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1.
Autops. Case Rep ; 12: e2021354, 2022. graf
Article in English | LILACS | ID: biblio-1360156

ABSTRACT

Peripheral neuropathy (PN) is characterized by the injury to the peripheral nervous system of varied etiology. Lymphoma is one of the etiologies of PN, presenting various neurological manifestations. Neuropathy associated with peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) is unusual and fewer cases are documented in the literature. In addition, PTCL, NOS is extremely rare as primary in the female genital tract, especially uterine cervix, and exhibits aggressive clinical course with poor therapy response. We hereby describe a 47-year-old female who presented with fever and chills for 15 days. Clinical examination revealed left-sided lower motor neuron type of facial nerve palsy with Bell's phenomenon. Nerve conduction study of all four limbs illustrated asymmetrical axonal neuropathy (motor > sensory), suggesting mononeuritis multiplex. She developed vaginal bleeding during her hospital stay. Pelvic examination and imaging revealed a 4x3cm polypoidal mass on the posterior lip of the cervix, which was excised and diagnosed as extranodal primary PTCL, NOS based on morphology, immunohistochemistry, and in-situ hybridization findings. Besides, the cerebrospinal fluid (CSF) was infiltrated by the lymphoma cells, detected on cell block preparation. The patient succumbed to her illness within one week despite best efforts and the commencement of chemotherapy. No consent was obtainable for nerve biopsy and autopsy. Thus, we report an extremely rare case of primary extranodal PTCL, NOS of the uterine cervix with unusual presentation of mononeuritis multiplex. Further, we discussed the differentials of PTCL, NOS at this extranodal site.


Subject(s)
Humans , Female , Middle Aged , Uterine Cervical Neoplasms/complications , Lymphoma, T-Cell, Peripheral/complications , Mononeuropathies/etiology , Biopsy , Immunohistochemistry , Uterine Cervical Neoplasms/diagnosis , Lymphoma, T-Cell/diagnosis , In Situ Hybridization , Fatal Outcome
2.
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
3.
Chinese Medical Journal ; (24): 1584-1592, 2021.
Article in English | WPRIM | ID: wpr-887592

ABSTRACT

BACKGROUND@#There were few studies on real-world data about autologous hematopoietic stem cell transplantation (auto-HSCT) or allogeneic HSCT (allo-HSCT) in peripheral T-cell lymphoma (PTCL). This study aimed to investigate the clinical outcomes of patients who received auto-HSCT or allo-HSCT in China.@*METHODS@#From July 2007 to June 2017, a total of 128 patients who received auto-HSCT (n  = 72) or allo-HSCT (n  = 56) at eight medical centers across China were included in this study. We retrospectively collected their demographic and clinical data and compared the clinical outcomes between groups.@*RESULTS@#Patients receiving allo-HSCT were more likely to be diagnosed with stage III or IV disease (95% vs. 82%, P = 0.027), bone marrow involvement (42% vs. 15%, P = 0.001), chemotherapy-resistant disease (41% vs. 8%, P = 0.001), and progression disease (32% vs. 4%, P < 0.001) at transplantation than those receiving auto-HSCT. With a median follow-up of 30 (2-143) months, 3-year overall survival (OS) and progression-free survival (PFS) in the auto-HSCT group were 70%(48/63) and 59%(42/63), respectively. Three-year OS and PFS for allo-HSCT recipients were 46%(27/54) and 44%(29/54), respectively. There was no difference in relapse rate (34%[17/63] in auto-HSCT vs. 29%[15/54] in allo-HSCT, P = 0.840). Three-year non-relapse mortality rate in auto-HSCT recipients was 6%(4/63) compared with 27%(14/54) for allo-HSCT recipients (P = 0.004). Subanalyses showed that patients with lower prognostic index scores for PTCL (PIT) who received auto-HSCT in an upfront setting had a better outcome than patients with higher PIT scores (3-year OS: 85% vs. 40%, P = 0.003). Patients with complete remission (CR) undergoing auto-HSCT had better survival (3-year OS: 88% vs. 48% in allo-HSCT, P = 0.008). For patients beyond CR, the outcome of patients who received allo-HSCT was similar to that in the atuo-HSCT group (3-year OS: 51% vs. 46%, P = 0.300).@*CONCLUSIONS@#Our study provided real-world data about auto-HSCT and allo-HSCT in China. Auto-HSCT seemed to be associated with better survival for patients in good condition (lower PIT score and/or better disease control). For patients possessing unfavorable characteristics, the survival of patients receiving allo-HSCT group was similar to that in the auto-HSCT group.


