Primary lymphoma of the breast (PLB) is a rare disease, representing 0.04-0.5% of all malignant breast neoplasms. We present a patient with bilateral breast involvement by a high-grade diffuse large B-cell lymphoma, which was diagnosed initially by fine-needle aspiration cytology (FNAC). Mammography revealed a diffuse increase in density of the right breast and a large solitary mass on the left breast, suggestive of an inflammatory carcinoma. The patient underwent FNAC and the diagnosis of a non-Hodgkin's lymphoma (NHL) was suggested. Physical examination revealed palpable bilateral axillary lymph nodes but no evidence of concurrent widespread disease. The patient underwent complete staging evaluation. The only positive findings were an elevated lactate dehydrogenase (LDH) and evidence of axillary lymphadenopathy on CT. Excisional biopsy was performed on the left breast. The morphological and immunohistochemical analysis confirmed the diagnosis of a high-grade diffuse large B-cell lymphoma with an immunophenotype suggestive of a germinal center cell origin.
We report the immunohistologic and the genotypic analysis of lymph node biopsies from 23 cases of reactive processes, and two cases of atypical lymphoproliferations (AL). Clonal gene rearrangements were detected in 5 cases of proven reactive processes as well as in both AL, in which no signs of malignancy were detected during the phenotypic analysis. No patient, apart from the two AL cases, showed any progression to malignancy during a follow-up period of 28-43 months after the initial biopsy.
Purpose The evaluation of wet type of AMD after intravitreal injections with anti‐angiogenic factors in patients with good initial visual aquity. Correlation between final and initial visual acuity, as well as with the number of injections
Methods 101 patients of average age 76 participated in the study. All of them suffered from wet type of AMD. Study group included 24 of them with good initial visual acuity, defined as visual acuity of 6/10 of the decimal scale or higher. The remaining 77 patients served as control group. The initial evaluation included full ophthalmologic examination, OCT imaging and fluorescein angiography. The decision for the treatment was based on the findings of the first examination and of the monthly reevaluation thereafter.
Results In the 24 patients of the study group, visual acuity increased significantly from 0,61 (+/‐0,2) to 0,82 (+/‐0,2) in decimal scale or from 0,27 (+/‐0,22) to 0,14 (+/‐0,2) in LOGMAR scale (p<0,001). The average number of intravitreal injections was 4,9 in a mean monitoring time of 9 months. In this team the final visual acuity depends on the initial one (p= 0,013), but not on the number of intravitreal injections (p> 0,05).
Conclusion the final visual acuity in the group with good initial visual acuity correlates well with the initial visual acuity and does not correlate with the number of injections. This finding shows the significance of early diagnosis of subretinal neovascularisation in AMD, when the vision is still high.
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