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Clonal relationship of extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma) involving multiple organ systems with review of the literature. J Hematop 2022. [DOI: 10.1007/s12308-022-00516-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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2
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Zhang S, Rossetti-Chung A, Sood S, Terezakis S. The use of whole-body fluorine-18-fluorodeoxyglucose positron emission tomography integrated with computed tomography for accurate staging and surveillance in the case of mucosa-associated lymphoid tissue. J Radiol Case Rep 2021; 15:19-28. [PMID: 34267867 DOI: 10.3941/jrcr.v15i3.4193] [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: 11/15/2022] Open
Abstract
We present the case of a 79-year-old male, who was initially treated for mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the right eyelid, and later for disease relapse in the stomach. During follow up, he was noted to have developed left arm nodules just medial to the proximal biceps muscle, which were found to be multiply enlarged lymph nodes on subsequent ultrasound imaging. Excisional biopsy of these nodes revealed MALT lymphoma. He was initially referred for consideration of radiation, but a restaging F-18 fluorodeoxyglucose positron emission tomography integrated with computed tomography (F-18 FDG PET/CT) further identified a focus of suspicious uptake in left calf, which was later also biopsy proven to be MALT lymphoma. His disease was upstaged as the result of this later finding, and the overall recommendation for treatment changed to favor systemic treatment with Rituximab.
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Affiliation(s)
- Shunqing Zhang
- Department of Radiation Oncology, University of Minnesota, Minneapolis, USA
| | | | - Sumit Sood
- Department of Radiation Oncology, University of Minnesota, Minneapolis, USA
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3
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Lee YM, Kim JM. Epstein-Barr virus-positive mucocutaneous ulcer colliding with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (malt lymphoma) that developed in the palatine tonsils of an immunocompetent patient after gastric lymphoma relapse. Blood Res 2018; 53:329-332. [PMID: 30588472 PMCID: PMC6300682 DOI: 10.5045/br.2018.53.4.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/10/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Yong-Moon Lee
- Department of Pathology, Dankook University School of Medicine, Cheonan, Korea
| | - Jin-Man Kim
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea
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4
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Shrestha B, Kim B, Huffstetler A. An unusual presentation of gastric mucosa-associated lymphoid tissue (MALT)-type lymphoma. J Community Hosp Intern Med Perspect 2016; 6:31707. [PMID: 27609718 PMCID: PMC5016814 DOI: 10.3402/jchimp.v6.31707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/20/2016] [Accepted: 06/28/2016] [Indexed: 11/29/2022] Open
Abstract
Mucosa-associated lymphoid tissue (MALT)-type lymphoma is a relatively rare disease; nevertheless, it is the third most common lymphoma type, accounting for 5–7% of all non-Hodgkin lymphomas. Case series and retrospective analysis published in the literature have suggested that extra gastrointestinal (GI) MALT-type lymphoma can occur simultaneously with MALT-type lymphoma involving the GI tract. We report the case of a healthy, 64-year-old Caucasian male who presented with progressive fatigue, non-productive cough, and worsening exertional shortness of breath for 3 months who was subsequently diagnosed with gastric extra-nodal marginal zone B-cell lymphoma or MALToma with simultaneous metastasis to the lung (bronchi) based on biopsy reports.
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Affiliation(s)
- Bikram Shrestha
- Department of Internal Medicine, Saint Agnes Hospital Center, Baltimore, MD, USA;
| | - Bernard Kim
- Department of Critical Care and Pulmonary Medicine, Saint Agnes Hospital Center, Baltimore, MD, USA
| | - Alison Huffstetler
- Department of Family Medicine, University of Virginia Health System, Charlottesville, VA, USA
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5
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Martínez Pérez A, Camarasa Lillo N, Domingo Del Pozo C, Vázquez Tarragón A, Castro García C. [MALT lymphoma of the gallbladder]. GASTROENTEROLOGIA Y HEPATOLOGIA 2014; 38:320-2. [PMID: 25113861 DOI: 10.1016/j.gastrohep.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 04/25/2014] [Accepted: 05/14/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Aleix Martínez Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, España.
