffuse hypoechogenic changes of the liver, there was no obvious mass lesion in the liver. Conclusion: The diagnosis of PHL was affirmed, and the subtype was non-Hodgkin’s lymphoma.展开更多
To comparatively study the sensitivity and specificity of 67Ga planar and SPECT images in diagnosis of non-Hodgkin’s lymphoma. Methods Simultaneous 67Ga planar and SPECT were conducted by using Sopha DS7 SPECF for 48...To comparatively study the sensitivity and specificity of 67Ga planar and SPECT images in diagnosis of non-Hodgkin’s lymphoma. Methods Simultaneous 67Ga planar and SPECT were conducted by using Sopha DS7 SPECF for 48 intermediate lesions in 30 patients that had been pathologically confirmed, with their healthy counterparts as controls. Results Thesensitivity of planar images in head-neck, chest and abdomen was 60.0%, 72.7% and 72.7% respectively, and that of SPECTwas 93.3%, 90.9% and 81.8% respectively. The planar imaging had a general false-neck rate of 31.3%, 2.5 times higherthan SPECF imaging (12.5%) had. Both of them had the same false-positive rate (6.3%). Conclusion SPECT imaging is superior in sensitivity to planar imaging for head-neck, chest and abdomen in detection of intermediate NHL.展开更多
18F-FDG PET/CT was used for evaluation of spleen infiltration in patients with B-cell non-Hodgkin lymphoma(NHL).Five patients with histological diagnosed B-cell NHL underwent1 8F-FDG PET/CT examination.On integrated P...18F-FDG PET/CT was used for evaluation of spleen infiltration in patients with B-cell non-Hodgkin lymphoma(NHL).Five patients with histological diagnosed B-cell NHL underwent1 8F-FDG PET/CT examination.On integrated PET/CT image,spleen infiltration was considered when PET images revealed a discrete margin of solid splenic masses or diffuse lesion of spleen with higher maximum standardized uptake value(SUV) greater than those of normal liver structures.CT images demonstrating a positive splenic index(>480 mL)or focal hypodensities were classified as positive for spleen infiltration.All the patients underwent systemic chemotherapy.The1 8F-FDG PET and CT results were compared with final diagnoses.All patients had spleen infiltration originating from B-cell NHL at final diagnosis.Final diagnoses,which were confirmed by clinical and CT(n=3) or1 8F-FDG PET/CT(n=1) follow-up in 4 patients and biopsy of 1 patient.On integrated PET/CT image,1 8F-FDG PET was true-positive in all 5 patients with spleen infiltration.CT was true-positive in 4 of the 5 patients with spleen infiltration and false-negative in 1 patients (spleen infiltration without morphology changes).The accuracies of1 8F-FDG PET and CT for evaluating the spleen infiltration were 100% and 80% at staging,respectively.Our preliminary results suggested metabolic imaging of1 8F-FDG PET/CT may be helpful in the diagnosis of spleen infiltration in B-cell NHL patients.These patients may benefit from1 8F-FDG PET/CT in diagnosis,when spleen infiltration without morphology changes,which may not be diagnosed exactly by conventional image.展开更多
KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt...KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt renal disease including acute kidney injury （AKI） as its primary manifestation is rarely reported, moreover, Fanconi syndrome （FS） is extremely rare as the main manifestation in NHL. In this report, we presented a case of NHL primarily presenting with FS and AKI due to diffuse interstitial infiltration of NHL cells and emphasized the important role of renal biopsy, especially renal immunohistochemical analysis in the diagnosis of renal diffuse lymphoma.展开更多
A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma(PGDLBL)by PET/CT examination,gastroscopy,biopsy and histopathological analysis at a regular physical check in April,2016.The patient r...A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma(PGDLBL)by PET/CT examination,gastroscopy,biopsy and histopathological analysis at a regular physical check in April,2016.The patient received R-CO chemotherapy(rituximab,cyclophosphamide,and vincristine)and radiotherapy subsequently,with enteral nutritional treatment through 3-cavity nasogastric tube due to development of pyloric obstruction.To satisfy patient's strong desire of eating by himself,we performed surgery of exploratory laparotomy and Roux-en-Y gastric bypass(RGB)to relieve pylorus obstruction.Postoperatively,the patient resumed oral feeding,supplemented by nasogastric tube feeding at 1350-1550 Kcal daily.He is now 94 years old with fairly well nutrition and normal communication.The outcome of 4 year follow-up suggests that nutritional treatment and palliative medicine are important for improving prognosis and life-quality of very elderly patients with end-stage tumors apart from the effective chemotherapy,radiotherapy,and surgery.展开更多
Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative...Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative MRI data of 81 patients with glioblastoma and 28 patients with primary CNS lymphoma admitted to the Chinese PLA General Hospital and Hainan Hospital of Chinese PLA General Hospital were retrospectively collected. All patients underwent plain MR imaging and enhanced T1 weighted imaging to visualize imaging features of lesions. Texture analysis of T2 weighted imaging(T2 WI) was performed by use of GLCM texture plugin of ImageJ software, and the texture parameters including Angular Second Moment(ASM), Contrast, Correlation, Inverse Difference Moment(IDM), and Entropy were measured. Independent sample t-test and Mann-Whitney U test were performed for the between-group comparisons, regression model was established by Binary Logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to compare the diagnostic efficacy. Results The conventional imaging features including cystic and necrosis changes(P = 0.000), ‘Rosette' changes(P = 0.000) and ‘incision sign'(P = 0.000), except ‘flame-like edema'(P = 0.635), presented significantly statistical difference between glioblastoma and primary CNS lymphoma. The texture features, ASM, Contrast, Correlation, IDM and Entropy, showed significant differences between glioblastoma and primary CNS lympoma(P = 0.006,0.000, 0.002, 0.000, and 0.015 respectively). The area under the ROC curve was 0.671, 0.752, 0.695, 0.720 and 0.646 respectively, and the area under the ROC curve was 0.917 for the combined texture variables(Contrast, cystic and necrosis, ‘Rosette' changes, and ‘incision sign') in the model of Logistic regression. Binary Logistic regression analysis demonstrated that cystic and necrosis changes, ‘Rosette' changes and ‘incision sign' and texture Contrast could be considered as the specific texture variables for the differential diagnosis of glioblastoma and primary CNS lymphoma. Conclusion The texture features of T2 WI and conventional imaging findings may be used to distinguish glioblastoma from primary CNS lymphoma.展开更多
PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Prim...PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Primary thyroid lymphoma （PTL） is a lymphomatous process which develops in the thyroid without involvement of primary lymphoid organs or distant metastases at diagnosis.2 It is a rare malignancy that accounts for 1%-5% of all thyroid malignancies and less than 2% of all extranodal lymphomas. The incidence of PTL is one or two cases per million.2＇ 3 It occurs frequently in elder woman, with a peak incidence in the sixth decade of life.展开更多
Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. ...Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.展开更多
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 ...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.展开更多
Objective To construct hu-PBL/SCID chimeras and to investigate the development of lymphoma and oncogenicity of the Epstein-Barr virus (EBV). Methods Human peripheral blood lymphocytes (PBLs) were isolated from healthy...Objective To construct hu-PBL/SCID chimeras and to investigate the development of lymphoma and oncogenicity of the Epstein-Barr virus (EBV). Methods Human peripheral blood lymphocytes (PBLs) were isolated from healthy adult donors and transplanted intraperitoneally into severe combined immunodeficient(SCID) mice. Mice with hu-PBL engraftment from healthy EBV seronegative donors were injected intraperitoneally with EBV-containing supernatant from suspension culture of B95-8 cell line (active infection), whereas mice receiving lymphocytes from healthy EBV seropositive donors were not re-infected with B95-8 derived EBV (latent infection). Pathological examination and molecular analysis were performed on experime-ntal animals and induced neoplasms. Results In the early stage of this experiment, 12 mice died of acute graft-versus-host disease, mortality was 34.3% (12/35 mice) with an average life span of 17.5 days. In 19 survival hu-PBL/SCID chimeric recipients from 12 healthy donors, tumor incidence was 84.2% (16/19 mice). The average survival time of tumor-bearing mice was 65.5 days. EBV-related neoplasms in SCID mice were nodular tumors with aggressive and fatal features. Histological morphology of tumors exhibited diffuse large cell lymphomas. Immunohistochemistry revealed that LCA (CD45) and L26 (CD20) were positive, but both PS1 (CD3) and UCHL-1 (CD45RO) were negative, and EBV products ZEBRA, LMP1, and EBNA2 were expressed in a small number of tumor cells. EB virus particles were seen in the nuclei of some tumor cells by electron microscopy, and EBV DNA could be amplified in the tumor tissues by PCR. In situ hybridization indicated that the nuclei of tumor cells contained human-specific Alu sequence. Conclusions EBV-induced tumors were human B-cell malignant lymphomas. We obtained direct causative evidence dealing with EBV-associated tumor deriving from normal human cells.展开更多
Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage ...Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital.The median age of these patients was 53.36±14.45 years.Female-male ratio was 1:1.2.The average course of disease was 10.82±3.37 years.All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51(40-74) Gy in an average of 24.55±5.57(20-40) fractions,5 fractions per week.Results The median follow-up time was 55.27±29.3(13-103) months.No severe acute or chronic side effects of irradiation were observed.Complete clinical response(CR) rate of the radiated sites was 54.5%(6/11),partial response(PR) rate was 36.4%(4/11),and the overall response rate(CR+PR) was 90.9%.One patient showed no response.Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.展开更多
