The primary lymphoma in the lung is very rare. Most of the primary pulmonary lymphomas, which represent 3-4 % of extra-nodal lymphomas, are low-grade B-cell lymphoma. The low-grade B-cell lymphomas progress slowly and the prognosis of these are more favorable than that of the nodal lymphomas. However, high-grade forms progress rapidly with more severe course. The diagnosis of primary pulmonary lymphomas generally relies on the histopathologic findings of lung specimens obtained by surgical excision of the lesions or open-lung biopsy. Recently, less aggressive biopsies(transbronchial, transthoracic) and/or immunocyto -chemical, immunochemical and gene rearrangement studies on materials obtained by bronchoalveolar lavage have been used occasionally. The treatment of the primary pulmonary lymphomas has not been precisely codified. Several clinical data suggest that limited surgery or non -aggressive chemotherapy can provide long-term survival in patients with such slowly developing neoplasm, and demonstrated the need for the development of noninvasive diagnostic methods. In this study, we report a case of high-grade B-cell lymphoma of the lung which was treated with combination chemotherapy.
B-Lymphocytes ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Gene Rearrangement ; Humans ; Lung* ; Lymphoma* ; Lymphoma, B-Cell ; Prognosis

Primary nodal marginal zone B-cell lymphoma (MZBCL) is recognized as a rare and distinct entity. The rate of histologic transformation into diffuse large B-cell lymphoma (DLBCL) seems lower than the rate of transformation in follicular lymphoma. We herein report a rare case ofnodal MZBCL showing transformation into DLBCL. The patient was a 73-year-old female withcervical lymphadenopathy. On the initial biopsy, the lymph node architecture was diffuselyeffaced with an extensive interfollicular and parafollicular infiltrate of monocytoid B-cells. Therewere scattered large blastic B-cells without formations of compact sheets. The diagnosis ofnodal MZBCL was made. The patient did not receive chemotherapy and was treated with aconservatively supportive regimen. Forty two months later, the patient developed a new cervicallymphadenopathy and a biopsy was performed. Histologically, the lymph node revealeddiffuse sheets of transformed large B-cells showing prominent nucleoli. The diagnosis ofDLBCL transformed from nodal MZBCL was made. The patient was treated with 3 cycles ofcombined CHOP chemotherapy and she showed clinical improvement. These observationssuggest that an untreated primary nodal MZBCL may undergo high-grade transformation.
Aged ; B-Lymphocytes ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Follicular

Primary gastrointestinal lymphomas originating from the mucosa-associated lymphoid tissue (MALT) have been reported with increasing frequency. The stomach is the most frequent site of MALT lymphoma, and a relationship with Helicobacter pylori infection has been studied. However, primary MALT lymphoma arising from the ampulla of Vater is extremely rare, and its relationship with Helicobacter pylori infection is still obscure. We report here a case of a 71-year-old man with marginal zone B cell lymphoma of MALT with large B cell lymphoma of the ampulla of Vater that was not associated with Helicobacter pylori. A pancreaticoduodenectomy was performed, and the pathologic examination of the resected specimen confirmed the diagnosis. The patient tolerated just one course of systemic chemotherapy, but has been doing well for 18 months after surgery.
Aged ; Ampulla of Vater* ; Diagnosis ; Drug Therapy ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Pancreaticoduodenectomy ; Stomach

