Hepatitis C virus (HCV) is one of the main viral causes of hepatocellular carcinoma (HCC) and is associated with lymphoproliferative disorder such as non-Hodgkin's lymphoma (NHL). However, there are only few case reports on concomitantly induced NHL and HCC by HCV. Herein, we report a case of synchronous NHL and HCC in a patient with chronic hepatitis C which was unexpectedly diagnosed during liver transplantation surgery. This case suggests that although intrahepatic lymph node enlargements are often considered as reactive or metastatic lymphadenopathy in chronic hepatitis C patients with HCC, NHL should also be considered as a differential diagnosis.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/complications/*diagnosis/radiotherapy ; Drug Therapy, Combination ; Embolization, Therapeutic ; Fluorodeoxyglucose F18 ; Gadolinium DTPA ; Genotype ; Hepatitis B virus/genetics ; Hepatitis C, Chronic/complications/*diagnosis/*virology ; Humans ; Liver Neoplasms/complications/*diagnosis/radiotherapy ; Lymph Nodes/pathology ; Lymphoma, Non-Hodgkin/complications/*diagnosis/drug therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the clinicopathological features and prognosis of primary hepatic lymphoma (PHL).

METHODSThirty-five patients with PHL who underwent surgical resection and were confirmed by pathology in our hospital from 1982 to 2012 were re-evaluated for clinicopathological data, including their symptoms, radiological features, recurrence interval, histopathological properties and prognosis.

RESULTSOf the 35 patients, 25 were men (71.4%) and 10 were women (28.6%), with an average age of 52.6 years old (range, 17-79 years). Presented symptoms were epigastric phymatosis, abdominal pain and low-grade fever. In the present study, 21 (60.0%) patients were positive for HBsAg, 1(2.9%) patient was positive for anti-HCV, 3 patients were positive for AFP, 12 patients and 2 patients were complicated by cirrhosis and hepatocellular carcinoma, respectively. Pathologically, 35 PHL were classified into 19 DLBCL (54.3%), 13 T cell-lymphoma (37.1%), and 3 MALT lymphoma (8.6%). Patients with DCBCL showed better postoperative survival than patients with T cell-lymphoma (31.7 ± 3.2) months vs. (22.9 ± 2.2) months (P < 0.05).

CONCLUSIONSHepatitis B virus (HBV) infection may contribute to the pathogenesis of Chinese patients with PHL. Surgical resection followed by comprehensive therapy is the first-line option for PHL. The prognosis of patients with PHL is associated with PHL subtypes.

Adolescent ; Adult ; Aged ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; pathology ; therapy ; virology ; Chemotherapy, Adjuvant ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Hepatitis B ; complications ; Hepatitis B Surface Antigens ; metabolism ; Hepatitis C Antibodies ; metabolism ; Humans ; Leukocyte Common Antigens ; metabolism ; Liver Cirrhosis ; complications ; Liver Neoplasms ; pathology ; therapy ; virology ; Lymphoma ; pathology ; therapy ; virology ; Lymphoma, B-Cell, Marginal Zone ; pathology ; therapy ; virology ; Lymphoma, Large B-Cell, Diffuse ; pathology ; therapy ; virology ; Lymphoma, T-Cell ; pathology ; therapy ; virology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Retrospective Studies ; Survival Rate ; Vincristine ; therapeutic use ; Young Adult ; alpha-Fetoproteins ; metabolism

No abstract available.
Epstein-Barr Virus Infections/*complications/diagnosis ; Herpesvirus 4, Human/pathogenicity ; Humans ; Lymphoma, Follicular/complications ; Lymphoproliferative Disorders/*complications/diagnosis/virology ; Male ; Middle Aged ; *T-Lymphocytes/pathology/virology

