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PubMed2005

[Angioimmunoblastic T-cell lymphoma complicated with EBV-associated B-cell lymphoma].

A 71-year-old man with high fever and enlargement of the bilateral submandibular, cervical and inguinal lymph nodes was hospitalized at Hiroshima University Hospital. The immunohistochemical and pathologic findings from the biopsy specimens led to the diagnosis of angioimmunoblastic T-cell lymphoma (AILT) with a cluster of CD20-positive cells. Flow cytometry analysis by two-color staining did not reveal any neoplastic B cells. Southern blot analysis showed rearrangement of both the IgH gene and the TCR gene. Furthermore, PCR of the IgH gene using DNA extracted from purified CD19-positive cells from the lymph nodes showed a monoclonal band, and it was different from that of purified CD138-positive cells from the bone marrow. Furthermore, monoclonal Epstein-Barr virus (EBV) infection was detected with PCR using the SL18 and SL19 primers of the LMP-1 gene. Numerous EBER-positive cells were detected diffusely in the lymph nodes. These findings indicated a diagnosis of angioimmunoblastic T-cell lymphoma complicated with EBV-associated B-cell lymphoma, and that immunodeficiency in AILT led to an expansion of EBV infected B-cells.

Aged↗

PubMed1990

Expression of the alpha/beta and gamma/delta T-cell receptors in 57 cases of peripheral T-cell lymphomas. Identification of a subset of gamma/delta T-cell lymphomas.

Fifty-seven cases of peripheral T-cell lymphoma were studied for cell expression of the T-cell receptor (TCR) chains, using monoclonal antibodies specific for the beta chain (beta F1) of the alpha/beta TCR, and for the delta chain (anti-TCR delta-1) of the gamma/delta TCR. Three different patterns were demonstrated: in 39 cases (69%), the phenotype (CD3+beta F1+TCR delta-1-) was that of most normal T cells. A second pattern was found on six cases (10%), which were of CD3+beta F1-TCR delta-1+ phenotype, and in which DNA analysis showed a clonal rearrangement of the delta locus in the five cases studied. It is suggested that these cases are the neoplastic counterpart of the small subpopulation of normal T cells that express gamma delta receptor. It is of considerable interest that these gamma delta lymphomas had unusual clinicopathologic presentations, as one case corresponded to a lethal midline granuloma and the five others to hepatosplenic lymphomas with a sinusal/sinusoidal infiltration in spleen, marrow, and liver. The fact that the distribution of the neoplastic gamma delta cells in the splenic red pulp resembles that of normal gamma delta cells reinforces the concept of a preferential homing of gamma delta T cells to this tissue. A third pattern (CD3 +/- beta F1-TCR delta-1-) was seen in 12 cases (21%), in which, by contrast to normal post-thymic T cells, no evidence of either alpha beta or gamma delta T cell receptor was found.

Antibodies, Monoclonal↗

PubMed2006

[Peripheral T-cell lymphoma presenting with eosinophilia due to interleukin-5 produced by lymphoma cells].

A 72-year-old male was admitted to our hospital to determine the cause of neck lymphadenopathies. He was diagnosed pathologically by a lymph node biopsy as having peripheral T-cell lymphoma (PTCL). He also had developed eosinophilia and his serum concentration of Interleukin-5 (IL-5) was extremely high. Immunostaining of a resected lymph node revealed that there were lymphoma cells which were stained with anti-IL-5 antibody. After 2 courses of CHOP therapy, the lymphadenopathies and eosinophilia disappeared and the concentration of serum IL-5 was normalized. It was suggested that IL-5 produced by lymphoma cells had induced his eosinophilia.

Aged↗

PubMed1991

[Malignant non-Hodgkin's lymphomas in abdominal surgery: apropos 3 cases of Burkitt's lymphoma].

On the occasion of three observations of the extremely rare and malignant Burkitt's lymphoma, the authors record their 7-year experience in the operative treatment of 22 patients with non-Hodgkin's malignant lymphomas. Proceeding also from data available in the current literature, the most frequently encountered syndrome-complex is presented, the knowledge of which is of major importance for the early diagnosis, resp. for the results of combined treatment. The possibilities of the operative treatment are evaluated. In the authors' series it was radical in 31.8 per cent of the cases with 13.6 per cent early postoperative lethal outcome and 5.2 months average postoperative survival rate. Proceeding for the rarity of the disease in everyday surgical practice and that it is poorly known, but has become a nosologic entity of increasing interest, the authors have devoted the first part of their article to a discussion on the basic characteristics of non-Hodgkin's malignant lymphomas and the modern achievements of their treatment.

