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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Most NHLs present with lymphadenopathy. B symptoms are often a presenting feature. Lymphomas follow one of two clinical patterns: they grow rapidly (high-grade lymphomas, e.g. Burkitt's lymphoma and DLBCL) or slowly (low-grade lymphomas, e.g. follicular lymphoma). The rapid growth rate seen in high-grade NHL makes these tumours more sensitive to chemotherapy and therefore potentially curable. Low-grade lymphomas progress much more slowly but are generally incurable although multiple courses of chemotherapy can be given which can keep the disease under control for many years, and allogeneic HSCT can be curative for carefully selected patients.
Skull deformities
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Which of the following statements regarding Hodgkin’s lymphoma are true? Lower socio-economic groups are associated with a greater risk of developing Hodgkin’s disease.Epstein–Barr virus infection has been implicated strongly in the development of Hodgkin’s lymphoma.Reed–Sternberg cells are pathognomonic of Hodgkin’s lymphoma.The presence of B symptoms is associated with a worse prognosis.St Jude staging system is used to stage Hodgkin’s lymphoma.
Cervical lymphadenopathy
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Suggestive of systemic disease or lymphoma. Fever, night sweats: So-called ‘B symptoms’ [3].Flushing, palpitations, hypertension: In phaeochromocytoma associated with paragangliomas (glomus tumours).
The prognostic role of lymphocyte to monocyte ratio (LMR) in patients with Myelodysplastic Neoplasms
Published in Hematology, 2023
Chuanyang Lu, Qiuni Chen, Jiaxin Li, Chunling Wang, Liang Yu
The underlying mechanisms by which LMR correlates with prognosis have not been completely elucidated. Former researchers suggested that systematic inflammation contributes to the development of malignancies and has a vital role in the survival of cancer patients [20]. Specifically, systemic inflammatory and immune response causes tumor-related symptoms, including fever, sweating and weight loss (so-called B symptoms). Additionally, it can mitigate the effectiveness of treatment, increase toxicity and even lead to treatment failure [20,21]. Previous studies have also demonstrated that biochemical indicators and peripheral blood counts or ratios can be used as markers of immunological and inflammatory responses. They include albumin, C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophils, lymphocytes, monocytes, platelets, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and the systemic immune-inflammation index (SII) [22]. Furthermore, a retrospective study of 503 patients with non-del(5q) MDS verified that lymphocytopenia at diagnosis has an unfavorable influence on the prognosis of MDS patients, as ALC could reflect the host's immune status [23]. Monocytes differentiate into macrophages that participate in tumor infiltration and metastasis in the tumor microenvironment [11]. In solid tumors, increased numbers of monocytes have been shown to be associated with worse prognosis [24,25]. Thus, it can be postulated that lower LMR correlates with the worse prognosis of cancer patients.
Clinical, endoscopic and pathological characteristics of primary gastrointestinal T-cell and NK/T-cell lymphomas
Published in Scandinavian Journal of Gastroenterology, 2023
Yi Lu, Hailing Liu, Xianhua Zhuo, Tingzhi Liu, Xiaoying Lou, Chujun Li, Min Zhi
Clinical stage was determined according to the Lugano classification [11]. B symptoms were defined as systemic symptoms of fever, night sweats, and weight loss [8]. Among the complications, perforation was confirmed by X-ray or CT scans, intestinal fistula was confirmed by CT, and hemorrhage was defined as loss of more than 500 mL blood in less than 24 h or hemoglobin level lower than 90 g/L. The endoscopic features of primary gastrointestinal lymphomas were divided into four types as described in a previous study: superficial/erosive, ulcerative, ulceroinfiltrative and infiltrative [5]. Since most of the patients had more than one lesion on endoscopy, we evaluated the most prominent lesion as its endoscopic feature. To obtain an overview of the pathologic features, if the patients have received surgery, then we analyzed the surgical specimens; otherwise, we chose the biopsy specimens.
Bilateral Multiple Retinal Detachments Associated with Diffuse Large B-Cell Lymphoma: Masquerading as Vogt-Koyanagi-Harada Disease
Published in Ocular Immunology and Inflammation, 2023
The initial clinical impression was incomplete VKH disease3; however, considering the patient’s high fever and generalized symptoms, we performed additional systemic evaluation before administering systemic steroid pulse therapy. Lab test results revealed elevated levels of aspartate transaminase (81 IU/L) and alanine transaminase (31 IU/L). Moreover, lactic acid dehydrogenase (LDH) levels were remarkably high (2522 IU/L). Given that LDH levels are elevated in cases of myopathy and various malignancies,4 we performed abdominopelvic CT; it revealed a hepatic mass with multiple lymphadenopathy. Liver biopsy confirmed the diagnosis of DLBCL. On positron emission tomography-CT, a hypermetabolic nodular thickening was observed in the posterior poles of both eyes; furthermore, other lesions were observed along with the hypermetabolic lesions invading multiple organs such as the lungs, liver, spleen, bone marrow, bone, meninges, left maxillary sinus, and peritoneum. Accordingly, chemotherapy was initiated for DLBCL, which invades multiple organs with B symptoms. Post-chemotherapy, the patient’s visual symptoms rapidly improved. The BCVA recovered to 20/25 in both eyes and remained stable until the 3-year follow-up; furthermore, the subretinal fluid was completely resolved (Figure 2a,b).