Subject(s)
China , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, T-Cell, Peripheral/therapy , Neoplasm Recurrence, Local , Retrospective Studies , Transplantation, Autologous , Transplantation, Homologous , Treatment Outcome
4.
J. oral res. (Impresa) ; 9(6): 516-521, dic. 31, 2020. ilus, tab
Article in English | LILACS | ID: biblio-1178950

ABSTRACT

Peripheral T-Cell Lymphoma Not Otherwise Specified it is a rare type of Non-Hodgkin t-cells malignant tumor whose oral manifestations are difficult to diagnose. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. The patient treatment consisted of chemotherapy, but after the second cycle, died from immunosuppressive complications. Early stage diagnosis of oral lesions is imperative to avoid aggressive treatment and low overall survival rate of such pathologies.


Introducción: El linfoma periférico de células T no especificado es un tipo raro de tumor maligno no Hodgkin de células T cuyas manifestaciones orales son difíciles de diagnosticar. Se presenta el caso de un varón de 48 años con lesión hemimaxilar histológica e inmunohistoquímicamente compatible con linfoma periférico de células T no especificado. El tratamiento del paciente consistió en quimioterapia, pero después del segundo ciclo, falleció por complicaciones inmunosupresoras. El diagnóstico temprano de las lesiones orales es imperativo para evitar un tratamiento agresivo y la baja tasa de supervivencia.


Subject(s)
Humans , Male , Middle Aged , Mouth Neoplasms/diagnosis , Mouth Neoplasms/therapy , Lymphoma, T-Cell, Peripheral/diagnosis , Lymphoma, T-Cell, Peripheral/therapy , Antineoplastic Combined Chemotherapy Protocols , Early Diagnosis , Drug Therapy
5.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(2): 103-110, Apr.-June 2020. ilus
Article in English | LILACS | ID: biblio-1134022

ABSTRACT

ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.


Subject(s)
Leukemia, Lymphoid , Coronavirus , COVID-19 , Lymphoma , Hodgkin Disease , Leukemia, Lymphocytic, Chronic, B-Cell , Lymphoma, B-Cell , Lymphoma, T-Cell, Peripheral , Lymphoma, Mantle-Cell
6.
Article in English | WPRIM | ID: wpr-741208

ABSTRACT

Primary central nervous system lymphoma of T-cell origin (T-PCNSL) is rare, and its clinicopathological features remain unclear. Peripheral T-cell lymphoma of γδ T-cell origin is an aggressive lymphoma mainly involving extranodal sites. Here, we report a case of γδ T-PCNSL involving the intramedullary spinal cord and presenting with paraplegia. A 75-year-old Korean woman visited the hospital complaining of back pain and lower extremity weakness. Magnetic resonance imaging revealed multifocal enhancing intramedullary nodular lesions in the thoracic and lumbar spinal cord. An enhancing nodular lesion was observed in the periventricular white matter of the lateral ventricle in the brain. There were no other abnormalities in systemic organs or skin. Laminectomy and tumor removal were performed. The tumor consisted of monomorphic, medium-to-large atypical lymphocytes with pale-to-eosinophilic cytoplasm. Immunohistochemically, the tumor cells were CD3(+), TCRβF1(-), TCRγ(+), CD30(-), CD4(-), CD8(-), CD56(+), TIA1(+), granzyme B(+), and CD103(+). Epstein-Barr virus in situ was negative. This case represents a unique T-PCNSL of γδ T-cell origin involving the spinal cord.


