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Kwak K, Yoo KH, Choi YS, Park Y, Kim BS, Yoon SE, Kim WS, Kang KW, Kim SJ. Long-term survival outcomes of 'watch and wait' in patients with bronchus-associated lymphoid tissue lymphoma: a multicenter real-world data analysis in Korea. Ann Hematol 2024; 103:4193-4202. [PMID: 39075295 DOI: 10.1007/s00277-024-05902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/13/2024] [Indexed: 07/31/2024]
Abstract
Bronchus-associated lymphoid tissue (BALT) is a rare cause of extranodal marginal zone lymphoma (MZL). Although most patients with BALT lymphoma (BALToma) show an indolent clinical course and are monitored without treatment, there are limited real-world data on the long-term outcome of "watch-and-wait' strategy in comparison with other treatments. The survival outcomes of patients newly diagnosed with BALToma at three tertiary hospitals in Korea undergoing two treatment strategies were analyzed: group A, patients who were monitored without any treatment or received only radiotherapy after diagnosis; and group B, patients receiving any kind of systemic chemotherapy after diagnosis, regardless of their history of any local treatment such as surgery or radiotherapy. Of the 67 patients included in our analysis, the 10-year progression-free survival (PFS) and 10-year overall survival (OS) rates were 65.3% and 83.2%, respectively. The 10-year PFS rates for observation or localized treatment and systemic chemotherapy were 78.7% and 56.9%, respectively (p = 0.044). Ten-year OS rates for observation or localized treatment and systemic chemotherapy were 100% and 71.7%, respectively (p = 0.016). Multivariate analysis showed that bilateral lung (HR 2.462, p = 0.047) and extrapulmonary organ (HR 4.485, p = 0.004) involvement were the only significant factors associated with poor PFS. Prognostic factor analysis for OS did not yield significant results. Patients with BALToma show a favorable prognosis, suggesting that observation or localized therapy alone may be effective for patient management. However, patients with bilateral lung or extrapulmonary involvement may require careful monitoring for disease progression and more aggressive treatment approaches.
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Affiliation(s)
- Kunye Kwak
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Kwai Han Yoo
- Division of Hematology, Department of Internal Medicine, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yoon Seok Choi
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Yong Park
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Byung Soo Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Sang Eun Yoon
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro Gangnam-gu, Seoul, 06351, Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro Gangnam-gu, Seoul, 06351, Korea
| | - Ka-Won Kang
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea.
| | - Seok Jin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro Gangnam-gu, Seoul, 06351, Korea.
- Department of Health Sciences and Technology, Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, Korea.
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Lin JS, Liu CJ. Mucosa-associated lymphoid tissue lymphoma at the parotid gland. J Cancer Res Ther 2024; 20:467-468. [PMID: 38554366 DOI: 10.4103/jcrt.jcrt_1909_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/03/2022] [Indexed: 04/01/2024]
Abstract
MALT (mucosa-associated lymphoid tissue) lymphomas are low-grade extra-nodal B-cell lymphomas that may involve various sites in the head and neck including the thyroid, salivary, and lacrimal glands. Development of MALT lymphoma in the head and neck is often associated with auto-immune diseases such as Sjögren syndrome or Hashimoto thyroiditis. Here, we report a case of a MALT lymphoma of the left buucal mucosa that likely arose in the parotid gland. The patient was successfully treated with surgical excision with chemotherapy and remained disease-free at the 10-year follow-up. Since it was rare in the head and neck region, we present this case.
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Affiliation(s)
- Jiun-Sheng Lin
- Department of Oral and Maxillofacial Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Ji Liu
- Department of Oral and Maxillofacial Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Munasinghe BM, Karunatileke CT, Prashanthan J, Ranathunga ND. Primary thyroid MALT lymphoma with a probable brain secondary in a male patient: A case report. Int J Surg Case Rep 2024; 114:109126. [PMID: 38064860 PMCID: PMC10757030 DOI: 10.1016/j.ijscr.2023.109126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 01/02/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Primary Mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid is a rare tumor. PRESENTATION OF CASE A previously well male in his 50s presented to our institution with difficulty in breathing and sleep apnea. He was diagnosed with a large retrosternal multinodular goiter with level 2 unilateral cervical lymphadenopathy. Fine needle aspiration cytology of the thyroid revealed chronic thyroiditis and the enlarged lymph node cytology was inconclusive. He underwent total thyroidectomy and level VI bilateral cervical lymph node clearance. The histology revealed an extra-nodal marginal zone lymphoma of MALT. A whole-body CT scan did not demonstrate any other primary site. The patient received 4 cycles of local radiotherapy. Subsequently, he was diagnosed with a brain tumor not amenable to surgical interventions following persistent headaches. He died shortly after due to complications of probable cerebral metastasis. CASE DISCUSSION MALT lymphomas of the thyroid carry a good prognosis; however, no universal guidance exists regarding the optimal therapy and follow-up. CONCLUSION This case report highlights the importance of early diagnosis, identification of poor prognostic factors, and patient-tailored therapy and follow-up.
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Affiliation(s)
- B M Munasinghe
- Department of Anaesthesiology and Intensive Care, Kent and Canterbury Hospital, Canterbury CT1 3NG, UK; Department of Anaesthesiology and Intensive Care, District General Hospital, Mannar, Sri Lanka.
| | - C T Karunatileke
- Department of Surgery, District General Hospital, Mannar, Sri Lanka
| | - J Prashanthan
- Department of Anaesthesiology and Intensive Care, District General Hospital, Mannar, Sri Lanka
| | - N D Ranathunga
- Department of Histopathology, District General Hospital, Mannar, Sri Lanka
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Qureshi A, Patel A, Ajumobi AB. H pylori-Negative MALT-Associated Extranodal Marginal Zone Lymphoma: A Comprehensive Case Report and Literature Review. J Investig Med High Impact Case Rep 2024; 12:23247096241238531. [PMID: 38494775 PMCID: PMC10946082 DOI: 10.1177/23247096241238531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/19/2024] Open
Abstract
Extranodal marginal zone B-cell lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT), a rare subtype of B-cell lymphoma, is typically associated with Helicobacter pylori (H pylori) infection, especially in gastric cases. However, this article presents 2 unique cases of H pylori-negative colonic ENMZL, challenging the conventional understanding of the disease. The first case involves an 80-year-old male diagnosed with Stage 1E ENMZL in the descending colon, and the second describes a 74-year-old male with sigmoid colon ENMZL. Both cases lacked H pylori infection, adding complexity to their management. Accompanying these case studies is a comprehensive literature review, delving into the epidemiology, pathology, clinical features, diagnosis, and treatment of H pylori-negative ENMZL, with a focus on gastrointestinal involvement. This review highlights the importance of considering H pylori-negative cases in ENMZL diagnosis and management, illustrating the need for further research and individualized treatment approaches in this uncommon lymphoma subtype.
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Affiliation(s)
| | | | - Adewale B. Ajumobi
- University of California, Riverside, USA
- Eisenhower Health, Rancho Mirage, CA, USA
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Singh S, Bhatnagar S, Bisht N, Kapoor A, Mishra PS, Lohia N. Low-grade malt lymphoma of the nasopharynx in young adults: Successful treatment of a rare diagnosis at a rare site by radiotherapy. J Cancer Res Ther 2024; 20:429-434. [PMID: 38554356 DOI: 10.4103/jcrt.jcrt_1681_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/19/2022] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Mucosa Associated Lymphoid Tissue (MALT) lymphoma is the third most common subgroup of Non-Hodgkin's lymphoma and is the most common type of primary extranodal lymphoma. They are rarely found in the nasopharyngeal region and their mean age at presentation is the sixth decade of life. MATERIALS AND METHODS We present the clinical, pathological, treatment and 5-year follow-up data of 5 cases of nasopharyngeal MALT lymphoma treated with definitive radiotherapy at our hospital, between 2009 and 2011. RESULTS The average age of diagnosis was 27 years which is more than a decade earlier than what has been reported previously. Clinical symptoms included nasal obstruction, tinnitus and hearing loss. All five patients had locoregional disease. They were treated by definitive radiotherapy to a dose between 30 to 40 Gy. At 5 years of follow-up, 4 patients were in complete remission while one had disease relapse. CONCLUSION The younger age of presentation compared to older reports in this rare subsite was an interesting finding in our study. The authors speculate that rising levels of particulate air pollution may have played a part in the etiology in this younger population. Our series shows that despite the younger age, the disease displays an indolent course and responds well to radiotherapy alone as the primary treatment. Recurrence or disseminated disease is also highly treatable with systemic chemotherapy.
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Affiliation(s)
- Sankalp Singh
- Department of Radiation Oncology, Army Hospital (R&R), Delhi, India
| | - Sharad Bhatnagar
- Department of Radiation Oncology, Army Hospital (R&R), Delhi, India
| | - Niharika Bisht
- Department of Radiation Oncology, Command Hospital (CC), Lucknow, India
| | - Amul Kapoor
- Department of Medical Oncology, Army Hospital (R&R), Delhi, India
| | | | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital (Air Force), Bengaluru, India
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Serbest Ceylanoglu K, Guneri Beser B, Singalavanija T, Juntipwong S, Worden FP, Demirci H. Targeted Therapy and Immunotherapy for Advanced Malignant Conjunctival Tumors: Systematic Review. Ophthalmic Plast Reconstr Surg 2024; 40:18-29. [PMID: 38241616 DOI: 10.1097/iop.0000000000002488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
PURPOSE To review the outcomes of targeted therapy and immunotherapy in advanced conjunctival tumors, including conjunctival squamous cell carcinoma, conjunctival melanoma, and conjunctival lymphoma. METHODS A Pubmed database systematic search was performed between January 1999 and December 2022. The literature search was limited to studies published in English. RESULTS This review included 142 patients with advanced malignant conjunctival tumors from 42 articles. In the conjunctival squamous cell carcinoma group, 2 cases of advanced conjunctival squamous cell carcinoma treated with epidermal growth factor receptor inhibitors showed significant tumor size improvement after 7.5 months of follow-up. Among 7 cases treated with systemic immunotherapy, 5 cases (72%) had complete response (CR), 1 case (14%) showed partial response (PR), and 1 case (14%) had stable disease (SD) after 16 months. In the conjunctival melanoma group, among 18 cases treated with combined v-raf murine sarcoma viral oncogene homolog B1/mitogen-activated extracellular signal-regulated kinase inhibitors, 6 (33%) had CR, 5 (28%) had PR, 2 (11%) had SD, and 5 (28%) had progressive disease after 24.8 months of follow-up. Of 44 conjunctival melanoma cases treated with immunotherapy, 12 (28%) had CR, 9 (20%) had PR, 7(16%) had SD, and 16 (36%) had progressive disease after 14.2 months. Systemic Rituximab treatment for conjunctival lymphoma cases resulted in CR in 21 patients (63%), PR in 11 patients (33%), and SD in 1 patient (3%) after 20.5 months of follow-up. Intralesional Rituximab injections in 38 conjunctival lymphoma cases showed CR in 28 patients (75%), PR in 7 patients (19%), SD in 1 patient (2%), and progressive disease in 2 patients (4%) after 20.4 months of follow-up. CONCLUSIONS Despite limited clinical case reports and short-term follow-ups, targeted therapy and immunotherapy have shown promising results for advanced malignant conjunctival tumors.
