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Puapatanakul P, Banjongjit A, Srisawat N, Townamchai N, Kanjanabuch T. A Case of Extranodal NK/T-cell Lymphoma Infiltrating Kidneys, Presenting With Hematuria and Proteinuria With False-Positive Serum Anti-proteinase 3, and Mimicking Granulomatosis With Polyangiitis. Cureus 2023; 15:e49794. [PMID: 38161567 PMCID: PMC10757817 DOI: 10.7759/cureus.49794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
We report a case of misdiagnosed extranodal NK/T-cell lymphoma, nasal type, mimicking granulomatosis with polyangiitis (GPA). A 30-year-old male presented with chronic non-resolving right paranasal sinusitis for two years accompanied by multiple generalized cutaneous nodules, and subnephrotic-range proteinuria. Biopsies from skin lesions and paranasal sinuses demonstrated leukocytoclastic vasculitis and necrotizing granulomatous inflammation, respectively. Serum proteinase 3 (PR3)-antineutrophilic cytoplasmic antibody (ANCA) was positive, suggesting the diagnosis of GPA based on the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology Classification Criteria for GPA. A kidney biopsy was not pursued due to the cause of glomerulonephritis (GN) being clinically evident, per the KDIGO 2021 GN Clinical Practice Guidelines. Immunosuppression was administered, which led to a transient improvement in clinical symptoms. However, subsequent kidney biopsy and other organ biopsies with cytogenic and molecular tests eventually confirmed extranodal NK/T-cell lymphoma infiltrating kidneys, skin, and paranasal sinuses. Physicians should always consider the possibility of hematologic malignancy in young adults presenting with multiple-organ involvement with vasculitic lesions or pauci-immune crescentic GN, albeit positive ANCA serologies. Kidney biopsy with cytogenic support should be performed to exclude threatening diseases, especially in atypical cases such as in young patients despite a context of compatible manifestations with other syndromes.
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Affiliation(s)
- Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
| | | | - Nattachai Srisawat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
| | - Natavudh Townamchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
- Renal Immunology and Renal Transplant Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, THA
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Mahmoud EM, Howard E, Ahsan H, Cousins JP, Nada A. Cross-sectional imaging evaluation of atypical and uncommon extra-nodal head and neck Non-Hodgkin lymphoma: Case series. J Clin Imaging Sci 2023; 13:6. [PMID: 36751565 PMCID: PMC9899482 DOI: 10.25259/jcis_134_2022] [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: 11/29/2022] [Accepted: 01/14/2023] [Indexed: 01/26/2023] Open
Abstract
Extra-nodal Non-Hodgkin lymphoma (ENHL) of the head and neck is not uncommon and has variable clinical and imaging presentations. It represents about 25% of extra-nodal lymphomas. In addition, lymphoma is the third most common malignancy of the head and neck just after squamous cell carcinoma (SCC) and salivary gland neoplasms. Unlike SCC, ENHL usually presents as a well-defined mass in the oral cavity, along the pharyngeal mucosa, sinonasal cavity, orbit, and other different neck spaces. One of the common presentations of ENHL is the glandular type which can arise within the salivary or thyroid glands as marginal zone non-Hodgkin lymphoma. ENHL can infiltrate the bone resembling high grade osseous malignancies. Rarely, ENHL can present as perineural spread without definitive mass and manifest clinically with several neuropathies. In this case series, we presented different imaging features and presentation of ENHL of the head and neck. The knowledge of various presentations of ENHL of the head and neck can help early diagnosis and prompt management of these patients' population.
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Affiliation(s)
- Esmat M. Mahmoud
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo, Egypt
| | - Emily Howard
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Humera Ahsan
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Joseph P. Cousins
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Ayman Nada
- Department of Radiology, University of Missouri, Columbia, Missouri, United States.,Corresponding author: Ayman Nada, Department of Radiology, University of Missouri, Columbia, Missouri, United States.
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Dell’Aquila K, Hodges H, Moshiri M, Katz DS, Elojeimy S, Revzin MV, Tembelis M, Revels JW. Imaging evaluation of lymphoma in pregnancy with review of clinical assessment and treatment options. Abdom Radiol (NY) 2023; 48:1663-1678. [PMID: 36595067 PMCID: PMC9808767 DOI: 10.1007/s00261-022-03779-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
Lymphoma-related malignancies can be categorized as Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL) based on histologic characteristics. Although quite rare during pregnancy, HL and NHL are the fourth and fifth most common malignancies during the pregnancy period, respectively. Given the rarity of lymphoma among pregnant patients, radiologists are usually unfamiliar with the modifications required for staging and treatment of this population, even those who work at centers with busy obstetrical services. Therefore, this manuscript serves to not only review the abdominopelvic imaging features of lymphoma in pregnancy, but it also discusses topics including birthing parent and fetal lymphoma-related prognosis, both antenatal and postpartum, current concepts in the management of pregnancy-related lymphoma, as well as the current considerations regarding birthing parent onco-fertility.
