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Jain A, Arun VA, Bal A, Malhotra P. Primary chest wall Burkitt lymphoma in a case of HIV infection with immune reconstitution. BMJ Case Rep 2021; 14:e243873. [PMID: 34969787 PMCID: PMC8719129 DOI: 10.1136/bcr-2021-243873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/03/2022] Open
Abstract
Burkitt lymphoma (BL) develops at an increased frequency in patients with HIV irrespective of the CD4 count. Lymph nodes and gastrointestinal tract are common sites of involvement by BL; however, primary chest wall BL is rare. A 52-year-old man on highly active antiretroviral therapy (HAART) for HIV with a CD4 count of 0.204 x 109 cells/L presented with a 3-month history of enlarging chest wall mass. PET-CT scan imaging showed a bulky mass involving the musculoskeletal planes of left chest wall with the involvement of underlying pleura. Biopsy with immunohistochemistry confirmed BL. Patient received EPOCH-R (infusional etoposide, vincristine, and doxorubicin with prednisone, cyclophosphamide and rituximab) regime for six cycles along with HAART, attained complete remission (CR) and remains free of BL at 5 years. BL should be considered in the differential diagnosis of soft tissue masses in HIV-infected patients irrespective of their CD4 count.
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Affiliation(s)
- Arihant Jain
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kumar P, Gupta P, Prakash G, Rajwanshi A. Fungating anterior chest wall mass in an adult: Cytologic diagnosis of a rare presentation. Diagn Cytopathol 2020; 49:436-438. [PMID: 33058525 DOI: 10.1002/dc.24642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Pankaj Kumar
- Department of Pathology, PGIMER, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
| | - Gaurav Prakash
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
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Rashid S, Mohamed SF, Yassin M, Tbishat LF, Al-Thani H, Albozom I. Intramural great vessel lymphoma presenting as thrombus in an aortic aneurysm. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Abstract
RATIONALE Primary diffuse large B-cell lymphoma of the chest wall is extremely rare. A majority of the pleural lymphomas develop in patients with chronic tuberculous pyothorax. The underlying mechanism might be attributed to the sustained stimulation of chronic inflammation. Surgery followed by adjuvant chemotherapy can improve the outcome in some patients with lymphoma localized only in the chest wall. Thus, an early diagnosis of pyothorax-associated lymphoma is essential as it is a malignant, life-threatening condition. PATIENT CONCERNS A 79-year-old male complained of left-side chest pain for more than 2 months, which was not alleviated with nitrates and aspirin. The patient presented an intermittent low fever, anorexia, and marasmus, accompanied by tuberculosis 40 years ago and chronic left-side pyothorax. Also, ANCA (antineutrophil cytoplasmic autoantibody)-associated vasculitis occurred for >3years. DIAGNOSIS Computed tomography scan showed a solid mass in the left lateral chest wall. The patient underwent ultrasonic-guided biopsy of the lesion. A diagnosis of primary diffuse large B-cell lymphoma of the chest wall was established after histological examination. INTERVENTION Due to advanced age and poor physical condition, the patient received CHOP chemotherapy at a reduced dose. OUTCOMES The patient died 5 days after the first cycle of chemotherapy with severe dyspnea and high fever. LESSONS The chronic inflammation stimulation might result in the development of lymphoma in the chest wall of patients with long-term pyothorax, vasculitis, or other autoimmune diseases associated with malignancies. The fever, chest pain, or other nonspecific clinical symptoms in these patients should be under intensive focus as it might indicate the development of malignant lymphoma. Thus, histological examination in these patients is essential for accurate early diagnosis.
