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Wei C, Wang M, Li J, Su J, Huang J, Tong S, Yang D. Light chain deposition disease presenting with gastrointestinal disorder as primary manifestation: report of two cases and literature review. J Int Med Res 2024; 52:3000605241233972. [PMID: 38488658 PMCID: PMC10943736 DOI: 10.1177/03000605241233972] [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: 09/26/2023] [Accepted: 01/29/2024] [Indexed: 03/18/2024] Open
Abstract
Light chain deposition disease (LCDD) is an under-recognized condition characterized by deposition of abnormal monoclonal light chains in tissues, leading to organ dysfunction. LCDD involving the gastrointestinal tract is very uncommon, and its diagnosis is challenging. We herein report two cases of LCDD that manifested as inflammatory bowel disease-like symptoms and protein-losing gastroenteropathy. Both patients were women in their early 60s. Tissue biopsies from the gastrointestinal mucosa demonstrated extracellular deposits, which were negative by Congo red staining but positive for κ-light chain by immunohistochemistry. The recent literature on LCDD was reviewed. When patients unexpectedly show extracellular deposits in gastrointestinal biopsy specimens, evaluation of immunoglobulin chains is recommended for diagnosis of LCDD after systemic amyloidosis has been excluded.
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Affiliation(s)
- Chenxiang Wei
- Division of Gastroenterology and Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Min Wang
- Division of Gastroenterology and Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Jiamin Li
- Department of Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Jiajun Su
- Department of Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Jing Huang
- Department of Hematology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Sunwing Tong
- Department of Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Dongye Yang
- Division of Gastroenterology and Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
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Ali K, Habib MB, Alloush F, Yassin MA. Mantle cell lymphoma presenting with severe upper gastrointestinal bleeding: A case report. Medicine (Baltimore) 2022; 101:e29236. [PMID: 35687772 PMCID: PMC9276165 DOI: 10.1097/md.0000000000029236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/29/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Although it usually involves extranodal sites such as the gastrointestinal tract in more than 80% of cases, mantle cell lymphoma is considered a rare cause of gastrointestinal bleeding, especially severe and life-threatening bleeding. PATIENT CONCERN A 60-year-old man with peptic ulcer disease, who presented with severe upper gastrointestinal (GI) bleeding and large gastric ulcer. DIAGNOSIS Primary gastric mantle cell lymphoma. INTERVENTIONS He was treated conservatively with blood transfusion and started on Traneximic acid for 3 days. Then, the patient underwent urgent hemostatic radiotherapy. OUTCOMES The patient became stable and kept in the hospital for monitoring with a definite diagnosis of stage IV Mantle cell lymphoma is made. CONCLUSION Mantle cell lymphoma should be kept in mind when assessing massive upper GI bleeding, as an unusual cause of bleeding gastric ulcer, given that bleeding is an uncommon presenting feature of GI lymphoma.
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Affiliation(s)
- Khaled Ali
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Mhd Baraa Habib
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ferial Alloush
- Pathology Department, Hamad Medical Corporation, Doha, Qatar
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Tekinalp A, Kars TU, Dikici HZ, Yılmaz PD, Demircioğlu S, Çeneli Ö. Treatment with doxorubicin-based protocol in cardiac involvement diffuse large B-cell lymphoma: A case report. J Oncol Pharm Pract 2021; 28:449-452. [PMID: 34549658 DOI: 10.1177/10781552211035120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Cardiac involvement in diffuse large B-cell lymphoma is a rare entity in non-Hodgkin lymphomas. Symptoms are usually related to heart failure. Patients who are severely symptomatic due to cardiac mass could be considered treatment as soon as possible. In this report, we present a patient diagnosed with diffuse large B-cell lymphoma with cardiac involvement. CASE REPORT A 61-year-old female patient was admitted to our unit with gastric biopsy diffuse large B-cell lymphoma. Computerized tomography of the chest and positron emission tomography/computed tomography demonstrated a neoplastic mass in the intra-atrial septum extended to inferior vena cava (5 × 4 cm in size and standardized uptake value maximum 24.6). She was in stage III and in the high-risk group. Because of pronounced heart failure findings associated with the mass-specific chemotherapy was planned early. MANAGEMENT & OUTCOME Although a fraction of ejection was 60% by echocardiography before the treatment, she had a cardiac risk for doxorubicin due to being over 60 years old and hypertension. Complete remission was achieved after three cycles of rituximab-cyclophosphamide-doxorubicin-vincristine and methylprednisolone protocol including doxorubicin. Treatment was completed with six cycles and she was followed up for three months. DISCUSSION Because of the cardiotoxicity of doxorubicin-based protocols, patients should be evaluated according to cardiac functions before and during the chemotherapy.