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Affiliation(s)
- Kevin Dell’Aquila
- grid.260914.80000 0001 2322 1832New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY USA
| | - Hannah Hodges
- grid.266832.b0000 0001 2188 8502Department of Radiology, University of New Mexico, Albuquerque, NM USA
| | - Mariam Moshiri
- grid.412807.80000 0004 1936 9916Department of Radiology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Douglas S. Katz
- grid.137628.90000 0004 1936 8753Department of Radiology, New York University Langone Health–Long Island, Mineola, NY USA
| | - Saeed Elojeimy
- grid.259828.c0000 0001 2189 3475Department of Radiology, Medical University of South Carolina, Charleston, SC USA
| | - Margarita V. Revzin
- grid.47100.320000000419368710Department of Radiology, Yale University School of Medicine, New Haven, CT USA
| | - Miltiadis Tembelis
- grid.137628.90000 0004 1936 8753Department of Radiology, New York University Langone Health–Long Island, Mineola, NY USA
| | - Jonathan W. Revels
- grid.137628.90000 0004 1936 8753Department of Radiology, New York University Langone Health–Long Island Division, 560 1St Avenue, 2nd Floor, New York, NY 10016 USA
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[18F]FDG PET/CT and PET/MR in Patients with Adrenal Lymphoma: A Systematic Review of Literature and a Collection of Cases. Curr Oncol 2022; 29:7887-7899. [PMID: 36290900 PMCID: PMC9600011 DOI: 10.3390/curroncol29100623] [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: 09/20/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022] Open
Abstract
AIM The present study aimed to assess the existing data about Primary Adrenal Lymphoma (PAL) evaluated with FDG PET and to describe a small monocentric series of cases. A systematic analysis (from 2010 to 2022) was made by using PubMed and Web of Science databases reporting data about the role of FDG PET/CT in patients with suspicious or known adrenal lymphoma. The quality of the papers was assessed by using QUADAS-2 criteria. Moreover, from a single institutional collection between 2010 and 2021, data from patients affected by adrenal lymphoma and undergoing contrast-enhanced compute tomography (ceCT)/magnetic resonance (MR) and FDG PET/CT or PET/MR were retrieved and singularly described. Seventy-eight papers were available from PubMed and 25 from Web of Science. Forty-seven (Nr. 47) Patients were studied, most of them in the initial staging of disease (n = 42; 90%). Only in one paper, the scan was made before and after therapy. The selected clinical cases were relative to the initial staging of disease, the restaging, and the evaluation of response to therapy. PET/CT and PET/MR always showed a high FDG uptake in the primary adrenal lesions and in metastatic sites. Moreover, PET metrics, such as maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV), were elevated in all primary adrenal lesions. In conclusions, FDG PET either coupled with CT or MRI can be useful in staging, restaging, and for the evaluation of treatment response in patients affected by PAL.
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Bae YJ, Kim H, Cha W, Choi BS. Primary pharyngeal synovial sarcoma in a pediatric patient: A case report. Medicine (Baltimore) 2021; 100:e28411. [PMID: 34967377 PMCID: PMC8718205 DOI: 10.1097/md.0000000000028411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Synovial sarcoma is a rare malignant tumor that typically originates from the soft tissue of the extremities. The occurrence of primary pharyngeal synovial sarcoma is even rarer, and few studies have reported its radiological features. Here, we report a case of pediatric primary pharyngeal synovial sarcoma and describe the conventional and advanced magnetic resonance imaging (MRI) findings with pathologic correlation. PATIENT CONCERNS An 11-year-old girl presented to the otolaryngologic clinic with dysphagia. DIAGNOSIS Laryngoscopy revealed a large mass in the oropharynx. MRI revealed a well-defined soft tissue mass with a maximal diameter of approximately 5 cm originating from the submucosal space of the oropharynx. The mass was primarily solid and showed homogeneous contrast-enhancement. The mass was hypointense on T1-weighted images and hyperintense on T2-weighted images. The mass showed a homogeneously low apparent diffusion coefficient value on diffusion-weighted imaging, which indicated high tumor cellularity. Dynamic contrast-enhanced MRI revealed a hypovascular tumor with low values of the volume transfer constant between the extracellular extravascular space and blood plasma and blood plasma volume per unit tissue volume. Amide proton transfer-weighted MRI revealed a relatively high amide proton transfer signal in the tumor, indicating a high protein/peptide component. The patient underwent partial surgical resection of the tumor, and the diagnosis of biphasic synovial sarcoma was confirmed on postoperative pathological examination. INTERVENTION The patient was started on chemotherapy with vincristine, ifosfamide, doxorubicin, and etoposide. OUTCOMES The tumor did not respond to the 3 cycles of the chemotherapy. Thus, the patient underwent second surgery and subsequent radiation therapy. The patient is now under ifosfamide/carboplatin/etoposide chemotherapy. LESSON Synovial sarcoma should be considered in the differential diagnosis of pediatric oropharyngeal submucosal tumors. Multimodal MRI may aid diagnosis, although the final diagnosis should be based on the postoperative pathological examination findings.
