Contribution of HBV and HCV infection in mortality of B cell non-Hodgkin’s lymphoma subjects / Монголын Анагаах Ухаан

Background@#The correlation between hepatitis B, C viruses (HBV, HCV) and B cell non-Hodgkin’s Lymphoma (B-NHL) and reducing mortality have been studied extensively worldwide@*Objective@#In this study, we aimed to determine the prevalence of HBsAg and anti-HCV positive cases among B-NHL patients and its influence on the survival rate of these patients (on ≤12 months).@*Materials and Methods@#We have done a retrospective analysis on patients who aged over 20 years and newly diagnosed at the Hematology Center of the First State Hospital between 2015-2018. The patients’ information was collected according the study ethics. We divided the patients into 2 groups, survival rate less than 12 months (≤12 months) and survival rate more than 13 months (≥13 months), and compared them regarding age, gender, seroprevalence, and Ann-Arbor stage. @*Results@#Overall, 226 patients (107 males and 119 females with average 54.4) were enrolled in the study. There were 15% HBsAg positive and 41,6% anti-HCV positive cases, while Baatarkhuu et al. (2005) reported (11.8%, 15.6%; p=0.160, p<0.00001) and Bekhbold et al. (2013) reported (11.1%, 10.6%; p=0.055, p<0.00001) in apparently healthy population. Moreover, anti-HCV positive cases among B-NHL patients were higher (p<0.00001) than those (27%) among hepatocellular carcinoma (HCC) patients and same (p=0.404) with those (39%) among liver cirrhosis patients in Mongolia (Bolormaa et al., 2009). Furthermore, 72.0% of all subjects in III-IV stages was accounted for HBsAg, anti-HCV positive group which had ≤12 months, while 52.1% of them was accounted for HBsAg, anti-HCV positive group which had ≥13 months and was statistical significantly lower (p=0.02).@*Conclusion@#Anti-HCV and HBsAg positive cases might contribute to survival rate with the B-NHL patients diagnosed at the III-IV stages. HCV prevalence among B-NHL subjects was significantly higher than that among the general population prevalence and was same with anti-HCV positive prevalence among the HCC.

Linfoma no Hodgkin localizado en el tejido mamario. presentación de un caso / Non-Hodgkin lymphoma located in the breast tissue. presentation of a case

Se presentó el caso de una adolescente de 12 años de edad que acudió a consulta externa de Cirugía del Hospital Pediátrico Docente "Gral. Pedro Agustín Pérez", de Guantánamo; la misma presentó aumento de volumen a nivel del cuadrante superior externo de la mama izquierda, no doloroso. Se palpó tumoración de bordes irregulares, o sea mal definidos, de 3 cm de diámetro aproximadamente, sin signos de inflamación. Se realizó biopsia por aspiración con aguja fina y se informó el diagnóstico de fibroadenoma de mama. La exéresis del nódulo y el estudio histopatológico demostraron el diagnóstico de linfoma no Hodgkin de alto grado de malignidad y se procedió a la atención multidisciplinaria. Al momento del reporte la paciente continúa con quimioterapia y evoluciona satisfactoriamente. Se revisó la literatura médica sobre el tema y se expusieron sus bases esenciales para la familiarización de los médicos generales(AU)

A 12 years old young female presented to the surgical outpatient clinic at the Hospital Pediátrico Docente "Gral. Pedro Agustín Pérez" in Guantanamo. Patient showed swelling in the upper right breast, with no pain. Examination revealed irregular edges (with approximately 3 cm in diameter) and no swollen tissue. Fine-needle aspiration biopsy was performed and breast fibroadenoma was diagnosed. Node exeresis and histopathological study both showed a high risk malignant non-Hodgkin's lymphoma, and a multidisciplinary care team assumed the case. At the time of the report, the patient is still under chemotherapy and prognosis evolves positively. The medical literature on the subject was put on review and a layout of the essentials to familiarize the general practitioners with the topic was set(AU)

Linfoma no Hodgkin localizado en el tejido mamario. Presentación de un caso / Non-Hodgkin lymphoma located in the breast tissue. Presentation of a case

RESUMEN Se presentó el caso de una adolescente de 12 años de edad que acudió a consulta externa de Cirugía del Hospital Pediátrico Docente Gral. Pedro Agustín Pérez, de Guantánamo; la misma presentó aumento de volumen a nivel del cuadrante superior externo de la mama izquierda, no doloroso. Se palpó tumoración de bordes irregulares, o sea mal definidos, de 3 cm de diámetro aproximadamente, sin signos de inflamación. Se realizó biopsia por aspiración con aguja fina y se informó el diagnóstico de fibroadenoma de mama. La exéresis del nódulo y el estudio histopatológico demostraron el diagnóstico de linfoma no Hodgkin de alto grado de malignidad y se procedió a la atención multidisciplinaria. Al momento del reporte la paciente continúa con quimioterapia y evoluciona satisfactoriamente. Se revisó la literatura médica sobre el tema y se expusieron sus bases esenciales para la familiarización de los médicos generales.