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Affiliation(s)
- Kubra Serbest Ceylanoglu
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkiye
| | - Buse Guneri Beser
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A
| | - Tassapol Singalavanija
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A
- Department of Ophthalmology, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Sarinee Juntipwong
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A
| | - Francis Paul Worden
- Division of Hematology-Oncology, Department of Internal Medicine, Roger Cancer Center, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Hakan Demirci
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A
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Alvi AT, Shankar M. A Rare Case of Primary Extra-Nodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) in the Rectum. Cureus 2023; 15:e49447. [PMID: 38149148 PMCID: PMC10751178 DOI: 10.7759/cureus.49447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/28/2023] Open
Abstract
Mucosa-associated lymphoid tissue (MALT) is a unique clinical condition that can manifest in different anatomic locations. In the gastrointestinal tract, it is typically seen in the stomach but is less commonly found in other sites. There have been a few cases in the literature in which primary MALT lymphoma is found in the rectum. We describe a case of a 63-year-old male who presented with rectal pain and bleeding. Colonoscopy revealed a rectal mass, which was excised with a trans-anal approach. Histopathological examination of the biopsy specimen was significant for MALT lymphoma. Therefore, the patient underwent radiation therapy followed by repeat colonoscopies to monitor disease recurrence.
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Affiliation(s)
- Ali Tariq Alvi
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
- Internal Medicine, HCA Florida Northwest Hospital, Margate, USA
| | - Murali Shankar
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
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Vyas P, Gupta P, Yadav D, Sethi N, Bansal S. Perplexity of Preoperative Multimodal Investigations in a Case of Parotid MALToma. Indian J Otolaryngol Head Neck Surg 2023; 75:2529-2533. [PMID: 37636800 PMCID: PMC10447745 DOI: 10.1007/s12070-023-03811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/13/2023] [Indexed: 08/29/2023] Open
Abstract
Mucosa-associated lymphoid tissue(MALT) lymphoma is a distinct subtype of lymphoma, presenting as a diffuse gland involvement or a discrete mass. Pre-operative diagnosis is a challenge as Fine Needle Aspiration Cytology is often inconclusive and presently no radiological investigation is confirmatory, therefore final diagnosis is made after surgical resection and immunohistopathology. We report a case of MALT lymphoma, which clinically presented as a unilateral large diffuse swelling of the parotid gland with a diagnostic dilemma eventually underwent total parotidectomy to be finally diagnosed as MALT lymphoma of parotid gland and received field radiotherapy with complete cure and no recurrence in a 2-year follow-up.
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Affiliation(s)
- Pratibha Vyas
- Department of ENT, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Sitapura, Jaipur, Pin code 302022 Rajasthan India
| | - Priyanshi Gupta
- Department of ENT, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Sitapura, Jaipur, Pin code 302022 Rajasthan India
| | - Dinesh Yadav
- Department of Surgical Oncology, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur, India
| | - Neha Sethi
- Department of Oncopathology, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur, India
| | - Shweta Bansal
- Department of Oncopathology, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur, India
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Chiesa-Estomba CM, Barillari MR, Mayo-Yáñez M, Maniaci A, Fakhry N, Cammaroto G, Ayad T, Lechien JR. Non-Squamous Cell Carcinoma of the Larynx: A State-of-the-Art Review. J Pers Med 2023; 13:1084. [PMID: 37511697 PMCID: PMC10381862 DOI: 10.3390/jpm13071084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Non-squamous cell laryngeal carcinoma includes endothelial tumors, such as minor salivary gland tumors, lymphoepithelial tumors, neuroendocrine tumors, soft and hard tissue sarcomas, and malignant melanomas. (2) Methods: A state-of-the-art review using the MEDLINE/PUBMED, Google Scholar, Ovid Medline, Embase, and Scopus electronic databases was performed. (3) Conclusions: In order to optimize overall treatment outcomes, a multidisciplinary, patient-centered approach to the management of non-SCC of the larynx must be adopted universally; a national or international registry on non-SCC laryngeal cancer can be useful to improve understanding about the behavior of this kind of tumor.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Donostia University Hospital, Osakidetza, 20014 San Sebastian, Spain
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
| | - Maria Rosaria Barillari
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, 81100 Naples, Italy
| | - Miguel Mayo-Yáñez
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Antonino Maniaci
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Via S. Sofia 78, 95125 Catania, Italy
| | - Nicolas Fakhry
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otorhinolaryngology-Head and Neck Surgery, APHM, La Conception University Hospital, 13005 Marseille, France
| | - Giovanni Cammaroto
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Morgagni Pierantoni Hospital, 47100 Forli, Italy
| | - Tareck Ayad
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Otolaryngology-Head & Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Jerome R Lechien
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France
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Sreenivasan S, Solanki R, Kancharla P, Khan C, Samhouri Y. A Meningioma Mimic and Distinct Subtype of Primary Central Nervous System Lymphoma: Primary Dural Lymphoma. J Hematol 2023; 12:87-91. [PMID: 37187500 PMCID: PMC10181329 DOI: 10.14740/jh1113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is an aggressive form of extranodal non-Hodgkin lymphoma that arises in the brain parenchyma, eyes, meninges, or spinal cord in the absence of systemic disease. Primary dural lymphoma (PDL), in contrast, arises from the dura mater of the brain. PDL is usually a low-grade B-cell marginal zone lymphoma (MZL), whereas other types of PCNSL are usually high-grade large B-cell lymphoma. This specific pathological subtype has important therapeutic and prognostic implications, making PDL a distinct subtype of PCNSL. Herein, we report a case of PDL in an African American patient, in her late thirties, who presented to our emergency room with chronic headaches. An emergent magnetic resonance imaging (MRI) of the brain showed a dural-based homogeneously enhancing extra-axial mass along the left hemisphere, which was contained within the anterior and parietal dural mater. A surgical specimen was collected after an emergency debulking procedure. The flow cytometry, done on the surgical specimen obtained, was positive for CD19+, CD20+, and CD22+, but negative for CD5- and CD10-. These findings were consistent with a clonal B-lymphoproliferative disorder. The surgical pathology specimen immunohistochemistry was positive for CD20+ and CD45+, but negative for Bcl-6Cyclin D1- and CD56-. The Ki67 was 10-20%. These findings were consistent with extranodal MZL. Given the location and pathology, the patient was diagnosed with PDL. Due to MZL's indolent nature, location outside the blood-brain barrier, and known efficacy to bendamustine-rituximab (BR), we decided to treat our patient with BR. She completed six cycles without major complications, and her post-therapy brain MRI showed complete remission (CR). Our case adds to the sparse literature about PDL and highlights the efficacy of BR systemic chemotherapy on MZLs.
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Affiliation(s)
- Sushanth Sreenivasan
- Department of Internal Medicine, West Penn Hospital, Pittsburgh, PA, USA
- Corresponding Author: Sushanth Sreenivasan, Department of Internal Medicine, West Penn Hospital, Pittsburgh, PA, USA.
| | - Risha Solanki
- Division of Hematology and Cellular Therapy, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - Pragnan Kancharla
- Division of Hematology and Cellular Therapy, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - Cyrus Khan
- Division of Hematology and Cellular Therapy, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - Yazan Samhouri
- Division of Hematology and Cellular Therapy, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
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Zhen CJ, Zhang P, Bai WW, Song YZ, Liang JL, Qiao XY, Zhou ZG. Mucosa-associated lymphoid tissue lymphoma of the trachea treated with radiotherapy: A case report. World J Clin Cases 2023; 11:1607-1614. [PMID: 36926401 PMCID: PMC10011992 DOI: 10.12998/wjcc.v11.i7.1607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/04/2023] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma originates in the marginal zone of lymphoid tissue. lung is one of the most frequent non-gastrointestinal organs involved, here known as bronchus-associated lymphoid tissue (BALT) lymphoma. BALT lymphoma of unknown etiology, and most patients are asymptomatic. The treatment of BALT lymphoma is controversial.
CASE SUMMARY A 55-year-old man admitted to hospital had a three-month history of progressively coughing up yellow sputum, chest stuffiness, and shortness of breath. Fiberoptic bronchoscopy revealed mucosal visible beaded bumps 4 cm from the tracheal carina at 9 o 'clock and 3 o 'clock, the right main bronchus, and the right upper lobe bronchus. Biopsy specimens showed MALT lymphoma. Computed tomography virtual bronchoscopy (CTVB) showed uneven main bronchial wall thickening and multiple nodular protrusion. BALT lymphoma stage IE was diagnosed after a staging examination. We treated the patient with radiotherapy (RT) alone. A total dose of 30.6 Gy/17 f/25 d was given. The patient had no obvious adverse reactions during RT. The CTVB was repeated after RT and showed that the right side of the trachea was slightly thickened. CTVB was repeated 1.5 mo after RT and again showed that the right side of the trachea was slightly thickened. Annual CTVB showed no signs of recurrence. The patient now has no symptoms.
CONCLUSION BALT lymphoma is an uncommon disease and shows good prognosis. The treatment of BALT lymphoma is controversial. In recent years, less invasive diagnostic and therapeutic approaches have been emerging. RT was effective and safe in our case. The use of CTVB could provide a noninvasive, repeatable, and accurate method in diagnosis and follow-up.
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Affiliation(s)
- Chan-Jun Zhen
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Ping Zhang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Wen-Wen Bai
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Yu-Zhi Song
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Jun-Li Liang
- Nursing Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Xue-Ying Qiao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhi-Guo Zhou
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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Kalicińska E, Giza A, Zaucha JM, Giebel S, Zimowska‐Curyło D, Andrasiak I, Spychałowicz W, Wojnar J, Balcerzak A, Romejko‐Jarosińska J, Paszkiewicz‐Kozik E, Knopińska‐Posłuszny W, Rybka J, Jabłonowska P, Wróbel T. A survey across orbital lymphoma in Poland: Multicenter retrospective study of polish lymphoma research group (PLRG). Cancer Med 2022; 12:3036-3045. [PMID: 36161781 PMCID: PMC9939129 DOI: 10.1002/cam4.5223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of histopathological subtypes, the clinical stage at presentation and treatment modalities in Polish patients with orbital lymphoma (OL) and to determine prognostic outcomes. METHODS The retrospective study of 107 patients with OL treated in a 14-year period in Polish hematological centers. The analysis included histopathological subtype, disease clinical advancement, treatment modalities, progression-free survival (PFS), and overall survival (OS). RESULTS The median patient age was 60 years (range 51-71). Mucosa-associated lymphoid tissue (MALT) lymphoma accounted for slightly more than half of all cases of orbital lymphoma (51%). The second most common subtype was diffuse large B-cell lymphoma (DLBCL) (29%). Primary orbital lymphoma was diagnosed in 48% of all patients. According to the Ann Arbor, localized stage IE of orbital lymphoma was diagnosed only in 39% of all patients. Systemic involvement was observed in more than half of all patients (52%). The median follow-up period was 30 months (range 0-160 months). Patients with non-MALT lymphoma had a significantly inferior PFS compared to patients with MALT lymphoma, (p = 0.047). Patients with primary orbital lymphoma had a superior PFS compared to patients with secondary orbital lymphoma [median PFS 104.5 months vs. 33.4 months], (p = 0.069). Younger patients with MALT lymphoma were characterized by superior PFS (median PFS not reached) compared to other studied subgroups of patients (older patients with MALT lymphoma, younger and older non-MALT lymphoma patients) with a median PFS of 30.5, 32.2, 32.6 months respectively (p = 0.039). Patients treated with chemotherapy alone had inferior PFS compared to patients treated with combined therapies (p = 0.034). The median PFS across patients who received chemotherapy alone was 23.7 months, whereas across other patients was 73.9 months. CONCLUSIONS Secondary lymphoma accounts for more than half of the orbital lymphoma in Polish population. The advanced clinical stage of the disease (non-IE according to Ann Arbor) concerns two-thirds of the overall population of patients with orbital lymphomas and one-third of MALT lymphoma patients. The high incidence of advanced stages of orbital lymphoma may indicate the need for combined treatment. Combined orbital lymphoma treatment is associated with superior PFS compared to chemotherapy alone in overall population of patients with orbital lymphoma.
