1.Clinical analysis of 11 cases of lymphoma complicated with paraneoplastic neurological syndrome.
Chong WEI ; Dan Qing ZHAO ; Yan ZHANG ; Wei WANG ; Wei ZHANG ; Dao Bin ZHOU
Chinese Journal of Hematology 2022;43(4):311-315
Objective: To evaluate the clinical characteristics, treatment, and prognosis of patients with paraneoplastic neurological syndrome (PNS) associated with lymphoma. Methods: Between January 2012 and May 2021, the clinical data of 11 patients with lymphoma complicated with PNS treated at Peking Union Medical College Hospital were retrospectively reviewed. Results: Among the 11 patients (8 male and 3 female) , the median onset age was 61 (range, 33-78) years. The symptoms of PNS preceded lymphoma in 10 patients. The median time from the onset of PNS to the diagnosis of lymphoma was 4 months. Of the 11 patients, one had Hodgkin's lymphoma, 8 had B-cell non-Hodgkin's lymphoma, and 2 had peripheral T-cell lymphoma. Seven patients were evaluated for onconeural antibody, of whom 2 were positive (1 for anti-Ma2 antibody and 1 for anti-Yo antibody) . Of the 11 patients, the PNS symptoms of 3 patients were located in the central nervous system, 4 were located in the peripheral nervous system, and 3 were located in the muscle. Eight of the 11 patients were treated with glucocorticoid-based immunosuppressive therapy before the diagnosis of lymphoma. Patients with central nervous system involvement and dermatomyositis responded well to glucocorticoid, whereas patients with peripheral neuropathy did not significantly benefit. All 11 patients were treated with chemotherapy after the diagnosis of lymphoma. The efficacy of chemotherapy was assessed in 9 patients, 7 cases achieved complete remission, 1 case was evaluated as stable disease, and 1 case was evaluated as disease progression. The PNS symptoms of the patients who achieved complete response were almost completely recovered. The median follow-up time was 42 (range, 4-95) months. At the end of the follow-up period, 6 of the 11 patients survived, 3 were lost to follow-up, and 2 died. The median overall survival of the whole group was not reached. Conclusions: PNS can involve various parts of the nervous system and can be associated with different types of lymphoma. Through early diagnosis and treatment, the PNS symptoms could improve in most patients who achieve complete remission of lymphoma.
Adult
;
Aged
;
Antibodies, Neoplasm
;
Autoantibodies
;
Female
;
Glucocorticoids
;
Humans
;
Lymphoma/diagnosis*
;
Male
;
Middle Aged
;
Paraneoplastic Syndromes, Nervous System/complications*
;
Retrospective Studies
2.Clinical Characteristics for Cutaneous Involvement in Diffuse Large B-Cell Lymphoma and Hemophagocytic Syndrome patients with First Presentation of Dermatomyositis.
Qiong LIU ; Yan GUAN ; Dong-Ping HUANG ; He-Sheng HE
Journal of Experimental Hematology 2021;29(1):253-258
OBJECTIVE:
To present one patient initially diagnosed with dermatomyositis(DM) who was eventually revealed to be diffuse large B-cell lymphoma(DLBCL) complicated with hemophagocytic syndrome(HPS), and to improve the understanding of the disease.
METHODS:
The clinical characteristics, diagnostic approach, treatment of the patient were retrospectively analyzed, and some related literatures were reviewed.
RESULTS:
A 52-year-old female patient suffered from muscle weakness, elevated serum creatine kinase activity, electromyography changes and characteristic skin rashes and diagnosed as DM. The patient was treated with glucocorticoid therapy and the muscle strength, skin rashes, and creatine kinas index turns into remission. Subsequently, subcutaneous nodules appeared during treatment, and the patient was confirmed as DLBCL based on pathological biopsy; And the patient was considered HPS because of presenting with repeated fever, splenomegaly, cytopenias, hypofibrinogenemia, hypertriglyceridemia, hyperferritinemia, high levels of sCD25, low NK-cell activity and hemophagocytosis in bone marrow. But the patient refused chemotherapy, and only treated with "DXM+VP-16" to control hemophagocytic syndrome, and unfortunately died due to the disease progression.
CONCLUSION
Cutaneous involvement in diffuse large B-cell lymphoma and hemophagocytic syndrome patients with first presentation of dermatomyositis is relatively rare. Malignacy screening should be performed as soon as possible after newly diagnosed DM, so that the patient can get early diagnosis and effective treatment to improve survival rate.
Dermatomyositis/complications*
;
Etoposide
;
Female
;
Humans
;
Lymphohistiocytosis, Hemophagocytic/diagnosis*
;
Lymphoma, Large B-Cell, Diffuse/complications*
;
Middle Aged
;
Retrospective Studies
3.Management of Suspicious Mucosa-Associated Lymphoid Tissue Lymphoma in Gastric Biopsy Specimens Obtained during Screening Endoscopy.
