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1.
Article in Spanish | LILACS, COLNAL | ID: biblio-1363402

ABSTRACT

Introducción: Los quistes de retención mucoso de los senos paranasales son un hallazgo imagenológico incidental muy frecuente. Usualmente comprometen el seno maxilar. Metodología: Se realizó una amplia búsqueda de la literatura, sobre quistes de retención mucoso nasosinusales, en enero de 2021 en múltiples bases de datos. Se seleccionaron 21 artículos sobre el tema para la realización de la revisión. Discusión: En la mayoría de los casos el tratamiento de los quistes de retención mucoso nasosinusales debe ser expectante debido a su tendencia a la involución y curso asintomático. Sin embargo, en la práctica clínica se observa con frecuencia un manejo quirúrgico sin una indicación clara. Conclusiones: Las indicaciones quirúrgicas de los quistes de retención mucoso son: obstrucción del ostium del seno paranasal, compromiso del complejo ostiomeatal o compromiso del nervio infraorbitario con síntomas secundarios. Es importante que el cirujano reconozca la naturaleza y comportamiento de esta patología para evitar procedimientos quirúrgicos innecesarios.


Introduction: Mucous retention cysts of the paranasal sinuses are a very common incidental imaging finding. They usually involve the maxillary sinus. Methodology: An extensive literature search on nasosinusal mucosal retention cysts was conducted in January 2021 through multiple databases. 21 articles on the subject were included as evidence for this paper. Discussion: In most cases, treatment should be expectant due to its tendency to involution and asymptomatic course. However, in clinical practice, surgical management is frequently observed without a clear indication. Conclusions: Surgical indications for mucosal retention cysts are: obstruction of the sinus ostium, involvement of the ostiomeatal complex, or involvement of the infraorbital nerve with secondary symptoms. It is important for the surgeon to recognize the nature and behavior of this pathology in order to avoid unnecessary surgical procedures.


Subject(s)
Humans , Orbital Neoplasms , Lymphoma, Non-Hodgkin , Natural Orifice Endoscopic Surgery
2.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6)01-dic-2021. ilus
Article in Spanish | LILACS | ID: biblio-1357666

ABSTRACT

Introducción: el linfoma con células en anillo de sello es una entidad poco frecuente y simuladora de neoplasias epiteliales, sarcomas y condiciones reactivas de histiocitos. Representa una variante morfológica de distintos linfomas no Hodgkin, por lo que su diagnóstico puede representar un desafío y debe ser considerado al realizar estudios complementarios. Objetivo: mostrar un caso con una morfología muy poco frecuente y recalcar la importancia de conocer esta entidad para no cometer errores en su diagnóstico. Caso clínico: se documenta el caso de un hombre de 67 años que desarrolló crecimientos ganglionares en axila derecha, cuello, ingle derecha, y región submandibular, con aparente afección en pulmones y bazo, que fue diagnosticado como linfoma B difuso de células grandes con morfología en anillo de sello, originado en el centro germinal. Se realizó estudio de microscopía electrónica de transmisión para una mejor caracterización de la morfología. Desafortunadamente el paciente no regresó a consulta de seguimiento, por lo que no inició tratamiento, falleció a los 6 meses posteriores al diagnóstico. Conclusiones: el linfoma con fenotipo en anillo de sello es poco frecuente, y puede presentarse en cualquier tipo de linfomas no Hodgkin; sin embargo, esta morfología es más comúnmente asociada a carcinomas y, en menor frecuencia, a sarcomas, melanomas o histiocitos reactivos, por lo que el considerar esta entidad junto con el uso adecuado de estudios complementarios es de gran importancia para su adecuado diagnóstico.


Background: Signet-ring cell lymphoma is a rare entity that simulates epithelial neoplasms, sarcomas and reactive histiocytes conditions. It represents a morphological variant of non-Hodgkin's lymphomas, its diagnosis can represent a challenge, therefore it should be considered in complementary studies. Objective: The aim of this work is to show a case with a very rare morphology and to emphasize the importance of awareness this entity and avoid mistakes in its diagnosis. Clinical case: We present a case of a 67-year-old man, who developed lymph node growths in the right armpit, neck, right groin, and submandibular region, with apparent involvement of the lungs and spleen; was diagnosed as diffuse large B cell lymphoma with signet-ring morphology, originated in the germinal center. Transmission electron microscopy study was carried out for a more precise characterization of the morphology. Unfortunately, the patient did not return for a follow-up consultation, so he did not start treatment and died 6 months after diagnosis. Conclusions: Lymphoma with the signet-ring phenotype is rare, and can occur in any type of non-Hodgkin lymphoma; however, this morphology is more commonly associated with carcinomas and, less frequently, with sarcomas, melanomas or reactive histiocytes conditions, therefore should be considered this entity together with the appropriate use of complementary studies for proper diagnosis.