Abdominal Neoplasms↗

PubMed1991

Small non-cleaved-cell lymphoma (undifferentiated lymphoma, Burkitt's type) in American adults: results with treatment designed for acute lymphoblastic leukemia.

PURPOSE: Small non-cleaved-cell lymphoma (SNCL) "Burkitt's type," a rapidly growing lymphoma, has been rare among adults in the United States, but has greatly increased in incidence with the acquired immunodeficiency syndrome epidemic. This report details the results of treatment of adult SNCL with a series of protocols originally designed for the treatment of acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: Between July 1973 and May 1987, 29 adults with newly diagnosed SNCL were treated at Memorial Hospital with intensive chemotherapy originally designed for ALL: the cyclophosphamide L-2, L-10, L-17, and L-20 protocols. Nine patients had positive serologies for human immunodeficiency virus (HIV) infection. One patient with all measurable disease resected was not evaluable for response. RESULTS: Sixteen of 28 evaluable patients (57%) achieved a complete remission with treatment. With follow-up as long as 153 months (median, 47 months), 50% of all patients and 59% of patients with negative or unknown HIV serologies have survived and are probably cured. Patients with an initial serum lactic acid dehydrogenase (LDH) level of greater than 500 U/L had a significantly shortened survival as compared with those with a lower serum LDH. Other pretreatment patient characteristics associated with a shortened survival of borderline statistical significance were high National Cancer Institute stage (C, D) and bone marrow involvement. These results are similar to those for ALL and lymphoblastic lymphoma and are comparable to those for American SNCL in the literature. CONCLUSIONS: Approximately one half of adults with SNCL are curable with intensive chemotherapy. More intensive chemotherapy with hematopoietic growth factor and/or autologous bone marrow or peripheral stem cell support may increase curability.

Adolescent↗

PubMed1990

A comparison of galactosyltransferase activity in mouse ascites lymphoma cells (Ly/Ya), in cultured lymphoma cells, in ascitic fluid and culture medium.

Comparative studies were carried out on the galactosyltransferase activity in ascites lymphoma cells isolated from mouse with ascitic lymphoma Ly/Ya, in these cells grown in vitro (24 hrs culture), in ascitic fluid and culture medium. The effect of varying amounts of UDP-galactose on transfer rate of galactose to ovomucoid by the cell enzyme (ascitic and cultured lymphoma cells) and by the soluble enzyme (ascitic fluid and culture medium) was studied. The activity of the enzyme in the cell culture medium was 2.5-fold higher than that in ascitic fluid. The apparent Km values for UDP-galactose of the enzyme from both kinds of cells and from the two fluids was 7.14 x 10(-7) M. At saturating concentrations of donor substrate, V values for the cells and culture medium was 765 pmoles/10(6) cells/h and 180 pmoles/10(6) cells/h for the ascitic fluid.

Animals↗

PubMed1990

[Non-Hodgkin's malignant lymphomas in primates (immunodiagnostic principles in T-cell lymphomas)].

Morphological and immunological phenotyping was carried out on 20 cases of peripheral baboon T-cell non-Hodgkin's malignant lymphomas (NHL) observed in a Sukhumi monkey colony. Morphologically, the lymphomas were prolymphocytic, immunoblastic, or rarely lymphoblastic types. For immunophenotyping studies, the panel of 29 monoclonal antibodies (MAb) to human or mouse leukocytic antigens were used (18 CD clusters). Three polyclonal sera to human IgG and light chains kappa and lambda were also taken in experiments. The investigated NHLs and CD4+CD8- (12 cases) or CD4-CB8+ (5 cases) phenotypes. In some cases loss of pan T-cell antigens or unusual antigen expression--loss (one case) or coexpression (two cases) of T-subset antigens--or the presence of abnormal lymphoid antigens have been revealed. In most studies, baboon T-cell NHLs tumor cells belonged to activated T-cells because they expressed Ia-like antigens and IL2R at high levels. There was no correlation between the discovered immunophenotype and the morphological pattern of malignant lymphomas.

Animals↗

PubMed1990

Monoclonal antibody HML-1, a marker for intraepithelial T cells and lymphomas derived thereof, also recognizes hairy cell leukemia and some B-cell lymphomas.

Current views regard monoclonal antibody HML-1 as an exquisite marker for intraepithelial T cells and primary intestinal and cutaneous T-cell lymphomas. We show that HML-1 reacted with 11 of 12 cases of hairy cell leukemia, with 1 of 13 cases of primary gastrointestinal B-cell lymphoma, and with an unclassified large-cell B lymphoma of the thoracic wall. We conclude that HML-1 is not restricted to the T-cell lineage and that the HML-1 antigen is expressed in a small subset of both T- and B-cell neoplasms.

