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Xu H, Yan R, Ye C, Li J, Ji G. Specific mortality in patients with diffuse large B-cell lymphoma: a retrospective analysis based on the surveillance, epidemiology, and end results database. Eur J Med Res 2024; 29:241. [PMID: 38643217 PMCID: PMC11031870 DOI: 10.1186/s40001-024-01833-4] [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: 01/17/2024] [Accepted: 04/06/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND The full potential of competing risk modeling approaches in the context of diffuse large B-cell lymphoma (DLBCL) patients has yet to be fully harnessed. This study aims to address this gap by developing a sophisticated competing risk model specifically designed to predict specific mortality in DLBCL patients. METHODS We extracted DLBCL patients' data from the SEER (Surveillance, Epidemiology, and End Results) database. To identify relevant variables, we conducted a two-step screening process using univariate and multivariate Fine and Gray regression analyses. Subsequently, a nomogram was constructed based on the results. The model's consistency index (C-index) was calculated to assess its performance. Additionally, calibration curves and receiver operator characteristic (ROC) curves were generated to validate the model's effectiveness. RESULTS This study enrolled a total of 24,402 patients. The feature selection analysis identified 13 variables that were statistically significant and therefore included in the model. The model validation results demonstrated that the area under the receiver operating characteristic (ROC) curve (AUC) for predicting 6-month, 1-year, and 3-year DLBCL-specific mortality was 0.748, 0.718, and 0.698, respectively, in the training cohort. In the validation cohort, the AUC values were 0.747, 0.721, and 0.697. The calibration curves indicated good consistency between the training and validation cohorts. CONCLUSION The most significant predictor of DLBCL-specific mortality is the age of the patient, followed by the Ann Arbor stage and the administration of chemotherapy. This predictive model has the potential to facilitate the identification of high-risk DLBCL patients by clinicians, ultimately leading to improved prognosis.
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Affiliation(s)
- Hui Xu
- Department of Hematology, Taixing People's Hospital, No. 98, Runtai South Road, Taixing, 225400, Jiangsu, China
| | - Rong Yan
- Taixing People's Hospital, Taixing, Jiangsu, China
| | - Chunmei Ye
- Department of Hematology, Taixing People's Hospital, No. 98, Runtai South Road, Taixing, 225400, Jiangsu, China
| | - Jun Li
- Department of Hematology, Taixing People's Hospital, No. 98, Runtai South Road, Taixing, 225400, Jiangsu, China
| | - Guo Ji
- Department of Hematology, Taixing People's Hospital, No. 98, Runtai South Road, Taixing, 225400, Jiangsu, China.
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2
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Jiang YL, Mu J, Cui R, Li X, Wang J, Li Q, Li J, Mou N, Deng Q. Efficacy and side effects of anti-CD19 CAR T-cell therapy in patients with relapsed/refractory gastrointestinal lymphoma. Cancer Med 2024; 13:e7064. [PMID: 38457256 PMCID: PMC10923045 DOI: 10.1002/cam4.7064] [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: 10/01/2023] [Revised: 12/26/2023] [Accepted: 02/16/2024] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Although anti-CD19 chimeric antigen receptor (CAR) T cell therapy was approved as a very effective salvage strategy in relapsed/refractory (R/R) B cell lymphoma, the experience in R/R gastrointestinal (GI) lymphoma is still insufficient. METHODS We summarized the efficacy and side effects of anti-CD19 CAR T-cell therapy in 12 patients with R/R GI lymphoma. Based on literature, the R/R GI lymphoma patients were divided into subgroups with different characteristics: Bulky/No bulky disease, Gastric/Gastrointestinal involvement, Gastrointestinal/Combined extra-gastrointestinal lesions, Ulcer/Lumps or nodules type, With/without gastrointestinal bleeding. RESULTS The objective response rate (ORR) was 66.67% in these 12 patients. The ORR was 83.33% in no bulky disease group, 80.00% in gastric involvement group, 100.00% in ulcer type group, and 80.00% in no gastrointestinal bleeding group. The CR rate was 33.33% in these 12 patients. The CR was 50.0% in no bulky disease group, 60.00% in gastric involvement group, and 80.00% in ulcer type group. The PFS and OS rate of the 12 patients at 6 months after infusion were 54.55% and 58.33%, respectively. The overall survival (OS) at 6 months was higher in no bulky disease group. There was no difference of the OS or the progression free survival (PFS) at 6 months between the other groups. The mean peak of CAR-T cells and Cytokine Release Syndrome (CRS) grade were higher in gastrointestinal lesions group. The mean peak of IFN-γ and CRS grade were higher in gastrointestinal bleeding group. Four out of six patients in group of gastrointestinal lesions group were patient with high tumor burden. Patients with gastrointestinal involvement only were at higher risk for gastrointestinal bleeding. CONCLUSIONS The ORR and CR of high tumor load, gastrointestinal involvement, lumps or nodules type and gastrointestinal bleeding group were lower. The CRS grade was higher in gastrointestinal lesions group and in gastrointestinal bleeding group. Patients with gastrointestinal involvement only were at higher risk for gastrointestinal bleeding.