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Affiliation(s)
- Yun Jung Bae
- Department of Radiology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Hyojin Kim
- Department of Pathology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
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Reginelli A, Urraro F, Sangiovanni A, Russo GM, Russo C, Grassi R, Agostini A, Belfiore MP, Cellina M, Floridi C, Giovagnoni A, Sica A, Cappabianca S. Extranodal Lymphomas: a pictorial review for CT and MRI classification. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:34-42. [PMID: 32945277 PMCID: PMC7944666 DOI: 10.23750/abm.v91i8-s.9971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
Extranodal lymphomas represent an extranodal location of both non-Hodgkin and Hodgkin lymphomas. This study aims to evaluate the role of CT and MRI in the assessment of relationships of extranodal lymphomas with surrounding tissues and in the characterization of the lesion. We selected and reviewed ten recent studies among the most recent ones present in literature exclusively about CT and MRI imaging of extranodal lymphomas. Contrast-enhanced computed tomography (CT) is usually the first-line imaging modality in the evaluation of extranodal lymphomas, according to Lugano classification. However, MRI has a crucial role thanks to the superior soft-tissue contrast resolution, particularly in the anatomical region as head and neck. (www.actabiomedica.it)
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Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Carolina Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Andrea Agostini
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Michaela Cellina
- Department of Radiology, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Chiara Floridi
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Andrea Giovagnoni
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Antonello Sica
- Oncology and Hematology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
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Nguyen TT, Thelen JC, Bhatt AA. Bone up on spinal osseous lesions: a case review series. Insights Imaging 2020; 11:80. [PMID: 32601958 PMCID: PMC7324468 DOI: 10.1186/s13244-020-00883-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
Spinal osseous neoplasms are frequently encountered and can be challenging when present as solitary lesions. Familiarity with the range of benign and malignant spinal pathology can help the radiologist formulate a comprehensive differential diagnosis. This article focuses on the spectrum of extradural spinal tumors, accounting for the majority of primary spinal tumors, by comparing the epidemiology, pathophysiology, clinical presentation, and characteristic imaging appearance of these lesions. The discussion includes the commonly encountered benign lesions, such as vertebral venous vascular malformation and enostosis, as well as malignant lesions including metastases and lymphoma. The article also includes other less-encountered primary spinal tumors such as plasmacytoma, osteoid osteoma, osteoblastoma, giant cell tumor, eosinophilic granuloma, chordoma, chondrosarcoma, osteosarcoma, Ewing’s sarcoma, and angiosarcoma. Familiarity with the characteristic imaging features can help the radiologist reach an accurate diagnosis and obviate the need for unnecessary invasive procedures such as biopsy and surgery.
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Affiliation(s)
- Trinh T Nguyen
- University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA
| | - Jarett C Thelen
- University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA
| | - Alok A Bhatt
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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8
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Spectrum of imaging findings in AIDS-related diffuse large B cell lymphoma. Insights Imaging 2020; 11:67. [PMID: 32430699 PMCID: PMC7237590 DOI: 10.1186/s13244-020-00871-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/06/2020] [Indexed: 02/08/2023] Open
Abstract
Lymphoma in HIV-infected patients is AIDS defining. This is the second most common AIDS defining malignancy after Kaposi's sarcoma. Development of lymphoma in HIV patients is related to immunosuppression and high viral load. Co-infection with other lymphotrophic viruses especially EBV is also strongly associated with development of lymphoma in HIV patients. Despite advances in HAART therapy, incidence of diffuse large B cell lymphoma in HIV-infected patients remains significantly higher than in the general population.Early diagnosis is challenging due to presence of opportunistic infections and atypical presentation of the lymphoma in this subset of patients. Atypical imaging findings are not unusual, and the diagnosis of lymphoma on imaging is on many occasions unexpected as the patient would ideally be initially investigated for presumed opportunistic infection.Lymphoma treatment approaches in HIV patients are complicated by comorbidity with opportunistic infections and performance status of the patients. Treatment failure and early relapse are also common in AIDS-related lymphoma. This review article highlights the common and unusual multimodality imaging findings in HIV-associated lymphoma.