ABSTRACT A 12 years old young female presented to the surgical outpatient clinic at the Hospital Pediátrico Docente Gral. Pedro Agustín Pérez in Guantanamo. Patient showed swelling in the upper right breast, with no pain. Examination revealed irregular edges (with approximately 3 cm in diameter) and no swollen tissue. Fine-needle aspiration biopsy was performed and breast fibroadenoma was diagnosed. Node exeresis and histopathological study both showed a high risk malignant non-Hodgkin's lymphoma, and a multidisciplinary care team assumed the case. At the time of the report, the patient is still under chemotherapy and prognosis evolves positively. The medical literature on the subject was put on review and a layout of the essentials to familiarize the general practitioners with the topic was set.

The prognostic significance of peripheral lymphocyte/monocyte ratio and PET-2 evaluation in adult Hodgkin’s lymphoma / 中华血液学杂志

Objective@#To evaluate the prognostic value of lymphocyte to monocyte ratio (LMR) and PET scan performed after first two cycles of chemotherapy (PET-2) in Hodgkin’s lymphoma (HL) .@*Methods@#The clinical data of 133 patients with HL diagnosed from January 2007 to March 2016 at the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The X-tile software was used to calculate the optimal cut-off value of LMR. Kaplan-Meier method and Cox regression were used for survival analysis.@*Results@#The median age of 133 HL patients was 33 (18–84) years, and the male to female ratio was 1.9∶1. The optimal cut-off value of LMR was 2.5, and progression free survival (PFS) (P<0.001) and overall survival (OS) (P<0.001) were significantly lower in the LMR<2.5 group than that of LMR≥2.5. Multivariate survival analysis showed that LMR<2.5 was an independent predictor of PFS (P=0.002, HR=2.35, 95%CI 1.36–4.07) and OS (P=0.002, HR=10.36, 95%CI 2.35–45.66) in HL patients. The analysis of PET-2 from 56 HL patients showed that PET-2 positive patients had significantly poorer PFS (P=0.022) . After grouping LMR combined with PET-2, significant differences were found in PFS and OS between the three groups (P values were 0.009 and 0.012) .@*Conclusion@#LMR<2.5 is an independent prognostic factor for patients with HL. PET-2 combined with LMR may have better prognostic value.

Primary Spinal Epidural Non-Hodgkin’s Lymphoma: A case report

Introduction@#Non-Hodgkin’s lymphomas (NHLs) are a varied group of malignancy originating in the lymphatic system. As a subset of lymphomas, primary spinal epidural lymphomas are diagnosed when there are no other recognizable sites of lymphomas at the time of diagnosis. It mimics other spinal diseases making the diagnosis difficult to establish as well as in obtaining tissue diagnosis. We present an atypical case of a 45-year-old female who presented initially with back pain then eventual loss of sensory and motor function of the lower extremities, further work up showed primary spinal epidural NHL.@*Case@#This is a case of a 45-year-old female with chief complaint of back pain. Magnetic resonance imaging (MRI) of the thoracic spine showed nonspecific epidural soft tissue mass at T5 to T6 level compressing the spinal cord. Operative procedure was done with histopathology of the epidural lesion consistent of NHL. Immunohistochemical staining showed CD20 (+), thus a diagnosis of diffuse large B cell lymphoma (DLBCL) was made. Patient underwent six cycles of cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) regimen.@*Conclusion@#Signs and symptoms of primary spinal epidural NHL often overlaps its manifestations with other spinal diseases. A high index of clinical suspicion warrants inclusion of such neoplastic condition in determining the exact and definitive diagnosis of cases manifesting spinal compression.

MicroRNA-138 regulates cell adhesion-mediated drug resistance phenotype by targeting SGTA in non-Hodgkin’s lymphoma / 中华血液学杂志

Objective@#To analyze the effects of miR-138 on the expression of small glutamine-rich TPR-containing protein A (SGTA) and cell adhesion-mediated drug resistance (CAM-DR) phenotype in non-Hodgkin's lymphoma (NHL).@*Methods@#The adhesion model was constructed using fibronectin (FN) or bone marrow stromal cells HS-5. The effect of miR-138 on the expression of SGTA was analyzed by Western blotting and RQ-PCR. Dual-luciferase assays were performed to probe the effects of miR-138 on SGTA 3' UTR activities. Subsequently, we investigated the effect of miR-138 on cell cycle, adhesion ability and CAM-DR. Moreover, the correlation between miR-138 expression and therapeutic response was analyzed in 35 paraffin-embedded diffuse large B cell lymphoma samples.@*Results@#Our data showed that adhesion of NHL cells to FN or HS-5 cells significantly increased miR-138 expression (P<0.05). Knockdown of miR-138 markedly increased the protein (all P<0.05) but not for mRNA (all P>0.05) levels of SGTA in NHL cell. The luciferase activity of SGTA 3' UTR was significantly suppressed by miR-138 transfected cells (0.73±0.03 vs 1.00±0.02, t=0.914, P=0.002). No change in terms of reporter activity was observed in SGTA 3'UTR mutant transfected cells (0.93±0.04 vs 1.00±0.02, t=1.375, P=0.241). Also we found that ectopic expression of miR-138 significantly induced cell cycle arrest at G1 phase in both suspension and adherent cells (all P<0.05). Knockdown of miR-138 had no effect on cell adhesion ability (all P>0.05). More importantly, in suspension cells, knockdown of miR-138 significantly decreased the percentage of doxorubicin-induced cell death. However, knockdown of miR-138 dramatically increased the percentage of doxorubicin-induced cell death in FN/HS-5-adherent cells. Furthermore, the miR-138 expression was significantly higher in patients with progression of disease/stable disease than those experiencing complete response/partial response (9.72±1.11 vs 3.06±0.22, t=9.144, P<0.001).@*Conclusion@#MiR-138 promoted CAM-DR phenotype through cell adhesion-mediated SGTA down-regulation and cell cycle arrest.

