RESUMEN

Sarcoidosis is an inflammatory disease characterised by non-caseating granulomas that can affect any organ, although lung involvement is the most common. It is rare to find sarcoidosis isolated to extrapulmonary organs. We describe a case of extrapulmonary sarcoidosis with involvement of the liver in a man in his late 40s. His initial clinical history and investigations were more consistent with a diagnosis of lymphoma until a liver biopsy was performed revealing non-caseating granulomas more suggestive of a diagnosis of sarcoidosis. This patient had a history of young-onset ischaemic heart disease (IHD). We discuss the possible links between sarcoidosis, an inflammatory condition, and IHD, as well as the challenges to treating such patients with concurrent metabolic syndrome. This case also highlights the heterogeneous nature of sarcoidosis, with the diagnosis being important as prompt treatment can prevent complications of end-stage liver disease, including portal hypertension and cirrhosis.

Asunto(s)

Hepatopatías , Linfoma , Sarcoidosis , Humanos , Masculino , Sarcoidosis/diagnóstico , Sarcoidosis/patología , Diagnóstico Diferencial , Hepatopatías/diagnóstico , Hepatopatías/patología , Linfoma/diagnóstico , Linfoma/patología , Hígado/patología , Hígado/diagnóstico por imagen , Adulto , Biopsia , Persona de Mediana Edad

RESUMEN

BACKGROUND: Lymphoma is the most common secondary cause of hemophagocytic lymphohistiocytosis (HLH) in adults. Lymphoma-associated HLH (LA-HLH) in the elderly population is not rare, however, little has been reported regarding clinicopathological characteristics, prognostic factors, and outcomes of LA-HLH in the elderly population. METHODS: We retrospectively analyzed a multicenter cohort of elderly patients with LA-HLH. Clinicopathological features and treatment information were collected. The impacts of baseline characteristics and treatments on survival outcomes were analyzed. RESULTS: A total of 173 elderly patients with LA-HLH were included. Compared with young patients, elderly patients showed different clinical and laboratory features. Regarding lymphoma subtypes, B-cell lymphoma was more common in elderly patients (elderly 61.3% vs. young 32.3%, p < 0.001) while T/NK-cell lymphoma was more common in young patients (65.3% vs. 35.3%, p < 0.001). The median survival of elderly patients with LA-HLH was only 92 days. The prior use of HLH therapy or etoposide-containing HLH therapy was not associated with improved overall survival. T/NK-cell subtype, a lower platelet count (≤53 × 109/L), a lower albumin level (≤32.1 g/L), a higher LDH level (>1407 U/L), and a higher creatinine level (>96.8 µmol/L) were independent predictors of decreased overall survival and 60-day survival. A prognostic index was established and demonstrated to be robust in predicting the overall survival and 60-day survival of elderly patients with LA-HLH. CONCLUSIONS: LA-HLH in elderly patients displayed heterogeneous clinicopathological features and survival outcomes. Treatments need to be optimized to improve the outcomes of elderly patients with LA-HLH.

Asunto(s)

Linfohistiocitosis Hemofagocítica , Humanos , Linfohistiocitosis Hemofagocítica/mortalidad , Linfohistiocitosis Hemofagocítica/patología , Linfohistiocitosis Hemofagocítica/diagnóstico , Masculino , Femenino , Anciano , Pronóstico , Estudios Retrospectivos , Anciano de 80 o más Años , Persona de Mediana Edad , Factores de Edad , Linfoma/mortalidad , Linfoma/complicaciones , Linfoma/patología , Resultado del Tratamiento

RESUMEN

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Asunto(s)

Neoplasias de las Glándulas Suprarrenales , Ultrasonografía , Humanos , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Neoplasias de las Glándulas Suprarrenales/patología , Ultrasonografía/métodos , Linfoma/diagnóstico por imagen , Linfoma/patología , Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/patología , Masculino , Femenino , Persona de Mediana Edad

RESUMEN

Recent advances in high-resolution mapping of spatial interactions among regulatory elements support the existence of complex topological assemblies of enhancers and promoters known as enhancer-promoter hubs or cliques. Yet, organization principles of these multi-interacting enhancer-promoter hubs and their potential role in regulating gene expression in cancer remain unclear. Here, we systematically identify enhancer-promoter hubs in breast cancer, lymphoma, and leukemia. We find that highly interacting enhancer-promoter hubs form at key oncogenes and lineage-associated transcription factors potentially promoting oncogenesis of these diverse cancer types. Genomic and optical mapping of interactions among enhancer and promoter elements further show that topological alterations in hubs coincide with transcriptional changes underlying acquired resistance to targeted therapy in T cell leukemia and B cell lymphoma. Together, our findings suggest that enhancer-promoter hubs are dynamic and heterogeneous topological assemblies with the potential to control gene expression circuits promoting oncogenesis and drug resistance.