BACKGROUND:Perforin gene(PRF1) mutations have been reported in patients with lymphoma,but the prevalence and characteristics of PRF1 mutation have not been identified in Chinese patients with lymphoma.METHODS:Seventy-...BACKGROUND:Perforin gene(PRF1) mutations have been reported in patients with lymphoma,but the prevalence and characteristics of PRF1 mutation have not been identified in Chinese patients with lymphoma.METHODS:Seventy-seven patients with lymphoma,including 6 patients with Hodgkin lymphoma and 71 patients with non-Hodgkin lymphoma,were recruited.DNA samples from peripheral blood were used for PRF1 mutation detection by the PCR-sequencing method.RESULTS:Eleven novel PRF1 mutations were found in 8 of the 77 patients with lymphoma.Biallelic or compound monoallelic missense mutations in 3 patients indicated the severe impairment of perforin function,monoallelic missense mutations in 3 patients possibly contributed a genetic predisposition to malignancies,and synonymous mutations in 2 patients showed unknown significance.CONCLUSIONS:The frequency of EBV infection was similar in lymphoma patients with PRF1 mutations and those without the mutations.The same PRF1 mutations were also found in DNA samples from nails or hair follicles from 4 patients with PRF1 mutations,suggesting that these mutations may be of germ-line origin.展开更多
The gene rearrangement of βand γchain of T-cell receptors (TCR) was detected in 13 cases of non-Hodgkin's lymphoma with T-cell immunophenotype with Southern blot and PCR. Clonally rearranged.TCR βgene was seen ...The gene rearrangement of βand γchain of T-cell receptors (TCR) was detected in 13 cases of non-Hodgkin's lymphoma with T-cell immunophenotype with Southern blot and PCR. Clonally rearranged.TCR βgene was seen in 11 cases out of the 13 and rearranged TCR γgene in 12. These facts suggest that clonal rearrangement of antigen receptors is a sensitive and specific marker to establish the T-cell monoclonality and lineage and a useful adjunct to morphological diagnosis and immunophenotyping.展开更多
Objective To search novel method for diagnosis and therapy of B-lymphoma, specific small mo-lecular peptide ligands against binding site of tumor cells were screened and its effects on signal transduction and cell apo...Objective To search novel method for diagnosis and therapy of B-lymphoma, specific small mo-lecular peptide ligands against binding site of tumor cells were screened and its effects on signal transduction and cell apoptosis were tested. Methods Specific peptide ligands were screened by binding with site of human B lymphoma cell(OC1LY8)using peptide-bead libraries. The identified peptides were characterized with responsible cellsby rebinding test. The role of tyrosine phosphorylation of peptide ligand was tested by Western blot; and its apoptosispromoting role was observed by confocal fluorescent microscope. Results Specific peptide ligand was able to bind specifically to site on cell surface and enter into cytoplasm. Tetrameric peptide ligand was able to strongly trigger signal transduction resulting in tyrosine phosphorylation and cellular apoptosis in OC1LY8 cell line. Conclusion Screened peptide ligand can effectively bind with OC1LY8 cell, stimulate cellular tyro-sine phosphorylation and induce cellular apoptosis.展开更多
Proliferative activity in 106 cases of non-Hodgkin’s lymphoma was estimated using the monoclonal antibody Ki67 and by counting the number of mitotic figures. The percentage of Ki67-positive cells was compared with th...Proliferative activity in 106 cases of non-Hodgkin’s lymphoma was estimated using the monoclonal antibody Ki67 and by counting the number of mitotic figures. The percentage of Ki67-positive cells was compared with the median number of mitotic figures per square millimeter. Both Ki67 positivity and the number of mitotic figures were found to be greater in high grade than in low grade lymphomas, although there was an overlap between the two grades of malignancy. A close correlation was found between the number of mitotic figures and the percentage of Ki67-positive cells not only in all lymphoma typo taken together (r_s= 0. 834 . P<0. 001). but also in B-cell lymphoma (r_s= 0. 8 1 P< 0. 001) and T-cell lymphoma (r_s = 0. 764. P<0. 00 1) taken seprately. Thus, both methods are useful for the estimation of proliferative activity. but each method has its advantages and disadvantages.展开更多
Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT ...Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT scans were done on all patients, enhanced CT scans simultaneously with 5-10 mm section thickness, and 5-10 mm table increments in 6 cases. Results: Primary involved sites were on the cecum (n=3), the ascending colon (n=2), and the rectum (n=1). The tumor was found in multiple areas of the large bowel in 2 cases. CT appearance fell into 3 typical patterns in our study. The first was focal mass type in 2 cases, with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases, with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases. Multiple nodules were seen in the rectum in 1 case. Conclusion: CT was found to be accurate in detecting the primary sites and complications of lymphoma, and evaluating invasion of adjacent structures; Focal mass type, segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.展开更多
We describe a 70-year-old female patient with diffuse large B-cell lymphoma of the cerebellum;she received resection of a left atrial myxoma five months ago.To the best of our knowledge,to date no association of atria...We describe a 70-year-old female patient with diffuse large B-cell lymphoma of the cerebellum;she received resection of a left atrial myxoma five months ago.To the best of our knowledge,to date no association of atrial myxoma with the malignant cerebellar diffuse large B-cell lymphoma has been reported in the literature,except for high level of interleukin-6 (IL-6) in the serum under both conditions.IL-6 as a pro-inflammatory cytokine has been shown to be associated with tumor progression,including inhibition of cancer cell apoptosis and stimulation of angiogenesis.IL-6 concentrations may provide possible aetiological links between atrial myxoma and cerebellar diffuse large B-cell lymphoma in our case.展开更多
Background:Patient outcomes are poor for aggressive B-cell non-Hodgkin's lymphomas not responding to or progressing within 12 months after first-line therapy.Tisagenlecleucel is an anti-CD19 chimeric antigen recep...Background:Patient outcomes are poor for aggressive B-cell non-Hodgkin's lymphomas not responding to or progressing within 12 months after first-line therapy.Tisagenlecleucel is an anti-CD19 chimeric antigen receptor T-cell therapy approved for diffuse large B-cell lymphoma after at least two treatment lines.Methods:We conducted an international phase 3 trial involving patients with aggressive lymphoma that was refractory to or progressing within 12 months after first-line therapy.Patients were randomly assigned to receive tisagenlecleucel with optional bridging therapy(tisagenlecleucel group)or salvage chemotherapy and autologous hematopoietic stem-cell transplantation(HSCT)(standard-care group).The primary end point was event-free survival,defined as the time from randomization to stable or progressive disease at or after the week 12 assessment or death.Crossover to receive tisagenlecleucel was allowed if a defined event occurred at or after the week 12 assessment.Other end points included response and safety.展开更多
To detect the prognostic significance of interim F-FDG PET/CT SUV(standard uptake value) reduction(△SUV_(max)) associated with Ki67 in patients with diffuse large B cell lymphoma(DLBCL).47 DLBCL patients underwent PE...To detect the prognostic significance of interim F-FDG PET/CT SUV(standard uptake value) reduction(△SUV_(max)) associated with Ki67 in patients with diffuse large B cell lymphoma(DLBCL).47 DLBCL patients underwent PET/CT before initiation and after 2-4 cycles of chemotherapy were included.The SUV_(max)of the dominant lesions were calculated.Ki67 positive indices were provided by enzyme-labeled immunohistochemistry.SPSS17.0 was used for statistical analysis.ASUV_(max) of different groups were compared by t test.Receiver-operator characteristic analysis was performed to determine the optimal cutoff values.KaplanMeier analyses of PFS(Progression-free survival) were compared using log-rank test.The average of △SUV_(max)and △SUV_(max)%were 11.53 and 69.10%,respectively.The optimal cutoff values of △SUV_(max)x and △SUV_(max)%were 11.45 and 82.92%,respectively.Higher △SUV_(max) and △SUV_(max)%indicated longer PFS(p < 0.001).The optimal cutoff value of Ki67 was 55%.Ki67>55%was revealed to be an indicator of shorter PFS(p = 0.019).Either △SUV_(max)≤11.45 or Ki67>55%was defined as an indicator to poor outcome and scored 1 point.The PFS rate was 100%in patients scored 0 point,yet 0%in patients scored 2 points.PFS tended to be shorter along with the score getting higher(p = 0.006).△SUV_(max) and Ki67 positive index were both of significance in DLBCL prognosis.The prognostic value may be confirmed when △SUV_(max) was accordant with Ki67.展开更多
文摘Psychotic manifestations of brain tumours are rare but described in the literature mostly along with other neurological defcits. Memory loss, diffculty in attention and concentration, depression, anxiety, and mood symptoms are commonly described in brain tumours. A schizophrenia-like picture without a defcit in motor or sensory function may land the clinician into a diagnostic dilemma. Primary central nervous system lymphoma （PCNSL） is a highly malignant disease with high mortality and needs immediate attention. Our case which had a unique recurrence in the postoperative period with psychotic symptoms can be an eye-opener to be more vigilant about underlying clinical extension.
