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Harris AC, MacLean KA, Grunau GL, Chang SD, Martin N. Imaging Intra-abdominal Burkitt's Lymphoma: From Discrete Bowel Wall Thickening to Diffuse Soft Tissue Infiltration. Can Assoc Radiol J 2017; 68:286-292. [PMID: 28578810 DOI: 10.1016/j.carj.2016.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 08/12/2016] [Accepted: 08/15/2016] [Indexed: 11/18/2022] Open
Abstract
Burkitt's lymphoma is a highly aggressive non-Hodgkin's B-cell lymphoma, which often presents with intra-abdominal involvement. The purpose of this pictorial review is to illustrate the various intra-abdominal imaging findings of Burkitt's lymphoma. Extranodal disease at presentation is common, including involvement of the bowel, stomach, pancreas, spleen, and mesentery.
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Affiliation(s)
- Alison C Harris
- Department of Radiology, Abdominal Division, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly A MacLean
- University of British Columbia Radiology Residency Program, Vancouver, British Columbia, Canada
| | - Gilat L Grunau
- University of British Columbia Radiology Residency Program, Vancouver, British Columbia, Canada.
| | - Silvia D Chang
- Department of Radiology, Abdominal Division, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy Martin
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
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Tarella C, Gueli A, Delaini F, Rossi A, Barbui AM, Gritti G, Boschini C, Caracciolo D, Bruna R, Ruella M, Gottardi D, Passera R, Rambaldi A. Rate of primary refractory disease in B and T-cell non-Hodgkin's lymphoma: correlation with long-term survival. PLoS One 2014; 9:e106745. [PMID: 25255081 PMCID: PMC4177839 DOI: 10.1371/journal.pone.0106745] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/01/2014] [Indexed: 01/27/2023] Open
Abstract
Background Primary refractory disease is a main challenge in the management of non-Hodgkin’s Lymphoma (NHL). This survey was performed to define the rate of refractory disease to first-line therapy in B and T-cell NHL subtypes and the long-term survival of primary refractory compared to primary responsive patients. Methods Medical records were reviewed of 3,106 patients who had undergone primary treatment for NHL between 1982 and 2012, at the Hematology Centers of Torino and Bergamo, Italy. Primary treatment included CHOP or CHOP-like regimens (63.2%), intensive therapy with autograft (16.9%), or other therapies (19.9%). Among B-cell NHL, 1,356 (47.8%) received first-line chemotherapy with rituximab. Refractory disease was defined as stable/progressive disease, or transient response with disease progression within six months. Results Overall, 690 (22.2%) patients showed primary refractory disease, with a higher incidence amongst T-cell compared to B-cell NHL (41.9% vs. 20.5%, respectively, p<0.001). Several other clinico-pathological factors at presentation were variably associated with refractory disease, including histological aggressive disease, unfavorable clinical presentation, Bone Marrow involvement, low lymphocyte/monocyte ration and male gender. Amongst B-cell NHL, the addition of rituximab was associated with a marked reduction of refractory disease (13.6% vs. 26.7% for non-supplemented chemotherapy, p<0.001). Overall, primary responsive patients had a median survival of 19.8 years, compared to 1.3 yr. for refractory patients. A prolonged survival was consistently observed in all primary responsive patients regardless of the histology. The long life expectancy of primary responsive patients was documented in both series managed before and after 2.000. Response to first line therapy resulted by far the most predictive factor for long-term outcome (HR for primary refractory disease: 16.52, p<0.001). Conclusion Chemosensitivity to primary treatment is crucial for the long-term survival in NHL. This supports the necessity of studies aimed to early identify refractory disease and to develop different treatment strategies for responsive and refractory patients.