| | | | - Carlos Domingo Del Pozo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, España
| | - Antonio Vázquez Tarragón
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, España
| | - Carmen Castro García
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Doctor Peset, Valencia, España
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Wang Y, Dong S, Jiang Z, Li A. A case report of concurrent gastric and pulmonary mucosa-associated lymphoid tissue lymphomas and review of the literature on clonality analysis. Ann Hematol 2013; 92:1707-9. [PMID: 23612771 DOI: 10.1007/s00277-013-1749-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Yongjie Wang
- Department of Gastroenterology, Sir Run Run Shaw Affiliated Hospital, College of Medicine, Zhejiang University, 310016, Hangzhou, Zhejiang Province, China
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Carlos Bregni R, Nuyens M, Vassallo J, Soares FA, Romañach MJ, León JE, Almeida OP. Marginal zone lymphoma of mucosa-associated lymphoid tissue with prominent plasma cell differentiation affecting the palatine tonsil: histopathological and immunohistochemical analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:526-32. [PMID: 22668431 DOI: 10.1016/j.oooo.2011.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/29/2011] [Accepted: 11/10/2011] [Indexed: 12/18/2022]
Abstract
Non-Hodgkin lymphomas (NHLs) of the oral cavity and oropharynx constitute 13% of all primary extranodal NHLs. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) in the palatine tonsil is rare, corresponding to 6% of the NHLs of the Waldeyer ring. Some cases of MALT lymphoma can present prominent plasma cell differentiation, and less commonly, monoclonal gammopathy. The differential diagnosis of these cases from other NHLs with plasmacytic differentiation or plasma cell neoplasms is very difficult. In this article, we describe a rare case of MALT lymphoma in a 34-year-old man presenting as a swelling of the palatine tonsil. The tumor mass was diagnosed as MALT lymphoma with prominent plasma cell differentiation. Systemic evaluation was noncontributory. This is the first report of MALT lymphoma showing extensive plasmacytic differentiation of the palatine tonsil, and reinforces a possible relationship between extramedullary plasmacytoma and MALT lymphoma.
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Affiliation(s)
- Román Carlos Bregni
- Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
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8
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Affiliation(s)
| | | | | | | | - Gene Coppa
- North Shore University Hospital Manhasset, New York
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9
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Gall bladder and extrahepatic bile duct lymphomas: clinicopathological observations and biological implications. Am J Surg Pathol 2010; 34:1277-86. [PMID: 20679881 DOI: 10.1097/pas.0b013e3181e9bb8b] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Lymphomas of the gall bladder and extrahepatic bile ducts are exceedingly rare. We present the clinicopathological features of 19 cases from our files; 14 patients had primary lymphoma (13 involving gall bladder and 1 involving common hepatic duct), while 5 had systemic lymphoma on further work-up. Most patients presented with symptoms mimicking cholecystitis. The most common primary lymphoma types were diffuse large B-cell lymphoma, extranodal marginal zone lymphoma, B-lymphoblastic lymphoma, and follicular lymphoma. Two cases had features of lymphomatous polyposis, one a case of follicular lymphoma and the second a case of mantle cell lymphoma, with disease limited to the mantle zones, so-called in situ mantle cell lymphoma. Other rare lymphoma subtypes not described earlier in this site included the extracavitary variant of primary effusion lymphoma and plasmablastic lymphoma. Patients with diffuse large B-cell lymphoma and extranodal marginal zone lymphoma were older (mean age 75.8 y) than those with other subtypes (mean age 47 y) and more likely to have gallstones (60% vs. 12.5%). A comprehensive literature review revealed 36 primary gall bladder and 16 primary extrahepatic bile duct lymphomas. When compared with primary gall bladder lymphomas, those involving the extrahepatic bile ducts present at a younger age (47 y vs. 63 y) usually with obstructive jaundice, and are less often associated with gallstones (17% vs. 50%) or regional lymph node involvement (6% vs. 31%). In conclusion, primary lymphomas of the gall bladder and extrahepatic bile ducts show a broad spectrum of disease types, but in many respects mirror the spectrum of primary lymphomas of the gastrointestinal tract.