The construction of anti-CD19 chimeric receptor modified NK-92 cells and the killing effect of CD19 positive non-Hodgkin lymphoma cells / 中国肿瘤生物治疗杂志

@# Objective: A second generation CAR-NK-92 cell line expressing CD19 was constructed to investigate its specific killing effect on CD19 positive non-Hodgkin lymphoma cells. Methods: First, build CD19-CAR gene expression vector and packaged slow virus particles, then the infection rate was detected by flow cytometry after infected NK-92 cells and positive cells were further separated. Finally, detected the expression of CD19-CAR in NK-92 cells by Western blotting. U-266 with CD19 negative myeloma cells,ARH77 and HS-Sultan with CD19 positive non-Hodgkin’s lymphoma cells as target cells, and CD19CAR-NK-92 as effector cells, then the killing rate was calculated by the absolute number of tumor cells alive in the cell killing experiment. Results: Construct lentivirus vector pLVX-CD19-CAR and packaged virus particles successfully, the purity of CD19-CAR-NK-92 cells also was over 90% after infected with NK-92 cells; and Western blotting analysis showed that CD19-CAR had been successfully expressed in NK-92 cell. The killing effect of CD19CAR-NK-92 onARH-77 ([70.10±1.86]% vs [1.95±0.63]%, P<0.01) and HS-Sultan ([74.98±1.60]% vs [0.58±1.49]%, P< 0.01) cells was significantly higher than the empty vector control group of ZsGreen-NK-92, but there was no difference in killing U266 (P>0.05). Conclusion: The NK-92 cell lines expressing CD19CAR were successfully constructed, and also has specific killing effects on CD19 positive non-Hodgkin lymphoma cells.

Linfoma no Hodgkin primario testicular / Non hodgkin primary testicular limphoma

Los linfomas constituyen un grupo diverso de neoplasias malignas, que se originan del sistema linfático(1). Aproximadamente el 85% se agrupan dentro de los denominados Linfomas No Hodgkin (LNH). Los LNH constituyen un numeroso grupo de linfomas derivados de la transformación neoplásica de los linfocitos B, T y Células NK, provenientes de diversas zonas que comprometen los folículos linfáticos en los nódulos linfáticos o en el sistema linfoide extranodal(2). Las localizaciones extra ganglionares primarias representan más de 10% de los casos y los sitios más frecuentes comprenden estómago, intestino delgado, orofaringe, piel, hígado y cerebro; además de otras bastante raras como ano, corazón, músculos y encías. Los linfomas testiculares primarios son muy raros, representan aproximadamente el 5% de todas las neoplasias testiculares malignas, menos del 1% de los LNH y el 4% de los LNH extra nodales(3). Esta neoplasia constituye el tumor maligno testicular más frecuente en sujetos ancianos. La presentación clínica típica es una masa testicular unilateral acompañada en ocasiones de hidrocele y dolor agudo escrotal. A continuación presentamos un caso que requirió de la participación de múltiples especialidades de nuestra institución para un manejo conjunto y finalmente el paciente falleció(AU)

The lymphomas constitute a diverse group of malignant neoplasms, which originate from the lymphatic system(1). Approximately 85% are grouped into the so-called Non-Hodgkin's Lymphomas (NHL). NHL are a large group of lymphomas derived from the neoplastic transformation of B, T and NK cells of different areas with involvement of lymphatic follicles in the lymph nodes or the extranodal lymphoid system(2). The primary extraganglionic sites represent more than 10% of the cases and the most frequent sites include stomach, small intestine, oropharynx, skin, liver and brain; others, quite rare, are anus, heart, muscles and gums.Primary testicular lymphomas are extremely rare, accounting for approximately 5% of all malignant testicular neoplasms, less than 1% of NHL and 4% of extranodal NHL(3). This neoplasm constitutes the most frequent testicular malignant tumor in elderly subjects. The typical clinical presentation is a unilateral testicular mass, sometimes accompanied by hydrocele and acute scrotal pain. We present a case which required the participation of multiple specialties of our institution for management but the patient finally died(AU)

Linfoma primario del intestino delgado: reporte de un caso y revisión de la literatura / Primary Lymphoma in the Small Intestine: A Case Report and Literature Review

