BACKGROUND: Pulmonary nodular lymphoid hyperplasia (PNLH) is a non-neoplastic pulmonary lymphoid disorder that can be mistaken for malignancy on radiography. Herein, we present nine cases of PNLH, emphasizing clinicoradiological findings and histological features. METHODS: We analyzed radiological and clinicopathological features from the electronic medical records of nine patients (eight females and one male) diagnosed with PNLH. IgG and IgG4 immunohistochemical staining was performed in three patients. RESULTS: Two of the nine patients had experienced tuberculosis 40 and 30 years prior, respectively. Interestingly, none were current smokers, although two were ex-smokers. Three patients complaining of persistent cough underwent computed tomography of the chest. PNLH was incidentally discovered in five patients during examination for other reasons. The remaining patient was diagnosed with the disease following treatment for pneumonia. Imaging studies revealed consolidation or a mass-like lesion in eight patients. First impressions included invasive adenocarcinoma and mucosal-associated lymphoid tissue‒type lymphoma. Aspergillosis was suspected in the remaining patient based on radiological images. Resection was performed in all patients. Microscopically, the lesions consisted of nodular proliferation of reactive germinal centers accompanied by infiltration of neutrophils and macrophages in various degrees and surrounding fibrosis. Ultimately, all nine patients were diagnosed with PNLH and showed no evidence of recurrence on follow-up. CONCLUSIONS: PNLH is an uncommon but distinct entity with a benign nature, and understanding the radiological and clinicopathological characteristics of PNLH is important.
Adenocarcinoma ; Aspergillosis ; Cough ; Electronic Health Records ; Female ; Fibrosis ; Follow-Up Studies ; Germinal Center ; Humans ; Hyperplasia ; Immunoglobulin G ; Lymphoma ; Macrophages ; Neutrophils ; Pneumonia ; Pseudolymphoma ; Radiography ; Recurrence ; Thorax ; Tuberculosis

Diffuse large B cell lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin's lymphoma. As treatments continues to evolve, so do imaging strategies, and positron emission tomography (PET) has emerged as the most important imaging tool to guide oncologists in the diagnosis, staging, response assessment, relapse/recurrence detection,and therapeutic decision making of DLBCL. Other imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, and conventional radiography are also used in the evaluation of lymphoma. MRI is useful for nervous system and musculoskeletal system involvement and is emerging as a radiation free alternative to PET/CT. This article provides a comprehensive review of both the functional and morphological imaging modalities, available in the management of DLBCL.
B-Lymphocytes* ; Decision Making ; Diagnosis ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Musculoskeletal System ; Nervous System ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Radiography ; Ultrasonography

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

The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.
Aged ; Antibodies, Monoclonal, Murine-Derived/adverse effects/therapeutic use ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Biopsy/methods ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy/microbiology ; Pneumocystis jirovecii/pathogenicity ; Pneumonia, Pneumocystis/*diagnosis/*radiography ; Positron-Emission Tomography ; Prednisone/adverse effects/therapeutic use ; Solitary Pulmonary Nodule/*microbiology ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed ; Vincristine/adverse effects/therapeutic use

A 39-year-old man infected with human immunodeficiency virus (HIV) was admitted to our hospital because of sudden onset of chest pain. Chest radiography revealed pneumothorax of the right lung. Computed tomographic scans disclosed a 5.8-cm-sized emphysematous bulla in the right middle lobe of the lung. Histologically, the wedge-resected lung showed medium to large atypical cells within the bullous cavity of the Pneumocystis jirovecii pneumonia, without solid mass formation. These atypical cells were confirmed to be large B-cell lymphoma, Epstein-Barr virus-positive and human herpesvirus 8-negative. Therefore, this case was not diagnosed as primary effusion lymphoma, but effusion-based lymphoma arising in an emphysematous cavity of an HIV-infected patient. This type of effusion-based lymphoma has never been reported, and, although rare, it should be noted in order to clinically diagnose this lymphoma.
Adult ; Chest Pain ; Herpesvirus 4, Human ; Herpesvirus 8, Human ; HIV* ; Humans* ; Lung ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Pneumocystis jirovecii ; Pneumonia ; Pneumothorax ; Radiography ; Thorax

