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Thyroid
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Lymphoma of the thyroid is rare, representing 2% of thyroid malignancies and 2% of extra-nodal lymphomas. Chronic autoimmune stimulation, as in Hashimoto’s thyroiditis, is a predisposing factor. There is a strong female predominance, and the median age at diagnosis is in the seventh decade, similar to that of anaplastic cancer, from which it must be distinguished (Figure 4.1e). An analysis of the U.S. National Cancer Database published in 2019 identified 3466 patients between 2004 and 2015. The median all-cause survival was 11.6 years (CI: 11.1 to 12.1 years). The majority were diffuse large B cell lymphoma (DLBCL, 59.5%), with marginal zone lymphoma (18.3%) and follicular and Burkitt lymphoma (8% and 1.9%, respectively) making up the rest.38 Mucosa-associated lymphoid tissue (MALT) is a form of marginal zone lymphoma and is characterized by a low grade of malignancy, slow growth rate, and a tendency for late relapse or second lymphomas in other MALT sites.37
Immunomodulation at Mucosal Surfaces: Prospects for the Development of Antiinfectious and Antiinflammatory Vaccines
Published in Thomas F. Kresina, Immune Modulating Agents, 2020
Cecil Czerkinsky, Jan Holmgren
Apart from the need for maintaining self-tolerance, the MALT has three main functions: to protect against colonization and invasion by the large number of potentially dangerous microbes encountered each day, to prevent uptake of undegraded antigens including foreign proteins derived from ingested food and commensal microorganisms, and, most importantly, to prevent the development of potentially harmful immune responses to these antigens. At variance with the systemic immune apparatus, which is a sterile compartment and can respond vigourously to most invaders, the mucosal immune system guards organs that are replete with foreign matter including microorganisms. It follows that on encounter with a given antigen, the mucosal immune system must select appropriate effector mechanisms and regulate the intensity of its response so as to prevent bystander tissue damage and exhaustion.
Lymphoma
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Rodney J Hicks
MALT lymphomas arise from epithelial and mucosal sites that normally have no organized lymphoid tissue, within which lymphoid tissue has arisen as a result of chronic inflammation or autoimmunity. Examples include Hashimoto's thyroiditis, Sjögren's syndrome and Helicobacter-induced chronic follicular gastritis. The association between gastric MALT lymphoma and H. pylori infection was established in 1991 by Wotherspoon et al. (137), who found the organism in over 90% of cases and demonstrated remission in response to antibiotic treatment for H. pylori. More recent studies suggest that the incidence of gastric MALT lymphoma is decreasing as a result of widespread eradication therapy for H. pylori. Consequently, fewer cases are associated with H. pylori at diagnosis (138).
Quadruple therapy for gastric high-grade B-cell lymphoma
Published in Baylor University Medical Center Proceedings, 2020
Ted George Achufusi, Kegan Jessamy, Ernesto Zamora, Nuri Ozden
The pathological findings described in this case were suggestive of an aggressive large-cell germinal center phenotype lymphoma, which is a subtype of DLBCL, consistent with a diagnosis of high-grade B-cell lymphoma, not otherwise specified, per 2016 criteria of the World Health Organization.5 This aggressive tumor with a high proliferation rate may arise de novo or from transformation from a MALT lymphoma. DLBCL represents about 40% to 70% of all gastric lymphomas, with guidelines recommending combination chemotherapy (e.g., R-CHOP) for optimal treatment.6–8 This is distinctly different from an extranodal marginal-zone lymphoma of MALT, which has a more indolent course and may respond to treatment of H. pylori; these represent 50% of gastric lymphomas.6
Natural and vaccine-induced B cell-derived systemic and mucosal humoral immunity to human papillomavirus
Published in Expert Review of Anti-infective Therapy, 2020
Ralph-Sydney Mboumba Bouassa, Hélène Péré, Mohammad-Ali Jenabian, David Veyer, Jean-François Meye, Antoine Touzé, Laurent Bélec
More globally, mucosal epithelia of the human body were protected by the MALT [28]. The MALT includes all of the immune cells and tissues involved in the defenses of all mucosa of the body, including the upper and lower gastrointestinal and respiratory tracts as well as the lower male and female genital tract [28]. Thus, whatever the mucosa through which the pathogenic organism penetrates inside the body, the immune response put in place is almost the same for all the body’s mucosa [28,29]. However, each mucosal tissue has his own regionalized and specialized lymphoid nodes which coordinate the local immune response [29]. The immune response elicited in the mucosal sites could be divided into two principal pathways according to the nature of the antigen and the main immune cells involved. Briefly, the first phase is the afferent or inductive stage which starts with the detection, the uptake and the preparation of antigen by sentinel local APCs. The digested antigens are then presented by APCs to the lymphocytes population into the regional lymph node. Then, the efferent phase can be carried out according to the signaling pathways Th1 and Th2.
Histological transformation in malignant lymphoma: a possible role of PET/CT and circulating tumor DNA as noninvasive diagnostic tools
Published in Expert Review of Hematology, 2020
MZL is a rare subtype of indolent lymphoma, and is pathologically classified into splenic MZL, nodal MZL, or the more common extranodal MZL in the mucosa-associated lymphoid tissue (MALT) [47]. Clinical data in transformed MZL are listed in Table 2. According to an analysis of a 453-MZL series of patients, the 10-year HT rate was 8%, with splenic/nodal MZL harboring a higher HT risk than MALT (HR: 2.60, P = 0.023) [48]. In addition, the OS was significantly shorter in splenic/nodal MZL than in MALT (HR: 2.04, P = 0.007). Another study including 467 cases of MALT lymphoma showed outstanding outcomes (15-year HT rate of 5% and 5-year post-HT OS rate of 94%) [49]. MALT may possibly be distinguished from other subtypes in terms of favorable outcome, which may be explained partly by the higher proportion of localized diseases.