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)

A 68-year-old man was admitted to our hospital because of left back pain and systemic lymphadenopathy with hypercalcemia. Serum anti-HTLV-1 antibody was positive. Left cervical lymph node (LN) biopsy revealed proliferation of medium-sized to large CD4-positive atypical cells with modest infiltration of CD20 and Epstein-Barr virus (EBV)-encoded RNA dual-positive atypical large cells. Monoclonal integration of HTLV-1 proviral DNA, plus clonal rearrangement of the T-cell receptor chain gene and the immunoglobulin heavy chain gene, were detected in the same LN specimen. Composite lymphoma consisting of adult T-cell leukemia/lymphoma (ATL) and EBV positive diffuse large B-cell lymphoma (DLBCL) was diagnosed. He was successfully treated with aggressive chemotherapy including rituximab and attained remission. However, eight months later, he developed right shoulder pain due to multiple bone invasions with bilateral cervical lymphadenopathy. Biopsies of a bone lesion and cervical LN revealed recurrence of ATL alone. The patient died despite salvage chemoradiotherapy. These findings suggest that ATL-related immunodeficiency might induce EBV-associated DLBCL.
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PMID:[Composite lymphoma consisting of adult T-cell leukemia-lymphoma and diffuse large B-cell lymphoma]. 2430 40

The non-Hodgkin lymphoma (NHL) is one of the most common shoulder neoplasms, especially the diffuse large B cell lymphoma (DLBCL). We report a rare case of shoulder pain in a 80-year-old man presenting with a six-month history of continuous severe pain to the right shoulder. Routine laboratory studies were normal. Shoulder MRI showed an in-growing inhomogeneous lesion in the anteromedial aspect of the right humeral head extended within the cortical bone of the humerus (osteolitic lesion), next to the surrounding soft tissues. He also underwent shoulder arthroscopy: the intra-articular involvement of the shoulder was therefore excluded. A percutaneous bone biopsy performed on the same day was diagnostic for lymphoma. Three days later, the patient underwent surgical excision of the mass; a reverse shoulder prosthesis was then implanted (Aequalis reversed prosthesis). The patient started chemiotherapy according with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen, but did not tolerate it because of the sudden onset of herpes zoster. At 9-month follow-up, the patient is doing well, with fair range of motion, due to the delay of rehabilitation, but no shoulder pain and no evidence of local or systemic recurrence. A painful shoulder may be due to lymphoma even in the absence of classical symptoms. In suspected patients, plain radiographs should be followed by magnetic resonance imaging and bone biopsy. Tumor removal and shoulder arthroplasty can be an effective therapy. Given the devastating side effects of adjuvant chemotherapy, we do not recommend it in elderly patients.
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PMID:Non-Hodgkin's lymphoma: unexpected cause of shoulder pain. A systematic review of the literature. 2436 86

A 56-year-old man suffered from diffuse large B-cell lymphoma (DLBCL) originated from the stomach. He received R-CHOP therapy, and had a complete remission. However, at age 57, he experienced left shoulder pain and weakness of left arm, and his muscle weakness and sensory disturbance subacutely progressed to other limbs. Cervical and lumbosacral MRI showed enhanced extended lesions of cervical, thoracic, lumbar, and sacral nerve roots and cauda equina. Cerebrospinal fluid analysis revealed a sustained low glucose level. Nerve conduction study showed abnormalities of measurement parameters of F-waves in all limbs. A diagnosis of recurrent DLBCL presenting neurolymphomatosis could be established by repeated cytology of cerebrospinal fluid. He received high dose methotrexate therapy, but his symptoms were worsened to tetraplegia. It should be noticed that DLBCL can involve spinal nerve roots extensively.
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PMID:[A case of neurolymphomatosis presenting extended involvement of spinal nerve roots]. 2602 96

A 55-year-old man with large B-cell lymphoma developed atraumatic left shoulder pain. F-FDG PET/CT revealed new left supraspinatus and infraspinatus muscle uptake while the initial disease resolved. Given the discrepancy between initial disease treatment response and new left shoulder findings, an MRI scan was performed. This demonstrated diffuse supraspinatus and infraspinatus muscle edema and enhancement with no focal lesion. Muscle biopsy was negative for lymphoma, but features of muscle denervation were seen. Overall, clinical and imaging findings were compatible with Parsonage-Turner syndrome (acute brachial neuritis), an uncommon condition that presented as a false-positive finding on PET/CT.
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PMID:18F-FDG Uptake in Parsonage-Turner Syndrome. 2875 27

Gray zone lymphoma, also known as B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a rare malignancy with overlapping features of both diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Most commonly mediastinal involvement is seen. Extranodal involvement is rare. In this case report, we present the case of a 59-year-old male who presented with stress-related left shoulder pain, ultimately diagnosed with gray zone lymphoma. The patient was treated with etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin-rituximab (EPOCH-R) regimen followed by consolidation radiotherapy resulting in complete response. We are highlighting this case as rare and atypical presentation of a rare disease.
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PMID:"Do Not Ignore Musculoskeletal Pain"-Initial Presentation of a Rare Malignant Disease: Case Report and Literature Review. 3266 Feb 77