Paediatric T-cell lymphoma of the appendix: a case report

Low-grade intraductal carcinoma in minor salivary glands: A case report and clinical insights

Rationale

Low-grade intraductal carcinoma (LG-IC), is a rare malignant tumour of the salivary glands which has a very good prognosis and must be differentiated from the other types of salivary gland malignant tumours, which have a totally different behaviour and a worse prognosis.

Patient Concerns

A case is presented of a 52-year-old woman who was first diagnosed and treated in another clinic in 2019 for an LG-IC in the left submandibular gland space. Two years later, she was admitted to our department with a new lesion, this time in the upper jaw lip on the left side, which also turned out to be LG-IC.

Diagnosis

Magnetic resonance imaging and positron emission tomography-computed tomography were performed in order to diagnose and adequately stage the disease prior to the therapeutic intervention.

Outcomes

A 6-month follow-up reveals no sign of recurrence.

Takeaway Lessons

Literature on this rare histopathological entity, as well as the differential diagnosis with the other malignant lesions of the salivary glands and the frequency of metastasis, were reviewed.

Peripheral Cytotoxic T Cell Lymphoma of the Appendix Presenting as Acute Appendicitis

Introduction

Lymphoma of the appendix is a rare cause of acute appendicitis; however, acute appendicitis is a common first manifestation of appendiceal lymphomas. Cytotoxic peripheral T cell lymphoma (PTCL) is a type of aggressive non-Hodgkin lymphoma that portends a generally poor outcome. Cytotoxic PTCL of the appendix is extremely rare with few cases reported in the literature. Case Presentation. This is the report of a 23-year-old man who had experienced lower abdominal pain for three months before presenting to the emergency department with severe right lower abdominal pain, nausea, vomiting, and anorexia since the day prior to admission. The patient was diagnosed with acute appendicitis, and the pathology report confirmed cytotoxic PTCL of the appendix.

Conclusion

Patients with appendiceal PTCL commonly present with signs and symptoms of acute appendicitis due to luminal obstruction by the tumor. Therefore, appendiceal tumors such as PTCL should be considered in the differential diagnosis of patients presenting as acute appendicitis. In addition, since there is no standard chemotherapy regimen for cytotoxic PTCL, this and other case reports hopefully help in providing the clinical evidence needed for establishing appropriate treatment guidelines.

Mantle cell lymphoma presenting as acute appendicitis

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Mantle cell lymphoma is an extremely rare form of lymphoma associated with appendicitis.

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This is one of few reported cases of mantle cell lymphoma showing obstruction of appendiceal lumen.

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Appendicitis associated with mantle cell lymphoma in this incident is unaffected by the effect of chemotherapy treatments.

INTRODUCTION

Most cases of appendicitis associated with lymphoma reported in literature are in patients with Burkitt's or large B-cell lymphoma. Mantle cell lymphoma only makes up 4% of all lymphoma cases in the U.S. We report a case of a patient with mantle cell lymphoma presenting with acute appendicitis.

PRESENTATION OF CASE

A 75 year old male with a history of left cervical lymphadenopathy biopsied to be mantle cell lymphoma presented with right lower abdomen pain for 3 days. An outpatient CT scan revealed acute appendicitis. Laparoscopic appendectomy was performed without any complication. The histologic examination showed mantle cell lymphoma occluding the lumen of appendix.

DISCUSSION

Typically, appendicitis is caused by obstruction of the lumen of appendix by fecalith or lymphoma. A previously reported case of a patient with mantle cell lymphoma who developed appendicitis received chemotherapy before appendectomy. The author could not determine how mantle cell lymphoma contributed to appendicitis because the lumen of appendix was not occluded by the lymphoma, likely from cytoreduction from chemotherapy. We have a patient with mantle cell lymphoma before the patient received chemotherapy who presented with appendicitis. The appendiceal specimen shows the lumen filled with mantle cell lymphoma.

CONCLUSION

This is a rare case of mantle cell lymphoma causing obstruction of appendiceal lumen and subsequently appendicitis, unaffected by chemotherapy.

A rare presentation of Hodgkin's lymphoma in a very young child, with involvement of the appendix

Hodgkin's lymphoma involving the appendix in young children is an exceptionally rare disease. We report a case of a child less than 3 years who presented to us with gradual weight loss, progressive pallor and diffuse abdominal pain. The symptoms were preceded by a history of varicella infection about 6 months ago. The clinical progression was marked by intermittent episodes of acute abdominal pain and fever, mimicking acute intra-abdominal inflammatory process such as appendicitis. Investigations revealed that the child had direct Coomb's test positive haemolytic anaemia, raised platelet counts, lymphopenia and hypergammaglobulinaemia. The CT of the abdomen showed the presence of significant lymph nodes. Abdominal laparoscopy and biopsy of the lymph nodes showed mixed cellularity Hodgkin's lymphoma that also involved the appendix. Subsequent staging detected an advanced stage IV disease. The child was referred immediately to a specialised oncology centre for further management. Unfortunately he was lost in follow-up.

Unusual presentation of primary T-cell lymphoblastic lymphoma: description of two cases

Abstract

Virtual Slides

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Low-grade intraductal carcinoma of the lacrimal gland

Intraductal carcinoma has been described in the salivary glands as a relatively benign tumour with low-grade histopathologic features. To our knowledge, this tumour has not previously been reported in the lacrimal gland. We report the first case of low-grade intraductal carcinoma occurring in the lacrimal gland. This tumour was discovered incidentally on neuro-imaging in an asymptomatic 65-year-old patient. Incisional biopsy revealed uniform, polygonal cells with eosinophilic cytoplasm and minimal nuclear atypia, arranged in solid, cribiform and micropapillary nests. The patient underwent complete surgical excision with no evidence of recurrence at 8 months of follow-up.