Severe ataxia uncovered Hodgkin’s lymphoma: do not forget CT neck when looking for covert malignancy

2021 ◽  
Vol 14 (11) ◽  
pp. e245225
Author(s):  
Naim Izet Kajtazi ◽  
Ehtesham Khalid ◽  
Juman Al Ghamdi ◽  
Ahmad Abulaban ◽  
Majed H AlHameed
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Distant Metastases ◽  
Neurological Status ◽  
Hodgkin's Lymphoma ◽  
Medical Problems ◽  
Cervical Lymph Nodes ◽  
Remarkable Recovery ◽  
Severe Ataxia ◽  
Intravenous Steroids ◽  
Whole Spine

A 53-year-old woman without medical problems presented with 5-month history of dizziness, difficulty speaking, severe ataxia, which worsened a day before admission to inability to stand unsupported. An extensive workup was initiated to find the cause of ataxia. The laboratory investigations and imaging of the brain and whole spine revealed no lesions. She was found to have autoimmune thyroiditis, positive coeliac disease antibodies without clinical features and vitamin D deficiency. No intravenous steroids or immunosuppressive therapy was given. Cerebrospinal fluid showed lymphocytic pleocytosis. The workup for the cause of severe ataxia revealed an oropharyngeal lesion with cervical lymph nodes, and the biopsy showed classical Hodgkin’s lymphoma of mixed cellularity. She was treated with chemotherapy followed by radiation therapy and made a remarkable recovery, and currently, she is in remission without distant metastases, 5 years after the initial diagnosis. Her neurological status improved, and she remained with mild ataxia.

scholarly journals Coexistence of Hodgkin’s Lymphoma and Castleman’s Disease: A Case Report with Successful Response to Chemotherapy and Radiotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Amina Mohtaram ◽  
Mohammed Afif ◽  
Tanae Sghiri ◽  
Amal Rami ◽  
Rachida Latib ◽  
...  
Keyword(s):  
Lymph Node ◽  
Hodgkin's Disease ◽  
Cervical Lymph Node ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Castleman’S Disease ◽  
Hodgkin's Lymphoma ◽  
Castleman's Disease ◽  
Cervical Lymph Nodes ◽  
Response To Chemotherapy

Background. Castleman’s disease is a rare clinicopathological entity of unknown origin. Coexistence of Hodgkin’s lymphoma and Castleman’s disease is rare. We report a case of Hodgkin’s disease of cervical lymph nodes in a patient previously diagnosed with Castleman’s disease.Case Presentation. A 43-year-old man admitted in July 2009 for a right cervical pain with lymph node at the physician examination. He underwent a right adenectomy and histological studies showed typical features of Castleman’s disease. Three years after, the patient consulted for increasing the volume of cervical lymph node. Clinical examination showed a right cervical lymph node of 3 cm. The computed tomography scan of chest, abdominal and pelvic was normal. Histological and immunohistochemical studies of cervical lymph node biopsy specimen were in favor of Castleman’s disease associated with Hodgkin’s disease. Reed-Sternberg cells were positive for CD15 and CD30. The patient received chemotherapy based on anthracyclines, bleomycin, vinblastine, and dacarbazine (ABVD) and radiotherapy with complete response.Conclusion. Prevalence of Hodgkin’s lymphoma in Castleman’s disease is more difficult to establish because of the low number of cases reported in the literature.

scholarly journals Infiltration of cervical lymph nodes by B- and T-cell non-Hodgkin's lymphoma and Hodgkin's lymphoma: Preliminary ultrasonic findings

2001 ◽  
Vol 67 (4) ◽  
pp. 234-239 ◽  
Author(s):  
Satomi Asai ◽  
Hayato Miyachi ◽  
Chikako Kawakami ◽  
Mitsuhiro Kubota ◽  
Yuko Kato ◽  
...  
Keyword(s):  
T Cell ◽  
Lymph Nodes ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Cervical Lymph Nodes ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

scholarly journals THE FIRST EXPERIENCE OF USING 99MTC-1-THIO-D-GLUCOSE FOR SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY IMAGING OF LYMPHOMAS

2018 ◽  
Vol 17 (4) ◽  
pp. 81-87 ◽  
Author(s):  
V. I. Chernov ◽  
E. A. Dudnikova ◽  
R. V. Zelchan ◽  
T. L. Kravchuk ◽  
A. V. Danilova ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
B Cell ◽  
Malignant Lymphoma ◽  
Bone Tissue ◽  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Emission Computed Tomography ◽  
Ct Image ◽  
Cervical Lymph Nodes

