Intestinal T-cell lymphoma not otherwise specified: a case report and literature review.

Intestinal T-cell lymphoma, not otherwise specified (ITCL, NOS), primarily affects the small bowel but can involve the stomach and large bowel. This report presents an uncommon case of ITCL, NOS in a patient affecting the large bowel, supported by a literature review. An 87-year-old female presented with abdominal pain, fever, vomiting and weight loss. Imaging revealed nodular thickening of the transverse and right colon, confirmed as polypoid mass lesions with ulceration through colonoscopy and biopsy, indicating ITCL, NOS. CT scan showed adrenal nodes classifying it as stage VI. The patient was referred for palliative care and passed away 40 days later, likely due to tumor progression. This case underscores the rarity of large bowel ITCL, NOS and the diagnosis challenge.

Primary colonic MALT lymphoma associated with Crohn's disease: Case report and review of the literature.

Key Clinical Message: To date, the pathogenic mechanisms of the association between Crohn's disease and MALT lymphoma are ambiguous and yet remain to be elucidated. The publication of other cases illustrating this rare association would be interesting to properly plan therapeutic strategies and to better understand the pathogenesis and the prognosis of this association. Abstract: Crohn's disease is a progressive disease, with increasing incidence, that leads to bowel damage and disability. Primary colonic MALT lymphoma is a low-grade B lymphoma, representing only 2.5% of all MALT lymphomas. The pathogenesis of these two cancers is still not clearly elucidated and their association is rare. To our knowledge, only two cases have illustrated synchronous Crohn's disease and MALT lymphoma. The possible role of Crohn's disease as a precursor of MALT lymphoma is still debated; some studies proposed that immunosuppressive drugs used in Crohn's disease are involved in the lymphomagenesis of MALT lymphoma. Other studies supposed no relation between these two neoplasms.We present a rare case of association between Crohn's disease and primary colonic MALT lymphoma in an elderly female patient who had not received any immunosuppressive therapy. The patient presented with chronic diarrhea, epigastric pain, and weight loss. A colonoscopy with biopsies was performed. The histopathologic examination concluded with the diagnosis of not only Crohn's disease but also MALT lymphoma. This discovery of MALT lymphoma was incidental. We highlight the clinical and histopathological features, and we discuss the association between Crohn's disease and MALT lymphoma, which may provide additional information about pathogenic mechanisms.

Status of Her2 over expression in muscle invasive urothelial bladder carcinoma: Report of 21 cases.

BACKGROUND: Invasive urothelial bladder carcinomas have a poor prognosis even with cystectomy and chemotherapy. A high number of these patients have Her2 overexpression. The goal of this study is to assess the Her2 status in muscle invasive urothelial bladder carcinoma, to evaluation heterogeneity and discordance with metastases. PATIENTS AND METHODS: We retrospectively analyzed 21 specimens of transurethral resection or cystectomy in patients with invasive urothelial bladder carcinoma. We selected one representative section from primary tumors and metastases for immunohistochemistry analysis. Staining was evaluated according to the same criteria of breast cancer. A chromogenic in situ hybridization (CISH) was performed in case of 2+ score or in heterogeneous samples. RESULTS: Median age of our patients was 62 years. Intratumoral heterogeneity was observed in 2 cases (less than 1%). One case showed a Her2 3+ score (high grade, pT2 stage) and 3 cases showed a 2+ score (all low grades, stage T2, T4, M1, respectively). Two metastatic lymph nodes scored 1+ for the first (primary 1+) and 2+ for the second (primary 1+). Two cases showed CISH gene amplification. The first one scored 2+ and had area of 3+ score. The second one scored 1+ and had area with 2+ score. Four patients died from disease, one of them had Her2 3+ score. CONCLUSION: Her2 overexpression can be observed in muscle invasive urothelial bladder carcinoma in an important number of patients. Evaluation criteria must be standardized, especially with heterogeneous cases. Metastases tests can also readdress the expression of Her2, which gives the patient a supplementary therapeutic tool.

Testicular synovial sarcoma: a case report.

This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in size involving the inguinal region. Histological examination of a surgical biopsy showed a grade III monophasic growth pattern of spindle cell proliferation. Immunohistochemical analyses indicated positive staining for pancytokeratine and epithelial membrane antigen. Cytogenetic analysis showed the presence of CYT-SSX1 mutation, and CT scan showed non-specific pleural micro-nodules with a size of 7.5 mm. The patient had an extended left orchidectomy but was lost to follow-up for 1 year. A local recurrent scrotal mass of 32 mm × 25 mm, multiple inguinal lymph nodes, and increased pleural nodules, which were confirmed by histological examination, were treated with three cycles of adriamycine and ifosfamide chemotherapy, surgical resection, and radiotherapy with complete response. After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxel. The patient had dyspnea at the time of this writing and chest pain, and is under third-line chemotherapy based on Deticene after 30 months of following up. This patient died on November 16, 2012 after a resperatory failure and malignant pelural effusion. Synovial sarcoma should be considered in the differential diagnosis of soft tissue tumor and it should be aggressively treated to improve prognosis. Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.

[Primary cutaneous plasmacytoma]. / Plasmocytome cutané primitif.

Primary cutaneous plasmacytoma (PCP) is a rare cutaneous B cell lymphoma. We report a case of PCP in a 64 year old woman presenting with a nodular lesion of the left cheek. Histologically, the lesion was composed predominately of variably maturated plasma cells with monotypic expression of lambda chain. Extracutaneous localizations of the disease had been excluded. The prognosis of PCP is better than that of the metastatic cutaneous lesion of myeloma. The main prognosis factors are the size tumor and clinical presentation (solitary, versus multiple lesions). Solitary lesions of the PCP are treated by surgical excision and sometimes local radiotherapy.