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Ahmadullah, Bilal M, Khan Y. Pattern of Clinical Presentation in Patients With Lymphoma. Cureus 2024; 16:e62211. [PMID: 39011218 PMCID: PMC11249278 DOI: 10.7759/cureus.62211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction Lymphomas take place when cells of the lymphatic system divide and re-divide in an uncontrolled fashion, and lymphomas have been termed as a "diverse group" of cancer, playing a major role in the area of oncology. The clinical behavior and manifestations of lymphomas in the head and neck region usually lack specific characteristics that would enable attribution to a specific lymphoma entity without biopsy and histological evidence. This study aimed to determine the frequency of common clinical features among patients with lymphoma. Methods This descriptive cross-sectional study was conducted at the Department of General Medicine, Lady Reading Hospital, Peshawar, from October 28, 2021 to April 28, 2022. The inclusion criteria consisted of individuals who were recently diagnosed with lymphoma and were between the ages of 10 and 50, regardless of their gender. This study enrolled a total of 186 patients diagnosed with lymphoma and assessed for common signs and symptoms. The data-gathering process included in-depth interviews, evaluations of medical history, physical exams, and initial investigations. The data analysis was done using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States). Results The mean age of the patients was 34.5±9.6 years. Out of the total, 115 (61.8%) were men and 71 (38.2%) were women. With regard to symptoms, 134 (72%) had a fever, 80 (43%) had abdominal pain, 102 (54.8%) had vomiting, 49 (26.3%) had a headache, 111 (59.7%) had weight loss, and 17 (9.1%) had a cough. With regard to signs, 33 (17.7%) had painless lymphadenopathy, 58 (31.2%) had jaundice, 157 (84.4%) had anemia, 147 (79%) had hepatomegaly, 160 (86%) had splenomegaly, 24 (12.9%) had ascites, and 16 (8.6%) had abdominal tenderness. Conclusion The varied clinical appearance of lymphoma makes treatment difficult. In severe cases of lymphoma, early and timely diagnosis is crucial for proper and prompt treatment. The signs and symptoms, along with demographic information of patients, thorough medical history, imaging testing, and clinical examination, may indicate lymphoma.
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Affiliation(s)
- Ahmadullah
- Department of Medicine, Lady Reading Hospital, Peshawar, PAK
| | - Muhammad Bilal
- Department of Internal Medicine, Lady Reading Hospital, Peshawar, PAK
| | - Yaseen Khan
- Department of Internal Medicine, Lady Reading Hospital, Peshawar, PAK
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Diao Z, Jiang H. A multi-instance tumor subtype classification method for small PET datasets using RA-DL attention module guided deep feature extraction with radiomics features. Comput Biol Med 2024; 174:108461. [PMID: 38626509 DOI: 10.1016/j.compbiomed.2024.108461] [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: 08/04/2023] [Revised: 03/21/2024] [Accepted: 04/07/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Positron emission tomography (PET) is extensively employed for diagnosing and staging various tumors, including liver cancer, lung cancer, and lymphoma. Accurate subtype classification of tumors plays a crucial role in formulating effective treatment plans for patients. Notably, lymphoma comprises subtypes like diffuse large B-cell lymphoma and Hodgkin's lymphoma, while lung cancer encompasses adenocarcinoma, small cell carcinoma, and squamous cell carcinoma. Similarly, liver cancer consists of subtypes such as cholangiocarcinoma and hepatocellular carcinoma. Consequently, the subtype classification of tumors based on PET images holds immense clinical significance. However, in clinical practice, the number of cases available for each subtype is often limited and imbalanced. Therefore, the primary challenge lies in achieving precise subtype classification using a small dataset. METHOD This paper presents a novel approach for tumor subtype classification in small datasets using RA-DL (Radiomics-DeepLearning) attention. To address the limited sample size, Support Vector Machines (SVM) is employed as the classifier for tumor subtypes instead of deep learning methods. Emphasizing the importance of texture information in tumor subtype recognition, radiomics features are extracted from the tumor regions during the feature extraction stage. These features are compressed using an autoencoder to reduce redundancy. In addition to radiomics features, deep features are also extracted from the tumors to leverage the feature extraction capabilities of deep learning. In contrast to existing methods, our proposed approach utilizes the RA-DL-Attention mechanism to guide the deep network in extracting complementary deep features that enhance