Asunto(s)

Carcinogénesis , Resistencia a Antineoplásicos , Elementos de Facilitación Genéticos , Regulación Neoplásica de la Expresión Génica , Redes Reguladoras de Genes , Regiones Promotoras Genéticas , Humanos , Regiones Promotoras Genéticas/genética , Elementos de Facilitación Genéticos/genética , Resistencia a Antineoplásicos/genética , Carcinogénesis/genética , Femenino , Neoplasias de la Mama/genética , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Oncogenes/genética , Línea Celular Tumoral , Factores de Transcripción/metabolismo , Factores de Transcripción/genética , Leucemia/genética , Leucemia/metabolismo , Linfoma/genética , Linfoma/metabolismo

RESUMEN

Background: Chimeric antigen receptor (CAR) T-cell therapy has attracted considerable attention since its recent endorsement by the Food and Drug Administration, as it has emerged as a promising immunotherapeutic modality within the landscape of oncology. This study explores the prognostic utility of [18F]Fluorodeoxyglucose positron emission tomography ([18F]FDG PET) in lymphoma patients undergoing CAR T-cell therapy. Through meta-analysis, pooled hazard ratio (HR) values were calculated for specific PET metrics in this context. Methods: PubMed, Scopus, and Ovid databases were explored to search for relevant topics. Dataset retrieval from inception until March 12, 2024, was carried out. The primary endpoints were impact of specific PET metrics on overall survival (OS) and progression-free survival (PFS) before and after treatment. Data from the studies were extracted for a meta-analysis using Stata 17.0. Results: Out of 27 studies identified for systematic review, 15 met the criteria for meta-analysis. Baseline OS analysis showed that total metabolic tumor volume (TMTV) had the highest HR of 2.66 (95% CI: 1.52-4.66), followed by Total-body total lesion glycolysis (TTLG) at 2.45 (95% CI: 0.98-6.08), and maximum standardized uptake values (SUVmax) at 1.30 (95% CI: 0.77-2.19). TMTV and TTLG were statistically significant (p < 0.0001), whereas SUVmax was not (p = 0.33). For PFS, TMTV again showed the highest HR at 2.65 (95% CI: 1.63-4.30), with TTLG at 2.35 (95% CI: 1.40-3.93), and SUVmax at 1.48 (95% CI: 1.08-2.04), all statistically significant (p ≤ 0.01). The ΔSUVmax was a significant predictor for PFS with an HR of 2.05 (95% CI: 1.13-3.69, p = 0.015). Conclusion: [18F]FDG PET parameters are valuable prognostic tools for predicting outcome of lymphoma patients undergoing CAR T-cell therapy.

Asunto(s)

Fluorodesoxiglucosa F18 , Inmunoterapia Adoptiva , Linfoma , Tomografía de Emisión de Positrones , Humanos , Inmunoterapia Adoptiva/métodos , Linfoma/terapia , Linfoma/diagnóstico por imagen , Linfoma/inmunología , Linfoma/mortalidad , Pronóstico , Radiofármacos

Asunto(s)

Neoplasias Encefálicas , Humanos , Neoplasias Encefálicas/líquido cefalorraquídeo , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patología , Secuenciación de Nanoporos/métodos , Masculino , Linfoma/líquido cefalorraquídeo , Linfoma/diagnóstico , Linfoma/patología , Linfoma/genética , Femenino , Persona de Mediana Edad , Anciano , Citología

