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Xie R, Mao Z, Xu X, Sun T. Epidemiological features and a survival nomogram for primary lymphoma of the male genital tract. Ann Hematol 2024; 103:1687-1695. [PMID: 38424302 DOI: 10.1007/s00277-024-05668-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Primary lymphoma of the male genital tract (PLMGT) is rare, and data on its epidemiology and prognosis are lacking. Our study aimed to estimate the incidence and develop a predictive nomogram for PLMGT. We pooled the incidence and survival data of PLMGT over the last 20 years from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence rates were calculated by year of diagnosis, age, race, and histology. Independent prognostic factors selected by Cox regression analysis were used to develop a nomogram for predicting overall survival (OS). Our study enrolled 1312 patients with PLMGT. The overall incidence rate of PLMGT was 0.437/1,000,000 during 2000-2019. OS was associated with age, marital status, histological subtype, Ann Arbor stage, and therapeutic strategy, which were used to construct nomograms to predict 1-, 3-, and 5-year OS rates. Receiver operating characteristic curves, calibration plots, and decision curve analysis showed good performance of the nomogram. Based on the total score of each patient from the nomogram, the patients were clustered into three risk groups, and the risk stratification model was more successful in predicting clinical outcomes than the traditional Ann Arbor staging system. The incidence rate of PLMGT has remained relatively stable over the past two decades. For the OS of patients with PLMGT, we established a novel predictive nomogram involving all independent risk factors obtained from the SEER database and developed a corresponding risk classification system that showed better predictive performance than the Ann Arbor staging system.
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Affiliation(s)
- Rongli Xie
- Department of Hematology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Zekai Mao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiaojun Xu
- Department of Hematology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Tiantian Sun
- Department of Hematology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China.
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Mega J, O'Brien V, Hammond N, Aeum J, Bunch K. A rare case of metastatic uterine lymphoma in a renal transplant patient. Radiol Case Rep 2021; 16:3675-3679. [PMID: 34630799 PMCID: PMC8493514 DOI: 10.1016/j.radcr.2021.08.061] [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: 08/13/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
Primary and disseminated lymphoma of the female reproductive tract are rare types of lymphoma. However, in the setting of solid organ transplant, recipients have an approximately doubled risk of acquiring and dying from malignancy. Multiple treatment modalities are available for post-transplant lymphoproliferative diseases (PTLD), including chemotherapy, radiotherapy, surgery, and immunosuppression radiotherapy. We report a case of a 61-year-old female with multifocal nodal diffuse large B-cell lymphoma and a history of a renal transplant secondary to IgA nephropathy who developed metastatic diffuse large B-cell lymphoma to the uterus. While the baseline incidence of PTLD is elevated when compared with lymphoma in the general population, metastatic uterine lymphoma is rare. Awareness of reproductive organ involvement by lymphomas and increased malignancy risk in organ transplant patients are important considerations for diagnostic evaluation, including radiologic assessment.
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Affiliation(s)
- James Mega
- Department of Radiology, Tripler Army Medical Center, 1 Jarrett White Rd. Honolulu, HI 96859 USA
| | - Victoria O'Brien
- Department of Obstetrics and Gynecology, Tripler Army Medical Center, 1 Jarrett White Rd. Honolulu, HI 96859 USA
| | - Nicholas Hammond
- Department of Radiology, Tripler Army Medical Center, 1 Jarrett White Rd. Honolulu, HI 96859 USA
| | - Judy Aeum
- Department of Pathology, Tripler Army Medical Center, 1 Jarrett White Rd. Honolulu, HI 96859 USA
| | - Kristen Bunch
- Department of Obstetrics and Gynecology, Tripler Army Medical Center, 1 Jarrett White Rd. Honolulu, HI 96859 USA
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Nepal P, Nagar A, Tirumani SH, Ojili V. Imaging of non-epithelial neoplasms of the prostate. Abdom Radiol (NY) 2020; 45:4117-4132. [PMID: 32964275 DOI: 10.1007/s00261-020-02774-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 02/05/2023]
Abstract
The purpose of this article is to review the spectrum of rare non-epithelial tumors of the prostate. This focused article will help the readers to understand the imaging findings of such rare entities attributed to their clinicopathological features. Radiologists must be familiar with the spectrum of non-epithelial tumors of the prostate, which helps to suggest alternate diagnosis other than adenocarcinoma, when imaging features are atypical. This is important because these tumors have different management approaches and prognoses when compared to adenocarcinoma of the prostate.
