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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report herein the case of a 57-year-old man in whom malignant lymphoma originating in the gastric remnant was confirmed 25 years after a subtotal gastrectomy with Billroth II reconstruction had been performed for gastric ptosis. Gastroscopy revealed an ulcerated tumor on the fornix, and histologic examination of the endoscopic biopsy specimens demonstrated malignant lymphoma. Thus, total gastrectomy with splenectomy, pancreatectomy, and resection of the previously anastomosed jejunal stoma were performed. Histologic examination of the stomach remnant confirmed a diagnosis of B-cell lymphoma of the large-cell type. Although we were unable to study the surgical specimen from the initial operation, the possible relationship between pseudolymphoma and malignant lymphoma has been presented in the literature, which is reviewed following this case report.
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PMID:Malignant lymphoma of the gastric stump developing 25 years after a distal gastrectomy for benign gastric disease: report of a case. 889 79

We describe three cases of primary low-grade B-cell lymphoma of the endometrium and contrast the histological, immunohistochemical, and molecular features with two examples of benign endometrial lymphoid infiltrates. The first case was an incidental finding in a curettage specimen, confirmed on a subsequent hysterectomy. The other two cases of lymphoma were incidental findings on hysterectomy procedures performed for prolapse and cervical dysplasia, respectively. All three lymphomas occurred in patients in their sixties; none formed gross tumors. Histologic examination revealed lymphoid nodules adjacent to endometrial glands. The lymphoid cells showed mild nuclear enlargement and slight irregularities of the nuclear contour. None of the three patients had evidence of disease outside the endometrium by physical examination, bone marrow biopsy, or sampling of pelvic lymph nodes. Immunohistochemistry demonstrated a B-cell phenotype of the lymphoid cells (CD20 positive, CD79a positive) with aberrant coexpression of the T-cell-associated marker CD43. Polymerase chain reaction (PCR) amplification of the VDJ region of the immunoglobulin heavy-chain was performed on DNA isolated from paraffin sections. These studies demonstrated a clonal proliferation of B-lymphocytes in two cases. In the third case, a faint band was found superimposed on a background smear, suggesting the presence of a B-cell clone. In contrast, the two examples of histologically benign lymphoid aggregates of the endometrium consisted predominantly of T cells with rare B-lymphocytes; there was no evidence of coexpression of CD43 by B-cells. The PCR amplification from the benign lymphoid aggregates did not support a clonal process. Primary lymphoid neoplasms of the endometrium are rare, and all cases described so far have been high-stage, high-grade neoplasms. To our knowledge, this is the first report of primary low-grade B-cell lymphoma of the endometrium, presumably arising from endometrial lymphoid tissue.
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PMID:Primary low-grade endometrial B-cell lymphoma. 904 85

Painless unilateral proptosis is a frequent manifestation of numerous orbital neoplastic and non-neoplastic processes. Various mesenchymal tumors of both fibrohistiocytic and vascular origin are well-described causes. Solitary fibrous tumors (SFTs) are rare spindle-cell neoplasms usually found associated with serosal surfaces, especially the pleura, but they have recently been described in a number of extrapleural sites including the orbit. The authors describe the case of an 18-year-old man who presented with a 6-month history of painless proptosis in the right eye. A visible nontender mass in the right supermedial orbit producing ptosis of the upper lid was present. Magnetic resonance imaging (MRI) showed a well-circumscribed soft tissue mass located above the right globe with no obvious invasion of adjacent orbital structures. Uneventful surgical excision through a right frontal-orbitotomy approach was performed. Histological evaluation showed a solid, highly vascular tumor mass composed of spindle cells arranged in short ill-defined fascicles. Intense immunohistochemistry staining for CD34 and B-cell lymphoma 2 (BCL-2) differentiated the lesion from the more common hemangiopericytoma. Though considered benign, local recurrence and extraorbital extension of orbital SFTs have been described. Malignant behavior, including distant metastases, has been documented in as many as 20% of pleural cases with mortality rates as high as 50%. The natural history of this tumor in the orbit is unclear. The authors report the 35th case of orbital solitary fibrous tumor and discuss the differential diagnosis, histopathology, radiological features, and clinical course.
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PMID:Solitary fibrous tumor of the orbit. 1221 91