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Affiliation(s)
- Elżbieta Kalicińska
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Agnieszka Giza
- Department of HematologyJagiellonian University Medical CollegeKrakówPoland
| | - Jan Maciej Zaucha
- Department of Hematology and TransplantologyMedical University of GdańskGdańskPoland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and OncohematologyMaria Sklodowska‐Curie National Research Institute of OncologyGliwicePoland
| | | | | | - Wojciech Spychałowicz
- Department of Internal Medicine and OncologySilesian Medical UniversityKatowicePoland
| | - Jerzy Wojnar
- Department of Internal Medicine and OncologySilesian Medical UniversityKatowicePoland
| | - Andrzej Balcerzak
- Department of Hematology and Bone Marrow TransplantationPoznan University of Medical SciencePoznańPoland
| | | | | | | | - Justyna Rybka
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Paula Jabłonowska
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Tomasz Wróbel
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
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13
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Tang T, Ni X, Song X. Mucosa-associated lymphoid tissue of nasopharynx: A case report and literature review. Radiol Case Rep 2022; 17:2991-2995. [PMID: 35755107 PMCID: PMC9217989 DOI: 10.1016/j.radcr.2022.05.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 11/27/2022] Open
Abstract
Nasopharyngeal MALT lymphoma is a rare disease, with limited cases reported in the literature. To the best of our knowledge, there is no research detailing the treatment of nasopharyngeal MALT lymphoma. In this present paper, we report an unusual case of a 70-year-old female patient with nasopharyngeal MALT lymphoma. The patient was treated with radiotherapy alone. The detailed radiation therapy of the treatment was demonstrated. The patient is free of locally recurrent or distant disease at two years. Radiotherapy alone can be a helpful treatment for MALT lymphoma confined to the nasopharyngeal cavity.
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14
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Fang P, Gunther JR, Pinnix CC, Dong W, Strati P, Nastoupil LJ, Steiner RE, Ahmed S, Damron EP, Fowler N, Nair R, Westin JR, Neelapu S, Ha CS, Dabaja BS. A Prospective Trial of Radiation Therapy Efficacy and Toxicity for Localized Mucosa-associated Lymphoid Tissue (MALT) Lymphoma. Int J Radiat Oncol Biol Phys 2021; 109:1414-1420. [PMID: 33309978 PMCID: PMC12007817 DOI: 10.1016/j.ijrobp.2020.11.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/17/2020] [Accepted: 11/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE We report the long-term results of a prospective trial conducted to determine the efficacy and safety of radiation therapy (RT) alone in treating localized mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS AND MATERIALS Patients with localized MALT lymphoma were eligible and treated with involved field RT to doses of 24 to 39.6 Gy. Relapse-free survival (RFS) was the primary endpoint. Kaplan-Meier analysis was used to estimate RFS, progression-free survival (PFS), and overall survival (OS) defined from time of study entry. Preplanned subgroup analyses were performed based on site of involvement. RESULTS From 2000 to 2012, 75 patients were accrued; 73 received protocol-specified RT. Median follow-up was 9.8 years. Thirty-four patients had gastric MALT, 17 orbital, 13 head and neck nonorbit, 4 skin, and 5 disease of other sites. Thirteen of 34 patients with gastric MALT were Helicobacter pylori positive at the time of initial diagnosis and underwent 1 to 3 courses of triple antibiotic therapy. All gastric MALT patients had documented persistent MALT without H. pylori on endoscopy before enrollment in the study. All patients achieved a complete response with a median time of 3 months. Eleven patients (15%) had disease relapse, 9 of which were at sites outside the RT field with median time to progression of 38.3 months. Median PFS was 17.5 years, and median RFS and OS were not reached. The 10-year relapse-free rate was 83% (95% confidence interval [CI], 74%-93%). The 10-year PFS rate was 71% (95% CI, 60%-84%). The 10-year OS rate was 86% (95% CI, 77%-96%). RFS, PFS, and OS did not differ by disease site (P = .17, .43, and .50, respectively). All relapses were successfully salvaged. One patient developed metastatic gastric adenocarcinoma and was found to also have recurrent MALT on biopsy. Otherwise, all relapsed patients were alive without evidence of disease at last follow-up, and no patient died of MALT lymphoma. Sixty-seven patients (92%) experienced acute toxicity during radiation, all of which were grade 1 and 2, with only 1 grade 3 toxicity. Twenty-two patients (30%) experienced late toxicity, with only 1 grade 3 toxicity. CONCLUSIONS This prospective study confirms that RT for MALT lymphoma provides excellent long-term RFS with acceptable rates of toxicity. Current efforts are focused on RT de-escalation in an effort to further avoid treatment-related morbidity. CLINICALTRIALS.GOV: NCT04465162.
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Affiliation(s)
- Penny Fang
- The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | | | - Chelsea C Pinnix
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wenli Dong
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paolo Strati
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | - Sairah Ahmed
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ethan P Damron
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nathan Fowler
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ranjit Nair
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jason R Westin
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sattva Neelapu
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chul S Ha
- The University of Texas Health Science Center San Antonio, San Antonio, Texas
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15
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Yu Lee-Mateus A, Garcia-Saucedo JC, Abia-Trujillo D, Khoor A, Fernandez-Bussy S. Endobronchial Extranodal Marginal Zone B-Cell Lymphoma with Plasmacytic Differentiation. Cureus 2021; 13:e13104. [PMID: 33728124 PMCID: PMC7934969 DOI: 10.7759/cureus.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Endobronchial tumors (ET) are unusual and mostly malignant, presenting with non-specific symptoms that often delay appropriate diagnosis and treatment. Lymphomas in the airway represent less than 1% of pulmonary malignancies and require multidisciplinary approach for their management. We present a case of a 48-year-old male former smoker with a one-year history of recurrent respiratory infections and new-onset shortness of breath. Diagnostic tests included a chest computed tomography (CT) reporting the presence of an endobronchial mass and neck and cervical lymph node biopsies with inconclusive results. Bronchoscopy was successfully performed for tumor resection, improving the patient’s respiratory symptoms. Histological analysis described an extranodal marginal zone B-cell lymphoma (ENMZL) with plasmacytic differentiation; a subtype of non-Hodgkin’s lymphoma (NHL) in mucosa-associated lymphoid tissue (MALT), rarely found as an endobronchial growth. ET should be considered in the setting of persistent and worsening respiratory symptoms. ENMZL with plasmacytic differentiation is rarely found as an ET and diagnosis requires bronchoscopic intervention and extensive immunohistochemical analysis.
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Affiliation(s)
| | | | | | - Andras Khoor
- Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, USA
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16
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Lapenta C, Gabriele L, Santini SM. IFN-Alpha-Mediated Differentiation of Dendritic Cells for Cancer Immunotherapy: Advances and Perspectives. Vaccines (Basel) 2020; 8:vaccines8040617. [PMID: 33086492 PMCID: PMC7711454 DOI: 10.3390/vaccines8040617] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/09/2020] [Accepted: 10/15/2020] [Indexed: 01/08/2023] Open
Abstract
The past decade has seen tremendous developments in novel cancer therapies through targeting immune-checkpoint molecules. However, since increasing the presentation of tumor antigens remains one of the major issues for eliciting a strong antitumor immune response, dendritic cells (DC) still hold a great potential for the development of cancer immunotherapy. A considerable body of evidence clearly demonstrates the importance of the interactions of type I IFN with the immune system for the generation of a durable antitumor response through its effects on DC. Actually, highly active DC can be rapidly generated from blood monocytes in vitro in the presence of IFN-α (IFN-DC), suitable for therapeutic vaccination of cancer patients. Here we review how type I IFN can promote the ex vivo differentiation of human DC and orientate DC functions towards the priming and expansion of protective antitumor immune responses. New epigenetic elements of control on activation of the type I IFN signal will be highlighted. We also review a few clinical trials exploiting IFN-DC in cancer vaccination and discuss how IFN-DC could be exploited for the design of effective strategies of cancer immunotherapy as a monotherapy or in combination with immune-checkpoint inhibitors or immunomodulatory drugs.
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17
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Ghosh S, Mehta AC, Abuquyyas S, Raju S, Farver C. Primary lung neoplasms presenting as multiple synchronous lung nodules. Eur Respir Rev 2020; 29:190142. [PMID: 32878970 PMCID: PMC9648507 DOI: 10.1183/16000617.0142-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/08/2020] [Indexed: 12/26/2022] Open
Abstract
Multiple synchronous lung nodules are frequently encountered on computed tomography (CT) scanning of the chest and are most commonly either non-neoplastic or metastases from a known primary malignancy. The finding may initiate a search for primary malignancy elsewhere in the body. An exception to this rule, however, is a class of rare primary lung neoplasms that originate from epithelial (pneumocytes and neuroendocrine), mesenchymal (vascular and meningothelial) and lymphoid tissues of the lung. While these rare neoplasms also present as multiple synchronous unilateral or bilateral lung nodules on chest CT, they are often overlooked in favour of more common causes of multiple lung nodules. The correct diagnosis may be suggested by a multidisciplinary team and established on biopsy, performed either as part of routine diagnostic work-up or staging for malignancy. In this review, we discuss clinical presentations, imaging features, pathology findings and subsequent management of these rare primary neoplasms of the lung.
