We report a case of systemic diffuse large B-cell lymphoma presenting with extensive infiltration of the skin. A 56-year-old woman presented with a two-month history of pruritic erythematous plaques and nodules over the neck, trunk and upper limbs. She also had night sweats, weight loss, lethargy and reduced effort tolerance. Systemic examination revealed a pale, ill appearance with hepatosplenomegaly and lymphadenopathy. Blood investigations showed pancytopenia (haemoglobin 6.3 g/dL, total white cell count 3.0 × 10(9)/L, platelet count 138 × 10(9)/L) with a few suspicious mononuclear cells and a mildly elevated lactate dehydrogenase level (478 U/L). Skin biopsy demonstrated diffuse sheets and nodular infiltrates of CD20 and CD79a positive neoplastic cells in the dermis and subcutis. Computed tomography revealed multiple cervical, axillary, mediastinal, para-aortic and mesenteric lymph nodes. Bone marrow aspiration and trephine biopsy confirmed marrow involvement by non-Hodgkin's lymphoma. The patient was treated with chemotherapy, which resulted in resolution of the skin lesions.
Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; complications ; drug therapy ; pathology ; Middle Aged ; Pancytopenia ; etiology ; Pruritus ; etiology ; Skin Neoplasms ; complications ; drug therapy ; pathology ; secondary

OBJECTIVE: To investigate the effects and molecular mechanisms of 2-12alkyl-6-methoxycyclohexa-2,5-diene-1,4-dione(DMDD) on diffuse large B lymphoma (DLBCL). METHODS: In animal experiments, 4-week-aged BALB/C mice were divided into 5 groups, 20 mice in each group. Mice were inguinal injected with DLBCL cell line OCI-LY19 cells 0.1 ml at the concention of 1 × 10 /ml. Two days later, mice were treated with DMDD at the doses of 0, 1, 5, 25 and 125 mg/kg by intragastric administration respectively, once /2 days. Ten mice of each group were killed on the 18th day of administration, and the tumor tissues were weighed. The survival time of the remaining mice were recorded. In cell experiments, OCI-LY19 cells were added to 96-well culture plates, 100 μl 1×10 cells/ml per well, then 100 μl DMDD was added to the well and the final concentrations were 0, 1, 5, 25 and 125 μmol/L respectively. The cells were treated with DMDD for 0, 24, 48 and 72 h, three wells in each group. The cell proliferation activity was detected by MTS assay. According to the results of cell proliferation experiments, OCI-LY19 cells were treated with DMDD at the concentrations of 0 μmol/L, 5 μmol/L and 25 μmol/L for 24 h. The apoptosis rate was analyzed by flow cytometry, the nuclear type was observed by hoechst staining, the mitochondrial membrane potential was observed by JC-1 staining, cytotoxicity of drugs was evaluated by LDH release experiment, gene expression and transcription were analyzed by qPCR and Western blot. RESULTS: Compared with 0 mg/kg drug group, DMDD at the dose of 1～125 mg/kg could inhibit the growth of tumor tissue in mice and prolong their survival time (P＜0.01). Cell experiments showed: in DMDD group, the proliferation activity of OCI-LY19 cells was decreased significantly and the level of apoptosis was increased significantly (P＜0.01), nuclear fragmentation, agglutination, apoptotic bodies occurred and mitochondrial membrane potential was decreased, the LDH release rate was increased significantly (P＜0.01), the expressions of caspase-3 and bax genes and the phosphorylation level of Ikappa B alpha in cells were up-regulated significantly, the protein expression levels of bcl-2, bcl-xL, jak2 and stat3 were inhibited significantly (P＜0.01). CONCLUSION DMDD can inhibit the expressions of JAK2, STAT3 and p-Ikappa B alpha in JAK2/STAT3 and NF-kappa B signal pathways, down-regulate BCL-2/BAX and activate Caspase-3, finally, activate the endogenous pathway of mitochondrial apoptosis in OCI-LY19 cells and promote the apoptosis of DLBCL cells, inhibit proliferation of OCI-LY19 cells. It has inhibitive effects on DLBCL.
Animals ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Cyclohexenes ; pharmacology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Mice ; Mice, Inbred BALB C ; Signal Transduction ; drug effects

