scholarly journals Follicular Lymphoma: A Clinicopathological Analysis from a Tertiary care Institute in Southern India

2016 ◽  
Vol 8 ◽  
pp. 2016060 ◽  
Author(s):  
Mary Theresa Sylvia ◽  
Biswajit Dey ◽  
Debdatta Basu ◽  
Sajini Elizabeth Jacob ◽  
Rakhee Kar ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Hodgkin Lymphoma ◽  
Bone Marrow Involvement ◽  
Tertiary Care ◽  
Proliferation Index ◽  
Clinicopathological Parameters ◽  
Low Grade ◽  
Female Ratio ◽  
Non Hodgkin Lymphoma ◽  
Granulomatous Response

IntroductionFollicular lymphoma (FL) is an indolent chronic lymphoproliferative disorder of B-cells with variable clinical behaviour. It is the second most common subtype of Non-Hodgkin lymphoma in western countries but reported to have a lower incidence in Asia.Materials and methodsCases of FL diagnosed in the Department of Pathology of our Institute from January 2009 to June 2015 were included in the study. The clinicopathological parameters including staging, histological details and immunohistochemical markers CD20, CD10, Bcl2 and Ki67 were recorded in all the cases.ResultsOf the 497 cases of Non-Hodgkin Lymphoma reported during the study period, 36 (7.2%) cases were follicular lymphoma. The mean age was 50 years with male to female ratio of 3.2:1. Grade 1/ 2 was seen in 70% cases. 22 % cases had low grade with high proliferation index (Ki67 > 40%). Granulomatous response was seen in two cases. Diffuse large cell lymphoma component was present in four cases. Bone marrow involvement and peripheral blood spill was seen in 12 (37.5%) and six cases (18.8%) respectively. 72% cases were in stage 3 or 4.ConclusionIncidence of FL was lower in our study than other Indian studies. FL presented in the elderly, with male predominance and disseminated stage. Features of low grade with high proliferation index, granulomatous response, leukemic involvement and transformation to high grade lymphoma are highlighted in the study.

scholarly journals CYTOMORPHOLOGICAL DETECTION OF MALIGNANT EFFUSIONS IN NON-HODGKIN LYMPHOMA: AN INSTITUTIONAL EXPERIENCE IN A DEVELOPING COUNTRY

2019 ◽  
pp. 148-150
Author(s):  
BHAVNA NAYAL ◽  
GEETHA V
Keyword(s):  
Hodgkin Lymphoma ◽  
Systemic Disease ◽  
Tertiary Care ◽  
The Body ◽  
Lymphoid Cells ◽  
Low Grade ◽  
Detection Rates ◽  
Tissue Biopsy ◽  
Non Hodgkin Lymphoma ◽  
Lymphoid Cell Population

Objective: Lymphomatous effusions of the body cavity may be the presenting feature or develop later as a complication of systemic disease. The detection rate of lymphoma in cytologic specimen is low, especially in the absence of clinical details and ancillary studies. The present study was carried out to identify light microscopic features that are useful in identifying lymphomas on effusion cytology. Methods: A 5-year retrospective study of all patients with fluid cytology or tissue biopsy reported as suspicious or positive for non-Hodgkin lymphoma (NHL) in a tertiary care was done. The cytology, histopathology, and immunohistochemistry slides were reviewed. Results: A total of 27 cases were included in the study. Correlation with the histopathological sections of all the positive cases revealed that the cytomorphology of the abnormal lymphoid cells was monomorphous and similar to those seen in the tissue biopsy. Mercury drop karyorrhexis when present was characteristic of lymphomatous effusions. The detection rates of large cell lymphomas are higher than low-grade counterparts. Non-lymphomatous effusions showed heterogeneous lymphoid cell population and lacked karyorrhexis. Conclusion: Lymphomas can give rise to effusions. In the absence of resources in developing countries, it is important to distinguish lymphomatous effusion from a reactive process based on morphology. Monomorphous population of the lymphoid cells and presence of mercury drop karyorrhexis are useful morphological clues in identifying a lymphomatous effusion. Further, tuberculosis is a common non-neoplastic process that can be mistaken for a low-grade NHL.

scholarly journals Follicular Lymphoma Involving Bilateral Ovaries following Routine Hysterectomy and Bilateral Salpingo-Oophorectomy: An Incidental Finding

2021 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Follicular Lymphoma ◽  
Hodgkin Lymphoma ◽  
Incidental Finding ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Growth Patterns ◽  
Primary Lymphoma ◽  
Low Grade ◽  
Non Hodgkin Lymphoma