Antibodies, Monoclonal↗

PubMed1990

Relationship between high-grade lymphoma and low-grade B-cell mucosa-associated lymphoid tissue lymphoma (MALToma) of the stomach.

The distinctive low-grade B-cell mucosa-associated lymphoid tissue lymphoma (MALToma) of the stomach has been well characterized in recent years, but its relationship with the more commonly occurring large B-cell gastric lymphoma has not been clarified. This study aimed to elucidate their relationship. Among 48 consecutive cases of primary malignant lymphoma found in gastrectomy specimens, there were 10 cases showing coexistence of these two elements, which were further studied in detail. The high-grade component predominated in six cases, the low-grade component predominated in two cases, and the two components were intermingled in two cases. In the low-grade component, the small neoplastic cells possessed irregular nuclei (centrocytelike), and glandular invasion was a prominent feature. In the high-grade component, the blasts occurred in clusters or sheets, and often possessed plasmacytoid cytoplasm; glandular invasion was a rare event. In both components, the neoplastic cells frequently showed formation of nodules suggestive of colonization of reactive lymphoid follicles. Immunohistochemical studies showed that the neoplastic cells in the low- and high-grade components expressed the same class of immunoglobulin light chain in eight of the nine cases studied; staining in one case was unsatisfactory. Their intimate relationship as well as identical light chain restriction suggests that the high-grade component arises through blastic transformation of the low-grade component.

B-Lymphocytes↗

PubMed1989

Cutaneous lymphoepithelioid lymphoma (Lennert's lymphoma). Combined immunohistological, ultrastructural, and DNA-flow-cytometric analysis.

Lymphoepithelioid lymphoma (LEL) is a peculiar type of low grade malignant T cell lymphoma usually arising in lymph nodes, characterized immunohistologically by predominant T-helper/inducer lymphocytes intermingled with clusters of epithelioid cells. An uncommon case of LEL with cutaneous involvement is reported with additional reference to ultrastructure and DNA-flow-cytometric analysis (DNA-FCM) of the lymphoma. Light microscopy showed subepidermal bandlike infiltrates of lymphocytes and clusters of epithelioid cells extending into the subcutaneous tissue. By immunohistochemistry the presence of a high percentage of T-helper/inducer lymphocytes was confirmed. DNA-FCM demonstrated an aneuploid cell population indicating malignant cells. Our results are in accordance with earlier ones established in lymph nodes.

Aged↗

PubMed1989

Transformed malignant lymphoma from Lennert's lesion is a CD4+ T cell lymphoma: an immunohistochemical study.

We describe a case of Lennert's lesion terminating in T cell non-Hodgkin's lymphoma (NHL). A 53-year-old woman showed inguinal lymphadenopathy. This was histologically interpreted as toxoplasmic lymphadenitis. However, Lennert's lesion was diagnosed in subsequent biopsies. Because additional lymphadenopathy and constitutional symptoms were absent, anti-neoplastic therapy was not given. During the five and a half years after the initial biopsy, generalized lymphadenopathy and constitutional symptoms developed. Histological examination of the cervical lymph node disclosed NHL, diffuse, large cell type. Transformed lymphoma cells were confirmed to be of peripheral T cell origin with a helper/inducer phenotype. We speculate that some cases of Lennert's lesion have a potentiality of spontaneous transformation into high grade malignant lymphoma associated with disappearance of epithelioid histiocytes.

Antigens, Differentiation, T-Lymphocyte↗

PubMed1989

Constitutive production of lymphokines by cloned murine B-cell lymphomas--CH12 B lymphoma produces interleukin-4.