Despite the prophylaxis and preemptive strategies using potent antiviral agents, cytomegalovirus (CMV) remains a major infectious cause of morbidity and mortality in allogeneic stem cell transplantation (SCT) recipients. Delayed immune reconstitution after SCT, such as cord blood and T-cell depleted SCT with the use of alemtuzumab, has been associated with an increased frequency of CMV disease as well as CMV reactivation. CMV disease involving central nervous system is an unusual presentation in the setting of SCT. We report a case of CMV ventriculoencephalitis after unrelated double cord blood SCT with an alemtuzumab-containing preparative regimen for Philadelphia-positive acute lymphoblastic leukemia.
Antibodies, Monoclonal/pharmacology/*therapeutic use ; Antibodies, Monoclonal, Humanized ; Antibodies, Neoplasm/pharmacology/*therapeutic use ; Antineoplastic Agents/pharmacology/*therapeutic use ; Cord Blood Stem Cell Transplantation/*adverse effects ; Cytomegalovirus/drug effects ; Cytomegalovirus Infections/*drug therapy/*etiology/physiopathology ; *Encephalitis/etiology/pathology/virology ; Fatal Outcome ; Humans ; Male ; *Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/drug therapy/virology ; Transplantation Conditioning/methods

Adult ; Aged ; B-Lymphocytes ; pathology ; Female ; Gastric Mucosa ; pathology ; Hepatitis B, Chronic ; complications ; epidemiology ; virology ; Hepatitis C, Chronic ; complications ; epidemiology ; virology ; Humans ; Immunohistochemistry ; Liver ; pathology ; Lymphoma ; etiology ; pathology ; virology ; Male ; Middle Aged ; Staining and Labeling

Adult ; Antigens, CD20 ; metabolism ; Empyema, Pleural ; complications ; diagnostic imaging ; pathology ; virology ; Epstein-Barr Virus Infections ; Humans ; Ki-67 Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; virology ; Male ; Pleural Neoplasms ; complications ; metabolism ; pathology ; surgery ; virology ; Radiography

Human immunodeficiency virus (HIV) infection is a risk factor for developing non-Hodgkin's lymphoma. Most acquired immune deficiency syndrome (AIDS)-related lymphomas are high-grade B cell non-Hodgkin's lymphomas. The use of highly active antiretroviral therapy has reduced the incidence of AIDS-related lymphoma. There have been 7 reports of AIDS-related extra-nodal lymphoma in Korea. We report a case of AIDS-related lymphoma detected by MiroCam(R) capsule endoscopy.
Acquired Immunodeficiency Syndrome/*complications/drug therapy/immunology ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; *Capsule Endoscopes ; HIV Infections/virology ; Humans ; Jejunal Neoplasms/*diagnosis/pathology ; Lymphoma, AIDS-Related/*diagnosis/pathology ; Lymphoma, Large B-Cell, Diffuse/immunology/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

To explore the clinical and pathological characteristics of hepatosplenic gammadelta T-cell lymphoma and its relationship with Epstein-Barr virus infection, the clinical features of a 9-year-old girl with hepatosplenic gammadelta T-cell lymphoma were investigated, the smears of bone marrow was stained with Wright' s stain, biopsies of bone marrow and liver specimen were embedded in plastic and sliced about 4 microm in thickness and routinely stained with HE staining, the immunohistochemical staining was used to mark the tumor cells, and EBER probes were used to detect Epstein-Barr virus RNA. The results showed that the girl presented with prolonged fever, anemia, thrombocytopenia, hepatosplenomegaly, chronic active Epstein-Barr virus infection, and elevated levels of serum ferritin and lactate dehydrogenase. Bone marrow aspirate revealed the infiltration of atypical lymphocytes in the bone marrow stroma. The liver biopsy specimen revealed the infiltration of lymphocytes in the sinusoids, which was positive for the T-cell associated marker CD3 and activated cytotoxicity-associated marker granzyme B. In-situ hybridization analysis with EBER probes revealed that the above-mentioned characteristics were negative in neoplastic cells. It is concluded that hepatosplenic gammadelta T-cell lymphoma is a disease with distinctive clinical, histopathologic, and phenotypic characteristics. Hepatic and/or splenic and/or bone marrow biopsy with combined phenotype is beneficial to diagnosis. Epstein-Barr virus infection is late event involving an already transformed gammadelta T-cell clone.
Child ; Epstein-Barr Virus Infections ; complications ; Female ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; virology ; Lymphoma, T-Cell, Peripheral ; diagnosis ; pathology ; virology ; Receptors, Antigen, T-Cell, gamma-delta ; analysis ; Splenic Neoplasms ; diagnosis ; pathology ; virology

BACKGROUNDIntestinal T-cell lymphoma (ITCL) is a heterogeneous lymphoid neoplastic group with variable clinical and pathological features. ITCL in oriental countries is different from enteropathy-type intestinal T-cell lymphoma (ETCL) in relation to celiac disease and Epstein-Barr virus (EBV). The objective of this study was to investigate the clinicopathological features, immunophenotype, expression of cytotoxic molecule (TIA-1), T-cell receptor (TCR)-gamma gene rearrangement, and Epstein-Barr virus (EBV) latent infection in primary ITCL without celiac disease in Chinese.

