Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 33-year-old Japanese woman visited our hospital with progressive dyspnea. A chest roentgenogram and a chest computed tomogram revealed a mediastinal tumor and pericardial effusion. Ultrasound cardiography revealed the existence of cardiac tamponade. She was successfully treated with emergency pericardial drainage, thoracocentesis and chemotherapy. The histological diagnosis of diffuse large B cell lymphoma was established with the tumor specimen obtained by transcutaneous fine needle aspiration biopsy and through immunohistochemical analysis. This is a rare case of primary mediastinal diffuse large cell lymphoma with initial presentation of a symptom related to pericardial effusion.
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PMID:Primary mediastinal diffuse large cell lymphoma initially presented with pericardial infiltration. 128 7

A 77-year-old man was admitted because of massive pericardial effusion and cardiac tumor. Cytological examination of the effusion and histological examination of a subcutaneous tumor in the chest wall revealed diffuse large B cell lymphoma. The immunophenotype of tumor cells was CD5+ CD20+ CD22+ CD38+ HLA-DR+ CD19-. Chromosome analysis revealed complex abnormal karyotypes containing t(8;14) (q24;q32). C-myc gene rearrangement was shown by Southern blotting. Chemotherapy with pirarubicin, cyclophosphamide, vincristin, and prednisolone (THP-COP) was not effective for his lymphoma. He suffered from cardiac tamponade and died at 5 months after diagnosis. Autopsy revealed a large cardiac tumor, extensive epicardial infiltration, tiny tumors in the lung and pancreas, but no lymphadenopathy, the combination of which suggested a primary cardiac lymphoma. Immunohistochemistry for p53 protein showed nuclear staining of more than 50% of the lymphoma cells. In situ hybridization for EBER-1 was negative. Rearrangement of c-myc gene and overexpression of p53 protein are usually observed in Burkitt's lymphoma and some cases of high grade lymphomas including AIDS-associated non-Hodgkin lymphomas. In this case the association of these molecular findings and resistance to chemotherapy is suggested.
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PMID:[Diffuse large B-cell lymphoma mainly involving the heart and showing t(8;14) (q24;q32) with c-myc rearrangement]. 936 67

Pericardial effusion with cardiac tamponade is an unusual presentation of lymphoma, although cardiac involvement is often a late finding in widespread malignancy. Clinical identification can be difficult ante-mortem. New cardiac symptoms or classic findings of cardiac tamponade should prompt aggressive investigation. We present a case of B-cell lymphoma that initially presented as pericardial effusion with tamponade and discuss the characteristic physical findings and radiographic data that assist in diagnosis.
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PMID:Cardiac tamponade: an unusual clinical presentation. 1144 82

A 76-year-old man was found to have esophageal squamous cell carcinoma and had been treated with radiational therapy and chemotherapy. Five years later, he was readmitted with dyspnea and marked edema of his extremities and face. An echocardiographic examination revealed a mass lesion in the pericardium with pericardial effusion behind the left ventricular posterior wall, which was near the site of the original esophageal cancer. Coronary arteriography revealed a feeder artery to the mass from the left circumflex branch. No findings indicated a recurrence of the esophageal cancer; cytologic studies showed malignant lymphoma cells of B-cell origin. A second primary cancer of some organs including blood cells might be induced by the carcinogenic effects of ionizing radiation or chemotherapeutic agents. This is the first case of second primary cardiac B-cell lymphoma after combination therapy.
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PMID:Second primary cardiac B-cell lymphoma after radiation therapy and chemotherapy--a case report. 1151 97

Primary cardiac lymphoma (PCL) is a rare and usually fatal neoplasm, which may cause syncope, arrhythmia, heart failure and pericardial effusion as presenting clinical complaints. A case of PCL in a 72-year-old man with moderate aortic stenosis is presented. The patient was investigated because of pericardial effusion and diagnosis of diffuse large B-cell lymphoma was obtained by open-chest biopsy of the heart. Fatal ventricular arrhythmia developed the day after the first course of chemotherapy. Clinical presentations and diagnostic approach of this rare tumour are discussed. While chemotherapy is the only effective treatment of PCL, early post-chemotherapy phase should be considered critical in patients with PCL, as suggested by other reported fatal complications in this period.
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PMID:Primary lymphoma of the heart. A case report and review of the literature. 1173 10

Treatment of patients with primary mediastinal B-cell lymphoma (PMBCL) remains controversial. We started a controlled clinical trial to evaluate the efficacy and toxicity of a conventional versus more intensive regimen of combined chemotherapy followed by radiotherapy to the mediastinum with the mantle technique. From 1989 to 1997, 68 patients diagnosed with previously untreated PMBCL, aged 18-65 years and negative for immunodeficiency virus test, were considered candidates to receive either conventional chemotherapy with CEOP-Bleo (cyclophosphamide 750 mg/m(2), vincristine 1.4 mg/m(2), prednisone 40 mg/m(2), epirubicin 70 mg/m(2), and bleomycin 10 mg/m(2)) or mega CEOP-Bleo (cyclophosphamide 1000 mg/m(2), epirubicin 120 mg/m(2), vincristine, prednisone, and bleomycin at the same doses) every 21 days for six cycles, followed by radiotherapy to the mediastinum with the mantle technique (35-45 Gy, mean 38 Gy). Complete response (CR) rates were not statistically different: 64% [95 percent confidence interval (CI): 58 percent to 70 percent] for conventional arm vs 81 percent (95 CI: 77-86 percent) in the intensive group (p=0.2). However, failure-free survival (FFS) and overall survival (OS) had statistical differences. At 5 years, actuarial FFS for patients treated with conventional chemotherapy was 51 percent (95 percent CI: 44-59 percent) compared to 70 percent (95 percent CI: 65-76 percent) in the intensive arm (p>0.01). OS rates were also different: 54 percent (95 percent CI: 48-57 percent) vs 70 percent (95 percent CI: 65-76 percent), respectively (p<0.01). Toxicity was mild and no therapy-related deaths were observed. At a median follow-up of 7.3 years, no second neoplasia or acute leukemia has been observed. The international prognostic index was not useful to define clinical risk in this selected group of patients. Multivariate analysis identified pleural and pericardial effusion and chemotherapy regimen as prognostic factors influencing FFS and OS. We feel that patients with PMBCL should be treated with more intensive, but not myeloablative chemotherapy, followed by adjuvant radiotherapy to achieve an improvement in outcome in this setting of patients. Patients with pleural or pericardial effusion are considered at high risk for failure with the actual programs of treatment and probably will be considered for experimental therapeutic approaches.
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PMID:Combined therapy in the treatment of primary mediastinal B-cell lymphoma: conventional versus escalated chemotherapy. 1218 5