El tracto gastrointestinal es el sitio más frecuente de presentación del linfoma no Hodgkin (LNH) extraganglionar. Sin embargo, los linfomas primarios del tracto gastrointestinal son tumores raros y es mucho más frecuente la afectación de este tracto de manera secundaria en el curso de la enfermedad. Representan del 1% al 4% de los tumores malignos del tracto gastrointestinal, aunque tienen un curso, manejo y pronóstico muy diferente de los adenocarcinomas, por lo que es importante conocerlos y tenerlos en mente como un diagnóstico diferencial posible en el ejercicio clínico diario. Afectan más a los adultos jóvenes, con una mayor frecuencia en hombres (1). Reportamos el caso de una mujer de 47 años de edad con linfoma primario del intestino delgado, diagnosticado luego de múltiples consultas por síntomas abdominales y revisamos la literatura al respecto

The gastrointestinal tract is the most frequent site of non-Hodgkin’s lymphoma (NH) outside of the lymph nodes themselves. This tract is much more frequently compromised by tumors secondary to primary disease elsewhere in the body than by primary lymphomas of the gastrointestinal tract itself which are rare. They account for only one to four percent of malignant tumors of the gastrointestinal tract. Their development and prognoses are quite different from those of adenocarcinomas, hence their management must differ as well. It is important to understand them and keep them in mind in differential diagnosis in daily clinical practice. Young adults are most frequently affected, and men are more frequently affected than are women. We review the literature and report the case of a 47 year old woman with primary small bowel lymphoma that was diagnosed after several consultations due to abdominal symptoms

Human umbilical cord-drived mesenchymal stem cells as vehicles of CD20 specific-TRAIL fusion protein against non-Hodgkin’ s lymphoma / 中国免疫学杂志

Objective:To study the therapeutic effect of a novel double-target system,in which human umbilical cord-derived MSCs were used as vehicles to deliver fusion protein scFvCD20:sTRAIL to non-Hodgkin ’ s lymphoma. Methods: The traditional methods in molecular biology were used to construct lentivirus expression vectors pLenR. scFvCD20: sTRAIL and contrast vectors. Human umbilical cord-derived MSCs ( HUMSCs ) were labeled with the copGFP by transducing with pseudo viral particles which had been packaged in 293T cells with four plasmid-lentivirus packaging system. Fusion protein scFvCD20:sTRAIL were secreted from MSC. scFvCD20:sTRAIL after that HUMSCs were infected by pseudo viral particles. CCK8 assay was applied to detect the antigen-restricted cell death induced by scFvCD20:sTRAIL in CD20-positive BJAB and Raji cells as well as CD20-negtive Jurkat cells and human normal peripheral blood mononuclear cells (PBMCs). To evaluate the therapeutic effect of MSC. scFvCD20:sTRAIL in vivo,ge-netically modified HUMSCs were intravenously injected into tumor-bearing mice with BJAB cells. The volume of tumor was measured every three days, and the inhibition ratio of tumor was calculated according to tumor volume. Results: Lentivirus expression vectors pLenR. scFvCD20:sTRAIL, pLenR. ISZ:sTRAIL, pLenR. scFvCD20 and pLenR. CopGFP were successfully constructed and these constructs could be expressed stably in HUMSCs by lentivirus transduction. scFvCD20:sTRAIL fusion protein produced a potent inhibition of cell proliferation in CD20-positive BJAB cells,moderate inhibition of the growth of Raji cells,and weak inhibition in CD20-negtive Jurkat cells when compared with ISZ-sTRAIL treatment,and it had no effect on normal human peripheral blood mononuclear cells (PBMCs). The MSC. scFvCD20:sTRAIL treatment significantly inhibited the tumor growth when compared with those treated with MSC. ISZ-sTRAIL. Conclusion: A double-target therapeutic system is well established, in which HUMSCs migrated to tumor site, secreted a novel fusion protein scFvCD20:sTRAIL,and thus locally concentrated scFvCD20:sTRAIL extended antigen-restricted anti-tumor activity. The engineered HUMSCs secreting scFvCD20:sTRAIL showed potent effect on inhibiting tumor growth in BJAB lymphoma malignancy,which may play an essential role in the clinical research .

Lennert’s lymphoma - a diagnostic dilemma: a case report and pathologic review of literature.

Lymphoepitheloid lymphoma, also referred to as Lennert‟s lymphoma is a T-cell lymphoma characterized by the massive proliferation of epithelial cell clusters infiltrating normal lymph nodal architecture along with lymphoid cells. Epithelial cells can also be associated with infectious lymphadenopathy and Hodgkin‟s lymphoma. This presents a diagnostic dilemma. We present a case of Lennert‟s lymphoma along with review of literature with special emphasis on morphological features and immmunohistochemistry findings.