the expressive capacity of the final features while minimizing redundancy. To address the challenges of limited and imbalanced data, our method avoids using classification labels during deep feature extraction and instead incorporates 2D Region of Interest (ROI) segmentation and image reconstruction as auxiliary tasks. Subsequently, all lesion features of a single patient are aggregated into a feature vector using a multi-instance aggregation layer. RESULT Validation experiments were conducted on three PET datasets, specifically the liver cancer dataset, lung cancer dataset, and lymphoma dataset. In the context of lung cancer, our proposed method achieved impressive performance with Area Under Curve (AUC) values of 0.82, 0.84, and 0.83 for the three-classification task. For the binary classification task of lymphoma, our method demonstrated notable results with AUC values of 0.95 and 0.75. Moreover, in the binary classification task of liver tumor, our method exhibited promising performance with AUC values of 0.84 and 0.86. CONCLUSION The experimental results clearly indicate that our proposed method outperforms alternative approaches significantly. Through the extraction of complementary radiomics features and deep features, our method achieves a substantial improvement in tumor subtype classification performance using small PET datasets.
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Affiliation(s)
- Zhaoshuo Diao
- Software College, Northeastern University, Shenyang 110819, China
| | - Huiyan Jiang
- Software College, Northeastern University, Shenyang 110819, China; Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang 110819, China.
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Li X, Zhang Y, Wang C, Wang L, Ye Y, Xue R, Shi Y, Su Q, Zhu Y, Wang L. Drug-Loaded Biomimetic Carriers for Non-Hodgkin's Lymphoma Therapy: Advances and Perspective. ACS Biomater Sci Eng 2024; 10:723-742. [PMID: 38296812 DOI: 10.1021/acsbiomaterials.3c01480] [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] [Indexed: 02/02/2024]
Abstract
Chemotherapy remains the mainstay of treatment for the lymphoma patient population, despite its relatively poor therapeutic results, high toxicity, and low specificity. With the advancement of biotechnology, the significance of drug-loading biomimetic materials in the medical field has become increasingly evident, attracting extensive attention from the scientific community and the pharmaceutical industry. Given that they can cater to the particular requirements of lymphoma patients, drug-loading biomimetic materials have recently become a potent and promising delivery approach for various applications. This review mainly reviews the recent advancements in the treatment of tumors with biological drug carrier-loaded drugs, outlines the mechanisms of lymphoma development and the diverse treatment modalities currently available, and discusses the merits and limitations of biological drug carriers. What is more, the practical application of biocarriers in tumors is explored by providing examples, and the possibility of loading such organisms with antilymphoma drugs for the treatment of lymphoma is conceived.
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Affiliation(s)
- Xiaoqi Li
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong China
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
- Linyi Key Laboratory of Nanomedicine, Linyi 276000, Shandong China
| | - Yu Zhang
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
- Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong China
| | - Chao Wang
- Department of Hematology, Linyi People's Hospital, Linyi 276000, Shandong China
| | - Liyuan Wang
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong China
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
- Linyi Key Laboratory of Nanomedicine, Linyi 276000, Shandong China
| | - Yufu Ye
- Department of Hepatobiliary and Pancreatic Surgery, the First Affliliated Hospital, Zhejiang University School of Medicine, Hangzhou310000, Zhejiang China
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, School of Medicine, Hangzhou310000, Zhejiang China
| | - Renyu Xue
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
| | - Yuanwei Shi
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong China
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
| | - Quanping Su
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
| | - Yanxi Zhu
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
- Linyi Key Laboratory of Nanomedicine, Linyi 276000, Shandong China
- Key Laboratory for Translational Oncology, Xuzhou Medical University, Xuzhou 221000, Jiangsu China
| | - Lijuan Wang
- Central Laboratory, Linyi People's Hospital, Linyi 276000, Shandong China
- Linyi Key Laboratory of Tumor Biology, Linyi 276000, Shandong China
- Linyi Key Laboratory of Nanomedicine, Linyi 276000, Shandong China