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Affiliation(s)
- Yi Li Jiang
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Juan Mu
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Rui Cui
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Xin Li
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Jia Wang
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Qing Li
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Jingyi Li
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
| | - Nan Mou
- Shanghai Genbase Biotechnology Co., LtdShanghaiChina
| | - Qi Deng
- Department of Hematology, Tianjin First Central Hospital, School of MedicineNankai UniversityTianjinChina
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Khdhir M, El Annan T, El Amine MA, Shareef M. Complications of lymphoma in the abdomen and pelvis: clinical and imaging review. Abdom Radiol (NY) 2022; 47:2937-2955. [PMID: 35690955 PMCID: PMC10509750 DOI: 10.1007/s00261-022-03567-5] [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: 03/28/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023]
Abstract
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
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Affiliation(s)
- Mihran Khdhir
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
| | - Tamara El Annan
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon
| | | | - Muhammed Shareef
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, CT, USA
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A Delayed Presentation of Perforated Diffuse Large B Cell Lymphoma of the Small Bowel Resulting in a Large Interloop Faecaloma. Case Rep Surg 2022; 2022:3881598. [PMID: 35572481 PMCID: PMC9098343 DOI: 10.1155/2022/3881598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Primary small bowel lymphomas are a rare entity but with significant morbidity and a low five-year overall survival even after surgery. Its diagnosis is often delayed due to the lack of clear specific signs, unfamiliarity amongst clinicians, and the lack of screening tools. This often results in patients presenting with tumour-associated complications such as perforation, obstruction, or gastrointestinal bleeding which warrant urgent surgical intervention. We present the case of a patient presenting with a perforated small bowel lymphoma resulting in a large interloop extraluminal faecaloma causing subacute small bowel obstruction. He proceeded to have an emergency open right hemicolectomy and extended small bowel resection to facilitate gross resection of tumour which in conjunction with adjuvant systemic chemotherapy is considered current best practice to manage such neoplasms. Early referral to specialist centres and raising awareness of this rare entity will allow earlier recognition and therefore a more planned approach to the management of such pathology with fewer post-operative complications.
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5
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Kim SR, Chun SH, Jin JY, Gweon TG, Lee H, Jin MS, Lee GJ. Experience of serious intestinal hemorrhage and perforation in small bowel lymphoma: a case report. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2021; 17:126-130. [PMID: 36945674 PMCID: PMC9942752 DOI: 10.14216/kjco.21020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/19/2021] [Indexed: 11/07/2022]
Abstract
There have been several reports of complications of small bowel lymphoma, such as bleeding, obstruction, and perforation, often require emergency surgery. It is hardly showed complications of bleeding and wound dehiscence for diffuse large B cell lymphoma with distal ileum involvement, which needed urgent surgery and medical management. A 65-year-old man with diffuse large B-cell lymphoma with distal ileum involvement experienced both intestinal bleeding and perforation during the course of treatment. As the patient was diagnosed with stage III disease, resection before chemotherapy was not considered due to the resulting delay in chemotherapy, which necessitated sufficient tissue healing. Chemotherapy is important when treating small bowel lymphoma, complications such as bleeding and perforation should always be considered for the treatment of small bowel lymphoma, and surgery is necessary in this situation. After surgery of the small bowel, subsequent chemotherapy could cause wound dehiscence and perforation; therefore, adequate recovery time should be given before chemotherapy.
