BACKGROUND/AIMS: The staging work-up for patients with non-Hodgkin's lymphoma includes bone marrow aspiration and biopsy. Consistent results of both procedures can clarify the diagnosis. However, no clear guidelines have been established regarding positive results for bone marrow aspiration alone. The aim of this study was, therefore, to analyze the overall survival (OS) for the clinical diagnoses of these patients using morphological methods. METHODS: We performed a retrospective analysis of patients who were consecutively enrolled in the Korea University Lymphoma Registry from 1991 to 2016. OS was compared according to the bone marrow group: without bone marrow involvement (BMA−/BMBx−), with positive results for aspiration and negative results for biopsy (BMA+/BMBx−), and with bone marrow involvement in biopsy (BMBx+). OS was assessed using the Kaplan-Meier method and multivariate analysis. RESULTS: Of 1,735 patients, 1,326 were analyzed and 409 were excluded. In the Kaplan-Meier survival analysis, OS was significantly worse for patients in the BMBx+ group compared with those in the BMA−/BMBx− group (p < 0.001). However, there was no significant difference in OS between patients in the BMA+/BMBx− group and those in other groups (vs. BMA−/BMBx−, p = 0.163; BMBx+, p = 0.292). In multivariate analysis, by adjusting survival-related variables, the BMA+/BMBx− group showed marginal significance compared to the BMA−/BMBx− group (p = 0.081), and showed significance in the subgroup of indolent non-Hodgkin's lymphoma patients (p = 0.003). CONCLUSIONS: This study suggested that even if there are positive results in bone marrow aspiration alone in patients with non-Hodgkin lymphoma, attention to patient characteristics, involving significance as a poor prognosis for OS, is required.
Biopsy ; Bone Marrow ; Diagnosis ; Humans ; Korea ; Lymphoma ; Lymphoma, Non-Hodgkin ; Methods ; Multivariate Analysis ; Prognosis ; Retrospective Studies

PURPOSE: The aim of this study was to review the common conditions associated with mandibular canal widening. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were used to find relevant studies by using the following keywords: “mandibular canal,” “alveolar canal,” “inferior alveolar nerve canal,” “inferior dental canal,” “inferior mandibular canal,” “widening,” “enlargement,” “distension,” “expansion,” and “dilation.” RESULTS: In total, 130 articles were found, of which 80 were broadly relevant to the topic. We ultimately included 38 articles that were closely related to the topic of interest. When the data were compiled, the following 7 lesions were found to have a relationship with mandibular canal widening: non-Hodgkin lymphoma, osteosarcoma, schwannoma, neurofibroma, vascular malformation/hemangioma, multiple endocrine neoplasia syndromes, and perineural spreading or invasion. CONCLUSION: When clinicians encounter a lesion associated with mandibular canal widening, they should immediately consider these entities in the differential diagnosis. Doing so will help dentists make more accurate diagnoses and develop better treatment plans based on patients' radiographs.
Dentists ; Diagnosis ; Diagnosis, Differential ; Humans ; Lymphoma, Non-Hodgkin ; Mandibular Nerve ; Multiple Endocrine Neoplasia ; Neurilemmoma ; Neurofibroma ; Odontogenic Cysts ; Odontogenic Tumors ; Osteosarcoma ; Search Engine

BACKGROUND AND PURPOSE: Brain-derived neurotrophic factor (BDNF) is a neuronal growth factor that plays an essential role in the maintenance of the nervous system. We have evaluated the peripheral blood protein levels of BDNF and the valine-to-methionine substitution at codon 66 (Val66Met) single-nucleotide polymorphism (SNP) as potential biomarkers for the early recognition of chemotherapy-induced peripheral neuropathy (CIPN) in non-Hodgkin lymphoma and multiple myeloma patients. METHODS: CIPN was assessed in 45 patients at the diagnosis and during vincristine or bortezomib-based therapy using objective [reduced version of the Total Neuropathy Score (TNSr)] and subjective (FACT-GOG-NTx) tools. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) questionnaire. BDNF protein levels and the Val66Met SNP were determined using ELISA and Sanger sequencing. RESULTS: The pretreatment BDNF protein level was inversely correlated with the maximum TNSr, FACT-GOG-NTx, and PHQ-9 scores in both genotypes. BDNF patients with the Val/Val genotype demonstrated significantly higher maximum FACT-GOG-NTx and PHQ-9 scores than those with the Val/Met and Met/Met genotypes (Met-BNDF carriers). Correlations between PHQ-9 and TNSr score were found only in Met-BDNF carriers, suggesting that peripheral neuropathy and depression coincide in Met-BDNF carriers. CONCLUSIONS: Determining the BDNF protein levels before initiating chemotherapy might be a useful tool for CIPN risk assessment and preemptive dose modification. The present data should be validated in larger studies that include other neurotoxic agents.
Biomarkers ; Brain-Derived Neurotrophic Factor ; Codon ; Depression ; Diagnosis ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Genes, vif ; Genotype ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Multiple Myeloma ; Nervous System ; Neurons ; Peripheral Nervous System Diseases ; Risk Assessment ; Vincristine