RESUMEN

Primary central nervous system lymphoma (PCNSL) is a rare and frequently fatal lymphoma subtype. The programmed death-1 (PD-1) pathway has emerged as a potential therapeutic target, but the effectiveness of PD-1 antibody sintilimab in combination with immunochemotherapy as a frontline treatment for PCNSL remains to be determined. In this phase 2 trial (ChiCTR1900027433) with a safety run-in, we included patients aged 18-70 with newly diagnosed PCNSL. Participants underwent six 21-day cycles of a SMTR regimen, which includes sintilimab (200 mg, Day 0), rituximab (375 mg/m2, Day 0), methotrexate (3.0 g/m2, Day 1 or 1.0 g/m2 for patients aged ≥65 years), and temozolomide (150 mg/m2/d, Days 1-5). Among 27 evaluable patients, the overall response rate (ORR) was 96.3% (95% confidence interval: 81-99.9%), with 25 complete responses. At a median follow-up of 24.4 months, the medians for duration of response, progression-free survival (PFS), and overall survival were not reached. The most common grade 3-4 treatment-related toxicities were increased levels of alanine aminotransferase (17.9%) and aspartate aminotransferase (14.3%). Additionally, baseline levels of interferon-α and the IL10/IL6 ratio in cerebrospinal fluid emerged as potential predictors of PFS, achieving areas under the curve of 0.88 and 0.84, respectively, at 2 years. Whole-exome sequencing revealed a higher prevalence of RTK-RAS and PI3K pathway mutations in the durable clinical benefit group, while a greater frequency of Notch and Hippo pathway mutations in the no durable benefit group. These findings suggest the SMTR regimen is highly efficacious and tolerable for newly diagnosed PCNSL, warranting further investigation.

Asunto(s)

Anticuerpos Monoclonales Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias del Sistema Nervioso Central , Metotrexato , Rituximab , Temozolomida , Humanos , Masculino , Femenino , Persona de Mediana Edad , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Rituximab/administración & dosificación , Temozolomida/administración & dosificación , Temozolomida/farmacología , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/genética , Neoplasias del Sistema Nervioso Central/inmunología , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Adulto , Linfoma/tratamiento farmacológico , Linfoma/genética , Linfoma/inmunología

RESUMEN

Lymphoid malignancies are complex diseases with distinct biological behaviors, clinical presentations, and treatment responses. Ongoing research and advancements in biotechnology enhance the understanding and management of these malignancies, moving towards more personalized approaches for diagnosis and treatment. Nanotechnology has emerged as a promising tool to improve some limitations of conventional diagnostics as well as treatment strategies for lymphoid malignancies. Nanoparticles (NPs) offer unique advantages such as enhanced multimodal detection, drug delivery, and targeted therapy capabilities, with the potential to improve precision medicine and patient outcomes. Here, we comprehensively examine the current landscape of nanoconstructs applied in the management of lymphoid disease. Through a comprehensive analysis of preclinical studies, we highlight the translational potential of NPs in revolutionizing the field of hematological malignancies, with a specific focus on lymphoid neoplasms.

Asunto(s)

Nanopartículas , Nanotecnología , Humanos , Nanotecnología/métodos , Nanopartículas/química , Nanopartículas/uso terapéutico , Animales , Linfoma/diagnóstico , Linfoma/terapia , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/terapia , Sistemas de Liberación de Medicamentos/métodos , Medicina de Precisión/métodos , Nanomedicina/métodos

RESUMEN

BACKGROUND: Immune checkpoint blockade with anti-programmed cell death 1 (PD-1) antibodies has demonstrated efficacy in multiple tumor types. Nofazinlimab is a humanized rat antibody targeting PD-1. A first-in-human study of nofazinlimab conducted in Australia found no dose-limiting toxicities (DLTs) and the maximum tolerated dose (MTD) was not reached in the range of 1-10 mg/kg. OBJECTIVE: We evaluated nofazinlimab for multiple advanced malignancies in Chinese patients. PATIENTS AND METHODS: This was a phase 1a/1b, open-label, multicenter, dose-escalation/expansion trial. In phase 1a, patients received an abbreviated dose escalation of nofazinlimab at 60 mg and 200 mg every 3 weeks (Q3W) to determine DLTs and the recommended phase 2 dose (RP2D). In phase 1b, patients received the RP2D (monotherapy/combination) in six arms by tumor type; DLTs were evaluated for nofazinlimab plus lenvatinib in the unresectable hepatocellular carcinoma (uHCC) arm. Safety (continuously monitored in patients who received nofazinlimab) and efficacy (patients with measurable baseline disease) were assessed. RESULTS: Overall, 107 patients were eligible and received nofazinlimab. In phase 1a, no DLTs were observed; the RP2D was 200mg Q3W. In phase 1b, no DLTs were observed with nofazinlimab plus lenvatinib. The safety profile was consistent with that observed in the first-in-human study (NCT03475251). In phase 1b, 21/88 (23.9%) patients achieved confirmed objective responses, 26 (29.5%) had stable disease, and 9/20 (45.0%) patients with uHCC achieved confirmed objective responses to nofazinlimab plus lenvatinib. CONCLUSIONS: Nofazinlimab was well tolerated in Chinese patients. Preliminary efficacy was encouraging, particularly for nofazinlimab plus lenvatinib in uHCC, which is being studied in an ongoing phase 3 trial. CLINICAL TRIAL REGISTRATION: NCT03809767; registered 18 January 2019.