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Affiliation(s)
- Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sree Harsha Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
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KANTARCIOĞLU COŞKUN S, ÖZTÜRK NAZLIOĞLU H, BÜYÜKUYSAL MÇ. Clinicopathological Features of Extranodal Lymphomas. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.789919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Karaosmanoglu AD, Uysal A, Onur MR, Hahn PF, Ayhan AS, Ozmen MN, Akata D, Karcaaltincaba M. Primary lymphomas of the intraabdominal solid organs and the gastrointestinal tract: spectrum of imaging findings with histopathological confirmation. Abdom Radiol (NY) 2019; 44:2988-3005. [PMID: 31209544 DOI: 10.1007/s00261-019-02100-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Unlike nodal lymphoma, primary lymphomas of the intraabdominal organs are uncommon neoplasms whose diagnosis may be challenging in certain clinical circumstances. Despite this difficulty for imaging diagnosis, there are several imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography that may suggest the correct diagnosis. The scope of this review is to describe and illustrate the imaging features of primary lymphoma of intraabdominal organs providing clues to the diagnosis, together with their pathological correlations.
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Karaosmanoglu AD, Onur MR, Salman MC, Usubutun A, Karcaaltincaba M, Ozmen MN, Akata D. Imaging in secondary tumors of the ovary. Abdom Radiol (NY) 2019; 44:1493-1505. [PMID: 30361868 DOI: 10.1007/s00261-018-1809-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Metastatic involvement of the ovaries is not rare. The most common tumor types metastasizing to the ovaries, from non-gynecological organs, are breast, colorectal, gastric, and appendix tumors. Lymphogenous, hematogenous, and transcoelomic pathways have all been proposed among potential pathways. Early diagnosis and treatment have an important potential to improve the patient outcome. Krukenberg tumors typically appear as complex semisolid masses with varying amounts of solid and cystic components. Ovarian metastases from the colon primaries are predominantly cystic in nature. Secondary lymphomatous involvement of ovary is mostly bilateral and solid with heterogeneous signal intensity on MRI. Metastatic breast cancer to the ovaries is typically bilateral and tends to be of small size. Among all the other imaging characteristics, bilateral involvement of secondary tumors of the ovary appears to be most potentially helpful finding in differentiating from primary ones.
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Affiliation(s)
- Ali Devrim Karaosmanoglu
- Department of Radiology, Faculty of Medicine, School of Medicine, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
| | - Mehmet Ruhi Onur
- Department of Radiology, Faculty of Medicine, School of Medicine, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey.
| | - Mehmet Coskun Salman
- Faculty of Medicine, Department of Obstetrics and Gynecology, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
| | - Alp Usubutun
- Faculty of Medicine, Department of Pathology, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
| | - Musturay Karcaaltincaba
- Department of Radiology, Faculty of Medicine, School of Medicine, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Faculty of Medicine, School of Medicine, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Faculty of Medicine, School of Medicine, Hacettepe Universitesi Tıp Fakültesi Hastanesi, 06100, Sıhhiye, Ankara, Turkey
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Rohena-Quinquilla IR, Lattin GE, Wolfman D. Imaging of Extranodal Genitourinary Lymphoma. Radiol Clin North Am 2017; 54:747-64. [PMID: 27265606 DOI: 10.1016/j.rcl.2016.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The genitourinary (GU) system is commonly affected by disseminated lymphoma. Rarely, lymphoma can originate from and remain localized to one of the GU organs and thus presents as primary extranodal disease. Up to 40% of lymphomas present as extranodal disease, with only 3% having the GU system as the primary site of involvement. This article describes and correlates the radiologic and pathologic features of extranodal lymphomatous disease affecting the GU system with specific focus on the kidneys, adrenal glands, testicles, and ovaries. Lymphoma of the uterine body and cervix, external female genitalia, urinary bladder, and prostate gland is briefly discussed.
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Affiliation(s)
- Iván R Rohena-Quinquilla
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Department of Radiology, Martin Army Community Hospital, 6600 Van Aalst Boulevard, Fort Benning, GA 31905-5637, USA
| | - Grant E Lattin
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; American Institute for Radiologic Pathology, 1010 Wayne Avenue, Suite 320, Silver Spring, MD 20910, USA
| | - Darcy Wolfman
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; American Institute for Radiologic Pathology, 1010 Wayne Avenue, Suite 320, Silver Spring, MD 20910, USA; Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814, USA.
