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Objective@#To explore the imaging presentation of 18F-FDG PET-CT and clinical characteristics of the patients with lymphoblastic lymphoma (LBL).@*Methods@#The clinical and imaging data of 18 patients with newly diagnosed LBL in the First Affiliated Hospital with Nanjing Medical University from July 2009 to June 2017 were retrospectively analyzed. The sensitivity, specificity and accuracy of 18F-FDG PET-CT to diagnose bone marrow involvement (BMI) was calculated respectively.@*Results@#There were 18 LBL patients, including 12 male and 6 female with median age of 24.5 (14-51) years old. Eleven patients were T-LBL, and 7 patients were B-LBL. All lesions were presented with high 18F-FDG uptake on 18F-FDG PET-CT imaging, with a median SUVmax of 14.3 (10.6, 16.8). The most frequent lymph node involvement site was mediastinal lymph nodes, and 7 T-LBL cases had jugular node involvement. The most frequent extranodal involvement site was bone marrow, with multifocal FDG accumulation in bone marrow on 18F-FDG PET-CT imaging in 8 cases. The median SUVmax of node and extranodal involvement were 15.0 (9.0, 18.2), 12.3 (8.4, 15.3), and there was no significant difference (Z=-0.867, P= 0.386). The median SUVmax of T-LBL and B-LBL patients was 14.1 (9.2, 15.9), 14.5 (12.1, 19.5) respectively, and there was no significant difference (Z=-0.679, P= 0.497). According to clinical features, 18F-FDG PET-CT and bone marrow biopsy (BMB), 12 patients were diagnosed as BMI. If multifocal FDG accumulation and diffuse hypermetabolism of FDG in bone marrow were considered as the diagnosis criteria, the sensitivity, specificity and accuracy of PET-CT was 91.7% (11/12), 66.7% (4/6), 83.3% (15/18), respectively. The parameters in BMB were 50.0% (6/12), 100.0% (6/6), 66.7% (12/18), respectively.@*Conclusions@#LBL mostly occurs in young men and its clinical manifestations include lymphadenectasis and invasion of bone marrow. 18F-FDG PET-CT has certain characteristics which are helpful to diagnose and staging.
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Objective To investigate the effect of bortezomib combined with doxorubicin on lymphoblastic lymphoma cell line Molt-4.Methods Molt-4 cells were cultured in the presence of bortezomib and doxorubicin,cell viability was monitored by CCK-8 and trypan-blue exclusion.Apoptosis was detected by flow cytometry and mitochondrial membrane potential,expression of Fas was also measured with flow cytometry.Results Molt-4 cell proliferation was substantially inhibited in concentration-dependent manners when treated with either bortezomib or doxorubicin.The combination of both drugs synergistically inhibited Molt-4 cell proliferation at 48 hours [(57.24±0.10) ％].Combination therapy further enhanced bortezomib and doxorubicin induced apoptosis [48 h (23.08±1.25) ％] (P ＜ 0.05).Detection of mitochondrial membrane potential showed that combination therapy could promote apoptosis (15.84 ％,5.38 ％,5.52 ％) but did not significantly change the level of Fas expression (P ＞ 0.05).Conclusion Combination therapy of bortezomib with doxorubicin efficiently inhibits proliferation and induces apoptosis of Molt-4 cells.Activation of mitochondrial and intrinsic apoptotic pathway may play important roles.
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ObjectiveTo investigate the clinicopathologic features of lymphoblastic lymphoma (LBL).Methods21 cases of LBL were examined by light microscopy and immunohistochemistry,and analyzed with clinical features.Results21 cases of LBL patients ranging in age from 4 to 86 years old,including 17 cases originated from the lymph nodes, the other 4 were from the nasopharynx, breast, pleura and mediastinum respectively. Histopathologically: lymphoid cells were median sized, showing a diffuse infiltration. The neoplastic cells had fine chromatin, higer nuclei mitoses. The tumors were positive for TdT and CD99.ConculsionPatients especially who have enlarged lymph nodes in adolescents favor the diagnosis of LBL.The tumor cells show a diffuse infiltration,usually with median size,fine chromatin.The positivity for TdT in immunostaining can confirm the diagnosis of LBL.
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Objective To study the clinicopathologic features and prognosis factor of Chinese lymphoblastic lymphoma.Methods 105 LBL cases were collected.Routine HE staining,immunostaining were used to investigate the clinicopathologic features,immunotype.Results The ratio of male to female was 1.76:1 (67:38),the medial age was 13 years old (0-73 years old).53 cases (53/105,50.48 ％) primarily showed lymph node involvement,including 34 cases (34/53,64.15 ％) showed jugular node involvement;mediastinum (12/52,23.08 ％) was the most frequent extranodal involvement site.69 cases (69/105,65.71％)showed bone marrow involvement with 15 cases as the primary involvement.The expression of TdT,CD99,CD3(E),CD20,CD79a,PAX5,MPO,CD34 and CD117 was 84.76 ％ (89/105),85.00 ％ (68/80),54.37 ％ (56/103),16.67 ％ (16/96),40.00 ％ (8/20),46.67 ％ (28/60),14.29 ％ (8/56),25.00 ％ (4/16) and 0.All cases were divided in to two groups,62 cases as T-LBL (59.05 ％,62/105) and 33 cases as B-LBL (31.43 ％,33/105),with 9 cases (8.57 ％,9/105) without the expression of T or B cell marker and 1 cases with the expression of both T and B cell marker.61 cases were detected the expression of myeloid markers and 8 cases were positive.All cases were followed up.The medial survival was 36 months.The survival at 1 year,2 year and 3 year was 66.67 ％ (70/105),48.81％ (41/84) and 20.69 ％ (12/58) respectively.Age was the prognosis associated factor.The children had better progonosis than adults.Immunotype,bone marrow involovement and transplantation didn' t show prognosis indicator (P ＞ 0.05).Conclusion Most of Chinese LBL occurs in child and younger male,multi-lymphadehypertrophy and bone marrow involvement are common.LBL is an aggressive tumor.Age is the prognosis associated factor.Children have a better prognosis than the adult.