Asunto(s)

Linfoma , Neoplasias , Humanos , Masculino , Femenino , Persona de Mediana Edad , Linfoma/tratamiento farmacológico , Neoplasias/tratamiento farmacológico , Anciano , Adulto , China , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Dosis Máxima Tolerada , Pueblos del Este de Asia

RESUMEN

BACKGROUND: MR perfusion is a standard marker to distinguish progression and therapy-associated changes after surgery and radiochemotherapy for glioblastoma. TRAMs (Treatment Response Assessment Maps) were introduced, which are intended to facilitate the differentiation of vital tumor cells and radiation necrosis by means of late (20-90 min) contrast clearance and enhancement. The differences of MR perfusion and late-enhancement are not fully understood yet. METHODS: We have implemented and established a fully automated creation of rapid wash-out (15-20 min interval) maps in our clinic. We included patients with glioblastoma, CNS lymphoma or brain metastases who underwent our MR protocol with MR perfusion and rapid wash-out between 01/01/2024 and 30/06/2024. Since both wash-out and hyperperfusion are intended to depict the active tumor area, this study involves a quantitative and qualitative comparison of both methods. For this purpose, we volumetrically measured rCBV (relative cerebral blood volume) maps and rapid wash-out maps separately (two raters). Additionally, we rated the agreement between both maps on a Likert scale (0-10). RESULTS: Thirty-two patients were included in the study: 15 with glioblastoma, 7 with CNS lymphomas and 10 with brain metastasis. We calculated 36 rapid wash-out maps (9 initial diagnosis, 27 follow-up). Visual agreement of MR perfusion with rapid wash-out by rating were found in 44 ± 40% for initial diagnosis, and 75 ± 31% for follow-up. We found a strong correlation (Pearson coefficient 0.92, p < 0.001) between the measured volumes of MR perfusion and rapid wash-out. The measured volumes of MR perfusion and rapid wash-out did not differ significantly. Small lesions were often not detected by MR perfusion. Nevertheless, the measured volumes showed no significant differences in this small cohort. CONCLUSIONS: Rapid wash-out calculation is a simple tool that provides new information and, when used in conjunction with MR perfusion, may increase diagnostic accuracy. The method shows promising results, particularly in the evaluation of small lesions.

Asunto(s)

Neoplasias Encefálicas , Glioblastoma , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/patología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Glioblastoma/diagnóstico por imagen , Glioblastoma/patología , Adulto , Imagen por Resonancia Magnética/métodos , Linfoma/diagnóstico por imagen , Linfoma/patología , Angiografía por Resonancia Magnética/métodos , Medios de Contraste