METHODSThe clinical data of 42 patients were analyzed, and the patients were followed up. Compared with human reactive lymphoid tissues, in situ hybridization for EBER1/2, polymerase chain reaction for TCR-gamma gene rearrangement, and immunohistochemical staining for immunophenotypes, TIA-1 and EBV latent membrane proteins (LMP-1) were investigated. Survival curves of different clinicopathological features, immuno-phenotypes, expression of LMP1, TCR-gamma gene rearrangement and therapy were analyzed.

RESULTSThree fourths of the patients suffered from ITCL in China were men with a peak age incidence in the 4th decade. Common presenting features included fever and hemotochezia. The prognosis was poor with a median survival of 3.0 months. The lesions were mostly localized in the ileocecum and colon. About 38/42 (90.5%) patients demonstrated pleomorphic medium-sized on large cells. Histological features of celiac disease were rarely seen. All 42 patients with ITCL revealed CD45RO positive. Neoplastic cells partially expressed T-cell differentiated antigens (CD3epsilon, CD4, CD8) and NK cell associated antigen (CD56). The positive frequency of CD3epsilon, CD4, CD8 and CD56 was 28/42 (66.7%), 7/42 (16.7%), 10/42 (23.8%) and 12/42 (28.6%) respectively. Thirty-nine cells (92.9%) expressed TIA-1, but none expressed CD20 and CD68. More than half of the patients (64.3%, 64.3% and 59.5%) revealed TCR-gamma gene rearrangement by three different TCR-gamma primers respectively. EBER1/2 was detected in 41 (97.6%) of the 42 patients. The expression frequency of LMP-1 was 38.1% (16/42).

CONCLUSIONSPrimary ITCL without celiac disease in Chinese is a special highly EBV-associated clinicopathological entity. There are few similarities in patients with celiac disease in western countries. A small proportion of primary ITCLs in Chinese and extranodal NK/T-cell lymphoma of nasal type belong to the same spectrum.

Adolescent ; Adult ; Celiac Disease ; complications ; Child ; Epstein-Barr Virus Infections ; complications ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Immunophenotyping ; In Situ Hybridization ; Intestinal Neoplasms ; immunology ; pathology ; virology ; Lymphoma, T-Cell ; immunology ; pathology ; virology ; Male ; Middle Aged ; RNA, Viral ; genetics ; Viral Matrix Proteins ; genetics

To evaluate the frequency of bone marrow involvement by nasal-type NK/T cell lymphoma, we retrospectively studied biopsy specimens from 40 patients by EBV in situ hybridization (ISH). Three patients had marrow involvement at initial diagnosis (7.5%). In one patient (1/40, 2.5%), the disease in bone marrow was recognized by routine morphological assessment, while two other patients had minimal involvement of lymphoma cells which was recognized only by EBV in situ hybridization (2/40, 5%). Two patients had a disseminated disease at diagnosis and died 6 days and 214 days after diagnosis. One patient had diffuse colonic lesion and died 82 days later. In conclusion, marrow involvement in nasal NK/T cell lymphoma is infrequent at initial diagnosis, and EBV ISH is a useful technique for identifying the minor subgroup of patients which have easily overlooked neoplastic involvement.
Adult ; Aged ; Aged, 80 and over ; Biopsy ; Bone Marrow/*pathology ; Epstein-Barr Virus Infections/complications/pathology ; Female ; Herpesvirus 4, Human/genetics ; Human ; Killer Cells, Natural/*pathology ; Lymphoma, T-Cell/complications/*pathology ; Male ; Middle Aged ; Nasal Cavity/*pathology/virology ; Prognosis ; RNA, Viral/analysis ; Retrospective Studies