Factores que participan en la interacción huésped-agente patógeno en el riesgo de Linfoma de Hodgkin inducido por el virus Epstein Barr / Factors involved in host-pathogen interaction for the risk of Hodgkin lymphoma induced by Epstein Barr virus

El linfoma de Hodgkin (LH) es una neoplasia del sistema linfático. La incidencia mundial anual del LH es de 3-10/100,000 habitantes. El mecanismo mediante el cual se lleva a cabo la transformación celular no es completamente claro; sin embargo, algunas evidencias parecen indicar que ciertos virus oncogénicos como el virus Epstein Barr (VEB), pueden tener alto impacto en la patogénesis de la linfoproliferación. También algunos factores genéticos y ambientales pueden estar involucrados, pues se ha encontrado una alta incidencia de casos de LH entre individuos de una misma familia que comparten características genéticas y conviven en un mismo ambiente. En México se han realizado estudios encaminados a conocer la prevalencia del VEB en pacientes con LH y se ha encontrado la presencia de este virus hasta en el 64,2%. El VEB ha sido detectado en las Células Reed Sternberg (CRS) y en Células de Hodgkin (CH) en el 50% de los casos de LH clásico. No se ha dado hasta ahora una explicación satisfactoria, pero se ha propuesto que la variabilidad geográfica y la variabilidad inmunológica desempeñan un papel determinante en la positividad del VEB en LH. A pesar de los avances que hasta ahora se tienen, no existen suficientes evidencias que permitan establecer una clara asociación entre los factores del huésped, el medio ambiente y el agente patógeno en el riesgo de la linfoproliferación que conduce al desarrollo de LH. La presente revisión tiene como objetivo analizar algunos de los factores de riesgo que influyen durante la interacción huésped, agente patógeno y medio ambiente en la etiología del LH.

Hodgkin lymphoma (HL) is a neoplasm characterized by malignant cells called Reed Sternberg and Hodgkin’s cells in the lymphatic system. Such cells comprise 1% of the tumor while the remainder is made up of lymphocytes, histiocytes, eosinophils and plasma non-neoplastic cells. The annual global incidence of HL is 3-10/100,000 inhabitants and is most commonly found in young adults. The mechanism by which cell transformation is accomplished is not entirely clear; however, some evidences suggest that oncogenic viruses like the Epstein Barr virus (EBV) may have a high impact on the pathogenesis of lymphoproliferation. Genetic and environmental factors could be involved, since it has been found a high incidence of HL among members of the same family. In Mexico, there have been studies to determine the prevalence of EBV in patients with HL and found the presence of this virus in up to 64.2% of the cases. EBV has been detected in the Reed Sternberg cells and Hodgkin cells in 50% of cases of classical HL. There is not a satisfactory explanation for this, but it has been proposed that geographic and immunological variabilities play a role in the positivity of EBV in HL. However, despite recent advances in the field, there is insufficient evidence to show a clear association between host factors, environment and pathogens, and the risk of lymphoproliferation leading to the development of HL. This review aims to give an overview about the risk factors that influence the interaction of host, pathogens and environment in the etiology of HL.

Linfoma no hodgkin asociado a infección por virus de inmunodeficiencia humana estudio de cohorte / Non hodgkin lymphoma associated to human immunodeficiency virus cohort study

Los pacientes con linfoma no Hodgkin asociado a la infección por el virus de inmunodeficiencia humana tienen una mejor sobrevida después de la terapia antirretroviral de alta eficacia. Evaluar el comportamiento de los pacientes con linfoma no Hodgkin asociado a la infección por el virus de inmunodeficiencia humana antes y después de la terapia antirretroviral de alta eficacia. Estudio de cohorte entre 1986 y 2011 de los pacientes con linfoma no Hodgkin asociado a la infección por el virus de inmunodeficiencia humana tratado con ciclofosfamida doxorrubicina vincristina-prednisona. Hubo un 34% de respuestas globales (completa + parcial) en el grupo tratado antes de la terapia antirretroviral de alta eficacia y un 66% después de ella 65% de los pacientes antes de esta terapia murieron de infección por oportunista y 70% después de ella murieron de progresión o recaída del linfoma; hubo mayor toxicidad hematológica y hepática antes de la terapia antirretroviral; la sobrevida fue mayor en los pacientes tratados después de esta. En pacientes con un estado general satisfactorio, buena adherencia a la terapia antirretroviral de alta eficacia, en quienes se mejora la inmunidad celular y se obtiene una carga viral indetectable; podemos lograr que un grupo de ellos tenga una sobrevida larga, con respuestas clínicas completas posterior al tratamiento con el esquema de quimioterapia antes mencionado.

The human immunodeficiency virus infections related to non-Hodgkin´s lymphoma patients have improved their survival since the introduction of highly active antiretroviral therapy of high efficacy. These study behavior of the human immunodeficiency infection related to non Hodgkin lymphoma patients before and after the introduction of highly active and efficacy antiretroviral therapy. Study of cohort between the years 1986 and 2011 of the human immunodeficiency virus infection related to non Hodgkin lymphoma patients treated with these chemotherapy schedule: Cyclophosphamide, doxorubicin, vincristine, and the prednisone. There was 34% of a global (complete + partial) response in the group of patients treated before highly active and efficacy antiretroviral therapy and 66% after these antiretroviral therapy; 65% of patients died due to opportunistic infections before the highly active antiretroviral and efficacy therapy and 70% died due to progression or relapse of lymphoma after the antiretroviral therapy; hematologic and hepatic toxicity were higher before the highly active antiretroviral and efficacy therapy; and the survival was better after the antiretroviral therapy. The patients with good performance status and good adherence to highly active antiretroviral efficacy therapy, and in who improved of the cellular immunity and undetected the viral load were obtained, we can achieve a group of patients with long survival, in complete clinical response after treatment with chemotherapy regimen previous mentioned.

