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

Complete regression of high-grade lymphoma is extremely rare. We report 1 such case that might have been conceivably mediated by Ganoderma lucidum (Lingzhi), an immunomodulatory herbal medicine. A 47-year-old man presented with epigastric pain. Endoscopy revealed a large gastric ulcer, which on biopsy was diagnostic of large B-cell lymphoma. At gastrectomy 11 days later, no evidence was found of large B-cell lymphoma despite thorough sampling. Instead, there was a dense and permeative infiltrate of CD3(+) CD8(+) cytotoxic small T lymphocytes spanning the whole thickness of the gastric wall. In situ reverse transcription polymerase chain reaction for T-cell receptor beta-chain family did not detect a monoclonal T-cell population. We postulate that the cytotoxic T cells may represent an active host-immune response against the large B-cell lymphoma that resulted in a complete regression. On questioning, the patient had taken megadoses of Ganoderma lucidum, which might have triggered the successful immune reaction.
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PMID:Regression of gastric large B-Cell lymphoma accompanied by a florid lymphoma-like T-cell reaction: immunomodulatory effect of Ganoderma lucidum (Lingzhi)? 1747 79

T-cell/histiocyte-rich diffuse large B-cell lymphoma is characterized by abundant reactive T-cell and histiocyte infiltration within nodal diffuse large B-cell lymphoma, and only limited cases of primary cutaneous T-cell-rich B-cell lymphoma have been documented. These reactive T-cells usually show a T-helper phenotype. Gamma/delta T-cell is a functionally distinct T-cell lineage, which constitutes on average 5% of all T-cells in the peripheral blood. Herein, we report the first documented case of primary cutaneous malignant B-cell lymphoma with abundant reactive gamma/delta(+) T-cells within the skin lesion and peripheral blood. An 80-year-old Japanese male presented with a gradually enlarged knee nodule. Histopathological study revealed diffuse infiltration of lymphoid cells in the dermis and subcutis. Proliferation of large-sized atypical lymphoid cells was observed among medium-sized lymphocytes with convoluted nuclei. Immunohistochemically, these large-sized atypical lymphocytes were CD20(+), and relatively many gamma/delta(+) cell infiltration was also noted. Flowcytometric analysis revealed deviation of lambda+ cells (lambda/kappa 58) and increase of CD3(+) gamma/delta(+) cells (6%). Peripheral blood had CD3(+) gamma/delta(+) cells (28.8%). Rearrangement of immunoglobulin heavy chain, but not of T-cell receptor beta and gamma chains, was observed. Accordingly, an ultimate diagnosis of cutaneous B-cell lymphoma with abundant reactive gamma/delta(+) cells was made. Recent studies have shown reactive gamma/delta(+) T-cell infiltration and/or elevation in the peripheral blood in patients with various types of carcinoma, and that they play a role in the pathogenesis of some carcinomas. Therefore, additional analysis is needed to clarify the role of reactive gamma/delta(+) T-cells in malignant lymphoma.
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PMID:Primary cutaneous B-cell lymphoma with abundant reactive gamma/delta T-cells within the skin lesion and peripheral blood. 2469 37

The patient was a 73-year-old man diagnosed with low-grade B-cell lymphoma not otherwise specified based on a biopsy of the enlarged cervical lymph nodes. He remained untreated and was monitored during follow-up visits only. Progressive anemia developed after 5 years. Enteroscopy revealed stricture and ulcerative lesions involving the entire circumference of the middle section of the small intestine. Based on the biopsy results, he was diagnosed with enteropathy-associated T-cell lymphoma (EATL). Biopsy of an enlarged axillary lymph node simultaneously revealed Epstein-Barr virus-negative diffuse large B-cell lymphoma (DLBCL) and peripheral T-cell lymphoma not otherwise specified (PTCL, NOS) as well as rearrangement of immunoglobulin heavy-chain and T-cell receptor beta and gamma chain genes. These findings suggested that the axillary lymph node contained composite lymphoma comprising DLBCL and PTCL and that EATL represented a discordant lymphoma. The present case emphasizes the importance of re-biopsy and genetic analysis following an atypical clinical course.
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PMID:[Enteropathy-associated T-cell lymphoma coexisting with composite lymphoma composed of DLBCL and PTCL]. 3106 15


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