Hyo Joon YANG ; Seon Hee LIM ; Changhyun LEE ; Ji Min CHOI ; Jong In YANG ; Su Jin CHUNG ; Seung Ho CHOI ; Jong Pil IM ; Sang Gyun KIM ; Joo Sung KIM
Journal of Korean Medical Science 2016;31(7):1075-1081
It is often difficult to differentiate gastric mucosa-associated lymphoid tissue (MALT) lymphoma from Helicobacter pylori-associated follicular gastritis, and thus, it becomes unclear how to manage these diseases. This study aimed to explore the management strategy for and the long-term outcomes of suspicious gastric MALT lymphoma detected by forceps biopsy during screening upper endoscopy. Between October 2003 and May 2013, consecutive subjects who were diagnosed with suspicious gastric MALT lymphomas by screening endoscopy in a health checkup program in Korea were retrospectively enrolled. Suspicious MALT lymphoma was defined as a Wotherspoon score of 3 or 4 upon pathological evaluation of the biopsy specimen. Of 105,164 subjects who underwent screening endoscopies, 49 patients with suspicious MALT lymphomas who underwent subsequent endoscopy were enrolled. Eight patients received a subsequent endoscopy without H. pylori eradication (subsequent endoscopy only group), and 41 patients received H. pylori eradication first followed by endoscopy (eradication first group). MALT lymphoma development was significantly lower in the eradication first group (2/41, 4.9%) than in the subsequent endoscopy only group (3/8, 37.5%, P = 0.026). Notably, among 35 patients with successful H. pylori eradication, there was only one MALT lymphoma patient (2.9%) in whom complete remission was achieved, and there was no recurrence during a median 45 months of endoscopic follow-up. H. pylori eradication with subsequent endoscopy would be a practical management option for suspicious MALT lymphoma detected in a forceps biopsy specimen obtained during screening upper endoscopy.
Adult
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Aged
;
Anti-Bacterial Agents/therapeutic use
;
Biopsy
;
Female
;
Follow-Up Studies
;
Gastric Mucosa/*pathology
;
Gastritis/diagnosis/etiology/microbiology
;
Gastroscopy
;
Helicobacter Infections/complications/*diagnosis/drug therapy
;
Humans
;
Lymphoma, B-Cell, Marginal Zone/complications/*diagnosis/pathology
;
Male
;
Middle Aged
;
Republic of Korea
;
Retrospective Studies
4.Chronic Intussusception Caused by Diffuse Large B-Cell Lymphoma in a 6-Year-Old Girl Presenting with Abdominal Pain and Constipation for 2 Months.
Sun Hee CHOI ; Sang Ah HAN ; Kyu Yeoun WON
Journal of Korean Medical Science 2016;31(2):321-325
The classical triad of abdominal pain, vomiting, and bloody stool is absent in chronic intussusception for more than 2 weeks. Here, we report a 6-year-old female with recurrent abdominal pain for 2 months. Ultrasonography of the abdomen revealed an ileocolic-type intussusception. The lesion accompanying the tight fibrous adhesion was treated by resection and ileocolic anastomosis. It was diagnosed as intussusception with diffuse large B-cell lymphoma. A high index of suspicion for abdominal pain in children should result in the correct diagnosis and appropriate management.
Abdominal Pain/*etiology/ultrasonography
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Child
;
Constipation/*etiology
;
Diagnosis, Differential
;
Female
;
Humans
;
Intussusception/diagnosis/*etiology/surgery
;
Lymphoma, Large B-Cell, Diffuse/*complications/*diagnosis
;
Tomography, X-Ray Computed
5.Research Advances on Extranodal Nasal Type NK/T Cell Lymphoma--Review.
Journal of Experimental Hematology 2016;24(1):271-274
Extranodal NK/T cell lymphoma is a relatively uncommon type of non-Hodgkin's lymphoma, which is prevalently distributed in Asia and South America, and is highly associated with Epstein-Barr virus (EBV) infection. Due to its highly aggressive course and poor response to treatment because of its multi-drug resistance, for the timebeing there is not yet a definite treatment strategy. The clinical manifestation, pathological diagnosis and the progress of treatment methods of ENTNKCL are reviewed below.
Epstein-Barr Virus Infections
;
complications
;
Herpesvirus 4, Human
;
Humans
;
Lymphoma, Extranodal NK-T-Cell
;
diagnosis
;
therapy
;
virology
6.Marked Increase of Circulating Double-Negative gammadelta T Cells in a Patient With Hydroa Vacciniforme-Like Lymphoma.
Sang Yong SHIN ; Chang Hun PARK ; Duck CHO ; Hee Jin KIM ; Sun Hee KIM
Annals of Laboratory Medicine 2016;36(3):268-270
No abstract available.