Primary cardiac lymphoma is an extranodal non-Hodgkin's lymphoma exclusively located in the heart and/or pericardium, extremely rare in immunocompetent patients, and more frequent in immunodepressed patients. We present 3 retrospectives cases of primary cardiac lymphoma in immunocompetent patients and review 35 cases reported in the literature. Two patients were adults and one was a child. Primary cardiac lymphoma presented with constitutional symptoms in two cases and superior vena caval syndrome in one case. Diagnosis of a tumor mass was made in all cases by transthoracic echocardiography. Primary cardiac lymphoma arose in the heart right chambers in two cases. Histological diagnoses, obtained after thoracotomy, were diffuse large B-cell lymphoma in two cases, and Burkitt's lymphoma in one case. All three cases received chemotherapy, combined with radiotherapy in one patient. Of our patients, 2 are alive and asymptomatic 12 months and 33 months after diagnosis. In conclusion, diagnosis of primary cardiac lymphoma is difficult due to non-specific clinical manifestations and should be considered in patients with a cardiac mass sometimes with pericardial effusion. It is confirmed using transthoracic echocardiography and magnetic resonance imaging and certified using cytology or open biopsy. The only effective treatment is chemotherapy, but prognosis remains poor.
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PMID:Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature. 1244 75

Primary cardiac lymphoma is very rare and clinical symptoms of cardiac involvement are unusual. The development of conduction defects as the first symptom of cardiac involvement is very uncommon. We report the case of a 57-year-old woman with syncope and complete atrioventricular block due to large B-cell primary cardiac lymphoma. The patient showed a refractory pericardial effusion. Transthoracic echocardiography revealed the presence of a mass in the pericardial space. The diagnosis of diffuse large B-cell lymphoma was made following open-chest biopsy of the heart. The clinical presentation of and the diagnostic approach to primary cardiac lymphoma are discussed. Atrioventricular block and refractory unexplained pericardial effusion and/or the existence of a cardiac mass should arouse the clinical suspicion of this rare malignancy.
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PMID:[Primary cardiac lymphoma presenting with complete atrioventricular block. Case report and review of the literature]. 1247 32

A 71-year-old man was admitted to our hospital because of systemic edema and exertional dyspnea. Chest radiographs revealed infiltrative shadows in both lung fields, pleural effusion, and pericardial effusion. Seven years before, he had undergone gastric surgery for a gastric ulcer with lymphoid hyperplasia. In the pathologic diagnosis based on the percutaneous lung biopsy, hyalinizing granuloma was suspected. For a more thorough diagnosis, the patient was subjected to an open lung biopsy, and the final diagnosis was low-grade B-cell lymphoma of the MALT (mucosa-associated lymphoid tissue) type. Gallium scintigraphy showed accentuated accumulation in the left neck and hypothyroidism was present. Histologic re-examination of the resected stomach revealed infiltration of centrocyte-like cells and lymphoepithelial lesions, compatible with the pathologic features of MALT lymphoma. We considered that the gastric neoplasm and the pulmonary, pleural, and thyroid tumors of MALT lymphoma had occurred seven years apart in this case. Thyroid hormone replacement and CHOP therapy improved the symptoms and decreased the lung tumor size by 73%. MALT lymphomas tend to remain localized for a long period. The multiorgan involvement seen in this case is rather rare.
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PMID:[A case of pulmonary low-grade B cell lymphoma (MALT type) presenting seven years after gastric lymphoma resection]. 1272 33

In a retrospective review of all patients who visited our hospital between January 1997 and December 2001, we identified 22 with mediastinal lymphoma or mediastina granulocytic sarcoma. They represented 24.2% of the 91 patients with mediastinal tumors. Histology revealed 6 cases of diffuse large B-cell lymphoma, 6 of lymphoblastic lymphoma, 6 of Hodgkin's disease, 2 of granulocytic sarcoma, and 1 of lymphoplasmacytic lymphoma. More than 1/3 of the tumors had highly aggressive histological pictures. Immunocytochemical analysis of cell surface markers by flow cytometry was very useful for reaching a definitive diagnosis of these tumors. In two cases, definitive diagnosis could be obtained only by flow cytometric examination of pleural or pericardial effusion. Careful attention should be paid to the relatively high incidence of hematologic malignancies in mediastinal tumors. Early and accurate diagnosis of these tumors is essential because some of these patients require immediate treatment by hematology specialists.
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PMID:[Clinical evaluation of mediastinal hematologic malignancies (lymphoma and granulocytic sarcoma)]. 1450 34


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