Linfoma no Hodgkin y leucemia mieloide crónica metacrónica en una paciente: reporte de un caso / Non Hodgkin´s lymphoma and metachronus chronic myeloid leukemia in a patient: case report

INTRODUCCIÓN: Los linfomas no Hodgkin son neoplasias linfáticas de incidencia creciente en el mundo y que en Chile representan la séptima causa de muerte por cáncer. El tratamiento con quimioterapia de los linfomas de alto grado de malignidad ha significado que globalmente se logren sobrevidas de 60 por ciento a cinco años. La ocurrencia de segundas neoplasias en pacientes con linfomas tratados es aproximadamente un 7 por ciento, correspondiendo la mayoría a tumores sólidos de pulmón, mama y leucemias agudas. No se ha descrito la leucemia mieloide crónica como complicación del tratamiento o forma secundaria en pacientes tratados por linfoma. PRESENTACIÓN DEL CASO: Paciente que un año y medio después de ser tratada de una recaída tardía de un Linfoma no Hodgkin de alto grado, avanzado, presenta leucemia mieloide crónica confirmada por cariograma y reacción de polimerasa en cadena. Recibe tratamiento con Imatinib con respuesta citogenética completa. DISCUSIÓN: Revisada la literatura no se encontró reportado otro caso similar. Está descrita la asociación entre ambas entidades, pero siempre el linfoma sigue o se presenta simultáneamente con la leucemia mieloide crónica. Esto podría tratarse de diferentes formas de expresión de una alteración de la stem cell pluripotente o bien de una ocurrencia al azar en una persona con defecto en los mecanismos antioncogénicos.

INTRODUCTION: Non-Hodgkin´s lymphoma is lymphatic neoplasms with increasing incidence in the world and in Chile represents the 7th cause of cancer death. Chemotherapy treatment of lymphomas of high malignancy has meant that overall survivals are prolonged in approximately 60 percent of all patients. The occurrence of second malignancies in patients after treatment of lymphoma is approximately 7 percent, beeing mostly solid tumors of lung, breast and acute leukemias. It has not been reported chronic myeloid leukemia as a complication of treatment or secondarily in patients treated of lymphoma. CASE REPORT: Patient that one and a half year after treatment of a late relapse of non-Hodgkin lymphoma of high grade, advanced, presents a chronic myeloid leukemia confirmed by karyotype and by polymerase chain reaction. After treatment with Imatinib the patient achieved a complete cytogenetic response. DISCUSSION: Review of the literature found no similar case report. It describes the association between both entities but lymphoma always following or occurring simultaneously with chronic myeloid leukemia. This could be different forms of expression of an alteration of the pluripotent stem cell or a random occurrence in a person with antioncogénicos defect mechanisms.

Burkitt's lymphoma: clinic progression and prognosis. Two different cases reports in young patients / Linfoma de Burkitt: evolução clínica e prognóstico. Relato de dois casos diferentes em pacientes jovens

Purpose: Burkitt's lymphoma is one of the fastest growing malignancies in the pediatric population. It is a high-grade B-cell non-Hodgkin's lymphoma with endemic, sporadic and human immunodeficiency-associated subtypes. The African, or endemic, variant usually involves the maxilla and other facial bones, while head and neck manifestations in sporadic Burkitt's lymphoma are rare. Case description: Two cases of oral manifestations of Burkitt's lymphoma are described on the right jaw in young patients, which had different clinical evolution and prognosis.

Objetivo: O linfoma de Burkitt é uma das mais importantes neoplasias de crescimento rápido na população pediatra. É um linfoma Não-Hodgkin primário de células B subdividido em endêmico, esporádico ou associado a imunodeficiência humana. O tipo africano (endêmico), quando em cabeça e pescoço, envolve geralmente os maxilares e outros ossos faciais, enquanto que o envolvimento facial da forma esporádica é bem raro. Descrição do caso: São descritos dois casos intra-bucais de linfomas de Burkitt envolvendo maxila direita em pacientes jovens, os quais apresentaram evolução clínica e prognósticos diferentes.