Subject(s)
Humans , Male , Female , Lymphoma, Large B-Cell, Diffuse , Neoplasms, Glandular and Epithelial , Lymphoma, Non-Hodgkin , Carcinoma, Signet Ring Cell , Lymph Nodes , Melanoma , Mexico
3.
Rev. méd. Urug ; 37(3): e37313, set. 2021. graf
Article in Spanish | LILACS, BNUY | ID: biblio-1341561

ABSTRACT

Resumen: Introducción: si bien la esplenectomía laparoscópica en esplenomegalias masivas y supramasivas constituye un desafío técnico, su realización es factible y segura en centros con equipos con experiencia en cirugía laparoscópica. Objetivo: presentar el primer caso de esplenectomía laparoscópica en esplenomegalia masiva realizada en Uruguay. Caso clínico: se trata de una paciente de 70 años portadora de una pancitopenia periférica, esplenomegalia masiva y diagnóstico realizado por punción de médula ósea de neoplasia linfoproliferativa tipo B de bajo grado, a quien se le indicó la esplenectomía con fines diagnósticos y terapéuticos. La paciente se operó en decúbito lateral derecho a 15 grados, los trócares se colocaron bajo visión directa adaptados al tamaño del bazo que se extendía desde el diafragma hasta el estrecho superior de la pelvis. Se realizó la esplenectomía en un tiempo de 220 minutos, extrayéndose la pieza íntegra y sin haberla colocado en bolsa a través de un hemi Pfannenstiel, protegiendo la pared con un retractor de heridas quirúrgicas. No presentó complicaciones, fue dada de alta a las 48 horas. El hemograma realizado a las 24 horas demostró un aumento de las cifras de todas las series celulares y el informe anatomopatológico diagnosticó un linfoma no Hodgkin de zona marginal. Discusión: la esplenectomía laparoscópica en esplenomegalias masivas requiere de un mayor tiempo quirúrgico, aunque las pérdidas sanguíneas y la estadía hospitalaria son menores en comparación a los procedimientos convencionales, presentando una morbilidad similar. En la experiencia inicial de los equipos quirúrgicos se reporta un porcentaje de conversiones y reingresos cercanos al 30%.


Abstract: Introduction: despite the fact that laparoscopic splenectomy for massive and supramassive splenomegaly constitutes a technical challenge, it is a feasible and safe procedure in the context of institutions with experienced teams in laparoscopic surgery. Objective: to present the first case of laparoscopic splenectomy for massive splenomegaly in Uruguay. Clinical case: the study presents the case of a 70-year-old patient carrier of peripheral pancytopenia, massive splenomegaly and a diagnosis of type B lymphoproliferative neoplasm based on bone marrow aspiration and biopsy, who underwent diagnostic and therapeutic splenectomy. The patient was operated in supine position with a 15-degree tilt, the trocars were placed under direct view, adapted to the size of the spleen which went from the diaphragm until the superior pelvic outlet. Splenectomy was performed in 220 minutes, the entire piece was removed through a hemi Pfannenstiel incision, without placing it in a bag, the wall being protected with a surgical wound retractor. There were no complications and the patient was discharged from hospital 48 hours. The blood count performed after 24 hours evidenced increase in all cell series and the pathology report confirmed diagnosis of marginal zone non- Hodgkin lymphoma. Discussion: laparoscoppic splenectomy in massive splenomegaly requires of a greater surgical time, although blood loss and hospital star are lower when compared to conventional procedures and evidence similar morbility. The initial experience of surgical teams reports 30% of conversions and readmissions.


