[A clinical study of the non-Hodgkin's lymphomas according to the Kiel classification (author's transl)].
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A study of 138 patients with Non-Hodgkin's lymphomas was performed. The results were compared with retro- and prospective investigations of patients of the Kiel lymphoma study group. The aim of the study is to evaluate the value of the Kiel classification for the therapy and prognosis of malignant lymphomas. The malignant lymphomas of low- and high-grade malignancy differ significantly in their biological behaviour. Especially the clinical progress of the disease and the response to therapy are different. The lymphomas of low-grade malignancy may not need any treatment for long periods in some patients. In contrary, patients with lymphomas of high-grade malignancy need an active treatment immediately after the establishment of the diagnosis. In stages I and II radiotherapy is sufficient, in stages III and IV chemotherapeutic regimens are necessary. Each type of malignant lymphoma may be accompanied by leukemia. Most of the malignant lymphomas, particularly the immunocytomas, may produce monoclonal gammopathies, most of them being macroglobulinemias. Thus the macroglobulinemia Waldenström is just a clinical necessary to evaluate the significance of the subtypes of the Kiel classification for the planning of specific treatment.Keywords:
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Macroglobulinemia
Malignant lymphoma
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Objective To explore the relationship between the expression of p53、bcl-2 and bax genes and the malignancy of non-Hodgkin's lymphomas. Method The expression of p53、bcl-2 and bax genes in non-Hodgkin's lymphoma cells from 62 cases was measured by employing immunohistochemical staining. Results The expression rate, expression intensity and positive cell density of p53 and Bcl-2 oncoproteins in non-Hodgkin's lymphomas increased gradually with the increment of tumor malignancy. It was significantly higher in low malignancy group compared with intermediate and high malignancy group (P0.01). Obvious difference between intermediate and high malignancy group was not observed (P0.05). In contrast, the expression level of Bax oncoprotein in low malignancy group was markedly higher than that in intermediate and high malignancy group (P0.01).Conclusion Aberrant apoptosis regulation might play an important role in the occurrence and exacerbation of non-Hodgkin's lymphoma. There is significant correlation between the expression of these genes and the malignant degree of non-Hodgkin's lymphoma.
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A study of 138 patients with Non-Hodgkin's lymphomas was performed. The results were compared with retro- and prospective investigations of patients of the Kiel lymphoma study group. The aim of the study is to evaluate the value of the Kiel classification for the therapy and prognosis of malignant lymphomas. The malignant lymphomas of low- and high-grade malignancy differ significantly in their biological behaviour. Especially the clinical progress of the disease and the response to therapy are different. The lymphomas of low-grade malignancy may not need any treatment for long periods in some patients. In contrary, patients with lymphomas of high-grade malignancy need an active treatment immediately after the establishment of the diagnosis. In stages I and II radiotherapy is sufficient, in stages III and IV chemotherapeutic regimens are necessary. Each type of malignant lymphoma may be accompanied by leukemia. Most of the malignant lymphomas, particularly the immunocytomas, may produce monoclonal gammopathies, most of them being macroglobulinemias. Thus the macroglobulinemia Waldenström is just a clinical necessary to evaluate the significance of the subtypes of the Kiel classification for the planning of specific treatment.
Working Formulation
Macroglobulinemia
Malignant lymphoma
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Objective:To explore the relationship between the microvessel density (MVD) and the malignancy,immuno-types and prognosis of Non-Hodgkin's lymphoma (NHL). Methods:By using biotinated UEA-I (Bio-UEA-I) immunohis-tochemical ABC method,the MVD in 102 cases of NHL were detected. Results: MVD in high grade and middle grade NHL were significantly higher than that in low grade NHL;T cell NHL MVD was apparently higher than B cell NHL MVD,and MVD in short survival group was remarkably higher compared with that in long survival group. Conclusion: MVD in NHL can be a valuable parameter in assessing the malignancy degree,immunotypes and prognosis of NHL.
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A retrospective analysis of 1514 patients with non-Hodgkin's lymphoma treated between 1972 and 1985 was performed. Of these cases, 114 with histology of low-grade malignancy and 750 with intermediate malignancy were localized in the head and neck. All patients received definitive course of radiation therapy, including 390 cases with adjuvant chemotherapy. For cases with low-grade malignancy, all cases were locally controlled and five-year relapse free survival rates were 85% in stage I, and 75% in stage II. For cases with intermediate malignancy, local control rates were 97% in stage I, and 87% in stage II. Five-year survival rates were 67% in stage I and 50% in stage II. There were no benefit on survival rates from adjuvant use of chemotherapy with radiation therapy as compared to radiation therapy alone.
Adjuvant Therapy
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While the histologic progression from low-grade non-Hodgkin’s lymphoma (NHL) to intermediate- or high-grade NHL has been well documented, a rare phenomenon called downgrading in which the histologic conversion of a low-grade NHL occurs after treatment for intermediate- or high-grade NHL has recently been recognized. We report the clinical, immunologic, and genetic features of a patient with a diffuse NHL (intermediate grade) who initially achieved complete remission by both chemotherapy and radiation therapy and then presented with a follicular NHL (low grade) 14 years later. The immunohistochemical study of the lymphoma cells showed B lymphocytes in biopsied lymph nodes at both the initial and the second diagnosis. However, a polymerase chain reaction (PCR) analysis for the immunoglobulin gene rearrangement indicated that the clone of the initial intermediate-grade NHL showed monoclonal cell population, and was distinct from that of the second downgraded form. Given the PCR results and the clinical features, we suggest that a follicular NHL can occur as a secondary malignancy following combined therapy for a diffuse NHL.