Subject(s)
Aged , Back Pain , Brain , Central Nervous System , Cytoplasm , Female , Granzymes , Herpesvirus 4, Human , Humans , Laminectomy , Lateral Ventricles , Lower Extremity , Lymphocytes , Lymphoma , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Magnetic Resonance Imaging , Paraplegia , Skin , Spinal Cord Diseases , Spinal Cord , T-Lymphocytes , White Matter
7.
Journal of Experimental Hematology ; (6): 1973-1978, 2019.
Article in Chinese | WPRIM | ID: wpr-781509

ABSTRACT

OBJECTIVE@#To explore the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of relapsed or refractory peripheral T-cell lymphoma(PTCL).@*METHODS@#The clinical data of 6 patients with relapsed or refractory PTCL undergoing allo-HSCT from Sep. 2014 to Sep. 2018 in the department of hematology, aerospace center hospital were retrospectively analyzed. Complications and disease-free survival after HSCT were observed.@*RESULTS@#All the patients could well tolerate the conditioning regimen and acquired hematopoietic recon-struction. Following up till December 2018, with a median time of 11.5 months (1-51); acute GVHD developed in 2 cases and chronic GVHD developed in 5 cases, Among 6 cases one case died of viral pheumonia and the other 5 patients remained disease-free survival. The longest disease-free survival time has reached 51 months.@*CONCLUSION@#allo-HSCT is a safe and effective method for relapsed or refractory peripheral T-cell lymphoma, which can be chosen as salvage treatment method for patients with primary resistance. Optimization of the conditioning regimen may result in better efficacy of allo-HSCT.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, T-Cell, Peripheral , Therapeutics , Retrospective Studies , Transplantation Conditioning , Transplantation, Homologous
8.
Blood Research ; : 108-113, 2019.
Article in English | WPRIM | ID: wpr-763063

ABSTRACT

BACKGROUND: Bendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the conditioning regimen for autologous SCT in refractory/relapsed lymphomas. METHODS: We designed a descriptive study to evaluate bendamustine in combination with etoposide, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT. RESULTS: Fourteen patients (median age, 28 yr) with Hodgkin's lymphoma (HL) (N=8), non-Hodgkin's lymphomas (NHL) (N=5), or peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) (N=1) were included in the study. A median number of 5.95×10⁶ CD34+ cells/kg were transfused. Median times to absolute neutrophil count and platelet engraftment were 17 days and 24 days, respectively. The 100-day transplantation mortality rate was 28% (4 patients). Eight patients (57.14%) had GII-III acute kidney injury, four patients (28.5%) had GIII-IV hyperbilirubinemia, and twelve patients (85%) had GII-III diarrhea. After 3 months, 37% (5 patients) and 21.4% (3 patients) demonstrated complete response and partial response, respectively. The median follow-up was 5.5 months (15 days–19 mo). At the final follow-up, 7 patients (50%) were alive and in CR. CONCLUSION: Our study showed that bendamustine is a potentially toxic agent in the conditioning regimen for autologous SCT, resulting in significant liver, kidney, and gastrointestinal toxicity. Further studies are required to assess its safety and efficacy at reduced doses.