Resumo: Introdução: embora a esplenectomia laparoscópica em esplenomegalias massivas e supremassivas seja um desafio técnico, sua realização é viável e segura em centros com equipes com experiência em cirurgia laparoscópica. Objetivo: apresentar o primeiro caso de esplenectomia laparoscópica em esplenomegalia maciça realizada no Uruguai. Caso clínico: paciente de 70 anos com pancitopenia periférica, esplenomegalia maciça e diagnóstico feito por punção de medula óssea de neoplasia linfoproliferativa tipo B de baixo grau, com indicação de esplenectomia para fins diagnósticos e terapêuticos. A paciente foi operada em decúbito lateral direito a 15 graus, os trocartes foram colocados sob visão direta adaptados ao tamanho do baço que se estendia do diafragma ao estreito superior da pelve. A esplenectomia foi realizada em um tempo de 220 minutos, retirando-se toda a peça e sem colocá-la em bolsa por meio de uma hemi Pfannenstiel, protegendo a parede com afastador de ferida operatória. Sem apresentar complicações a paciente teve alta após 48 horas. O hemograma realizado 24 horas depois da cirurgia mostrou um aumento no número de todas as séries de células e o laudo anatomopatológico diagnosticou linfoma não Hodgkin de zona marginal. Discussão: a esplenectomia laparoscópica nas esplenomegalias maciças requer um tempo cirúrgico maior, embora as perdas sanguíneas e a permanência hospitalar sejam menores em comparação aos procedimentos convencionais, apresentando morbidade semelhante. Na experiência inicial das equipes cirúrgicas, é relatado um percentual de conversões e readmissões próximo a 30%.


Subject(s)
Humans , Female , Aged , Splenectomy , Splenomegaly/surgery , Laparoscopy , Lymphoma, Non-Hodgkin
4.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1369006

ABSTRACT

RESUMO O linfoma de células NK/T subtipo nasal tem baixa incidência e alta agressividade, mostrando-se necessário diagnóstico precoce. Tal se mostra desafiador devido à sua manifestação clínica inicial, semelhante a quadro infeccioso de vias aéreas superiores. Por meio deste estudo observacional descritivo, relatam-se casos deste linfoma acometendo paciente masculino e outro feminino, ambos com diagnóstico tardio e com envolvimento de vias aéreas superiores sem resposta à antibioticoterapia. À exame de imagem, apresentaram lesão expansiva em cavidade nasal e o diagnóstico se deu por meio de estudo histológico com marcadores imuno-histoquímicos de células NK atípicas e presença de vírus Epstein-Barr (EBV). PALAVRAS-CHAVE: Linfoma de células NK/T tipo nasal, Epstein-Barr vírus, linfoma não-hodgkin, linfoma de células T periférico


ABSTRACT Nasal subtype NK/T cell lymphoma has a low incidence and high aggressiveness, and early diagnosis is necessary. This is challenging due to its initial clinical manifestation, similar to an upper airway infection. Through this descriptive observational study, we report cases of this lymphoma affecting a male and a female patient, both with late diagnosis and involvement of the upper airways without response to antibiotic therapy. On imaging scan, they presented an expansive lesion in the nasal cavity and the diagnosis was made through histological study with immunohistochemical markers of atypical NK cells and the presence of Epstein-Barr virus (EBV). KEYWORDS: NK/T-cell lymphoma nasal type, Epstein-Barr virus, Lymphoma non Hodgkin, T-cell lymphoma


Subject(s)
Humans , Lymphoma, Non-Hodgkin , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Herpesvirus 4, Human , Lymphoma, Extranodal NK-T-Cell , Lymphoma
5.
Rev. venez. oncol ; 33(1): 40-45, mar. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147477

ABSTRACT

El linfoma de Burkitt es una neoplasia altamente agresiva y es un tipo raro de linfoma no Hodgkin localizado. Aunque los niños son los más frecuentemente afectados, en adultos ocurren principalmente durante el embarazo o el puerperio. La mama rara vez constituye la localización primaria del linfoma no Hodgkin. Se presenta un caso de linfoma de Burkitt primario de mama durante el embarazo. Paciente de 37 años con embarazo de 24 semanas quien presentó aumento de volumen difuso de mama derecha. La mama estaba aumentada de tamaño, dolorosa y homogénea con tumoración elástica y firme. La ecografía demostró inflamación difusa con tumoración heterogénea e hipoecoica con contornos ligeramente irregulares, marcadores tumorales estaban normales las pruebas serológicas fueron negativas. La biopsia de la lesión mostró tejido mamario reemplazado por células linfoideas de tamaño mediano con citoplasma basófilo y múltiples vacuolas. Estudios inmunohistoquímicos fueron positivos para el antígeno leucocitario común, CD10, CD20, CD43, Bcl-6. El análisis cromosómico reveló que más del 90 % de las células neoplásicas exhibieron translocación t llevando al diagnóstico final de linfoma de Burkitt de mama. Luego de evaluar las posibilidades terapéuticas y del consentimiento de la paciente se inició tratamiento citostático sistémico. Los linfomas primarios de mama son extremadamente raros. El linfoma de Burkitt primario de la mama es mucho menos común que los otros linfomas. Los métodos de clasificación, detección y tratamiento de esta afección siguen siendo objeto de debates e investigaciones(AU)