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Konoplev S, Lin P, Qiu X, Medeiros LJ, Yin CC. Clonal relationship of extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue involving different sites. Am J Clin Pathol 2010; 134:112-8. [PMID: 20551275 DOI: 10.1309/ajcp0ht6zgszknft] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Patients with mucosa-associated lymphoid tissue (MALT) lymphoma often have multiple sites of disease at initial diagnosis or during the clinical course. The neoplasms at multiple sites are often presumed to be identical, indicating dissemination or relapse. However, evidence to support this presumption is usually not available. We compared IGH VDJ sequences in 4 patients with 2 sequential sites of MALT lymphoma. The specimen pairs were stomach and nasopharynx, stomach and lung, ocular adnexa and nasopharynx, and ocular adnexa and parotid gland. The median interval between biopsies was 4 months (range, 1-32 months). Monoclonal IGH gene rearrangement was detected in all cases. In 3 patients, the VDJ sequences were distinct; in 1 patient the 2 biopsy specimens shared the same clone. MALT lymphomas involving multiple sites in a patient are usually not clonally related but arise independently, likely due to chronic antigenic stimulation, inducing oligoclonal B-cell proliferations and eventually a dominant B-cell clone.
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Affiliation(s)
- Sergej Konoplev
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA
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11
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Anemia crónica como forma de presentación de linfangioma abdominal. An Pediatr (Barc) 2009; 70:499-500. [DOI: 10.1016/j.anpedi.2009.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 01/13/2009] [Accepted: 01/18/2009] [Indexed: 11/27/2022] Open
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12
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Raderer M, Wöhrer S, Streubel B, Troch M, Turetschek K, Jäger U, Skrabs C, Gaiger A, Drach J, Puespoek A, Formanek M, Hoffmann M, Hauff W, Chott A. Assessment of Disease Dissemination in Gastric Compared With Extragastric Mucosa-Associated Lymphoid Tissue Lymphoma Using Extensive Staging: A Single-Center Experience. J Clin Oncol 2006; 24:3136-41. [PMID: 16769982 DOI: 10.1200/jco.2006.06.0723] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Molecular data and preliminary clinical findings have suggested mucosa-associated lymphoid tissue (MALT) lymphoma as a multifocal disease in a high percentage of patients. We report our findings with an extensive staging routine applied in patients diagnosed with MALT lymphoma at our institution. Patients and Methods A total of 140 consecutive patients (61 with gastric and 79 with extragastric MALT lymphoma) underwent staging according to a standardized protocol. Staging included gastroscopy with multiple biopsies, endosonography of the upper GI tract, computed tomography of thorax and abdomen, lymph node sonography, colonoscopy with multiple biopsies, otorhinolaryngologic assessment, magnetic resonance imaging of salivary and lacrimal glands, and bone marrow biopsy. All lesions suggestive of lymphoma involvement were subjected to biopsy, if accessible, and biopsies were evaluated for MALT lymphoma–specific genetic aberrations by means of reverse transcriptase polymerase chain reaction and/or fluorescent in situ hybridization. Results Fifteen (25%) of 61 patients with gastric MALT lymphoma had multiorgan involvement, with dissemination beyond the GI tract in six patients. By contrast, significantly more patients with extragastric MALT lymphoma had dissemination to another MALT organ (37 of 79 patients, 46%; P = .045). Nine of these 37 patients had dissemination to the stomach. Only three (2%) of 140 patients had bone marrow involvement. Multifocality was significantly associated with t(11;18)(q21;q21) in gastric lymphomas (P = .045) and with trisomy 18 in extragastric lymphomas (P = .011). Conclusion Our findings suggest that MALT lymphoma frequently presents as a multifocal disease. Extragastric MALT lymphomas are significantly more prone to dissemination than gastric MALT lymphomas.
