• Title, Summary, Keyword: non-Hodgkin lymphoma

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Importance of PET/CT Scan Use in Planning Radiation Therapy for Lymphoma

  • Milana, Mitric-Askovic;Marko, Erak;Miroslav, Latinovic;Tihomir, Dugandzija
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2051-2054
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    • 2015
  • Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.

Solitary Lymphoblastic Lymphoma of the Thoracic Spine

  • Park, Dong Am;Park, Sang Gon;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.564-566
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    • 2012
  • Non-Hodgkin's lymphoma rarely originates from bone, and even more infrequently from a vertebral body. Lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma, and results from an abnormality in adaptive immune cells. A 27-year-old man presented with a two-month history of night sweats, weight loss, and severe back pain. Radiological studies demonstrated an osteolytic lesion compressing the subarachnoid space at the T11 level. Posterolateral fusion with decompression was performed and a pathologic examination confirmed lymphoblastic lymphoma of the B-cell precursor type. To our knowledge, this is the first report of solitary lymphoblastic lymphoma from B-cell precursors in of the thoracic spine. Herein, we discuss the presenting symptoms and the management of this rare case of lymphoblastic lymphoma.

Multimodal Approaches in the Patients with Stage I,II Non-Hodgkin's Lymphoma of the Head and Neck (국한성 두경부 비호지킨스 림프종 환자에서의 다방면치료)

  • Pyo Hong Ryull;Suh Chang Ok;Kim Gwi Eon;Rho Jae Kyung
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.129-142
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    • 1995
  • Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

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Primary Extra Nodal Non Hodgkin Lymphoma: A 5 Year Retrospective Analysis

  • Padhi, Somanath;Paul, Tara Roshni;Challa, Sundaram;Prayaga, Aruna K.;Rajappa, Senthil;Raghunadharao, D.;Sarangi, Rajlaxmi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4889-4895
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    • 2012
  • Background and Aim: The incidence of extra nodal non Hodgkin lymphoma (ENL) is rising throughout the world. However, data regarding ENL as a group is limited. The aim was to study the epidemiological and histomorphological trends of primary ENL (pENL) in India. Material and Methods: The biopsy materials from sixty eight patients with pENL (45 male, 23 female, M:F= 1.9:1), diagnosed over a five year period (2005-2009), were analysed and pathologically reclassified according to the World Health Organization (WHO) classification, 2008 criteria. Results: Primary extra nodal non Hodgkin lymphomas constituted 22.0% (68/308) of all non Hodgkin lymphomas (NHL). The mean age at presentation for pENL and primary nodal NHL was 43 years and 58 years, respectively with a male predilection (M: F=2:1). Central nervous system (CNS) constituted the most common extranodal site (20/68, 29.5%) followed by gastrointestinal tract (17/68, 25%), and nose/nasopharynx (8/68, 11.8%). Diffuse large B-cell lymphoma (DLBCL, not otherwise specified), extranodal marginal lymphoma of mucosa associated lymphoid tissue (MALT) type, and B cell NHL unclassified (U) were the three most common histological types observed. T-cell phenotype was rarely noted (4%). Follicular lymphomas and anaplastic large cell lymphoma, seen among nodal NHL, were absent at extra nodal sites. Majority (41/68, 60%) of the patients with pENL were immunocompetent and 55% were in stage I-II with favorable prognosis. Conclusion: Central nervous system was the most common site of ENL, followed by gastrointestinal tract. Majority of pENL occurred in immunocompetent hosts with a favorable prognosis.

Fine Needle Aspiration Cytology of Metastatic Small Cell Carcinoma of Lymph Nodes - Comparison to Non-Hodgkin's Lymphoma on 5 Cases - (림프절의 전이성 소세포암종의 세침흡인 세포학적 소견 - 악성 림프종과의 감별을 중심으로 5예 분석 -)

  • Kim, Yeon-Mee;Cho, Hye-Je;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.44-50
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    • 1996
  • Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration (FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small ceil carcinoma of classic oat cell type nay simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of in-termediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear melding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.