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Affiliation(s)
- Subha Ghosh
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sami Abuquyyas
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shine Raju
- Pulmonary, Critical Care and Sleep Medicine, University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Carol Farver
- Dept of Pathology, Cleveland Clinic, Cleveland, OH, USA
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18
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Husnain M, Kuker R, Reis IM, Iyer SG, Zhao W, Chapman JR, Vega F, Lossos IS, Alderuccio JP. Clinical and radiological characteristics of patients with pulmonary marginal zone lymphoma: A single center analysis. Cancer Med 2020; 9:5051-5064. [PMID: 32452658 PMCID: PMC7367627 DOI: 10.1002/cam4.3096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Pulmonary marginal zone lymphoma (PMZL) is the most common non‐Hodgkin lymphoma affecting the lung. PMZL is usually an indolent disease. Clinical and radiological variables associated with shorter survival are largely unknown and no consensus exists on preferred treatment strategy in PMZL. Herein we aimed to identify clinical and radiological features associated with shorter survival and inferior treatment outcomes. Forty patients with PMZL were analyzed. FDG‐avid disease was evident in most patients (93%) with staging PET/CT (n = 15). With a median follow‐up in treated patients (n = 38) of 8.4 years (range 0.07‐18.44), the median progression‐free survival (PFS) and overall survival (OS) were 7.5 years (95% CI 1.8‐9.5) and 15.7 years (95% CI 9.3‐NE) respectively. Shorter PFS was observed in patients who presented at diagnosis with elevated LDH, B symptoms, advanced stage and failed to achieve complete response (CR) after initial treatment. Patients with multifocal lung disease, extrapulmonary MZL and cavitary lesions on CT scans exhibited shorter PFS. Nevertheless, no clinical or radiologic findings were associated with shorter OS. All patients treated with surgery (n = 4) and radiation therapy (n = 3) achieved and remained in CR. No higher grade transformations occurred during the follow‐up period. PMZL exhibited excellent outcomes with a 15‐year PMZL‐related OS of 94.9% (95% CI: 81.25%‐98.7%). Radiation therapy and surgery are potentially curative strategies in localized PMZL.
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Affiliation(s)
- Muhammad Husnain
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Russ Kuker
- Division of Nuclear Medicine, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Department of Public Health Science, University of Miami Miller School of Medicine, Miami, FL, USA.,Biostatistics and Bioinformatics Core Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sunil Girish Iyer
- Division of Internal Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Wei Zhao
- Biostatistics and Bioinformatics Core Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer R Chapman
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Francisco Vega
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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19
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Cox MC, Lapenta C, Santini SM. Advances and perspectives of dendritic cell-based active immunotherapies in follicular lymphoma. Cancer Immunol Immunother 2020; 69:913-925. [PMID: 32322910 DOI: 10.1007/s00262-020-02577-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/11/2020] [Indexed: 12/13/2022]
Abstract
Follicular lymphoma (FL) is a remarkably immune-responsive malignancy, which is still considered incurable. As, standard immunochemotherapy is complex, toxic and not curative, improvement in FL care is now a crucial topic in hemato-oncology. Recently, we and others have shown that dendritic cell (DC)-based therapies allow a specific immune response associated with sustained lymphoma regression in a proportion of low-tumor burden FL patients. Importantly, the rate of objective clinical response (33-50%) and of sustained remission is remarkably higher compared to similar studies in solid tumors, corroborating the assumption of the immune responsiveness of FL. Our experimental intra-tumoral strategy combined injection with rituximab and interferon-α-derived dendritic cells (IFN-DC), a novel DC population particularly efficient in biasing T-helper response toward the Th1 type and in the cross-priming of CD8 + T cells. Noteworthy, intra-tumoral injection of DC is a new therapeutic option based on the assumption that following the induction of cancer-cell immunogenic death, unloaded DC would phagocytize in vivo the tumor associated antigens and give rise to a specific immune response. This approach allows the design of easy and inexpensive schedules. On the other hand, advanced and straightforward methods to produce clinical-grade antigenic formulations are currently under development. Both unloaded DC strategies and DC-vaccines are suited for combination with radiotherapy, immune checkpoint inhibitors, immunomodulators and metronomic chemotherapy. In fact, studies in animal models have already shown impressive results, while early-phase combination trials are ongoing. Here, we summarize the recent advances and the future perspectives of DC-based therapies in the treatment of FL patients.
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Affiliation(s)
- Maria Christina Cox
- Department of Haematology, King's College Hospital NHS Foundation Trust and Sant'Andrea University Hospital, Rome, Italy
| | - Caterina Lapenta
- Dipartimento Di Oncologia e Medicina Molecolare, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Stefano M Santini
- Dipartimento Di Oncologia e Medicina Molecolare, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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20
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Zhang T, Wu Y, Ju H, Meng J, Guo W, Ren G. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue in the oromaxillofacial head and neck region: A retrospective analysis of 105 patients. Cancer Med 2019; 9:194-203. [PMID: 31733094 PMCID: PMC6943149 DOI: 10.1002/cam4.2681] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/11/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022] Open
Abstract
Background Extranodal marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma) in the oromaxillofacial head and neck region is rare, with limited data available. This retrospective study explored the clinical features, stage, treatment, and prognosis of this disease. Methods Overall, 105 patients with MALT lymphomas in the oromaxillofacial head and neck region were included in this retrospective analysis. SPSS 22.0 software package was used for data analysis and a two‐tailed P value of ≤.05 was considered statistically significant. Primary endpoints of the study were the complete response (CR) rate, overall survival (OS), and progression‐free survival (PFS). Results About 52% of the patients had long‐term xerostomia, autoimmune diseases, or chronic parotitis and 81% had diseases involving the large salivary glands. Ann Arbor staging of the patients was as follows: stages I/II, 73 patients and stages III/IV, 32 patients. In the 97 patients followed up, CR rate after initial treatment was 80%. Tumor progression was observed in 12 patients and 14 patients died. There was a significant difference between the rate of CR in localized (87%) and disseminated (67%) lymphoma patients (P = .02). The 5‐ and 10‐year PFS of the localized lymphoma patients were both 91%, whereas those of the disseminated lymphoma patients were 83% and 65%, respectively (P = .03). The 5‐year PFS rates of the chemotherapy and non‐chemotherapy groups in the disseminated lymphoma patients were 85% and 73% (P = .04). Meanwhile, the 5‐year PFS rates of the rituximab and non‐rituximab groups in the disseminated lymphoma patients were 100% and 70% (P = .03). In multivariate analysis, MALT Lymphoma International Prognostic Index (MALT‐IPI) was an independent prognostic factor affecting OS, whereas Ann Arbor staging affected PFS. Conclusions This study suggests that the outcome after initial treatment of MALT lymphomas in the oromaxillofacial head and neck region is satisfactory and that this disease progresses slowly. The CR rate and PFS of localized lymphoma patients are better than those of disseminated lymphoma patients. Systemic treatment (chemotherapy or rituximab) may improve PFS in disseminated disease patients. MALT‐IPI and Ann Arbor staging are independent prognostic factors.
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Affiliation(s)
- Tian Zhang
- Department of oromaxillofacial head and neck region Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunteng Wu
- Department of oromaxillofacial head and neck region Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Houyu Ju
- Department of oromaxillofacial head and neck region Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Meng
- Department of Stomatology, Central Hospital of Xuzhou, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Guo
- Department of oromaxillofacial head and neck region Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoxin Ren
- Department of oromaxillofacial head and neck region Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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21
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Tanenbaum RE, Galor A, Dubovy SR, Karp CL. Classification, diagnosis, and management of conjunctival lymphoma. EYE AND VISION 2019; 6:22. [PMID: 31372366 PMCID: PMC6660942 DOI: 10.1186/s40662-019-0146-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/15/2019] [Indexed: 02/06/2023]
Abstract
Lymphoma is a malignant lymphoproliferative tumor that can involve the conjunctiva. Approximately 5-15% of all extranodal lymphomas are found in the ocular adnexal region, with approximately 25% of those involving the conjunctiva. Ninety-eight percent of conjunctival lymphomas arise from B-lymphocytes. The most common subtype of conjunctival lymphoma is extranodal marginal zone lymphoma (80%), followed by follicular lymphoma (8%), diffuse large B-cell lymphoma (3%) and mantle cell lymphoma (3%). Natural killer and T cells (NK/T) are rare causes of lymphoma. While most conjunctival lymphomas are localized to the ocular adnexa at the time of presentation, systemic examination and management are of key importance in the long-term care of the patient. This review outlines the classification, etiology, presentation, diagnosis, and management of conjunctival lymphoma. The novel use of high resolution optical coherence tomography, both as a diagnostic tool and as a means for ongoing evaluation during treatment, is illustrated. Treatment options discussed include external beam radiation, chemotherapy, immunotherapy, antibiotic therapy, and combination regimens. Future investigation of the etiology and pathogenesis of conjunctival lymphoma is expected to reveal opportunities for innovative and individualized therapeutic agents. Collaboration between multiple disciplines is key in the advancement of the field.
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Affiliation(s)
- Rebecca E Tanenbaum
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, Miami, FL 33136 USA
| | - Anat Galor
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, Miami, FL 33136 USA
| | - Sander R Dubovy
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, Miami, FL 33136 USA
| | - Carol L Karp
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, Miami, FL 33136 USA
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22
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Frata P, Buglione M, Grisanti S, Bonetti B, Vitali E, De Stefani A, Magri E, Peveri A, Marini G, Rossi G, Magrini SM. Localized Extranodal Lymphoma of the Head and Neck: Retrospective Analysis of a Series of 107 Patients from a Single Institution. TUMORI JOURNAL 2019; 91:456-62. [PMID: 16457141 DOI: 10.1177/030089160509100602] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To retrospectively analyze the outcome and patterns of relapse in localized extranodal non-Hodgkin's lymphoma of the head and neck (HN-NHL) after radiotherapy alone or combined modality treatment. Patients and Methods A retrospective analysis of 107 patients with HN-NHL was performed. Relapse patterns, overall survival (OS) and relapse-free survival (RFS) were analyzed. Only stage I (n = 50) and stage II (n = 57) patients were included with either low-grade (n = 21) or high-grade (n = 86) lymphoma. Fifty-nine patients were treated with radiotherapy (RT) alone and 48 patients received combined-modality treatment (CMT) consisting of chemotherapy (CHOP or CHOP-like) followed by radiotherapy. The volumes of irradiation included local field (n = 24), involved field (n = 13) and extended field (n = 70). The median age at diagnosis was 63 years (range, 17-86 years). Results The overall response rates (CR+PR) in the radiotherapy group and the combined modality group were 100% and 96%, respectively. With a median follow-up of 49.4 months, 29 of 59 patients after RT alone (37%) and 30 of 48 patients after CMT (62%) were disease-free. In the whole series the projected five-year OS and RFS were 58.7% and 61.8%. At univariate analysis of clinical variables with potential impact on survival including age, stage, histology, IPI score, single or combined treatment and volumes of irradiation, only age and, to a limited extent, type of treatment influenced OS (age ≤60 years 79%, >60 years 41%, P<0.001; RT alone 54.9%, CMT 62.8%, P = 0.0487) and RFS (≤60 years 75%, >60 years 50%, P<0.001; RT alone 54%, CMT 71%, P = 0.039). Better OS and RFS rates were obtained in patients with stage II and high-grade disease treated with CMT (five-year OS and RFS 63% and 69%, respectively; the corresponding values for RT alone were 38% and 34%). The final model of the multivariate analysis retained only age (≤60 years) as a significant prognostic factor for both RFS and OS ( P<0.001). In the whole series, the sites of relapse were mainly systemic (n = 32/40, 80%) and in-field relapses were rare (n = 3/40, 7.5%). Conclusion HN-NHL is characterized by a high risk of relapse, particularly at distant sites. Older patients have a significantly worse prognosis. Radiotherapy offers a very good local control rate although combined modality treatment possibly produces better RFS and OS, especially for stage II and high-grade disease. Better systemic approaches are warranted for a more consistent impact on survival in this particular subset of extranodal lymphoma. However, radiotherapy alone may offer a feasible and effective modality for patients who cannot tolerate more aggressive treatments. Extended-field radiotherapy and the treatment of a larger number of uninvolved lymph nodal regions does not confer a RFS or OS advantage, either after RT alone or after CMT.
