Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined mul...Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined multimodal approach with a review of the literature. Case Report: A patient aged 69-year-old male, newly hypertensive, who presented with a twelve-month history of right testis progressive painful scrotal swelling, which worsens following a motorbike accident. Clinical examination revealed a large tender mass in an erythematous right scrotal bursa. A scrotal ultrasound showed a right heterogenous intra-testicular mass. The patient underwent unilateral (right) radical orchiectomy. Histopathological examination revealed presence of monomorphic lymphoid cells, with moderate to increased size, dissociated inconstantly by macrophages consistent with a Burkitt’s-like non-Hodgkin Lymphoma. After surgery, the patient was transferred to oncologist for adjuvant chemotherapy. Conclusion: A testicular mass is a usual circumstance for the discovery of a primary tumour of the testicle. Burkitt’s testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non-consensual etiological or predisposing factors. The treatment depends imperatively on the stage of the disease. Therapeutic modalities relay on in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized.展开更多
Background:The prognostic values of interim and post-therapy fluorine-18-fluorodeoxyglucose(^(18)F-FDG) positron emission tomography(PET) and PET/computed tomography(CT) scanning have been confirmed in several subtype...Background:The prognostic values of interim and post-therapy fluorine-18-fluorodeoxyglucose(^(18)F-FDG) positron emission tomography(PET) and PET/computed tomography(CT) scanning have been confirmed in several subtypes of lymphoma.However,its prognostic value in Burkitt's lymphoma has not been clearly defined.The aim of the present study was to assess the prognostic value of PET/CT scanning during different treatment processes of Burkitt's lymphoma.Methods:A total of 29 adult patients with newly diagnosed Burkitt's lymphoma were retrospectively involved in this study;of them,23 patients underwent baseline PET/CT,15 patients underwent mid-therapy PET/CT after 1-4 cycles of chemotherapy,and 17 patients underwent post-therapy PET/CT after all planned first-line chemotherapy cycles.Mid-therapy and post-therapy PET/CT results(positive vs.negative) were visually interpreted according to the criteria of the International Harmonization Project.The reduction in the maximum standardizes uptake values(ASUVmax)of 25%,50%,and 75%were regarded as cutoff points.Overall survival(OS) and progression-free survival(PFS) were regarded as the major endpoints.Results:The median OS and PFS were 27.6 months(range 6.5-78.3 months) and 27.2 months(range 3.0-78.3 months),respectively.The median SUVmax of the baseline PET/CT was 18.3(range 1.6-35.9),whereas the median SUVmax of the mid-therapy and post-therapy PET/CT decreased to 4.0(range 0-17.6) and 3.0(range 0-14.5),respectively.The patients' Eastern Cooperative Oncology Group(ECOG) scores(<2 vs.≥2) were significantly associated with the baseline PET/CT SUVmax.The mid-therapy and post-therapy PET/CT results(positive vs.negative) showed no significant association with OS or PFS.The optimal cutoff ASUVmax from the baseline to the post-therapy PET/CT that could predict a change in OS in patients with Burkitt's lymphoma was 50%(P = 0.019).Conclusions:^(18)F-FDG uptake was intense in Burkitt's lymphoma,and there was a significant reduction in SUVmax during the interim and post-therapy PET/C展开更多
文摘Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined multimodal approach with a review of the literature. Case Report: A patient aged 69-year-old male, newly hypertensive, who presented with a twelve-month history of right testis progressive painful scrotal swelling, which worsens following a motorbike accident. Clinical examination revealed a large tender mass in an erythematous right scrotal bursa. A scrotal ultrasound showed a right heterogenous intra-testicular mass. The patient underwent unilateral (right) radical orchiectomy. Histopathological examination revealed presence of monomorphic lymphoid cells, with moderate to increased size, dissociated inconstantly by macrophages consistent with a Burkitt’s-like non-Hodgkin Lymphoma. After surgery, the patient was transferred to oncologist for adjuvant chemotherapy. Conclusion: A testicular mass is a usual circumstance for the discovery of a primary tumour of the testicle. Burkitt’s testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non-consensual etiological or predisposing factors. The treatment depends imperatively on the stage of the disease. Therapeutic modalities relay on in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized.