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Non Hodgkin lymphoma in the maxillary sinus mimicking dental abscess: a case report (치성 농양과 유사한 상악동에 발생한 비호지킨 림프종의 증례 보고)

  • Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.2
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    • pp.130-134
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    • 2016
  • Malignant lymphomas are neoplasms with diffuse proliferation of neoplastic lymphocytes and their precursor cells. Diffuse large B-cell lymphoma, which is a subtype of non-Hodgkin's lymphomas, rarely occurs in the head and neck area and is especially rare in the maxillary sinus. We report a case of a 76-year-old female patient who was referred to the oral and maxillofacial surgery office for evaluation of a dental abscess as a clinical diagnosis. Laboratory tests revealed no signs of inflammation or infection; therefore, incisional biopsy was performed. The final diagnosis was diffuse large B-cell lymphoma in the maxillary sinus. Here we describe this case with a review of relevant literature.

Bendamustine, etoposide, and dexamethasone to mobilize peripheral blood hematopoietic stem cells for autologous transplantation in non-Hodgkin lymphoma

  • Greenbaum, Adam M.;Green, Damian J.;Holmberg, Leona A.;Gooley, Ted;Till, Brian G.;Budde, Lihua E.;Rasmussen, Heather;Press, Oliver W.;Gopal, Ajay K.
    • BLOOD RESEARCH
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    • v.53 no.3
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    • pp.223-226
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    • 2018
  • Background Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may adversely affect stem cell collection. Here we describe the lymphoma subset of a prospective, non-randomized phase II study of bendamustine, etoposide, and dexamethasone (BED) as a mobilization agent for lymphoid malignancies. Methods This subset analysis includes diffuse large B-cell lymphoma (N=3), follicular lymphoma (N=1), primary mediastinal B-cell lymphoma (N=1), and NK/T-cell lymphoma (N=1). Patients received bendamustine ($120mg/m^2$ IV d 1, 2), etoposide ($200mg/m^2$ IV d 1-3), and dexamethasone (40 mg PO d 1-4) followed by filgrastim (10 mcg/kg/d sc. through collection). Results We successfully collected stem cells from all patients, with a median of $7.9{\times}10^6/kg$ of body weight (range, 4.4 to $17.3{\times}10^6/kg$) over a median of 1.5 days (range, 1 to 3) of apheresis. All patients who received transplants were engrafted using kinetics that were comparable to those of other mobilization regimens. Three non-hematologic significant adverse events were observed in one patient, and included bacterial sepsis (grade 3), tumor lysis syndrome (grade 3), and disease progression (grade 5). Conclusion For non-Hodgkin lymphoma, mobilization with bendamustine is safe and effective.

MR Spectroscopy and Diffusion Weighted Imaging Findings of Primary Non-Hodgkin Lymphoma of the Breast: Two Case Reports (유방에 발생한 일차성 비호지킨림프종의 자기공명 분광법 및 확산강조 영상: 2예)

  • Nam, Sang Yu;Yoo, Eun Young;Choi, Hye-Young
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.176-181
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    • 2014
  • Primary non-Hodgkin lymphoma (NHL) of the breast is a very rare disease, and the mammographic and ultrasonographic findings of breast lymphoma are variable. There are several reports of magnetic resonance (MR) imaging findings in patients with breast lymphomas; however, few reports have described the findings observed on MR spectroscopy or the features of diffusion weighted (DW) imaging. The authors report the findings of classical MR imaging, MR spectroscopy and DW imaging of a 48-year-old woman and a 40-year-old woman with primary non-Hodgkin's lymphoma of breasts. Mammography and breast ultrasonography revealed a mass with circumscribed margin. The mass showed strong enhancement after contrast injection on MR imaging. DW imaging showed reduced diffusion and high-amplitude choline (Cho) peak at 3.22 ppm was detected by single voxel MR spectroscopy which was consistent with malignancy.

Non-Hodgkin's Lymphoma Mimicking Second Bronchial Cleft Cyst (제2새열 낭종으로 오인된 비호지킨 림프종 1예)

  • Park, Hyun-Woo;Kim, Jin-Pyeong;Won, Sung-Jun;Woo, Seung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.96-98
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    • 2011
  • Non-Hodgkin's Lymphoma(NHL) is a malignant tumor that is derived from the lymphatic system. The most common symptoms of NHL are painless lymph node enlargement. However, we should not diagnose NHL by only fragmentary clinical symptom and radiologic finding because of the various lymphoma characters. We have treated a patient with such preoperative findings of Branchial cleft cyst. However, the pathologic diagnosis of the surgical specimen was diffuse large b-cell lymphoma.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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