Lymphoblastic lymphoma: A clinicopathologic study of 95 patients (original) (raw)
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Annals of Oncology, 2013
Background: Lymphoma occurring in patients aged 90 or older is not uncommon, and its incidence is expected to increase over time. Management of these patients is difficult given their underlying fragility and the lack of information regarding this population. Patients and methods: We retrospectively analyzed 234 patients diagnosed with lymphoma at the age of 90 years or older (90+) between 1990 and 2012 to describe their characteristics, management, outcomes and prognostic factors. Results: The median age was 92 years; 88% were B-cell lymphomas consisting mainly in diffuse large B-cell lymphoma. The median overall survival (OS) was 7.2 months (range, 0-92 months) for the 227 patients with non-Hodgkin Lymphoma (NHL), with a significant difference between aggressive and indolent NHL (5.2 months versus 19.4 months, respectively). We further analyzed 166 NHL patients for whom detailed characteristics were available. Among these patients, 63.5% received a treatment, either local (7.5%) or systemic (56%). Lymphoma was reported as the main cause of death (40%). Treatment administration was associated with improved OS in patients with aggressive (P < 0.001) but not indolent NHL (P = 0.96). In patients with aggressive NHL, hypoalbuminemia appeared as a strong and independent negative prognostic factor. Conclusions: The median OS is short in 90+ patients diagnosed with lymphoma but some patients experience prolonged survival. Lymphoma represents the main cause of death in these patients. Treatment may improve survival of selected patients with aggressive but not indolent NHL. Management of these patients may be guided by prognostic factors identified in this study, notably serum albumin.
Non-hodgkin's lymphomas iv. clinicopathologic correlation in 405 cases
Cancer, 1973
An analysis is presented of the histopathologic, clinical, and prognostic features in a series of 405 previously untreated patients with non-Hodgkin's lymphomas referred to Stanford University Medical Center between 1960 and 1971. .411 biopsies were histologically classified according to the criteria of Rappaport et al. and clinical extent of disease was thoroughly evaluated prior to treatment and staged according to the Ann Arbor Classification. Nodular lymphomas constituted 44% of the group and diffuse lymphomas 56%. Patients under the age of 35 years and those over 60 tended to have diffuse lymphomas. Although 39% of the patients had Stage I V disease at presentation, localized forms (Stage I, I,., 11, 11,) were observed in 37%. Localized extralymphatic involvement occurred more often in patients with diffuse than nodular lymphomas (11 < 0.001). Systemic symptoms occurred in 24% of patients with diffuse and 17% of those with nodular lymphomas; however, their presence did not adversely affect survival. Mediastinal adenopathy was noted in 24% of diffuse and 18% of nodular lymphomas (P = NS), and mediastinal "skipping" was observed in 20% of diffuse and 40% of nodular lymphomas ( p < 0.05). By the criteria used, 81% of evaluable patients (Stages I1 through 111,) with nodular lymphoma and 90% of those with diffuse lymphoma had contiguous sites of involvement ( p = 0.07). Two frequently observed sites of initial extralymphatic involvement were bone marrow and gastrointestinal; the former was observed more often in advanced lymphocytic lymphomas, whether nodular or diffuse, and the latter in advanced, diffuse lymphomas. Actuarial survival correlated strongly with the histopathologic type of lymphoma; in each cellular category, patients with nodular lymphomas survived significantly longer than those with diffuse lymphomas (1' < 0.05). Age at presentation also influenced survival in relation to certain histologic patterns. Patients with diffuse lymphocytic or mixed lymphomas who were less than 40 years of age had a worse prognosis than those over 40 (p = 0.02).
Presentation of lymphoma in childhood
IAR Consortium, 2023
Background: Lymphomas are the third most common group of malignant tumor in children; they are rapidly growing neoplasm, with a propensity fewer spread dissemination, and should be investigation and treated as expeditiously possible Aim of the study: To study epidemiological, clinical & pathological features of lymphoma in Iraqi children Method: Over a period of 7 years (from January 2003 to December 2009) all the cases diagnosed & treated as lymphoma in the oncology unit of the Child Central Teaching Hospital (Baghdad) were reviewed retrospectively. Result:-the total number of cases studied was 118 cases.40% of cases diagnosed during (2003,2004) while only 5% diagnose in 2007,NHL represent the most common type (80.5%) and HL account for (19.4%). regarding HL : the age range was between (2years-15 years), median age was 7 years , peak age was between (5-9 years) , male /female ratio was 5:1, cervical LAP represents the most common mode of presentation (95.6%). Mixed cellularity was the most histopathological subtype (60.8%), & most of patients with advanced disease stage (III, IV) (65.1%). Regarding NHL: the age range was between (9m-16 years), median age was 8 years, peak age was between (5-9 years) and male /female ratio was 2.1:1. Abdominal mass (distention) was the most common mode of presentation (61%). BL&BLL was the most common subtype (56.8%), &most of patient presented with advanced disease (stage III&IV) 86.2%. Conclusion:-the study show male predominant in both type of lymphoma,NHL was the most common subtype of lymphoma, MC the most common subtype of HL while BL&BLL was the most common subtype of NHL and high percentage of patients (HL&NHL) presented with advanced disease.