文摘Objective: To gain more data for the diagnosis and treatment for primary hepatic lymphoma(PHL). Methods: A 32-year-old man was admitted due to fatigue, anorexia, loss of weight and fever. Physical examination was carried out and bone marrow aspitation, blood culture, endoscopy of stomach and colon, chest X-ray, renal fumction and liver function test were all done. Results: Physical examination showed slight abdominal tenderness all edema of the legs, and the liver was unpalpable. Alpha- fetoprotein (AFP ) and carcinomoembryonic antigen (CEA ) were negative. Laboratory tests of rheumatic diseases such as ANA and ENA were all normal. Abdominal ultrasonography and computerized tomography showed diffuse low density or diffuse hypoechogenic changes of the liver, there was no obvious mass lesion in the liver. Conclusion: The diagnosis of PHL was affirmed, and the subtype was non-Hodgkin’s lymphoma.
文摘To comparatively study the sensitivity and specificity of 67Ga planar and SPECT images in diagnosis of non-Hodgkin’s lymphoma. Methods Simultaneous 67Ga planar and SPECT were conducted by using Sopha DS7 SPECF for 48 intermediate lesions in 30 patients that had been pathologically confirmed, with their healthy counterparts as controls. Results Thesensitivity of planar images in head-neck, chest and abdomen was 60.0%, 72.7% and 72.7% respectively, and that of SPECTwas 93.3%, 90.9% and 81.8% respectively. The planar imaging had a general false-neck rate of 31.3%, 2.5 times higherthan SPECF imaging (12.5%) had. Both of them had the same false-positive rate (6.3%). Conclusion SPECT imaging is superior in sensitivity to planar imaging for head-neck, chest and abdomen in detection of intermediate NHL.
基金Supported by Commission of Science and Technology of Xiamen City (Grant No.3502720077056)
文摘18F-FDG PET/CT was used for evaluation of spleen infiltration in patients with B-cell non-Hodgkin lymphoma(NHL).Five patients with histological diagnosed B-cell NHL underwent1 8F-FDG PET/CT examination.On integrated PET/CT image,spleen infiltration was considered when PET images revealed a discrete margin of solid splenic masses or diffuse lesion of spleen with higher maximum standardized uptake value(SUV) greater than those of normal liver structures.CT images demonstrating a positive splenic index(>480 mL)or focal hypodensities were classified as positive for spleen infiltration.All the patients underwent systemic chemotherapy.The1 8F-FDG PET and CT results were compared with final diagnoses.All patients had spleen infiltration originating from B-cell NHL at final diagnosis.Final diagnoses,which were confirmed by clinical and CT(n=3) or1 8F-FDG PET/CT(n=1) follow-up in 4 patients and biopsy of 1 patient.On integrated PET/CT image,1 8F-FDG PET was true-positive in all 5 patients with spleen infiltration.CT was true-positive in 4 of the 5 patients with spleen infiltration and false-negative in 1 patients (spleen infiltration without morphology changes).The accuracies of1 8F-FDG PET and CT for evaluating the spleen infiltration were 100% and 80% at staging,respectively.Our preliminary results suggested metabolic imaging of1 8F-FDG PET/CT may be helpful in the diagnosis of spleen infiltration in B-cell NHL patients.These patients may benefit from1 8F-FDG PET/CT in diagnosis,when spleen infiltration without morphology changes,which may not be diagnosed exactly by conventional image.
文摘KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt renal disease including acute kidney injury （AKI） as its primary manifestation is rarely reported, moreover, Fanconi syndrome （FS） is extremely rare as the main manifestation in NHL. In this report, we presented a case of NHL primarily presenting with FS and AKI due to diffuse interstitial infiltration of NHL cells and emphasized the important role of renal biopsy, especially renal immunohistochemical analysis in the diagnosis of renal diffuse lymphoma.