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Affiliation(s)
- Paolo Frata
- University Department of Radiation Oncology, Istituto del Radio O. Alberti, Spedali Civili, Brescia, Italy
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23
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Alderuccio JP, Zhao W, Desai A, Ramdial J, Gallastegui N, Kimble E, Fuente MI, Husnain M, Rosenblatt JD, Alencar AJ, Schatz JH, Moskowitz CH, Chapman JR, Vega F, Reis IM, Lossos IS. Short survival and frequent transformation in extranodal marginal zone lymphoma with multiple mucosal sites presentation. Am J Hematol 2019; 94:585-596. [PMID: 30784098 DOI: 10.1002/ajh.25446] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 01/25/2023]
Abstract
Between 11 and 37% of extranodal marginal zone lymphoma (EMZL) patients present with disease involvement in multiple mucosal sites (MMS). We analyzed 405 EMZL patients seen between 1995 and 2017: 265 (65.4%) patients presented with stage I disease, 49 of 309 (15.8%) patients with bone marrow involvement, and 35 of 328 (10.7%) patients with monoclonal gammopathy (MG). Forty-three (10.6%) patients had MMS presentation, which was more frequently seen in patients aged >60 years (55.8%). Five (17.9%) of 28 MMS patients had MG. MMS patients commonly exhibited the International Prognostic Index (IPI) >2 (79.1%), Follicular Lymphoma International Prognostic Index (FLIPI) >2 (39.5%), and Mucosa-Associated Lymphoid Tissue Lymphoma International Prognostic Index (MALT-IPI) 2-3 (60.5%). Both MMS presentation and MG were associated with shorter survival univariately. In multivariable Cox regression models, shorter progression-free survival (PFS) and overall survival (OS) were observed in patients with MMS (hazard ratio [HR] = 3.08 and 2.92, respectively), age ≥60 years (HR = 1.52 and 2.45, respectively), and in patients who failed to attain a complete remission following initial therapy (HR = 3.27 and 2.13, respectively). Elevated lactate dehydrogenase was associated with shorter PFS (HR = 1.92), while anemia (HR = 2.46) was associated with shortened OS. MALT-IPI ≥2 (HR = 2.47 and 4.75), FLIPI >2 (HR = 1.65 and 2.09), and IPI >2 (HR = 2.09 and 1.73) were associated with shorter PFS and OS, respectively. Higher grade transformation (HGT) occurred in 11 (25.6%) MMS patients with a 5-year cumulative incidence of 13.2% (95% CI 4.7-26.1%). EMZL patients with MMS presentation represent a novel clinical subset associated with shorter PFS, OS, and higher incidence of HGT that needs novel therapeutic approaches.
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Affiliation(s)
- Juan Pablo Alderuccio
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Wei Zhao
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Biostatistics and Bioinformatics Shared ResourceUniversity of Miami, Miller School of Medicine Miami Florida
| | - Amrita Desai
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Jeremy Ramdial
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Nicolas Gallastegui
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Erik Kimble
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Division of Internal Medicine, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
| | - Macarena I. Fuente
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Division of Neuro‐Oncology, Department of NeurologyUniversity of Miami, Miller School of Medicine Miami Florida
| | - Muhammad Husnain
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Joseph D. Rosenblatt
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Alvaro J. Alencar
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Jonathan H. Schatz
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Craig H. Moskowitz
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
| | - Jennifer R. Chapman
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Division of Hematopathology, Department of Pathology and Laboratory MedicineUniversity of Miami, Miller School of Medicine Miami Florida
| | - Francisco Vega
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Division of Hematopathology, Department of Pathology and Laboratory MedicineUniversity of Miami, Miller School of Medicine Miami Florida
| | - Isildinha M. Reis
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Biostatistics and Bioinformatics Shared ResourceUniversity of Miami, Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami, Miller School of Medicine Miami Florida
| | - Izidore S. Lossos
- Division of Hematology, Department of MedicineUniversity of Miami, Miller School of Medicine Miami Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami, Miller School of Medicine Miami Florida
- Department of Molecular and Cellular PharmacologyUniversity of Miami, Miller School of Medicine Miami Florida
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24
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Hosoda C, Ishiguro T, Takahashi N, Kamiishi N, Shimizu Y, Takayanagi N. Spontaneous regression of primary endobronchial extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Respir Med Case Rep 2019; 27:100826. [PMID: 30963024 PMCID: PMC6434167 DOI: 10.1016/j.rmcr.2019.100826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/09/2019] [Accepted: 03/17/2019] [Indexed: 12/02/2022] Open
Abstract
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of pulmonary origin is a relatively rare disease. In particular, reports of MALT lymphoma occurring and localized in the trachea or bronchus have been limited. Pulmonary MALT lymphoma has been reported to demonstrate spontaneous regression, whereas there is only one reported case of spontaneous regression of primary endobronchial MALT lymphoma. We herein report the case of a 70-year-old man with primary endobronchial MALT lymphoma who showed spontaneous regression with an interest of endobronchial findings.
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Affiliation(s)
- Chiaki Hosoda
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0105, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0105, Japan
| | - Nobumasa Takahashi
- Department of Thoracic Surgery, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0105, Japan
| | - Nobufumi Kamiishi
- Department of Internal Medicine, Saitama Jikei Hospital, 3-208 Ishihara, Kumagaya, Saitama, 360-0816, Japan
| | - Yoshihiko Shimizu
- Department of Pathology, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0105, Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0105, Japan
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25
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Teckie S, Qi S, Chelius M, Lovie S, Hsu M, Noy A, Portlock C, Yahalom J. Long-term outcome of 487 patients with early-stage extra-nodal marginal zone lymphoma. Ann Oncol 2018; 28:1064-1069. [PMID: 28327924 DOI: 10.1093/annonc/mdx025] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Localized early-stage extra-nodal marginal zone lymphoma (MZL) presents with heterogeneous organ involvement and is treated with various modalities, including resection, radiotherapy, and systemic therapy. We report the long-term outcome of a large cohort of extra-nodal MZL and assess the impact of patient and disease characteristics, organ site, and treatment strategy on disease control and survival. Patients and methods We identified 487 consecutive patients with stage IE or IIE MZL referred between 1992 and 2012 to Memorial Sloan Kettering Cancer Center. Pathology was reviewed by hematopathologists at our institution. Patient and disease factors as well as treatment types were analyzed for association with relapse-free survival, overall survival, and cumulative incidence of relapse. Results Median follow-up after treatment was 4.7 years. Five-year relapse-free survival and overall survival were 60% and 89%, respectively. Cumulative incidence of disease-specific death at 5 years was 1.3%. Radiotherapy alone was the initial treatment in 50% of patients, followed by surgical resection (30%), observation (8%), immunotherapy (4%), and chemotherapy (2%). Initial treatment type, primary disease site, and number of involved sites were significant factors in multivariable analysis of relapse (all P < 0.05). When compared with stomach, MZL originating in other disease sites (HR > 2.0, P ≤ 0.001), except for thyroid, had higher risk of relapse. Strategies such as antibiotics or topical therapies were associated with higher risk of relapse when compared with radiation therapy (P < 0.001). Crude rate of transformation to pathologically confirmed large-cell lymphoma was 2% (11 patients). Conclusion Overall and cause-specific survival are high in early-stage extra-nodal MZL. Curative-intent treatment led to fewer relapses and reduced the need for salvage. Stomach cases had lower risk of relapse than other anatomic primary sites. This study supports the use of local therapies to treat stage IE and IIE MZL.
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Affiliation(s)
- S Teckie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York.,Department of Radiation Medicine, Northwell Health, New York.,Hofstra Northwell School of Medicine, Hempstead, USA
| | - S Qi
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York.,Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - M Chelius
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - S Lovie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - M Hsu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - A Noy
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Weill Cornell Medical College, New York, USA
| | - C Portlock
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York.,Weill Cornell Medical College, New York, USA
| | - J Yahalom
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York.,Weill Cornell Medical College, New York, USA
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26
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Watanabe N, Narimatsu H, Noh JY, Iwaku K, Kunii Y, Suzuki N, Ohye H, Suzuki M, Matsumoto M, Yoshihara A, Kameyama K, Kobayashi K, Kami M, Sugino K, Ito K. Long-Term Outcomes of 107 Cases of Primary Thyroid Mucosa-Associated Lymphoid Tissue Lymphoma at a Single Medical Institution in Japan. J Clin Endocrinol Metab 2018; 103:732-739. [PMID: 29165612 DOI: 10.1210/jc.2017-01478] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/15/2017] [Indexed: 02/03/2023]
Abstract
CONTEXT Thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is a type of extranodal lymphoma with a favorable prognosis. OBJECTIVE To provide information on long-term outcomes that would facilitate establishment of the optimal management strategy for thyroid lymphoma. DESIGN, SETTING, AND PARTICIPANTS Medical records of 107 patients (median age 67 years, 20 males, 87 females) who were diagnosed with localized thyroid MALT lymphoma stage IE or IIE at Ito Hospital were retrospectively reviewed. MAIN OUTCOME MEASURE Overall and event-free survival (EFS). RESULTS Initial treatments included radiation therapy (RT) alone (n = 58), combined modality therapy (CMT) (n = 48), or chemotherapy alone (n = 1). All 107 patients responded to the treatment, six of whom experienced relapse. Only one patient died of lymphoma. The 5-year overall survival (OS) and EFS rates were 94% [95% confidence interval (CI), 87% to 97%] and 92% (95% CI, 85% to 95%), respectively, and the 10-year OS and EFS rates were 91% (95% CI, 83% to 95%) and 84% (95% CI, 74% to 90%), respectively. Of the 106 patients with information available on adverse events, 71 patients (67%) developed hypothyroidism after primary thyroid lymphoma treatment. The CMT group showed additional chemotherapy-induced adverse reactions in the form of neutropenia, neuropathy, constipation, and pneumonia. The 5-year OS rates of patients treated with CMT and RT were 93% (95% CI, 81% to 98%) and 94% (95% CI, 84% to 98%), respectively. CONCLUSIONS Long-term outcomes of localized thyroid MALT lymphoma are favorable with all initial treatment modalities.