- Key Laboratory for Translational Oncology, Xuzhou Medical University, Xuzhou 221000, Jiangsu China
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Tyryshkin K, Moore A, Good D, Popov J, Crocker S, Rauh MJ, Baetz T, LeBrun DP. Expression of TCF3 target genes defines a subclass of diffuse large B-cell lymphoma characterized by up-regulation of MYC target genes and poor clinical outcome following R-CHOP therapy. Leuk Lymphoma 2023; 64:119-129. [PMID: 36336953 DOI: 10.1080/10428194.2022.2136968] [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: 11/09/2022]
Abstract
TCF3 is a lymphopoietic transcription factor that acquires somatic driver mutations in diffuse large B-cell lymphoma (DLBCL). Hypothesizing that expression patterns of TCF3-regulated genes can inform clinical management, we found that unsupervised clustering analysis with 15 TCF3-regulated genes and eight additional ones resolved local DLBCL cases into two main clusters, denoted Groups A and B, of which Group A manifested inferior overall survival (OS, p = 0.0005). We trained a machine learning model to classify samples into the Groups based on expression of the 23 transcripts in an independent validation cohort of 569 R-CHOP-treated DLBCL cases. Group A overlapped with the ABC cell-of-origin subgroup but its prognostic power was superior. GSEA analysis demonstrated asymmetric expression of 30 gene sets between the Groups, pointing to biological differences. We present, validate and make available a novel method to assign DLBCL cases into biologically-distinct groups with divergent OS following R-CHOP therapy.
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Affiliation(s)
- Kathrin Tyryshkin
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.,School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Alison Moore
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - David Good
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Jesse Popov
- Department of Internal Medicine, Queen's University, Kingston, Ontario, Canada
| | - Susan Crocker
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Michael J Rauh
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Tara Baetz
- Department of Medical Oncology, Queen's University, Kingston, Ontario, Canada
| | - David P LeBrun
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
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Dreval K, Boutros PC, Morin RD. Minimal information for reporting a genomics experiment. Blood 2022; 140:2549-2555. [PMID: 36219881 PMCID: PMC10653092 DOI: 10.1182/blood.2022016095] [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: 05/27/2022] [Revised: 09/08/2022] [Accepted: 09/30/2022] [Indexed: 11/20/2022] Open
Abstract
Exome and genome sequencing has facilitated the identification of hundreds of genes and other regions that are recurrently mutated in hematologic neoplasms. The data sets from these studies theoretically provide opportunities. Quality differences between data sets can confound secondary analyses. We explore the consequences of these on the conclusions from some recent studies of B-cell lymphomas. We highlight the need for a minimum reporting standard to increase transparency in genomic research.
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Affiliation(s)
- Kostiantyn Dreval
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
- Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
| | - Paul C. Boutros
- Departments of Human Genetics and Urology, University of California, Los Angeles, CA
| | - Ryan D. Morin
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
- Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
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Jakša R, Karolová J, Svatoň M, Kazantsev D, Grajciarová M, Pokorná E, Tonar Z, Klánová M, Winkowska L, Maláriková D, Vočková P, Forsterová K, Renešová N, Dolníková A, Nožičková K, Dundr P, Froňková E, Trněný M, Klener P. Complex genetic and histopathological study of 15 patient-derived xenografts of aggressive lymphomas. J Transl Med 2022; 102:957-965. [PMID: 36775424 PMCID: PMC9420679 DOI: 10.1038/s41374-022-00784-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/14/2022] Open
Abstract
Non-Hodgkin lymphomas (NHL) represent the most common hematologic malignancies. Patient-derived xenografts (PDXs) are used for various aspects of translational research including preclinical in vivo validation of experimental treatment approaches. While it was repeatedly demonstrated that PDXs keep majority of somatic mutations with the primary lymphoma samples, from which they were derived, the composition of PDX tumor microenvironment (TME) has not been extensively studied. We carried out a comparative genetic and histopathological study of 15 PDX models derived from patients with various types of NHL including diffuse large B-cell lymphoma (DLBCL; n = 7), Burkitt lymphoma (BL; n = 1), mantle cell lymphoma (MCL; n = 2), and peripheral T-cell