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Affiliation(s)
- Atakan Tekinalp
- Department of Internal Medicine Division of Hematology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
| | - Taha U Kars
- Department of Internal Medicine Division of Hematology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
| | - Hatice Z Dikici
- Department of Internal Medicine Division of Hematology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
| | - Pınar D Yılmaz
- Department of Radiology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
| | - Sinan Demircioğlu
- Department of Internal Medicine Division of Hematology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
| | - Özcan Çeneli
- Department of Internal Medicine Division of Hematology Konya, 427826Necmettin Erbakan University Meram Faculty of Medicine, Turkey
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Qian Z, Chen L, Wang X, Kan Y, Wang Y, Yu Y, Wang X, Zhao Z, Yang H, Ge P, Ding T, Zhai Q, Zhao H. Increased MALAT1 expression predicts poor prognosis in primary gastrointestinal diffuse large B-cell lymphoma. Clin Exp Med 2021; 22:183-191. [PMID: 34427833 DOI: 10.1007/s10238-021-00748-2] [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: 02/23/2021] [Accepted: 07/22/2021] [Indexed: 11/24/2022]
Abstract
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is involved in the pathogenesis and progression of several cancers. However, the potential effect of MALAT1 in primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) has not been elucidated. This study aimed to explore the prognostic value of MALAT1 in patients with PGI-DLBCL. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to determine the expression of MALAT1 in 90 patients with PGI-DLBCL. MALAT1 was remarkably upregulated in PGI-DLBCL tissues compared to paired adjacent non-tumor tissues (P < 0.001), and the area under the receiver operating characteristic (ROC) curve (AUC) was 0.838. MALAT1 expression was further increased in the non-germinal center B-cell-like (non-GCB), advanced stage (stages IIE-IV) and International Prognostic Index (IPI) score (3-5) groups (P = 0.01, P < 0.001 and P < 0.001, respectively). Furthermore, Kaplan-Meier analysis showed that elevated MALAT1 expression correlated with inferior overall survival (OS) and progression-free survival in PGI-DLBCL patients (P < 0.001 and P < 0.001, respectively), and our multivariate analysis results suggested that upregulation of MALAT1 and high IPI score (3-5) were two unfavorable prognostic factors for PGI-DLBCL. In conclusion, our results demonstrate that MALAT1 may serve as a novel prognostic biomarker and an ideal therapeutic target for patients with PGI-DLBCL.
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Affiliation(s)
- Zhengzi Qian
- Key Laboratory of Cancer Prevention and Therapy, Department of Lymphoma, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China
| | - Leiyuan Chen
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Xinyuan Wang
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Yutian Kan
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Yafei Wang
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Yong Yu
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Xiaofang Wang
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Zhigang Zhao
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Hongliang Yang
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Peng Ge
- Key Laboratory of Cancer Prevention and Therapy, Department of Laboratory, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China
| | - Tingting Ding
- Key Laboratory of Cancer Prevention and Therapy, Department of Pathology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China
| | - Qiongli Zhai
- Key Laboratory of Cancer Prevention and Therapy, Department of Pathology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China
| | - Haifeng Zhao
- Key Laboratory of Cancer Prevention and Therapy, Department of Hematology, National Clinical Research Center for Cancer, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China.