The Burkitt's lymphoma is a highly aggressive neoplasm and is a rare type of localized non-Hodgkin lymphoma. Although children are the most frequently affected, in adults they occur mainly during the pregnancy or the puerperium. The breast rarely constitutes the primary location for non-Hodgkin lymphoma. The study of a case of primary Burkitt lymphoma of the breast during pregnancy is presented. This is a 37 year old patient with a 24 week pregnancy who presented a diffuse increase in the volume of the right breast. The breast was enlarged, painful and homogeneous with a firm, elastic mass. The ultrasonography showed diffuse inflammation with a heterogeneous and hypoechoic tumor with slightly irregular contours. The tumor marker values were normal and the serological tests were negative. The biopsy of the lesion showed breast tissue replaced by medium-sized lymphoid cells with basophilic cytoplasm and multiple vacuoles. Immunohistochemically studies were positive for the common leukocyte antigen, CD10, CD20, CD43, Bcl-6. The chromosomal analysis revealed that more than 90 % of neoplastic cells exhibited t translocation leading to the final diagnosis of Burkitt lymphoma of the breast. After evaluating the therapeutic possibilities and the patient's consent, systemic cytostatic treatment was started. Primary breast lymphomas are extremely rare. The primary Burkitt lymphoma of the breast is much less common than other lymphomas. The methods of classification, detection, and the treatment of this condition continue to be the subject of debate and research(AU)


Subject(s)
Humans , Female , Adult , Lymphoma, Non-Hodgkin , Breast Neoplasms , Burkitt Lymphoma/physiopathology , Precursor Cells, B-Lymphoid , Vincristine/therapeutic use , Prednisone/therapeutic use , Doxorubicin/therapeutic use , Tomography, X-Ray Computed , Cyclophosphamide/therapeutic use , Rituximab/therapeutic use
6.
Autops. Case Rep ; 11: e2021324, 2021. graf
Article in English | LILACS | ID: biblio-1285406

ABSTRACT

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse large B-cell lymphoma, characterized by malignant B-cells primarily localized to the lumina of small- and medium-sized blood vessels without lymphadenopathy. Two patients initially presented with fever of unknown origin and persistent lactic acidosis without evidence of tissue hypoxia. Neither patient had an identifiable source of infection and both underwent peripheral blood smear demonstrating leukocytosis with a neutrophilic predominance and thrombocytopenia without evidence of hematologic malignancy. One had previously had a bone marrow biopsy which was unremarkable. Both patients' condition deteriorated rapidly, progressing to multiorgan failure requiring pressors and mechanical ventilation, which ultimately resulted in cardiopulmonary arrest. At autopsy, each patient demonstrated malignant lymphocytoid cells, staining positive for CD20, localized to the lumina of small- and medium-sized vessels in multiple organs, including the lungs, liver, spleen, and kidneys, among others, allowing for the diagnosis of IVLBCL. IVLBCL is exceedingly rare, which in combination with significant variability in presentation, can make identification and diagnosis challenging. Diagnosis requires biopsy, therefore a high index of suspicion is needed to obtain an adequate tissue sample, whether pre- or postmortem. In the presented cases, both patients exhibited type B lactic acidosis with an unknown etiology that was ultimately determined at autopsy.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Acidosis, Lactic/pathology , Lymphoma, Non-Hodgkin/pathology , Lymphoma, Large B-Cell, Diffuse/pathology , Hematologic Neoplasms , Autopsy
7.
Autops. Case Rep ; 11: e2021250, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249025

ABSTRACT

We describe an unusual case of lymphomatosis cerebri in a middle-aged lady presenting with rapid-onset dementia. The lymphomatous infiltrate, instead of forming mass lesions, percolated throughout the brain parenchyma, which is often missed on a stereotactic biopsy and hence warrants caution and awareness about this entity. The nonspecific symptoms at presentation and a variable picture at imaging make this entity diagnostically challenging.