PURPOSE: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is a rare subtype of non-Hodgkin lymphoma, and asparaginase-based regimens are the best first-line treatments. Data on the role of specific circulating lymphocyte subsets in the progression of ENKTL are limited. The aim of this study was to investigate the clinical correlation and distribution of circulating absolute CD4+ T-cell counts (ACD4Cs) in ENKTL. MATERIALS AND METHODS: We retrospectively searched medical records for 70 newly diagnosed ENKTL patients treated with pegaspargase-based regimens. Comparison of ACD4Cs as a continuous parameter in different groups was calculated. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS). RESULTS: Stage III/IV, B symptoms, elevated lactate dehydrogenase, monocytopenia, high-intermediate and high risk International Prognostic Index (IPI) and Korean Prognostic Index (KPI), high risk Prognostic Index of Natural Killer Lymphoma (PINK), and lower lymphocytes were significantly associated with low ACD4C at diagnosis. With a median follow-up time of 32 months, patients who had an ACD4C < 0.30×109/L had a worse OS. Median OS was 11 months and median PFS was 5 months in the low ACD4C cohort. There were significant differences in both OS and PFS between the two cohorts. Moreover, multivariate Cox analysis identified ACD4Cs as an independent predictor for OS and PFS. CONCLUSION: Low ACD4Cs were associated with poorer survival and could act as a negative predictor for ENKTL patients treated with asparaginase-based regimens.
Cell Count* ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase ; Lymphocyte Subsets ; Lymphocytes ; Lymphoma* ; Lymphoma, Extranodal NK-T-Cell ; Lymphoma, Non-Hodgkin ; Medical Records ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; T-Lymphocytes

Diagnosis, Differential ; Humans ; Inflammatory Bowel Diseases ; diagnosis ; Lymphoma, Non-Hodgkin ; diagnosis

A primary hepatic lymphoma (PHL) is a rare malignancy; misdiagnosis and mistreatment are very common. We report the case of a 56-year-old female who presented with a 2-week history of upper abdominal pain. She exhibited no risk factors for hepatocellular carcinoma (HCC) and her serum tumor marker levels were normal. A computed tomography scan and gadolinium-enhanced magnetic resonance imaging of the liver revealed multiple liver masses, suggestive of multiple liver and lung metastases or an intrahepatic cholangiocarcinoma with lung metastasis. A diagnosis of PHL (a diffuse large B cell lymphoma) was confirmed by biopsy followed by immunohistochemistry. This case emphasizes that a PHL must be considered in the differential diagnosis of space-occupying liver lesions in patients with no risk factors for HCC and normal levels of serum tumor markers. It is notable that neither B cell lymphoma symptoms nor an elevated lactate dehydrogenase level were apparent in this case. We thus report a case of PHL mimicking multiple liver metastases or an intrahepatic cholangiocarcinoma, and we review the literature.
Abdominal Pain ; Biomarkers, Tumor ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiocarcinoma* ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Immunohistochemistry ; L-Lactate Dehydrogenase ; Liver Neoplasms ; Liver* ; Lung ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Risk Factors

PURPOSE: We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL). MATERIALS AND METHODS: TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time. RESULTS: The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors. CONCLUSION: The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.
Cohort Studies* ; Diagnosis ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin* ; Neoplasms, Second Primary ; Prospective Studies* ; Quality of Life* ; Recurrence ; Survivors*

To investigate the clinical manifestations, imaging features, and diagnosis for non-Hodgkin's lymphoma in the jaw, we retrospectively analyzed 3 cases of non-Hodgkin's lymphoma in the jaw and reviewed relevant literature. Three patients' lesion occurred in the maxilla with early painless masses. Two patients were diagnosed as diffuse large B-cell lymphoma via biopsy, and one patient underwent maxillofacial resection with pathological examination which showed plasmaoblastoma lymphoma. Non-Hodgkin's lymphoma in the maxilla is rare and easily misdiagnosed due to the atypical clinical features. Biopsy at the early stage of the lesion and pathological examination can assist the diagnosis for non-Hodgkin's lymphoma.
Biopsy ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; surgery ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; surgery ; Retrospective Studies

Non-Hodgkin's lymphoma on the parotid gland is a relatively rare occurrence among head and neck tumors. The mass of parotid gland lymphoma cannot be distinguished from other benign masses of the parotid gland; therefore, it is important to consider lymphoma in the differential diagnosis when examining parotid swellings and masses. Parotid gland lymphoma is most likely to be B-cell, non-Hodgkin's lymphoma of one of three types, which include follicular, marginal zone, and diffuse large B-cell, although other histologic patterns have been described. We present a review of a patient with diffuse large B-cell lymphoma (DLBCL) who presented to the Department of Oral and Maxillofacial Surgery of Pusan National University Hospital (Yangsan, Korea).
B-Lymphocytes ; Busan ; Diagnosis, Differential ; Head ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Neck ; Parotid Gland* ; Surgery, Oral

STUDY DESIGN: Case report. OBJECTIVES: To present a rare case of a spinal epidural lymphoma mimicking a hematoma. SUMMARY OF LITERATURE REVIEW: The incidence of extranodal invasion of lymphoma is very low, and spinal compression as a clinical symptom rarely occurs in extranodal lymphoma. MATERIALS AND METHODS: A 37-year-old woman who complained of neck pain that had lasted for the past 3 months with no underlying disease visited the hospital and was treated conservatively with medication and physical therapy. Even though the patient was given an epidural injection 1 month prior to visiting our hospital, the pain lingered and the cervical myelopathy became aggravated, so the patient was initially diagnosed with epidural hematoma. This predisposed the patient to treatment strategies such as laminectomy and fusion, but the patient was ultimately diagnosed with non-Hodgkin lymphoma. RESULTS: The patient underwent a laminectomy with excision of the lesion and fusion. The patient was diagnosed with non-Hodgkin lymphoma as a result of this, and the patient's radicular pain and numbness improved immediately following surgery, except for mild weakness in both hands. CONCLUSIONS: Although spinal epidural lymphoma is similar to hematoma, and is a very rare disease, surgeons should take it into consideration in the differential diagnosis of patients with a spinal epidural lesion.
Adult ; Diagnosis, Differential ; Female ; Hand ; Hematoma* ; Humans ; Hypesthesia ; Incidence ; Injections, Epidural ; Laminectomy ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Neck Pain ; Rare Diseases ; Spinal Cord Diseases ; Surgeons