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Wang X, Kan Y, Chen L, Ge P, Ding T, Zhai Q, Yu Y, Wang X, Zhao Z, Yang H, Liu X, Li L, Qiu L, Qian Z, Zhang H, Wang Y, Zhao H. miR-150 is a negative independent prognostic biomarker for primary gastrointestinal diffuse large B-cell lymphoma. Oncol Lett 2020; 19:3487-3494. [PMID: 32269622 PMCID: PMC7115130 DOI: 10.3892/ol.2020.11452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/30/2020] [Indexed: 12/11/2022] Open
Abstract
A number of studies suggest an association between miRNAs and diffuse large B-cell lymphoma (DLBCL). The present study aimed to investigate the prognostic value of microRNA (miR-150) in primary gastrointestinal (PGI)-DLBCL, by assessing the association between miR-150 expression and clinicopathological characteristics in patients with PGI-DLBCL. A total of 84 patients diagnosed with PGI-DLBCL were recruited and both tumor and adjacent non-tumor tissue samples were collected. miR-150 expression was assessed via reverse transcription-quantitative (RT-q)PCR analysis. The results demonstrated that miR-150 expression was significantly lower in PGI-DLBCL tissues compared with adjacent non-tumor tissues. Furthermore, receiver operating characteristic (ROC) curve analysis indicated that the optimal cut-off value of miR-150 for predicting survival was 8.965 with high sensitivity (79.8%) and specificity (77.1%). Patients were divided into two groups according to this cut-off value, as follows: High (n=18) and low expression (n=66) groups. Low miR-150 expression was significantly associated with clinical stage, International Prognostic Index (IPI), Eastern Cooperative Oncology Group status and use of rituximab. RT-qPCR analysis demonstrated that miR-150 expression was significantly lower in patients with high IPI scores compared with patients with low IPI scores. Downregulated miR-150 expression was significantly associated with shorter overall survival (OS) time and progression-free survival (PFS) time in patients with PGI-DLBCL. Furthermore, miR-150 level and IPI score were identified as two risk factors for OS and PFS. The diagnostic value of miR-150 was evaluated via ROC curve analysis, with an area under the curve value of 0.882. Taken together, the results of the present study suggest that miR-150 is a potential diagnostic marker of PGI-DLBCL, and may also serve as a useful prognostic factor for survival outcomes in patients with PGI-DLBCL.
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Affiliation(s)
- Xinyuan Wang
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Yutian Kan
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Leiyuan Chen
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Peng Ge
- Department of Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Tingting Ding
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Qiongli Zhai
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Yong Yu
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Xiaofang Wang
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Zhigang Zhao
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Hongliang Yang
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Xianming Liu
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Lanfang Li
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Lihua Qiu
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Zhengzi Qian
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Huilai Zhang
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Yafei Wang
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
| | - Haifeng Zhao
- Department of Hematology and Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin 300060, P.R. China
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Zhao P, Zang L, Zhang X, Chen Y, Yang H, Zhao H, Yu Y, Wang Y, Zhang Y, Wang X. The Lymphocyte-Monocyte Ratio and the Platelet-Lymphocyte Ratio at Diagnosis as Independent Prognostic Factors in Primary Gastrointestinal Diffuse Large B Cell Lymphoma. Indian J Hematol Blood Transfus 2016; 33:333-341. [PMID: 28824234 DOI: 10.1007/s12288-016-0720-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/22/2016] [Indexed: 12/13/2022] Open
Abstract
To study the role of the absolute lymphocyte count (ALC), absolute monocyte count (AMC), platelet count (PLT), lymphocyte-monocyte ratio (LMR) and the platelet-lymphocyte ratio (PLR) in the prognosis of primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL). We retrospectively analyzed the prognostic value of the ALC, AMC, PLT, LMR, PLR at diagnosis in 173 PGI-DLBCL patients through histopathological examination from March 2009 to February 2015. In total, 173 patients with histopathological diagnosis of PGI-DLBCL in this study, the median age was 51 years (range 12-90 years), median follow-up time was 44 months (range 7-89 months). In univariate analysis, age <60 years, B symptoms, Lugano stage I-II, low international prognostic index (IPI) or low age-adjusted international prognostic index (aaIPI), normal lactate dehydrogenase (LDH), normal β2-microglobulin (β2m), Hb ≥ 11 g/dL, ALC ≥ 1.5 × 109/L, AMC ≤ 0.50 × 109/L, LMR ≥ 2.5, PLR ≤ 170 were related with superior overall survival (OS) and progression-free survival (PFS) (p ≤ 0.05). Multivariate analysis suggested that ALC, LMR, LDH were related with PFS (p ≤ 0.05). Similarly, age and LMR were related with OS (p ≤ 0.05). The parameters (ALC, AMC, LMR, PLR) may be valuable prognostic factors in PGI-DLBCL patients. LMR, PLR at diagnosis are expected to be independent prognostic factors for PGI-DLBCL patients.