Subject(s)
Humans , Female , Middle Aged , Lymphoma, Non-Hodgkin/pathology , Central Nervous System Neoplasms/pathology , Autopsy , Dementia
8.
Article in Spanish | LILACS, COLNAL | ID: biblio-1253868

ABSTRACT

Introducción: a raíz del siguiente reporte de caso clínico se pretende repensar el diagnóstico diferencial de los tumores orbitales y revisar la literatura existente al respecto. Caso: paciente de 54 años, fumadora, acude a nuestro centro por una pérdida de agudeza visual progresiva de dos años de evolución en el ojo derecho, que se acompañaba de proptosis. Las pruebas de imagen basadas en resonancia magnética y tomografía por emisión de positrones ­ tomografía computarizada (PET-TC) realizadas describían una lesión intraconal derecha de morfología indefinida, que rodeaba el nervio óptico. El estudio inmunohistoquímico y molecular anatomopatológico confirmó la sospecha de síndrome linfoproliferativo extranodal de bajo grado. Discusión: el manejo endoscópico de estas lesiones puede resultar en una menor comorbilidad en comparación con el abordaje externo tradicional. El papel de la cirugía radica en la obtención de una muestra de la lesión que permita un correcto diagnóstico. Conclusiones: el abordaje multidisciplinar con oftalmólogos, hematólogos y expertos en radioterapia permite obtener buenos resultados quirúrgicos y clínicos en la inmensa mayoría de casos.


Introduction: as result of the following clinical case report, we intend to review the differential diagnosis of orbital tumors and review the existing literature in this regard. Case report: a 54-year-old smoking patient, consulted to our department due to a progressive visual impairment over the last two years in her right eye. She presented proptosis in her clinical examination. Imaging studies based on MRI and PET-CT described a right intraconal lesion with an undefined morphology surrounding the optic nerve. Orbital tumors differential diagnosis is delicate. Nevertheless, Non-Hodgkin lymphomas followed by metastasis are the two most common found in this location. The immunohistochemistry and molecular studies, confirmed the suspected diagnosis of extranodal low-grade lymphoproliferative syndrome. Discussion: endoscopic management of these lesions may result in a lower comorbidity compared to traditional external approaches. Role of surgery lays in obtainment of a quality sample which allows a proper diagnosis. Conclusions: multidisciplinary approach with ophthalmologists, hematologists and radiotherapy experts enhance good surgical and clinical results in the vast majority of cases.


Subject(s)
Humans , Female , Adult , Lymphoma, Non-Hodgkin/complications , Orbital Neoplasms/complications , Exophthalmos/etiology , Vision, Low/etiology , Lymphoproliferative Disorders/complications , Lymphoma, Non-Hodgkin/surgery , Lymphoma, Non-Hodgkin/diagnosis , Orbital Neoplasms/surgery , Orbital Neoplasms/diagnosis , Exophthalmos/surgery , Exophthalmos/diagnosis , Vision, Low/surgery , Vision, Low/diagnosis , Diagnosis, Differential , Lymphoproliferative Disorders/surgery , Lymphoproliferative Disorders/diagnosis
10.
Chinese Journal of Oncology ; (12): 707-735, 2021.
Article in Chinese | WPRIM | ID: wpr-887467

ABSTRACT

Lymphoma is one of the most common malignancies in China. In China, there were 6 829 new Hodgkin lymphoma cases and 2 807 deaths in 2020, with 92 834 new non-Hodgkin lymphoma cases and 54 351 deaths. Due to the complicated pathological subtypes and heterogeity, the treatment strategies for lymphoma vary largely. In recent years, with the deep understanding for the nature of lymphoma, much research progress has been achieved in the diagnosis and treatment, leading to a remarkable improvement in survival outcome of patients. In order to update the progress in the treatment of lymphoma worldwide timely, and further improve the level of standardized diagnosis and treatment of lymphoma in China, the China Anti-cancer Association Lymphoma Committee, Chinese Association for Clinical Oncologists, and Medical Oncology Branch of Chinese International Exchange and Promotion Association for Medical and Healthcare organized experts to formulate "Clinical practice guideline for lympoma in China (2021 Edition)" .


Subject(s)
China/epidemiology , Hodgkin Disease/drug therapy , Humans , Lymphoma/therapy , Lymphoma, Non-Hodgkin/drug therapy , Medical Oncology
11.
Article in Chinese | WPRIM | ID: wpr-880143

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics and risk factors of nosocomial infection in patients with non-Hodgkin lymphoma (NHL), in order to guide better clinical prevention and treatment of nosocomial infection.@*METHODS@#The incidence of nosocomial infection, infection site, characteristics of pathogenic bacteria, drug sensitivity test results and infection risk factors of 472 non-Hodgkin lymphoma patients admitted to the Second Affiliated Hospital of Fujian Medical University from January 2015 to September 2020 were retrospectively analyzed.@*RESULTS@#Among the 472 patients, 97 (20.6%) had nosocomial infection, mainly in the lower respiratory tract (41.2%), followed by oral cavity, upper respiratory tract, urogenital tract, and blood. A total of 71 strains of pathogenic bacteria were isolated, including Gram-negative (G@*CONCLUSION@#NHL patients show high nosocomial infection rate and lower respiratory tract infection is common. Hospital day, clinical stage, presence of bone marrow invasion, and neutrophil count in peripheral blood are independent risk factors.


