Clinical Features and Long-term Outcomes of Lymphoma Patients Initially Presenting as Fever With Unknown Origin
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Abstract BackgroundLymphoma is found to be the main source of non-infectious fever of unknown origin (FUO). However, there is a lack of clinical features and outcomes in lymphoma patients initially presenting as FUO.MethodsFrom January 1, 2013 to December 31, 2019, our center enrolled 185 patients who initially presented as FUO then confirmed to be lymphoma in Huadong Hospital of Fudan University. During the same study period, 332 lymphoma patients without FUO received treatment in our center. After the exclusion, 509 patients were included in the retrospectively study. The differences in clinical manifestations, laboratory examinations, overall response rates and survival rates between the FUO and non-FUO groups were analyzed. The clinical endpoints were overall survival (OS) and progress-free survival (PFS).ResultsIn the non-FUO group (329 in total), Hodgkin’s lymphoma (HL) was 17 (5.2%), B cell non-Hodgkin’s lymphoma (B-NHL) was 276 (83.9%), T cell non-Hodgkin’s lymphoma (T-NHL) was 32 (9.7%) and NK/T cell lymphoma (NK/T-CL) was 4 (1.2%). In the FUO group (180 in total), B-NHL was 88 (48.9%), T-NHL was 60 (33.3%), NK/T-CL was 24 (13.3%) and HL was 8 (4.4%). During the hospitalization, the maximum body temperature of the FUO group diagnosed with B-NHL, T-NHL and NK/T-CL was statistically higher than that of the non-FUO group (all P<0.05). Concerning the overall response rates, there was no difference between the FUO and non-FUO groups, whatever the pathological subtype was. The differences in OS between the FUO and non-FUO groups were significant for HL (P=0.006), B-NHL (P=0.007) and T-NHL (P=0.013). No difference in overall survival was observed in the two groups for the subtype of NK/T-CL (P=0.141). In terms of PFS, there was no significant difference between FUO and non-FUO groups for any subtype (all P>0.05).ConclusionWe found that the major subtypes of lymphoma initially presenting as FUO were B-NHL and T-NHL. The main diagnostic biopsy sites were subcutaneous lymphnodes, bone marrow and spleen for lymphoma patients with FUO. Patients with FUO suffered from a higher risk of all-cause death in the long term.Keywords:
T-Cell Lymphoma
Single Center
Journal Article A Practical Approach to the Diagnosis of Hodgkin Lymphoma Get access Catherine M. Listinsky, MD Catherine M. Listinsky, MD 1Department of Pathology, University of Alabama at Birmingham, and the Birmingham Veterans Affairs Medical Center *Address reprint requests to Dr Listinsky: Dept of Pathology, University of Alabama at Birmingham, 1922 7th Ave South, Kracke Bldg, Room 506, Birmingham, AL 35233. Search for other works by this author on: Oxford Academic Google Scholar Pathology Patterns Reviews, Volume 117, Issue suppl_1, 1 June 2002, Pages S76–S94, https://doi.org/10.1309/A9FA-RVFF-5RF7-DA0D Published: 01 June 2002
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T-Cell Lymphoma
Follicular lymphoma
Large cell
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A patient with a nodular lymphoma morphologically indistinguishable from follicular B-cell lymphoma subsequently developed a diffuse T-cell lymphoma. This T-cell lymphoma displayed characteristics analogous to mature T-lymphocytes, and typed as a suppressor/cytotoxic T-cell with the monoclonal antibodies. The light and electron microscopy morphology of the T-cell lymphoma was similar to that reported for node-based T-cell lymphomas. There was a polymorphous proliferation of variably transformed lymphocytes including immunoblasts. This case could represent either a nodular form of T-cell lymphoma converting to a diffuse T-cell lymphoma, or a follicular B-cell lymphoma preceding, and possibly inducing, a suppressor T-cell lymphoma.