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Affiliation(s)
| | - Hiroto Narimatsu
- Department of Genetic Medicine, Kanagawa Cancer Center, Kanagawa, Japan
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | - Kaori Kameyama
- Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan
| | - Kazuhiko Kobayashi
- Division of Hematology, Teikyo University Chiba Medical Center, Chiba, Japan
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27
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Alongi F, Aniko MD, Ferreri AJM, Rosso A, Cozzarini C, Fallanca F, Berardi G, Schipani S, Gianolli L, Guazzoni G, Di Muzio N. Consolidation Radiotherapy for a Rare Case of Extranodal Mucosa-Associated Lymphoid Tissue Non-Hodgkin's Lymphoma Synchronous with Prostate Adenocarcinoma. TUMORI JOURNAL 2018; 96:498-502. [DOI: 10.1177/030089161009600322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Nongastric primary extranodal mucosa-associated lymphoid tissue (MALT) lymphomas are uncommon, with around 0.1% occurring in the prostate. Even less frequent is the presence of MALT lymphoma synchronous with another type of neoplasm in the same organ, especially the prostate. Only a single case of concurrent adenocarcinoma and MALT lymphoma of the prostate has been reported in the literature. We report a rare case of primary extranodal marginal zone MALT lymphoma incidentally diagnosed during radical prostatectomy for an adenocarcinoma of the prostate in a 53-year-old patient. Fourteen months later a recurrence of the MALT lymphoma involving both sides of the diaphragm was found and was treated with chemoimmunotherapy. High-dose radiotherapy was delivered to residual bulky disease in the pelvic region. At 18 months from the end of radiation treatment the patient was without signs of relapse of MALT lymphoma. This preliminary result confirms that rare cases of MALT lymphoma of the prostate should be discussed and treated under the collaborative supervision of hematologists and medical and radiation oncologists. In fact, at an advanced stage of the disease, a chemotherapy regimen with additional consolidation radiotherapy could be an effective strategy, as in all other lymphomas.
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Affiliation(s)
- Filippo Alongi
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
- IBFM-CNR, Italy; Centro di Bioimmagini e Radioterapia, LATO HSR-Giglio, Cefalù, Italy
| | - Maria Deli Aniko
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
| | | | - Alberto Rosso
- Medical Oncology Unit, Scientific Institute H San Raffaele, Milan, Italy
| | - Cesare Cozzarini
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
| | - Federico Fallanca
- Nuclear Medicine Unit, Scientific Institute H San Raffaele, Milan, Italy
| | - Genoveffa Berardi
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
| | - Stefano Schipani
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
| | - Luigi Gianolli
- Nuclear Medicine Unit, Scientific Institute H San Raffaele, Milan, Italy
| | | | - Nadia Di Muzio
- Radiotherapy Unit, Scientific Institute H San Raffaele, Milan, Italy
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28
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Zhao S, Zhang L, Gu Z, Zhu C, Fang S, Yang N, Wang F, Guan L, Luo L, Gao C. Clinical manifestations of pulmonary mucosa-associated lymphoid tissue lymphoma: single-center experience with 18 patients. Onco Targets Ther 2018; 11:555-561. [PMID: 29416356 PMCID: PMC5790107 DOI: 10.2147/ott.s147275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a rare entity. To date, the optimal treatment for this disease is still under debate. The aim of this study was to analyze and summarize the clinical manifestations and therapeutic experience of 18 pulmonary MALT lymphoma patients to collect information about the optimal treatment modality. Patients and methods A retrospective analysis was performed in patients who were diagnosed with pulmonary MALT lymphoma at the Chinese People’s Liberation Army General Hospital from April 1995 to April 2016. Results Clinical data of 18 patients were available. The median age was 55 (range, 34–67) years. Also, 61.1% of the patients were male. Only 33.3% had a history of smoking and 27.8% of the patients had tuberculosis. Treatment modalities included surgery alone in 1 patient (5.6%), chemotherapy in 10 patients (55.5%), surgery in combination with chemotherapy in 6 patients (33.3%) and observation in 1 patient (5.6%). Over the median observation period of 93 months, 2 patients died, the median progression-free survival was 6 years, and the estimated 5- and 10-year overall survival rates were 94.1% and 83.7%, respectively. The survival data confirmed the indolent nature of the disease. There was no difference in progression-free survival between the chemotherapy group and the surgery in combination with chemotherapy group. Conclusion Pulmonary MALT lymphoma tended to be an indolent disease. In order to preserve the lung function and reduce the risks associated with surgery, chemotherapy might be an optimal choice for the treatment of pulmonary MALT lymphoma.
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Affiliation(s)
- Shasha Zhao
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Lin Zhang
- Department of Hematology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Zhenyang Gu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Chengying Zhu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Shu Fang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Nan Yang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Feiyan Wang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Lixun Guan
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Lan Luo
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Chunji Gao
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
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29
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Uehara N, Otsuki N, Shinomiya H, Uehara K, Nibu KI. Mucosa-associated lymphoid tissue lymphoma of parotid gland with involvement of subglottis and trachea. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2018. [DOI: 10.1080/23772484.2018.1532294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Natsumi Uehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, School of Medicine, Chuo-ku, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, School of Medicine, Chuo-ku, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, School of Medicine, Chuo-ku, Japan
| | - Keiichiro Uehara
- Department of Diagnostic Pathology, Kobe University Hospital, Chuo-ku, Japan
| | - Ken-ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, School of Medicine, Chuo-ku, Japan
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30
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Takimoto T, Maegawa S, Tatsumi H, Nagoshi H, Chinen Y, Shimura Y, Kobayashi T, Horiike S, Nakamura S, Kitawaki J, Kuroda J, Taniwaki M. Extranodal marginal zone lymphoma of the uterine cervix with concomitant copy number gains of the MALT1 and BCL2 genes: A case report. Oncol Lett 2017; 13:3641-3645. [PMID: 28521466 PMCID: PMC5431356 DOI: 10.3892/ol.2017.5944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 01/31/2017] [Indexed: 11/16/2022] Open
Abstract
Extranodal marginal zone lymphoma (EMZL) of mucosa-associated lymphoid tissue (MALT) of the uterus is rare, and the etiology, pathophysiology and cytogenetic features remain unknown at present. The present study reports a case of a 71-year-old female with EMZL of the uterine cervix that was 80 mm in diameter and invaded directly into the rectal serosa. Complete remission was successfully induced by 6 courses of immunochemotherapy with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone. Although the metaphase spread of the tumor cells was unavailable for whole cytogenetic analysis, fluorescence in situ hybridization (FISH) detected triple signals for MALT1 and B-cell lymphoma 2, located at chromosome 18q21, and the centromere of chromosome 18, which was suggestive of trisomy 18, and in combination with previous studies, suggested a possible association between trisomy 18 and the large tumor at initial presentation in the present patient. In addition, FISH examination detected immunoglobulin heavy chain gene rearrangement, although the translocation partner was unconfirmed. A total of 18 previously-studied patients with EMZL of the uterus, including that of the present study, were reviewed with respect to their clinical features and treatment and cytogenetic abnormality. In the evaluation of the English scientific literature, this is the first reported patient with EMZL of the uterus with partly determined cytogenetic abnormalities.
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Affiliation(s)
- Tomoko Takimoto
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Saori Maegawa
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Hiroshi Tatsumi
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Hisao Nagoshi
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Yoshiaki Chinen
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Yuji Shimura
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Tsutomu Kobayashi
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Shigeo Horiike
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Jo Kitawaki
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Junya Kuroda
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Masafumi Taniwaki
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
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31
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Kelley SR. Mucosa-associated lymphoid tissue (MALT) variant of primary rectal lymphoma: a review of the English literature. Int J Colorectal Dis 2017; 32:295-304. [PMID: 27995323 DOI: 10.1007/s00384-016-2734-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Primary rectal lymphoma (PRL) is the third most common cause of rectal cancer following adenocarcinoma (90-95 %) and carcinoid (5 %). The most common variant of PRL is the mucosa-associated lymphoid tissue (MALT) type. To date, no study has been able to recommend an optimal treatment algorithm for this rare disease. The aim of our study was to review the English literature on primary rectal MALT lymphoma. METHODS A review of the English literature was conducted to identify articles describing the MALT variant of PRL. RESULTS Fifty-one cases were identified. A complete response was achieved in 12 of 19 cases treated with Helicobacter pylori eradication therapy, 5 of 6 with radiation, 2 of 4 cases with chemotherapy, 2 of 4 with endoscopic resection, 6 of 8 cases with surgical resection, and all 8 with combination therapies. Cases failing initial therapies were responsive to various second-line treatments. Two cases spontaneously regressed with observation alone. CONCLUSION Complete regression of primary rectal MALT lymphoma was achieved using various therapeutic strategies, although the numbers of different treatment modalities are too small to draw definitive conclusions.
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Affiliation(s)
- Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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32
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Yonal-Hindilerden I, Hindilerden F, Arslan S, Turan-Guzel N, Dogan IO, Nalcaci M. Primary B-Cell Mucosa-Associated Lymphoid Tissue Lymphoma of the Hard Palate and Parotid Gland: Report of One Case and Review of the Literature. J Clin Med Res 2016; 8:824-830. [PMID: 27738485 PMCID: PMC5047022 DOI: 10.14740/jocmr2733w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/15/2022] Open
Abstract
A 61-year-old woman was admitted to our hospital with an ulcerated palate mass and swelling of the right parotid gland. Incisional biopsy from the hard palate revealed an extranodal marginal zone B-cell lymphoma, also called mucosa-associated lymphoid tissue (MALT) lymphoma. Final diagnosis was MALT lymphoma of the parotid gland with concomitant involvement of an extremely seldom site of involvement: the hard palate. To our knowledge, this report illustrates the first case of MALT lymphoma of the hard palate and parotid gland without an underlying autoimmune disease. Rituximab-based combination regimen (R-CHOP) provided complete remission with total regression of mass lesions at the hard palate and parotid gland. At 44-month follow-up, there is no disease relapse. We adressed the manifestations and management of MALT lymphoma patients with involvement of salivary gland and oral cavity.
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Affiliation(s)
- Ipek Yonal-Hindilerden
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Fehmi Hindilerden
- Hematology Clinic, Istanbul Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Serkan Arslan
- Radiology Clinic, Istanbul Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nalan Turan-Guzel
- Department of Pathology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Ibrahim Oner Dogan
- Department of Pathology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Meliha Nalcaci
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Singh AD, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of extranodal marginal zone lymphoma reveals excellent long-term outcomes. Br J Haematol 2016; 173:404-12. [DOI: 10.1111/bjh.13975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Arun D. Singh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Marcos J.G. De Lima
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
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Iftikhar H, Siddiqui MI, Minhas K. MALT lymphoma of the base of the tongue: a rare case entity. BMJ Case Rep 2016; 2016:bcr-2015-213830. [PMID: 26912765 DOI: 10.1136/bcr-2015-213830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Lymphoma is a malignant tumour arising from lymphoid tissue, with the majority of cases being in the lymph nodes, however, in 1/4th of cases, these tumours are found in extralymphoid tissue. Lymphoid tissue is also found in organs having mucosa, such as the digestive tract, salivary gland and in tracheal tissue. This collection of lymphoid tissue is known as mucosa-associated lymphoid tissue (MALT), and non-Hodgkin lymphoma involving this extralymphoidal lymph tissue is known as MALT lymphoma. It was first reported by Isaacson and Wright in 1983, however, it was not included as a working diagnosis in clinical use until it was reclassified as 'marginal zone B-cell lymphoma' in a 1994 Revised European American Lymphoma (REAL) classification. It is rarely seen in the head and neck region, and we report the sixth case of MALT lymphoma of the base of the tongue. A 61-year-old man presented with dysphagia and the feeling of a lump in his throat for 5 months.