lymphomas (PTCL; n = 5). Whole exome sequencing (WES) of the PDXs and primary lymphoma cells was implemented in 13 out of 15 cases with available DNA samples. Standard immunohistochemistry (IHC) was used to analyze the composition of PDX TME. WES data confirmed that PDXs maintained the genetic heterogeneity with the original primary lymphoma cells. In contrast, IHC analysis revealed the following recurrently observed alterations in the composition of PDX tumors: more blastoid lymphoma cell morphology, increased proliferation rate, lack of non-malignant cellular components including T cells and (human or murine) macrophages, and significantly lower intratumoral microvessel density and microvessel area composed of murine vessels. In addition, PDX tumors derived from T-NHL displayed additional differences compared to the primary lymphoma samples including markedly lower desmoplasia (i.e., the extent of both reticular and collagen fibrosis), loss of expression of cytotoxic granules (i.e., perforin, TIA, granzyme B), or loss of expression of T-cell specific antigens (i.e., CD3, CD4, CD8). Our data suggest that despite keeping the same genetic profiles, PDX models of aggressive NHL do not recapitulate the microenvironmental heterogeneity of the original lymphomas. These findings have implications on the relevance of PDX models in the context of preclinical research.
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Affiliation(s)
- Radek Jakša
- Institute of Pathology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Karolová
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michael Svatoň
- CLIP- Childhood Leukaemia Investigation Prague, Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Dmitry Kazantsev
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martina Grajciarová
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Eva Pokorná
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zbyněk Tonar
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Magdalena Klánová
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lucie Winkowska
- CLIP- Childhood Leukaemia Investigation Prague, Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Diana Maláriková
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petra Vočková
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristina Forsterová
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nicol Renešová
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexandra Dolníková
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristýna Nožičková
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Dundr
- Institute of Pathology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eva Froňková
- CLIP- Childhood Leukaemia Investigation Prague, Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marek Trněný
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Klener
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- First Department of Medicine- Hematology, University General Hospital Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic.
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Etrych T, Braunova A, Zogala D, Lambert L, Renesova N, Klener P. Targeted Drug Delivery and Theranostic Strategies in Malignant Lymphomas. Cancers (Basel) 2022; 14:626. [PMID: 35158894 PMCID: PMC8833783 DOI: 10.3390/cancers14030626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 12/12/2022] Open
Abstract
Malignant lymphomas represent the most common type of hematologic malignancies. The first clinically approved TDD modalities in lymphoma patients were anti-CD20 radioimmunoconjugates (RIT) 131I-tositumomab and 90Y-ibritumomab-tiuxetan. The later clinical success of the first approved antibody-drug conjugate (ADC) for the treatment of lymphomas, anti-CD30 brentuximab vedotin, paved the path for the preclinical development and clinical testing of several other ADCs, including polatuzumab vedotin and loncastuximab tesirine. Other modalities of TDD are based on new formulations of "old" cytostatic agents and their passive trapping in the lymphoma tissue by means of the enhanced permeability and retention (EPR) effect. Currently, the diagnostic and restaging procedures in aggressive lymphomas are based on nuclear imaging, namely PET. A theranostic approach that combines diagnostic or restaging lymphoma imaging with targeted treatment represents an appealing innovative strategy in personalized medicine. The future of theranostics will require not only the capability to provide suitable disease-specific molecular probes but also expertise on big data processing and evaluation. Here, we review the concept of targeted drug delivery in malignant lymphomas from RIT and ADC to a wide array of passively and actively targeted nano-sized investigational agents. We also discuss the future of molecular imaging with special focus on monoclonal antibody-based and monoclonal antibody-derived theranostic strategies.