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Affiliation(s)
- Seo Ree Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Hoon Chun
- Division of Hematology-Oncology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Youl Jin
- Division of Hematology-Oncology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-Geun Gweon
- Division of Gastroenterology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hayemin Lee
- Department of Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Sun Jin
- Department of Pathology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Guk Jin Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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6
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Molina-Valencia JL, Delgado-López CA. Complicaciones quirúrgicas del linfoma con compromiso gastrointestinal. REVISTA COLOMBIANA DE CIRUGÍA 2021. [DOI: 10.30944/20117582.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El linfoma puede afectar el tracto gastrointestinal de manera primaria o secundaria, y representa hasta el 2 % de todas las neoplasias malignas del intestino delgado y colon. El tracto gastrointestinal es la ubicación extraganglionar primaria más común en el linfoma no Hodgkin.
Métodos. Se realizó una búsqueda de la literatura en las principales bases de datos académicas, con revisión de textos publicados sobre el tema en los últimos 5 años.
Discusión. La presentación clínica del linfoma con compromiso gastrointestinal es inespecífica y, hasta en la mitad de los pacientes, se puede presentar de manera inicial con complicaciones que requieran manejo quirúrgico. Entre las principales se encuentran la perforación intestinal, el sangrado digestivo y la obstrucción intestinal.
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7
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Shen Y, Ou J, Wang B, Wang L, Xu J, Cen X. Influence of Severe Gastrointestinal Complications in Primary Gastrointestinal Diffuse Large B-Cell Lymphoma. Cancer Manag Res 2021; 13:1041-1052. [PMID: 33568947 PMCID: PMC7869708 DOI: 10.2147/cmar.s295671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background This study assessed the clinical characteristics of gastrointestinal bleeding (GIB), obstruction (GIO), and perforation (GIP) in patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) and the influence on long-term survival. Methods A retrospective analysis was performed of 148 patients with PGI-DLBCL admitted to Peking University First Hospital from August 1994 to May 2018. The clinical characteristics of GIB, GIO, and GIP before and after chemotherapy were recorded. The associated overall survival and progression-free survival were analyzed. Results Among 148 patients, 56.8% had gastrointestinal complications (GICs), including GIB, GIO, GIP, and multiple complications, and 22.6% of them occurred after chemotherapy, mostly during the first 4 cycles. The most common clinical manifestations of patients with GICs were abdominal pain or discomfort (79.8%), hematemesis or melena (22.6%), and abnormal bowel habits (17.9%). Patients with Eastern Cooperative Oncology Group (ECOG) score ≥2, tumor mass ≥10 cm, or intestinal involvement had significantly higher risk of severe GICs as initial manifestations. Among 130 patients who received chemotherapy, B symptoms, tumor mass ≥10 cm, and Lugano stage (IIE, IV) strongly correlated with GICs after chemotherapy (P < 0.05). Rituximab did not increase the risk of GICs. GICs which occurred before or after chemotherapy reduced the objective response rate at the end of chemotherapy. The prognosis of patients was significantly worsened by GIP, GIB, or multiple complications after chemotherapy (P < 0.05). GIB at presentation or GIO before or after chemotherapy had no prognostic value (both P > 0.05). Conclusion GICs adversely affect the quality of life, prolong the length of hospitalization, and shorten the long-term survival of patients with PGI-DLBCL.
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Affiliation(s)
- Ye Shen
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Jinping Ou
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Bingjie Wang
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Lihong Wang
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Junhui Xu
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Xinan Cen
- Department of Hematology, Peking University First Hospital, Beijing, 100034, People's Republic of China
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Warsinggih, Darmadi S, Prihantono, Faruk M. Non-Hodgkin Lymphoma of the jejunum presenting as perforation peritonitis: A case report. Ann Med Surg (Lond) 2020; 55:131-134. [PMID: 32477511 PMCID: PMC7251296 DOI: 10.1016/j.amsu.2020.04.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/26/2020] [Indexed: 12/22/2022] Open
Abstract
Primary gastrointestinal lymphoma is very rare compared to gastrointestinal tract lymphoma arising from secondary to primary nodal disease. Extra nodal lymphoma can involve any part of the gastrointestinal tract, most commonly being the stomach followed by small intestine and ileocecal region. They are indistinguishable from other benign and malignant conditions and are clinically non-specific. While perforation is common among patients undergoing lymphoma treatment, presentation of primary gastrointestinal lymphoma as perforation is rare and needs proper evaluation and management. Here, we describe an interesting case in which a patient presenting with peritonitis was found to have perforation and mass of the jejunum. Resection and anastomosis were performed as intervention, with subsequent histopathological examination showing Malignant Non-Hodgkin lymphoma (NHL). Postoperative follow up was provided along with the appropriate chemotherapy regimen.