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Affiliation(s)
- Markus Raderer
- Department of Internal Medicine I and IV, University of Vienna, Austria.
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Raderer M, Streubel B, Woehrer S, Puespoek A, Jaeger U, Formanek M, Chott A. High relapse rate in patients with MALT lymphoma warrants lifelong follow-up. Clin Cancer Res 2005; 11:3349-52. [PMID: 15867234 DOI: 10.1158/1078-0432.ccr-04-2282] [Citation(s) in RCA: 147] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is thought to be an indolent disease, with a good prognosis following various forms of treatment. Little, however, is known about the rate and pattern of relapse following successful treatment. PATIENTS AND METHODS We have analyzed time to and pattern of relapse in patients with MALT lymphoma, along with investigation of t(11;18)(q21;q21), t(1;14)(p22;q32), and t(14;18)(q32;q21) involving IGH/MALT1, trisomy 3, and trisomy 18. Eighty-six patients achieving complete remission (CR) after initial therapy with sufficient follow-up data were available. Primary site of disease was the stomach (n = 36), salivary gland (n = 19), ocular adnexa/orbit (n = 12), lung (n = 8), thyroid (n = 5), breast (n = 3), liver (n = 2), and skin (n = 1). RESULTS Thirty-two patients (37%) relapsed between 14 and 307 months (median 47 months) after initial CR. Ten relapses were local, whereas the remaining patients relapsed in a distant organ. Eight of 36 gastric versus 24 of 50 nongastric MALT lymphomas (P = 0.02) relapsed. Five patients had a second recurrence 26 to 56 months after a second CR. Relapse rates were not related to forms of initial treatment. Chromosomal aberrations were detected in 14 of 28 (50%) relapsing patients, and chromosomal alterations were identical at diagnosis and relapse. No significant association of any of the genetic changes investigated with relapse was found. Interestingly, patients with t(11;18)(q21;q21) had a significantly longer median time to relapse (76 months) than patients without this translocation (29 months; P = 0.012). CONCLUSIONS In view of the late relapses seen in our series, lifelong observation of all patients treated for MALT lymphoma seems to be required.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 4/genetics
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Neoplasm Recurrence, Local/therapy
- Retrospective Studies
- Time Factors
- Translocation, Genetic
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Affiliation(s)
- Markus Raderer
- Clinical Division of Oncology, Departments of Medicine I, Pathology, Medicine IV, and Otorhinolaryngology, Medical University Vienna, Austria.