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Affiliation(s)
- Qianwen Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan
- Department of Respiratory, Weihai Municipal Hospital, Weihai
| | - Yuanrong Ju
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan
| | - Tao Qu
- Department of Respiratory, Weihai Municipal Hospital, Weihai
| | - Tao Wang
- Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan
| | - Xiaoqin Liu
- Department of Pathology, Weihai Municipal Hospital, Weihai, Shandong, China
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Lai M, Zhang X, Li Q, Guo C, Zhang Y. Fast-Growing Subcutaneous Tumors with Lower-Extremity Edema and Rib Lesions: A Case of Non-Hodgkin's Lymphoma in an HIV-1-Infected Patient. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1135-1139. [PMID: 29066707 PMCID: PMC5667585 DOI: 10.12659/ajcr.905904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patient: Male, 41 Final Diagnosis: Non-Hodgkin’s lymphoma Symptoms: Fast-growing subcutaneous tumors with lower-extremity edema Medication: — Clinical Procedure: — Specialty: Hematology
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Affiliation(s)
- Man Lai
- Department of Infectious Diseases, Capital Medical University Affiliated Beijing You An Hospital, Beijing, China (mainland)
| | - Xiuqun Zhang
- Department of Hematology, Nanjing Medical University Affiliated Nanjing First Hospital, Nanjing, Jiangsu, China (mainland)
| | - Qunhui Li
- Department of Infectious Diseases, Capital Medical University Affiliated Beijing You An Hospital, Beijing, China (mainland)
| | - Caiping Guo
- Department of Infectious Diseases, Capital Medical University Affiliated Beijing You An Hospital, Beijing, China (mainland)
| | - Yulin Zhang
- Department of Infectious Diseases, Capital Medical University Affiliated Beijing You An Hospital, Beijing, China (mainland)
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Das DK, Pathan SK, Al-Waheeb SKM, Ali AE, Joneja M, Al-Kanderi MG, John B, Mallik MK. Chest wall lymphomas: Fine needle aspiration cytodiagnosis and review of the literature. Cytopathology 2017; 28:364-370. [PMID: 28730684 DOI: 10.1111/cyt.12433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Compared to other chest wall malignancies, lymphoma is a common disease. However, published literature on a series of lymphoma cases involving the chest wall is scarce. The aim of the present study, was to describe experience with chest wall swellings diagnosed as lymphoid neoplasms on fine needle aspiration (FNA) cytology. METHODS Eleven chest wall swellings were diagnosed as lymphoid neoplasms on FNA over a period of 15 years (January 2000-December 2014). The age of patients ranged from 19 to 73 years (median, 46). The male-to -emale ratio was 7:4. Ten cases had an anterior or lateral chest wall mass, and one swelling was in the scapular region. Six cases had concurrent lymphadenopathy, and one had bone involvement. The FNA smears were reviewed and classified under WHO Classification of Hematopoietic Neoplasms. The histopathological diagnoses were available in eight cases. RESULTS The preliminary cytodiagnoses in 11 cases of chest wall lymphoid neoplasms were anaplastic large cell lymphoma (ALCL) in two cases, and ALCL/malignant melanoma, ALCL/T-cell-rich-B-cell lymphoma (TCRBCL)/Hodgkin's lymphoma (HL), plasmacytoma/neuroendocrine carcinoma, Hodgkin's lymphoma, small cell NHL/CLL, NHL, suggestive of NHL, post-transplant peripheral T-cell lymphoma (PTCL), and a malignant plasma cell tumour in one case each. The reviewed cytodiagnoses of lymphoid neoplasms were as follows: ALCL ( five cases), centroblastic lymphoma (two cases), and small cell lymphoma/CLL, post-transplant peripheral T-cell lymphoma, Hodgkin's lymphoma and plasmacytoma (one case each). Histopathological diagnoses available in eight cases confirmed the presence of lymphoid neoplasms. CONCLUSION A variety of lymphoid neoplasms involved the chest wall, and among them, ALCL was a common form.