B cells can be activated by T-independent antigens or mitogens such as lipopolysaccharide (LPS) which will induce proliferation and differentiation of the B cells into Ig-secreting cells, without the intervention of T cells. The precise mechanism of T-independent proliferation and differentiation of B cells is still unclear. It is possible however that antigen-stimulated B cells may produce some factors which play a role in T-independent B-cell responses. In addition, since it has now been established that B cells can function as antigen-presenting cells, it is possible that they too secrete a molecule which is involved in the activation of T cells, analogous to IL-1 production by antigen-presenting macrophages. A number of human B-cell lines, as well as human normal B cells activated appropriately, have been shown to produce various cytokines, and similar studies are now being undertaken in the mouse. In the present study, six cloned murine B-cell lymphomas of different origin were analyzed for the presence of mRNA encoding a number of lymphokines by hybridization of specific cDNA probes to poly-A RNA, followed by the sensitive S1 nuclease digestion technique. The lymphokines included (IL-) 1, 2, 3, 4, 5, and neuroleukin. Whereas none of the lines expressed detectable levels of IL-2, IL-3, or IL-5 mRNA, all the lines expressed high levels of neuroleukin mRNA. Three of the lymphomas (CH12, CH31, and NBL) expressed low levels of IL-1 mRNA. The most striking finding was that one lymphoma, CH12, constitutively expressed IL-4 mRNA. This mRNA appeared to be functional, as IL-4 activity measured by the HT-2 T cell proliferation assay could be detected in supernatants collected from CH12 cells. The growth-inducing activity of CH12 supernatant on HT-2 cells could be completely blocked by an anti-IL-4 monoclonal (11B11), but not by an anti-IL-2 antibody (S4B6), consistent with our observations that CH12 cells produce IL-4 but not IL-2. CH12 cells were also found to express high affinity receptors for IL-4. Proliferation of CH12 cells was not affected by the addition of exogenous IL-4. Addition of anti-IL-4 antibodies to CH12 cells in culture caused a slight but reproducible increase in their proliferation at low cell numbers, which is probably not highly significant. These findings open the possibilities that murine B lymphocytes are capable of lymphokine production or alternatively that aberrant lymphokine production underlies B-lymphocyte transformation.

Animals↗

PubMed1986

Investigation of the additive potential of teniposide and vincristine in non-Hodgkin's lymphoma. Australian and New Zealand Lymphoma Group.

Two hundred forty-seven patients with non-Hodgkin's lymphoma were randomized to receive doxorubicin, cyclophosphamide, and prednisolone in combination with vincristine (ACVP) or teniposide (ACTP) or both vincristine and teniposide (ACTVP). ACVP produced 44% complete remissions (CRs) and 32% partial remissions (PRs), whereas ACTP produced 46% CRs and 33% PRs and ACTVP produced 47% CRs and 36% PRs. Survival and relapse-free survival were also comparable for the three arms. The majority (59%) of patients had diffuse large cell lymphoma. Within this group, CR was achieved in 52% and no significant difference was observed in the response rates, survival, or relapse-free survival for the three treatment arms. Toxic effects occurred with equivalent frequency in the three regimens, except for neurotoxicity and myelosuppression. Moderate to severe neurotoxicity occurred in 20% of ACTVP-treated patients and in 8% of ACVP-treated patients but was not seen in any of the ACTP-treated patients (P = 0.0004). Severe myelosuppression occurred in 27% of ACTVP-treated patients and in 22% of ACTP-treated patients but only in 8% of ACVP-treated patients (P = 0.02), indicating an increased risk of myelosuppression for the combinations including teniposide. These results confirm our previous findings that teniposide can replace vincristine in the treatment of non-Hodgkin's lymphoma, with freedom from neurotoxicity and comparable survival and response rates. However, the combined use of teniposide and vincristine in the schedule as described has not increased response rates or survival but has instead added to neurotoxicity.

Actuarial Analysis↗

PubMed1987

Lymphocyte nuclear morphology in diffuse well-differentiated lymphocytic lymphoma. Comparative morphometry of normal lymphoid tissues, non-Hodgkin's lymphoma, and Hodgkin's disease.

Precise morphologic data on the relationship of diffuse well-differentiated lymphocytic lymphoma (DWDLL) to other non-Hodgkin's lymphomas (NHLs) are lacking in current classifications of lymphomas. Morphometry of plastic-embedded tissues describes details of the mean nuclear parameters and distribution of lymphocyte-types in 14 cases of DWDLL in nodal and extranodal sites. The results indicate that the proportion of small (unstimulated or nontransformed) lymphocytes in DWDLL varies from 50% to 86%. The mean nuclear area of small lymphocytes in DWDLL is either within the size range or somewhat smaller, and many examples are more irregular in shape, than the small lymphocytes in germinal centers that are morphologically comparable with the majority of lymphocytes in DWDLL and mantle zones. The morphologic relationship of DWDLL to other NHLs, Hodgkin's disease, and paracortical, mantle, and germinal center lymphocytes in lymphoid-reactive hyperplasia was established by morphometric analysis of the nuclear profiles of small lymphocytes. The small (nontransformed) lymphocytes in those subtypes of NHL other than DWDLL have abnormally small and more irregular nuclear profiles than those in normal small lymphocytes, or the small-lymphocyte population of Hodgkin's disease. Such findings may be of diagnostic significance to pathologists.

Biopsy↗

PubMed1986

[A phase II study of mitoxantrone in refractory and relapsed malignant lymphomas. Cooperative Study Group of Mitoxantrone in Malignant Lymphomas].