Subject(s)
Acute Kidney Injury , Bendamustine Hydrochloride , Blood Platelets , Carmustine , Cytarabine , Diarrhea , Etoposide , Follow-Up Studies , Hodgkin Disease , Humans , Hyperbilirubinemia , Kidney , Liver , Lymphoma , Lymphoma, Non-Hodgkin , Lymphoma, T-Cell, Peripheral , Melphalan , Mortality , Neutrophils , Stem Cell Transplantation , Stem Cells
9.
Article in English | WPRIM | ID: wpr-759690

ABSTRACT

Peripheral T cell lymphoma, unspecified (PTCL-U) comprises a heterogenous group of mature T-cell lymphomas that do not match with any defined T-cell entities in the current classification system. A 68-year-old man presented with extensive erythematous to brownish ulcerative tumors with yellowish discharge on the neck, trunk, and both upper extremities that had persisted for the past 7 months. Histological findings showed medium- to large-sized pleomorphic lymphocytes with cellular atypia infiltrating the deep dermis and subcutis. Immunohistochemical analysis of specimens from this patient revealed positive staining for CD2, CD45, and granzyme B and mildly positive staining for CD3, CD4, CD30, and CD79a. Based on these clinico-pathological findings, the patient was finally diagnosed with PTCL-U. We report herein a rare case of PTCL-U presenting as multiple ulcerative tumors.


Subject(s)
Aged , Classification , Dermis , Granzymes , Humans , Lymphocytes , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Neck , T-Lymphocytes , Ulcer , Upper Extremity
10.
Article in English | WPRIM | ID: wpr-739114

ABSTRACT

Assessment of bone marrow (BM) involvement in peripheral T-cell lymphoma, not otherwise specified (PTCL) is straightforward in cases of extensive involvement but difficult in cases of minimal to partial involvement. We evaluated the usefulness of CD3 as an immunohistochemical marker for assessing BM involvement in PTCL patients. BM biopsies of 92 PTCL patients were immunohistochemically stained for CD3, CD4, CD8, CD20, and CD56, and evaluated by two hematopathologists. CD3 positivity was graded according to the proportion of CD3-positive cells and the number of CD3-positive cells in a cluster. These criteria were used to determine the cut-offs at which significant differences in progression-free survival (PFS) and overall survival (OS) were observed. Multivariate analysis controlling the International Prognostic Index (IPI) score and its individual factors revealed that >20 CD3-positive cells in a cluster adversely affected PFS (relative risk [RR], 2.1; 95% confidence interval [CI], 1.0–4.3; P=0.047) and OS (RR, 2.4; 95% CI, 1.1–5.1; P=0.028) independent of IPI score. A cluster with >20 CD3-positive cells is a candidate indicator for BM involvement in PTCL.


Subject(s)
Biopsy , Bone Marrow , Disease-Free Survival , Humans , Lymphoma, T-Cell, Peripheral , Multivariate Analysis
11.
Journal of Experimental Hematology ; (6): 1101-1104, 2018.
Article in Chinese | WPRIM | ID: wpr-689522

ABSTRACT

<p><b>OBJECTIVE</b>To compare the clinical characteristics, clinical efficacy, overall survival rate and progression-free survival rate between different subtypes of early nasopharyngeal NK/T cell lymphoma.</p><p><b>METHODS</b>The clinical data of 83 patients with early nasopharyngeal NK/T cell lymphoma in our hospital were retrospectively analyzed, the 83 patients were divided into 2 group: 59 cases of NK cell lymphoma as group A, 24 cases of cytotoxic T-cell phenotype as group B. The differences of clinical characteristics, clinical efficacy and survival prognosis were compared between the 2 groups.</p><p><b>RESULTS</b>The incidence rate of lesion and bone destruction in the group A was significantly lower than those in the group B (P<0.05). The total effective rate in the group A was (91.53%) significantly higher than that in group B (58.33%) (P<0.05), and overall survival rate (59.32%) and progression-free survival rate (45.76%) of 5 years in the group A were significantly higher than those in the group B (29.17%, 16.67%) (Log-rank=4.22, 4.41, P<0.05). Hemophagocytic syndrome was a risk factor for overall survival in patients with nasopharyngeal NK/T cell lymphoma (OR=3.03, 95%CI:1.53-6.00, P<0.01), and sex, tumor subtype and involvement of lymph node were the related factors affecting progression-free survival (OR=2.01, 1.12, 3.68, 95% CI:1.07∼3.77,1.05-1.19, 1.63-8.27, P<0.05).</p><p><b>CONCLUSION</b>In the patients with early nasopharyngeal NK/T cell lymphoma, T cell lymphoma as compared with NK cell lymphoma is more prone to local invasion with poor clinical efficacy, survival and prognosis, therefore, chemotherapy methods should be actively adopted to improve prognosis of patients in clinic.</p>