MALT lymphoma of the ocular adnexa, an indolent B-cell lymphoma, rarely affects the lacrimal gland. The case of a 73-year-old man with ptosis and edema of the left upper eyelid, due to lacrimal gland swelling, is presented. Clinical evaluation and imaging examination led to excision biopsy. The mass histopathology, presenting organized lymphoid tissue, composed mainly of small B-cells, accompanied by immunophenotypic characteristics, was compatible with MALT lymphoma. Treatment with monoclonal antibody against CD-20 achieved a successful long-term disease control (4 years). The diagnostic approach is described and the pathological features and clinical signs of this rare entity are discussed, based on recent literature. The indolent clinical course of this lymphoma, either remaining localized or disseminating to other mucosal sites, is a distinct characteristic affecting prognosis.
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PMID:Mucosa-associated lymphoid tissue lymphoma of the lacrimal gland--a case report. 1627 31

Ptosis on its own is an infrequent initial manifestation of orbital lymphoma. Orbital lymphoma usually presents as a palpable mass with proptosis, diplopia, and conjunctival ("salmon-pink") swelling. We report here a 62-year-old female patient who presented with right eye ptosis. The initial imaging study showed an indistinct enlargement of the superior rectus-levator muscle complex. After 3-4 months, ptosis and upward gazing movement were further restricted. The imaging study revealed a definite soft-tissue mass in the superior orbit surrounding the superior rectus-levator muscle complex. A tumor biopsy through anterior orbitotomy revealed a large diffuse B-cell lymphoma. With the experience of this case, we suggest that orbital lymphoma should be included in the differential diagnosis of ptosis accompanied by impairment of levator muscle function.
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PMID:Ptosis as an initial manifestation of orbital lymphoma: a case report. 1667 2

A 55-year-old man presented with mist, ptosis, and headache. Repeated imaging studies of the brain showed wandering lesions with small hemorrhage and/or infarct-like change. Leptomeningeal enhancement was noted. Angiography revealed filling defects in dural sinuses, particularly in the left cavernous sinus. Under the diagnosis of dural sinus thrombosis accompanied with rhinitis, antibiotics and anticlotting drugs were administered. Rhinitis was improved, however, the cavernous sinus lesion remained and grew. Autopsy revealed that large B-cell lymphoma occupied the cavernous sinuses and made a mass involving sella turcica, left sphenoid bone, hypophysis. No tumor mass in the brain or tumor dissemination in the leptomeninx was observed. Intima of the brain venous system, however, was widely involved by lymphoma cells admixed with thrombi, which produced occlusion of the leptomeningeal veins and dural sinuses. Various figures of recanalization were also present. It seems that a unique type of thrombosis, i.e. tumoral thrombosis of leptomeningeal veins and dural sinuses, caused by intravascular lymphoma resulted in fatal outcome with multiple brain lesions like hemorrhagic infarct. Recanalization may partly explain transient resolutions of these multiple lesions. It may be suggested that intravascular lymphomatosis can cause marked phlebothrombosis of the brain and can mimic dural sinus thrombosis.
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PMID:[Intravascular lymphomatosis complicated with marked tumoral thrombosis of the brain venous system including dural sinuses. An autopsy case report with 5 months' follow-up and fatal outcome]. 1732 80

Primary extranodal marginal zone B-cell lymphoma (EMZL) of the female genital tract is a clinical indolent disease. A 61-year-old woman presenting with vaginal prolapse underwent a vaginal hysterectomy and anterior colporrhaphy. Histological examination of the uterus revealed lymphocytic infiltration of the endometrium. The immunohistochemical profile was not in accordance with any known reactive lymphocytic proliferation. Additional polymerase chain reaction and fluorescence in situ hybridization established the diagnosis of EMZL. After staging workup, it was classified as Ann-Arbor stage 1E. Therefore, no adjuvant therapy was needed. Incidental finding of EMZL in the endometrium is exceptional. The asymptomatic presentation is according to the indolent character of extranodal marginal zone lymphoma.
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PMID:Primary extranodal marginal zone B-cell lymphoma of the female genital tract: a case report and literature review. 1831 17