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Affiliation(s)
- Corrado Tarella
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Division, Mauriziano Hospital, Torino, Italy
- * E-mail:
| | - Angela Gueli
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Division, Mauriziano Hospital, Torino, Italy
| | - Federica Delaini
- Hematology and Bone Marrow Transplant Units, A. O. Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Rossi
- Hematology and Bone Marrow Transplant Units, A. O. Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Maria Barbui
- Hematology and Bone Marrow Transplant Units, A. O. Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Gritti
- Hematology and Bone Marrow Transplant Units, A. O. Papa Giovanni XXIII, Bergamo, Italy
| | - Cristina Boschini
- Hematology and Bone Marrow Transplant Units, A. O. Papa Giovanni XXIII, Bergamo, Italy
| | - Daniele Caracciolo
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Division of Hematology I, A. O. Città della Salute, Torino, Italy
| | - Riccardo Bruna
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Division, Mauriziano Hospital, Torino, Italy
| | - Marco Ruella
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Division, Mauriziano Hospital, Torino, Italy
| | - Daniela Gottardi
- Department of Biotechnology and Life Sciences, University of Torino, Torino, Italy
- Hematology and Cell Therapy Division, Mauriziano Hospital, Torino, Italy
| | - Roberto Passera
- Division of Nuclear Medicine, University of Torino, Torino, Italy
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Abstract
Malignant lymphomas represent approximately 5% of all malignant neoplasms of the head and neck area. They are classically divided into two subgroups, Hodgkin's lymphomas (HLs) and non-Hodgkin's lymphomas (NHLs). We describe the clinical characteristics of head and neck lymphomas and the methods to establish the diagnosis. The World Health Organization classification of lymphoid tissues describes more than 50 different histological types, and we analyse the most common staging system for lymphomas, the Ann Arbor staging system. Finally, the different therapeutic approaches are discussed.
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Affiliation(s)
- E Zapater
- ENT Department, University General Hospital, Valencia Medical School, Valencia, Spain.
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Ojha J, Gupta A, Aziz N. Intraoral diffuse large B-cell lymphoma with Burkitt-like morphology in an HIV-positive patient--a diagnostic dilemma. J Oral Maxillofac Surg 2010; 68:2632-8. [PMID: 20591554 DOI: 10.1016/j.joms.2009.09.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Revised: 09/07/2009] [Accepted: 09/11/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Junu Ojha
- Department of Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI 48208-2576, USA.
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Affiliation(s)
- Cary Peterson
- Southeast Nebraska Hematology and Oncology Consultants, PC, Lincoln, NE
| | | | - Warren Sanger
- Human Genetics Laboratory, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Parker SM, Olteanu H, VanTuinen P, Lawton CA, Schultz CJ, Christians KK, Fenske TS. Follicular lymphoma transformation to dual translocated Burkitt-like lymphoma: improved disease control associated with radiation therapy. Int J Hematol 2009; 90:616-622. [PMID: 19937165 DOI: 10.1007/s12185-009-0444-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 09/16/2009] [Accepted: 10/29/2009] [Indexed: 10/20/2022]
Abstract
Dual translocated (or "dual hit") lymphomas are highly aggressive B cell neoplasms associated with an extremely poor prognosis. The optimal treatment for these lymphomas remains undefined. We present two cases of follicular lymphoma with transformation to Burkitt-like lymphoma. In both cases dual translocations involving both the bcl-2 and c-myc loci were present. Each patient underwent intensive induction immunochemotherapy followed by autologous stem cell transplantation and radiation therapy. The first patient received post-transplant mediastinal radiation and developed recurrence in multiple areas outside of the radiation field. The second patient received total body irradiation as part of the conditioning regimen, and is without recurrence 18 months after transplant, and 24 months after diagnosis of the dual translocated lymphoma. We review dual translocation B cell lymphoma in the setting of transformation from follicular lymphoma, and suggest a potential role for total body irradiation in the management of this highly aggressive non-Hodgkin lymphoma.
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Affiliation(s)
- Stacey M Parker
- Department of Internal Medicine, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Horatiu Olteanu
- Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Peter VanTuinen
- Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Colleen A Lawton
- Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christopher J Schultz
- Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Timothy S Fenske
- Division of Neoplastic Diseases and Related Disorders, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA.
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