• Title/Summary/Keyword: Non-Hodgkin's lymphoma(NHL)

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Lymphoma - clinical questions

  • Kim, Hyo-Cheol
    • 대한핵의학회:학술대회논문집
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    • 2002.05a
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    • pp.32-36
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    • 2002
  • Lymphoma is a group of neoplastic disease of lymphoid tissues, which can be classified into categories of Hodgkin's disease and non-Hodgkin's lymphoma(NHL). Prognosis of lymphoma depends on the extent of disease(staging) especially in Hodgkin's disease, but also depends on the histologic make up in non-Hodgkin's lymphoma. Although non-Hodgkin's lymphoma is a neoplastic transformation of lymphoid cell it is a collection of disease with merphologically and immunologically diverse make up. Consequently the classification of NHL has changed frequently and evolved according to the progress of immunologic and molecular knowledge added to the original morphologic classification. Lymphoma is a disorder sensitive to chemotherapy which often leads to cure of the disease even in advanced stage, while many other patients die from the progression of disease. Therefore, better understanding in newer classification and sensitive imaging technique, such as PET, in lymphoma will likely lead to the improvement of survival rate.

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Primary Extra Nodal Non Hodgkin Lymphoma: A 5 Year Retrospective Analysis

  • Padhi, Somanath;Paul, Tara Roshni;Challa, Sundaram;Prayaga, Aruna K.;Rajappa, Senthil;Raghunadharao, D.;Sarangi, Rajlaxmi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4889-4895
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    • 2012
  • Background and Aim: The incidence of extra nodal non Hodgkin lymphoma (ENL) is rising throughout the world. However, data regarding ENL as a group is limited. The aim was to study the epidemiological and histomorphological trends of primary ENL (pENL) in India. Material and Methods: The biopsy materials from sixty eight patients with pENL (45 male, 23 female, M:F= 1.9:1), diagnosed over a five year period (2005-2009), were analysed and pathologically reclassified according to the World Health Organization (WHO) classification, 2008 criteria. Results: Primary extra nodal non Hodgkin lymphomas constituted 22.0% (68/308) of all non Hodgkin lymphomas (NHL). The mean age at presentation for pENL and primary nodal NHL was 43 years and 58 years, respectively with a male predilection (M: F=2:1). Central nervous system (CNS) constituted the most common extranodal site (20/68, 29.5%) followed by gastrointestinal tract (17/68, 25%), and nose/nasopharynx (8/68, 11.8%). Diffuse large B-cell lymphoma (DLBCL, not otherwise specified), extranodal marginal lymphoma of mucosa associated lymphoid tissue (MALT) type, and B cell NHL unclassified (U) were the three most common histological types observed. T-cell phenotype was rarely noted (4%). Follicular lymphomas and anaplastic large cell lymphoma, seen among nodal NHL, were absent at extra nodal sites. Majority (41/68, 60%) of the patients with pENL were immunocompetent and 55% were in stage I-II with favorable prognosis. Conclusion: Central nervous system was the most common site of ENL, followed by gastrointestinal tract. Majority of pENL occurred in immunocompetent hosts with a favorable prognosis.

Determination of Frequency of Epstein-Barr Virus in Non-Hodgkin Lymphomas Using EBV Latent Membrane Protein 1 (EBV-LMP1) Immunohistochemical Staining

  • Ishtiaq, Sheeba;Hassan, Usman;Mushtaq, Sajid;Akhtar, Noreen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3963-3967
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    • 2013
  • Background: The presence of Epstein-Barr virus (EBV) in Non-Hodgkin's lymphoma can be identified by immunohistochemistry for detection of EBV latent membrane protein (LMP). The role of EBV as an etiologic agent in the development of non-Hodgkin lymphoma has been supported by detection of high levels of latent membrane protein 1 (LMP-1) expression in tumors. However, no study has been conducted in a Pakistani population up till now to determine the frequency of Epstein-Barr virus positivity. The objective of our study was to determine a value for non-Hodgkin lymphoma patients using EBV LMP-1 immunostaining in our institution. Materials and Methods: This study was carried out at the Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Pakistan from December 2011 to December 2012. It was a cross sectional study. A total of 71 patients who were diagnosed with various subtypes of NHL after histological and EBV LMP-1 immunohistochemical evaluation were studied. Sampling technique was non-probability purposive. Statistical analysis was achieved using SPSS version 17.0. Mean and SD were calculated for quantitative variables like patient age. Frequencies and percentages were calculated for qualitative variables like subgroup of NHL, results outcome of IHC for EBV and gender distribution. Results: Mean age of the patients was $53.6{\pm}16$ years (Mean${\pm}$SD). A total of 50 (70.4%) were male and 21 (29.6%) were female. Some 9 (12.7%) out of 71 cases were positive for EBV-LMP-1 immunostaining, 2 (22.2%) follicular lymphoma cases, 1 (11.1%) case of T-cell lymphoblastic lymphoma, 4 (44.4%) cases of diffuse large B cell lymphomas, 1 (11.1%) mantle cell lymphoma and 1 (11.1%) angioimmunoblastic T cell lymphoma case. Conclusion: In our study, frequency of EBV in NHL is 12.7% and is mostly seen in diffuse large B cell lymphoma. This requires further evaluation to find out whether this positivity is due to co-infection or has a role in pathogenesis.

