Current status of self-perceived burden and related factors in the patients with non-Hodgkin's lymphoma / 上海交通大学学报（医学版）

Objective • To investigate the current status of self-perceived burden of the patients with non-Hodgkin's lymphoma (NHL) and analyze the related factors. Methods • A total of 169 NHL patients who were hospitalized in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. to Oct., 2019, and their caregivers were enrolled by convenience sampling method. The general information questionnaire, Social Support Rating Scale (SSRS), Self-rating Depression Scale (SDS), Zarit Caregiver Burden Interview (ZBI) and Self-perceived Burden Scale (SPBS) were used to investigate, and the factors related to the score of SPBS were analyzed. Results • The average score of SPBS was 28.95±11.27, while the score of economic burden was the highest (3.13±1.37). Multiple regression analysis suggested that the family income per month per person (P=0.001), Karnofsky performance status (KPS) (P=0.027), SDS score (P=0.006) and ZBI score (P=0.000) were associated with the SPBS score in the NHL patients. Conclusion • The overall selfperceived burden in the patients with NHL is mild-to-moderate, but the economic burden is not neglectable. Low monthly income, poor ability of self-care, depressive symptoms and heavy burden of caregivers can aggravate the self-perceived burden of the patients with NHL.

Progress on diagnosis and treatment of primary non- Hodgkin lymphoma in the female genital tract / 中国肿瘤临床

Primary lymphoma of female genital tract (PLFGT) is uncommon, and its etiology is unclear. It can present with pain, distention, vaginal bleeding, or discharge or be found as an incidental finding at a routine pelvic examination or surgery for other indications. PLFGT can be diagnosed with imaging, with pathomorphology being the key to diagnosing this disease. Further diagnosis and typing are needed with flow cytometry and immunohistochemistry. PLFGT should be differentiated from secondary genital lymphoma and other primary malignant tumors of the reproductive system. Preoperative diagnosis can be challenging due to its rarity. In addition, there is a lack of experience in treating PLFGT. Based on the pathological classification, staging, and non-Hodgkin lymphoma (NHL) guidelines, an individualized approach should be determined. R-CHOP has been found to significantly improve the survival of patients with NHL. However, the efficacy and safety of chemotherapy as the standard treatment for PLFGT still needs to be confirmed. Prognosis was evaluated according to the international prognostic index (IPI).

Primary Extranodal Non-Hodgkin Lymphoma-A Rare Presentation as a Soft Tissue Mass

Non-Hodgkin lymphoma (NHL) is an adverse group of neoplasms that can occur at nodal and extranodal sites with varied prognosis. NHL involving soft tissue as a primary site accounts to 0.1% of cases and may mimic sarcoma; therefore, it is necessary to differentiate them as described by travis and co-authors, similarly. We describe a case of 72-year-old male patient with a mass in the right thigh. Magnetic resonance image reported a benign soft tissue tumour; fine-needle aspiration cytology suggested a soft tissue sarcoma and computed tomography imaging reported no other sites of involvement. PET (Positron emission tomography) scan done after first cycle of chemotherapy revealed enlarged right-side femoral and external iliac group of lymph nodes. On histological examination and immunohistochemistry, it was diagnosed as primary diffuse large B-cell lymphoma involving skeletal muscle. The case is presented to highlight the diagnostic difficulties due to its presentation on a rare site.

Prognostic significance of absolute lymphocyte count in the diagno-sis of diffuse large B-cell lymphoma / 中国肿瘤临床

Objective: We investigated the clinical significance and prognostic value of peripheral blood absolute lymphocyte count (ALC) in the diagnosis of diffuse large B-cell lymphoma. Methods:The medical records of 143 patients with diffuse large B-cell lymphoma were reviewed. These patients were diagnosed and underwent surgery in Tianjin Medical University Cancer Institute and Hospital, China, between February 2002 and April 2008. The correlation between different ALC levels and clinical features was statisti-cally analyzed. Results:Patients with low ALC (<1.0×109/L) at diagnosis showed B symptoms, an international prognostic index score of ≥2, advanced clinical stage (Ann Arbor III/IV), high lactate dehydrogenase level, and high β2-microglobulin level (P<0.05). Pa-tients with high ALC (≥1.0 × 109/L) responded well to treatment (P=0.003). In multivariate analysis, Ann Arbor stage and ALC level were independent prognostic factors of patients with diffuse large B-cell lymphoma. Patients with low ALC often exhibited advanced clinical stage (Ann ArborⅢ/Ⅳ). Conclusions:ALC level obtained at diagnosis is a novel, powerful prognostic factor of diffuse large B-cell lymphoma.

Non-Hodgkin's Lymphoma Manifest as Gingival Hyperplasia in a Renal Transplant Recipient

Gingival hyperplasia is a frequent complication in transplant patients who receive cyclosporine or calcium channel blockers. We studied an unusual case involving a renal transplant recipient with post-transplant non-Hodgkin's lymphoma that manifested as gingival hyperplasia. We initially consider that it was a side effect of cyclosporine and nifedipine. The lesion did not respond to dose reductions or the withdrawal of cyclosporine and nifedipine, and the gingival hyperplasia progressed in a localized fashion, becoming ulcerated and bleeding easily. Histological examination revealed the presence of malignant lymphoma.

A case of endobronchial presentation of non-Hodgkin's lymphoma / 대한내과학회지

Endobronchial involvement in non-Hodgkin's lymphoma is rare. We experienced 36-year-old woman with endobronchial non-Hodgkin's lymphoma whose first presentation was breathless ness due to the total atelectasis of the left lung. The patient underwent fiberoptic bronchoscopy and the histologic finding with immunohistochemical staining confirmed CD30(+), EMA(+) anaplastic large cell lymphoma. Although the patient showed dramatic response to radiation therapy and combination chemotherapy, subsequently she died of disease progression.

Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal cavity / 대한치료방사선과학회지

From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation. 13 patients were stage IE and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55 Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33% (2/6) for T1 and T2, 86% (6/7) for T3 and T4, and 100% (2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tumor dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.