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

UNLABELLED: AbstractObjective: To explore the distribution characteristics and clinical significance of peripheral blood monocyte subgroups in patients with diffuse large Bcell lymphoma(DLBCL). METHODS: The percentage of peripheral blood monocyte subsets of 82 DLBCL patients (including 32 newly diagnosis, 29 remission and 21 relapse) and 30 healthy controls were detected by flow cytometry, and the correlation with the clinical characteristics and its diagnostic value of DLBCL were analyzed. RESULTS: The proportion of intermediate monocytes in patients with newly diagnosed DLBCL group was higher than that in healthy controls (t=5.888, P<0.01). The proportion in relapsed group was higher than those in newly diagnosed DLBCL group（t=2.106，P=0.04） and remission group （t=6.882， P＜0.01）, and the proportion of intermediate monocytes in newly diagnosed DLBCL group was higher than that in Remission group (t=3.969, P<0.01). With the increase of International Prognostic Index (IPI) score, the percentage of intermediate monocytes in patients with DLBCL increased (r=0.37). Furthermore, when the proportion of intermediate monocytes was 10.91% as the cutoff value, the sensitivity and specificity of the whole sample were 90.60% and 9100%, respectively. CONCLUSION The disease progression is related to the increased intermediate monocytes, which can be used as a potential diagnostic index for DLBCL.
Antineoplastic Combined Chemotherapy Protocols ; Disease Progression ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Monocytes/pathology* ; Neoplasm Recurrence, Local/pathology* ; Prognosis ; Retrospective Studies

Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Diagnosis, Differential ; Humans ; Leg ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Skin Neoplasms ; drug therapy ; metabolism ; pathology

Among malignant tumors of the stomach, adenocarcinoma takes up about 95% and the remaining are mostly lymphomas, being less than 5%. The majority of lymphomas are B cell lymphomas, and the most common types are low-grade B cell lymphoma of mucosa-associated lymphoid tissue and diffuse large B cell lymphoma (DLBL). The synchronous occurrence of adenocarcinoma and lymphoma in the stomach is being reported rarely. Especially the concurrence of adenocarcinoma and DLBL is very scarce and less than 10 cases have been reported inside and outside this country. In the past, the general treatment for cases of concurrence of adenocarcinoma and DLBL when surgery is possible according to cancer stages was gastrectomy, followed by single or combined chemotherapy and radiation treatment. However, when considering that most cases of concurrent adenocarcinoma were early gastric cancer which is limited to the mucosa, endoscopic submucosal dissection (ESD) can become an alternative treatment method for gastrectomy. We report the experience with chemotherapy and ESD done together instead of surgery, in patients concurrently diagnosed with early gastric cancer and gastric lymphoma.
Adenocarcinoma/*drug therapy/surgery ; Anti-Bacterial Agents/therapeutic use ; Antineoplastic Agents/therapeutic use ; Drug Therapy, Combination ; Helicobacter Infections/drug therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse/*drug therapy/pathology ; Male ; Middle Aged ; Stomach Neoplasms/*drug therapy/surgery

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; drug therapy ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Sarcoma ; pathology ; Spleen ; pathology ; Splenic Neoplasms ; drug therapy ; pathology ; Vincristine ; therapeutic use

<b>OBJECTIVEb>To evaluateclinical features, treatment and outcomes of patients diagnosed with primary breast diffuse large B-cell lymphoma（DLBCL）.

<b>METHODSb>Clinical data were analyzed for all patients diagnosed with primary breast DLBCL（n=21）. Kaplan-Meier method was used to estimate 5- year overall survival（OS）rate, and the difference was compared by Log- rank test.

