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Pediatric Oncology
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Stephen Lowis, Rachel Cox, John Moppett, Helen Rees
Anaplastic large cell lymphoma (ALCL) may present with painful lymph node involvement, with skin involvement, and often systemic symptoms such as fever. ALCL may have episodes of spontaneous regression, with adenopathy waxing and waning, which is otherwise unusual for malignancy.
Primary adrenal malignancy
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Ayshea Hameeduddin, Anju Sahdev, Rodney H Reznek
Less than 200 cases of PAL have been reported in the literature. Typically elderly men are affected, although the age varies between 27 and 89 (37). Half of patients present with adrenal insufficiency. The commonest subtype is diffuse large B-cell lymphoma with sporadic cases of anaplastic and T-cell lymphoma. In 70%–80% of cases, there is bilateral involvement of the adrenal glands. Typically, imaging findings include large masses with both homogeneous and heterogeneous appearances due to haemorrhage and necrosis. On MRI, lesions are low on T1 and high on T2. On both CT and MRI, the lesions do not demonstrate significant enhancement post-contrast. Intense tracer uptake is present on 18F-FDG PET-CT (Figure 14.21). Treatment options include debulking surgery prior to chemotherapy; however, the prognosis is poor with overall survival reported at 12–15 months (102).
Involvement of Dopamine with Various Cancers
Published in Nira Ben-Jonathan, Dopamine, 2020
B-cell lymphomas have several subtypes, including diffuse large B cell lymphoma, follicular lymphoma, Burkitt lymphoma, and mantle cell lymphoma [20,21]. Normal and malignant human B lymphocytes were examined for expression of DA pathway components and for cytostatic responses to DA and related compounds [22]. DA in the micromolar range rapidly arrested the proliferation of both normal and malignant lymphocytes. L-Dopa and apomorphine also showed antiproliferative activity. With the exception of D4R, all other DAR subtypes were variably expressed in normal and neoplastic B cells, as was DAT. The authors concluded that the impact of DA on lymphocytes provides an opportunity for therapeutic intervention in B cell neoplasia and other lymphoproliferative disorders. Another study reported that addition of DA to cultured Burkitt lymphoma cells (Raji, Namalwa, Daudi, and Jijoye) caused a rapid and an extensive cell death, while a myeloma cell line, SKO, was unresponsive [23]. Additions of fetal calf serum or supernatant from cultures of Raji or T24 bladder carcinoma cells partially counteracted the effect of DA, suggesting that DA acted by inhibiting the production of unidentified endocrine/autocrine factors.
Heart of lymphoma: a case report
Published in Acta Cardiologica, 2023
Annemie Jacobs, Thomas Gevaert, Wim Volders, Dieter De Cleen, Katrien Van Kolen, Frank Cools, Steven Hellemans
Cardiac tumours have many clinical presentations and have many differential diagnoses. Cardiac metastases from any histologic tumour types are relatively more common than primary cardiac tumours. Diffuse large B-cell lymphoma is an aggressive non-Hodgkin’s lymphoma often presenting with bulky and invasive mediastinal tumours. Cardiac involvement occurs in a subset of patients estimated between 8.7% and 27.2%. Tumours may invade the endocardium, myocardium, or pericardial space through either haematogenous, lymphatic or direct spread. However, invasive cardiac DLBCL affecting cardiac function due to tumour invasion is rare [3]. Despite its life-threatening nature, the cardiac manifestations are often subclinical. Cardiac failure at initial presentation is extremely rare, requiring a high level of suspicion for diagnosis and result in a poor prognosis for the patient [2]. In about 20% of deaths from lymphoma, cardiac involvement is found only in autopsy.
Identifying aggressive subsets within diffuse large B-cell lymphoma: implications for treatment approach
Published in Expert Review of Anticancer Therapy, 2022
Timothy J Voorhees, Narendranath Epperla
The international prognostic index (IPI) and age-adjusted IPI were first proposed in 1993 to risk stratify patients with aggressive non-Hodgkin lymphoma [3]. This study composed of patients with either DLBCL, immunoblastic lymphoma, centroblastic lymphoma, or unclassifiable high-grade lymphoma. In a dataset of over two thousand patients, age, tumor stage (Ann Arbor staging), serum lactate dehydrogenase (LDH), performance status (PS), and extranodal (EN) sites were identified and used to classify four risk groups with 5-year overall survival (OS) of 73% (low risk), 51% (low-intermediate risk), 43% (high-intermediate risk), and 26% (high risk) respectively (Table 1). This represented a significant improvement in the identification of high-risk subsets of aggressive large B-cell lymphoma as compared to Ann Arbor staging alone.
COVID-19 outcomes in a large pediatric hematology-oncology center in Houston, Texas
Published in Pediatric Hematology and Oncology, 2021
Kala Y. Kamdar, Taylor O. Kim, Erin E. Doherty, Thomas M. Pfeiffer, Shawki L. Qasim, Mary Nell Suell, Amber M. Yates, Susan M. Blaney
Perhaps the most important question for clinicians is whether treatment of the primary cancer or hematologic disorder should be delayed if SARS-CoV-2 is detected. In one Italian study, treatment was postponed in 16 cases for a median of 26 days and resumed when testing was negative. While all patients recovered from infection, an anaplastic large cell lymphoma patient with residual molecular disease had disease progression after chemotherapy was held 2 weeks.6 Another single-center study included a patient with new diagnosis of ALL, whose initiation of therapy was delayed due to detection of SARS-CoV-2. She suffered pulmonary hemorrhage and death related to her underlying cancer.38 A large adult study from the United Kingdom reported that patients who received cancer therapies within 4 weeks of COVID-19 diagnosis did not fare worse than cancer patients without recent therapy.39 At our institution, delays have occurred less frequently as the pandemic evolved, particularly for asymptomatic patients, without detrimental effect. New diagnoses in our study were aggressive malignancies, and treatment initiation was not delayed. Rituximab was delayed in a patient with newly diagnosed Burkitt lymphoma and critical respiratory illness due to COVID-19 until the respiratory status improved.