ABSTRACT
Objective:To investigate the clinical features, diagnosis and treatment of lymphoplasmacytic lymphoma (LPL) with biclonal M protein.Methods:The clinical data of one LPL patient with biclonal M protein at Yancheng First People's Hospital in January 2018 was retrospectively analyzed, and relevant literature was reviewed.Results:The patient was an elderly woman with clinical manifestations of lymphadenopathy, kidney damage, anemia, and bone destruction. The diagnosis was confirmed based on lymph node biopsy, immunofixation electrophoresis, bone marrow cytology, and genetic mutation testing (MYD88 L265P mutation-positive). Partial remission was achieved after 4 courses of treatment with bortezomib-based regimen.Conclusions:Clinically, LPL with biclonal M protein shows one characteristic of M protein, and the immunoglobulin IgM and IgA biclonal LPL is even rarer. The treatment scheme based on bortezomib has a certain therapeutic effect.
ABSTRACT
Objective@#To study the clinicopathological features and therapeutic regimens of primary testicular lymphoma (PTL).@*Methods@#The clinical data of 16 patients diagnosed with PTL from January 2005 to December 2015 in Jiangsu Province Hospital were collected, and the clinicopathological characteristics were retrospectively analyzed. Kaplan-Meier method was used to make the survival analysis.@*Results@#The median onset age of 16 patients was 63 years old (33-81 years old). According to Ann Arbor stage, there were 8 cases of stage ⅠE, 2 cases of stage ⅡE, 6 cases of stage Ⅲ-Ⅳ. The initial symptoms included painless solid enlargement of the testis (9 cases), painful testis (3 cases), distending pain of testis (1 case), and the patients had no other systemic symptoms. The pathological type was diffuse large B-cell lymphoma (DLBCL), of which 2 patients were germinal center B-cell (GCB) type and the other 14 patients were non-GCB type. All the patients received the orchiectomy, of which 14 received chemotherapy alone after the operation, 2 received chemotherapy and radiotherapy. Complete follow-up data were available for 14 patients, and the median follow-up time was 23.5 months (1.0-97.0 months). Among 14 patients, complete remission was achieved in 11 patients, partial remission in 1 patient, no response in 1 patient, and 1 patient was undergoing treatment. Among 11 patients with complete remission, 5 patients relapsed, and the recurrence occurred at the central nervous system (3 cases), skin of right lower extremity (1 case), and contralateral testis (1 case). The mean progression-free survival (PFS) time was 19.0 months (14.0-95.0 months).@*Conclusions@#Most PTL is primary testis DLBCL, and the comprehensive treatment based on surgery is the main therapy of PTL. Postoperative chemotherapy with or without radiotherapy is recommended to prevent relapse.