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Affiliation(s)
- Warsinggih
- Division of Digestive, Department of Surgery, Faculty of Medicine, Hasanuddin University Makassar, Indonesia
| | - Suluh Darmadi
- Division of Digestive, Department of Surgery, Faculty of Medicine, Hasanuddin University Makassar, Indonesia
| | - Prihantono
- Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University Makassar, Indonesia
| | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University Makassar, Indonesia
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Aoki T, Yamada A, Takahashi M, Niikura R, Toyama K, Ushiku T, Kurokawa M, Momose T, Fukayama M, Koike K. Development and internal validation of a risk scoring system for gastrointestinal events requiring surgery in gastrointestinal lymphoma patients. J Gastroenterol Hepatol 2019; 34:693-699. [PMID: 30151937 DOI: 10.1111/jgh.14452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/18/2018] [Accepted: 08/19/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The predictors of severe gastrointestinal (GI) events in GI lymphoma patients are unclear. We aimed to develop a risk scoring system for GI events requiring surgery. METHODS In this retrospective study of 192 patients with GI lymphoma, the state of lymphoma, macroscopic findings, examination results, and International Prognostic Index were assessed. We developed a risk score for GI events that required surgery and assessed its accuracy by calculating the area under the receiver operating characteristic curve (AUC). Internal validation was performed using bootstrap resampling. RESULTS Severe GI events occurred in 21 (11%) patients. We developed a 4-point scoring system (the FLASH score) comprising the following three independent predictors (weighted by regression coefficients): (i) focal appearance and large size (≥ 40 mm), 1 point; (ii) aggressive lymphoma of the small bowel, 2 points; and (iii) high (18)F-fluorodeoxyglucose positron emission tomography uptake, 1 point. The score predicted severe GI events with an AUC value of 0.91 (internal validation; AUC, 0.86). Risk was classified into three categories: the GI event rate was 0% in the low-risk group (0 points), 9% in the intermediate-risk group (1-2 points), and 61% in the high-risk group (3-4 points) (AUC, 0.89). CONCLUSIONS We developed and internally validated a risk scoring system (the FLASH score) that included macroscopic findings to predict severe GI events in GI lymphoma patients. Patients with high scores are candidates for elective surgery to prevent GI events.
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Affiliation(s)
- Tomonori Aoki
- Department of Gastroenterology Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsuo Yamada
- Department of Gastroenterology Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miwako Takahashi
- Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Niikura
- Department of Gastroenterology Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Toyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshimitsu Momose
- Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Morrice M, Polton G, Beck S. Evaluation of the histopathological extent of neoplastic infiltration in intestinal tumours in cats. Vet Med Sci 2019; 5:307-316. [PMID: 30859750 PMCID: PMC6682799 DOI: 10.1002/vms3.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
With the exception of intestinal lymphoma, surgery is the most commonly recommended treatment for solitary feline intestinal tumours. However, there is a lack of evidence to substantiate resection margin recommendations for these tumours. The aim of this study was to add knowledge concerning resection margins for discrete intestinal masses in cats. Thirty confirmed feline intestinal tumours removed at veterinary centres across the UK from March 2017 to March 2018 underwent histological assessment at the palpable edge of the intestinal tumour and then at every 1 cm increment to the surgeon‐cut tissue border in oral, aboral and mesenteric directions. Histological margin recommendations were developed for carcinoma and lymphoma tumour types and non‐lymphoma intestinal tumours collectively. Seventeen intestinal lymphomas, nine carcinomas, two sarcomas and two mast cell tumours were evaluated in this study. Seven of the nine intestinal carcinomas would have been completely removed with histological margins of 4 cm in oral and aboral directions. Both sarcomas and one mast cell tumour would have been removed in their entirety with 4 cm histological margins in oral and aboral directions. There was extensive and varied microscopic invasion of intestinal tissue away from discrete intestinal lymphomas in the majority of the cases in this study. There is increasing evidence in veterinary as well as human literature supporting the role of surgical resection in the treatment of discrete intestinal lymphoma. If surgery is to be considered this study supports the removal of the gross tumour only. A histological margin of 4 cm should be considered, where possible, for intestinal masses other than lymphomas.