Subject(s)
Disease-Free Survival , Humans , Lymphoma, T-Cell, Peripheral , Prognosis , Retrospective Studies , Survival Rate
12.
Chinese Medical Journal ; (24): 2105-2111, 2018.
Article in English | WPRIM | ID: wpr-773920

ABSTRACT

Objective@#Peripheral T-cell lymphomas (PTCLs) confer dismal prognosis and no consensus has been established on the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) due to its rarity and heterogeneity. The purpose was to review key points of allo-HSCT for PTCLs, including indication, times of transplantation, conditioning regimen, graft versus host disease prophylaxis, and treatment of relapse.@*Data Sources@#A comprehensive search in PubMed and Cochrane up to February 28, 2018, with the keywords "Peripheral", "T", "Lymphoma", and "Transplantation" was done.@*Study Selection@#Relevant articles including HSCT for PTCLs were carefully reviewed.@*Results@#Promising data have been reported from advances in transplant technology and more and more PTCLs patients with poor prognosis could benefit from allo-HSCT.@*Conclusion@#Allo-HSCT is a useful choice for patients with refractory/relapsed PTCLs or high-risk new diagnosed PTCLs.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, T-Cell, Peripheral , Therapeutics , Neoplasm Recurrence, Local , Transplantation Conditioning , Transplantation, Homologous
14.
Rev. bras. hematol. hemoter ; 39(1): 13-19, Jan.-Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-843943

ABSTRACT

Abstract Background: Adult T-cell leukemia/lymphoma is a peripheral disease associated with human T-cell lymphotropic virus type 1. Treatment is carried out according to clinical type with watchful waiting being recommended for less aggressive types. Aggressive adult T-cell leukemia/lymphoma is generally treated with chemotherapy and/or antivirals. The objective of this study was to correlate the survival of patients diagnosed in Bahia, Brazil, with the therapeutic approaches employed and to evaluate what issues existed in their treatment processes. Methods: Eighty-three adult T-cell leukemia/lymphoma patients (26 smoldering, 23 chronic, 16 acute, 13 lymphoma and five primary cutaneous tumoral) with available data were included in this study. Results: Complete response was achieved in seven smoldering patients with symptomatic treatment, in two with chronic disease using antivirals/chemotherapy, in one with acute disease using antivirals and in one lymphoma using the LSG15 regimen [vincristine, cyclophosphamide, doxorubicin, and prednisolone (VCAP); doxorubicin, ranimustine, and prednisolone (AMP); and vindesine, etoposide, carboplatin, and prednisolone (VECP)]. Smoldering patients who received symptomatic treatment presented longer survival. Favorable chronic patients treated with antivirals presented longer survival compared to the unfavorable subtype. However, for the acute form, first-line chemotherapy was better, albeit without significance, than antivirals. Only one of the patients with lymphoma and primary cutaneous tumors responded. Conclusions: Watchful waiting associated with phototherapy represents the best option for smoldering adult T-cell leukemia/lymphoma with survival in Bahia being superior to that described in Japan. There was a trend of better results with zidovudine/interferon-alpha in favorable chronic disease. Excellent results were achieved in the lymphoma type treated with the LSG15 protocol. Patients are diagnosed late probably due to lack of knowledge of adult T-cell leukemia/lymphoma by primary healthcare doctors and a Brazilian treatment protocol needs to be established.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , HTLV-I Infections , Human T-lymphotropic virus 1 , Leukemia , Leukemia-Lymphoma, Adult T-Cell , Lymphoma, T-Cell, Peripheral , Zidovudine
15.
Article in English | WPRIM | ID: wpr-208880