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Affiliation(s)
- D K Das
- Department of Pathology, Faculty of Medicine, Kuwait University, Al-Jabriya, Kuwait.,Cytology Unit, Mubarak Al-Kabeer Hospital, Al-Jabriya, Kuwait
| | - S K Pathan
- Cytology Unit, Mubarak Al-Kabeer Hospital, Al-Jabriya, Kuwait
| | - S K M Al-Waheeb
- Department of Pathology, Faculty of Medicine, Kuwait University, Al-Jabriya, Kuwait.,Histopathology Laboratory, Hussain Makki Al-Juma Center for Specialized Surgery, Shuwaikh, Kuwait
| | - A E Ali
- Histopathology Laboratory, Hussain Makki Al-Juma Center for Specialized Surgery, Shuwaikh, Kuwait
| | - M Joneja
- Department of Histopathology, YACO Medical's Radiology Nuclear Medicine Laboratory Center, Al-Adan Hospital, Mahboula-Fahaheel, Kuwait
| | - M G Al-Kanderi
- Cytology Unit, Mubarak Al-Kabeer Hospital, Al-Jabriya, Kuwait
| | - B John
- Department of Pathology, Faculty of Medicine, Kuwait University, Al-Jabriya, Kuwait
| | - M K Mallik
- Cytology Unit, Mubarak Al-Kabeer Hospital, Al-Jabriya, Kuwait
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Tanriverdi E, Acat M, Ozgul G, Abbasli K, Gul S, Yasar Z, Cortuk M, Fener NA, Akin H, Ozgul MA, Cetinkaya E. Primary pulmonary lymphoma: four different and unusual radiologic and clinical manifestations. Leuk Lymphoma 2016; 58:1231-1233. [PMID: 27658461 DOI: 10.1080/10428194.2016.1225210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Elif Tanriverdi
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Murat Acat
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Guler Ozgul
- c Department of Chest Diseases , Bağcılar Education and Research Hospital , İstanbul , Turkey
| | - Kenan Abbasli
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Sule Gul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Zehra Yasar
- d Department of Chest Diseases , Abant İzzet Baysal University Faculty of Medicine , Bolu , Turkey
| | - Mustafa Cortuk
- b Department of Chest Diseases , Karabük University Faculty of Medicine , Karabük , Turkey
| | - Neslihan Akanil Fener
- e Department of Pathology , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Hasan Akin
- f Department of Thoracic Surgery , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Akif Ozgul
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
| | - Erdogan Cetinkaya
- a Department of Chest Diseases , Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital , Istanbul , Turkey
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Foroulis CN, Kleontas AD, Tagarakis G, Nana C, Alexiou I, Grosomanidis V, Tossios P, Papadaki E, Kioumis I, Baka S, Zarogoulidis P, Anastasiadis K. Massive chest wall resection and reconstruction for malignant disease. Onco Targets Ther 2016; 9:2349-58. [PMID: 27143930 PMCID: PMC4846065 DOI: 10.2147/ott.s101615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes. Methods Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males) was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted. Results The median maximum diameter of tumors was 10 cm (5.4–32 cm). Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2). Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%), most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh) in nine cases of large anterior defects or by using a 2 mm polytetrafluoroethylene (e-PTFE) mesh in nine cases of lateral or posterior defects. Support from a plastic surgeon was necessary to cover the full-thickness chest wall defects in seven cases. Adjuvant oncologic treatment was administered in 13 patients. Local recurrences were observed in five cases where surgical reintervention was finally necessary in two cases. Recurrences were associated with larger tumors, histology of malignant fibrous histiocytoma, and initial incomplete resection or misdiagnosis made by nonthoracic surgeons. Three patients died during the study period because of recurrent disease or complications of treatment for recurrent disease. Conclusion Chest wall tumors are in their majority mesenchymal neoplasms, which often require major chest wall resection for their eradication. Long-term survival is expected in low-grade tumors where a radical resection is achieved, while big tumors and histology of malignant fibrous histiocytoma are connected with the increase rate of recurrence.
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Affiliation(s)
- Christophoros N Foroulis
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Athanassios D Kleontas
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - George Tagarakis
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Chryssoula Nana
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Ioannis Alexiou
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Vasilis Grosomanidis
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Paschalis Tossios
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Elena Papadaki
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kioumis
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, European Interbalkan Medical Center, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Anastasiadis
- Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, Thessaloniki, Greece
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