基金the Millitary Logistical Special Project for Health Care(18BJZ07)。
文摘A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma(PGDLBL)by PET/CT examination,gastroscopy,biopsy and histopathological analysis at a regular physical check in April,2016.The patient received R-CO chemotherapy(rituximab,cyclophosphamide,and vincristine)and radiotherapy subsequently,with enteral nutritional treatment through 3-cavity nasogastric tube due to development of pyloric obstruction.To satisfy patient's strong desire of eating by himself,we performed surgery of exploratory laparotomy and Roux-en-Y gastric bypass(RGB)to relieve pylorus obstruction.Postoperatively,the patient resumed oral feeding,supplemented by nasogastric tube feeding at 1350-1550 Kcal daily.He is now 94 years old with fairly well nutrition and normal communication.The outcome of 4 year follow-up suggests that nutritional treatment and palliative medicine are important for improving prognosis and life-quality of very elderly patients with end-stage tumors apart from the effective chemotherapy,radiotherapy,and surgery.
文摘Objective To investigate the difference in tumor conventional imaging findings and texture features on T2 weighted images between glioblastoma and primary central neural system(CNS) lymphoma. Methods The pre-operative MRI data of 81 patients with glioblastoma and 28 patients with primary CNS lymphoma admitted to the Chinese PLA General Hospital and Hainan Hospital of Chinese PLA General Hospital were retrospectively collected. All patients underwent plain MR imaging and enhanced T1 weighted imaging to visualize imaging features of lesions. Texture analysis of T2 weighted imaging(T2 WI) was performed by use of GLCM texture plugin of ImageJ software, and the texture parameters including Angular Second Moment(ASM), Contrast, Correlation, Inverse Difference Moment(IDM), and Entropy were measured. Independent sample t-test and Mann-Whitney U test were performed for the between-group comparisons, regression model was established by Binary Logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to compare the diagnostic efficacy. Results The conventional imaging features including cystic and necrosis changes(P = 0.000), ‘Rosette' changes(P = 0.000) and ‘incision sign'(P = 0.000), except ‘flame-like edema'(P = 0.635), presented significantly statistical difference between glioblastoma and primary CNS lymphoma. The texture features, ASM, Contrast, Correlation, IDM and Entropy, showed significant differences between glioblastoma and primary CNS lympoma(P = 0.006,0.000, 0.002, 0.000, and 0.015 respectively). The area under the ROC curve was 0.671, 0.752, 0.695, 0.720 and 0.646 respectively, and the area under the ROC curve was 0.917 for the combined texture variables(Contrast, cystic and necrosis, ‘Rosette' changes, and ‘incision sign') in the model of Logistic regression. Binary Logistic regression analysis demonstrated that cystic and necrosis changes, ‘Rosette' changes and ‘incision sign' and texture Contrast could be considered as the specific texture variables for the differential diagnosis of glioblastoma and primary CNS lymphoma. Conclusion The texture features of T2 WI and conventional imaging findings may be used to distinguish glioblastoma from primary CNS lymphoma.
基金Supported by the Natural Science Foundation of China(81541131)
文摘PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Primary thyroid lymphoma （PTL） is a lymphomatous process which develops in the thyroid without involvement of primary lymphoid organs or distant metastases at diagnosis.2 It is a rare malignancy that accounts for 1%-5% of all thyroid malignancies and less than 2% of all extranodal lymphomas. The incidence of PTL is one or two cases per million.2＇ 3 It occurs frequently in elder woman, with a peak incidence in the sixth decade of life.
文摘Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.
文摘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.
基金Supportedby the National Natural Science Foundation of China(39730200) and by a specialgrantfrom Departmentof Education,Hunan Province(02B040 ).