To characterize the clinical manifestations, and histologic features of CNS lymphoma in immunocompetent patients, we collected 15 cases of biopsy proven primary CNS lymphoma. Evidences of systemic lymphoma, HIV infection, and immune-compromising diseases were absent at the diagnosis. Brain MRI had been taken before radiation or chemotherapy, and pathologic specimens were classified according to working formulation and some cases underwent immunological marker studies. Mean duration of illness was 1. 8 months, mild CSF protein elevation(mean=58mg%) was observed in 5 of 6 patients, CSF cytology was positive in 2 of 7, and the recurrence rate was 69%. In MR imaging, tumor size was variable, and 5 patients had multiple lesions at diagnosis. All patients showed homogeneous(87%) or heterogeneous(13%) gadolinium enhancement, and secondary tumor change was shown in I case. The tumor had high tendency in abutting on CSF space(60%), and there was no relationship between histologic types and MR imaging I s. Classified by working formulation, the intermediate grade lymphomas(diffuse large cell and small cell cleaved types) were 14 out of 15(93%) and I showed low grade(small lymphocytic). B-cell lymphoma was 8 out of 9, and T-cell was only 1. As compared with the previous reported pathologic data of AIDS-related CNS lymphoma, the histology of lymphoma in immunocompetent patients were less malignant than those related to AIDS and immune-compromised patients.
Biopsy ; Brain ; Diagnosis ; Drug Therapy ; Gadolinium ; HIV Infections ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Magnetic Resonance Imaging ; Recurrence ; T-Lymphocytes

OBJECTIVE: To analyze the clinical characteristics of primary gastric lymphoma (PGL) and to improve its diagnosis and treatment. METHODS: The clinical manifestations, diagnosis, treatments and history of 50 PGL patients, who were hospitalized from September 2005 to September 2009, were reviewed and analyzed. RESULTS: The main manifestation of PGL was epigastric pain with infrequent systemic symptoms, such as stomach ache, abdominal discomfort, vomit, black stool, loss of appetite, fever, feeble, and skinny. Pathological examination indicated that only 1 patient had T cell lymphoma while the rest 49 had B cell lymphoma. Fourteen had mucosa-associated lymphoid tissue lymphoma (MALT), 35 had diffuse large B cell lymphoma (DLBCL), and 2 had both DLBCL and MALT (DLBCML). All the 50 patients received chemotherapy, and 12 underwent surgical treatment besides chemotherapy. Fourteen out of the 49 patients with B cell lymphoma received rituximab together with chemotherapy, and 35 received chemotherapy alone. The 2-year survival rate in the patients receiving rituximab together with chemotherapy was higher than that in the patients receiving chemotherapy alone (85.7% vs 77.1%, P< 0.05). The 2-year survival rate in patients of clinical stage I-II was higher than that in patients of clinical stage III-IV (90.9% vs 71.4%, P< 0.05). CONCLUSION The main clinical manifestation of PGL patients is non-specific gastrointestinal symptoms, among which abdominal pain is most common. The clinical examination mainly relies on pathological examinations, and the most common pathological type of primary gastric lymphoma is DLBCL. The main treatment is chemotherapy, and the prognosis is related to the clinical stage and the use of rituximab. After the treatment, the 2-year survival rate in the 50 patients reaches 80.0%.
Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Humans ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; diagnosis ; drug therapy ; pathology ; Prognosis ; Retrospective Studies ; Rituximab ; Stomach Neoplasms ; diagnosis ; drug therapy ; pathology ; Survival Rate

Intravascular large B-cell lymphoma is rare and generally fatal. It is defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of capillaries, small veins, and arteries with little or no other parenchymal involvement. The diagnosis can be delayed because of the rarity of the disease and the difficulty of detection in imaging studies, and a suspicious clinical observation is warranted to make the correct diagnosis. Early diagnosis is important because delayed treatment could result in a fatal outcome. We have encountered a case of intravascular large B-cell lymphoma involving only the bone marrow. An early diagnosis was made and the patient was treated with combination chemotherapy and rituximab targeting CD20. The patient went into complete remission after the third cycle of chemotherapy and maintained a disease free state up to 6 months.
Arteries ; B-Lymphocytes* ; Bone Marrow* ; Capillaries ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Early Diagnosis ; Fatal Outcome ; Humans ; Lymphocytes ; Lymphoma, B-Cell* ; Veins ; Rituximab