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Affiliation(s)
| | - Gerry Polton
- North Downs Specialist Referrals, Bletchingly, UK
| | - Sam Beck
- Bridge Pathology Ltd., Bristol, United Kingdom
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11
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Small AC, Benson CR, Brandes SB. Case of Delayed Ileal Conduit Necrosis Related to Infiltrative Diffuse Large B-cell Lymphoma. Urology 2018; 123:12-15. [PMID: 30266378 DOI: 10.1016/j.urology.2018.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 09/10/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Alexander C Small
- Department of Urology, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Cooper R Benson
- Department of Urology, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Steven B Brandes
- Department of Urology, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.
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12
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Zhuang N, Zhu Q, Li W, Wang M, Yang Q, Liu W, Li J, Yang H, Zhou W. Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review. Medicine (Baltimore) 2018; 97:e11407. [PMID: 29979438 PMCID: PMC6076109 DOI: 10.1097/md.0000000000011407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
RATIONALE Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula. PATIENT CONCERNS Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula. Ultrasound (US) showed small intestinal wall thickened and development of a fistula of the sigmoid colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a fistula between the sigmoid colon and the ileum, and CTE showed that the wall of the partial sigmoid colon was abnormally thickened and enhanced with an ileal-sigmoid fistula that strongly suggested the diagnosis of lymphoma. DIAGNOSES Both the two patients were diagnosed as intestinal fistula caused by primary non-Hodgkin's intestinal lymphoma. INTERVENTIONS The patient 1 underwent surgery followed by chemotherapy. The patient 2 accepted chemotherapy. OUTCOMES Two patients' general conditions remained stable and the imaging revealed no recurrence after follow-up of about 12 months. LESSIONS Cross-sectional imaging, such as US and CT, plays an essential role in intestinal lymphoma fistula diagnosis.
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Affiliation(s)
| | | | | | | | | | | | - Ji Li
- Department of Gastroenterology
| | | | - Weixun Zhou
- Department of Pathology, Peking Union Medical College Hospital, Beijing, China
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13
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Kagawa T, Kobayashi T, Ueyama S, Okabayashi H, Ogino T, Fujiwara T. Successful management of unresectable small bowel lymphoma with laparoscopy-assisted surgical exclusion of the affected intestine. Asian J Endosc Surg 2017; 10:454-458. [PMID: 28609811 DOI: 10.1111/ases.12393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/22/2017] [Accepted: 05/09/2017] [Indexed: 12/19/2022]
Abstract
The incidence of small bowel lymphoma (SBL) is increasing worldwide. In contrast to resectable SBL, the treatment of unresectable SBL is still contentious. Here, we report a case of unresectable SBL that was treated by laparoscopic exclusion of the affected intestine before systemic chemotherapy was administered. An 84-year-old man was diagnosed with primary SBL involving extranodal dissemination. The patient received prophylactic surgery, namely exclusion of the affected intestine. This therapy diminishes well-known and life-threatening complications, such as perforation, bleeding, and obstruction, which may still occur after chemotherapy, and it makes the administration of chemotherapy safer. In addition, the surgery provides easy access for direct endoscopic observation and biopsy, which are otherwise difficult to perform. Follow-up after two courses of chemotherapy showed that the patient had achieved complete remission. In conclusion, the procedure described here may be an effective strategy for unresectable SBL.
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Affiliation(s)
- Tetsuya Kagawa
- Department of Surgery, Mihara Red Cross Hospital, Mihara, Japan.,Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Satoshi Ueyama
- Department of Surgery, Mihara Red Cross Hospital, Mihara, Japan
| | | | - Tetsuya Ogino
- Department of Pathology, Mihara Red Cross Hospital, Mihara, Japan.,Department of Nursing Science, Faculty of Health and Welfare Science, Okayama Prefectural University, Soja, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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14
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Tatar C, Yavas M, Akkus O, Tapkan B, Batikan OK, Bayrak S, Arikan S. Intestinal perforation that developed after chemotherapy in a patient diagnosed with non-Hodgkin lymphoma: A case report and review of literature. Int J Surg Case Rep 2017; 39:321-323. [PMID: 28898795 PMCID: PMC5597875 DOI: 10.1016/j.ijscr.2017.08.058] [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] [Received: 08/08/2017] [Revised: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 01/08/2023] Open
Abstract
Intestinal perforations are one of the most well-known complications of NHLs. The reasons of perforation in patients who receive chemotherapy were fast tumor necrosis, tumor lysis, and tissue impairment. Depending on the steroids given to the patient, perforation may develop, and the clinical symptoms may be masked.
