Subject(s)
Bone Marrow , Leishmania/metabolism , Leishmaniasis, Visceral , Liver , Lymphoma, Large B-Cell, Diffuse , Bone Marrow/metabolism , Bone Marrow/parasitology , Bone Marrow/pathology , Humans , Leishmaniasis, Visceral/metabolism , Leishmaniasis, Visceral/parasitology , Leishmaniasis, Visceral/pathology , Liver/metabolism , Liver/parasitology , Liver/pathology , Lymphoma, Large B-Cell, Diffuse/metabolism , Lymphoma, Large B-Cell, Diffuse/parasitology , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle AgedABSTRACT
BACKGROUND: Intravascular large B-cell lymphoma (ivLBCL) is a rare blood dyscrasia that is difficult to diagnose. Healthy skin biopsies may prove useful in diagnosis of the condition. Herein we report a case of ivLBCL diagnosed using this type of examination, and we provide a literature review to determine the sensitivity of such testing. PATIENTS AND METHODS: A 67-year-old woman was hospitalised for unexplained prolonged fever (UPF) and impaired general well-being. Laboratory tests revealed inflammatory syndrome, elevated LDH>2000IU/L, hepatic cytolysis and decreased prothrombin time at 47 %. Analysis for infection and medical imaging ruled out both an infectious or inflammatory origin and solid tumour. A healthy skin biopsy enabled confirmation of the diagnosis of ivLBCL. DISCUSSION: This clinical case illustrates the value of healthy skin biopsy in establishing a diagnosis of ivLBCL in patients hospitalised for UPF. Following a systematic literature review in PubMed/Medline, we included eight studies involving at least three patients designed to assess the value of healthy skin biopsy in the diagnosis of ivLBCL. The diagnostic sensitivity of this approach ranged from 67% to 100%, with a sensitivity of 100% being seen in four of the eight studies. Details of the biopsy sites were available in three studies and diagnostic sensitivity was similar overall between samples taken from the thigh, abdomen and arms. CONCLUSION: Healthy skin biopsy sampling from at least two sites constitutes a sensitive and relatively non-invasive procedure for early diagnosis of ivLBCL.
Subject(s)
Lymphoma, Large B-Cell, Diffuse/parasitology , Skin/pathology , Vascular Neoplasms/pathology , Aged , Biopsy , Diagnosis, Differential , Female , HumansSubject(s)
Amebicides/therapeutic use , Antineoplastic Agents/therapeutic use , Colonic Neoplasms/complications , Colonic Neoplasms/diagnosis , Entamoeba histolytica/isolation & purification , Entamoebiasis/complications , Entamoebiasis/diagnosis , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/diagnosis , Metronidazole/therapeutic use , Abdominal Pain/parasitology , Aged , Antibodies, Monoclonal, Murine-Derived/administration & dosage , Antigens, Protozoan/isolation & purification , Colonic Neoplasms/drug therapy , Colonic Neoplasms/parasitology , Colonoscopy , Cyclophosphamide/administration & dosage , Entamoeba histolytica/immunology , Entamoebiasis/drug therapy , Entamoebiasis/pathology , Fever/parasitology , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/parasitology , Male , Prednisolone/administration & dosage , Remission Induction , Rituximab , Tomography, X-Ray Computed , Vincristine/administration & dosage , Weight LossABSTRACT
A patient with primary non-hodgkins lymphoma of the paranasal sinuses presenting as rhinoorbital myiasis is reported. The myiasis causing species was identified as Chrysomia bezziana Villeneuve. This case demonstrates the extreme destruction caused by myiasis and the inadequacy of therapeutic options available in such patients.
Subject(s)
Ethmoid Sinus/pathology , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Non-Hodgkin/complications , Myiasis/complications , Orbital Diseases/parasitology , Paranasal Sinus Neoplasms/complications , Rhinitis/parasitology , Ethmoid Sinus/parasitology , Female , Humans , Lymphoma, Large B-Cell, Diffuse/parasitology , Lymphoma, Non-Hodgkin/parasitology , Middle Aged , Myiasis/parasitology , Orbital Diseases/complications , Paranasal Sinus Neoplasms/parasitology , Rhinitis/complicationsABSTRACT
We observed considerable diversity in the cytoadherence of Plasmodium falciparum isolates from Malawi to melanoma cells, U937 cells and human peripheral monocytes. Each isolate exhibited a unique cytoadherence profile for the three human cell types. These isolates generally adhered well to U937 cells and fresh monocytes, moderately to melanoma cells and poorly to TE 671, MIA-Pa-Ca, WI 38, PLC/PRF/5 and HeLa cells. An antimalarial immunoglobulin pool inhibited binding to melanoma cells by 50% or more and to U937 cells by 25% or less. There was no correlation between in vitro cytoadherence to the three cells and clinical disease. These results suggest that malarial adherence ligands exposed on the surface of infected erythrocytes vary from one isolate to another.