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Affiliation(s)
- Haissan Iftikhar
- Section of Otolaryngology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Khurram Minhas
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
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Borie R, Wislez M, Antoine M, Copie-Bergman C, Thieblemont C, Cadranel J. Pulmonary mucosa-associated lymphoid tissue lymphoma revisited. Eur Respir J 2016; 47:1244-60. [PMID: 26797028 DOI: 10.1183/13993003.01701-2015] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022]
Abstract
This general review sought to clarify the pathophysiological, diagnostic, prognostic, and therapeutic features of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.MALT lymphoma is the most common pulmonary B-cell lymphoma, which usually occurs in the context of acquired MALT. The disease is slow-growing with an asymptomatic chronic alveolar opacity visible on radiography. Diagnosis requires tissue samples that should be retrieved using minimally invasive techniques, such as bronchoscopy or computed tomography-guided biopsies. The pathophysiology includes cytogenetic abnormalities and autoimmune diseases, whereas an association with a chronic pulmonary infection is still suspected but not yet demonstrated. Disease prognosis is typically excellent and the current available treatments are discussed in this review, including the decision not to treat, surgery, and single- or double-agent chemotherapy.
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Affiliation(s)
- Raphael Borie
- Service de Pneumologie A, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Bichat, Paris, France
| | - Marie Wislez
- Service de Pneumologie, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Tenon, Paris, France GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France
| | - Martine Antoine
- GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France Service d'Anatomie pathologique, AP-HP, Hôpital Tenon, Paris, France
| | | | - Catherine Thieblemont
- Service d'Hémato-oncologie, AP-HP, Hôpital Saint-Louis, Université Diderot, Sorbonne Paris Cité, Paris, France
| | - Jacques Cadranel
- Service de Pneumologie, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Tenon, Paris, France GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France
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36
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Kim KH, Kim RB, Woo SH. Individual participant data meta-analysis of primary laryngeal lymphoma: Focusing on the clinical characteristics and prognosis. Laryngoscope 2015; 125:2741-8. [PMID: 26404037 DOI: 10.1002/lary.25391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Primary lymphoma of the larynx is rare. The symptoms are ambiguous and nonspecific, and confirmation of the diagnosis is often difficult. To better understand the clinical characteristics of this distressing disease, we performed an individual participant data meta-analysis focusing on the diagnoses and treatment outcomes. STUDY DESIGN Systematic review article. METHODS A literature search of the MEDLINE, Embase, and Cochrane library databases was conducted using the following Medical Subject Headings and keywords: "primary," "lymphoma," "cancer," and "larynx." The individual data of 57 patients from 41 articles were selected based on the inclusion criteria for the analysis. RESULTS The mean age of the 57 patients at the time of diagnosis was 53.9 ± 18 years, and there was a preponderance of male patients (male:female = 35:22). The mean follow-up was 33.2 ± 40.5 months. The most common symptom was hoarseness (70.2%). Extension of the lymphoma was found in the supraglottic larynx (63.2%). B-symptoms were noted in only 14.0% of patients. The treatment method and disease extent were not significant factors. The significant prognostic factors were the biopsy frequency (P = .000), B-symptoms (P = .032), and cell type (P < .001). CONCLUSIONS From an analysis of larynx lymphoma patients, accurate biopsy, the presence of B-symptoms, and the cell type of the lymphoma are important to the prognosis. However, the treatment method was not effective in predicting the prognosis. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Kyung Hee Kim
- Department of Otolaryngology, Gyeongsang National University, Jinju.,College of Nursing, Gyeongsang National University, Jinju
| | - Rock Bum Kim
- Dong-A University Hospital Regional Cardiocerebrovascular Center (R.B.K.), Busan, South Korea
| | - Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University, Jinju.,Institute of Health Sciences, Gyeongsang National University, Jinju
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Satoh K, Morita T, Fumimoto S, Tsuji H, Ichihashi Y, Ochi K, Hanaoka N, Okada Y, Katsumata T. Rare Pulmonary Metastasis From Thyroid Mucosa-Associated Lymphoid Tissue Lymphoma. Ann Thorac Surg 2015; 100:700-2. [PMID: 26234841 DOI: 10.1016/j.athoracsur.2014.09.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 07/03/2014] [Accepted: 09/09/2014] [Indexed: 10/23/2022]
Abstract
Primary pulmonary lymphomas constitute up to 1% of all pulmonary malignancies. Patients with mucosa-associated lymphoid tissue (MALT) lymphoma represent approximately 90% of patients with primary pulmonary lymphoma. Most pulmonary MALT lymphomas are primary tumors. Pulmonary metastasis is extremely rare. A 65-year-old woman was diagnosed with a thyroid MALT lymphoma in 2008 and underwent total thyroidectomy, followed by chemotherapy. After 5 years of follow-up, she referred to our hospital with an abnormal shadow on a chest roentgenogram. She underwent video-assisted thoracoscopic surgery and was diagnosed with metastatic thyroid MALT lymphoma. Postoperatively, she was treated with chemotherapy, including rituximab, and is alive without recurrence.
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Affiliation(s)
- Kiyoshi Satoh
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan.
| | - Takuya Morita
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
| | - Satoshi Fumimoto
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
| | - Hiroyuki Tsuji
- Department of Respiratory Medicine, Osaka Medical College Hospital, Takatsuki, Japan
| | - Yoshio Ichihashi
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
| | - Kaoru Ochi
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
| | - Nobuharu Hanaoka
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
| | - Yoshikatsu Okada
- Department of Pathology, Osaka Medical College Hospital, Takatsuki, Japan
| | - Takahiro Katsumata
- Department of Thoracic Surgery, Osaka Medical College Hospital, Takatsuki, Japan
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Is there role of additional chemotherapy after definitive local treatment for stage I/II marginal zone lymphoma?: Consortium for Improving Survival of Lymphoma (CISL) study. Int J Hematol 2015. [PMID: 26210384 DOI: 10.1007/s12185-015-1845-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Even though local stage (Ann Arbor stage I/II) marginal zone lymphoma (MZL) is well controlled with local treatment-based therapy, no data exist on the role of additional chemotherapy after local treatment for stage I/II MZL. Patients with biopsy-confirmed Ann Arbor stage I/II MZL (n = 210) were included for analysis in this study. Of these, 180 patients (85.7 %) were stage I and 30 (14.3 %) were stage II. Most patients (n = 182, 86.7 %) were treated with a local modality including radiation therapy or surgery and 28 (13.3 %) received additional systemic chemotherapy after local treatment. The overall response rate was 98.3 % (95 % CI 96-100 %), with 187 complete responses and 20 partial responses. In the local treatment group, the mean progression-free survival (PFS) was 147.4 months (95 % CI 126.7-168.1 months) and the overall survival (OS) was 188.2 months (95 % CI 178.8-197.7 months). In the additional chemotherapy group, the mean PFS was 103.4 months (95 % CI 84.9-121.9 months) and the OS was 137.3 months (95 % CI 127.9-146.7 months). There was no difference between the two groups in OS (p = 0.836) and PFS (p = 0.695). Local stage MZL has a good clinical course and is well controlled with a local treatment modality without additional chemotherapy.
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Primary MALT Lymphoma of the Larynx. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015. [DOI: 10.1016/j.otoeng.2013.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kadota N, Shinohara T, Machida H, Nakanishi H, Suehiro F, Toda H, Yoshino T, Ogushi F. Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance. BMC Res Notes 2015; 8:223. [PMID: 26048050 PMCID: PMC4467634 DOI: 10.1186/s13104-015-1218-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 05/29/2015] [Indexed: 01/26/2023] Open
Abstract
Background Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. Case presentation We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. Conclusion The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.
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Affiliation(s)
- Naoki Kadota
- Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
| | - Tsutomu Shinohara
- Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
| | - Hisanori Machida
- Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
| | | | - Fumie Suehiro
- Kochi Kenshin Clinic, 2-4-36 Chiyori-cho, Kochi, 780-0806, Japan.
| | - Hiroko Toda
- Department of Pathology, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8525, Japan.
| | - Tadashi Yoshino
- Department of Pathology, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8525, Japan.
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
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41
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Tsuchiya Y, Fischer A, Solomon JJ, Lynch DA. Connective Tissue Disease-related Thoracic Disease. Clin Chest Med 2015; 36:283-97, ix. [PMID: 26024605 DOI: 10.1016/j.ccm.2015.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pulmonary involvement is a frequent manifestation of connective tissue disease (CTD)-related thoracic disease. It is important to characterize the underlying pattern when pulmonary involvement occurs in a patient with CTD, and to exclude other causes. A systematic approach, evaluating each compartment of the lung (airway, interstitium, pleura, pulmonary vasculature) may be helpful. In complex cases, a multidisciplinary approach should be considered, potentially including the pulmonologist, rheumatologist, radiologist, pathologist, and sometimes the infectious disease specialist or oncologist. New techniques, such as quantitative computed tomography and MRI, are expected to be helpful for evaluation and management of CTD-associated thoracic disease.
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Affiliation(s)
- Yutaka Tsuchiya
- Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Yokohama 227-8501, Japan.
| | - Aryeh Fischer
- Department of Rheumatology, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA
| | - Joshua J Solomon
- Department of Respiratory and Critical Care Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA
| | - David A Lynch
- Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA
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Papageorgiou A, Ziogas DC, Mavragani CP, Zintzaras E, Tzioufas AG, Moutsopoulos HM, Voulgarelis M. Predicting the outcome of Sjogren's syndrome-associated non-hodgkin's lymphoma patients. PLoS One 2015; 10:e0116189. [PMID: 25723713 PMCID: PMC4344229 DOI: 10.1371/journal.pone.0116189] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/08/2014] [Indexed: 01/14/2023] Open
Abstract
Background Non-Hodgkin's lymphoma (NHL) development in Sjögren’s syndrome (SS) remains a potentially lethal complication and efforts should focus on the identification of predictors that could aid in appropriate therapeutic decisions. Methods In order to identify potential prognostic factors for outcome in SS-associated NHL, we retrospectively analyzed a cohort of 77 patients, diagnosed with NHL according to WHO classification criteria and meeting the American-European Consensus Classification (AECC) criteria for SS and examined the effect of SS-activity (defined as the EULAR SS disease activity index-ESSDAI) in the prognosis of SS-related NHLs, as defined in terms of overall and event-free survivals (OS and EFS). An event was defined as lymphoma relapse, treatment failure, disease progression, histological transformation or death. The effect of NHL clinical and laboratory characteristics was also investigated. Results MALT lymphomas constituted the majority (66.2%) of lymphomas. During the follow-up (median = 57.93 months), the 5-year OS was 90.91% (95% CI: 82.14–95.80%) and the EFS was 77.92% (95% CI: 67.37–85.82%). Patients with high ESSDAI score at lymphoma diagnosis had a greater risk for death (OR = 5.241, 95% CI: 1.034–26.568) or for event (OR = 4.317, 95% CI: 1.146–9.699, p = 0.008). These patients had also significantly worse EFS (HR = 4.541, 95% CI: 1.772–11.637) and OS (HR = 5.946, 95% CI: 1.259–28.077). In addition, post-chemotherapy ESSDAI improvement was significantly lower in patients who had experienced an event (p = 0.005). An unfavorable International prognostic index (IPI) score (high-intermediate/high) was associated with high risk of death and event (OR = 13.867, 95% CI: 2.656–72.387 and OR = 12.589, 95% CI: 3.911–40.526, respectively), worse EFS (log-rank p<0.001, HR = 8.718, 95% CI: 3.477–21.858), as well as with worse OS (log-rank p<0.001, HR = 11.414, 95% CI: 2.414–53.974). After adjustment for identified risk factors, IPI score retained a significant prognostic role following by a strong effect of ESSDAI in survival outcomes. Conclusions At the point of NHL diagnosis, IPI and ESSDAI might be proved useful predictive tools in SS-associated lymphoma prognosis, directing to a more patient-tailored approach.
