Clinical evaluation of endolymphatic radiotherapy in malignant lymphoma

By endolymphatic injection of radioisotope 131I.Lipiodol, so.called endolymphatic radiotherapy, we treated 10 cases with malignant lymphoma and found a marked tumor reduction to normal size in all the 10 cases we tried. It seems that this method is one of the most effective therapeutic methods for malignant lymphoma, espe. cially invading into the retroperitoneal lymph nodes.</p

Malignant lymphoma of the penis: report of two cases

We report two cases of malignant lymphoma of the penis. A 64-year-old man presented with painful indurations of the penis. A computerized tomography (CT) scan showed a swollen retroperitoneal lymph node 5 cm in diameter. Penectomy confirmed the diagnosis of B cell malignant lymphoma, diffuse large type. Despite systemic chemotherapy with a CHOP regimen, he died of disease 7 months postoperatively. The second case was in a 63-year-old man presenting with multiple nodules in the penis and scrotum. Biopsy of a scrotal nodule revealed B cell malignant lymphoma, diffuse medium size type. A CT scan demonstrated widespread lesions (stage III E). He has been in complete remission for 10 months following, multidisciplinary treatments. We reviewed 21 cases of malignant lymphoma of the penis which have been reported in the literature

Primary Non-Hodgkin's Malignant Lymphoma of the Sinonasal Tract

Primary non-Hodgkin’s lymphomas (NHL) of the sinonasal tract are rather uncommon entities. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non- neoplastic processes. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and invasive fungal infection respectively. We report a case of primary NHL involving sinonasal tract in elderly female, which was clinically and radiologically mimicking as sinonasal malignany and was proven as NHL on histological examination and confirmed by immunohistochemistry. A high index of suspicion, appropriate histopathological examination and immunohistochemistry is necessary to differentiate sinonasal lymphomas from other possibilities. Failure to do so may miss the diagnosis and delay appropriate treatmen

Somatostatin receptor scintigraphy in cutaneous malignant lymphomas

Background: Lymphoid cells may express somatostatin receptors (SS-Rs) on their cell surface. Therefore radiolabeled somatostalin analogues may be used to visualize SS-R-positive lymphoid neoplasms in vivo. Exact staging is the basis for treatment decisions in cutaneous malignant lymphoma. We considered the possibility that SS-R scintigraphy might offer a clinically useful method of diagnostic imaging in patients with cutaneous malignant lymphoma. Objective: We evaluated SS-R scintigraphy in comparison with conventional staging methods in the staging of cutaneous malignant lymphoma. Methods: We conducted a prospective study in 14 consecutive patients with histologically proven cutaneous malignant lymphoma. SS-R scintigraphy was compared with physical, radiologic, and bone marrow examinations. Lymph node excisions were performed in patients with palpable lymph nodes. Results: SS-R scintigraphy was positive in the lymph nodes in all four patients with malignant lymph node infiltration and negative in the three patients with dermatopathic lymphadenopathy. In two patients, previously unsuspected lymphoma localizations were visualized by SS-R scintigraphy. In only three patients all skin lesions were visualized by SS-R scintigraphy; these three patients had not been treated with topical corticosteroids. SS-R scintigraphy failed to detect an adrenal mass in one patient and bone marrow infiltration in two patients. Conclusion: SS-R scintigraphy may help distinguish dermatopathic lymphadenopathy from malignant lymph node infiltration in patients with cutaneous malignant lymphoma

Mesenteric follicular lymphoma

When you see a patient with solid mesenteric tumors, malignant lymphoma should be considered as an important differential diagnosis. It is essential to include abdominal CT and F-18-FDG PET/CT examinations in these patients for early diagnosis of malignant lymphoma, giving extra weight on patients' complaints