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Affiliation(s)
- Tomas Etrych
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, 162 06 Prague, Czech Republic; (T.E.); (A.B.)
| | - Alena Braunova
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, 162 06 Prague, Czech Republic; (T.E.); (A.B.)
| | - David Zogala
- Institute of Nuclear Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, 128 08 Prague, Czech Republic;
| | - Lukas Lambert
- Department of Radiology, General University Hospital and First Faculty of Medicine, Charles University in Prague, 128 08 Prague, Czech Republic;
| | - Nicol Renesova
- First Faculty of Medicine, Institute of Pathological Physiology, Charles University, 121 08 Prague, Czech Republic;
| | - Pavel Klener
- First Faculty of Medicine, Institute of Pathological Physiology, Charles University, 121 08 Prague, Czech Republic;
- First Department of Internal Medicine-Hematology, General University Hospital and First Faculty of Medicine, Charles University in Prague, 128 08 Prague, Czech Republic
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Kumar C, Jain G, Gupta A, Pramanik R, Chopra A. Extra-nasal NK-T Cell Lymphoma: A rare case with a rarer presentation. Cytopathology 2022; 33:518-521. [PMID: 34995382 DOI: 10.1111/cyt.13095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chandan Kumar
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Jain
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Anshul Gupta
- Medical Oncology Department, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Raja Pramanik
- Medical Oncology Department, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
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Qi Y, Kong X, Wang X, Zhai J, Fang Y, Wang J. Metastasis to Breast from Extramammary Solid Tumors and Lymphomas: A 20-Year Population-Based Study. Cancer Invest 2021; 40:325-336. [PMID: 34937471 DOI: 10.1080/07357907.2021.2019264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To discuss the clinicopathological features and prognosis of metastases to the breast from extramammary solid tumors and lymphomas, we reviewed Cancer Hospital of Chinese Academy of Medical Sciences database from 01/01/2000 to 12/31/2020. Fifty-nine patients were identified. The most common primary sites for breast metastases were lymph node and pulmonary, followed by nasal cavity, ovary, skin, etc. All the patients were treated with chemotherapy, 18 were operated, 14 accepted radiotherapy. Metastasis to breast should be considered in any patient with tumor history presenting a breast lump. Pathological with immunohistochemical examination should be performed to identify the original site.
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Affiliation(s)
- Yihang Qi
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Zhai
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Cascone R, Carlucci A, Messina G, Noro A, Bove M, Natale G, Sagnelli C, Opromolla G, Martone M, Santoriello C, Santoriello E, Verolino P, Creta M, Vicidomini G, Fiorelli A, Santini M, Sica A. Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients. Healthcare (Basel) 2021; 9:healthcare9060770. [PMID: 34205526 PMCID: PMC8235016 DOI: 10.3390/healthcare9060770] [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] [Received: 05/07/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy.
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Affiliation(s)
- Roberto Cascone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Annalisa Carlucci
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonio Noro
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mary Bove
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Giovanni Natale
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-33938107860 or +39-08119573375
| | - Giorgia Opromolla
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Martone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Carlo Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Elena Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Pasquale Verolino
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, 80131 Naples, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
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New developments in non-Hodgkin lymphoid malignancies. Pathology 2021; 53:349-366. [PMID: 33685720 DOI: 10.1016/j.pathol.2021.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/23/2022]
Abstract