Subject(s)
Cross Infection/epidemiology , Drug Resistance, Bacterial , Humans , Lymphoma, Non-Hodgkin , Methicillin-Resistant Staphylococcus aureus , Retrospective Studies , Risk Factors
12.
Article in Chinese | WPRIM | ID: wpr-880125

ABSTRACT

Primary central nervous system lymphoma (PCNSL) is a rare aggressive non-Hodgkin's lymphoma outside the lymph nodes. At present, high-dose chemotherapy based on methotrexate is the standard induction therapy for newly diagnosed PCNSL, but the effective therapy of relapse/refractory and elderly PCNSL is still unclear. With the progress of clinical trials, new drugs and combined treatment method appear constantly, such as rituximab and ibrutinib, the remission rate of refractory and relapsed patients increased, while lenalidomide showed a good activity in the maintenance treatment of elderly patients. This review summarized briefly the recent advances of research on immunocheckpoint inhibitors, immunoregulatory agents, bruton tyrosine kinase (BTK) and PI3K/AKT/mTOR pathway inhibitors.


Subject(s)
Aged , Antineoplastic Combined Chemotherapy Protocols , Central Nervous System , Central Nervous System Neoplasms/drug therapy , Humans , Lymphoma, Non-Hodgkin/drug therapy , Neoplasm Recurrence, Local , Phosphatidylinositol 3-Kinases
13.
Article in Chinese | WPRIM | ID: wpr-880099

ABSTRACT

OBJECTIVE@#To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma.@*METHODS@#36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis.@*RESULTS@#The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis.@*CONCLUSION@#The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , B-Lymphocytes , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, Non-Hodgkin/therapy , Retrospective Studies , Transplantation Conditioning , Transplantation, Autologous , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-880035

ABSTRACT

METHODS@#From January 2005 to December 2013, 83 patients with refractory/recurrent CD20@*RESULTS@#All the patient achieved complete response. The median follow.up time was 39 months. Both the two groups collected peripheral blood stem cells successfully, and had no difference in hematopoietic reconstitution time. Three patients in treatment group and six patients in control group relapsed and the three year overall survival and EFS in treatment group was significantly higher than that in control group, that is(93.0% vs 73.1%, P=0.037) and (89.5% vs 65.4%, P=0.034), respectively. Subgroup analysis showed that: compared with the treatment group in which using R in the whole courses(before and after transplantation, and collection of stem cells) was superior to the control group in both OS and EFS, with the OS 97% vs 87.5% (P>0.05) and EFS 97% vs 76.2% (P=0.05) respectively. While stratified by the different courses of rituximab, the OS was 88.9% (1-2 courses, 9 cases), 93.1% (3-4 courses, 29 cases), 94.7%(more than 5 courses,19 cases), and EFS was 77.8%, 89.7% and 94.7%, respectively.@*CONCLUSION@#For the patients with refractory/recurrent CD20


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Hodgkin Disease , Humans , Lymphoma, Non-Hodgkin/drug therapy , Rituximab/therapeutic use , Transplantation, Autologous , Treatment Outcome
15.
Chinese Medical Journal ; (24): 1299-1309, 2021.
Article in English | WPRIM | ID: wpr-878164

ABSTRACT

BACKGROUND@#Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.@*METHODS@#This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR.@*RESULTS@#A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%-81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.@*CONCLUSION@#Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients.@*CLINICAL TRIAL REGISTRATION@#ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621.


Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols , Bendamustine Hydrochloride/therapeutic use , China , Humans , Lymphoma, Non-Hodgkin/drug therapy , Neoplasm Recurrence, Local/drug therapy , Prospective Studies , Rituximab/therapeutic use
16.
Journal of Experimental Hematology ; (6): 1175-1180, 2021.
Article in Chinese | WPRIM | ID: wpr-888535

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy of high dose methotrexate (HD-MTX), temozolomide (TMZ), and rituximab (R) in the treatment of patients with primary central nervous system lymphoma (PCNSL).@*METHODS@#Clinical data of patients with PCNSL diagnosed and treated in Guangdong Provincial People's Hospital from February 2010 to May 2017 were collected. First, patients were given 6-8 cycles of MTX (3.5 g/m@*RESULTS@#There were 42 patients enrolled in the study, 17 cases in HD-MTX+TMZ group and 25 cases in HD-MTX+TMZ+R group. The median PFS and OS times in HD-MTX+TMZ+R group were 56.7 months and N/A, respectively, while, 7.3 months and 34.7 months in HD-MTX+TMZ group, respectively. In addition, there was no significant difference in median survival between patients who received TMZ maintenance therapy and those who were only actively monitored. During the induction period, all the patients had grade 1-2 nausea and vomiting, while in the consolidation treatment period, no grade 3/4 toxicity was observed.@*CONCLUSION@#The combination of HD-MTX+TMZ+R in the treatment of PCNSL patients shows a definite short-term effect, which can increase the survival rate of the patients. The side effects are mild, and the patients can generally tolerate.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Central Nervous System , Central Nervous System Neoplasms/drug therapy , Humans , Lymphoma, Non-Hodgkin/drug therapy , Methotrexate/therapeutic use , Retrospective Studies , Rituximab/therapeutic use , Temozolomide/therapeutic use , Treatment Outcome
17.
Journal of Experimental Hematology ; (6): 1148-1155, 2021.
Article in Chinese | WPRIM | ID: wpr-888531

ABSTRACT

OBJECTIVE@#To investigate the types and laboratory characteristics of non-Hodgkin lymphoma(NHL) with bone marrow invasion as the first manifestation.@*METHODS@#81 non-Hodgkin lymphoma patients with bone marrow invasion as the first manifestation treated in our hospital from January 2010 to July 2019 were selected. The clinical features, blood routine, lactate dehydrogenase (LDH), EB virus results, bone marrow features, immunophenotyping, gene and genetic characteristics of all patients were analyzed retrospectivel.@*RESULTS@#Among 81 patients, 73 cases(90%) were B-cell lymphoma, 5 cases(6%) were T-cell lymphoma and 3 cases(4%) were NK/T-cell lymphoma, while the mantle cell lymphoma and diffuse large B-cell lymphoma were the highest, which accounted for 21%(17 cases) and 19.7%(16 cases), and lymphoma accounted for 8.6%(7 cases). There were 44 cases(54.3%) showed B symptoms, 65 cases (80.2%) showed abnormal blood routine. The MYD88 gene was detected in 5 of 17 cases. 25 cases of patients underwent chromosome examination, the result showed that 5 cases were t(8; 14) (q24; q32), 3 cases were complex karyotype and 17 cases were normal karyotype. 23 cases(23.4%) were EB virus positive, 42 cases(51.9%) were LDH increased. The proportion of bone marrow lymphoma cells was 1%-92%. Among them, 32 cases were diagnosed as lymphoma leukemia, and 6 cases of bone marrow lymphoma cells showed mass distribution similar to extramedullary tumor cells with bone marrow metastasis.@*CONCLUSION@#B-cell lymphoma is the predominant NHL with bone marrow invasion as the first manifestation, while mantle cell lymphoma and diffuse large B-cell lymphoma are the most common pathological types with blood routine abnormalities. Bone marrow lymphoma cells can also present clusters of bone marrow metastasis, different types of lymphoma cells can make directional diagnosis.


Subject(s)
Adult , Bone Marrow , Humans , Laboratories , Lymphoma, Large B-Cell, Diffuse , Lymphoma, Mantle-Cell , Lymphoma, Non-Hodgkin
18.
Journal of Experimental Hematology ; (6): 1493-1497, 2021.
Article in Chinese | WPRIM | ID: wpr-922284