Introduction Non-Hodgkin Lymphomas (NHL) appear with the malign transformation of mature lymphocytes. Intestinal perforations are one of the most well-known complications of NHLs. In this review, a 29-year-old male patient who was diagnosed with NHL with gastrointestinal involvement that developed intestinal perforation after chemotherapy is presented. Presentation of case A 29-year-old male patient who received systemic chemotherapy in another healthcare center due to Major B-Cell Lymphoma was examined because he had stomachache after the treatment. The patient was urgently taken to operation. In the exploration, there were partly mass lesions in all small intestine segments. It was determined that one of the lesion was perforated. Small intestine resection was applied. The pathology report on resection material was reported as High Grade Major B-Cell Lymphoma. Discussion In the treatment of Lymphoma with intestinal B-Cells, there is no consensus because this disease is rarely observed. Perforation may appear as a complication of the chemotherapy. Depending on the steroids given to the patient, perforation may develop, and the clinical symptoms may be masked. Conclusion It must be born in mind that there may be intestinal involvement in patients diagnosed with NHL, and intestinal perforation may develop due to chemotherapy.
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Affiliation(s)
- Cihad Tatar
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Mazlum Yavas
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Onder Akkus
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Bahaeddin Tapkan
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Oguz Kagan Batikan
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Savas Bayrak
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Soykan Arikan
- Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
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15
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Nutu OA, Marcacuzco Quinto AA, Jiménez Romero LC. Tumores malignos primarios de intestino delgado. Análisis de una experiencia de 15 años. Med Clin (Barc) 2017; 149:129-130. [DOI: 10.1016/j.medcli.2017.03.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/20/2017] [Accepted: 03/23/2017] [Indexed: 11/16/2022]
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16
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Reinartz G, Weiglein T, Kröger K, Dreyling M. Radiation Therapy in Mantle Cell Lymphoma. Radiat Oncol 2017. [DOI: 10.1007/978-3-319-52619-5_55-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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17
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Kulkarni AA, Thakur SS. Ileo-ileal Intussusception and Bowel Obstruction Caused by Plasmablastic Lymphoma of Small Bowel- A Rare Entity in Rare Location. J Clin Diagn Res 2016; 10:PD03-5. [PMID: 27134931 DOI: 10.7860/jcdr/2016/15750.7448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/16/2015] [Indexed: 11/24/2022]
Abstract
Intussusception of small bowel is considered a rare cause of bowel obstruction in adults accounting for only about 1% of bowel obstruction in adults. Intussusception in adults is uncommon with 95% cases of intussusceptions occurring in children. Adult intussusception from small intestinal lymphoma is also rare with only 36 cases reported in the literature between 2000 and 2011. Plasmablastic lymphoma (PBL) is an aggressive lymphoid neoplasm usually seen in the oral cavity in the clinical setting of human immunodeficiency virus (HIV) infection. Plasmablastic lymphoma of the small intestine is extremely rare. Here, we report a case of plasmablastic lymphoma of small bowel with ileoileal intussusception in an HIV-negative immunocompetent male patient.
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Affiliation(s)
- Aditya Atul Kulkarni
- Senior Resident, Department of General Surgery, B. J. Government Medical College , Pune, India
| | - Sanjiv S Thakur
- Professor and Head, Department of General Surgery, B. J. Government Medical College , Pune, India
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18
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Yadav SK, Yadav J, Anand A, Kumar RR. Ileal non-Hodgkin's lymphoma presenting as perforation. Int J Colorectal Dis 2015; 30:1741. [PMID: 25682071 DOI: 10.1007/s00384-015-2151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Sanjay Kumar Yadav
- Department of General Surgery, Rajendra Institute of Medical Sciences, Hostel No. 03, Room No. 50, Rims, Ranchi, Jahrkhand, 834009, India.
| | - Jitin Yadav
- Department of General Surgery, Rajendra Institute of Medical Sciences, Hostel No. 03, Room No. 50, Rims, Ranchi, Jahrkhand, 834009, India
| | - Abhinav Anand
- Department of General Surgery, Rajendra Institute of Medical Sciences, Hostel No. 03, Room No. 50, Rims, Ranchi, Jahrkhand, 834009, India
| | - Rajeev Ranjan Kumar
- Department of General Surgery, Rajendra Institute of Medical Sciences, Hostel No. 03, Room No. 50, Rims, Ranchi, Jahrkhand, 834009, India
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