A Case of Primary Hepatic B-cell Lymphoma of Mucosa-associated Lymphoid Tissue (MALT)-Type

Mucosa-associated lymphoid tissue (MALT) lymphoma is a low grade B cell lymphoma that, occurs in numerous sites including the stomach, ocular adnexa, thyroid, lung and breast; however, primary hepatic lymphoma is extremely rare. Only about 20 cases have been reported world wide. We recently experienced a case of primary hepatic B-cell lymphoma of the MALT type in a 63-year old female patient. She presented with abdominal pain. The CT, ultrasonogram and PET-CT showed a hepatic nodular mass. A biopsy specimen of the liver revealed MALT lymphoma. There was no evidence of the lymphoma in the extrahepatic lesion. She received segmentectomy of liver and was then treated with CVP (cyclophosphamide, vincristine and prednisolone) chemotherapy. She has been followed up for 6 months since the therapy, and she remains asymptomatic.

A case of relapsed renal plasmacytoma after complete remission of multiple myeloma / 대한내과학회지

Extramedullary plasmacytoma is a rare presentation of plasma cell dyscrasia. Most such tumors arise on the upper aerodigestive tract and renal plasmacytoma is very rare. The patient was 44 years old female presented with a 3 month-history of palpable mass in the right flank. There was a past history of complete remission after a chemotherapy for multiple myeloma (6 cycles of VAD chemotherapy) for the two years following the first diagnosis. After surgical resection, histologic and immunofluorescence studies of resected specimens revealed that the renal parenchyma was destroyed by sheets of mature plasma cells producing monoclonal protein (IgG-lambda) and by deposits of amorphous eosinophilic substance stained with anti-lambda antisera. Treatment with chemotherapy of Hyper-CVAD and local irradiation was done. The patient has been disease-free for 3 months after treatment. We report a case of relapsed renal plasmacytoma after complete remission of multiple myeloma.

A Case of Ig A Nephropathy Associated with Polycythemia Vera / 대한신장학회잡지

Secondary polycythemia is occasionally associated with renal diseases such as renal tumors, cysts, hydronephrosis, renal transplantation, renal artery stenosis and Bartter's syndrome and is rarely associated with nephrotic syndrome, nephrosclerosis, pyelonephritis, chronic gromerulonephritis and membranous nephropathy. The association of polycythemia vera and Immunoglobulin A nephropathy (IgAN) is well not known, and there are only a few isolated reports presenting the concomitance of polycythemia vera and IgAN. We report one patient with concomitant polycythemia vera and Ig A nephropathy. A 53 year-old male visited our hospital because of elevated hemoglobin level. Blood value of hemoglobin was 22.1 g/dL. Isotopic blood studies with radioactive chromium (51Cr)-labelled red blood cells revealed a total blood volume of 90 mL/kg and total red cell volume of 61.8 mL/kg. The concentration of serum erythropoietin measured by radioimmunoassay was 14.29 mIU/mL (normal 10.2-25.2 mIU/mL). Bone marrow aspirate revealed hypercellularity and panmyelosis, characteristically. Renal biopsy specimens showed moderate mesangioproliferative lesions with mesangial IgA and C3 deposition. Treatment with phlebotomy, hydroxyurea and oral prednisolone (1 mg/kg/day) was done. There was no decrease of urinary protein following treatment of phlebotomy and hydroxyurea. But urinary protein decreased and hemoglobin level normalized following combination treatment of phlebotomy, hydroxyurea and oral prednisolone.

MINE (mesna, ifosfamide, mitoxantrone, etoposide) Chemotherapy as a Treatment of Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The prognosis of non-Hodgkin's lymphoma (NHL) is disappointing for patients who experience primary treatment failure or relapse after an initial response. Patients in relapse may respond again to chemotherapy, however the time to disease progression becomes shorter and eventually the disease becomes resistant. The aim of this study was to evaluate the efficacy and safety of the MINE regimen in the treatment of patients with relapsed or refractory NHL. Material and Methods: Forty-three pretreated patients with a median age of 56 years were enrolled into the study between October 1995 and June 2000. Most patients (60.5%) had a performance status of 0 to 1, and a diffuse large cell subtype (55.8%). Seventy-four percent of patients had stage III or IV disease at the start of MINE treatment. Eighteen (41.9%) patients had complete response, 5 (11.6%) had partial response, and 20 (46.5%) had failed to respond to prior therapy. Ifosfamide 4 g/m2 was divided over 3 days and administered IV over a 1 hour period. Mitoxantrone 8 mg/m2 was administered as a short IV infusion on day 1. Etoposide (65 mg/m2/day) was infused over 1 hour on days 1 to 3. A total of 144 cycles was administered, with a mean of 3.34 cycles per patient (range, 1-8). The mean relative dose intensity was 87.4%. RESULTS: 1) Nine patients achieved a complete response and nine patients achieved a partial response, resulting in an overall response rate of 43.8% of the 41 assessable patients. 2) The median survival time was 6 months (95% CI, 4 to 8 months), and the median time to failure was 5 months (95% CI, 3 to 7 months). 3) A statistically significant association with complete response rates was found for complete response to prior therapy (p=0.049). The significant factors for overall survival were a complete response after MINE chemotherapy and serum 2-microglobulin (p=0.003, p=0.012, respectively). The significant factors for time to treatment failure were a complete response after MINE chemotherapy and serum 2-microglobulin (p=0.003, p=0.044, respectively). 4) The main result of toxicity of MINE was bone marrow suppression. CONCLUSION: The response to MINE chemotherapy and serum 2-microglobulin were both independent prognostic factors for overall survival and time to treatment failure. As the median time to treatment failure for complete responses was 14 months, the best use of this regimen could be in a strategy that includes prompt consolidation of a complete response with intense chemotherapy, with or without hematopoietic stem cell rescue.

Four Cases of HNPCC Including Two Cases with Synchronous Stomach Cancer

Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal dominant disease characterized by early manifestation of colorectal cancer (CRC), occurrence of multiple colorectal tumors and high frequencies of extracolonic malignancies. Evaluation of clinical findings in concert with a well-documented and extended pedigree and genetic studies of colorectal cancer can identify person who are at high risk and who thereby might benefit from targeted early detection and primary prevention programs. Here we report 4 cases of HNPCC including 2 cases with synchronous gastric cancers.