The revised fourth edition of the World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissues (2017) reflects significant advances in understanding the biology, genetic basis and behaviour of haematopoietic neoplasms. This review focuses on some of the major changes in B-cell and T-cell non-Hodgkin lymphomas in the 2017 WHO and includes more recent updates. The 2017 WHO saw a shift towards conservatism in the classification of precursor lesions of small B-cell lymphomas such as monoclonal B-cell lymphocytosis, in situ follicular and in situ mantle cell neoplasms. With more widespread use of next generation sequencing (NGS), special entities within follicular lymphoma and mantle cell lymphoma were recognised with recurrent genetic aberrations and unique clinicopathological features. The diagnostic workup of lymphoplasmacytic lymphoma and hairy cell leukaemia has been refined with the discovery of MYD88 L265P and BRAF V600E mutations, respectively, in these entities. Recommendations in the immunohistochemical evaluation of diffuse large B-cell lymphoma include determining cell of origin and expression of MYC and BCL2, so called 'double-expressor' phenotype. EBV-positive large B-cell lymphoma of the elderly has been renamed to recognise its occurrence amongst a wider age group. EBV-positive mucocutaneous ulcer is a newly recognised entity with indolent clinical behaviour that occurs in the setting of immunosuppression. Two lymphomas with recurrent genetic aberrations are newly included provisional entities: Burkitt-like lymphoma with 11q aberration and large B-cell lymphoma with IRF4 rearrangement. Aggressive B-cell lymphomas with MYC, BCL2 and/or BCL6 rearrangements, so called 'double-hit/triple-hit' lymphomas are now a distinct entity. Much progress has been made in understanding intestinal T-cell lymphomas. Enteropathy-associated T-cell lymphoma, type II, is now known to not be associated with coeliac disease and is hence renamed monomorphic epitheliotropic T-cell lymphoma. An indolent clonal T-cell lymphoproliferative disorder of the GI tract is a newly included provisional entity. Angioimmunoblastic T-cell lymphoma and nodal T-cell lymphomas with T-follicular helper phenotype are included in a single broad category, emphasising their shared genetic and phenotypic features. Anaplastic large cell lymphoma, ALK- is upgraded to a definitive entity with subsets carrying recurrent rearrangements in DUSP22 or TP63. Breast implant-associated anaplastic large cell lymphoma is a new provisional entity with indolent behaviour. Finally, cutaneous T-cell proliferations include a new provisional entity, primary cutaneous acral CD8-positive T-cell lymphoma, and reclassification of primary small/medium CD4-positive T-cell lymphoma as lymphoproliferative disorder.
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Farrall AL, Smith JR. Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study. Cancers (Basel) 2021; 13:cancers13030403. [PMID: 33499081 PMCID: PMC7865336 DOI: 10.3390/cancers13030403] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary In Australia, all cancers are recorded in the Australian Cancer Database. We used pathological and anatomical classification codes to identify cases of brain lymphoma—termed primary central nervous system lymphoma or PCNSL—that had occurred in Australia during the past four decades. This allowed us to calculate the incidence of PCNSL, as well as the overall survival after diagnosis with this lymphoma. PCNSL is rare, recently affecting approximately 4 per one million adult Australians per year. However, the number of people diagnosed with this cancer is increasing. Survival of people diagnosed with PCNSL has been improving, but is still low, with only 33% of people alive at 5 years after receiving this diagnosis. As the first survey of the incidence of PCSNL in Australia and the survival of Australians diagnosed with this rare cancer, our research supports current efforts to understand risk factors and improve outcomes. Abstract Primary central nervous system lymphoma (PCNSL) is a rare brain cancer that remains challenging to study. Epidemiology of PCNSL in the Australian population, which is racially and ethnically diverse, has not been examined previously. Using ICD-O-3.1 Morphology and Topography Codes to identify cases, we analyzed complete datasets from the comprehensive Australian Cancer Database (1982–2014, adults aged ≥ 20 years) to establish incidence rates and trends of PCNSL, and to define survival outcomes of individuals diagnosed with PCNSL, including the predominant diffuse large B-cell lymphoma (DLBCL) type. Age-standardized incidence of PCNSL increased by an average annual 6.8% percent over the study period, with current incidence of 0.43 (95% confidence interval, 0.41–0.46) per 100,000 person-years, in comparison to 21.89 (21.41–22.38) per 100,000 person-years for non-CNS lymphoma. Increase in incidence was characterized by an acute rise between 1996 and 1999, was more pronounced with increasing age, and was driven by increasing incidence of DLBCL. Overall survival for persons diagnosed with PCNSL improved significantly across the study period, with 5-year survival probability increasing from 0.21 (95% confidence interval, 0.16–0.26) to 0.33 (0.30–0.36), and median survival increasing from 318 to 600 days, between 1982–1999 and 2000–2014. Increase in survival was significantly higher for persons with DLBCL versus non-DLBCL PCNSL, but substantially lower than that for persons with non-CNS lymphoma, who had a 5-year survival probability of 0.62 (0.62–0.62) and a median survival of 3388 days in 2000–2014. This study links increasing incidence of PCNSL in Australia to increasing incidence of DLCBL, including in younger adults, and highlights the improving, but low, survival outcome of this cancer.