Child, Preschool
;
Female
;
Flow Cytometry
;
Humans
;
Hydroa Vacciniforme/*diagnosis/pathology
;
Immunophenotyping
;
Lymphocytosis/complications
;
Lymphoma/*diagnosis
;
Receptors, Antigen, T-Cell, gamma-delta/genetics/*metabolism
;
STAT3 Transcription Factor/genetics/metabolism
;
Sequence Analysis, DNA
;
Skin/metabolism
;
T-Lymphocytes/*metabolism
7.Usefulness of Flow Cytometric Analysis for Detecting Leptomeningeal Diseases in Non-Hodgkin Lymphoma.
Sang Yong SHIN ; Seung Tae LEE ; Hee Jin KIM ; Young Lyun OH ; Seok Jin KIM ; Won Seog KIM ; Sun Hee KIM
Annals of Laboratory Medicine 2016;36(3):209-214
BACKGROUND: The clinical usefulness of flow cytometry (FCM) for the diagnosis of leptomeningeal diseases (LMD) in non-Hodgkin lymphomas has been suggested in previous studies but needs to be further validated. With this regards, we evaluated the use of FCM for LMD in a series of Korean patients with non-Hodgkin lymphoma. METHODS: FCM and cytomorphology were conducted using samples obtained from clinically suspected LMD patients, follow-up LMD patients, and those with high risk of developing tumorigenic diseases. We then compared results of FCM and cytomorphology. In total, 55 and 47 CSF samples were analyzed by FCM and cytomorphology, respectively. RESULTS: Of the samples analyzed, 25.5% (14/55) and 12.8% (6/47) were positive by FCM and cytomorphology, respectively. No samples were determined as negative by FCM but positive by cytomorphology. Seven patients were positive only by FCM and negative by cytomorphology, and six among them were clinically confirmed to have LMD either by follow-up cytomorphology or imaging study. CONCLUSIONS: We observed a high detection rate of tumor cells by FCM compared with cytomorphology. FCM study can be useful in early sensitive detection of LMD.
Adult
;
Aged
;
Female
;
Flow Cytometry
;
Glucose/cerebrospinal fluid
;
Humans
;
Leukocytes/cytology
;
Lymphoma, Large B-Cell, Diffuse/diagnosis/mortality
;
Lymphoma, Non-Hodgkin/*complications
;
Male
;
Meningeal Neoplasms/cerebrospinal fluid/complications/*diagnosis
;
Middle Aged
;
Prognosis
;
Retrospective Studies
;
Survival Rate
9.The First Case Report of Composite Bone Marrow Involvement by Simultaneously Developed Peripheral T-Cell Lymphoma, Not Otherwise Specified, and Diffuse Large B-Cell Lymphoma.
Hyun Ki KIM ; Chan Jeoung PARK ; Seongsoo JANG ; Young Uk CHO ; Sang Hyuk PARK ; Jene CHOI ; Chan Sik PARK ; Jooryung HUH ; Young Hwa CHUNG ; Jung Hee LEE
Annals of Laboratory Medicine 2015;35(1):152-154
No abstract available.
Antibodies, Monoclonal, Murine-Derived/therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
B-Cell-Specific Activator Protein/metabolism
;
Bone Marrow/metabolism/*pathology
;
Cyclophosphamide/therapeutic use
;
Doxorubicin/therapeutic use
;
Endoscopy, Digestive System
;
Female
;
Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
;
Genetic Loci
;
Humans
;
Liver/metabolism/pathology
;
Lymphocytes/cytology/immunology
;
Lymphoma, Large B-Cell, Diffuse/complications/*diagnosis/drug therapy
;
Lymphoma, T-Cell, Peripheral/complications/*diagnosis/drug therapy
;
Middle Aged
;
Prednisone/therapeutic use
;
Receptors, Antigen, T-Cell, gamma-delta/genetics
;
Tomography, X-Ray Computed
;
Vincristine/therapeutic use
10.Simultaneous Occurrence of Angioimmunoblastic T-cell Lymphoma and Plasma Cell Leukemia.
Mi Ae JANG ; Seung Tae LEE ; Hee Jin KIM ; Seokjin KIM ; Sun Hee KIM
Annals of Laboratory Medicine 2015;35(1):149-151
No abstract available.
Aged
;
Humans
;
Leukemia, Plasma Cell/complications/*diagnosis/pathology
;
Leukocytosis
;
Lymph Nodes/pathology
;
Lymphoma, T-Cell/complications/*diagnosis/pathology
;
Male
;
Paraproteinemias/complications
;
Polymerase Chain Reaction
;
Receptors, Antigen, T-Cell, gamma-delta/genetics/metabolism
;
Tomography, X-Ray Computed

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