Background :Mediastinal cavity (anterior middle and posterior mediastinum) harbours many vital organs,nerves and vessels of the body and hence can give rise to various mass lesions arising from those organs, both benign and malignant. According to percentage of incidence lymphomas and germ cell tumor top the list.Even though imaging helps to localise the lesion histopathological examinations in the form of image guided trucut biopsy still happens to be the gold standard. However, early diagnosis of these lesions along with further categorisation and grading needs to be done promptly to start treatment and benefit the patients.This study presents an array of such cases with special emphasis to mediastinal lymphoma and their clinico pathologic correlation over a small period of time. Material And Methods : A cross sectional observational study was done in RGKar medical college over a period of 2 years. CT scan was done along with other imaging techniques to localise the mediastinal mass lesions and then guided tru cut biopsy was done for confirmation,categorisation and grading of the lesions. Immunohistochemistry was done as and when required. Result: All the avialable.information were meticulously documented in a grand chart along with other variables like age, sex, addictive habbits, presenting complaints, anatomical location etc. Spss software was used to calculate statistical significance if any,of these variables with the final etiology or histological dignosis. Conclusion : Lymphomas constitute a considerable peecentage of mediastinal masslesions.This study help in early diagnosis, classification, topographical, demographical and symptomatic correlation help us in initiating early treatment and will be beneficial to the patients in more than one ways.
Presentation, staging and diagnosis of lymphoma: a clinical perspective
Journal of Ayub Medical College, Abbottabad : JAMC, 2008
BACKGROUND Due to lack of awareness among health professionals, lymphoma is often misdiagnosed. This study was done to evaluate the clinical features and histopathologic subtypes of lymphoma. METHODS Sixty diagnosed cases of lymphoma were selected (aged 12-65 years) from medical units of Civil Hospital Karachi, during 1993 to 1998. Clinical history, physical examination and basic laboratory investigations including imaging procedures were done in all the patients. The diagnosis of lymphoma was based on histology, following the International Working Formulation classification system. This included lymph node biopsy and in some cases, biopsy of the bone marrow. The Ann Arbor Staging Classification was used to classify the extent of disease. RESULTS Out of 60 cases of lymphoma, 81.6% (49 cases) were diagnosed as non-Hodgkin's lymphoma and 18.3% (11 cases) as Hodgkin's disease, with an overall male predominance. Both categories exhibited a bimodal age distribution. Lymphadenopat...
Malignant lymphomas in the elderly: A single institute experience highlights future directions
Archives of Gerontology and Geriatrics, 2007
In this study, our experience with the diagnostics and treatment of malignant lymphoma patients were analyzed, with a special consideration of the elderly. Between 1980 and 2005, there were 181 cases found (35%) among 517 non-Hodgkin's lymphoma (NHL) patients and 46 cases (8.1%) among 565 Hodgkin's lymphoma (HL) patients, who were at least 65 years old at the time of diagnosis. Comparing elderly patients to young ones, the time from first symptoms to diagnosis was significantly longer (NHL: 7.6 months versus 4.1 months, HL: 11.4 months versus 5.6 months). B-cell and indolent NHL-s were more common (92.8% versus 79.2% and 56.4% versus 35.1%) such as classical lymphocyte predominant (cLP) HL-s (30.4% versus 15.0%); however nodular sclerosis (NS) HL-s occurred less frequently (10.9% versus 32.2%). Stages were more advanced and comorbidity was more common. Primary therapies were more often inappropriate (NHL: 20.4% versus 5.1%, HL: 26.0% versus 6.0%); there were more complications, but less cases with complete remission (NHL: 17.1% versus 61.1%, HL: 63.0% versus 79.2%) and dose reductions were more commonly applied (NHL: 46.7% versus 17.2%, HL: 52.9% versus 11.3%). Remission rates were significantly worsened by dose reductions (NHL: 68.5% versus 34.5%, HL: 61.8% versus 44.4%). Appropriate therapies resulted in significantly better overall survival (OS) rates (logrank < 0.05). It can be concluded that more favourable results can be achieved in the remission and survival rates of elderly malignant lymphoma patients if the appropriate curative or palliative therapies, considering new and less toxic protocols such as supportive care, are chosen.
