Simultaneous bone marrow involvement by CLL/SLL and LEF1/cyclin D1-positive metastatic melanoma

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

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An Unsuspected Finding of t(9;22): A Rare Case of Philadelphia Chromosome-Positive B-Lymphoblastic Lymphoma

Case Reports in Hematology ◽

10.1155/2017/2413587 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Prajwal Boddu ◽

C. Cameron Yin ◽

Rashmi Kanagal-Shamanna ◽

Guillin Tang ◽

Beenu Thakral ◽

...

Keyword(s):

Bone Marrow ◽

Kinase Inhibitors ◽

Bone Marrow Involvement ◽

Philadelphia Chromosome ◽

Lymphoblastic Lymphoma ◽

Accurate Diagnosis ◽

Biopsy Specimens ◽

B Lymphoblastic Lymphoma ◽

Prophylactic Chemotherapy

While rare, cases of isolated extramedullary disease of B-cell Lymphoblastic Lymphoma (B-LBL) without morphologic bone marrow involvement have been described. In this report, we illustrate the case of an elderly gentleman who presented with isolated testicular and vertebral LBL involvement but had no morphologic bone marrow involvement. The initial plan of treatment was to treat along the lines of Philadelphia negative B-ALL/LBL. During this time, fluorescence in situ hybridization (FISH) and PCR testing for BCR-ABL1 rearrangements were being performed on the marrow specimens as a part of routine diagnostic workup. While the FISH returned negative, PCR testing unexpectedly detected BCR-ABL1 fusion transcripts at a low level of 0.48%. Given their presence, we performed FISH for BCR/ABL1 rearrangement in both testicular and L5 vertebral specimens which were 80–90% positive. He subsequently received rituximab, hyper-CVAD, and dasatinib, along with prophylactic intrathecal prophylactic chemotherapy. The patient achieved a prolonged remission but eventually relapsed, 4 years later. Had it not been for this fortuitous discovery, the patient would not have been treated with tyrosine kinase inhibitors. We emphasize that FISH and PCR testing for BCR-ABL1 rearrangement are integral to arriving at an accurate diagnosis and should be routinely tested on B-LBL biopsy specimens.

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The use of monoclonal antibodies and flow cytometry to detect peripheral blood and bone marrow involvement of a diffuse, poorly differentiated lymphoma

International Journal of Immunopharmacology ◽

10.1016/0192-0561(85)90060-8 ◽

1985 ◽

Vol 7 (4) ◽

pp. 423-432 ◽

Cited By ~ 6

Author(s):

D.L. Shawler ◽

S.B. Wormsley ◽

R.O. Dillman ◽

D.M. Frisman ◽

S.M. Baird ◽

...

Keyword(s):

Bone Marrow ◽

Flow Cytometry ◽

Monoclonal Antibodies ◽

Peripheral Blood ◽

Bone Marrow Involvement ◽

Poorly Differentiated

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Exploring the role of FDG-PET in the assessment of bone marrow involvement in lymphoma patients as interpreted by qualitative and semiquantitative disease metabolic activity parameter

Indian Journal of Cancer ◽

10.4103/0019-509x.73569 ◽

2010 ◽

Vol 47 (4) ◽

pp. 380 ◽

Cited By ~ 4

Author(s):

S Basu ◽

RV Asopa ◽

UN Nayak ◽

PG Kand ◽

BP Tiwari

Keyword(s):

Bone Marrow ◽

Metabolic Activity ◽

Fdg Pet ◽

Bone Marrow Involvement ◽

Activity Parameter

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Isolated Gastric Myeloid Sarcoma: A Case Report and Review of the Literature

Case Reports in Hematology ◽

10.1155/2014/541807 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Pankit Vachhani ◽

Prithviraj Bose

Keyword(s):

Bone Marrow ◽

Acute Myeloid Leukemia ◽

Case Report ◽

Myeloid Leukemia ◽

Bone Marrow Involvement ◽

Myeloid Sarcoma ◽

Review Of The Literature ◽

Aged Woman ◽

Middle Aged Woman ◽

Acute Myeloid

Myeloid sarcoma represents the proliferation of myeloblasts of acute myeloid leukemia (AML) at extramedullary sites. While extramedullary involvement in AML is uncommon in itself, isolated myeloid sarcomas, that is, myeloid sarcomas without any bone marrow involvement, are extremely rare and pose a diagnostic and therapeutic challenge. Here, we present the case of a middle-aged woman with isolated myeloid sarcoma in the stomach—an organ seldom involved by this disease. Additionally, the literature on the epidemiology, diagnosis, pathology, prognosis, and therapeutic options in myeloid sarcomas has been reviewed.

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