Introduction. The purpose of this study was to evaluate the feasibility of using 99mTc-TG SPECT in the detection and staging of malignant lymphoma.Materials and methods.Fifteen patients with newly diagnosed malignant lymphoma  underwent 99mTc-TG SPECT. Six patients had Hodgkin’s lymphoma and 9 patients had aggressive forms of non-Hodgkin’s lymphoma (NHL): diffuse large B-cell lymphoma (7  cases), B-cell follicular lymphoma (1 case), and lymphoma from B cells in the marginal zone  (1 case). Stage IIA was diagnosed in 5 patients, stage IIB in 1, stage IIIA in 1, stage IVA in 4 and stage IVB in 4 patients.Results.Pathological 99mTc-TG uptake in lymph nodes was observed in 14 (93 %) of the  15 patients. In one patient, the enlarged submandibular lymph node (16 mm in size)  detected by CT was not visualized by 99mTc-TG SPECT. This false-negative result was likely  to be associated with increased accumulation of 99mTc-TG in the oropharyngeal region.  There were difficulties in the visualization of paratracheal, para-aortic and paracardial lymph  nodes. These difficulties were associated with a high blood background activity, which  persisted even 4 hours after intravenous injection of 99mTc-TG. Software-based SPECT and  CT image fusion allowed visualization of these lymph nodes. The pathological 99mTc-TG  accumulation in axillary, supraclavicular, infraclavicular and cervical lymph nodes was  observed most often. Extranodal involvement was seen in 9 patients. 99mTc-TG SPECT identified extranodal hypermetabolic lesions in 7 (78 %) of these patients. In one  patient, hypermetabolic lesion in the lung detected by 99mTc-TG SPECT was not detected on CT image. CT identified bone marrow involvement in the pelvic and scapula in 1 patient. The  use of 99mTc-TG SPECT allowed the visualization of hypermetabolic bone tissue lesions  in this patient (Figure 4). In addition, in a patient with intact bone tissue on CT, 99mTc-TG SPECT detected hypermetabolic lesions in the iliac bone.Conclusion.99mTc-1-Thio-D-glucose demonstrated increased uptake in nodal and  extranodal sites of lymphoma. The results indicate that SPECT with 99mTc-1-Thio-D-glucose is a feasible and useful tool in the detection and staging malignant lymphoma.

scholarly journals Hodgkin's Lymphoma: Epidemiological Clinical Characteristics in a Reference Hospital in Oncology in the Eastern Amazon.

2020 ◽  
Author(s):  
Bárbara Rafaela Bastos Vieira ◽  
Leonam Oliver Durval Oliveira ◽  
Claúdia Nazaré de Souza Almeida Titan Martins ◽  
Váleria Pereira Braz Homci ◽  
Juarez Antônio Simões Quaresma ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Giant Cells ◽  
Hodgkin's Lymphoma ◽  
Mixed Cellularity ◽  
Cross Sectional ◽  
Cervical Lymph Nodes ◽  
Nodular Sclerosis ◽  
Reference Hospital ◽  
Primary Location ◽  
Well Differentiated

Abstract Background: Lymphomas are a type of cancer that starts in the lymphatic system. This system is made up of organs, tissues and vessels responsible for immune function. Hodgkin's lymphoma is characterized by giant cells, well differentiated and binucleated. It is divided into two groups: classical hodgkin's lymphoma and hodgkin's lymphoma predominant in nodular lymphocytes. The classic in turn is subdivided into four more histological subtypes: nodular sclerosis, rich in lymphocytes, depleted in lymphocytes and mixed cellularity. This study analyzed the spatial distribution and clinical-epidemiological and Hodgkin's lymphoma characteristics and their histological types in patients diagnosed with the disease at a Reference Hospital in Oncology in the Eastern Amazon between the years 2006 to 2015.Methods: A study was carried out cross-sectional, retrospective, analytical and descriptive study through the analysis of the medical records of 336 patients diagnosed with the disease in that given period and location, the G test was performed to demonstrate the association between the variables. Results: The cases of Hodgkin's Lymphoma came from the following Brazilian states: Pará (318 cases), Amapá (15 cases), Maranhão (2 cases), Piauí (1 case). It affected more men (62%) and young adults (mean age 26 years). The most frequent histological type was nodular sclerosis (65%). The primary location of the tumor was predominant in the cervical lymph nodes (65%). Mostly, patients with no metastases (98%), but the presence of metastases was more frequent in Hodgkin's lymphoma, Nodular Lymphocytic Predominance (18%). Conclusion: The data obtained in this study allow to know some regional peculiarities about Hodgkin's Lymphoma, which can contribute to regional preventive policies, as well as can support comparisons about the disease in other regions, contributing to better understand the heterogeneity of LH.