BACKGROUND/AIMS: The aim of this study was to investigate the frequency of disseminated gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the role of bone marrow study in the initial staging work-up. METHODS: A total of 194 patients with gastric MALT lymphoma was enrolled. The incidence of disseminated disease was evaluated in the initial staging work-up. The demographic data and tumor characteristics were compared according to Helicobacter pylori infection status. RESULTS: Localized disease of Lugano stage I accounted for 97.4% of the enrolled cases. Abdominal computed tomography revealed abdominal lymph node metastasis in five patients (2.6%). Bone marrow (BM) involvement was found in only one patient without H. pylori infection (0.5%). No patient showed positive findings on chest computed tomography or positron emission tomography. H. pylori-negative cases showed a significantly higher frequency of advanced-stage disease than H. pylori-positive cases (10.0% vs 0.6%). In patients achieving complete remission, no extragastric recurrence occurred during follow-up. CONCLUSIONS: The incidence of disseminated disease, including BM involvement, was very low in Korean gastric MALT lymphoma patients. It might be beneficial to perform BM aspiration and biopsy as a part of staging work-up only in patients with risk factors for advanced disease such as H. pylori negativity.
Abdomen ; Adult ; Aged ; Bone Marrow/*pathology ; Bone Marrow Examination ; Cohort Studies ; Female ; Helicobacter Infections/*complications ; Humans ; Lymph Nodes/*radiography ; Lymphoma, B-Cell, Marginal Zone/complications/*pathology ; Male ; Mediastinum/radiography ; Middle Aged ; Neoplasm Staging ; Radiography, Abdominal ; Republic of Korea ; Retrospective Studies ; Stomach Neoplasms/complications/*pathology ; Tomography, X-Ray Computed

An Australian cattle dog (case 1: 6-year-old castrated male) and a Shih-Tzu dog (case 2: 8-year-old castrated male) were referred to the Gyeongsang Animal Medical Center due to anorexia and depression. Physical examinations, complete blood counts, serum chemical analysis, radiography, ultrasonography, and bone marrow biopsy were performed. Upon physical examinations of cases 1 and 2, enlargement of superficial lymph nodes was not identified. Hematologic findings in these dogs included leukocytosis with severe lymphocytosis, anemia, and thrombocytopenia. Upon radiography, both dogs showed splenomegaly. Upon examination of a peripheral blood smear in case 1, immature lymphoid cells, featuring decreased nuclear chromatin condensation and nuclear pleomorphism, were present. Biopsy samples of the bone marrow in case 1 revealed hypercellularity as well as a large number of immature lymphoblastic cells similar in shape to cells in the peripheral blood. The characteristic morphological features of peripheral blood and bone marrow samples in case 2 were small lymphocytes. Thus, the dogs were tentatively diagnosed with acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL), respectively. After diagnosis, the CLL patient was administered chlorambucil and prednisolone therapy. Due to its similarity to human leukemia, the canine leukemia model provides a valuable model for research into human leukemia.
Anemia ; Animals ; Anorexia ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cattle ; Child ; Chlorambucil ; Chromatin ; Depression ; Diagnosis ; Dogs* ; Humans ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukocytosis ; Lymph Nodes ; Lymphocytes ; Lymphocytosis ; Lymphoma ; Physical Examination ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisolone ; Radiography ; Splenomegaly ; Thrombocytopenia ; Ultrasonography

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

OBJECTIVETo investigate the prognostic value of interim and post-therapy PET-CT in patients with diffuse large B-cell lymphoma.

METHODSA retrospective analysis was conducted on data from 116 patients with newly diagnosed diffuse large B-cell lymphoma. 43 patients underwent interim PET-CT after 4 cycles of chemotherapy, 48 patients underwent post-therapy PET-CT after 6-8 cycles of chemotherapy, and 25 patients underwent both interim PET-CT and post-therapy PET-CT. The patients were divided into three groups: complete response group, partial response group and no response group. The therapeutic response was assessed by comparing with baseline PET-CT. PET-CT status was assessed for its ability to predict progression-free survival (PFS) and overall survival (OS). The 2-year PFS rate and 3-year OS rate were evaluated using chi-square test. PFS and OS were estimated according to the Kaplan-Meier method and survival curves were compared by log-rank test.

RESULTSInterim PET-CT: The interim PET-CT findings of 42 patients were judged as complete response, 15 were judged as partial response, and the rest 11 were judged as no response. The 2-year PFS rates of the complete response group, partial response group and no response group were 61.9%, 60.0%, and 18.2%, respectively, and the 3-year OS rates were 52.4%, 46.7% and 9.1%, respectively. There were no significant differences between the complete response group and partial response group in 2-year PFS rate and 3-year OS rate (P > 0.05 for both). But there was a significant difference between the partial response group and no response group (P < 0.05). The post-therapy PET-CT findings of 50 patients was judged as complete response, 11 as partial response, and the rest 12 were judged as no response. The 2-year PFS rate of the complete response group, partial response group and no response group were 82.0%, 45.5%, and 8.3%, respectively, and the 3-year OS rates were 88.0%, 54.5%, and 8.3%, respectively. There were significant differences between the complete response group and partial response group in 2-year PFS rate and 3-year OS rate (P < 0.05), and there was a significant difference between the partial response group and no response group (P < 0.05).

CONCLUSIONSCompared with the interim PET-CT, post-therapy PET-CT can accurately evaluate the prognosis of patients with DLBCL. Interim PET-CT cannot define the prognosis of the complete response and partial response patients.

Adult ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Prognosis ; Radiography ; Remission Induction ; Retrospective Studies ; Treatment Outcome

No abstract available.
Bone Marrow/*pathology ; Female ; Helicobacter Infections/*complications ; Humans ; Lymph Nodes/*radiography ; Lymphoma, B-Cell, Marginal Zone/*pathology ; Male ; Stomach Neoplasms/*pathology