A phase II clinical trial of mitoxantrone in refractory or relapsed malignant lymphomas was conducted by a cooperative study involving 17 institutions. Of 46 patients entered, 33 were evaluable for responses and toxicity. Thirty-one of the 33 had been previously exposed to adriamycin at a median dose of 220 mg/m2 (range 21-489 mg/m2), and two additional patients had each been given THP-adriamycin at a dose of 80 mg/m2 or 4'-epi adriamycin at a dose of 69 mg/m2. Mitoxantrone was administered in 3 different schedules: 8-12 mg/m2, every 3-4 weeks in 23 patients; 4-6 mg/m2, weekly, in 3 patients; and 2-4 mg/m2, for 5 days, in 7 patients. Summarizing the responses obtained in the 3 schedules, there were 2 partial responders among 5 with Hodgkin's disease, while there were 8 complete responders and 4 partial responders among 28 with non-Hodgkin's lymphoma. The overall response rate for all the evaluable patients was 42% with a complete response rate of 24%. The median response duration was 7+ weeks (range 4-27+ weeks) for complete responders and 7 weeks (range 4-46+ weeks) for partial responders. The major toxicity was myelosuppression: leukocytopenia less than 3,000/microliter occurred in 79% of patients, and thrombocytopenia less than 75,000/microliter in 35%. Other toxic effects were minimal, mild nausea and/or vomiting occurred in 39%, and diarrhea in 3%. Possible drug-related liver and renal dysfunctions were observed in 19% and 10%, respectively. The favorable response to mitoxantrone in patients with prior anthracycline antibiotic therapy suggests that the drug is not fully cross-resistant with anthracycline antibiotics, and that this drug is of value in combination with other drugs as a salvage therapy for patients with refractory or relapsed malignant lymphomas.

Adolescent↗

PubMed1983

Antibodies against three purified proteins of the human type C retrovirus, human T-cell leukemia-lymphoma virus, in adult T-cell leukemia-lymphoma patients and healthy Blacks from the Caribbean.

Six black patients of Caribbean origin with adult T-cell leukemia-lymphoma, 18 of their healthy family members and relatives, and 337 healthy black individuals from the Caribbean were investigated for the presence of serum antibodies against human T-cell leukemia-lymphoma virus (HTLV). Three distinct structural proteins of this virus with molecular weights of 24,000, 19,000, and 15,000 were purified, radiolabeled, and used in radioimmune precipitation assays. Five of the patients, three of the family members (two of them spouses), and 11 of the normals had specific antibodies against at least the proteins with molecular weights of 24,000 and 19,000. High antibody titers against these proteins were often associated with antibodies against the protein with a molecular weight of 15,000. In all cases, antibody titers against this protein were considerably lower than those against the proteins with molecular weights of 24,000 and 19,000. HTLV is highly associated with Caribbean adult T-cell leukemia-lymphoma and is also endemic among the normal Caribbean population. By comparison of the frequencies of anti-HTLV positives among family members of patients and the normal population, we conclude that infection by HTLV occurs in a horizontal way and at least in the West Indian black and Japanese population probably without a requirement for uncommon genetic factors.

Adult↗

PubMed1983

Löffler's endocarditis. Occurrence with malignant lymphoma with a high content of epithelioid histiocytes ('Lennert's lymphoma').

In a patient who had malignant lymphoma with a high content of epithelioid histiocytes (so-called Lennert's lymphoma), Löffler's endocarditis developed 18 months after her diagnosis of lymphoreticular malignant neoplasm. She died of refractory congestive heart failure, and an autopsy showed the typical gross and microscopic findings of Löffler's endocarditis. To our knowledge, this is the first reported association of these two diseases. We noted nine autopsy cases in the literature of Löffler's endocarditis occurring in patients with lymphoreticular malignant neoplasms (acute lymphoblastic leukemia and lymphoma). Löffler's endocarditis with eosinophilia may be a relatively uncommon but significant complication in patients with malignant lymphoproliferative disorders. The peripheral blood eosinophilia probably represents a reactive response to tumor antigen.

Autopsy↗

PubMed1993

[Composite gastric lymphoma: MALT gastric lymphoma associated with Hodgkin's disease].

We report a case of MALT (Mucosa Associated Lymphocytic Tissue) gastric lymphoma which occurred in a 52-year-old woman, associated with Hodgkin's disease, Lymphocyte Predominant type, in epiploic nodes. Although many cases of composite lymphomas have been reported, we were not able to find cases of gastric MALT lymphoma associated with Hodgkin's disease. This is probably the first case reported in the literature.

Female↗