T-Cell Lymphoma
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Objective To compare the detection rate of Epstein-Barr virus latent membrane protein 1 (LMP1) 30 base pair deletion in extranodal nasal type NK/T-cell lymphoma with that in chronic inflammation of nasopharynx and tonsillitis; and to analyze the prognostic significance of LMP1 deletion in extranodal nasal type NK/T-cell lymphoma.Methods Polymerase chain reaction was used to detect the deletion of LMP1 in 55 cases of extranodal nasal type NK/T-cell lymphoma and 19 cases of chronic inflammation of nasopharynx and tonsillitis.Follow-up information of 1 to 58-month duration was available in 33 patients.Results In all the 55 extranodal nasal type NK/T-cell lymphoma cases studied, 9 cases contained the wide-type or predominantly wide-type LMP1.On the other hand, 46 cases contained the deleted or predominantly deleted LMP1.In the non-lymphoma control group, 16 cases contained the deleted or predominantly deleted LMP1.However, no statistically significant difference was found in the detection rate of 30 base pair deleted LMP1 between extranodal nasal type NK/T-cell lymphoma and control group (P0.05).The prognosis of deleted or predominantly deleted LMP1 in extranodal nasal type NK/T-cell lymphoma was worse.Conclusion Though 30 base pair deletion of Epstein-Barr virus LMP1 may not be an important pathogenetic step in extranodal nasal type NK/T-cell lymphoma, it may play some role in tumor progression.
T-Cell Lymphoma
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Classical Hodgkin lymphoma
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To study the relationship of Epstein-Barr virus (EBV) and T cell lymphoma.Sixty cases of T cell lymphomas were examined for the presence of EBV using in situ hybridization for EBV encoded RNA (EBERs).EBERs were detected in tumor cells in 37(69.8%) of 53 cases with peripheral T cell lymphoma, but in none of seven cases of precursor T lymphoblastic lymphoma. The total detected EBERs were 37(61.6%) in 60 cases of T cell lymphomas. By Revised European-American Lymphoma(REAL) classification, EBERs were detected in 2/2 angioimmuno-blastic T cell lymphoma,17/18 angiocentric lymphoma, 4/6 anaplastic large cell lymphoma and 14/27 peripheral T cell lymphoma, unspecified (51.9%). The frequency of EBERs among the extranodal peripheral T cell lymphoma was higher than the nodal (P less than 0.01) there was no significant correlation with the sex, age and clinical stage.This study indicated that high incidence of EBV was observed in peripheral T cell lymphoma, with predilection for angiocentric lymphoma and extranodal presentation.
Peripheral T-cell lymphoma
T-Cell Lymphoma
Anaplastic large-cell lymphoma
Lymphoblastic lymphoma
Large cell
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Summary Non‐Hodgkin lymphoma ( NHL ) is a heterogeneous group of lymphoid malignancies accounting for a significant portion of cancers occurring in children, adolescents and young adults with an increasing incidence with age. The adolescent and young adult ( AYA ) population presents a specific set of characteristics and challenges. The most common diseases occurring in adolescents and young adults include Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B‐cell lymphoma, anaplastic large cell lymphoma and primary mediastinal B‐cell lymphoma. There is also a higher incidence of primary central nervous system lymphoma in AYA patients. Cure rates largely depend on risk‐stratification, and are generally superior to outcomes in comparison to older adult data but less than in younger children. Here, we review the unique clinical and biological characteristics of NHL occurring in the AYA population with a focus on how to achieve similar curative outcomes in AYA that have been established in younger cohorts.
Lymphoblastic lymphoma
Anaplastic large-cell lymphoma
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Objective To evaluate 18 F-fluorodeoxyglucose (FDG) PET imaging in fever of unknown origin for screening of lymphoma. Methods Fifty-nine patients with fever of unknown origin (fever more than three weeks,temperature over 38.3 ℃) underwent PET imaging with 18 F-FDG,the results were compared with the final diagnosis. Results Eight patients (13.6%) were diagnosed as lymphoma by PET imaging in the fifty-nine cases with fever of unknown origin,which were verified as two Hodgkin lymphoma and six non-Hodgkin lymphoma. Conclusions PET imagings can find the lesions of lymphoma with fever smaller than 1 cm or deep in body. 18 F-FDG PET imaging appears to be a valuable imaging procedure for screening of lymphoma in fever of unknown origin.
PET Imaging
Fluorodeoxyglucose
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Classical Hodgkin lymphoma
Anaplastic large-cell lymphoma
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