A seventeen-year-old female with hepatosplenic T-cell lymphoma associated with parvoviral infection

Hepatosplenic T-cell lymphoma (HSTL) is rare, being derived from cytotoxic T-cells, and manifests as an extranodal systemic lymphoma. We present an unusual case of a seventeen-year-old female, with no significant prior medical history, presenting with a hepatosplenic T-cell lymphoma. The diagnosis was confirmed by histological examination, immunohistochemisty, and flow cytometry. A staging work-up demonstrated bone marrow involvement by HSTL with concomitant intranuclear parvoviral inclusions

A thirteen year old female with primary T-cell rich B-cell lymphoma of bone masquerading as chronic recurrent multifocal osteomyelitis

Primary lymphoma of the bone (PLB) accounts for 2% of all non-Hodgkin's lymphomas, and until recently it had not been well characterized in literature. Most cases present in adulthood (average age 50), with localized painful lesions in the long bones, cranium, or axial skeleton

Precursor B-lymphoblastic lymphoma mimicking: An acute subdural hematoma

Objective and importanceWe present the first case of a precursor acute subdural B-lymphoblastic lymphoma mimicking an acute subdural hematoma.Clinical presentationA 19 year old male presented with an acute onset of headache, nausea and vomiting. CT scan showed crescentic right-sided, frontoparietal subdural mass isointense with cortex and showing homogeneous enhancement after gadolinium.InterventionThe patient underwent a craniotomy and a gray subdural tumor with invasion of both dura and brain was observed. The invaded dura was resected and duraplasty performed. Histopathologically, the tumor was composed of small round cells infiltrating soft tissue. In some areas of the tumor, cells were arranged in a linear, “Indian file” fashion between collagen bundles. Their nuclei were generally uniform, round to ovoid in shape, small to medium in size, and featured delicate chromatin. Accompanying cytoplasm was scant. Necrosis was absent. On immunohistochemical analysis, the tumor cells were positive for CD79a, TdT, CD10 and CD34.ConclusionSubdural lymphoma can present as a neurosurgical emergency, and lymphoma should be considered as a rare but possible diagnosis before operation

Incidental Metastatic Meningioma Presenting as a Large Liver Mass

Meningiomas are slow growing neoplasms of the central nervous system (CNS). Most of the tumors are benign and distant metastasis from a benign meningioma is rare. Metastasis to the liver, although rare, usually presents with hypoglycemia or occurs in conjunction with a clinical history of an intracranial meningioma or following the resection of a prior CNS meningioma, thus making clinical diagnosis relatively easy. Here we present an unusual case of metastatic meningioma to the liver in a 54-year-old female who presented with an incidental liver mass by ultrasound. Her clinical history and physical examination were unremarkable. A partial hepatectomy revealed a meningioma on histology. Further investigation by imaging studies showed a frontal parasagittal dural mass which was confirmed to be a World Health Organization (WHO) grade 1 meningioma. To our knowledge, this is the first report of a clinically silent metastatic meningioma to the liver without either a concurrent or a previous history of meningioma. Precise diagnosis of this challenging case requires high clinical suspicion, histopathology, and immunohistochemistry

Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis

Intravascular lymphoma is a rare type of lymphoma, characterized by growth of lymphoma cells within the microvasculature. The majority of the cases are of B-cell lineage, although rare examples of T or NK lineage have also been reported. The lymphoma is usually widely disseminated in the vascular spaces of any organ at the time of diagnosis including the skin and bone marrow. Lymph nodes are typically spared. The clinical picture depends on the specific organ involvement making the correct diagnosis very difficult. Here, we report a case of intravascular large B-cell lymphoma diagnosed postmortem on a 69-year-old African-American male who presented with unilateral proptosis and visual loss. An initial diagnosis of temporal arteritis was made and the patient received corticosteroids. However, the patient developed multiorgan failure and expired. On autopsy, there was disseminated intravascular lymphoma involving predominantly vessels within the heart, kidneys, liver, stomach, lungs, adrenal glands, small intestine, bladder, thyroid, and brain. Interestingly, there was also partial involvement of the retroperitoneal lymph nodes which is an unusual presentation in this disorder. Immunohistochemical staining showed that the lymphoma cells were positive for CD20, indicating B-cell phenotype. This case supports the “mimicking nature” of this rare entity with an unusual presentation with proptosis and visual loss, simulating temporal arteritis and a rare involvement of the retroperitoneal lymph nodes. The presentation of intravascular large B-cell lymphoma can vary, and the key to diagnosis is dependent on histopathology and immunohistochemistry. Increased awareness, early tissue diagnosis, and prompt chemotherapy are crucial for this otherwise lethal disease

Primary mucosa-associated lymphoid tissue lymphoma of the liver: A report of two cases and review of the literature

© The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. Mucosa-associated lymphoid tissue (MALT) lymphoma of the liver is a very rare condition and thus the diagnosis may be challenging. The clinical presentation is usually variable, ranging from minimal clinical symptoms to severe end stage liver disease. In this paper, we describe the clinicopathologic findings in two cases of primary hepatic MALT lymphoma. One case is an 80-year-old female with no underlying chronic liver disease and the second case is a 30-year-old female with autoimmune hepatitis complicated by MALT lymphoma. In both specimens, there was diffuse infiltration of atypical B-lymphocytes that were positive for CD20 and CD79a, but negative for CD5, CD43 and CD10. There were occasional lymphoepithelial lesions involving the hepatocytes or bile ducts. Polymerase chain reaction analysis showed monoclonal immunoglobulin heavy chain gene rearrangement in both cases. The first case was treated with surgery but developed pulmonary recurrence a year after complete resection but went into remission following treatment with rituximab. A second recurrence occurred in the right parotid gland 7 years later, which was treated with idelalisib. The second case was effectively treated with rituximab. To our knowledge, the second case is the first reported case linked to autoimmune hepatitis

Spinal cord tumor Oligodendroglioma: Diagnosis

Oligodendrogliomas arise throughout the central nervous system (CNS), primarily affecting the cerebral hemispheres of adults, and sometimes disseminating as intraspinal drop metastasis. Primary spinal cord oligodendrogliomas are rare, constituting less than 2% of spinal cord tumors. Clinically, patients present with sensorimotor deficits such as weakness and pain, genitourinary dysfunction or scoliosis, depending on location. Radiographically, the characteristic finding is that of a hypodense, well-demarcated mass lesion, sometimes with calcifications on CT. With MRI the expansile, masses appear hypointense on T1-weighted images and show signal hyperintensity on T2 and FLAIR sequences. The classic microscopic appearance is that of an infiltrating glial neoplasm composed of monotonous clear cells with perinuclear halos embedded in a scaffolding of “chicken wire” vessels. Occasionally, the neoplastic cells possess round, eccentric nuclei with more abundant eosinophilic cytoplasm (gliofibrillary oligodendrocytes and minigemistocytes). Tumors lack the expression of markers of mature oligodendrocytes; although, there may be focal expression of GFAP, especially in gliofibrillary oligodendrocytes and minigemistocytes. In adult oligodendrogliomas, approximately 80% contain characteristic 1p36 and 19q13 co-deletions, due to an unbalanced t(1,19) (q10; p10) translocation, which appears to correlate with chemosensitivity. Rarely, spinal cord oligodendrogliomas present as primary leptomeningeal oligodendrogliomas (PLO)/primary leptomeningeal gliomatosis (PLG) or “holocord” oligodendrogliomas. The age group, clinical features and MRI findings of these patients are different than the localized spinal cord parenchymal oligodendrogliomas. Accordingly, a high index of suspicion is required for the timely diagnosis of these tumors. Distinction from other spinal cord tumors is crucial due to differences in patient management and long-term prognosis