Despite their B cell origin, Reed-Berezovsky-Sternberg tumor cells (RBS) in classic Hodgkin's lymphoma (cHL) demonstrate an absolutely unique phenotype. Immunohistochemistry of RBS cells is positive for CD15 antigen in most of cases, CD30, PAX-5; they do not express the T cell antigen CD3, В cell CD19, and in most cases are negative for the B cell antigen CD20, as well as for common leukocyte antigen CD45. Taking into account such unequivocal immunophenotype, RBS cells can be identified by multiparameter flow cytometry. Thus, J.R. Fromm et al. (2006, 2014) have convincingly shown the possibility to identify RBS cells in a puncture and/or biopsy sample of lymphatic nodes in cHL and were of the fair opinion that such rather simple and reproducible technique as flow cytometry could be an additional diagnostic instrument in cHL. We have tested the technique proposed by J.R. Fromm et al. for the assessment of lymphatic node involvement in cHL and used 8 to 10-parameter flow cytometry for detection RBS cells in cHL in 8 biopsy samples of a lymphatic node, and confirmed the feasibility to identify RBS cells by high performance flow cytometry. We also performed morphological and immunohistochemical assessment of the biopsy samples of lymphatic nodes from patients with suspected cHL. The study included clinical cases with immunohistochemically confirmed cHL (n = 8), and the control samples were from those with other diagnoses than Hodgkin's lymphoma. In all cases of cHL we found RBS cells. In future we plan to analyze larger case samples by flow cytometry.
Primary cutaneous diffuse large B-cell lymphoma, leg type, is diagnosed in 20-25 % cases of all primary cutaneous B-cell lymphomas, primarily in elderly women (older than 70 years). The disease has aggressive recurrent progression and worse prognosis than other variants. The standard antitumor drug therapy are such regimens as R-CHOP and CHOP-like programs including anthracycline antibiotics. Use of these programs can be limited by the presence of cardiovascular and other concomitant disorders.Due to the limited variety of combinations of antitumor agents, low frequency of diagnosis of this immunomorphological variant of lymphoproliferative disease and absence of a single algorithm of drug therapy, every clinical case is interesting and informative.In the presented clinical case, an 80-year-old female patient with primary cutaneous diffuse large B-cell lymphoma, leg type, and concomitant pathology of the cardiovascular system underwent 2 courses of R-CVP regimen drug therapy without anthracyclines. A significant antitumor clinical effect was achieved in the form of complete tumor regression. Treatment was not accompanied by significant toxicity which allowed to complete therapy.
Plasma cell leukemia (PCL) is a rare malignant plasma cell neoplasm with aggressive clinical progression, minimal response to therapy and unfavorable prognosis. Concomitant new coronavirus infection COVID-19 and its complications significantly worsen prognosis in patients with PCL. Currently, approaches to PCL therapy are not finalized, and regimens developed for multiple myeloma are used. In PCL, the most common clinical symptoms are renal failure and hypercalcinemia which are frequently observed in multiple myeloma. Therefore, use of proteasome inhibitor (bortezomib) with proven effectiveness in multiple myeloma, is justified. A clinical observation of a 64-year-old female patient who was hospitalized in poor physical condition with the new coronavirus infection COVID-19 is presented. During hospitalization, debut of PCL was suspected, and as soon as possible after diagnosis confirmation using vital indications, antitumor drug therapy was started with positive effect.
In the presented observation, a female patient with diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (advanced stages) received R-ABVD regimen therapy. Return of clinical symptoms observed at the onset of the disease, as well as renewed growth of the lymph nodes after 4th therapy cycle showed refractory disease. Considering the results of earlier studies, generally showing high effectiveness of primary treatment of patients with nodular lymphocyte-predominant Hodgkin lymphoma, reevaluation of immunomorphological type of lymphoproliferative disease was performed. After change of diagnosis to grade 3A follicular lymphoma, therapy was changed to obinutuzumab in combination with bendamustine leading to fast positive antitumor effect.
периферическая Т-клеточная лимфома неспецифицированная (пТКлн) в большинстве наблюдений имеет агрессивное клиническое течение и характеризуется высокой частотой экстранодального поражения. Одним из признаков пТКлн, в частности лимфомы леннерта, является эозинофилия. Независимо от механизма развития эозинофилии могут протекать с поражением сердца, приводя к эндомиокардиальному фиброзу, тромбообразованию желудочков и в конечной стадии -к рестриктивной кардиомиопатии, являющихся признаками эндокардита леффлера (эл). Наличие эл усугубляет течение и прогноз пТКлн, ограничивая в первую очередь возможности противоопухолевой лекарственной терапии. Благодаря применению мультидисциплинарного подхода к ведению пациента с пТКлн и сопутствующим эл возможно диагностировать и своевременно начать проведение как специфической, так и кардиотропной терапии, улучшив в конечном итоге прогноз. представлено клиническое наблюдение пациентки 44 лет с впервые выявленной пТКлн (лимфомой леннерта) и эл.Ключевые слова: периферическая Т-клеточная лимфома неспецифицированная, эндокардит леффлера, мультидисциплинарный подход, лекарственная противоопухолевая терапия, кардиотропная терапия Для цитирования: Рябухина ю. Е., Тимофеева О. л., Ахобеков А. А. и др. Клиническое наблюдение пациентки 44 лет с впервые выявленной периферической Т-клеточной лимфомой неспецифицированной (лимфомой леннерта) и эндокардитом леффлера.
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