phenylephrine-hydrochloride and Lymphoma--T-Cell

Nasal NK/T-cell lymphoma is a rare disease entity with a poor outcome. Expression of antiapoptotic proteins has not been extensively investigated in this entity. Forty-eight patients with nasal T/NK-cell lymphoma who received first-line polychemotherapy (n = 44) or chemoradiotherapy (n = 4) were analyzed for expression of active caspase-3 (aC3), granzyme B protease inhibitor 9 (PI9), and Bcl-2 proteins. Lymphomas were CD3+/CD5-/granzyme B+ and EBV-associated. Median age was 46 years. Stage I/II disease was present in 75% of the cases and an International Prognostic Index (IPI) score less than 1 in 65%. With a median follow-up of 6.3 years, 5-year event-free survival (EFS) and overall survival (OS) rates were 39% and 49%, respectively. Apoptotic index was scored as high in 32% of cases and PI9 expression as positive in 68%, whereas 35% disclosed a high number of aC3+ tumor cells. Univariate analysis showed that absence of PI9 and low apoptotic index were associated with poor outcome, but not aC3 expression nor IPI score. By multivariate analysis, both parameters affected independently EFS (P = .02 and .08, respectively) and OS (P = .009 and .04). In view of its constitutive expression by normal NK cells, it is suggested that loss of PI9 expression in tumor cells may reflect some mechanism associated with progression.

Topics: Adult; Aged; Drug Therapy, Combination; Female; Granzymes; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Male; Middle Aged; Nose; Phenotype; Prognosis; Serpins; Survival Rate; T-Lymphocytes; Treatment Outcome

Topics: Diagnostic Errors; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Nose; Sinusitis

Subcutaneous emphysema and pneumomediastinum are rare complications associated with orbital blowout pathological fracture.. A 7-year old, castrated male Abbysinian cat presented with anorexia, lethargy, nausea, eyelid swelling, nasal discharge, and sneezing. Based on the clinical and diagnostic work-up, the cat was diagnosed with T cell high-grade nasal lymphoma associated with orbital pathological fracture due to the tumour invasion. After chemotherapy, the cat showed massive subcutaneous emphysema from frontal region to abdomen and pneumomediastinum due to orbital blowout pathological fracture. As the nasal mass decreased in volume; the air had moved from the maxillary sinus to the subcutaneous region and the mediastinum through fascial planes in the head and neck region.. This is a first case report of a massive subcutaneous emphysema and pneumomediastinum due to an orbital blowout pathological fracture following chemotherapy in feline nasal lymphoma in veterinary medicine.

Topics: Animals; Cat Diseases; Cats; Fractures, Spontaneous; Lymphoma, T-Cell; Lymphoma, T-Cell, Peripheral; Male; Mediastinal Emphysema; Nose; Subcutaneous Emphysema

Extranodal nasal-type natural killer/T-cell lymphoma presenting in skin, either primary or secondary, is relatively rare in China, accounting for about 4.1% of tumors. The clinicopathologic features of the neoplasm are still poorly understood. Sixteen Chinese cases of cutaneous natural killer/T-cell lymphomas were investigated retrospectively by pathology, immunophenotype, genotype, Epstein-Barr virus status, and survival analysis. The mean age of the patients was 36.3 years; 81% of the patients presented with multiple cutaneous lesions. Angiocentricity and epidermotropism were observed in 43.7% and 25%, respectively; the average number of mitoses was 12 per 10 high-power fields. The neoplastic cells of all 16 cases were positive for CD3varepsilon/CD45RO and granzyme B and negative for CD4, CD5, CD8, and CD20; 87.5% of the tumors expressed CD56. Signals for EBER were detected in 81.3% of cases. No clonal TCRgamma/TCRbeta gene rearrangement was demonstrated. Thirteen of 15 patients received chemotherapy; a partial response was achieved in 10 patients; 10 (66.7%) of 15 patients died of the disease, and the average survival time was 6.6 months. In conclusion, both primary and secondary cutaneous natural killer/T-cell lymphomas are highly aggressive. The outcome is closely related to the number and distribution of the lesions as well as the stage. In patients with generalized skin lesions and extracutaneous involvement, the prognosis usually is poor.