基金supported by grants from the National Natural Science Foundation of China(No.81472759 and 81301903)Guangdong Natural Science Foundation(No.S2013010016331)+3 种基金Science and Technology Planning Project of Guangdong Province,China(No. 2014J4100163)Science and Technology Planning Project of Guangzhou, China(No.2013B021800142)Fundamental Research Funds for the Central Universities(No.10ykpy36)Research Award Funds for Outstanding Young Researchers in Sun Yat-sen University Cancer Center
文摘Background:The prognostic values of interim and post-therapy fluorine-18-fluorodeoxyglucose(^(18)F-FDG) positron emission tomography(PET) and PET/computed tomography(CT) scanning have been confirmed in several subtypes of lymphoma.However,its prognostic value in Burkitt's lymphoma has not been clearly defined.The aim of the present study was to assess the prognostic value of PET/CT scanning during different treatment processes of Burkitt's lymphoma.Methods:A total of 29 adult patients with newly diagnosed Burkitt's lymphoma were retrospectively involved in this study;of them,23 patients underwent baseline PET/CT,15 patients underwent mid-therapy PET/CT after 1-4 cycles of chemotherapy,and 17 patients underwent post-therapy PET/CT after all planned first-line chemotherapy cycles.Mid-therapy and post-therapy PET/CT results(positive vs.negative) were visually interpreted according to the criteria of the International Harmonization Project.The reduction in the maximum standardizes uptake values(ASUVmax)of 25%,50%,and 75%were regarded as cutoff points.Overall survival(OS) and progression-free survival(PFS) were regarded as the major endpoints.Results:The median OS and PFS were 27.6 months(range 6.5-78.3 months) and 27.2 months(range 3.0-78.3 months),respectively.The median SUVmax of the baseline PET/CT was 18.3(range 1.6-35.9),whereas the median SUVmax of the mid-therapy and post-therapy PET/CT decreased to 4.0(range 0-17.6) and 3.0(range 0-14.5),respectively.The patients' Eastern Cooperative Oncology Group(ECOG) scores(<2 vs.≥2) were significantly associated with the baseline PET/CT SUVmax.The mid-therapy and post-therapy PET/CT results(positive vs.negative) showed no significant association with OS or PFS.The optimal cutoff ASUVmax from the baseline to the post-therapy PET/CT that could predict a change in OS in patients with Burkitt's lymphoma was 50%(P = 0.019).Conclusions:^(18)F-FDG uptake was intense in Burkitt's lymphoma,and there was a significant reduction in SUVmax during the interim and post-therapy PET/C
基金Specific Disease Foundationfor Lymphoma of Sun Yat-sen University Cancer Center(No.2008-00652)~~
文摘背景与目的:散发性Burkitt's淋巴瘤(sporadic Burkitt's lymphoma,sBL)少见,中国sBL的EB病毒(Epstein-Barrvirus,EBV)感染状况尚未见报道。本研究探讨广州地区sBL的临床特点、形态学特征、免疫表型及EBV的感染状况。方法:分析总结21例sBL患者的临床资料,并作一系列免疫组织化学染色确定免疫表型,EBV编码的小RNA(EBV-encoded small RNAs,EBERs)原位杂交检测EBV感染情况。结果:中山大学肿瘤防治中心2000年1月~2007年10月收治的2416例非霍奇金淋巴瘤中,明确诊断21例sBL(0.87%)。男女之比为4.25:1(17/4);中位年龄23岁。21例患者中,19例(90.48%)有淋巴结侵犯;16例(76.19%)多部位受累;12例(57.14%)临床分期为Ⅲ/Ⅳ期;15例化疗或手术加化疗患者的2年生存率为56.00%。20例形态学上表现为经典BL,另1例为伴有浆细胞样分化的BL变异型。该21例sBL主要的免疫表型为sIgM+/CD20+/CD10+/Bcl-6+/Bcl-2-[或Bcl-6+(>95%)/Bcl-2+(<10%)]/TdT-/Ki-67+100%。20例可检测病例中,11例有少数肿瘤细胞(3%~20%)表达CD5。10例肿瘤(47.62%)呈P53蛋白过表达。6例(28.57%)肿瘤细胞感染EBV,表达EBNA1和EBERs,但不表达LMP1。EBV阳性及阴性病例在形态学和免疫表型上均无显著差异。结论:广州地区sBL少见,主要见于儿童及年轻成年男性。多数病例有淋巴结的侵犯。形态学及免疫表型与地方性BL类同。28.57%病例呈EBVI型潜伏感染。