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Affiliation(s)
- Pan Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Li Zang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiaoying Zhang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yafang Chen
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hongliang Yang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Haifeng Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yong Yu
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yafei Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yizhuo Zhang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofang Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
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Rodríguez-Martín L, Aparicio Cabezudo M, Álvarez-Cuenllas B, Linares Torres P, Hernando Martín M, López-Cuesta D, Jorquera Plaza F, Olcoz Goñi JL. [Upper gastrointestinal bleeding due to an uncommon lymphoproliferative process]. GASTROENTEROLOGIA Y HEPATOLOGIA 2016; 39:279-281. [PMID: 25908224 DOI: 10.1016/j.gastrohep.2015.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 06/04/2023]
Affiliation(s)
| | | | | | | | | | - Daniel López-Cuesta
- Servicio de Digestivo, Complejo asistencial universitario de León, León, España
| | | | - J Luis Olcoz Goñi
- Servicio de Digestivo, Complejo asistencial universitario de León, León, España
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Chen Y, Chen Y, Chen S, Wu L, Xu L, Lian G, Yang K, Li Y, Zeng L, Huang K. Primary Gastrointestinal Lymphoma: A Retrospective Multicenter Clinical Study of 415 Cases in Chinese Province of Guangdong and a Systematic Review Containing 5075 Chinese Patients. Medicine (Baltimore) 2015; 94:e2119. [PMID: 26632732 PMCID: PMC5059001 DOI: 10.1097/md.0000000000002119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/10/2015] [Accepted: 10/27/2015] [Indexed: 12/27/2022] Open
Abstract
Primary gastrointestinal lymphoma (PGIL) is a rare malignant tumor without standard diagnosis and treatment methods. This study is aimed to systematically analyze its clinical characteristics and draw out an appropriate flow chart of diagnosis and treatment process for PGIL in China.This study retrospectively analyzed the clinicopathological characteristics, diagnostic approaches, prognostic factors, and therapeutic modalities in 415 cases of PGIL in Chinese province of Guangdong. A systematic review was conducted in 118 studies containing 5075 patients to further identify clinical manifestations and mortalities of therapeutic modalities.The most common clinical presentations were abdominal pain and bloody stools. Endoscopic biopsy was an important diagnostic means, and usually more than once to make a definite diagnosis. Retrospective multicenter clinical study showed that younger onset age (<60 years), female, one region involved, one lesion, early stage, International Prognostic Index (IPI ≤1), normal lactate dehydrogenase (LDH), normal albumin, and nonemergency operation were significant prognostic factors for B-cell lymphoma; non-B symptom, tumor restricted to gastric or ileocecal region, one lesion, performance status (PS ≤1), normal LDH, and nonsurgery alone were significant prognostic factors for T-cell lymphoma. Site of origin and IPI were independent prognostic factors for B-cell lymphoma; PS was the independent prognostic factor for T-cell lymphoma. And T-cell lymphoma had worse overall survival (OS) and progression-free survival (PFS) than B-cell lymphoma. Among different therapeutic modalities, chemotherapy alone or combined with surgery showed better OS and PFS than surgery alone for diffuse large B-cell lymphoma (DLBCL) of stage I/II E and T-cell lymphoma. For DLBCL of stage III E/IV and mucosa-associated lymphoid tissue lymphoma, OS and PFS did not differ among different therapeutic groups. In meta-analysis, surgery plus chemotherapy showed lowest mortality.Chemotherapy alone or combined with surgery may be the first-line treatment for DLBCL of stage I/II E and T-cell lymphoma. A flow chart of diagnosis and treatment process for PGIL was approximately drew out.