Follicular lymphoma
clone (Java method)
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Non-Hodgkin's lymphoma is a major public health problem with over 14.1 million people are diagnosed with it (2012). In the same year there were 8.2 million deaths due to cancer. The purpose of this study was to determine the relationship between clinical manifestations and the degree of malignancy based on histopathological features in patients with Non-Hodgkin's Lymphoma. This study used a retrospective analytical method with a cross-sectional approach using the patient's medical record at RSUD Dr. Soetomo, Surabaya who was diagnosed with Non-Hodgkin Lymphoma from 1st January 2015 to 31st December 2017. In this study, there were 139 samples include those criteria, with a greater number of male samples (62.6%) compared to women (37.4%). This study showed that 49.3% of patients with non- Hodgkin's lymphoma in RSUD Dr. Soetomo with clinical manifestations without symptoms actually experience malignancy with a high degree, this showed that clinical manifestations without symptoms are not always associated with a low level of malignancy. Then, based on the Chi Square test results obtained p-value of 0.289 (>0.05), so there was no significant relationship between clinical manifestations and the degree of malignancy.
Keywords: lymphoma; manifestation; histopatological
Medical record
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In 18 years of experience in the use of combined chemotherapy in Hodgkin's disease at the Instituto Nacional de la Nutrición Salvador Zubirán, the first case of non-Hodgkin's lymphoma secondary to Hodgkin's disease was identified. The patient was a 23 year old male who initially developed a nodular sclerosis type of Hodgkin's disease. Three years later, the biopsies showed lymphocyte predominance type of Hodgkin's disease. Finally, one year later, the patient developed a diffuse small cleaved cell lymphoma. Non-Hodgkin's lymphoma occurring in patients treated with combined chemotherapy and radiotherapy after Hodgkin's disease is a rare complication. We believe that the genesis of a second neoplasm in these cases may be due to both disturbances in the cellular immunity intrinsic to Hodgkin's disease and the treatment with combined chemotherapy and radiotherapy.
Nodular sclerosis
Hodgkin's lymphoma
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A rapidly fatal T-cell lymphoma developed in a 25-year-old man who, over a period of seven years, had been treated with radiotherapy and combination chemotherapy for Hodgkin's disease (HD). Non-Hodgkin's lymphoma (NHL) is increasingly being recognized as a late sequel of therapy for HD, but this is the first case in which NHL of T-cell type has been identified in such circumstances.
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There were 51 cases of non-Hodgkin's malignant lymphoma (NHL) and 9 cases of reactive follicular hyperplasia among 60 cases of lymphoproliferative conditions. According to the Kiel classification, lymphomas of a low grade of malignancy (17 cases) and lymphomas of a high grade of malignancy (34 cases) were distinguished among NML. Significantly higher activity of the nucleolar organizers (NO) was observed in lymphomas of a high malignancy grade, particularly in lymphomas formed of cells of early differentiation stages, and enhancement of NO activity with development of lymphoma aggression. "Anomalies" of NO activity expression reflecting clinical lymphoma presentation were noted among NML of various malignancy grade. NML with a high NO activity are described as having less favourable prognosis compared to lymphomas with low NO activity. No significant difference in NO activity was found between reactive follicular hyperplasia and follicular centroblast-centrocytic lymphoma. Thus, NO activity can be considered as an additional diagnostic marker of NML grade of malignancy and prognosis.
Follicular hyperplasia
Follicular lymphoma
Malignant lymphoma
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Clinical and morphological findings of lymph nodes in 150 consecutive untreated non-Hodgkin lymphoma (NHL) patients were retrospectively studied. One hundred and fifteen (77%) patients had B-NHL and 35 (23%) T-NHL, 96 (64%) patients had NHL low grade malignancy and 54 (36%) NHL of high grade malignancy according to the Kiel classification. Lymph nodes exceeding 2 cm in diameter (p less than 0.05), hepatomegaly (p less than 0.05), splenomegaly (p less than 0.05), and the duration of lymphadenopathy for more than 6 months preceding diagnosis (p less than 0.01) were significantly more common in low than high grade malignancy of NHL patients. Febrile episodes at the diagnosis were significantly more common in high than in low grade malignancy of NHL patients (p greater than 0.05). Lymph nodes exceeding 2 cm in diameter (p less than 0.05) in B-NHL, and lymph nodes above the diaphragm (p less than 0.05) and skin infiltration (p less than 0.001) were more common in T-NHL than in B-NHL patients. At the diagnosis low grade NHL patients have significantly more often splenomegaly, hepatomegaly, large palpable lymph nodes, and long lasting lymphadenopathy before diagnosis. High grade malignancy NHL patients have more often general symptoms, B-NHL patients have more often large palpable lymph nodes, T-NHL patients have more often skin infiltration and lymph nodes above the diaphragm. Precise clinical characterization of patients in addition to pathohistological diagnosis are very important in this highly variable disease.
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