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Narváez JA, Domingo-Domènech E, Roca Y, Romagosa V, De Lama E, González-Barca E, Petit J, Fernández-Sevilla A. Radiological features of non-gastric mucosa-associated lymphoid tissue lymphomas. Curr Probl Diagn Radiol 2005; 33:212-25. [PMID: 15459631 DOI: 10.1067/j.cpradiol.2004.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- José Antonio Narváez
- Department of CT and MR Imaging, Institut de Diagnòstic per la Imatge,Hospital Duran i Reynals, Barcelona, Spain
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15
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Wenzel C, Fiebiger W, Dieckmann K, Formanek M, Chott A, Raderer M. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue of the head and neck area: high rate of disease recurrence following local therapy. Cancer 2003; 97:2236-41. [PMID: 12712477 DOI: 10.1002/cncr.11317] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct entity with specific clinical and pathologic features that may affect diverse organs. MALT-lymphomas remain localized within their original environment for a long period of time. As recent data have demonstrated a relatively high rate of multiorgan involvement at diagnosis, the authors have retrospectively evaluated 36 patients presenting with MALT-lymphoma in the head and neck area. The authors focused on patients' disease localization, initial treatment, clinical course, and follow-up. METHODS Thirty-six patients with a histologically verified diagnosis of an extranodal marginal zone B-cell MALT-lymphoma arising in the head and neck area were included in this retrospective analysis. RESULTS Treatment consisted of surgical resection as the sole treatment in 4 patients (11%), surgical resection with consecutive radiotherapy in 13 patients (36%), radiotherapy alone in 11 patients (31%), chemotherapy in 2 patients (6%), surgical resection plus radiotherapy and chemotherapy in 4 patients (11%), and combined radiation and chemotherapy in 1 patient (3%). Complete and partial disease remissions after initial treatment were achieved in 22 (61%) and 13 patients (36%), respectively, whereas one patient refused any therapy. Four patients (11%) were lost to follow-up and 15 patients (43%) have had disease recurrence after a median time of 11 months (range, 3-80 months). CONCLUSIONS These data suggest that MALT-lymphomas of the head and neck area are preferentially treated using local modalities such as radiation and/or resection. This practice, however, is associated with an unexpectedly high rate of dissemination or disease recurrence. Obtaining an initial complete response is crucial in these patients. According to previous data, the possibility of understaging in such patients cannot be ruled out. Clinical trials with application of systemic treatment are warranted for these patients.
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Affiliation(s)
- Catharina Wenzel
- Department of Internal Medicine I/Division of Oncology, University of Vienna, Vienna, Austria
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16
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Raderer M, Isaacson PG. Extranodal lymphoma of MALT-type: perspective at the beginning of the 21st century. Expert Rev Anticancer Ther 2001; 1:53-64. [PMID: 12113133 DOI: 10.1586/14737140.1.1.53] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Extranodal lymphomas arising from mucosa associated lymphoid tissue (MALT) have become a focus of interest in recent years due to their unique pathological and clinical properties. The link between Helicobacter pylori and the development of gastric MALT-type lymphoma has revolutionized treatment options as up to 80% of patients with early gastric MALT-type lymphoma achieve complete remission of the tumor following eradication of H. pylori. As opposed to surgical intervention, which has been the preferred form of treatment in the past, organ conserving approaches are increasingly being applied, as both irradiation and chemotherapy have given excellent results. However, mature data from prospective, randomized studies taking into account the concept of MALT lymphoma as a distinct entity are still lacking in order to define the optimal approach to the management of MALT-type lymphoma.
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Affiliation(s)
- M Raderer
- Department of Internal Medicine I, Division of Oncology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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17
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Al-Maghrabi J, Kamel-Reid S, Jewett M, Gospodarowicz M, Wells W, Banerjee D. Primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type arising in the urinary bladder: report of 4 cases with molecular genetic analysis. Arch Pathol Lab Med 2001; 125:332-6. [PMID: 11231478 DOI: 10.5858/2001-125-0332-plgbcl] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Primary lymphoma of the urinary bladder is rare. Only 84 cases have been reported in the English literature to date, and none of these cases has had molecular confirmation of clonal immunoglobulin gene rearrangement. OBJECTIVES To review all cases with primary urinary bladder lymphoma in our records, to classify them using the REAL classification, to confirm their immunophenotype and genotype, and to determine their outcome. DESIGN We identified 4 cases of primary urinary bladder lymphoma in our medical records from a 30-year period. Immunohistochemical detection of immunoglobulin light chains and molecular analysis of immunoglobulin heavy-chain genes using the polymerase chain reaction were performed on paraffin-embedded material. RESULTS All patients were older than 60 years. The male-female ratio was 1:3. All patients had a history of chronic cystitis. Histologic features of mucosa-associated lymphoid tissue lymphoma with centrocyte-like cells, plasmacytoid B cells, or both were observed in all cases. Monoclonality of B cells was demonstrated by immunohistochemistry, polymerase chain reaction, or both methods in every case. All patients presented with stage IAE disease, were treated with radiotherapy alone, and have been in continuous complete remission for 2 to 13 years. CONCLUSIONS Primary bladder lymphomas are usually of low-grade mucosa-associated lymphoid tissue type. They are more common in females and are associated with a history of chronic cystitis. Lymphoepithelial lesions are seen only in association with areas of cystitis glandularis. B-cell clonality is readily demonstrable by immunohistochemistry and/or polymerase chain reaction analysis. Local radiotherapy appears to confer long-term control.