Activity of Rituximab-Bendamustine (RB) Combination in Nodular Lymphocyte Predominant Hodgkins Lymphoma (NLPHL)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4894-4894
Author(s):  
Srinivas S Devarakonda ◽  
Philip A Haddad
Keyword(s):  
Stem Cell ◽  
Hodgkin’S Lymphoma ◽  
Cervical Lymphadenopathy ◽  
Hodgkin's Lymphoma ◽  
Medical Attention ◽  
Proximal Jejunum ◽  
Significant Activity ◽  
Cervical Lymph Nodes ◽  
Pet Ct ◽  
Hodgkin's Lymphomas

Abstract Abstract 4894 Nodular Lymphocyte Predominant Hodgkin's Lymphoma (NLPHL) is an uncommon subtype of Hodgkin's lymphoma. NLPHL represents a more indolent disease than classical Hodgkin's lymphoma. It has unique clinicopathological features that resemble indolent Non Hodgkin's Lymphomas and hence, the tendency to manage it as such. We reviewed the activity of Rituximab-Bendamustine (RB) combination in 2 cases of relapsed NLPHL. The first patient is a 53 year old African American man who was diagnosed with Ann-Arbor Stage IIA NLPHL in 2005. He was initially treated with 3 cycles of ABVD after which he was lost to follow up. He sought medical attention in 2008 and a repeat PET/CT showed persistent cervical lymphadenopathy consistent with his known disease but the patient refused therapy at that time. Three years later, he presented with weight loss and enlarging cervical lymph nodes. A repeat biopsy of these nodes confirmed his initial diagnosis of NLPHL. He was reluctant to undergo any chemotherapy similar to the initial treatment because of the side effects. He was then treated with 4 cycles of RB followed by involved field radiation therapy, which he tolerated well. Post therapy PET/CT scan revealed a complete remission. The second patient is a 62 year old white man who was initially diagnosed with IE DLBCL of the proximal jejunum in 2004 which was successfully treated with R-CHOP. After five years he was found to have diffuse lymphadenopathy. Excisional biopsy revealed NLPHL. The patient refused to take adriamycin containing regimen or combination therapy since he poorly tolerated it before and agreed to try RB instead. He was treated with 6 cycles of RB. Re-staging PET/CT scans revealed near complete resolution. The patient was referred for autologous stem cell consolidation. He underwent adequate stem cell collection and successfully engrafted. Both patients continue to be disease free as of their last clinic visit. Rituximab –Bendamustine combination seems to have significant activity in NLPHL, reminiscent of its activity in indolent non-Hodgkin's lymphomas. Incorporation of the regimen into front line treatment of patients with this disease needs further study and evaluation. Disclosures: Off Label Use: Rituximab and Bendamustine are not FDA approved for NLPHL. Haddad:Cephalon: Honoraria, Speakers Bureau.

NODULAR SCLEROSIS HOGDKINS LYMPHOMA GRADE 2 MIMICKING ANAPLASTIC LARGE CELL LYMPHOMA - A CASE REPORT

2021 ◽  
pp. 72-73
Author(s):  
Neelam Sood ◽  
Shikha Chopra
Keyword(s):  
Lymph Node ◽  
Hodgkin’S Lymphoma ◽  
Giant Cells ◽  
Hodgkin's Lymphoma ◽  
Classical Type ◽  
Diagnostic Dilemma ◽  
Atypical Cell ◽  
Cervical Lymph Nodes ◽  
Nodular Sclerosis ◽  
Multinucleated Cells

INTRODUCTION: Hodgkin's lymphoma (HL) is a lymphoproliferative neoplasm constituting less than 1% of all neoplasms. It has been categorized into- nodular lymphocyte predominant HL and classical type with subtypeslymphocyte rich, lymphocyte depleted, nodular sclerosis and mixed cellularity. Nodular sclerosis Hodgkin's lymphoma (NSHL) is difcult to diagnose on FNA because of the lack of Reed Sternberg (RS) cells, low cellularity and difculty in identifying the counterpart of lacunar cells. CASE A 16-year-old female presented with anterior chest wall swelling si REPORT: nce 6 months measuring 5x4cm along with incidentally noted cervical lymph nodes measuring 2x2cm and 1x1cm. On examination, multiple papular skin lesions were observed. FNAC smears from cervical lymph node showed high cellularity, with sheets of binucleated and multinucleated cells having multiple nucleoli, some showing pale bluish abundant cytoplasm whereas others showing dense cytoplasm; in a background of reactive lymphoid population with few neutrophils. Few giant cells showed hyperchromatic nuclei. Abnormal mitosis seen. No typical RS cell was seen. Peripheral blood smear showed neutrophilic leukocytosis with no atypical cell. Possibility of NSHL was considered and biopsy advised to rule out ALCL. Histological sections showed near total effacement of lymph node architecture by nodules separated by broad brotic bands. These nodules exhibit proliferating lymphocytes with clustered lacunar cells along with some mononucleate, binucleate and multinucleated cells. Prominent mitotic activity, angiogenesis, focal micro abscesses were noted. Immunohistochemistry showed CD 15+ and CD 30+ expression in the giant cells, conrming diagnosis of NSHL grade 2. NSHL poses a cytological diagnostic dilemma specially in abse CONCLUSION: nce of sclerosis on FNA, making histological examination and IHC mandatory

Hodgkin's lymphoma and tuberculosis coexistence in cervical lymph nodes

2005 ◽  
Vol 46 (3) ◽  
pp. 471-475 ◽  
Author(s):  
Piotr Centkowski ◽  
Joanna Sawczuk-Chabin ◽  
Monika Prochorec ◽  
Krzysztof Warzocha
Keyword(s):  
Lymph Nodes ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Cervical Lymph Nodes
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