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Objective To explore the efficacy of non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma (T-LL). Methods 3 T-LL patients achieving complete remission received haploidentical bone marrow stem cell transplantation with granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow grafts from related donor without T-cell depletion. Two of them received a myeloablative conditioning regimen consisting of high-doses of cyclophosphamide and cytarabine with total body irradiation, whereas the other was preconditioned with busulfan, cyclophosphamide and cytarabine. All patients received strengthened phophylaxis regimen including rabbit anti-thymocyte globulin against acute graft-versus-host disease. Results All patients had rapid hematopoietic engraftment with the median time for neutrophil and platelet recovery being 12 days and 13 days, respectively. They are still alive without relapse at a median follow-up of 24 months (range: 9-75 months). Conclusion Treatment related toxicity can be acceptable in non-T cell depletion haploidenfical hematopoietic stem-cell transplantation for T-LL and the patients may achieve long term survival.
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Objective To study the expression of PTEN et al and their significance in T lymphoblastic lymphoma/leukaemia (T-LBL/ALL). Methods Seventy-six cases of T-LBL/ALL were studied by using immunohistochemistry (EnVision method) for CD3, CD7, CD10, CD20, CD23, CD43, CD45RO, CD99, TdT, MPO and PTEN. Follow-up was included. Results In the Seventy-six cases of T-LBL/ALL, the percentages of tumor cells expressing TdT, CD99, CD3, CD7, CD45RO and CD43 were 93.42%, 94.74%, 67.12%, 92.11%, 36.85%,and 51.33%, respectivly while MPO, CD20 and CD23 were all negative. The index of Ki-67 expression higher than 80 % was found in 27 and ≤80% in 49 cases. The expression of PTEN (64.47 %) in T-LBL/ALL was lower than that of in reactivated lymphoid tissue (100%, P0.05). Conclusion The antibodies of CD3,CD7, CD10, CD20, CD43, CD45RO, CD99, TdT, MPO and Ki-67 were very helpful for the diagnosis of T-LBL/ALL.Down-regulation of PTEN may play an important role on the development of T-LBL/ALL.
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In this short opinion review we discuss recent aspects of T-lymphoma lymphoblastic adults, like the evolution of the knowledge of classification, prognostic factors and the patients management.
Nesta breve revisão os autores apresentam diversos aspectos de evolução dos conhecimentos na classificação e no manuseio dos pacientes portadores de linfoma linfoblástico-T em adultos.
Subject(s)
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Transplantation, Autologous , Classification , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/drug therapyABSTRACT
Objective To improve the recognition of precursor T- lymphoblastic lymphoma (T-LBL)of the breast. Methods One case of breast T- LBL was reported, the development of breast non-Hodgkin lymphoma and T-LBL presenting as breast masses was reviewed. Results One case of breast T-LBL was diagnosed, the patient with a high leukocyte count, breast mass and peripheral lymph nodes was treated with Hyper-CVAD regimen after active therapy and achieved complete remission (CR). Followed by maintenance therapy with Hyper-CVAD regimen for three times, disease free survival had been obtained five month.Conclusion Lymphoma of the brest is a rare malignancy. T-LBL is a highly aggressive disease with adverse prognosis, it is very uncommon for presenting as lymphoma of breast. Initiation of intensive muhiagent chemotherapy can improve the free survival and the prognosis.
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p63 is a recently described p53 homologue. It is involved in survival and differentiation of reserve/stem cells in epithelia. To obtain new insights into the role of p63 in malignant lymphomas (MLs), immunohistochemical staining for p63 and p53 was performed in 126 cases of MLs. p63 was expressed in 38 cases of MLs (30.2%) including 32/61 cases (52.5%) of diffuse large B-cell lymphoma (DLBCL), 1/8 cases (12.5%) of precursor T-lymphoblastic lymphoma (T-LBL), 4/14 cases (28.6%) of follicular lymphoma, 1/6 cases (16.7%) of T/NK cell lymphoma. Among p63 positive cases, p63 was strongly expressed in 15/32 cases of DLBCL and 1/1 case of T-LBL. p63 was not expressed in mantle cell lymphomas, peripheral T-cell lymphomas, marginal zone B-cell lymphomas, plasma cell myelomas and Hodgkin's lymphomas. p63 was coexpressed with p53 in 18/38 p63 positive cases in which only 4 cases were strongly coexpressed. All p63+/p53+ cases were DLBCL. p63 overexpression (above 30%) cases showed significant poor survival (p=0.0228) in DLBCL. However, there was no statistically significant correlation between p63 expression and IPI score on Multivariate analysis. We could speculate that p63 could act indirectly as an oncogene by inhibiting p53 functions. Stage of differentiation of neoplastic lymphocytes appears to have a correlation with p63 expression in MLs.