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MESH Headings
- Aged
- Antigens, CD/analysis
- Female
- Gene Rearrangement, B-Lymphocyte, Heavy Chain
- Gene Rearrangement, B-Lymphocyte, Light Chain
- Humans
- Immunohistochemistry
- Lymphoma, B-Cell/chemistry
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/diagnostic imaging
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/chemistry
- Lymphoma, B-Cell, Marginal Zone/classification
- Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Middle Aged
- Polymerase Chain Reaction
- Radiography
- Treatment Outcome
- Urinary Bladder Neoplasms/chemistry
- Urinary Bladder Neoplasms/classification
- Urinary Bladder Neoplasms/diagnostic imaging
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- J Al-Maghrabi
- Department of Laboratory Medicine and Pathobiology, Princes Margaret Hospital, University Health Network, University of Toronto, Ontario
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18
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Mitropoulos FA, Angelopoulou MK, Siakantaris MP, Rassidakis G, Vayiopoulos GA, Papalampros E, Kalovidouris A, Pangalis GA. Primary non-Hodgkin's lymphoma of the gall bladder. Leuk Lymphoma 2000; 40:123-31. [PMID: 11426613 DOI: 10.3109/10428190009054889] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Primary non-Hodgkin lymphoma of the gallbladder is a very rare location of extranodal non-Hodgkin lymphomas. A patient with a primary non-Hodgkin lymphoma of the gallbladder is reported and in addition, the English literature is reviewed. Clinical presentation, diagnostic evaluation, histopathologic findings, treatment modalities and prognosis of primary gallbladder lymphomas reported up to date are reviewed and discussed. Our patient was diagnosed as a T-cell lymphoblastic lymphoma, after cholecystectomy, and had no evidence of disease elsewhere. She was treated with combination chemotherapy and complete remission was achieved. She remains free of disease 9 years later. Review of the literature over a 30-year period revealed only 12 cases of well-documented primary non-Hodgkin lymphoma involvement of the gallbladder, including the present case. Patients present clinically with symptoms and signs indicating either biliary tract pathology or a gastrointestinal tumor. Diagnostic investigation included ultrasound of the upper abdomen, computed tomography of the abdomen and pelvis, oral cholecystography, percutaneous cholangiography and endoscopic retrograde cholangiopangreatography. Preoperative diagnosis was established in none of the patients. Treatment modalities included surgery and postoperative chemotherapy and irradiation. The prognosis is overall poor and only 2 patients are alive after 1 and 9 years respectively, the latter being our case. Here we document the first reported case of a patient with primary T-cell lymphoblastic non-Hodgkin lymphoma of the gallbladder. Review of the literature shows the existence of non-Hodgkin lymphoma of the gallbladder, its rarity and its general dismal prognosis.
