• Asian Pacific Journal of Cancer Prevention
• /
• 제16권3호
• /
• pp.1135-1138
• /
• 2015

Background: The objective of this study was to investigate the MSCT characteristics of PTL in order to enhance the awareness of this uncommon entity among both clinicians and radiologists. Materials and Methods: The clinicopathological data and MSCT images of 27 patients with PTL were retrospectively reviewed. The MSCT appearances were classified into three types: type 1, solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, enlarged thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: The patients were enrolled in the study with a mean age of 68 years (range, 51-86years) and compression symptoms or enlarged cervical lymph nodes at diagnosis. Hashimoto's thyroiditis was in 20 patients. All patients had non-Hodgkin lymphoma of B-cell in origin, including 22 cases of diffuse large B-cell lymphoma (DLBCL) and 5 of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). For MSCT appearance, type 1 pattern was observed in 2 patients, type 2 in 8, and seventeen type 3 in 17. The lesions occurred in more than one lobe with a mean maximal transverse diameter of 6.9 cm and an ill-defined margin. Most tumors showed a homogeneous attenuation equal to that of surrounding muscles before contrast and obvious enhancement after contrast. Cervical lymph node involvement and invasion of the trahea and (or) esophagus were mainly observed in patients with DLBCL. Conclusions: PTL should be clinically considered in elder patients presenting with a history of Hashimoto's thyroiditis and cervical lymphadenopathy. The MSCT characteristics of PTL includes a mass diffusely affecting more than one thyroid lobe, isointense to muscle and obvious enhancement before and after contrast. DLBCL, the most common histological subtype of PTL, is associated with a higher invasive tendency.

• Journal of Yeungnam Medical Science
• /
• 제38권3호
• /
• pp.258-263
• /
• 2021

Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.

• Radiation Oncology Journal
• /
• 제31권4호
• /
• pp.177-184
• /
• 2013

Purpose: The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Materials and Methods: Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. Results: The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Conclusion: Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권8호
• /
• pp.3727-3731
• /
• 2016

Background: The most common type of ocular lymphoma is non-Hodgkin lymphoma (NHL), categorized into two groups: indolent (slow growing) and aggressive (rapid growing). Differentiating benign reactive lymphoid hyperplasia (RLH) from malignant ocular adnexal lymphoma (OAL) is challenging. Histopathology, immunohistochemistry (IHC) and flow cytometry have been used as diagnostic tools in such cases. Materials and Methods: In this retrospective case series, from 2002 to 2013 at Farabi Eye Center, 110 patients with ocular lymphoproliferative disease were enrolled. Prevalence, anatomical locations, mean age at diagnosis and the final diagnosis of the disease with IHC were assessed. Comparison between previous pathologic diagnoses and results of IHC was made. Immunoglobulin light chains and B-cell and T-cell markers and other immuno-phenotyping markers including CD20, CD3, CD5, CD23, CD10, CYCLIND1 and BCL2 were evaluated to determine the most accurate diagnosis. The lymphomas were categorized based on revised European-American lymphoma (REAL) classification. Results: Mean age ${\pm}$ SD (years) of the patients was $55.6{\pm}19.3$ and 61% were male. Patients with follicular lymphoma, large B-cell lymphoma or chronic lymphocytic leukemia/small cell lymphoma (CLL/SLL) tended to be older. Nine patients with previous diagnoses of low grade B-cell lymphoma were re-evaluated by IHC and the new diagnoses were as follows: extranodal marginal zone lymphoma(EMZL) (n=1), SLL(n=1), mantle cell lymphoma (MCL) (n=3), reactive lymphoid hyperplasia RLH (n=2). Two cases were excluded due to poor blocks. Flow cytometry reports in these seven patients revealed SLL with positive CD5 and CD23, MCLwith positive CD5 and CyclinD1 and negative CD23, EMZL with negative CD5,CD23 and CD10. One RLH patient was negative for Kappa/Lambda and positive for CD3 and CD20 and the other was positive for all of the light chains, CD3 and CD20. Orbit (49.1%), conjunctiva (16.1%) and lacrimal glands (16.1%) were the most common sites of involvement. Conclusions: Accurate pathological classification of lesions is crucial to determine proper therapeutic approaches. This can be achieved through precise histologic and IHC analyses by expert pathologists.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권8호
• /
• pp.3333-3338
• /
• 2015

Background: This study was conducted to analyze positron emission tomography (PET) / computed tomography (CT) and magnetic resonance imaging (MRI) performance with oropharyngeal non-Hodgkin's lymphoma (ONHL).Materials and Methods: The complete image data of 30 ONHL cases were analyzed, all patients were performed PET / CT and MRI examination before the treatment, with the time interval of these two inspections not exceeding 14 days. The distribution, morphology, MRI signal characteristics, enhancement feature, standardized uptake value (SUV) max value and lymph node metastasis way of the lesions were analyzed. Results: Among the 30 cases, 23 cases were derived from the B-cell (76.7%), 5 cases were derived from the peripheral T cells (16.7%) and 2 cases were derived from the NK/T cells (6.7%). 19 cases exhibited the palatine tonsil involvement (63.3%). As for the lesion appearance, 10 cases appeared as mass, 8 cases were the diffused type and 12 cases were the mixed type. 25 cases exhibited the SUVmax value of PET / CT primary lesions as 11 or more (83.3%). MRI showed that all patients exhibited various degrees of parapharyngeal side-compressed narrowing, but MRI still exhibited the high-signal fat, and the oropharyngeal mucosa was intact. 25 cases were associated with the neck lymph node metastasis, among who 22 cases had no necrosis in the metastatic lymph nodes, while the rest 3 cases exhibited the central necrosis in the metastatic lymph nodes. Conclusions: PET / CT and MRI have important value in diagnosing and determining the lesion extent of ONHL.