RESUMEN

BACKGROUND: The rarity of primary central nervous system lymphoma (PCNSL) and treatment heterogeneity contributes to a lack of prognostic models for evaluating posttreatment remission. This study aimed to develop and validate radiomic-based models to predict the durable response (DR) to high-dose methotrexate (HD-MTX)-based chemotherapy in PCNSL patients. METHODS: A total of 159 patients pathologically diagnosed with PCNSL between 2011 and 2021 across two institutions were enrolled. According to the NCCN guidelines, the DR was defined as the remission lasting ≥1 year after receiving HD-MTX-based chemotherapy. For each patient, a total of 1218 radiomic features were extracted from prebiopsy T1 contrast-enhanced MR images. Multiple machine-learning algorithms were utilized for feature selection and classification to build a radiomic signature. The radiomic-clinical integrated models were developed using the random forest method. Model performance was externally validated to verify its clinical utility. RESULTS: A total of 105 PCNSL patients were enrolled after excluding 54 cases with ineligibility. The training and validation cohorts comprised 76 and 29 individuals, respectively. Among them, 65 patients achieved DR. The radiomic signature, consisting of 8 selected features, demonstrated strong predictive performance, with area under the curves of 0.994 in training cohort and 0.913 in validation cohort. This signature was independently associated with the DR in both cohorts. Both the radiomic signature and integrated models significantly outperformed the clinical models in two cohorts. Decision curve analysis underscored the clinical utility of the established models. CONCLUSIONS: This radiomic signature and integrated models have the potential to accurately predict the DR to HD-MTX-based chemotherapy in PCNSL patients, providing valuable therapeutic insights.

Asunto(s)

Neoplasias del Sistema Nervioso Central , Imagen por Resonancia Magnética , Metotrexato , Humanos , Metotrexato/uso terapéutico , Metotrexato/administración & dosificación , Masculino , Femenino , Persona de Mediana Edad , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Neoplasias del Sistema Nervioso Central/patología , Imagen por Resonancia Magnética/métodos , Anciano , Linfoma/tratamiento farmacológico , Linfoma/diagnóstico por imagen , Linfoma/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Adulto , Pronóstico , Aprendizaje Automático , Resultado del Tratamiento , Estudios Retrospectivos , Radiómica

RESUMEN

BACKGROUND: Considering the invasiveness of the biopsy method, we attempted to evaluate the ability of the gamma distribution model using magnetic resonance imaging images to stage and grade benign and malignant brain tumors. METHODS: A total of 42 patients with malignant brain tumors (including glioma, lymphoma, and choroid plexus papilloma) and 24 patients with benign brain tumors (meningioma) underwent diffusion-weighted imaging using five b-values ranging from 0 to 2000 s/mm2 with a 1.5 T scanner. The gamma distribution model is expected to demonstrate the probability of water molecule distribution based on the apparent diffusion coefficient. For all tumors, the apparent diffusion coefficient, shape parameter (κ), and scale parameter (θ) were calculated for each b-value. In the staging step, the fractions (ƒ1, ƒ2, ƒ3) expected to reflect the intracellular, and extracellular diffusion and perfusion were investigated. Diffusion <1 × 10-4 mm2/s (ƒ1), 1 × 10-4 mm2/s < Diffusion > 3 × 10-4 mm2/s (ƒ2), and Diffusion >3 × 10-4 mm2/s (ƒ3); in the grading step, fractions were determined to check heavily restricted diffusion. Diffusion lower than 0.3 × 10-4 mm2/s (ƒ11). Diffusion lower than 0.5 × 10-4 mm2/s (ƒ12). Diffusion lower than 0.8 × 10-4 mm2/s (ƒ13). RESULTS: The findings were analyzed using nonparametric statistics and receiver operating characteristic curve diagnostic performance. Gamma model parameters (κ, ƒ1, ƒ2, ƒ3) showed a satisfactory difference in differentiating meningioma from glioma. For b value = 2000 s/mm2, ƒ1 had a better diagnostic performance than κ and apparent diffusion coefficient (sensitivity, 88%; specificity, 68%; P < .001). The best diagnostic performance was related to ƒ3 in b = 2000 s/mm2 (area under the curve = 0.891, sensitivity = 83%, specificity = 80%, P < .001). In the grading step, ƒ12 (area under the curve = 0.870, sensitivity = 92%, specificity = 72%, P < .001) had the best diagnostic performance in differentiating high-grade from low-grade gliomas with b = 2000 s/mm2. CONCLUSION: The findings of our study highlight the potential of using a gamma distribution model with diffusion-weighted imaging based on multiple b-values for grading and staging brain tumors. Its potential integration into routine clinical practice could advance neurooncology and improve patient outcomes through more accurate diagnosis and treatment planning.