International journal of health sciences
Mediastinal lymphoma is a rare tumor. Approximately 10% of primary mediastinal lymphoma occur in mediastinum. In this study we look for sex and age characteristics, histopathology and immunohistochemical profile of mediastinal lymphoma. Data were collected from the Anatomical Pathology laboratory Dr. Soetomo archives from January 2016 to August 2018. Seventeen cases of mediastinal lymphoma were found predominantly in males (76.47 %). The age range was between 17 and 64 years old. Distribution of tumor type was as follows: Non-Hodgkin’s Lymphoma, B-cell type high grade (Ki67 > 30%) 17.65 % and Non-Hodgkin’s Lymphoma, B-cell type low grade (Ki67 <30%) 11.76%, Non-Hodgkin’s Lymphoma, T-cell type high grade 11.76%, Non-Hodgkin’s Lymphoma unknown subtype 35.29%, Classical Hodgkin’s Lymphoma (CHL) 17.65%, T-cell Lymphoblastic Lymphoma (T-LBL) 5.88%. Histologically, Non-Hodgkin’s Lymphoma showed a diffuse pattern consisting of anaplastic lymphoid cells, pleomorphic nuclei, coarse chr...
Cancer, 1981
Twelve patients who developed non-Hodgkin's lymphoma with a follicular pattern during the first two decades of life were studied. Eight had the poorly differentiated lymphorytic type; the remaining four had the "histiocytic" type. Eleven of the 12 patients were male. Nine were asymptomatic, and eight had lymphadenopathy in the head and neck region. Comparison of ages reredkd the extent of disease tended to be localized (Stages I and 11) in the pediatric (<I6 years old) patient5 (83"r) and generalized in the adolescent-young adult (16-19 years old) patient3 (83%). Of ten patientc treated with chemotherapv and/or radiotherapy, eight achieved complete remissions that lasted 3 58 month\ (median, 17.5 months). Five are still in remission; three have relapsed. Seven are alive 12-120 months from diagnosis (median, 48 months); six have no clinical evidence of disease. The remaining fire patient5 died two to 164 months after diagnosis (median, 13 months). Three of the four patients who died with lymphoma had diffuse "histiocytic" lymphoma demonstrated a t autopsy examination. Poor prognostic factors included 1) failure to achieve a complete remission following initial therapy 2) extranodal diqease (with the exception of the poorly differentiated lymphocytic type involving the spleen and liver); 3) development of diffuse "histiocytic" lymphoma. Follicular lymphoma occurring in the second decade of life ha4 a biologic behavior similar to follicular lymphoma in adults. Cancer 4U222.3-2235, 1981. OST non-Hodgkin's lymphomas i n patients 19 M years old and younger have a diffuse histologic pattern and are of the lymphohlastic, undifferentiated, and "histiocytic"" types according to the Rapp:jport From the Division of Anatomic Pathology. City of Hope Nation:il
Biological and clinical features of non-Hodgkin's lymphoma in the elderly
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
The incidence of non-Hodgkin's lymphomas (NHLs) in elderly people has increased in recent years because the world population is getting older. The aim of this study was to compare the biological and clinical features in patients diagnosed with NHLs younger and older than 65 years, and the possible influence of age on the choice of optimal therapeutic approach. We retrospectively evaluated 193 patients with NHLs: 111 (68%) were <65 years and 82 (42%) ≥65 years. The following parameters were analysed: age, gender, clinical stage, International Prognostic Index (IPI), histological type, presence of B symptoms, disease localization, presence of bulky mass, Karnofsky performance status (PS), comorbidities, blood counts, liver and renal function and serum LDH. Elderly patients had statistically more frequent indolent NHLs (p=0.036), IPI 3 and 4 (p<0.0001), presence of comorbidities (p<0.001), and less frequent presence of bulky disease (p7equals;0.043). Response to therapy wa...
Leukemia, 2003
Since 1987, the GELA has initiated multicenter prospective trials for aggressive non-Hodgkin's lymphomas (NHL). Lymphoblastic lymphomas (LBL) were included in those studies until 1997, and 92 LBL patients under 61 years were identified after histological review. The protocols prescribed high-dose anthracycline regimens, four cycles given every 15 days as induction and lasted for p6 months. A total of 23 patients underwent high-dose therapy consolidation followed by autologous stem-cell transplantation and 69 received standard chemotherapy regimens. Clinical characteristics showed a male predominance (66%) with a median age of 31 years, bone marrow (BM) involvement (22%), mediastinal involvement (66%) and elevated LDH (62%). At the end of treatment, it was seen that 71% of the patients achieved complete remission; four (4%) patients died during induction; 43 patients relapsed at a median time of 10 months. With a median follow-up of 34 months, the 5year overall survival (OS) and event-free survival (EFS) rates were 32 and 22%, respectively. The only favorable factor significantly associated with survival was young age. These results are poorer than those obtained in other aggressive lymphomas treated with the same regimens and suggest that adult LBL patients should be treated with acute lymphoblastic leukemia protocols.