• 대한핵의학회지
• /
• 제37권3호
• /
• pp.171-177
• /
• 2003

목적: 악성 림프종 환자에서 골수 침범 여부를 평가하는 데 있어 FDG PET 스캔의 유용성을 장골 골수 생검에 비교하여 평가하고자 한다. 대상 및 방법: 73명의 림프종 환자(남:녀=43:30, 평균 연령 47세)를 대상으로 하였다. 이 중 69명은 비호지킨성 림프종이었으며 4명은 호지킨성 림프종이었다. FDG PET은53명의 환자에서 병기 결정을 목적으로, 20명에서는 치료후 효과 평가를 위해 시행되었다. 골수 침범에 대한 최종 판정은 두 검사의 일치성으로 판단되었으며 서로 다른 경우엔 장골 골수 생검, 방사선 검사 소견, 그리고 추적 검사에 의해 결정되었다. 결과: 73명중 54명(74%)에 있어 FDG PET과 장골 골수 검사 결과가 일치하였다. 두 검사 모두 음성인 환자는 54명중 47명이었으며 모두 양성인 환자는 7명이었다. 두 검사가 불일치 하는 경우는 19명 이었으며 이 중 6명은 골수 검사는 음성이었으나 FDG PET에서 양성 소견을 보였다. 반대로 12명에서는 FDG PET은 음성이었으나 장골 골수 생검상 골수 침범이 확인되었다. 불일치 결과를 보인 19명 중 마지막 1명의 환자에서는 골수 생검상 음성이었으나 FDG PET에서 위양성 소견을 보였다. 결론: FDG PET은 림프종 환자의 병기 결정에 있어 장골 골수 검사상 발견되지 않은 골수 침윤을 발견하는 데 도움이 되어 골수 생검에 보조적인 역할이 있었다. PET 검사상 횡격막 상하 림파절 침범과 다수의 골수 병변이 있는 환자에 있어 골수 생검의 필요성에 대해서는 치료 방침이나 예후를 변화시킬 수 있는지의 여부를 보는 연구가 필요하리라 생각된다. 치료후 효과를 판정하는 데 있어 FDG PET은 골수의 현미경학적 잔존 질환을 평가하는 데 있어 골수 생검을 대체하기는 어려울 것으로 사료된다.

• Radiation Oncology Journal
• /
• 제33권4호
• /
• pp.310-319
• /
• 2015

Purpose: Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Materials and Methods: Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). Results: All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. Conclusion: RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.

• Tuberculosis and Respiratory Diseases
• /
• 제40권2호
• /
• pp.192-196
• /
• 1993

저자들은 10일간의 우측 흉통을 주소로 내원한 17세 남자환자에서 흉벽에 발생한 악성 T 세포형 임파종 1예를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
• /
• 제39권6호
• /
• pp.409-412
• /
• 2006

Objective : Primary central nervous system lymphoma[PCNSL] is a non-Hodgkin's lymphoma arising in the central nervous system. Combined chemotherapy and radiation therapy is the standard treatment for PCNSL. However, treatment induced neurotoxicity is a major problem especially in elderly patients. Methods : From May 2001 to April 2004, elderly five patients with PCNSL confirmed via pathological examination were underwent Novalis radiosurgery in authors' institution, who were investigated retrospectively. Of these patients, 2 were male and 3 were female, with a mean age 68 years old [range $65{\sim}73$]. The number of lesions was 1 in 2 patients, 2 in 2, and 3 in 1. The mean follow up period was 12.6 months [range $8{\sim}16$]. Results : Clinical symptoms and signs in all patients markedly improved within 1 weeks after Novalis radiosurgery. The Karnofsky performance status score was also improved from a pre-radiosurgery average of 68 to a post-radiosurgery one of 82. All of treated lesions showed a partial or complete regression of the original mass. There have been no complication following Novalis radiosurgery. Conclusion : The preliminary results of our experience indicate that radiosurgery with Novalis provides a safe and effective therapeutic alternative treatment of PCNSL in elderly patients.

• Journal of Chest Surgery
• /
• 제37권4호
• /
• pp.376-381
• /
• 2004

원발성 심장 림프종은 원발성 심장 종양의 1.3%를 차지하는 드문 악성 종양으로, 절외성 림프종(Extronodal Lymphoma)의 한 형태로 심장 및 심장막에 발생한다. 급격히 진행하는 심부전, 부정맥, 심낭 삼출 및 심장 압전 등의 증상이 나타난다. 원발성 심장 림프종의 진단은 심초음파 및 흉부 단층촬영 및 자기공명영상 등이 이용되며, 종양에 대한 경정맥하 조직 생검과 심낭 삼출액의 세포학적 및 면역생화학 검사로 확진할 수 있다 원발성 심장 림프종은 진단이 지연되거나, 진단 시 이미 장기 내침범으로 인한 진행된 단계로 예후가 불량하다 따라서 조기 진단과 완전한 심장 종양의 절제가 필요하며, 수술 후 생존율 개선을 위해 적극적인 전신 항암 요법 및 방사선 요법이 보강요법으로 시행되어야 한다. 본 증례에서는 우심실 유입로와 방실구에 종괴의 광범위한 침윤이 있었고, 우심방 내로 침범이 되어 있어 수술적 절제가 불가능하였다. 종괴의 조직생검으로 확진 후 항암요법 및 방사선요법으로 증상의 개선 및 종괴의 크기 감소 소견을 보였다. 저자들은 우심실에서 발생하여 우심방을 침범한 원발성 심장 비호지킨써 림프종을 경험하였으며 그 조기 결과를 문헌고찰과 함께 보고한다.