ABSTRACT

OBJECTIVE@#To investigate the relationships between caspase-8 (CASP8), fatty acid synthetase (Fas) gene polymorphisms and prognosis of non-Hodgkin's lymphoma patients in Han nationality.@*METHODS@#The clinical data of 85 patients with non-Hodgkin's lymphoma were analyzed retrospectively. The polymorphisms of CASP8 and Fas gene were detected, and prognosis of the patients were analyzed. The polymorphisms of CASP8 and Fas gene in patients with different prognosis were compared, and the relationships between gene polymorphisms and the poor prognosis of the patients were investigated.@*RESULTS@#The incidence rate of poor prognosis of the patients enrolled in the study was 65.88%. The polymorphisms of CASP8 and Fas genes in the patients with poor or good prognosis were in accordance with Hardy Weinberg's law of genetic balance. The frequencies of GG genotype and G allele at rs 1035142 of CASP8 gene, GA genotype and A allele at rs 1377 of Fas gene in patients with poor prognosis were lower than those of the patients with good prognosis (P<0.05). The frequencies of GT, TT and T alleles at rs 1035142 of CASP8 gene, GG and G alleles at rs 1377 of Fas gene in patients with poor prognosis were higher than those of the patients with good prognosis (P<0.05). The proportions of Ann Arbor stage III-IV and high malignancy in patients with poor prognosis were higher than those of the patients with good prognosis (P<0.05). Logistic multiple regression analysis showed that Ann Arbor stage III-IV, moderate malignant, high malignancy, CASP8 rs 1035142 GT genotype, CASP8 rs 1035142 TT genotype and Fas rs 1377 GG genotype were all the risk factors for the poor prognosis of the patients (P<0.05).@*CONCLUSION@#The poor prognosis rate of non-Hodgkin's lymphoma patients in Han nationality is relatively high, and the risk factors for the prognosis of the patients include Ann Arbor stage III-IV, moderate and high malignancy, CASP8 rs 1035142 GT genotype, CASP8 rs 1035142 TT genotype and Fas rs 1377 GG genotype.


Subject(s)
Caspase 8/genetics , Ethnic Groups , Fatty Acids , Humans , Ligases , Lymphoma, Non-Hodgkin/genetics , Polymorphism, Genetic , Prognosis , Retrospective Studies , fas Receptor
19.
Chinese Medical Journal ; (24): 70-78, 2021.
Article in English | WPRIM | ID: wpr-921266

ABSTRACT

BACKGROUND@#Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).@*METHODS@#A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.@*RESULTS@#In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.@*CONCLUSION@#A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.


Subject(s)
Acquired Immunodeficiency Syndrome , Humans , Lymphoma, Non-Hodgkin , Neoplasm Staging , Nomograms , Prognosis , Retrospective Studies
20.
Rev. méd. panacea ; 9(2): 141-144, mayo-ago. 2020. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1121363

ABSTRACT

El síndrome pilórico es un conjunto de síntomas y signos que se producen por una obstrucción total o parcial de la región pilórica que trae como consecuencia la dificultad para el vaciamiento gástrico y la consiguiente retención de su contenido. Se trata de un paciente que presentó vómitos postpandrial tardíos y dolor abdominal difuso después de ingerir alimentos sólidos. Pasado un mes de estos síntomas, los vómitos procedían ante la ingesta de líquidos, acompañado de astenia, anorexia y pérdida de peso. Se atiende en el servicio de cirugía del Hospital "Dr. Ernesto Guevara de la Serna". Se realizó endoscopia que observó obstrucción pilórica completa sin etiología precisada. La laparotomía exploratoria encontró dilatación gástrica con edema y endurecimiento del antro pilórico, múltiples tumoraciones y endurecimientos de un segmento de la unión yeyuno e íleon. Se efectuó antrectomía con gastroyeyunostomía y Brown, con resección de 60 cm de intestino delgado, que incluyó las tumoraciones encontradas. El diagnóstico histológico fue de Linfoma no Hodgkin Linfocitico bien diferenciado. (AU)


Pyloric syndrome is a set of symptoms and signs that are produced by a total or partial obstruction of the pyloric region that results in difficulty in gastric emptying and the consequent retention of its contents. This patient presented with late postpandrial vomiting and diffuse abdominal pain after ingesting solid food. After one month of these symptoms, vomiting was even caused by the intake of liquids, accompanied by asthenia, anorexia and weight loss. He is treated in the surgery service of Dr. "Ernesto Guevara de la Serna" Hospital. An endoscopy was performed which observed complete pyloric obstruction without precise aetiology. Exploratory laparotomy found gastric dilatation with edema and hardening of the pyloric antrum, multiple tumors and hardening of a segment of the jejunum-ion junction. Antrectomy was performed with gastrojejunostomy and Brown, with resection of 60 cm of small intestine, which included the tumors found. The histological diagnosis was well-differentiated Lymphocytic Non-Hodgkin's Lymphoma. (AU)


Subject(s)
Humans , Male , Adult , Pyloric Antrum , Lymphoma, Non-Hodgkin , Pyloric Stenosis, Hypertrophic , Laparotomy
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