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Affiliation(s)
- F A Mitropoulos
- 1st Department of Internal Medicine, Laikon General Hospital, Athens, Greece
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19
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Raderer M, Vorbeck F, Formanek M, Osterreicher C, Valencak J, Penz M, Kornek G, Hamilton G, Dragosics B, Chott A. Importance of extensive staging in patients with mucosa-associated lymphoid tissue (MALT)-type lymphoma. Br J Cancer 2000; 83:454-7. [PMID: 10945490 PMCID: PMC2374656 DOI: 10.1054/bjoc.2000.1308] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lymphoma of the mucosa-associated lymphoid tissue (MALT) type usually arises in MALT acquired through chronic antigenic stimulation triggered by persistent infection and/or autoimmune processes. Due to specific ligand-receptor interactions between lymphoid cells and high-endothelial venules of MALT, both normal and neoplastic lymphoid cells display a pronounced homing tendency to MALT throughout the body. In the case of neoplastic disease these homing properties may be responsible for lymphoma dissemination among various MALT-sites. According to this concept, we have standardized staging procedures in all patients diagnosed with MALT-type lymphoma. All patients with MALT-type lymphoma underwent standardized staging procedures before treatment. Staging included ophthalmologic examination, otolaryngologic investigation, gastroscopy with multiple biopsies, endosonography of the upper gastrointestinal tract, enteroclysis, colonoscopy, computed tomography of thorax and abdomen and bone marrow biopsy. Biopsy was performed in all lesions suggestive for lymphomatous involvement, and evaluation of all biopsy specimens was performed by a reference pathologist. 35 consecutive patients with histologically verified MALT-type lymphoma were admitted to our department. Twenty-four patients (68%) had primary involvement of the stomach, five (15%) had lymphoma of the ocular adnexa, three (8.5%) had lymphoma of the parotid, and three (8,5%) of the lung. Lymph-node involvement corresponding to stage EII disease was found in 13 patients (37%), only one patient with primary gastric lymphoma had local and supradiaphragmatic lymph-node involvement (stage EIII). Bone marrow biopsies were negative in all patients. Overall, eight of 35 patients (23%) had simultaneous biopsy-proven involvement of two MALT-sites: one patient each had lymphoma of parotid and lacrimal gland, conjunctiva and hypopharynx, conjunctiva and skin, lacrimal gland and lung, stomach and colon, and stomach and lung. The remaining two patients had bilateral parotideal lymphoma. Staging work-up was negative for lymph-node involvement in all of these eight patients. The importance of extensive staging in MALT-type lymphoma is emphasized by the demonstration of multiorgan involvement in almost a quarter of patients. In addition, our data suggest that extra-gastrointestinal MALT-type lymphoma more frequently occurs simultaneously at different anatomic sites than MALT-type lymphoma involving the GI-tract.
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Affiliation(s)
- M Raderer
- Department of Internal Medicine I, University of Vienna, Austria
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Abstract
The gastrointestinal tract is the most common site for extranodal lymphomas. The most common, and consequently the most studied, gastrointestinal lymphoma is gastric mucosa-associated lymphoid tissue lymphoma, which is a paradigm for all gastrointestinal lymphomas. Recent advances in oncogenesis, genetics, and immunology have all yielded important discoveries that enhance our understanding of this lymphoma. The implications of these new advances are beginning to translate into changes in therapeutic approach.
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Affiliation(s)
- P G Burkard
- Division of Gastroenterology, Department of Medicine, State University of New York, Buffalo, New York 14203, USA.
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Abstract
Mucosa-associated lymphoid tissue (MALT) lymphoma has attracted attention because its concept has amalgamated the study of etiology and pathogenesis in an intriguing group of lymphomas. MALT lymphomas are a B-cell malignancy with characteristic lymphoepithelial lesions; cells are CD20-positive and CD5- and CD10-negative. The molecular changes observed include trisomy 3, t(11;18), and t(1;14) translocations. They commonly occur in the stomach, orbit, salivary glands, and thyroid. Localized disease is present in 60% to 70% of patients. Involvement of multiple extranodal sites has been observed at presentation or during the course of disease. Lymphocyte homing has been implicated in gastrointestinal MALT and may be involved in other MALT lymphomas. Local therapy, either through surgery or radiotherapy, is curative in a high proportion of patients. MALT lymphomas respond to chemotherapy, but there is no evidence that cure can be achieved, although prolonged survival is common. Long-term follow-up is essential for study of the outcomes in this disease.
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Affiliation(s)
- M Gospodarowicz
- Department of Radiation Oncology, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
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