<b>RESULTSb>The 21 cases of patients with primary breast DLBCL were all female with median age at diagnosis as 48 years （range 21-64 years）. 13 patients had International Prognostic Index（IPI）of 0, 6 IPI 1, and 2 IPI 2. The 5- year OS rates of CHOP/R- CHOP and R±DICE after R±EPOCH groups were 40.0% and 72.2% , respectively（P=0.035）. The central nervous system relapse rate of CHOP/R-CHOP and R±DICE after R± EPOCH groups were 16.7% and 6.7%（P=0.500）, respectively. The 5- year OS rates of patients with primary breast DLBCL staging Ⅱ E-Ⅲ E and Ⅰ E were 21.4% and 83.3% , respectively（P=0.025）.

<b>CONCLUSIONb>Primary breast DLBCL was rare. The patients of primary breast DLBCL with chemotherapy regimen of R±DICE after R±EPOCH might have a better prognosis and lower relapse rate of central nervous system; the primary breast DLBCL patients staging ⅡE-ⅢE might have a poor prognosis.

Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; diagnosis ; drug therapy ; pathology ; China ; Cisplatin ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Etoposide ; Female ; Humans ; Ifosfamide ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; drug therapy ; pathology ; Neoplasm Recurrence, Local ; Prednisone ; Prognosis ; Retrospective Studies ; Vincristine

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma that most commonly involves the central nervous system and skin. To our knowledge, no state-of-the art imaging findings have been reported for hepatic IVLBCL in the English literature. We report the first case of hepatic involvement of IVLBCL along with a literature review.
Antigens, CD20/metabolism ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Humans ; Liver Neoplasms/drug therapy/*pathology/radiography ; Lymphoma, Large B-Cell, Diffuse/drug therapy/*pathology/radiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Remission Induction ; Rituximab/administration & dosage ; Tomography, X-Ray Computed

<b>OBJECTIVEb>To explore the feasibility of semi-nested PCR technique for detection of immunoglobulin heavy chain (IgH) clonal rearrangement in bone marrow of B-cell lymphoma patient and to further evaluate its clinicopathological value.

<b>METHODSb>Gene clonal rearrangement of IgH was detected by semi-nested PCR using primers of FR2 & FR3A in 105 bone marrow samples of patients with B-cell lymphoma. The PCR detection results were compared with the cytomorphology of bone marrow aspiration biopsy. The correlation between PCR detection results and clinicopathological factors were evaluated.

<b>RESULTSb>Among 105 cases of B-cell lymphoma, bone marrow involvement was detected by PCR technique in 48 cases (45.7%), while only 22 cases (21.0%) were detected by bone marrow cytological analysis. There was a significant difference between two methods (P < 0.05), and the concordance rate was 71.4%. The incidence of bone marrow involvement at the time of initial diagnosis detected by PCR technique was 30.8% for diffuse large B cell lymphoma (DLBCL), 25.0% for follicular lymphoma (FL), and 100.0% for small lymphocytic lymphoma (SLL), respectively. Bone marrow involvement detected by PCR detection correlated with Ann Arbor stage. Rate of clonal IgH gene rearrangement by PCR in early B-cell lymphoma was lower than that in advanced stage B-cell lymphoma patients (P = 0.02). There was no statistically significant difference in efficacy between patients with positive and negative results detected by PCR (P > 0.05). But difference in complete response (CR) rate (23.3% and 46.3%) had significant difference (P = 0.019).

<b>CONCLUSIONb>Semi-nested PCR analysis may be an effective method for detection of abnormalities in bone marrow in patients with B-cell lymphoma and is superior to cytomorphology. The positive rate in patients with advanced Ann Arbor stage is higher than that in patients with early Ann Arbor stage, and patients with PCR negative result have more chances to achieved CR after treatment.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biopsy ; methods ; Bone Marrow ; pathology ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Leukemia, Lymphocytic, Chronic, B-Cell ; drug therapy ; genetics ; pathology ; Lymphoma, Follicular ; drug therapy ; genetics ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Polymerase Chain Reaction ; methods ; Remission Induction