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Zhang X, Zhang K, Jiang M, Yang L. Research on the classification of lymphoma pathological images based on deep residual neural network. Technol Health Care 2021; 29:335-344. [PMID: 33682770 PMCID: PMC8150517 DOI: 10.3233/thc-218031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Malignant lymphoma is a type of tumor that originated from the lymphohematopoietic system, with complex etiology, diverse pathological morphology, and classification. It takes a lot of time and energy for doctors to accurately determine the type of lymphoma by observing pathological images. OBJECTIVE At present, an automatic classification technology is urgently needed to assist doctors in analyzing the type of lymphoma. METHODS In this paper, by comparing the training results of the BP neural network and BP neural network optimized by genetic algorithm (GA-BP), adopts a deep residual neural network model (ResNet-50), with 374 lymphoma pathology images as the experimental data set. After preprocessing the dataset by image flipping, color transformation, and other data enhancement methods, the data set is input into the ResNet-50 network model, and finally classified by the softmax layer. RESULTS The training results showed that the classification accuracy was 98.63%. By comparing the classification effect of GA-BP and BP neural network, the accuracy of the network model proposed in this paper is improved. CONCLUSIONS The network model can provide an objective basis for doctors to diagnose lymphoma types.
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Affiliation(s)
- Xiaoli Zhang
- College of Intelligence and Information Engineering, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Kuixing Zhang
- College of Intelligence and Information Engineering, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Mei Jiang
- College of Intelligence and Information Engineering, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Lin Yang
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
- Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
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Ennishi D, Hsi ED, Steidl C, Scott DW. Toward a New Molecular Taxonomy of Diffuse Large B-cell Lymphoma. Cancer Discov 2020; 10:1267-1281. [DOI: 10.1158/2159-8290.cd-20-0174] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022]
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Scientific Advances and the Evolution of Diagnosis, Subclassification and Treatment of Lymphoma. Arch Med Res 2020; 51:749-764. [PMID: 32553461 DOI: 10.1016/j.arcmed.2020.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022]
Abstract
The diagnosis of lymphoma has evolved tremendously over time. Initially, diagnosis of lymphoma was largely based on morphology alone. Over time, immunophenotyping using flow cytometry and immunohistochemistry, and then in situ hybridization, have contributed dramatically to the pathologist's ability to recognize, diagnose and subclassify lymphomas more precisely. In recent years, cytogenetic and molecular genetic techniques have developed that allow evaluation of abnormalities in lymphomas, leading to an understanding of their pathogenesis and opening the door to targeted therapies that will lead to better outcomes for lymphoma patients.
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Drug Resistance in Non-Hodgkin Lymphomas. Int J Mol Sci 2020; 21:ijms21062081. [PMID: 32197371 PMCID: PMC7139754 DOI: 10.3390/ijms21062081] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/14/2020] [Accepted: 03/15/2020] [Indexed: 12/15/2022] Open
Abstract
Non-Hodgkin lymphomas (NHL) are lymphoid tumors that arise by a complex process of malignant transformation of mature lymphocytes during various stages of differentiation. The WHO classification of NHL recognizes more than 90 nosological units with peculiar pathophysiology and prognosis. Since the end of the 20th century, our increasing knowledge of the molecular biology of lymphoma subtypes led to the identification of novel druggable targets and subsequent testing and clinical approval of novel anti-lymphoma agents, which translated into significant improvement of patients’ outcome. Despite immense progress, our effort to control or even eradicate malignant lymphoma clones has been frequently hampered by the development of drug resistance with ensuing unmet medical need to cope with relapsed or treatment-refractory disease. A better understanding of the molecular mechanisms that underlie inherent or acquired drug resistance might lead to the design of more effective front-line treatment algorithms based on reliable predictive markers or personalized salvage therapy, tailored to overcome resistant clones, by targeting weak spots of lymphoma cells resistant to previous line(s) of therapy. This review focuses on the history and recent advances in our understanding of molecular mechanisms of resistance to genotoxic and targeted agents used in clinical practice for the therapy of NHL.
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