Primary non-Hodgkin's lymphoma of the thyroid, type MALT: a case report from the Adolphe SICE General Hospital, Pointe Noire (Congo - Brazzaville)

Primary lymphomas of the thyroid are rare tumours, representing less than 5% to 15% of thyroid cancers. These lymphomas develop on a pre-existing thyroid disease, notably Hashimoto's thyroiditis, or as a secondary site of a disseminated lymphoma. This pathology is aggressive and presents as a painful, rapidly evolving goitre with signs of compression. The most common histological types are non-Hodgkin's lymphoma type B. We report a case of thyroid non-Hodgkin's lymphoma of the MALT type in a 71 year old woman with a specific history; the positive diagnosis was made thanks to a histological study of the surgical specimen completed by an immunohistochemical study on paraffin sections. The postoperative clinical course after six years was favourable, with no local recurrence or distant metastasis. Keywords: Goiter; Primary Lymphoma; Thyroid; MALT; Immunohistochemistry

Primary Prostatic Diffuse Large B-Cell Lymphoma: a Case Report and Literature Review

Introduction: Primary lymphomas of the prostate are globally rare representing less than 0.1% of all prostatic neoplasms. In this paper we present a case of an early stage diffuse large B-cell lymphoma (DLBCL) of the prostate managed with six cycles of rituximab-based chemotherapy, and review the related literature. Case description: A 32-year-old man presented to our clinic with complaints of difficult urination and perineal pain. An enlarged, hard and nodular prostate was palpable on digital rectal examination. Needle biopsy of the prostate was performed, which revealed diffuse large B-cell non-Hodgkin's lymphoma by immunohistochemical studies. CT scan showed large pelvic mass arising from prostate encasing ureters with bilateral hydronephroureter. No abnormal finding was seen on abdominal CT and bone marrow histology. Therefore, the disease was classified into the clinical stage IAXE according to Ann Arbor's criteria. The patient achieved complete response (CR) to six cycles of rituximab based combination chemotherapy, R-CHOP with CNS prophylaxis. He remained disease free, until now, 36 months after the end of chemotherapy. Practical Implications: According to the literature, the treatment and prognosis of primary lymphoma of the prostate is the same as that of other nodal lymphomas. Rituximab-based regimen should be considered in the management of prostatic diffuse large B-cell lymphoma.

Primary diffuse large B-cell lymphoma of the prostate: a case report and review of the literature

Background Primary lymphoma of the prostate is an exceedingly rare disease, with diffuse large B-cell lymphoma being the most common known subtype in a small number of reported cases. Due to its low prevalence, there has been a chronic lack of targeted diagnostic guidelines and treatment procedures. Case presentation In this article, we report a case of primary diffuse large B-cell lymphoma of the prostate in a 70-year-old Asian man who presented with symptoms of urinary tract obstruction. Histological and immunocytochemical studies of transurethral biopsy of the prostate showed diffuse large B-cell lymphoma. The patient was managed by a combination of eight courses of chemotherapy with a regimen including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone and radiotherapy. Post-chemotherapy computed tomography scans showed complete remission. He remained disease free, until now, 15 months after the end of therapy. We also reviewed and analyzed relevant literature to illustrate the diagnosis, treatment, and prognosis of this disease. Conclusion Diffuse large B-cell non-Hodgkin’s lymphoma originating in the prostate is a rare and highly aggressive disease that lacks specificity in its clinical presentation and is easily misdiagnosed. This disease should be considered clinically in patients with significant prostate enlargement and insignificant prostate-specific antigen elevation. The diagnosis can be clarified with a prostate puncture biopsy. Chemotherapy is the main treatment for patients and may be supplemented with surgical treatment and radiotherapy.