Asunto(s)

Neoplasias Encefálicas , Imagen de Difusión por Resonancia Magnética , Glioma , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Glioma/diagnóstico por imagen , Glioma/patología , Diagnóstico Diferencial , Clasificación del Tumor , Adulto Joven , Linfoma/diagnóstico por imagen , Linfoma/patología , Linfoma/diagnóstico , Meningioma/diagnóstico por imagen , Meningioma/patología , Curva ROC , Papiloma del Plexo Coroideo/diagnóstico por imagen , Papiloma del Plexo Coroideo/patología , Sensibilidad y Especificidad , Estudios Retrospectivos , Adolescente

RESUMEN

Você já ouviu falar em linfoma? Ele é um tipo de câncer que atinge o sistema linfático, parte do corpo responsável por ajudar a combater doenças e infecções.

Asunto(s)

Linfoma

RESUMEN

Mediastinal lymphadenopathy has a broad differential diagnosis which includes lymphoma. The current preferred biopsy technique for mediastinal lymph nodes is transbronchial needle aspiration which has mixed results in terms of sensitivity, specificity and diagnostic yields; there are also limitations with subtyping lymphomas with needle aspiration alone which can be a barrier to determine management strategies. Invasive mediastinal lymph node sampling such was with mediastinoscopy provides higher yields and preserved lymph node architecture for both diagnosis and subtyping of lymphoma but carries a higher risk of morbidity and complications. Novel techniques that may increase the diagnostic yield of bronchoscopy in the diagnosis of lymphoma are core biopsy needles, intranodal forcep biopsy, and intranodal cryobiopsy. The evidence is limited due to a relatively small number of cases, so further research is needed to standardize best practices for the bronchoscopic diagnosis of lymphoma. Pleural effusions in lymphoma can be present in up to 30 % of cases with the majority being non-Hodgkins's lymphoma. The presence of exudative effusion in the setting of an existing or prior diagnosis of lymphoma should raise clinical suspicions. Other less common subtypes of lymphoma presenting as primary pleural effusions are explored as well.

Asunto(s)

Broncoscopía , Linfoma , Mediastinoscopía , Humanos , Linfoma/diagnóstico , Linfoma/patología , Broncoscopía/métodos , Diagnóstico Diferencial , Mediastinoscopía/métodos , Ganglios Linfáticos/patología , Linfadenopatía/patología , Linfadenopatía/diagnóstico , Mediastino/patología , Derrame Pleural/patología , Derrame Pleural/diagnóstico , Biopsia/métodos , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/patología

RESUMEN

The objective of this study was to categorise diseases associated with FeLV infection in cats. A total of 154 cats were submitted to necropsy, histopathology exam and anti-FeLV immunohistochemistry (IHC), and 83 (50.9 %) were IHC FeLV-positive. The cats age means of 4.1 years, including 3.6 % kittens, 34.9 % junior, 37.4 % prime, 18.1 % mature, 2.4 % senior, 3.6 % unknown age. Neoplastic diseases were most prevalent with leukaemia and lymphoma being most predominant, followed by viral diseases, bacterial, trauma, degenerative, intoxications, parasitic, malformation and others. FeLV+ cats were 5.73 times more likely to be diagnosed with neoplasms than other diseases. The odds ratio (OR) of FeLV+ cats developing leukaemia (OR = 7.75) and lymphoma (OR = 6.75) was higher than other neoplasms. FeLV infection was more prevalent in the mixed breed, junior to prime, male, with neoplastic diseases, including leukaemia and lymphoma. Therefore, understanding the diseases associated with FeLV is of paramount importance in Brazil due to its high prevalence, and it may encourage the implementation of prophylactic measures to reduce its dissemination.

Asunto(s)

Enfermedades de los Gatos , Virus de la Leucemia Felina , Leucemia Felina , Gatos , Animales , Virus de la Leucemia Felina/aislamiento & purificación , Brasil/epidemiología , Masculino , Enfermedades de los Gatos/virología , Enfermedades de los Gatos/epidemiología , Femenino , Prevalencia , Leucemia Felina/epidemiología , Leucemia Felina/virología , Linfoma/epidemiología , Linfoma/veterinaria , Linfoma/virología , Infecciones por Retroviridae/epidemiología , Infecciones por Retroviridae/veterinaria , Infecciones por Retroviridae/virología , Inmunohistoquímica , Neoplasias/epidemiología , Neoplasias/veterinaria , Neoplasias/virología , Infecciones Tumorales por Virus/veterinaria , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/virología