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The Spectrum of Rib Neoplasms in Adults: A Practical Approach and Multimodal Imaging Review. AJR Am J Roentgenol 2020; 215:165-177. [PMID: 32374664 DOI: 10.2214/ajr.19.21554] [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: 11/18/2022]
Abstract
OBJECTIVE. Adult neoplasms of the ribs are a heterogeneous group consisting of both benign and aggressive entities. Rib neoplasms have a variety of overlapping imaging features, with much of the imaging data disjointed across the musculoskeletal, thoracic, and oncologic imaging literature. Arrival at accurate diagnosis can therefore be quite challenging. This article consolidates this information and introduces the reader to an algorithmic approach to rib lesion evaluation based on imaging. CONCLUSION. Rib neoplasms are a diverse group of benign and malignant entities, which often makes determining an accurate diagnosis challenging. Evaluation requires a multipronged approach that incorporates radiographic imaging features, nonradiographic imaging findings, lesion location, and clinical data.
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Hassanien OA, Elahwal HMS, Abdelsattar MH, Shaban EAIN. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography as a diagnostic tool in therapeutic evaluation of lymphoma after completion of therapy. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hashi S, Goodwin CR, Ahmed AK, Sciubba DM. Management of extranodal lymphoma of the spine: a study of 30 patients. CNS Oncol 2018; 7:CNS11. [PMID: 29706086 PMCID: PMC5977280 DOI: 10.2217/cns-2017-0033] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Extranodal lymphoma of the spine is often a late manifestation of systemic disease, and may result in symptoms of pain, neurologic compromise or spinal instability. Symptomatic relief is generally achieved by radiotherapy alone, but is not sufficient in addressing spinal instability. The indications for surgery remain controversial, but may be required for spinal stabilization, or refractory disease. Currently, there is a lack of studies that compare the indications and clinical outcomes of patients receiving surgical and nonsurgical management of spinal extranodal lymphoma. Medical records of 30 patients seen from March 2006 to August 2015, with histologically confirmed spinal lymphoma, were retrospectively reviewed. Demographic information, clinical factors, imaging, treatment and clinical outcomes were recorded. 19 patients were treated surgically and 11 nonsurgically (i.e., chemotherapy, radiation or combination). Surgery was performed for emergent neurological deterioration, mechanical stabilization, refractoriness to medical management or to perform an open biopsy for pathological diagnosis. Among those treated surgically, significantly fewer patients could carry on normal activities (KPS <70) at baseline, compared with those treated nonsurgically. However, there were no significant differences regarding pain medication use, functional status at 1 year, or mean survival (87.6 months) between groups. Surgery for extranodal lymphoma may be required in specific cases, resulting in favorable and similar outcomes compared with nonsurgical management.
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Affiliation(s)
- Shamsudini Hashi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Courtney Rory Goodwin
- Department of Neurosurgery, Duke University Medical Center, 200 Trent Dr., Durham, NC 27710, USA
| | - Ali Karim Ahmed
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Derinkuyu BE, Boyunağa Ö, Öztunalı Ç, Tekkeşin F, Damar Ç, Alımlı AG, Okur A. Imaging features of Burkitt lymphoma in pediatric patients. Diagn Interv Radiol 2017; 22:95-100. [PMID: 26611257 DOI: 10.5152/dir.2015.15211] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Burkitt lymphoma is an aggressive and rapidly growing tumor that is curable and highly sensitive to chemotherapy. It can affect almost every tissue in the body, producing various clinical presentations and imaging appearances, according to the predilection of the different subtypes for certain sites. Awareness of its diagnostically specific imaging appearances plays an important role in rapid detection and treatment. In this pictorial review, we aimed to identify the most common imaging features of Burkitt lymphoma in pediatric patients.
