Cell Lymphoma
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Sindhu Kilaru ◽  
Soumya Surath Panda ◽  
Sourav Mishra ◽  
Debahuti Mohapatra ◽  
Spoorthy Kolluri ◽  

Extra-nodal Natural killer/T cell lymphoma (ENKTL) is a well-defined and highly aggressive form of NonHodgkin’s lymphoma with a scarcity of cases reported in literature. The most common primary site of involvement is the nasal cavity followed by skin and the gastrointestinal tract (GIT). Cutaneous involvement is a rarity. More than 95% of cases are usually in association with Epstein Barr Virus (EBV) infection. EBV negative ENKTL can be similar in clinical, pathological, and prognostic characteristics with EBV positive ENKTL. This malignancy is usually characterized by its poor prognosis irrespective of clinical stage and therapy. We describe here, a 58-year-old man presenting with multiple nodular lesions over legs and trunk, had an ileal perforation later, and was diagnosed as ENKTL on the ileal biopsy specimen. This case is being reported in view of the fulminant clinical course of the disease, simultaneous involvement of the GIT and skin without nasal or midline involvement, the usefulness of immunohistochemistry in arriving at a diagnosis, and EBV negativity which is quite rare in the Asian population.

Cureus ◽  
2021 ◽  
Umur Anil Pehlivan ◽  
Hasan Bilen Onan ◽  
Ertugrul Bayram ◽  
Celalet Keser ◽  
Semra Paydas

Yu. N. Vinogradova ◽  
M. S. Tlostanova ◽  
A. A. Ivanova ◽  
A. Yu. Pakhomov ◽  
N. V. Ilyin

Introduction: Metabolic Tumor Volume (MTV) and Total Tumor Lesion Glycolysis (TLG) are used in 18F-fluorodeoxyglucose Positron-Emission Tomography combined with Computed Tomography (18F-FDG PET/CT) as functional markers, indicating tracer uptake in whole tumor. MTV and TLG are not yet engaged in clinical practice, because volume measurement accuracy depends on the selected measurement method, and optimal MTV and TLG segmentation is not established.Purpose: Assessment of accuracy of metabolic tumor volume measurement ways, using 18F-FDG PET/CT in patients with Diffuse Large B-Cell Lymphoma (DLBCL).Material and methods: Baseline 18F-FDG PET/CT performed in 21 patients with DLBCL. Tumor Volume (TV), measured on contrast enhanced CT (CTTV), considered as reference. While measuring MTV, we aimed to achieve a 1:1 ratio between CTTV and MTV. If anatomical and metabolic tumor contours matched, MTV was considered true (MTVtrue). Overall MTV and TLG measurements are 254. Tumor contouring, using relative thresholds, was made around Standardized Uptake Value (SUVmax) of tracer in tumor and intact liver.Results: On CT, the size of the lesions varied from 24 to 241 mm, M = 103.4±62.3, Me = 93 (48.5–155.5). In 15 (71.4 %) foci, hypodense areas of necrosis were determined. PET imaging revealed high tracer uptake in all foci of varying degrees of intensity. SUVmax values in tumors ranged from 5.8 to 30.5, Me = 20.4 (17.3–23.2). No significant correlation was found between the size of the foci and SUVmax (ρ = 0.17, p = 0.4744). The best accuracy in measuring MTV was observed when several thresholds were applied: VOIPERCIST, VOI2.5, VOIauto-contour, as well as VOI10 %, VOI15 % and VOI20 %. The optimal absolute threshold values were SUV values in the range from 2 to 3, and relative values in the range from 10 % to 20 % of the SUVmax in the tumor. MTV underestimation was more often determined using relative cut-off indices in the range of25–50 % and SUV thresholds ≥ 5.3.Conclusion: The results obtained showed that the use of a single threshold value for MTV segmentation in patients with DLBCL is not advisable. The choice of the MTV measurement method should be carried out individually for each lesion, taking into account its shape, size and structure, as well as the intensity and uniformity of tracer uptake in the tumor and adjacent anatomical structures.


2021 ◽  
Ryosuke Ogata ◽  
Hiroshi Soda ◽  
Yasuhiro Tanaka ◽  
Hiroaki Senju ◽  
Midori Shimada ◽  

eJHaem ◽  
2021 ◽  
Yoshikazu Hori ◽  
Yu Aruga ◽  
Chiaki Ikeda ◽  
Akiko Miyagi Maeshima ◽  
Koji Izutsu ◽  

2021 ◽  
Vivek Sulekha Radhakrishnan ◽  
Padmaja Lokireddy ◽  
Mayur Parihar ◽  
Prashanth Srirangapattana Prakash ◽  
Hari Menon

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