scholarly journals Intravascular large B-Cell lymphoma (IVLBCL) presenting as lumbosacral polyradiculopathy

2015 ◽  
Vol 42 (S1) ◽  
pp. S28-S28 ◽  
Author(s):  
SR Peters ◽  
Z Dastani ◽  
CH Chalk
Keyword(s):  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Whole Body ◽  
Cardiorespiratory Arrest ◽  
Stool Incontinence ◽  
Large B Cell Lymphoma ◽  
Pet Scanning ◽  
Leg Weakness ◽  
Artery Obstruction ◽  
Lumbar Cord

Background: IVLBCL is potentially treatable but difficult to diagnose. Methods: A case of progressive leg weakness and sphincter dysfunction diagnosed only at autopsy. Results: A 72 year old female presented with three weeks of increasing leg weakness and three days of urine and stool incontinence. Electrophysiological testing showed reduced tibial and peroneal CMAPs, preserved sural SNAPs, and bilateral gastrocnemius fibrillations, consistent with a pre-ganglionic lesion. Lumbosacral MRI with gadolinium showed no abnormalities. CSF was examined three times (protein 1.18-1.25, glucose 2.6-3.1, normal cell count and cytology). Whole-body FDG PET scanning showed hypermetabolic foci at the tongue base and in the mediastinum, but biopsy of both revealed no abnormality. Leg weakness progressed over three months and spread to the arms despite a course of IVIg. Four months later she died of cardiorespiratory arrest. Autopsy revealed the presence of large atypical B-cells within the lumen of small and medium sized vessels in numerous organs. There was evidence of anterior spinal artery obstruction with lymphocytes and anterior horn infarction in the lumbar cord. Conclusions: Although the literature reports that IVLBCL responds well to chemotherapy, this patient illustrates the difficulty of ante-mortem diagnosis. Nerve root biopsy may be warranted in such patients.

scholarly journals Diffuse large B-cell lymphoma of the vagina in pregnancy

2020 ◽  
Vol 13 (1) ◽  
pp. e233145
Author(s):  
Nwabundo Anusim ◽  
Filip Ionescu ◽  
Olabisi Afolayan-Oloye ◽  
Susanna S Gaikazian
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Cardiac Activity ◽  
Pelvic Mass ◽  
B Cell Lymphoma ◽  
Whole Body ◽  
Rare Presentation ◽  
Whole Body Mri ◽  
Large B Cell Lymphoma ◽  
Large B Cell

A 28-year-old primigravida was evaluated for complaints of difficulty urinating and pelvic pain of 6-weeks duration. She denied fever, night sweats, weight loss or fatigue. Pelvic ultrasonography revealed a single fetal pole with cardiac activity and a 7 cm mass in the anterior vagina which encased the urethra. The diagnosis of diffuse large B-cell lymphoma germinal centre type was made on analysis of biopsied pelvic mass. Whole body MRI revealed the disease was limited to the vagina. The patient received six cycles of Rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone with significant improvement in her symptoms. Serial ultrasounds over the subsequent months showed appropriate development of the fetus. Whole body MRI after treatment showed decreased size and decreased signal of the primary pelvic mass compatible with favourable treatment response. Challenges in the management of this rare presentation of lymphoma are discussed.

Rituximab and CODOX-M / IVAC Without Stem Cell Transplantation For Poor Risk Diffuse Large B Cell Lymphoma (IPI3-5) and Burkitts Lymphoma Is Feasible and Gives a High Response Rate: Preliminary Results Of a Phase 2 UK National Cancer Research Institute Trial

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4348-4348 ◽  
Author(s):  
Andrew McMillan ◽  
Kirit M Ardeshna ◽  
Jo Gambell ◽  
Andrew Jack ◽  
Amy Kirkwood ◽  
...  
Keyword(s):  
Research Funding ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Poor Risk ◽  
Large B Cell Lymphoma ◽  
Pet Scanning ◽  
Burkitts Lymphoma ◽  
Grade 3 ◽  
Large B Cell