文摘Objective To construct hu-PBL/SCID chimeras and to investigate the development of lymphoma and oncogenicity of the Epstein-Barr virus (EBV). Methods Human peripheral blood lymphocytes (PBLs) were isolated from healthy adult donors and transplanted intraperitoneally into severe combined immunodeficient(SCID) mice. Mice with hu-PBL engraftment from healthy EBV seronegative donors were injected intraperitoneally with EBV-containing supernatant from suspension culture of B95-8 cell line (active infection), whereas mice receiving lymphocytes from healthy EBV seropositive donors were not re-infected with B95-8 derived EBV (latent infection). Pathological examination and molecular analysis were performed on experime-ntal animals and induced neoplasms. Results In the early stage of this experiment, 12 mice died of acute graft-versus-host disease, mortality was 34.3% (12/35 mice) with an average life span of 17.5 days. In 19 survival hu-PBL/SCID chimeric recipients from 12 healthy donors, tumor incidence was 84.2% (16/19 mice). The average survival time of tumor-bearing mice was 65.5 days. EBV-related neoplasms in SCID mice were nodular tumors with aggressive and fatal features. Histological morphology of tumors exhibited diffuse large cell lymphomas. Immunohistochemistry revealed that LCA (CD45) and L26 (CD20) were positive, but both PS1 (CD3) and UCHL-1 (CD45RO) were negative, and EBV products ZEBRA, LMP1, and EBNA2 were expressed in a small number of tumor cells. EB virus particles were seen in the nuclei of some tumor cells by electron microscopy, and EBV DNA could be amplified in the tumor tissues by PCR. In situ hybridization indicated that the nuclei of tumor cells contained human-specific Alu sequence. Conclusions EBV-induced tumors were human B-cell malignant lymphomas. We obtained direct causative evidence dealing with EBV-associated tumor deriving from normal human cells.
文摘Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides(MF).Methods From January 2008 to January 2013,a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital.The median age of these patients was 53.36±14.45 years.Female-male ratio was 1:1.2.The average course of disease was 10.82±3.37 years.All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51(40-74) Gy in an average of 24.55±5.57(20-40) fractions,5 fractions per week.Results The median follow-up time was 55.27±29.3(13-103) months.No severe acute or chronic side effects of irradiation were observed.Complete clinical response(CR) rate of the radiated sites was 54.5%(6/11),partial response(PR) rate was 36.4%(4/11),and the overall response rate(CR+PR) was 90.9%.One patient showed no response.Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.
基金supported by the grants from the International S&T Cooperation Project from Ministry of Science&Technology of China(2006DFB31430)National 863 High-Tech Research and Development Program of China(2008AA02503)
文摘BACKGROUND:Perforin gene(PRF1) mutations have been reported in patients with lymphoma,but the prevalence and characteristics of PRF1 mutation have not been identified in Chinese patients with lymphoma.METHODS:Seventy-seven patients with lymphoma,including 6 patients with Hodgkin lymphoma and 71 patients with non-Hodgkin lymphoma,were recruited.DNA samples from peripheral blood were used for PRF1 mutation detection by the PCR-sequencing method.RESULTS:Eleven novel PRF1 mutations were found in 8 of the 77 patients with lymphoma.Biallelic or compound monoallelic missense mutations in 3 patients indicated the severe impairment of perforin function,monoallelic missense mutations in 3 patients possibly contributed a genetic predisposition to malignancies,and synonymous mutations in 2 patients showed unknown significance.CONCLUSIONS:The frequency of EBV infection was similar in lymphoma patients with PRF1 mutations and those without the mutations.The same PRF1 mutations were also found in DNA samples from nails or hair follicles from 4 patients with PRF1 mutations,suggesting that these mutations may be of germ-line origin.
文摘The gene rearrangement of βand γchain of T-cell receptors (TCR) was detected in 13 cases of non-Hodgkin's lymphoma with T-cell immunophenotype with Southern blot and PCR. Clonally rearranged.TCR βgene was seen in 11 cases out of the 13 and rearranged TCR γgene in 12. These facts suggest that clonal rearrangement of antigen receptors is a sensitive and specific marker to establish the T-cell monoclonality and lineage and a useful adjunct to morphological diagnosis and immunophenotyping.
文摘Objective To search novel method for diagnosis and therapy of B-lymphoma, specific small mo-lecular peptide ligands against binding site of tumor cells were screened and its effects on signal transduction and cell apoptosis were tested. Methods Specific peptide ligands were screened by binding with site of human B lymphoma cell(OC1LY8)using peptide-bead libraries. The identified peptides were characterized with responsible cellsby rebinding test. The role of tyrosine phosphorylation of peptide ligand was tested by Western blot; and its apoptosispromoting role was observed by confocal fluorescent microscope. Results Specific peptide ligand was able to bind specifically to site on cell surface and enter into cytoplasm. Tetrameric peptide ligand was able to strongly trigger signal transduction resulting in tyrosine phosphorylation and cellular apoptosis in OC1LY8 cell line. Conclusion Screened peptide ligand can effectively bind with OC1LY8 cell, stimulate cellular tyro-sine phosphorylation and induce cellular apoptosis.