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Affiliation(s)
- Yinting Chen
- From the Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation (YiC, SC, GL, KY, YL, KH); Department of Gastroenterology (YiC, SC, GL, KY, YL, KH), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Intensive Care Unit of Internal Medicine (YaC), The First Affiliated Hospital of Sun Yat-Sen University; Department of Ultrasound (LW), The Third Affiliated Hospital of Sun Yat-Sen University; Department of Gastroenterology (LX), Guangdong General Hospital, Guangzhou; and Department of Oncology (LZ), The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
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ZHAO HAIFENG, ZHANG LE, GUO SHANQI, YUAN TIAN, XIA BING, ZHANG LIANYU, ZHANG YIZHUO. Overexpression of DNA methyltransferase 1 as a negative independent prognostic factor in primary gastrointestinal diffuse large B-cell lymphoma treated with CHOP-like regimen and rituximab. Oncol Lett 2015; 9:2307-2312. [PMID: 26137062 PMCID: PMC4467357 DOI: 10.3892/ol.2015.3038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 01/29/2015] [Indexed: 12/14/2022] Open
Abstract
The aims of the present study were to elucidate the transcript levels of DNA methyltransferase (DNMT)1, DNMT3a and DNMT3b by quantitative polymerase chain reaction in patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL), and determine the association of their expression with the clinical parameters and prognostic values of the disease. The results revealed that the expression of DNMT1 in patients with PGI-DLBCL was significantly higher than that in healthy controls (P=0.04), while the expression of DNMT3a and DNMT3b were significantly lower (P<0.001 and P=0.001, respectively). The increased expression of DNMT1 was significantly correlated with shorter overall survival and progression-free survival rates (P=0.018 and P=0.008, respectively). The multivariate analysis demonstrated that the level of DNMT1 was an independent prognostic factor. In conclusion, DNMT1 was identified to be an independent prognostic factor for predicting the survival of patients with PGI-DLBCL; this suggests that it could be used as a marker to indicate the prognosis of PGI-DLBCL.
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Affiliation(s)
- HAIFENG ZHAO
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - LE ZHANG
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - SHANQI GUO
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - TIAN YUAN
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - BING XIA
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - LIANYU ZHANG
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - YIZHUO ZHANG
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
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Chen F, Yang G, Xia B. Increased expression of the spindle checkpoint protein BubR1 is associated with high cell proliferation in primary gastrointestinal diffuse large B cell lymphoma. Cell Biochem Biophys 2014; 66:747-52. [PMID: 23400934 DOI: 10.1007/s12013-013-9519-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL) is a relatively rare malignancy with limited results on clinical characteristics and carcinogenesis. Chromosome instability (CIN) is a hallmark of cancer cells, including lymphoma. As a key component of spindle assembly checkpoint (SAC), BubR1 plays a crucial role in maintaining genome stability. To elucidate the roles of BubR1 in the pathogenesis of PGI-DLBCL, and its relationship to cell proliferation, Helicobacter pylori infection, and BCL-6 gene translocation, we examined the possible alterations of BubR1 protein expression in PGI-DLBCL patients. Paraffin-embedded cancer tissues from 20 PGI-DLBCL patients were evaluated for BubR1 and H. pylori expression by immunohistochemistry, as well as cell proliferative activity measured by Ki-67 proliferation index (PI). BCL-6 gene rearrangement was assessed by fluorescence in situ hybridization (FISH) and BubR1 expression status was compared with clinicopathological parameters in PGI-DLBCL patients. Overexpression of BubR1 was observed in the majority of PGI-DLBCL patients. The mean expression level of BubR1 was 57.33 ± 23.27% in PGI-DLBCL, which was higher than normal gastrointestinal tissue (10.18 ± 5.65%) and reactive lymph node (26.74 ± 8.60%) (P < 0.01), while it was comparable to nodal lymphoma (54.32 ± 21.28%) (P > 0.05). BubR1 overexpression had a positive correlation with Ki-67 proliferation index (PI) (r = 0.51, P < 0.01) in PGI-DLBCL, but had no relationship to H. pylori infection and BCL-6 gene translocation. In addition, no correlation was found between BubR1 expression levels and overall survivals (P > 0.05). BubR1 overexpression was associated with cell proliferation and may play a role in the carcinogenesis of PGI-DLBCL. Aberrant BubR1 expression may potentially be a biomarker for estimating biologic characteristics of PGI-DLBCL.
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Affiliation(s)
- Fei Chen
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, Wuhan, People's Republic of China
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Jawad A, Bar AH, Merianos D, Zhou J. MALT Lymphoma of the Gastric Remnant After Roux-en-Y Gastric Bypass. J Gastrointest Cancer 2012; 43 Suppl 1:S194-7. [DOI: 10.1007/s12029-012-9386-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Asadi Gharabaghi M, Abdollahi P, Kalany M, Sotoudeh M. Systemic lupus erythematosus presenting with eosinophilic enteritis: a case report. J Med Case Rep 2011; 5:235. [PMID: 21702974 PMCID: PMC3143100 DOI: 10.1186/1752-1947-5-235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 06/25/2011] [Indexed: 12/23/2022] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis. Case presentation A 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis. Conclusion Considering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.
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Affiliation(s)
- Mehrnaz Asadi Gharabaghi
- Department of General Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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