RESUMEN

PURPOSE: To describe a 41-gauge silicone fine-needle aspiration biopsy (S-FNAB) technique and assess its value in diagnosing primary vitreoretinal lymphoma (PVRL). METHODS: Retrospective review of seven consecutive patients who underwent vitreous biopsy (VB) and 41-gauge S-FNAB of retinal/subretinal lesions in a single tertiary center between January 2012 and March 2023. RESULTS: Of seven patients, S-FNAB confirmed the diagnosis of PVRL in six patients. In five of those patients, both VB and retinal/subretinal S-FNAB (performed at the same procedure) yielded positive results, with the retinal thickness at the biopsy site as small as 231 µm. Four of these five patients had one or more previous negative VB. In one patient, S-FNAB yielded positive results despite a negative VB. Silicone fine-needle aspiration biopsy failed to confirm positive VB for PVRL in the remaining patient. The time from symptom onset to diagnosis of PVRL ranged from 18 days to 26 months. There were no severe complications associated with the procedure. CONCLUSION: Silicone fine-needle aspiration biopsy might be a valuable method for obtaining a sufficient sample of viable cells to diagnose PVRL. It can be performed as a primary procedure along with VB. Further studies are warranted to determine where this technique could be most advantageous.

Asunto(s)

Neoplasias de la Retina , Cuerpo Vítreo , Humanos , Estudios Retrospectivos , Neoplasias de la Retina/cirugía , Neoplasias de la Retina/diagnóstico , Neoplasias de la Retina/patología , Masculino , Femenino , Biopsia con Aguja Fina/métodos , Cuerpo Vítreo/patología , Cuerpo Vítreo/cirugía , Anciano , Persona de Mediana Edad , Tomografía de Coherencia Óptica/métodos , Retina/patología , Siliconas , Linfoma Intraocular/diagnóstico , Linfoma Intraocular/cirugía , Linfoma Intraocular/patología , Vitrectomía/métodos , Linfoma/diagnóstico , Linfoma/cirugía , Linfoma/patología , Anciano de 80 o más Años , Adulto

RESUMEN

Primary central nervous system lymphoma (PCNSL) is a rare neoplasm that can affect the brain, eyes, and, rarely, the spinal cord. Clinical presentation and MRI findings can mimic a variety of diseases, including high-grade gliomas, infectious and granulomatous diseases, and demyelinating diseases. We describe three cases where the diagnosis of PCNSL was difficult due to an ambiguous clinical, radiological and laboratory results. The role of stereotactic biopsy remains leading in differential diagnosis; however, the invasiveness and frequent limitations of this method determine the search for additional biological markers of the disease. New evidence suggests a potential role for cerebrospinal fluid (CSF) cytokine profiles and proteomic analysis in differential diagnosis, disease progression, and treatment response.

Asunto(s)

Neoplasias del Sistema Nervioso Central , Enfermedades Desmielinizantes , Humanos , Biopsia , Neoplasias del Sistema Nervioso Central/diagnóstico , Neoplasias del Sistema Nervioso Central/líquido cefalorraquídeo , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Enfermedades Desmielinizantes/diagnóstico , Enfermedades Desmielinizantes/líquido cefalorraquídeo , Diagnóstico Diferencial , Linfoma/diagnóstico , Imagen por Resonancia Magnética

RESUMEN

Lymphoma is a highly heterogeneous lymphohematopoietic tumor. As our understanding of the biological and pathological characteristics of lymphoma improves, we are identifying an increasing number of lymphoma subtypes. Genotyping has enhanced our ability to diagnose, treat, and monitor the prognosis of lymphoma. Despite significant improvements in treatment effectiveness, traditional methods for assessing disease response and monitoring prognosis are imperfect, and there is no significant improvement in overall remission rates for lymphoma patients. Minimal Residual Disease (MRD) is often indicative of refractory disease or early relapse. For lymphoma patients, personalized MRD monitoring techniques offer an efficient means to estimate disease remission levels, predict early relapse risk, and assess the effectiveness of new drug regimens. In this review, we delve into the MRD procedures in lymphoma, including sample selection and requirements, detection methods and their limitations and advantages, result interpretation. Besides, we also introduce the clinical applications of MRD detection in lymphoma.