ABSTRACT

Epstein-Barr virus (human herpesvirus-4) is very common virus that can be detected in more than 95% of the human population. Most people are asymptomatic and live their entire lives in a chronically infected state (IgG positive). However, in some populations, the Epstein-Barr virus (EBV) has been involved in the occurrence of a wide range of B-cell lymphoproliferative disorders (LPDs), including Burkitt lymphoma, classic Hodgkin’s lymphoma, and immune–deficiency associated LPDs (post-transplant and human immunodeficiency virus–associated LPDs). T-cell LPDs have been reported to be associated with EBV with a subset of peripheral T-cell lymphomas, angioimmunoblastic T-cell lymphomas, extranodal nasal natural killer/T-cell lymphomas, and other rare histotypes. This article reviews the current evidence covering EBV-associated LPDs based on the 2016 classification of the World Health Organization. These LPD entities often pose diagnostic challenges, both clinically and pathologically, so it is important to understand their unique pathophysiology for correct diagnoses and optimal management.


Subject(s)
B-Lymphocytes , Burkitt Lymphoma , Classification , Diagnosis , Herpesvirus 4, Human , Humans , Lymphoma , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Lymphoproliferative Disorders , T-Lymphocytes , World Health Organization
16.
Korean Journal of Medicine ; : 326-329, 2017.
Article in Korean | WPRIM | ID: wpr-189022

ABSTRACT

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects various organs, so it is easily confused with other diseases and thus misdiagnosed. SLE is defined only by classification criteria and not by diagnostic criteria, so other diseases must be excluded before SLE can be diagnosed. We report a case of peripheral T cell lymphoma that mimicked SLE initially.


Subject(s)
Anemia, Hemolytic , Autoimmune Diseases , Classification , Lupus Erythematosus, Systemic , Lymphoma , Lymphoma, T-Cell, Peripheral
17.
Article in English | WPRIM | ID: wpr-79441

ABSTRACT

Peripheral T-cell lymphomas (PTCLs) are aggressive neoplasms which may involve the liver. The imaging manifestations of hepatic lymphoma are highly variable and show overlapping appearances of numerous other hepatic diseases. As the management and prognosis of lymphoma differ markedly from those of other malignant diseases, prompt diagnosis and early effective treatment are very important. Here, we report an atypical case of primary PTCL not otherwise specified involving the liver that exhibited a solitary hepatic mass mimicking hepatocellular carcinoma (HCC) on CT. Liver biopsy is not commonly recommended in highly suspicious cases of HCC. However, in a patient without risk factors for HCC, consideration of other diagnostic possibilities is required and needle biopsy may be a more rational choice. An imaging approach, based on a careful review of clinical and laboratory findings is essential to prevent false-positive diagnosis of HCC and subsequent invasive treatment.


Subject(s)
Biopsy , Biopsy, Needle , Carcinoma, Hepatocellular , Diagnosis , Hepatectomy , Humans , Liver , Lymphoma , Lymphoma, T-Cell, Peripheral , Prognosis , Risk Factors
18.
Blood Research ; : 270-275, 2017.
Article in English | WPRIM | ID: wpr-21831