Mortalidade por linfoma não Hodgkin em capitais da região sudeste e sobrevida de pacientes submetidos a transplante no Instituto Nacional do Câncer / Mortality from non-Hodgkin's capital in the Southeast and survival of transplant patients at National Cancer Institute

A mortalidade por linfoma não Hodgkin vem diminuindo em vários países, porém, para o Brasil, as estimativas apontam um crescimento em ambos os sexos. O objetivo deste estudo foi analisar a tendência da mortalidade por linfoma não Hodgkin em indivíduos com 20 ou mais anos, nas capitais da região Sudeste, entre 1980 e 2007. Utilizou-se como fonte de dados o Sistema de Informação sobre Mortalidade e o DATASUS. A tendência das taxas de mortalidade por linfoma não Hodgkin por faixas etárias foi analisada por meio de modelos de regressão polinomial. Foi observada tendência linear de incremento em Belo Horizonte e São Paulo para faixa etária de 60 ou mais anos. Ao analisar de forma separada os períodos 1980-1995 e 1996-2007, só se observou tendência de incremento no período inicial. Os resultados sugerem que o incremento observado entre 1980-2007 poderia ser resultante do crescimento das taxas entre 1980-95, já que, no último período, não foram observadas tendências estatisticamente significativas nessas cidades. A partir da década de 90, o transplante de células-tronco hematopoiéticas (TCTH) passou a ser utilizado de forma mais consistente no tratamento de pacientes com linfoma não-Hodgkin (LNH) e, entre as possíveis explicações para a redução da mortalidade por essa neoplasia, observada nas últimas décadas em diferentes países, encontram-se os avanços no seu tratamento. Realizou-se um estudo descritivo de sobrevida em uma coorte histórica de pacientes com LNH, de 18 ou mais anos de idade, submetidos ao primeiro TCTH em um hospital de referência em oncologia no Rio de Janeiro, entre janeiro de 1997 e maio de 2009. As informações do estudo foram obtidas através da análise dos prontuários médicos, utilizando-se instrumento elaborado especificamente para essa finalidade...

Mortality from non-Hodgkin’s lymphoma has decreased in many countries although for Brazil estimates indicate a growth in both sexes. The aim of this study was to analyze trends in mortality from non- Hodgkin’s lymphoma in individuals with 20 or more years in the capitals of the southeastern region ofBrazil between 1980 and 2007. Data were obtained through the National Information System on Mortalityand from the Brazilian Institute of Geography and Statistics. Trends of mortality rates for non-Hodgkin’slymphoma by age were analyzed by polynomial regression models. A linear trend of increment of the mortality was observed in Belo Horizonte and Sao Paulo for the age 60 years or older. When analyzed separately in two periods 1980-1995 and 1996-2007, a trend of increase was only observed in the initial period. These results suggest that the increment observed between 1980 and 2007 could be related toincreased mortality rates between 1980-95, as there were no statistically significant trends in these cities inthe last period. Since the 90's, hematopoietic stem cell transplantation (HSCT) is being used more consistently in the treatment of patients with non-Hodgkin lymphoma (NHL) and these advances are among the possibleexplanations for the reduction of mortality from this neoplasia, observed in recent decades in different countries. We conducted a descriptive study of survival in a historical cohort of patients with NHL, 18 or more years old, who underwent a first HSCT in a referral hospital in Rio de Janeiro, between January 1997 and May 2009. Study information was obtained through analysis of medical records, using aninstrument developed specifically for this purpose. We considered as the study’s outcomes: overall survival (in months), estimated from the date of transplantation until death; and disease-free survival (in months), estimated from the date of transplant until evidence of disease after transplantation...

Linfomas não hodgkin em crianças e adolescentes um estudo Descritivo no estado da Bahia-Brasil / Non - Hodgkin lymphoma in children and adolescents: a descriptive Study in the state of Bahia - Brazil

O objetivo desta pesquisa foi investigar as características sócio-demográficas e clínico-patológicas dos linfomas não Hodgkin LNH em crianças e adolescentes no estado da Bahia. Do ponto de vista da metodologia, trata se de estudo descritivo com dados secundários de 111 pacientes com LNH, procedentes de dois centros de referência. Critérios de inclusão idade 20 anos, residência na Bahia e admissão no período de janeiro de 2000 a dezembro de 2005, com diagnóstico anátomo patológico de LNH. Obtiveram se os seguintes resultados: dos 111 pacientes, 76 68,5% presentaram idade entre cinco e 14 anos, com uma média de 8,6 4,3 anos. Linfomas de Burkitt LB predominaram 56,8%seguidos pelos linfomas linfo blásticos e linfomas de grandes células, cada um com 23 casos 20,7%. Sítio primário do tumor predominante foi abdominal 57,7 %, seguido por cabeça e pescoço 19,8%, mediastino 16,2% e outros 6,3%. Manifestações clínicas mais freqüentes nos pacientes com LB foram: dor abdominal 39,7%, aumento do volume abdominal 20,6%e presença de massa no abdome 12,7%. Quase 41% dos pacientes com LB apresentavam sintomas há mais de um mês. O valor médio da enzima lactato desidrogenase foi 1.896 4.277,6 U/L nos pacientes com LB. Os resultados apontam as características quepredominaram em pacientes com LNH pediátricos. Deve-se sempre cogitar sobre a presença dessa afecção como diagnóstico diferencial quando tais características estiverem presentes.