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Alves Viera MA, Cunha TM. Primary lymphomas of the female genital tract: imaging findings. Diagn Interv Radiol 2015; 20:110-5. [PMID: 24412819 DOI: 10.5152/dir.2013.13288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary lymphomas of the female genital tract are extremely rare, and a definitive diagnosis requires correlation of the clinical, radiological, and pathological findings. Unlike nonlymphomatous malignant tumors, the treatment of lymphoma is typically nonsurgical, thus raising the possibility of lymphoma in the differential diagnosis of a pelvic mass, a radiologist can significantly change the approach to the disease. Although some imaging findings may appear nonspecific, others may suggest the possibility of lymphoma, such as the presence of one or more solid, well-defined, homogeneous masses without necrosis despite a large size or the presence of diffuse infiltration leading to organomegaly with architectural preservation. Additionally, pelvic lymphadenopathy may be evident. In this pictorial essay, we discuss the radiological appearances of gynecological primary lymphomas, grouped by organ, in ultrasonography, computed tomography, and magnetic resonance imaging.
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Affiliation(s)
- Mónica Alexandra Alves Viera
- From the Department of Radiology (M.A.A.V. e-mail: ), Hospital José Joaquim Fernandes-Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal; the Department of Radiology (T.M.C.), Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
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Primary diffuse large B-cell lymphoma of the ureter in a patient with HIV: a case report and review of literature. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:324-6. [PMID: 23290714 DOI: 10.1016/j.clml.2012.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 12/08/2012] [Accepted: 12/09/2012] [Indexed: 11/23/2022]
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Abstract
Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) represent a spectrum of malignant neoplasms arising from the lymphoid system with an incidence of around 8% of all malignancies. Although they are generally known as tumors of lymph nodes, 25% to 40% of HD/NHL tumors, especially NHL, arise at extranodal sites along the gastrointestinal tract, head and neck, orbit, central and peripheral nervous system, thorax, bone, skin, breast, testis, thyroid, and genitourinary tract. Extranodal involvement is an important pretreatment prognostic factor for patients with lymphoma and its incidence has increased in the past 2 decades. Imaging plays an important role in the noninvasive pretreatment assessment of patients with extranodal lymphoma. This involvement can be subtle and may be overlooked during computed tomography (CT). Positron emission tomography/CT (PET/CT) has evolved into an important imaging tool for evaluation of lymphomas, facilitating the detection of affected extranodal sites even when CT shows subtle or no obvious lesions. Familiarity with extranodal manifestations and suggestive PET/CT features in different sites is important for accurate evaluation of lymphoma. This article reviews the extranodal PET/CT imaging findings regarding HD and NHL.
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Schniederjan SD, Osunkoya AO. Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases. Mod Pathol 2009; 22:1057-65. [PMID: 19377442 DOI: 10.1038/modpathol.2009.65] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Lymphoid neoplasms of the urinary tract and male genital organs are relatively rare, comprising less than 5% of all primary extranodal lymphomas; only a handful of small case series and isolated case reports have been published describing their predominant sites and subtypes. We identified 40 patients with lymphoid neoplasms of the urinary tract and male genital organs. Hematoxylin and eosin slides and immunohistochemical stains were reviewed, and follow-up data were also obtained. Twenty-six of 40 cases (65%) were primary genitourinary lymphomas. Mean age at diagnosis was 56 years (range 4-86 years). Among renal, bladder, and ureter lymphomas, a male predominance was noted (1.6:1). The subtypes of the lymphoid neoplasms observed were diffuse large B-cell lymphoma (17 cases, 43%); Burkitt lymphoma, extranodal marginal zone lymphoma, SLL/CLL, and follicular lymphoma (4 cases, or 10% each); B-cell ALL (2 cases, 5%); B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, mantle cell lymphoma, plasmacytoma, polymorphic post-transplant lymphoproliferative disorder, and peripheral T-cell lymphoma NOS (1 case, or 2.5% each). In most cases, the genitourinary tract was the site of initial presentation. Genitourinary tract lymphomas most commonly occurred in the kidney. B-cell non-Hodgkin's lymphomas predominated, with diffuse large B-cell lymphoma being the most common subtype in the entire group. Extranodal marginal zone lymphoma was seen only in the kidney, rather than the bladder, where it is typically thought to be more common. Although this study confirms the predominance of diffuse large B-cell lymphoma in extranodal sites, the findings also highlight the variety of lymphomas that may occur in the genitourinary tract. This diversity of subtypes affirms the importance of fully characterizing lymphomas by immunohistochemistry and other modalities, which are indispensable for accurate diagnosis.
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