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Management of Anaplastic Thyroid Cancer and Lymphoma
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Thyroid lymphoma with aggressive histology is the most common, accounting for 65–70% of cases. Patients are more often female, with the mean age at presentation being 65. Patients typically present with a rapidly enlarging mass that is often as much as 10 cm+ when diagnosed. Cervical lymph nodes are frequently involved. Aggressive lymphoma can arise de novo or in pre-existing Hashimoto's thyroiditis. Diffuse large B-cell lymphoma is the most frequent histology, for which there is a well-established treatment, combining chemotherapy and radiotherapy. Systemic treatment is used, given the high rate of occult systemic disease. Patients will typically receive the CHOP-R regimen (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab), with chemotherapy given for 3–6 cycles followed by radiotherapy (30–40 Gy) 3–6 weeks later. This systemic treatment can achieve cure rates of 70–85%. Radiotherapy coverage and volume are dependent on the stage at presentation; stage IE patients can have radiotherapy limited to the primary thyroid disease only, without cover of the cervical lymph nodes, while stage IIE patients will typically have radiotherapy coverage of the thyroid primary site and the draining lymph nodes (Levels III–VI). Long-term cure is 75%.
Non-Melanoma Skin Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Irene De Francesco, Sean Whittaker, Stephen L. Morris
There has been considerable debate over the difference between the previous EORTC and WHO classifications of primary cutaneous B-cell lymphoma.174,177 Under the previous EORTC classification, primary cutaneous follicle center cell lymphoma (PCFCCL) defined a group of cutaneous lymphomas highly responsive to RT with an excellent prognosis. The same type of lymphoma with a diffuse growth pattern of large cells was classified under the previous WHO classification as a diffuse large B-cell lymphoma, leading to over-treatment with multi-agent chemotherapy. The other main group debated was primary cutaneous large B-cell lymphoma of the leg (PCLBCL-leg), which was recognized under the EORTC classification as a separate subgroup, reflecting its unfavorable prognosis. Recent clinicopathological and genetic studies support the contention that PCFCCL and PCLBCL-leg are distinct groups, and a consensus was agreed in the WHO-EORTC classification with PCFCCL being defined as primary cutaneous follicle center lymphoma (PCFCL) distinct from nodal follicular lymphoma and PCLBCL-leg as primary cutaneous diffuse large B-cell lymphoma, leg type (see Table 24.2).
Miscellaneous procedures
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Bulky disease is a term used to describe lymphoma measuring above a certain size. The exact measurement depends on the type of lymphoma. For example, in follicular lymphoma, bulky disease measures over 6 cm. In diffuse large B-cell lymphoma, bulky disease measures over 10 cm [49].
A case of primary central nervous system lymphoma presenting as a shunt complication
Published in British Journal of Neurosurgery, 2023
Roberto J. Perez-Roman, Zachary S. Hubbard, G. Damian Brusko, Robert M. Starke
To our knowledge, this is the first reported case of PCNSL in a patient with NPH treated with a VP shunt presenting as a shunt malfunction. Diffuse large B cell lymphoma is an aggressive tumor and early diagnosis is critical for optimization of therapy and prognosis. Despite advances in imaging, the diagnosis remains difficult. The typical appearance on CT imaging is usually characteristic of solitary intraparenchymal, well-defined, lobulated lesions which typically abut ependymal or meningeal surfaces.6,7 The lesions appear either isodense or hyperdense to gray matter. There is well-circumscribed homogenous enhancement following the administration of IV contrast.6 On MRI, less signal intensity on T1 and variable intensity on T2 is typically observed.1 Lesions are most commonly located supratentorially with isolated lobar involvement.6
Role of the BMP6 protein in breast cancer and other types of cancer
Published in Growth Factors, 2021
Andrea Marlene García Muro, Azaria García Ruvalcaba, Lourdes del Carmen Rizo de la Torre, Josefina Yoaly Sánchez López
mRNA BMP6 expression in non-small cell lung cancer tissues was found to be reduced compared to healthy adjacent tissue and downregulated in metastatic osteosarcoma compared to non-metastatic cases (Yang et al. 2020; Xiong, Wang, and Yu 2018), the low expression of mRNA was related to myeloma promoter methylation, and in multiple myeloma plasmacytoma cases, the multiple extramedullary plasmacytoma exhibited BMP6 promoter methylation and rapid progress (Hashida et al. 2012), as well as variable methylation between the different forms of myeloma, the analysis of various histological types of malignant lymphomas indicated a higher degree of methylation in BMP6 promoter mainly in Burkitt’s lymphoma and diffuse large b-cell lymphoma compared to other types of primary lymphoma (Daibata et al. 2007). In diffuse large b-cell lymphoma cell lines promoter hypermethylation was correlated with loss of BMP6 expression suggesting that promoter methylation is a likely predictor of poor outcome in patients with diffuse large b-cell lymphoma (Daibata et al. 2007).
Model-free slice screening for ultrahigh-dimensional survival data
Published in Journal of Applied Statistics, 2021
As an illustration, we apply the fused S-SIS method to the diffuse large-B-cell lymphoma (DLBCL) data. The DLBCL is one of the most common types of lymphoma in adults of the United States. Roughly 22] collected a dataset which consists of the survival time T and p = 7399 gene expression levels of n = 240 patients after certain medical treatment. They summarized the characteristics of patients with diffuse large-B-cell lymphoma in Table 1 of their paper. In this data set, all gene expression levels are standardized to have mean zero and standard deviation one during the exploratory data analysis. Our goal is to find the important genes which related to T among these 7399 genes. Observed survival times ranged from 0 to 21.8 years, with a median of 2.8 years across all samples. Of the 240 patients, 102 were still alive at the final follow-up visit, which led to the censoring rate of p = 7399 gene expression levels, ith patient and 22] randomly divided the dataset into a training set with 8.