Asunto(s)

Linfoma , Neoplasia Residual , Neoplasia Residual/diagnóstico , Humanos , Linfoma/diagnóstico , Pronóstico , Biomarcadores de Tumor , Relevancia Clínica

RESUMEN

Antibody-drug conjugate(ADC)contain monoclonal antibodies that target-specific tumor antigens, cytotoxic payloads, and linkers. ADCs use antibodies to selectively act on tumors, making them more effective and less toxic. In Japan, 4 drugs are approved as ADCs for leukemia and lymphoma: gemtuzumab ozogamicin(GO)consists of an anti-CD33 monoclonal antibody bound to calicheamicin via a linker, approved for relapsed/refractory acute myeloid leukemia. Brentuximab vedotin (BV)has anti-CD30 antibodies bound to MMAE via a linker and is approved for CD30-positive Hodgkin's lymphoma, peripheral T-cell lymphoma, and cutaneous T-cell lymphoma. BV, in combination with multi-agent chemotherapy, resulted in significantly prolonged progression-free survival(PFS)in classical Hodgkin's lymphoma and peripheral T-cell lymphoma compared to the control group. Inotuzumab ozogamicin(IO)has an anti-CD22 antibody bound to calicheamicin via a linker, approved for relapsed/refractory CD22-positive B-cell acute lymphoblastic leukemia. In relapsed/refractory B-cell acute lymphoblastic leukemia, IO showed a higher complete remission rate than the control group. Polatuzumab vedotin(PV)has an anti-CD79b monoclonal antibody bounds to MMAE via a linker, approved for diffuse large B-cell lymphoma(DLBCL). In DLBCL patients with an international prognostic index score(IPI score)of 2 or higher, the combination of PV plus rituximab, cyclophosphamide, doxorubicin, and prednisone(PV+R-CHP)extended PFS at 2 years compared with R-CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), which has long been the standard of care. As shown, ADCs exhibit high therapeutic efficacy in leukemia and lymphoma treatment, but many aspects of their resistance mechanisms remain unclear and require further research.

Asunto(s)

Inmunoconjugados , Leucemia , Linfoma , Humanos , Inmunoconjugados/uso terapéutico , Leucemia/tratamiento farmacológico , Leucemia/inmunología , Linfoma/tratamiento farmacológico , Linfoma/inmunología , Antineoplásicos/uso terapéutico

RESUMEN

OBJECTIVE: To understand the etiology, clinical characteristics and prognosis of secondary hemophagocytic syndrome (HLH), so as to improve the understanding of HLH and reduce the rates of misdiagnosis and missed diagnosis of HLH. METHODS: A retrospective study was conducted to analyze the cause, clinical characteristics, laboratory findings, therapy and outcomes of 75 adult patients with secondary HLH admitted to our hospital from January 2015 to December 2021. Follow-up continued until the last discharge time. RESULTS: Among 75 patients, infection-related HLH was the most common (45.33%), followed by lymphoma-related HLH (17.33%). Fever was the most common clinical manifestation (97.67%). Laboratory indicators such as NK cell activity (98.31% low or absent), sCD25 (93.22% increased), and serum ferritin (94.44% elevated) had higher sensitivity in diagnosis. By comparing the clinical manifestations and laboratory indicators of HLH patients with different causes, sex, lymph node enlargement and bone marrow morphology were more valuable for the diagnosis of primary disease (all P <0.05). By comparing the treatment and clinical outcomes of HLH patients with different causes, the highest clinical remission rate (83.3%) was achieved in patients with autoimmune disease-related HLH treated with hormone+cyclosporine (P <0.05). The overall 12-month survival rate of all patients was 26.7%, in which the infection-related HLH was the lowest (14.7%) while autoimmune disease-related HLH was the highest (63.6%). CONCLUSION: The causes and clinical characteristics of adult secondary HLH are varied, with poor prognosis and heterogeneity in disease severity. It is important to identify HLH cause early for diagnosis and needed to further understand HLH.

Asunto(s)

Linfohistiocitosis Hemofagocítica , Humanos , Linfohistiocitosis Hemofagocítica/diagnóstico , Linfohistiocitosis Hemofagocítica/etiología , Pronóstico , Estudios Retrospectivos , Masculino , Femenino , Adulto , Linfoma/complicaciones , Linfoma/diagnóstico