Burkitt Lymphoma ; diagnosis ; pathology ; Female ; Hodgkin Disease ; diagnosis ; pathology ; Humans ; Lymphoma ; classification ; diagnosis ; pathology ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; pathology ; Lymphoma, Follicular ; diagnosis ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; pathology

OBJECTIVETo investigate the clinical and pathological characteristics of patients with primary Waldeyer's ring lymphomas (PWRL), and to analyze its therapeutic efficacy and prognostic factors.

METHODSA total of 112 patients with PWRL confirmed by pathological and immunohistochemical methods between January 2009 and January 2014 were studied. Clinical data were collected and analyzed retrospectively.

RESULTSPWRL accounted for 3.9% of lymphoma over the same period. Median age of patients with PWRL was 51.5 years old. The affected areas were tonsil, nasopharynx, tongue base and oropharynx, which accounted for 63.4% (71/112), 22.3% (25/112), 5.3% (6/112) and 4.5% (5/112) respectively. The most common pathological types of these four areas were diffused large B-cell lymphoma (DLBCL) and extranodal NK/T cell lymphoma (NKTCL) which accounted for 58% and 15.2%. The overall response rate (CR/CRu = 51.4%; PR = 30.8%) in all patients was 82.2%, the estimated 5-year overall survival (OS) rate were 71.6%. The 5-year OS rate were 94.7% in the group used Rituximab. Meanwhile, chemotherapy combined with radiotherapy could improve the outcome of T-cell PWRL patients and the 5-year OS rate were 88.9%. Age, disease stages, pathological types, IPI scores, LDH level, β2-MG level and the efficacy of initial therapy were prognostic factors with statistical significance. Cox multivariate analysis showed that age of more than 60 years, LDH level, pathological types and the efficacy of the initial therapy were independently associated with OS.

CONCLUSIONPWRL has a relatively good prognosis. The pathological types affect the prognosis directly and guide treatment. Combined modality therapy should be chosen for patients with PWRL. Patients with T-cell PWRL should accept chemotherapy combined with radiotherapy, while rituximab may be better for B-cell PWRL. The efficacy of initial therapy is crucial for the outcome of patients. Age and LDH level are also important prognostic factors.

Combined Modality Therapy ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Rituximab ; Survival Rate

OBJECTIVE: To investigate the clinicopathological features and prognostic factors of nasal NK/T-cell lymphoma. METHOD: The clinicopathological data, treatment modality and survival status were analyzed. RESULT: The overall five year survival rate of: 62 patients was 63.5%. In univariate analysis, the prognosis of the patients was correlated with the age, perforation, B symptom, stage, Hb concentration, LDH level, size of tumor cell, number of involvement sites, angioinvasion and treatment modality (P < 0.05 or P <0.01). In multivariate analysis, the Hb concentration, the size of the tumor cell and the treatment modality were the independent prognostic factors. CONCLUSION The Hb concentration, the size of the tumor cell and the treatment modality play key role in the prognosis of nasal NK/T-cell lymphoma.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Nose Neoplasms ; diagnosis ; pathology ; Prognosis ; Survival Rate ; Young Adult

Dendritic Cells, Follicular ; pathology ; Diagnosis, Differential ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; pathology ; Lymphoma ; pathology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Follicular ; pathology ; Lymphoma, Large B-Cell, Diffuse ; pathology ; Lymphoma, Large-Cell, Anaplastic ; pathology ; Lymphoma, Mantle-Cell ; pathology ; Lymphoma, T-Cell, Peripheral ; pathology ; Neoplasm Invasiveness ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology

Antigens, CD20 ; metabolism ; Diagnosis, Differential ; Humans ; Infectious Mononucleosis ; metabolism ; pathology ; Leukocyte Common Antigens ; metabolism ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; metabolism ; pathology ; Nose Neoplasms ; diagnosis ; metabolism ; pathology ; Oral Ulcer ; metabolism ; pathology ; RNA, Viral ; metabolism ; Rhinoscleroma ; metabolism ; pathology

CD56 Antigen ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Killer Cells, Natural ; metabolism ; pathology ; Leukocyte Common Antigens ; metabolism ; Leukosialin ; metabolism ; Lymphoma, Extranodal NK-T-Cell ; metabolism ; pathology ; Lymphoma, Non-Hodgkin ; metabolism ; pathology ; Middle Aged ; Skin Neoplasms ; metabolism ; pathology

Adult ; CD56 Antigen ; metabolism ; Diagnosis, Differential ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Killer Cells, Natural ; pathology ; Lymph Nodes ; pathology ; Lymphoma ; metabolism ; pathology ; virology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Male

OBJECTIVETo study the diagnostic accuracy of hematolymphoid malignancy by using effusion fluid cytology specimens and to evaluate the values of immunocytochemistry for this assay.