Non-Hodgkin's Lymphoma Mimicking Second Bronchial Cleft Cyst (제2새열 낭종으로 오인된 비호지킨 림프종 1예)

  • Park, Hyun-Woo;Kim, Jin-Pyeong;Won, Sung-Jun;Woo, Seung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.96-98
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    • 2011
  • Non-Hodgkin's Lymphoma(NHL) is a malignant tumor that is derived from the lymphatic system. The most common symptoms of NHL are painless lymph node enlargement. However, we should not diagnose NHL by only fragmentary clinical symptom and radiologic finding because of the various lymphoma characters. We have treated a patient with such preoperative findings of Branchial cleft cyst. However, the pathologic diagnosis of the surgical specimen was diffuse large b-cell lymphoma.

Paraneoplastic demyelination in the brain presenting as a clinically occult non-Hodgkin's lymphoma

  • Son, Hyoshin;Choi, Jongsuk;Kim, Sung Un;Park, Kyung Seok
    • Annals of Clinical Neurophysiology
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    • v.21 no.2
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    • pp.108-112
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    • 2019
  • Non-Hodgkin's lymphoma (NHL) may initially present with atypical neurological manifestations, including paraneoplastic neurological syndromes. Herein, we report the case showing an initial manifestation of systemic NHL with paraneoplastic demyelination in the brain that initially mimicked the symptoms of stroke, seizure, and brain tumor. A high index of suspicion and timely diagnostic workup is required to prevent diagnostic delay and commence proper management of the condition. In this situation, a whole-body FDG PET/CT could be useful to screen for occult malignancy.

Importance of PET/CT Scan Use in Planning Radiation Therapy for Lymphoma

  • Milana, Mitric-Askovic;Marko, Erak;Miroslav, Latinovic;Tihomir, Dugandzija
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2051-2054
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    • 2015
  • Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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Dietary and Lifestyle Factors and Risk of Non-Hodgkin's Lymphoma in Oman

  • Ali, Amanat;Al-Belushi, Buthaina S.;Waly, Mostafa I.;Al-Moundhri, Mansour;Burney, Ikram A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.841-848
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    • 2013
  • Background: The incidence of various types of cancers including the non-Hodgkin's lymphoma (NHL) has increased during the recent years. Diet and lifestyle factors have been reported to play an important role in the etiology of NHL. However, no such data are available from the Middle Eastern countries, including Oman. Materials and Methods: Forty-three histologically confirmed cases of non-Hodgkin's lymphoma (NHL) diagnosed at the Sultan Qaboos University Hospital (SQUH) and the Royal Hospital (RH), Muscat, Oman and forty-three age and gender matched controls were the subjects of this study. Frequency matching was used to select the control population. Information on social and demographic data as well as the dietary intake was collected by personal interviews, using a 117-items semi-quantitative food frequency questionnaire. Results: A non-significant increased risk of NHL was observed with higher body mass index (BMI) (OR=1.20, 95%CI: 0.45, 2.93), whereas a significantly decreased risk of NHL was associated with a higher educational level (OR=0.12, 95%CI: 0.03, 0.53). A significantly increased risk was observed for higher intake of energy (OR=2.67, 95%CI: 0.94, 7.57), protein (OR=1.49, 95%CI: 0.54, 4.10) and carbohydrates (OR=5.32, 95%CI: 1.78, 15.86). Higher consumption of daily servings from cereals (OR=3.25, 95%CI: 0.87, 12.09) and meat groups (OR=1.55, 95%CI: 0.58, 4.15) were also found to be associated with risk of NHL, whereas a significantly reduced risk was associated with higher consumption of vegetables (OR=0.24, 95%CI: 0.07, 0.82). The consumption of fruits, milk and dairy products however showed no significant association with the risk of developing NHL. Conclusion: The results suggest that obesity, high caloric intake, higher consumption of carbohydrate and protein are associated with increased risk of NHL, whereas a significantly reduced risk was observed with higher intake of vegetables.

Signs, Symptoms and Complications of Non-Hodgkin's Lymphoma According to Grade and Stage in South Iran

  • Dehghani, Mehdi;Haddadi, Sara;Vojdani, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3551-3557
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    • 2015
  • Background: Non-Hodgkin's lymphoma (NHL) is a heterogeneous type of neoplasm of the lymphatic system. To have a more accurate and early diagnosis we need to know signs, symptoms and complications of lymphoma in early stages besides pathology and immunohistochemistry. Materials and Methods: This prospective study included 110 cases of NHL that were followed since February 2012 till November 2013. Biopsies were taken from all the patients besides bone marrow study. Signs and symptoms were categorized into "B" symptoms, general, lymphadenopathy and extranodal involvement and we compared the frequencies by stage and grade. Results: Of 110 cases, 88.9% had B-cell and 11.1% T-cell type with mean age $48.5{\pm}18.6$ years. "B" symptoms and lymphadenopathy were more common in men. Cervical lymphadenopathy was the most common sign (44.8%). and hematologic, bone marrow, bone and neurologic lesions were the most common complications. All complications were more common in males. "B" symptoms were seen mostly in stage III, general signs and symptoms in stage IV, and lymphadenopathy in stage II. Intermediate grade was also the most common in all signs and symptoms. In this study 12 (10.9%) patients had relapse, with neurologic and bone marrow as the most common sites of tumor recurrence. Conclusions: There is a meaningful relationship between male gender for NHL and anemia that can be due in part to higher incidence of bone marrow involvement and stage IV disease in male cases. We also found a strong relationship between low grade NHL and age. On the other hand extranodal involvement is more common in female groups.

Primary non-Hodgkin lymphoma of the parotid gland: a case report

  • Ryoo, Hyun Jung;Lim, Jin Soo;Kim, Min Cheol
    • Archives of Craniofacial Surgery
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    • v.23 no.3
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    • pp.125-129
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    • 2022
  • Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are nonspecific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.