Ovarian lymphoma is an infrequent disease, accounting for less than 1% of all non-Hodgkin lymphoma diagnosis. Symptoms include abnormal vaginal bleeding or discharge, abdominal pain, and urinary obstruction due to the large mass. In our case, a 60-year-old woman, underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, as she presented with low-grade follicular lymphoma (FL) in both the ovaries and the left ovary was observed to be enlarged. The tumor is categorized as lymphoma based upon immunohistochemical markers. Computed tomography (CT) scan of the chest, abdomen, and pelvis and bone marrow biopsy are important for the staging of primary lymphoma of the ovary. The first-line chemotherapy regimen includes rituximab ,cyclophosphamid ,doxorubicin hydrochloride (hydroxydaunorubicin), vincristine sulfate (Oncovin), and prednisone (R-CHOP) for rapidly proliferative non-Hodgkin lymphoma (NHL). Lymphomas with slower growth patterns can be treated with Bendamustine-Rituximab and don’t need aggressive R-CHOP treatment.

scholarly journals Observations of PET Scan Levels of Standard Uptake Values (SUV) in Low Grade Follicular Lymphoma (LGFL) with High Proliferation Index (HPI)

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 14-14
Author(s):  
Mahmoud Aldyab ◽  
Mohammed Shiekhmohammed
Keyword(s):  
Follicular Lymphoma ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Statistical Significance ◽  
Pet Scan ◽  
Proliferation Index ◽  
Low Grade ◽  
Grey Zone ◽  
High Grade ◽  
Female Ratio

Introduction: Low grade follicular lymphoma (LGFL) with high proliferation index (HPI) behave more like high grade follicular lymphoma (HGFL) and therefore, may require different therapeutic options. Currently they're only identified histologically. We studied the PET scan observations of this subset of follicular lymphoma (FL) which occupy a clinical grey zone between LGFL and HGFL to determine whether these lymphomas can be distinguished based on PET scan SUV. Methods: One hundred and twenty-four FL cases at the pathology department at Albany Medical Center between years 2013-2019 were collected. The grade, evaluated based upon the WHO criteria for grading of FL, and KI67 index were recorded. PET scan reports of these cases were reviewed. Cases with no PET scan report, or where the PET scan report did not match the date criteria or site of the biopsy (Bx) were excluded. Of the 87 cases that were included 67 cases were of low grade and 20 cases were of high grade. Among the low grade cases, 23 cases had a high proliferation index (KI67>40%). 53 cases were excisional Bx and 34 Core Bx. The male to female ratio was: 46:40, and the age ranged from 35-92 with a mean of 63.59. Results: KI67 and SUV means were compared using an independent sample t test and the analysis (table 1) shows that although PET SUV may differentiate HGFL from LGFL, it does not differentiate HGFL from LGFL with HPI when using KI67≥40 % or KI67≥30% as cutoff points. However, the statistical significance noted in SUV between HGFL and LGFL with HPI when using KI67≥20% as a cut off point, is probably due to the grade of lymphoma, given the loss of significance (p>0.05) when LGFL with KI67≥20% is compared to LGFL with KI67≤20%. Conclusion: Our findings indicate that LGFL with HPI cannot be reliably identified on PET scan alone. Histology remains the gold standard for identifying low grade follicular lymphoma with high proliferation index. Disclosures No relevant conflicts of interest to declare.

scholarly journals Follicular Lymphoma Involving Bilateral Ovaries Following Routine Hysterectomy and Bilateral Salpingo-Oophorectomy: An Incidental Finding

2020 ◽  
Author(s):  
Anoshia Afzal ◽  
Michael Quinton ◽  
Umar Farooque ◽  
Sepideh Asadbeigi ◽  
Bilal Ahmed Khan ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Hodgkin Lymphoma ◽  
Incidental Finding ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Growth Patterns ◽  
Primary Lymphoma ◽  
Low Grade ◽  
Non Hodgkin Lymphoma

Ovarian lymphoma is an infrequent disease, accounting for less than 1% of all non-Hodgkin lymphoma diagnosis. Symptoms include abnormal vaginal bleeding or discharge, abdominal pain, and urinary obstruction due to the large mass. In our case, a 60-year-old woman, underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, as she presented with low-grade follicular lymphoma (FL) in both the ovaries, and the left ovary was observed to be enlarged. The tumor is categorized as lymphoma based upon immunohistochemical markers. Computed tomography (CT) scan of the chest, abdomen, and pelvis and bone marrow biopsy are important for the staging of primary lymphoma of the ovary. The first-line chemotherapy regimen includes rituximab, cyclophosphamide, doxorubicin hydrochloride (hydroxydaunorubicin), vincristine sulfate (Oncovin), and prednisone (R-CHOP) for rapidly proliferative non-Hodgkin lymphoma (NHL). Lymphomas with slower growth patterns can be treated with Bendamustine-Rituximab and don’t need aggressive R-CHOP treatment.