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Affiliation(s)
- Aristea Papageorgiou
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Dimitrios C. Ziogas
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Clio P. Mavragani
- Department of Physiology, School of Medicine, University of Athens, Athens, Greece
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece
| | | | | | - Michael Voulgarelis
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
- * E-mail:
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Bauduer F, Robin H, Labadie JC, Darrasse D. MALT lymphoma of initial gastric site relapsing as simultaneous bilateral palpebral and salivary glands localizations. Presse Med 2014; 43:1387-8. [DOI: 10.1016/j.lpm.2014.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 05/06/2014] [Indexed: 10/24/2022] Open
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Rituximab monotherapy as a first-line treatment for pulmonary mucosa-associated lymphoid tissue lymphoma. Int J Hematol 2014; 101:46-51. [PMID: 25378228 DOI: 10.1007/s12185-014-1694-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/24/2014] [Accepted: 10/29/2014] [Indexed: 01/22/2023]
Abstract
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal lymphoma with a 5-year survival rate of 80-95 %. There is no standard treatment strategy for pulmonary MALT lymphoma. In the present study, we performed a retrospective evaluation of systemic rituximab monotherapy (375 mg m(-2) day(-1), 4-8 cycles) as first-line treatment in patients with pulmonary MALT lymphoma. Of the eight patients enrolled, five achieved complete response, one achieved partial response, and two showed stable disease. Median progression-free survival was 66.0 months (range 9.7-87.2 months). Treatment was well tolerated and all patients were alive during the median follow-up period of 64.0 months. Rituximab monotherapy was efficacious in patients with pulmonary MALT lymphoma, demonstrating long-term disease stabilization and symptom reduction. Larger prospective studies are warranted to further assess the efficacy of rituximab monotherapy. In conclusion, rituximab monotherapy may be considered for first-line therapy in patients with pulmonary MALT lymphoma.
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45
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Tuncer S, Tanyıldız B, Basaran M, Buyukbabani N, Dogan O. Systemic Rituximab Immunotherapy in the Management of Primary Ocular Adnexal Lymphoma: Single Institution Experience. Curr Eye Res 2014; 40:780-5. [PMID: 25247376 DOI: 10.3109/02713683.2014.959605] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the efficacy of systemic rituximab immunotherapy in the management of primary ocular adnexal lymphomas (OAL). MATERIALS AND METHODS Clinical records of 10 consecutive patients (11 eyes) with biopsy-proven OAL managed with systemic anti-CD20 monoclonal antibody (rituximab; 375 mg/m(2) intravenously once every three weeks for 6-8 cycles) between June 2008-March 2013 were evaluated retrospectively. Orbital magnetic resonance imaging and positron emission tomography were performed to evaluate any orbital and systemic involvement, respectively. Clinical response was classified as complete or partial. RESULTS The age of patients ranged between 27-85 (median, 55) years. Nine patients (90%) presented with unilateral and one (10%) with bilateral conjunctival involvement. Orbit was affected in 4 patients (40%), one of which had also choroidal involvement (10%). None of the patients had systemic involvement at initial presentation. All patients received an average of 7 cycles (range, 6-8) of systemic immunotherapy. After a median follow-up of 31 months (range, 10-61 months), complete response without recurrence could be achieved in 4 eyes (36%) with rituximab monotherapy. No systemic or ocular side effects were observed in any patient. Additional radiotherapy was required in 6 patients (7 eyes; 64%) with partial response or recurrence. CONCLUSIONS Complete regression of primary OALs without recurrence was observed in about one-third of eyes after systemic rituximab monotherapy. Adjunctive radiotherapy was required in remaining two-thirds of the cases to achieve complete response. Thus, considering the balance between high rate of local control and potential ocular complications of radiotherapy, systemic rituximab can be considered as a first-line therapeutic option in the management of primary OAL.
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Affiliation(s)
- Samuray Tuncer
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology , Ocular Oncology Service, Istanbul , Turkey
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Meyer AH, Stroux A, Lerch K, Eucker J, Eitle J, Hohloch K, Andrzejak M, Possinger K, Dörken B, Pezzutto A, Scholz CW. Transformation and additional malignancies are leading risk factors for an adverse course of disease in marginal zone lymphoma. Ann Oncol 2014; 25:210-5. [PMID: 24356632 DOI: 10.1093/annonc/mdt507] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Marginal zone lymphoma (MZL) is a non-Hodgkin lymphoma that occurs as extra nodal, nodal, or splenic. While MZL is generally considered an indolent disease, a substantial percentage of patients follow an unfavorable course. The objective of this retrospective analysis was to identify predictors for a reduced overall survival (OS), or conversely an increased OS. PATIENTS AND METHODS One hundred and ninety-seven MZL patients were analyzed. Apart from assessing previously published risk factors, concomitant morbidity at diagnosis, transformation into aggressive lymphoma, and occurrence of additional malignancies were evaluated. RESULTS Next to the known risk factors, i.e. above 60 years of age and elevated serum lactate dehydrogenase (LDH), we demonstrate that transformation into aggressive lymphoma, as well as additional malignancies, are important independent risk factors for a shortened OS in a multivariate analysis, irrespective of the MZL localization. Impressively, in the group of patients lacking LDH elevation, transformation, and/or additional malignancies, only 1 of 63 patients died during follow-up compared with 37 of 87 patients in the high-risk group (HR = 22.8; 95% confidence interval 3.1-167.0; P = 0.002). CONCLUSIONS Our analysis proposes novel risk factors and warrants for a continuous follow-up to detect the occurrence of transformation and additional malignancies early on.
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Affiliation(s)
- A H Meyer
- Department of Hematology, Oncology and Tumor Immunology
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47
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Macías-Rodríguez DH, Blanco-Pérez P, Santa Cruz-Ruiz S, Batuecas-Caletrio Á. Primary MALT lymphoma of the larynx. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014; 66:e17-9. [PMID: 24930857 DOI: 10.1016/j.otorri.2013.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 11/25/2013] [Accepted: 11/28/2013] [Indexed: 02/08/2023]
Affiliation(s)
| | - Pedro Blanco-Pérez
- Departamento de Otorrinolaringología, Hospital Universitario de Salamanca, Salamanca, España
| | | | - Ángel Batuecas-Caletrio
- Departamento de Otorrinolaringología, Hospital Universitario de Salamanca, Salamanca, España
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Watanabe N, Narimatsu H, Noh JY, Kunii Y, Mukasa K, Matsumoto M, Suzuki M, Sekiya K, Ohye H, Yoshihara A, Iwaku K, Kobayashi S, Kameyama K, Kobayashi K, Nishikawa Y, Kami M, Sugino K, Ito K. Rituximab-including combined modality treatment for primary thyroid lymphoma: an effective regimen for elderly patients. Thyroid 2014; 24:994-9. [PMID: 24547778 PMCID: PMC4046220 DOI: 10.1089/thy.2013.0523] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Primary thyroid lymphoma (PTL) develops mostly in middle-aged and older females. However, the optimal treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL), which accounts for most PTL cases, is unclear. Rituximab is a promising drug that, in combination with traditional combination therapy, has demonstrated an increased antitumor effect without a substantial increase in toxicity. In this study, treatment outcomes of elderly patients with thyroid DLBCL who underwent rituximab-including combination therapy were analyzed. METHOD Between January 2005 and December 2011, 43 patients 60 years of age or older (median 71 years, range 60-80 years) were diagnosed as having stage IE (n=12) or stage IIE (n=31) DLBCL, and three courses of R-CHOP therapy (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m2, and prednisolone 100 mg/body) and involved field irradiation were planned. Treatment outcomes of these patients were retrospectively reviewed. RESULTS Two patients terminated the treatment because of interstitial pneumonia during R-CHOP therapy. Only one patient showed treatment resistance and the regimen was changed; 42 patients (98%) responded to the treatment. Five-year overall survival and event-free survival were 87% (95% confidence interval [95% CI], 64-96%) and 74% (95% CI, 50-89%), respectively. CONCLUSION The results of the present study indicate that rituximab-including combination therapy was effective for elderly patients with thyroid DLBCL. A multicenter, long-term observational study is needed to confirm this, and additional refinement of the treatment protocol is required to optimize the antitumor effect.
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Affiliation(s)
| | - Hiroto Narimatsu
- Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | | | | | | | | | | | | | | | | | | | | | - Kaori Kameyama
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Masahiro Kami
- Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
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Dong Y, Wen F, Shi A, Guan HW, Ge Y, Jiang Y. Value of multidetector computed tomography in the diagnosis of mucosa-associated lymphoid tissue-lymphomas in the parotid gland: A case report and review of the literature. Oncol Lett 2013; 7:781-786. [PMID: 24520295 PMCID: PMC3919924 DOI: 10.3892/ol.2013.1769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 08/16/2013] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to review the multidetector computed tomography (MDCT) imaging features of eight mucosa-associated lymphoid tissue (MALT)-lymphoma cases of the parotid gland and to explore the diagnostic value of MDCT. A total of eight patients with pathologically confirmed MALT-lymphomas of the parotid gland underwent pre-operative MDCT plain and dual-phase scans. The changes in the CT values and enhancement patterns of the tumors were assessed. Quantitative analysis was performed to determine the CT value changes of the tumors in the various enhanced phases compared with the plain scan. The MALT-lymphomas of the parotid gland exhibited even density isodense or hyperdense nodules, with occasional calcification and necrosis. The dual-phase scan of the MALT-lymphomas revealed a pattern of lower or moderate enhancement, circumambient enhancement or delayed enhancement. The MALT-lymphomas were closely associated with Sjögre's syndrome and demonstrated malignant features and isodense or hyperdense nodules and lower or moderate enhancement on the CT scans.
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Affiliation(s)
- Yue Dong
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Feng Wen
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China
| | - Aijun Shi
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Hong Wei Guan
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Ying Ge
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Yuan Jiang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
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