RESUMO
PURPOSE: Anaplastic thyroid carcinoma (ATC) is the most lethal form of thyroid cancer with most patients dying of their disease within a few months. Only a very small percentage of long-term survivors (LTS) are alive for 2 years or longer. In this retrospective case-control study, we provided a comprehensive comparison between 46 ATC LTSs and 75 ATC control patients who suffered disease-specific mortality within 2 years, aiming to identify factors that may be associated with prolonged survival in ATC. METHODS: A comprehensive clinicopathologic and molecular comparison was performed between 46 ATC LTSs and 75 ATC control patients. Peripheral neutrophil count and neutrophil-to-lymphocyte ratio (NLR) were recorded. The composition of the tumor microenvironment was compared using immunohistochemistry. RESULTS: Compared with ATC control patients, ATC LTSs were characterized by 1) higher frequency of (primary) resection as well as clinicopathologic parameters attributed to resectability; 2) lower rate of concurrent RAS/BRAF and TERT promoter mutations; 3) lower peripheral neutrophil count and NLR; and 4) lower number of tumor-infiltrating neutrophils/myeloid-derived suppressor cells (MDSC). The survival benefits of low peripheral neutrophil counts and low NLR persisted even when controlling for distant metastasis status at presentation. CONCLUSIONS: In addition to traditional beneficial prognostic factors, e.g., surgical resection, factors attributed to resectability, and absence of co-existing RAS/BRAF and TERT promoter mutations, we herein show that tumor-infiltrating and circulating neutrophils/MDSC are adverse prognostic factors in ATC.
Assuntos
Células Supressoras Mieloides , Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Estudos de Casos e Controles , Humanos , Linfócitos/patologia , Células Supressoras Mieloides/patologia , Neutrófilos , Prognóstico , Proteínas Proto-Oncogênicas B-raf , Estudos Retrospectivos , Carcinoma Anaplásico da Tireoide/genética , Carcinoma Anaplásico da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/genética , Microambiente TumoralRESUMO
BACKGROUND: Low-grade B-cell lymphomas located around the eye present unique challenges in diagnosis and treatment. Extranodal marginal zone B-cell lymphoma is the most common lymphoma of the ocular adnexa (conjunctiva, orbit, lacrimal gland, and eyelid). METHODS: A systematic search of the relevant literature was performed. Material pertinent to the diagnosis, prognosis, pathogenesis, and treatment of extranodal marginal zone B-cell lymphoma of the ocular adnexa was identified, reviewed, and analyzed, focusing on management strategies for primary localized disease. RESULTS: The primary cause of extranodal marginal zone B-cell lymphoma of the ocular adnexa remains elusive, although an infectious agent is suspected. Radiotherapy is the most common initial treatment for localized disease. Initial treatment with chemotherapy, immunotherapy, and antibiotics has shown promising results, but the number of series is limited and controlled trials do not exist. CONCLUSIONS: Although the long-term outcome of localized extranodal marginal zone B-cell lymphoma of the ocular adnexa is good, optimal treatment remains a goal. The variation in rates of local and systemic relapse among treated stage 1E tumors suggests that critical factors affecting outcomes are not fully understood. Radiotherapy is the standard of care; at this time, the evidence is insufficient to recommend chemotherapy, immunotherapy, or antibiotics for initial treatment of extranodal marginal zone B-cell lymphoma localized to the ocular adnexa. Well-controlled comparative studies are needed.
Assuntos
Neoplasias Oculares/tratamento farmacológico , Neoplasias Oculares/terapia , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Linfoma de Zona Marginal Tipo Células B/terapia , Humanos , PrognósticoRESUMO
Mature B-cell lymphomas with both BCL2 and MYC translocations are known as "double hit" lymphomas. These lymphomas are aggressive and show high proliferation rate due to the growth advantages provided by MYC and BCL2 translocation and overexpression. Mantle cell lymphoma (MCL) is a neoplasm of mature B-lymphocytes with characteristic t(11;14) and subsequent Cyclin D1 overexpression. Secondary cytogenetic changes are frequent in MCL, but MYC translocation has only been rarely reported. In this study, we report four cases of MCL with MYC translocation or MYC gene amplification detected by conventional cytogenetics, fluorescence in situ hybridization and whole genome single nucleotide polymorphism (SNP) array, and determined the clinicopathologic features. Our study provides further evidence supporting the concept of "double hit" MCL with co-involvement of MYC gene rearrangement and/or amplification and CCND1 gene rearrangement.
Assuntos
Amplificação de Genes/genética , Rearranjo Gênico do Linfócito B/genética , Linfoma de Célula do Manto/genética , Proteínas Proto-Oncogênicas c-myc/genética , Idoso , Idoso de 80 Anos ou mais , Ciclina D1/genética , Feminino , Humanos , Linfoma de Célula do Manto/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Cervical cancers spread locally through the angiolymphatic apparatus and very rarely metastasize to the brain. The intracranial metastasis is a late event and a sign of poor prognosis. We present two cases of uterine cervical carcinomas with brain metastasis presenting with severe headaches in one case and hemiparesis and aphasia in the other one. Palliative craniotomy and debulking of the tumor was performed in both patients.
Assuntos
Adenocarcinoma/secundário , Neoplasias Encefálicas/secundário , Cérebro/patologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/metabolismo , Adenocarcinoma/terapia , Adulto , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/terapia , Terapia Combinada , Craniotomia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Prognóstico , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/terapiaAssuntos
Cladribina/uso terapêutico , Leucemia de Células Pilosas/tratamento farmacológico , Segunda Neoplasia Primária/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Deleção Cromossômica , Cromossomos Humanos Par 10/genética , Cromossomos Humanos Par 14/genética , Cromossomos Humanos Par 9/genética , Cladribina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/induzido quimicamente , Segunda Neoplasia Primária/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Translocação GenéticaRESUMO
We report a unique case of periocular nonnecrobiotic necrobiotic xanthogranuloma in a 52-year-old white woman with Sjögren syndrome who was subsequently found to have an immunoglobulin G paraproteinemia and coexisting small lymphocytic lymphoma. Therapy with fludarabine, cytoxan, and rituximab (FCR) resulted in a dramatic resolution of her sicca symptoms and periocular xanthogranulomas. This case further illustrates the association of hematolymphoid disorders with cutaneous xanthogranulomatous disease and the importance of additional appropriate laboratory and radiologic investigation for the accurate diagnosis of an underlying malignancy.