METHODSThe cytospin preparations/smears and cell block sections of effusion cytology specimens from 33 cases of hematolymphoid malignancy were retrospectively reviewed. Immunocytochemical study was performed. In selected cases, in-situ hybridization for Epstein-Barr virus-encoded RNA and immunoglobulin and T-cell receptor gene rearrangement study were carried out as indicated.

RESULTSThere were 33 cases of hematolymphoid malignancy, including 12 cases of T-lymphoblastic leukemia/lymphoma, 16 cases of mature B cell neoplasm (including 9 cases of diffuse large B-cell lymphoma, 2 cases of Burkitt lymphoma, 2 cases of plasmacytoma/multiple myeloma, 2 cases of B-small lymphocytic leukemia/lymphoma and 1 case of mantle cell lymphoma), 3 cases of mature T or NK-cell neoplasm (including 1 case of extranodal nasal NK/T-cell lymphoma, 1 case of angioimmunoblastic T-cell lymphoma and 1 case of T-cell prolymphocytic leukemia), 1 case of myeloid sarcoma and 1 case of mast cell sarcoma. Amongst the 33 cases studied, 16 represented disease relapses, including 8 cases of diffuse large B-cell lymphoma, 2 cases of plasmacytoma/multiple myeloma, 2 cases of B-small lymphocytic leukemia/lymphoma, 1 case of T-lymphoblastic leukemia/lymphoma, 1 case of angioimmunoblastic T-cell lymphoma, 1 case of mantle cell lymphoma and 1 case of mast cell sarcoma. The remaining 17 cases showed serous effusion as the primary manifestation, with the diagnosis primarily made upon cytologic examination. The cytologic findings seen in all the 33 cases studied were in agreement with the corresponding histologic diagnosis.

CONCLUSIONSDiagnosis of hematolymphoid malignancy by effusion fluid cytology specimens is possible, especially when coupled with the clinical history, immunophenotype, in-situ hybridization and gene rearrangement study findings. This is especially so for cases with disease relapses.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ascitic Fluid ; metabolism ; pathology ; Burkitt Lymphoma ; diagnosis ; metabolism ; pathology ; Child ; Cytodiagnosis ; methods ; Female ; Humans ; Immunohistochemistry ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; metabolism ; pathology ; Plasmacytoma ; diagnosis ; metabolism ; pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; pathology ; Retrospective Studies ; Young Adult

Extranodal NK/T-cell lymphoma is a recently recognized distinct entity within the World Health Organization classification of lymphoid tumors. It is relatively prevalent in Asian and South American populations. It most commonly occurs in the nasal or paranasal areas and less frequently in the skin, the soft tissue, and the gastrointestinal tract. Among these, extranodal NK/T-cell lymphoma of the gastrointestinal tract has shown an aggressive clinical course. We report a case of CD56+ extranodal NK/T-cell lymphoma presenting as a duodenal ulcer bleeding. A 62-year-old male patient presented with melena and abdominal pain. Endoscopic examination of the upper gastrointestinal tract showed the duodenal ulcer covered by blood clot. Pathologic examination revealed the diffuse infiltration of atypical lymphocytes with an angiocentric growth pattern, which was positive for CD3, CD56, and granzyme. The patient showed rapid deteriorating clinical course and died on day 14 after admission. Thus, we report this case with the review of literatures.
Antigens, CD3/metabolism ; Antigens, CD56/*metabolism ; Bone Marrow/pathology ; Duodenal Ulcer/*diagnosis ; Herpesvirus 4, Human/genetics/metabolism ; Humans ; Lymphoma, Extranodal NK-T-Cell/*diagnosis/pathology ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*diagnosis ; Tomography, X-Ray Computed

A 68-year-old Chinese man presented with an eight-month history of pyrexia of unknown origin and chronic sinusitis despite multiple courses of antibiotics. He underwent extensive investigations, including workups for infections, chronic granulomatous diseases and malignancy. Nasal biopsies were performed twice under local anaesthesia, but did not show any evidence of malignancy. Eventually, the patient was diagnosed with natural killer (NK)/T-cell lymphoma, nasal variant, based on histopathological findings from harvested deep tissue obtained via functional endoscopic sinus surgery. This study highlights that, for patients presenting with pyrexia of unknown origin and nasal symptoms, NK/T-cell lymphoma must be considered as a differential diagnosis. Generous amounts of tissue should be harvested under general anaesthesia rather than limited tissue under local anaesthesia, in order to facilitate and ensure a definitive diagnosis.
Aged ; Anti-Bacterial Agents ; chemistry ; Biopsy ; China ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; diagnostic imaging ; pathology ; Male ; Nasal Cavity ; pathology ; Nose Neoplasms ; complications ; diagnosis ; radiotherapy ; Prognosis ; Radiography ; Radiotherapy ; Sinusitis ; complications ; diagnosis ; Treatment Outcome