Abstract Introduction R-CHOP is the standard of care for patients with diffuse large B cell lymphoma (DLBCL) however poor risk patients (IPI 3-5) still have an inadequate outcome. Neither first remission high dose chemotherapy and peripheral blood stem cell transplantation (HDC+PBSCT) nor selection of cases for intensification by interim PET scanning have demonstrated a proven benefit. In the case of Burkitts lymphoma (BL) there is a paucity of data on the addition of Rituximab to the CODOX-M and IVAC regimen. Patients and Methods 113 patients with DLBCL and 37 with BL were recruited from 53 UK sites between May 2008 and April 2013. Median age was 49 years (18-65). For DLBCL patients IPI scores were 3 – 72 ( 64%), 4 -40 (35%) and 5 – 1 (1%). All patients received the modified CODOX-M and IVAC regimen including all CNS directed therapy( Mead et al Ann Oncol. 2002 Aug;13(8):1264-74) and 8 doses of rituximab. The primary end point of the study was Progression Free survival (PFS) and secondary endpoints included toxicity and CR rate. Results The main toxicities reported were neutropenia ( 89% grade 3 or 4), thrombocytopenia (84.2% grade 3 or 4), infection 61.6% grade 3 or 4 and mucositis (30.1% grade 3 or 4). 4 patients were excluded from toxicity assessment as they did not start therapy after registration. There were 8 treatment related deaths observed (infection with neutropenia (5), GI haemorrhage (1), acute cerebral haemorrhage (1) and bowel perforation (1) ). 78 patients with DLBCL and 31 with BL have completed all therapy ( 78.5 % of patients with available data) with an overall response rate of 92 % for DLBCl and 94% for BL. In patients who completed all therapy CR was achieved in 34 (44%), CR (u) in 8 (10%) and PR in 30 (38%) for DLBCL patients and CR was achieved in 21 (68%), CR (u) in 6 (19%) and PR in 2 (6%) in BL patients. 3 patients ( 2 DLBCL and 1 BL) who progressed during therapy have been included in the response analysis. End of treatment PET scanning was not obligatory. 80 patients with DLBCL and 30 patients with BL remain alive and without progression at a median follow up of 18.6 and 19.3 months respectively. Conclusion The R-CODOX-M -R-IVAC regimen can be delivered to patients with poor risk DLBCL in a multicentre setting. High rates of haematological toxicity and consequent infection are inevitable with treatment of this intensity but appear acceptable when compared with other treatments such as HDC+PBSCT. Response rates are encouraging in view of the very poor risk IPI profile of the patients included in this study. Burkitts lymphoma patients also achieved an excellent response rate with no apparent additional toxicity attributable to the addition of rituximab to the regimen. We currently plan the first analysis for the primary endpoint of PFS in 2015. The Trial was supported by Leukaemia and Lymphoma Research (LLR). Disclosures: McMillan: Roche: Consultancy, Honoraria; Amgen: Research Funding. Off Label Use: Rituximab usage in Burkitts Lymphoma. Ardeshna:Roche: Honoraria, Research Funding. Jack:Roche/Genentech: Research Funding. Patmore:Roche: Consultancy, Honoraria. Pettengell:Roche: Honoraria; Amgen: Honoraria. Linch:Roche: Honoraria, Research Funding.

Diffuse Large B-Cell Lymphoma Infiltrating Limb Bones With a Few Lymphadenopathy Revealed on Whole-Body 18F-FDG PET/CT

2015 ◽  
Vol 40 (7) ◽  
pp. 569-571 ◽  
Author(s):  
Lin Qiu ◽  
Yue Chen ◽  
Zhanwen Huang ◽  
Yan Zhu ◽  
Qinglian Wen
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Whole Body ◽  
Limb Bones ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Large B Cell

Predicting primary treatment failure using interim FDG‐PET scanning in Diffuse large B‐cell lymphoma

2021 ◽  
Author(s):  
Joel Wight ◽  
Shin Hnin Wai ◽  
Edward Shen ◽  
Sze‐Ting Lee ◽  
Salvatore Berlangieri ◽  
...  
Keyword(s):  
Treatment Failure ◽  
B Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Primary Treatment ◽  
Large B Cell Lymphoma ◽  
Pet Scanning ◽  
Large B Cell

scholarly journals Diagnostic accuracy of pelvic magnetic resonance imaging for the assessment of bone marrow involvement in diffuse large B-cell lymphoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252226
Author(s):  
Qing Ke ◽  
Cheng-Cheng Liao ◽  
Xiao-Hong Tan ◽  
Bao-Ping Guo ◽  
Hong Cen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Diagnostic Value ◽  
Whole Body ◽  
Pelvic Mri ◽  
Pelvic Magnetic Resonance Imaging ◽  
Large B Cell Lymphoma ◽  
Pet Ct

Purpose We investigated the efficacy of pelvic magnetic resonance imaging (MRI) in the diagnosis of bone marrow involvement (BMinv) in diffuse large B-cell lymphoma (DLBCL) patients. Patients and methods This was a retrospective study of data from a previous study (NCT02733887). We included 171 patients who underwent bone marrow biopsy (BMB) and bone marrow smear (BMS), pelvic MRI, and whole-body positron emission tomography-computed tomography (PET/CT) from January 2016 to December 2019 at a single center. BMB/BMS and whole-body PET/CT results were used as reference standards against which we calculated the diagnostic value of pelvic MRI for BMinv in DLBCL patients. A chi-square test was used to compare detection rates, and a receiver operating characteristic curve was used to evaluate diagnostic value of pelvic MRI. Propensity-score matching was performed according to clinical information, and Kaplan-Meier curves were constructed to compare progression-free survival (PFS) and overall survival (OS) of patients. Results The BMinv detection rate of pelvic MRI (42/171) was higher (P = 0.029) than that of BMB/BMS (25/171), and similar to that of PET/CT (44/171; P = 0.901). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pelvic MRI were 83.33%, 98.37%, 94.15%, 95.24%, and 93.80%, respectively. Median PFS values were as follows: BMB/BMS-positive, 17.8 months vs. BMB/BMS-negative, 26.9 months (P = 0.092); PET/CT-positive, 24.8 months vs. PET/CT-negative, 33.0 months (P = 0.086); pelvic MRI-positive, 24.9 months vs. pelvic MRI-negative, 33.1 months (P<0.001). Median OS values were as follows: BMB/BMS-positive, 22.3 months vs. BMB/BMS-negative, 29.8 months (P = 0.240); PET/CT-positive, 27.9 months vs. PET/CT-negative, 33.9 months (P = 0.365); pelvic MRI-positive, 27.3 months vs. pelvic MRI-negative, 35.8 months (P = 0.062). Conclusion Pelvic MRI is effective for detecting BMinv in DLBCL patients, providing a more accurate indication of PFS than BMB/BMS and PET/CT do. It may ultimately be used to improve the accuracy of clinical staging, guide patient treatment, and evaluate prognosis.

Sign in / Sign up

Export Citation Format

Share Document