To investigate socio-demographic and clinical-pathological characteristics of the non-Hodgkin?s lymphoma NHL in children and adolescents in the State of Bahia. It is a descriptive study with secondary data from 111 patients with NHL, coming from two reference health centers. Criteria for inclusion: age 20 years, resident in Bahia, and admission from January 2000 to December 2005, with anatomic pathological diagnosis of NHL. Among the 111 patients, 76 68.5% were aged 5 14 years, with a mean of 8.6 4.3 years. The Burkitt lymphoma BL prevailed 56.8%, followed by lymphoblastic lymphoma LL and large cell lymphoma LCL, each with 23 cases 20.7%. Abdominal region was the dominant site 57.7%, followed by head and neck 19.8%, mediastinum 16.2% and other sites 6.3%. The most frequent clinical manifestations in patients with BL were: abdominal pain 39.7%, increase in the abdominal volume 20.6% and presence of mass in the abdomen 12.7%. Approximately 41% of patients with BL had symptoms one month before diagnosis. Average level of serum lactate dehydrogenase enzyme in patients with BL was 1,896 4,277.6 U L. These results show the characteristics that prevailed in pediatric patients with NHL. So, this disease should be thought of as differential diagnosis when these characteristics are present.

Associação rara de duas neoplasias malignas em paciente portadora de febre de origem obscura: relato de caso / Rare association between two types of cancer in patient with fever of unknown origin: case report

JUSTIFICATIVA E OBJETIVOS: A febre de origem obscura é uma entidade presente no dia-a-dia do clínico, muitas vezes de difícil diagnóstico e tratamento. O objetivo deste estudo foi ressaltar a importância de pesquisar um segundo tumor maligno como causa de febre de origem obscura em pacientes portadores de neoplasia maligna de mama. RELATO DO CASO: Paciente do sexo feminino, 58 anos, portadora de câncer de mama submetida a tratamento multimodal, que evoluiu com febre de origem obscura decorrente do aparecimento de segundo tumor primário, um linfoma de alto grau, acompanhado por manifestações paraneoplásicas cutâneas e neurológicas, assim como importante síndrome de resposta inflamatória sistêmica não relacionada à infecção intercorrente. CONCLUSÃO: O aspecto extremamente incomum da associação foi o de linfoma não-Hodgkin, este representando o segundo tumor primário e adenocarcinoma primário da mama.

BACKGROUND AND OBJECTIVES: Fever of unknownorigin is a common entity present on the clinician's work dayand, usually, difficult to diagnose. The aim of this paper was to enhance the importance of look after a second cancer in a patient with fever of unknown origin and breast cancer. CASE REPORT: A female patient, 58-year-old with breast cancer, who was being submitted to multimodal treatment, developed a fever of unknown origin, due to the appearance of a second primary tumor, a high grade malignant lymphoma, accompanied by cutaneous and neurologic paraneoplastic manifestations, as well as a significant systemic inflammatory response syndrome, unrelated to infection. CONCLUSION: The extremely uncommon aspect of the association was of a non-Hodgkin lymphoma, representing a second primary tumor, and a breast adenocarcinoma.

Associação de ictiose adquirida, linfoma de Hodgkin e Hepatite B / Combination of acquired ichthyosis, Hodgkin’s lymphoma and Hepatitis B

Ictiose adquirida é um distúrbio raro da queratinização, associado a diversas doenças, como neoplasias. Aqui relatamos o caso de uma paciente que se apresentou com ictiose de início recente e no decorrer da investigação foi descoberta hepatite B crônica e linfoma de Hodgkin. Não encontramos relatos da associação destas três entidades na literatura.

Acquired Ichthyosis is a rare disorder of keratinization associated with several diseases such as neoplasias. Here we report the case a patient presenting with ichthyosis of recent onset, and along the investigation chronic hepatitis B and Hodgkin lymphoma were diagnosed. No previous report of the combination of these three entities was found in the literature.

Linfoma renal primario en paciente con gammapatía monoclonal IgM / Primary renal lymphoma in a patient with IgM monoclonal gammapathy

Son infrecuentes los casos de linfoma renal primario, ya que la afectación renal por un proceso linfoproliferativo es, por lo general, secundaria a una enfermedad sistémica. Presentamos el caso de una paciente mujer de 48 años que acude por dolor lumbar y masa abdominal. Después de realizar estudios (TC), se práctica nefrectomía cuyo resultado anatomopatológico fue de linfoma no-hodking B primario renal. Asimismo el paciente presentaba una gammapatía monoclonal IgM asociada, por lo que precisó tratamiento quimioterápico sistémico. Realizamos una revisión bibliográfica centrándonos en los criterios diagnósticos y terapéuticos actuales.

Reports on primary renal lymphoma are scarce in the urological literature, the most part f them are secondary on a lymphomatous infiltration of the kidneys. We report the case of a 48 year old women with lumbar pain and adominal mass. After radiological studies (CT), we practise nephrectomy with a pathological result of a non-hodking B primary lymphoma. The patient present a IgM monoclonal gammapathy who need complementary treatment with chemotherapy. A literature review on currently recommended diagnostic and treatment practices in presented.