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Affiliation(s)
- Betül Emine Derinkuyu
- Division of Pediatric Radiology, Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
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Bathla G, Hegde A. Lymphomatous involvement of the central nervous system. Clin Radiol 2016; 71:602-9. [PMID: 27038652 DOI: 10.1016/j.crad.2016.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 01/21/2016] [Accepted: 02/10/2016] [Indexed: 12/15/2022]
Abstract
Lymphoma may arise within the central nervous system (CNS), known as primary CNS lymphoma (PCNSL) or may involve the CNS secondary to systemic disease. Clinical features are non-specific. A provisional diagnosis of PCNSL can be made on imaging, potentially changing the management algorithm from neurosurgical resection to biopsy. PCNSL in immunocompetent patients generally presents late, is solid, is bright on diffusion weighted imaging and shows uniform enhancement. Contiguity with a cerebrospinal fluid (CSF) surface and perivascular enhancement are useful clues. Immunocompromised patients, on the other hand, present earlier and often have multiple, necrotic, haemorrhagic lesions with irregular or rim enhancement. Secondary CNS involvement predominantly affects the leptomeninges. This review illustrates the varied imaging features of CNS lymphoma, atypical presentations, and differential diagnoses.
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Affiliation(s)
- G Bathla
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, USA
| | - A Hegde
- Department of Radiology, Raffles Hospital, 585 North Bridge Drive, Singapore 188770, Singapore.
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Johnson SA, Kumar A, Matasar MJ, Schöder H, Rademaker J. Imaging for Staging and Response Assessment in Lymphoma. Radiology 2015. [PMID: 26203705 DOI: 10.1148/radiol.2015142088] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Lymphoma comprises a heterogeneous group of diseases; remarkable advances have been made in diagnosis and treatment. Diagnostic imaging provides important information for staging and response assessment in patients with lymphoma. Over the years, staging systems have been refined, and dedicated criteria have been developed for evaluating response to therapy with both computed tomography (CT) and fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/CT. The most recent system proposed for staging and response assessment, known as the Lugano classification, applies to both Hodgkin and non-Hodgkin lymphoma. The use of standardized criteria for staging and response assessment is important for making accurate treatment decisions and for determining the direction of further research. This review provides an overview of the updated CT and PET response criteria to familiarize the radiologist with the most important and clinically relevant aspects of lymphoma imaging. It also provides a short clinical update on lymphoma and the associated spectrum of imaging findings.
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Affiliation(s)
- Sarah A Johnson
- From the Department of Radiology (S.A.J., J.R.), Department of Medicine (A.K., M.J.M.), and Molecular Imaging and Therapy Service, Department of Radiology (H.S.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Anita Kumar
- From the Department of Radiology (S.A.J., J.R.), Department of Medicine (A.K., M.J.M.), and Molecular Imaging and Therapy Service, Department of Radiology (H.S.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Matthew J Matasar
- From the Department of Radiology (S.A.J., J.R.), Department of Medicine (A.K., M.J.M.), and Molecular Imaging and Therapy Service, Department of Radiology (H.S.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Heiko Schöder
- From the Department of Radiology (S.A.J., J.R.), Department of Medicine (A.K., M.J.M.), and Molecular Imaging and Therapy Service, Department of Radiology (H.S.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Jürgen Rademaker
- From the Department of Radiology (S.A.J., J.R.), Department of Medicine (A.K., M.J.M.), and Molecular Imaging and Therapy Service, Department of Radiology (H.S.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
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Conjunctival MALT lymphoma: utility of FDG PET/CT for diagnosis, staging, and evaluation of treatment response. Clin Nucl Med 2014; 39:295-7. [PMID: 24458180 PMCID: PMC3969153 DOI: 10.1097/rlu.0000000000000356] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 67-year-old woman was referred for staging of a mucosa-associated lymphoid tumor lymphoma involving the left conjunctiva. CT scan had shown paravertebral and pelvic masses, and a breast nodule. FDG PET/CT demonstrated moderately increased uptake in the left ocular conjunctiva and confirmed the paravertebral and pelvic masses and the breast nodule. Moreover, abnormal FDG uptake was shown in 2 breast nodules, the flank, the gluteus maximus, and the gastric cardia. The patient received 6 cycles of rituximab-bendamustine chemotherapy with a complete clinical and metabolic response at the 6-month follow-up PET/CT and remained relapse-free without visual acuity problem after a 36-month follow-up.
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17
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e318256e7f2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE Lymphoma can affect virtually every tissue in the body, producing a variety of imaging appearances. In this article, the extranodal manifestations of this disease in the trunk and extremities are illustrated and the imaging features that aid in the diagnosis are reviewed. CONCLUSION Knowledge of the imaging appearances of extranodal lymphoma can aid the differential diagnosis of mass lesions encountered in tissues throughout the body on different imaging modalities.
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