ABSTRACT

BACKGROUND: While cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is the most commonly used chemotherapeutic regimen for patients with peripheral T-cell lymphomas (PTCLs), elderly patients are more vulnerable to associated toxicities. We evaluated the efficacy and safety of dose-attenuated CHOP in elderly patients with PTCL. METHODS: Patients with PTCL aged >70 years or 65–70-years with comorbidities were treated with dose-attenuated CHOP (cyclophosphamide: 562.5 mg/m2, doxorubicin: 37.5 mg/m2, vincristine: 1.4 mg/m2, and prednisolone: 100 mg for five days; 25% reduced dose of cyclophosphamide and doxorubicin vs. full-dose CHOP) as first-line therapy were included. RESULTS: Forty-four patients (median age, 74 yr) were analyzed. The majority (N=42, 95.5%) had advanced stage disease and 36 (81.8%) were classified as high/high-intermediate risk by the international prognostic index. The overall response rate was 61.4%, and 21 patients achieved complete response (47.7%). With median follow-up period of 28.8 months, the estimated two-year progression-free and overall survival rates were 36.7% and 46.6%, respectively. Grade 3/4 neutropenia and thrombocytopenia occurred in 26.9% and 7.4% of 204 total cycles, which affected 76.7% and 25.6% of the patients, respectively. Nineteen patients (44.2%) experienced febrile neutropenia, and six died due to treatment-related toxicities. High lactate dehydrogenase levels and an involvement of >1 extranodal sites were prognostic indicators of poor survival. CONCLUSION: Dose-attenuated CHOP does not compromise treatment efficacy but retains significant toxicity. Our results suggest that some patients can be effectively treated with dose-attenuated CHOP, however a novel therapy for elderly patients with PTCL is required.


Subject(s)
Aged , Comorbidity , Cyclophosphamide , Doxorubicin , Drug Therapy , Febrile Neutropenia , Follow-Up Studies , Humans , L-Lactate Dehydrogenase , Lymphoma, T-Cell, Peripheral , Neutropenia , Prednisolone , Survival Rate , Thrombocytopenia , Treatment Outcome , Vincristine
19.
Article in Korean | WPRIM | ID: wpr-155825

ABSTRACT

A 72-year-old male presented with respiratory discomfort. A simple chest X-ray and abdominal computed tomography showed pleural effusion and multiple lymph node enlargement. The pleural effusion was determined by thoracentesis to be chylothorax. An inguinal lymph node biopsy showed peripheral T-cell lymphoma. Following three cycles of cyclophospamide, hydroxyl doxorubicin, vincristine, prednisolone (CHOP) chemotherapy, a partial response was observed. Chylothorax is an extremely rare complication of T-cell lymphoma. We present a case of peripheral T-cell lymphoma presenting with chylothorax. We suggest that clinicians should consider chylothorax when examining patients with lymphoma who present with atypical pleural effusion.


Subject(s)
Aged , Biopsy , Chylothorax , Doxorubicin , Drug Therapy , Humans , Lymph Nodes , Lymphoma , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Male , Pleural Effusion , Prednisolone , Thoracentesis , Thorax , Vincristine
20.
Blood Research ; : 187-192, 2016.
Article in English | WPRIM | ID: wpr-209254

ABSTRACT

BACKGROUND: This study aimed to assess the treatment outcomes of ifosphamide, mesna, etoposide, and prednisolone (IMEP) combination regimen as a front-line chemotherapy in patients with peripheral T-cell lymphomas (PTCLs). METHODS: Clinical data of 38 newly diagnosed PTCLs patients who underwent IMEP at Busan Paik Hospital from January 2002 to December 2013 were retrospectively analyzed. RESULTS: The overall response rate was 68.5%, with 21 (55.3%) complete response/complete response unconfirmed and 6 (15.8%) partial response (PR). The median follow-up duration was 25.5 months (range, 0.2-87.3). The median overall survival was not reached and 2-year survival rate was 67%. The median progression free survival was 23 months. The most frequently reported adverse effects higher than grade 3 were hematologic toxicities including neutropenia (68.4%), thrombocytopenia (42.1%). There was no treatment-related mortality. CONCLUSION: IMEP regimen is effective and safe as a front-line chemotherapy in patients with PTCLs.


Subject(s)
Disease-Free Survival , Drug Therapy , Etoposide , Follow-Up Studies , Humans , Lymphoma, T-Cell, Peripheral , Mesna , Mortality , Neutropenia , Prednisolone , Retrospective Studies , Survival Rate , Thrombocytopenia
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