ABSTRACT
INTRODUCTION: Diffuse large B-cell lymphoma is a diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or exceeding the normal macrophage nuclei. We report a case of a clear cell variant of diffuse large B-cell lymphoma involving a lymph node in the neck, which was clinically suspected of being metastatic carcinoma. CASE PRESENTATION: A 39-year-old Caucasian ethnic Albanian man from Kosovo presented with a rapidly enlarging lymph node in his neck, but he also disclosed B symptoms and fatigue. A cytological aspirate of the lymph node revealed pleomorphic features. Our patient underwent a cervical lymph node biopsy (large excision). The mass was homogeneously fish-flesh, pale white tissue replacing almost the whole structure of the lymph node. The lymph node biopsy showed a partial alveolar growth pattern, which raised clinical suspicion that it was an epithelial neoplasm. With regard to morphological and phenotypic features, we discovered large nodules in diffuse areas, comprising large cells with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In these areas, there was high mitotic activity, and in some areas there were macrophages with tangible bodies. Staining for cytokeratins was negative. These areas had the following phenotypes: cluster designation marker 20 (CD20) positive, B-cell lymphoma (Bcl)-2-positive, Bcl-6-, CD5-, CD3-, CD21+ (in alveolar patterns), prostate-specific antigen-negative, human melanoma black marker 45-negative, melanoma marker-negative, cytokeratin-7-negative and multiple myeloma marker 1-positive in about 30% of cells, and exhibited a high proliferation index marker (Ki-67, 80%). CONCLUSION: According to the immunohistochemical findings, we concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of activated cell type, post-germinal center cell origin. Our patient is undergoing R-CHOP chemotherapy treatment.
ABSTRACT
OBJECTIVE: The purpose of our study was to analyze the frequency of preterm deliveries in Obstetrics & Gynecology Clinic, University Clinical Centre of Kosovo, Prishtina (Republic of Kosovo), as well as to assess the survival advantage of premature newborns according to mode of delivery (cesarean section vs. vaginal). MATERIAL AND METHODS: A cohort of 12,466 deliveries from the year 2002 was studied retrospectively and preterm deliveries were analyzed. Survival advantage until 28 days of life associated with cesarean and vaginal delivery was assessed with regard to birth weights (500-999 g, 1000-1499 g, 1500-1999 g, and 2000-2499 g). RESULTS: There were 1,135 preterm deliveries which resulted in 1,189 preterm infants (including multiples). The overall cesarean delivery rate in this group was 32.2%. Among preterm newborns with birth weight 500-999 g, 68 children were delivered vaginally and 5 by caesarean section (5.7% and 0.4% of all preterm babies respectively). None of the infants survived. The percentage of children from cesarean deliveries in the other groups was higher: for preterm infants with birth weight 1000-1499 g--3.2%, 1500-1999 g--8.8% and 2000-2499 g--19.8%. A survival advantage associated with cesarean section was observed in neonates with birth weight 1000-1499 g (p < 0.01). CONCLUSIONS: On the basis of our study it can be concluded that cesarean delivery is associated with a decreased neonatal mortality risk in preterm neonates but only in those with birth weight of 1000-1499 g.