Malignant lymphoma of the prostate--a case report

We report a case of prostatic malignant lymphoma causing bilateral hydronephrosis. A 73-year-old man was referred to our department, suffering from urinary frequency and gross hematuria. The mild elevation of serum prostatic tumor markers made us suspect prostatic carcinoma. He was admitted to our hospital and needle biopsy of the prostate was performed. Unexpectedly histological findings revealed "malignant lymphoma, diffuse large cell type". CT scan showed bilateral hydronephrosis, and renal function was decreased. As the patient suddenly vomited blood, gastric fiberscopy and biopsy was performed. Histological diagnosis of stomach was the same as for the prostate. After systemic chemotherapy of cyclophosphamide, adriamycin, vincristine, prednisone (CHOP) regimen, renal function improved and the tumor of stomach reduced, but his respiratory condition rapidly worsened, and he died about 1 month after chemotherapy. Malignant lymphoma involving the prostate is very rare. Especially in Japan only 19 cases have been reported including our case. Four of the 19 men were in their twenties and so we remind the urologists of the possibility of "malignant lymphoma of the prostate" in young patients with dysuria or frequency

Experimental studies of the endolymphatic radiotherapy

By injecting 131I-Lipiodol into lymphatics of the dorsum of dog feet, the distribution of 13JI in the lymph nodes and other principal organs as well as its histological effect were studied periodically after the injection for the period of two months. The characteristic feature of J3JI distribution was the fact that J31I was accumulated into lymph nodes markedly higher than in any other organs and it was retained there over a long period of time. Histological examinations of the lymph nodes revealed a marked lymphocytopenia, the loss of germinal center, practically complete loss of lymphoid elements already 5 days after injection, and marked fibrosis. In the lung a considerable J3JI·distribution could be seen in early stage:, but with lapse of time it decreased rapidly. The distribution in other organs such as liver, spleen, bone marrow, kidney, ureter, bladder, thyroid gland, pancreas, testicles and small and large intestines was negligible in amount, and any specific histologic effect of irradiation could not be recognized in these organs including the lung. From these results, the authors concluded that 131I-Lipiodol has a selective activity on lymph nodes by injecting it via lymphatics and it is a safe method in clinical application to treat the patients bearing malignant lymphoma or metastatic lymph nodes.</p

Case-based similar image retrieval for weakly annotated large histopathological images of malignant lymphoma using deep metric learning

In the present study, we propose a novel case-based similar image retrieval (SIR) method for hematoxylin and eosin (H&E)-stained histopathological images of malignant lymphoma. When a whole slide image (WSI) is used as an input query, it is desirable to be able to retrieve similar cases by focusing on image patches in pathologically important regions such as tumor cells. To address this problem, we employ attention-based multiple instance learning, which enables us to focus on tumor-specific regions when the similarity between cases is computed. Moreover, we employ contrastive distance metric learning to incorporate immunohistochemical (IHC) staining patterns as useful supervised information for defining appropriate similarity between heterogeneous malignant lymphoma cases. In the experiment with 249 malignant lymphoma patients, we confirmed that the proposed method exhibited higher evaluation measures than the baseline case-based SIR methods. Furthermore, the subjective evaluation by pathologists revealed that our similarity measure using IHC staining patterns is appropriate for representing the similarity of H&E-stained tissue images for malignant lymphoma

A Case of Malignant T-Cell Lymphoma of Gastric Origin Accompanied by Pyothorax

The patient was a 74-year-old man suffering from tuberculotic chronic pyothorax. He had hematemesis in January 2006. Hb was 6.1 g/dl. A type 2 tumor 3 cm in diameter was found in the vaulted region on the greater curvature side. It was diagnosed as a malignant lymphoma. WBC and differential count were normal, and the patient tested negative for HTVL-1 antibody. sIL2-R was elevated to 1,500 U/ml. The superficial lymph nodes were not palpable. CT examination was not remarkable for the liver and spleen. There was no generalized lymph node enlargement. Based on these findings, a diagnosis of malignant lymphoma of gastric origin was made. As the patient had respiratory disorders, too, wedge-shaped gastrectomy was performed to inhibit invasion. Pathological examination revealed CD3 positive large atypical lymphocytes diffusely, EBV positive, HP negative. As a result, a diagnosis of non-Hodgkin T-cell lymphoma was made. The tumor did not return for 1 year and 8 months after surgery, but the patient died of sudden aggravation of respiratory disorders in September 2007. Pathological anatomy was performed. The gastric remnant was left with lymphoma, and the bone marrow and systemic lymph nodes were negative for a malignant lymphoma. The possibility of stomach metastasis from the preoperative pyothorax-related malignant lymphoma was considered, but was ruled out because the lungs were devoid of a malignant lymphoma. We report a case of an extremely rare malignant T-cell lymphoma of gastric origin