ABSTRACT
A 68-year-old man was referred to our hospital due to a high fever and pancytopenia. Neither tumors nor infectious lesions were detected. Hemophagocytosis was observed on the bone marrow (BM) smear, although without abnormal cells. Prednisolone therapy was ineffective for the patient's high fever. Later on, we obtained the results of a BM biopsy indicating the presence of infiltration of atypical Reed-Sternberg cells, leading to a diagnosis of HIV-negative primary bone marrow Hodgkin lymphoma (PBMHL). However, the patient died of multiple organ failure before receiving chemotherapy. As the clinical course of PBMHL is rapid, physicians must keep in mind its possibility in similar cases.
Subject(s)
Bone Marrow/pathology , Fever/etiology , HIV Seronegativity , Hodgkin Disease/diagnosis , Aged , Biopsy , Diagnosis, Differential , Hodgkin Disease/pathology , Humans , Male , Pancytopenia/pathology , Reed-Sternberg Cells/pathologyABSTRACT
We report a case of primary cardiac lymphoma (PCL) occurring in a 76-year-old man during maintenance hemodialysis. Chest computed tomography (CT) revealed a tumor with pericardial effusion in the left ventricular posterior wall. Cytological examination of the pericardial fluid revealed monotonous lymphoid cells positive for B-cell markers, and clonal immunoglobulin heavy chain gene rearrangement was detected, indicating B-cell lymphoma. Rituximab monotherapy was administered biweekly at the therapeutic level on hemodialysis. The follow-up chest CT showed tumor disappearance with pericardial fluid after two courses of therapy. Rituximab monotherapy was effective for an elderly hemodialysis patient with PCL.
Subject(s)
Antibodies, Monoclonal, Murine-Derived/therapeutic use , Heart Neoplasms/therapy , Lymphoma, B-Cell/therapy , Aged , Antibodies, Monoclonal, Murine-Derived/blood , Gene Rearrangement, B-Lymphocyte, Heavy Chain , Heart Neoplasms/diagnosis , Heart Neoplasms/genetics , Heart Neoplasms/immunology , Humans , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/genetics , Lymphoma, B-Cell/immunology , Male , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/pathology , Renal Dialysis , Rituximab , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A 74-year-old man was hospitalized with hypoglossal nerve paralysis and severe great occipital neuralgia. Enhanced MRI of the head showed tumor on the left petrous bone, which compressed the medulla oblongata. Soluble IL-2 receptor was elevated and malignant lymphoma was clinically diagnosed. PET-CT demonstrated a single hot spot on the spleen. After radiation therapy to the lesion on the petrous bone, splenectomy was performed. Pathological findings established a diagnosis of diffuse large B-cell lymphoma. After chemotherapy consisting of rituximab and THP-COP, complete remission was achieved.