A 66 year old woman with end-stage renal disease and liver cirrhosis due to chronic hepatitis C virus infection was introduced to hemodialysis therapy in 2003. In 2007, hepatocellular carcinoma was identified and the patient underwent radio frequency ablation (RFA) and ethanol injection therapy (EIT) under laparotomy. A large vaginal tumor was incidentally found at gynecological examination. Histological diagnosis was diffuse large B-cell lymphoma (Stage IE). During the first course of chemotherapy, the vaginal tumor began to prolapse from the vaginal wall due to an excellent response to the chemotherapy and finally was resected. The patient received another course of chemotherapy followed by radiotherapy. The vaginal tumor was undetectable in the follow-up imaging studies. Although patients with end-stage renal disease are at increased risk for several cancers, the occurrence of malignant lymphoma following hepatocellular carcinoma is rare. Furthermore, lymphomas arising from the female genital tract are very uncommon.
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PMID:Non-Hodgkin's lymphoma of the vaginal wall in a hemodialysis patient with hepatocellular carcinoma. 2169 6

The entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. We describe a patient with SPL showing a good prognosis. A 78-year-old woman presented with diplopia, left ptosis, and back pain. Magnetic resonance (MR) imaging revealed a parasellar mass lesion extending to the upper clivus and another mass lesion with compression fracture of the Th3 vertebral body. Transsphenoidal exploration was performed, and it showed diffuse large B-cell lymphoma. Based on the positive tumor cells in the following bone marrow aspiration and hepatosplenomegaly in computed tomography (CT) findings, this patient was diagnosed as having a pituitary involvement of systemic lymphoma. After chemotherapy, she achieved complete remission for 4 years. The entity of pituitary lymphoma is extremely rare. Nineteen cases of PPL and 16 cases of SPL have been reported. Generally, clinical and radiological diagnosis was difficult because there are no specific findings. Therefore, biopsy was necessary in all of the cases. T2 hypointensity of a lesion in MR imaging in addition to an elevated serum level of soluble interleukin-2 receptor (sIL-2R) in a patient with a sellar lesion can be useful clues for the differential diagnosis of this rare disease.
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PMID:Malignant lymphoma in the parasellar region. 2466 2

We report the case of a 62-year-old man who presented with malignant lymphoma as recurrent multiple cranial nerve palsy after spontaneous regression of oculomotor nerve palsy. He developed ptosis and diplopia due to right oculomotor nerve palsy. Brain MRI/MRA showed no abnormality, and he recovered with conservative medical management. Three months later, he showed diplopia due to right abducens nerve palsy and facial pain and trigeminal sensory loss. Neurological examination revealed multiple cranial nerve palsy involved cranial nerve III, V, IX, and X of the right side. Serum soluble interleukin-2 receptor levels were normal, and cerebrospinal fluid examination was unremarkable. Steroid and subsequent intravenous immunoglobulin therapy didn't improve his symptoms. Six weeks after his admission, he showed rapid enlargement of the cervical lymph node and the right tonsil, and post-contrast T1-weighted MRI showed enlargement and enhancement of the left infraorbital nerve, the bilateral cavernous sinus, the bilateral facial nerves, and the left trigeminal nerve. The histopathologic examination of the tonsil biopsy revealed diffuse large B cell lymphoma. The cause of these symptoms was thought to be infiltrating the cavernous sinus, and adjacent nerves. Spontaneous regression of malignant lymphoma is an exceptional event, but this possibility should be considered so as to the correct diagnosis and proper treatment.
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PMID:[Malignant lymphoma presented as recurrent multiple cranial nerve palsy after spontaneous regression of oculomotor nerve palsy: A case report]. 2661 89


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