文摘Proliferative activity in 106 cases of non-Hodgkin’s lymphoma was estimated using the monoclonal antibody Ki67 and by counting the number of mitotic figures. The percentage of Ki67-positive cells was compared with the median number of mitotic figures per square millimeter. Both Ki67 positivity and the number of mitotic figures were found to be greater in high grade than in low grade lymphomas, although there was an overlap between the two grades of malignancy. A close correlation was found between the number of mitotic figures and the percentage of Ki67-positive cells not only in all lymphoma typo taken together (r_s= 0. 834 . P<0. 001). but also in B-cell lymphoma (r_s= 0. 8 1 P< 0. 001) and T-cell lymphoma (r_s = 0. 764. P<0. 00 1) taken seprately. Thus, both methods are useful for the estimation of proliferative activity. but each method has its advantages and disadvantages.
文摘Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT scans were done on all patients, enhanced CT scans simultaneously with 5-10 mm section thickness, and 5-10 mm table increments in 6 cases. Results: Primary involved sites were on the cecum (n=3), the ascending colon (n=2), and the rectum (n=1). The tumor was found in multiple areas of the large bowel in 2 cases. CT appearance fell into 3 typical patterns in our study. The first was focal mass type in 2 cases, with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases, with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases. Multiple nodules were seen in the rectum in 1 case. Conclusion: CT was found to be accurate in detecting the primary sites and complications of lymphoma, and evaluating invasion of adjacent structures; Focal mass type, segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.
文摘We describe a 70-year-old female patient with diffuse large B-cell lymphoma of the cerebellum;she received resection of a left atrial myxoma five months ago.To the best of our knowledge,to date no association of atrial myxoma with the malignant cerebellar diffuse large B-cell lymphoma has been reported in the literature,except for high level of interleukin-6 (IL-6) in the serum under both conditions.IL-6 as a pro-inflammatory cytokine has been shown to be associated with tumor progression,including inhibition of cancer cell apoptosis and stimulation of angiogenesis.IL-6 concentrations may provide possible aetiological links between atrial myxoma and cerebellar diffuse large B-cell lymphoma in our case.
文摘Background:Patient outcomes are poor for aggressive B-cell non-Hodgkin's lymphomas not responding to or progressing within 12 months after first-line therapy.Tisagenlecleucel is an anti-CD19 chimeric antigen receptor T-cell therapy approved for diffuse large B-cell lymphoma after at least two treatment lines.Methods:We conducted an international phase 3 trial involving patients with aggressive lymphoma that was refractory to or progressing within 12 months after first-line therapy.Patients were randomly assigned to receive tisagenlecleucel with optional bridging therapy(tisagenlecleucel group)or salvage chemotherapy and autologous hematopoietic stem-cell transplantation(HSCT)(standard-care group).The primary end point was event-free survival,defined as the time from randomization to stable or progressive disease at or after the week 12 assessment or death.Crossover to receive tisagenlecleucel was allowed if a defined event occurred at or after the week 12 assessment.Other end points included response and safety.
文摘To detect the prognostic significance of interim F-FDG PET/CT SUV(standard uptake value) reduction(△SUV_(max)) associated with Ki67 in patients with diffuse large B cell lymphoma(DLBCL).47 DLBCL patients underwent PET/CT before initiation and after 2-4 cycles of chemotherapy were included.The SUV_(max)of the dominant lesions were calculated.Ki67 positive indices were provided by enzyme-labeled immunohistochemistry.SPSS17.0 was used for statistical analysis.ASUV_(max) of different groups were compared by t test.Receiver-operator characteristic analysis was performed to determine the optimal cutoff values.KaplanMeier analyses of PFS(Progression-free survival) were compared using log-rank test.The average of △SUV_(max)and △SUV_(max)%were 11.53 and 69.10%,respectively.The optimal cutoff values of △SUV_(max)x and △SUV_(max)%were 11.45 and 82.92%,respectively.Higher △SUV_(max) and △SUV_(max)%indicated longer PFS(p < 0.001).The optimal cutoff value of Ki67 was 55%.Ki67>55%was revealed to be an indicator of shorter PFS(p = 0.019).Either △SUV_(max)≤11.45 or Ki67>55%was defined as an indicator to poor outcome and scored 1 point.The PFS rate was 100%in patients scored 0 point,yet 0%in patients scored 2 points.PFS tended to be shorter along with the score getting higher(p = 0.006).△SUV_(max) and Ki67 positive index were both of significance in DLBCL prognosis.The prognostic value may be confirmed when △SUV_(max) was accordant with Ki67.