Clinical diagnosis and treatment of primary small intestinal lymphoma

Objective: To report experiences in the diagnosis and treatment of primary lymphoma of the small intestine (PSIL). Method: The clinical data of 15 patients with PSIL treated from January 2015 to July 2019 at Guangzhou First People’s Hospital were investigated retrospectively. Among the 15 patients, 9 were male, and 6 were female, with ages ranging from 18 to 73 years, with a median age of 51.6 years. Data relating to gender, age, clinical manifestation, laboratory examination, imaging, diagnosis, and treatment of the patients were reviewed. Results: The most common clinical manifestations were abdominal pain, abdominal lump, bowel obstruction, gastrointestinal hemorrhage, and athrepsy. Serum tumor markers were checked and found to be normal. In all 15 cases, tumors were found by spiral computed tomography (CT), and 12 cases were diagnosed as PSIL. Eleven cases were given barium meal examinations, and positive results were found in 4 cases, with only 1 case considered to be PSIL. All 15 patients underwent surgery. All patients were diagnosed as having nonHodgkin lymphoma by postoperative pathology (8 patients with diffuse large B-cell lymphoma, 5 with mucosa associated lymphoid tissue type B-cell lymphoma and 2 with enteropathy-type intestinal T-cell lymphoma). There were no cases of perioperative deaths. Ten patients received adjuvant chemotherapy with the CHOP (cyclophosphamide, epirubicin, vincristine, and prednisone) regimen after the operation. Fourteen cases were followed up for a mean duration of 30 months (range of 6-52 months). The 1- and 3-year survival rates were 85.7% and 57.1%, respectively. Conclusions: PSIL has no specific clinical manifestations. The diagnostic rate with barium study is low, whereas spiral CT is a promising diagnostic method for PSIL. Surgery combined with chemotherapy is important for the treatment of PSIL

A novel 3D culture model recapitulates primary FL B cell features and promotes their survival

Non-Hodgkin B-cell lymphomas (B-NHL) mainly develop within lymph nodes (LN) as densely packed aggregates of tumor cells and their surrounding microenvironment, creating a tumor niche specific to each lymphoma subtypes. In vitro preclinical models mimicking biomechanical forces, cellular microenvironment, and 3D organization of B-cell lymphomas remain scarce, while all these parameters constitute key determinants of lymphomagenesis and drug resistance. Using a microfluidic method based on cell encapsulation inside permeable, elastic, and hollow alginate microspheres, we developed a new tunable 3D-model incorporating lymphoma B cells, extracellular matrix (ECM), and/or tonsil stromal cells (TSC). We revealed that under 3D confinement lymphoma B cells were able to form cohesive spheroids resulting from overexpression of ECM components. Moreover, lymphoma B cells and TSC dynamically formed self-organized 3D spheroids favoring spheroid growth. 3D culture induced resistance to classical chemotherapeutic agent doxorubicin, but not to BCL2 inhibitor ABT-199, identifying this approach as a relevant in vitro model to assess the activity of therapeutic agents in B-NHL. RNAseq analysis highlighted the synergy of 3D, ECM, and TSC in upregulating similar pathways in malignant B cells in vitro than those overexpressed in primary lymphoma cells in situ. Finally, our 3D model including ECM and TSC allowed long-term in vitro survival of primary follicular lymphoma B cells. In conclusion, we propose a new high throughput 3D model mimicking lymphoma tumor niche and making it possible to study the dynamic relationship between lymphoma B cells and their microenvironment and to screen new anti-cancer drugs.

Testicular non-Hodgkin’s lymphoma – a rare tumor

Primary lymphoma of the testis is an exceedingly rare disease. We present a case of a 65 years old gentleman who presented with a brief history of testicular pain. Imaging studies and serum tumour markers indicated a testicular lesion of suspicious aetiology. High inguinal orchidectomy was performed. Histopathology and immunohistochemistry revealed diffuse large B-cell lymphoma. Positron emission tomography (PET) scan revealed a metabolically active retroperitoneal lymph node in aortocaval location. Subsequently he underwent chemotherapy with Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen plus intravenous Methotrexate, following which PET scan showed disappearance of the previously detected metabolically active lesion.