T-regulatory cells suppress specific anti-tumor immune responses in non-hematological malignancies and thus lead to tumor growth and unfavorable prognosis. In malignant lymphomas arising from follicular center cells T-regulatory cells are directed not only to cytotoxic lymphocytes but also to tumor B-cells. As in normal lymph node T-regulatory cells can suppress growth and differentiation of germinal center B-cells, and even kill them by cytotoxic mechanism. Generally it may have favourable effect, and lead to the improvement of prognosis in patients. We quantitatively studied FOXP3-positive lymphocytes in different microanatomical lymph node compartments of 66 patients with follicular lymphoma and found favourable influence on prognosis of a large number of intrafollicular FOXP3 cells.
AIM:To study morphoimmunological and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL).MATERIAL AND METHODS:We analysed the results of biopsy material study and treatment of 86 PMLBCL patients, effects of different factors on the disease prognosis, efficacy of some therapeutic programs and overall therapeutic efficacy.RESULTS:PMLBCL manifests mainly with massive lesions of anterior upper mediastinum with involvement of adjacent organs and tissues, absence of bone marrow involvement, frequent affection of CNS. Many primary patients have resistance to treatment, sensitive patients have no late recurrences.CONCLUSION:PMLBCL is an independent extranodal variant of non-Hodgkin's lymphoma with special clinical and morphoimmunological characteristics. Criteria are proposed for differential diagnosis of different variants of PMLBCL. New approaches to PMLBSL patients' management are outlined.
The purpose of this study was to analyze morphoimmunologic features of large-cell mediastinal lymphomas, i. e. primary mediastinal large B-cell lymphoma and Hodgkins lymphoma with nodular sclerosis. Morphologic and immunohistochemicl analysis of tumor tissue specimens from 31 patients with primary mediastinal large B-cell lymphoma and 20 patients with Hodgkins lymphomawas made. A case of gray zone lymphoma was identified. Immunohistochemical study was done by standard assay using 8 markers such as CD10, CD11c, CD23, MUM1, c-REL, TRAF1, HLA-DR. Nuclear oncoprotein c-REL was found in 24 (77%) and cytoplasmatic reactivity with TRAF1 was seen in 80% of primary mediastinal large B-cell lymphoma cases. In contrast, none of Hodgkins lymphomas presented with nuclear c-REL. The conclusion was made that NF-B signaling activation markers (c-REL and TRAF1) were very useful and might be recommended for differential diagnosis of primary mediastinal large B-cell lymphoma from Hodgkins lymphoma.
Testicular diffuse large B-cell lymphoma (TDLBCL) is a rare presentation of extranodal lymphoma with poor prognosis and high incidence of CNS and contralateral testis relapses. This study was designed to determine response and outcome of 27 patients with TDLBCL, treated at the N. N. Blokhin Cancer Research Center in 1992-2007. All patients received combined treatment of CHOP, 14 (52 %) had addition rituximab (R-CHOP), intrathecal methotrexate (68 %) and scrotal radiotherapy (44 %). 23 pts (85 %) achieved a complete response (CR), 3-years progression free survival (PFS) was 40 % with median 20 months, overall survival (OS) 57 % with median 48 months. 11 pts experienced a relapse in multiple extranodal sites, 5 of them had CNS and 4 contralateral testis involvement. Addition of rituximab (R-CHOP vs CHOP) improves the outcome CR were 100 and 69 %, 2-y PFS 66 and 35 % respectively. No testicular relapse was observed in patients receiving scrotal radiation. The results showed, that R-CHOP with complete CNS and scrotal prophylaxis improves the outcome of TDLBCL, induce, but not eliminated fully CNS relapse.
Диффузная B-крупноклеточная лимфома (ДВКЛ) с первичным поражением яичка составляет 1–2% от всех неходжкинских лимфом взрослых и характеризуется крайне неблагоприятным прогнозом. Процесс часто связан с ранней генерализацией с вовлечением контралатерального яичка, центральной нервной системы (ЦНС), кольца Пирогова – Вальдейера, мягких тканей, кожи, легких. Сравнение эффективности стандартной терапии у больных с первичной лимфомой яичка ± Ритуксимаб является целью настоящей работы.
В России неходжкинские лимфомы (НХЛ) составляют 2,6% от всех злокачественных опухолей. В последнее время отмечается увеличение экстранодальных форм заболевания. Поражение мягких тканей (первичное или при распространении процесса), по данным литературы, составляет 5,2%. В РОНЦ им. Н.Н.Блохина РАМН с 1983 по 2007 г. наблюдалось 582 больных с первичными экстранодальными НХЛ; поражение мягких тканей выявлено у 73 (12%) больных.Цель исследования – анализ НХЛ с первичным и метастатическим (на протяжении болезни) поражением мягких тканей.
Первичная медиастинальная (тимическая) В-крупноклеточная лимфома (ПМВКЛ) является самостоятельным клинико-иммуноморфологическим вариантом экстранодальных неходжкинских лимфом (НХЛ) и характеризуется преимущественно местным распространением опухоли в переднем верхнем средостении с возможным вовлечением смежных органов и тканей в пределах грудной клетки. Молодой возраст больных, тяжесть клинических проявлений и отсутствие единых тактических подходов делают необходимым и актуальным дальнейшие изучения ПМВКЛ.