scholarly journals FREQUENCY OF BONE MARROW INVOLVEMENT IN CASES OF LYMPHOMA: A HOSPITAL BASED OBSERVATIONAL STUDY

2020 ◽  
pp. 1-3
Author(s):  
Surbhi Mahajan ◽  
Subhash Bhardwaj ◽  
Poonam Sharma
Keyword(s):  
Bone Marrow ◽  
Hodgkin Lymphoma ◽  
Hodgkin’S Lymphoma ◽  
Bone Marrow Involvement ◽  
Hodgkin's Lymphoma ◽  
Classical Type ◽  
Low Grade ◽  
High Grade ◽  
Intermediate Grade ◽  
Non Hodgkin Lymphoma

Background: In patients with lymphoma, bone marrow involvement is definite evidence of disseminated disease and hence assessment of bone marrow status in these patients provides important information for decisions regarding treatment. Aim: To determine frequency of bone marrow involvement in cases of lymphoma. Results: Out of 60 histologically confirmed lymphoma patients, 51(85%) patients were of Non Hodgkin’s lymphoma and 9 (15%) patients were of Hodgkin’s lymphoma. International working formulation was followed to classify Non Hodgkin Lymphoma into low, intermediate and high grade. The low grade Non Hodgkin lymphoma cases comprised of 41.18% (21/51), high grade 39.21% (20/51) and intermediate grade 19.61% (10/51) cases. Out of 9 Hodgkin lymphoma (HL) cases, 8 (88.9%) were of classical type and there was a single case (11.1%) of lymphocytic predominant Hodgkin’s lymphoma. 25 (41.7%) cases showed bone marrow infiltration by the atypical lymphomatous cells. Bone marrow involvement was seen in 47.05% (24/51) cases of NHL. Among Non Hodgkin lymphoma cases, maximum involvement was seen in low grade NHL 57.14% (12/21) followed by intermediate grade NHL 50% (5/10) & minimum was seen in high grade NHL 35% (7/20). Conclusion: Thorough examination of bone marrow in lymphoma patients can increase the diagnostic accuracy as it may be the single most important finding in a patient with an otherwise localized disease thereby contributing to the prognosis and appropriate treatment modalities.

Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial

Blood ◽  
2002 ◽  
Vol 99 (12) ◽  
pp. 4336-4342 ◽  
Author(s):  
Gregory A. Wiseman ◽  
Leo I. Gordon ◽  
Pratik S. Multani ◽  
Thomas E. Witzig ◽  
Stewart Spies ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Bone Marrow Involvement ◽  
Complete Response ◽  
Clinical Activity ◽  
Low Grade ◽  
Ibritumomab Tiuxetan ◽  
Reduced Dose ◽  
Non Hodgkin Lymphoma ◽  
Kaplan Meier ◽  
Increased Risk

Mildly thrombocytopenic patients with relapsed or refractory low-grade non-Hodgkin lymphoma (NHL) have an increased risk of chemotherapy-induced myelosuppression following treatment. The safety and efficacy of radioimmunotherapy with a reduced dose of90Y ibritumomab tiuxetan (0.3 mCi/kg [11 MBq/kg]; maximum 32 mCi [1.2 GBq]) was evaluated in 30 patients with mild thrombocytopenia (100-149 × 109 platelets/L) who had advanced, relapsed or refractory, low-grade, follicular, or transformed B-cell NHL. The ibritumomab tiuxetan regimen included an infusion of rituximab (250 mg/m2) and injection of 111In ibritumomab tiuxetan (5 mCi [185 MBq]) for dosimetry evaluation, followed 1 week later with rituximab (250 mg/m2) and90Y ibritumomab tiuxetan (0.3 mCi/kg [11 MBq/kg]). Patients (median age, 61 years; 90% stage III/IV at study entry; 83% follicular lymphoma; and 67% with bone marrow involvement) had a median of 2 prior therapy regimens (range, 1-9). Estimated radiation-absorbed doses were well below the study-defined maximum allowable for all 30 patients. With the use of the International Workshop criteria for NHL response assessment, the overall response rate was 83% (37% complete response, 6.7% complete response unconfirmed, and 40% partial response). Kaplan-Meier estimated median time to progression (TTP) was 9.4 months (range, 1.7-24.6). In responders, Kaplan-Meier estimated median TTP was 12.6 months (range, 4.9-24.6), with 35% of data censored. Toxicity was primarily hematologic, transient, and reversible. The incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 33%, 13%, and 3%, respectively. Reduced-dose ibritumomab tiuxetan is safe and well tolerated and has significant clinical activity in this patient population.

scholarly journals FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials

2021 ◽  
Author(s):  
Dominic Kaddu-Mulindwa ◽  
Bettina Altmann ◽  
Gerhard Held ◽  
Stephanie Angel ◽  
Stephan Stilgenbauer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

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

Vaccine strategies in the treatment of low-grade non-Hodgkin lymphoma

2008 ◽  
Vol 109 (3-5) ◽  
pp. 230-232 ◽  
Author(s):  
Anna Koumarianou ◽  
Pantelis Kountourakis ◽  
Theophanis Economopoulos
Keyword(s):  
Hodgkin Lymphoma ◽  
Low Grade ◽  
Non Hodgkin Lymphoma
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