Primary pulmonary lymphoma (PPL) is an uncommon tumor, which constitutes 3-4% of all exuanodal lymphomas and 0.3-0.5% of all primary pulmonary malignant tumors. Low-grade B-cell lymphomas of bronchus-associated lymphoid tissue (BALT) accounted for the majority of PPL. This BALT lymphomas are frequently asymptomatic and have an excellent prognosis and an indolent clinical course by contrast with T-cell type. Therefore, determination of the B- or T-immunophenotype of the tumor cells is known 13 be very important from a clinical aspect Recent advances in immunohistochemical techniques, cytogenetics, and molecular biology have allowed better definition of type, maturation and clonality of lymphoma cells and have made it possible to better understand the PPL. We experienced an asymptomatic 43-year-old man who was evaluated for infiltrates on both sides discovered incidentally after a routine chest roentgenogram. He was eventually diagnosed as low-grade B-cell lymphoma of BALT by immunohistochemical staining from specimens obtained by open lung biopsy. He was treated with combination chemotherapy. At follow up 12 months following initial diagnosis he remains in stable. We report this case, who showed a relatively favorable prognosis and indolent clinical course compatible with low-grade B-cell lymphoma.
Adult ; B-Lymphocytes* ; Biopsy ; Cytogenetics ; Diagnosis ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lung ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Molecular Biology ; Prognosis ; T-Lymphocytes ; Thorax

Primary lymphomas of the prostate are extremely rare and can mimic other more common prostatic lesions clinically. We report a case of primary diffuse large B-cell lymphoma of the prostate in an 81-year-old man. The patient presented with voiding difficulty as an initial symptom and enlargement of the prostate on rectal digital examination. Transurethral prostatic resection was performed. On microscopic examination, atypical lymphoid cells infiltrated and replaced the prostatic parenchyma. The tumor cells had large nuclei with irregular nuclear membrane and vesicular clumped chromatin. Nucleoli were not distinct and the cells had scanty cytoplasm. Immunohistochemically, the tumor cells were immunoreactive for CD20 and CD79a but not reactive for CD5, BCL-2 and BCL-6. Histopathological diagnosis was diffuse large B-cell lymphoma of the prostate. The patient received 5 cycles of chemotherapy after histologic diagnosis but died from pulmonary and scrotal metastases 6 months later.
Aged, 80 and over ; B-Lymphocytes* ; Chromatin ; Cytoplasm ; Diagnosis ; Drug Therapy ; Humans ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell* ; Neoplasm Metastasis ; Nuclear Envelope ; Prostate*

Diffuse large B-cell lymphoma that arises from the gallbladder is extremely rare, and the associated studies are not well described in the literature. We report our experience that diffuse large B-cell lymphoma of the gallbladder was diagnosed by histological findings after laparoscopic cholecystectomy in a 75-year-old man. The patient was diagnosed with stage IV lymphoma, and chemotherapy was performed following surgery. The abdominal, chest, neck computed tomography (CT) and positron emission tomography (PET)-CT were performed after chemotherapy, and the results showed that there were no multiple lymphadenopathies. The patient was considered to have achieved complete remission. Diffuse large B-cell lymphoma of the gallbladder is extremely rare and never been diagnosis preoperatively. Pathological examination of the cholecystectomy specimen is important. This will be very helpful for identifying patients who need additional treatment.
Aged ; B-Lymphocytes ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Diagnosis ; Drug Therapy ; Gallbladder ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Neck ; Positron-Emission Tomography ; Thorax

Primary lymphomas of the prostate are extremely rare and can mimic other more common prostatic lesions. We report a case of a primary diffuse large B-cell lymphoma of the prostate in a 59 years old man, who presented with lower urinary tract symptoms, gross hematuria and enlargement of the prostate on digital rectal examination. On microscopic examination, the tumor, composed of diffuse large cells, with B cell immunophenotypes, was diagnosed as a non-Hodgkin's lymphoma. After the histological diagnosis, the patient underwent 6 cycles of combination chemotherapy, with cyclophosphamide, doxorubicin, vincristine and prednisone, followed by involved-field radiation therapy. He is followed well for 5 months without any problem.
Cyclophosphamide ; Diagnosis ; Digital Rectal Examination ; Doxorubicin ; Drug Therapy, Combination ; Hematuria* ; Humans ; Lower Urinary Tract Symptoms ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prednisone ; Prostate* ; Vincristine