Topics: Adolescent; Adult; Aged; China; Female; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Male; Middle Aged; Nose; Nose Neoplasms; Retrospective Studies; Skin Neoplasms

Overexpression of P-glycoprotein (P-gp) has been identified by a variety of methods in NK cells and NK malignancies. The aim of this study was to determine the clinical significance of P-gp in previously untreated extranodal NK/T-cell lymphoma, nasal type. Tumor specimens from 30 patients initially treated with CHOP or CHOP-based chemotherapy were examined by immunohistochemistry using JSB-1, a monoclonal antibody recognizing the intracellular epitope of P-gp molecule. Twenty cases (67%) were positive for P-gp expression. The complete response rate achieved in P-gp positive patients was significantly lower than in P-gp negative ones (20% vs. 60%, P = 0.045). With a median follow-up of 25 months, the 2-year progression-free survival (PFS) and overall survival (OS) rates for all patients were 66 and 69%, respectively. Compared with both PFS and OS rates of P-gp positive patients, those of P-gp negative patients showed a trend of benefit that did not reach statistical significance for borderline P values (PFS: 90% vs. 54%, P = 0.1057; OS: 90% vs. 61%, P = 0.2028). Our results suggest that P-gp expression is related with poor treatment outcomes of extranodal NK/T-cell lymphoma, nasal type.

Topics: Antineoplastic Combined Chemotherapy Protocols; ATP Binding Cassette Transporter, Subfamily B, Member 1; Cyclophosphamide; Disease-Free Survival; Doxorubicin; Female; Follow-Up Studies; Humans; Immunohistochemistry; Killer Cells, Natural; Lymphoma, T-Cell; Male; Middle Aged; Multivariate Analysis; Nasal Mucosa; Neoplasm Staging; Nose; Nose Neoplasms; Prednisone; Time Factors; Treatment Outcome; Vincristine

Topics: Aged; Edema; Female; Humans; Lymphoma, T-Cell; Neoplasm Invasiveness; Nose

Sinonasal lymphomas are uncommon malignancies. They are difficult to differentiate from carcinomas, and immunohistochemistry is needed to make the diagnosis. We describe an unusual case of a T cell lymphoma that involved only the paranasal sinuses in a middle-aged man. The patient presented with a complete loss of vision in one eye and lateral rectus muscle palsy, but no nasal symptoms.

Topics: Adult; Blindness; Chemotherapy, Adjuvant; Diagnosis, Differential; Humans; Immunohistochemistry; Leukocyte Common Antigens; Lymphoma, T-Cell; Male; Neoplasm Invasiveness; Nose; Paranasal Sinus Neoplasms; Radiotherapy, Adjuvant; Treatment Outcome

We present history, clinical presentation and anatomo-pathologic findings of a 24-year-old female patient with a nasal NK/T-cell lymphoma. This rare tumor is characterized by its angiocentric and angiodestructive growth, which results in extensive tumor necrosis. At the first encounter this tumor necrosis made it difficult to identify the nature of the tumor cells. However, this necrosis is a key feature: it is the result of the capacity of neoplastic NK/T-cells to invade vessels. The T-cell character of the neoplastic lymphoid has been shown by immunohistochemitry.

Topics: Adult; Diagnosis, Differential; Fatal Outcome; Female; Granuloma, Lethal Midline; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Nose; Nose Neoplasms

Topics: Adult; Combined Modality Therapy; Fatal Outcome; Granuloma, Lethal Midline; Humans; Immunophenotyping; Karyotyping; Killer Cells, Natural; Lymphoma, T-Cell; Male; Neoplasm Recurrence, Local; Nose; Nose Neoplasms

Topics: Adaptor Proteins, Signal Transducing; Antigens, CD; B-Cell CLL-Lymphoma 10 Protein; Base Sequence; Cell Nucleus; DNA Primers; DNA, Complementary; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Mutation; Neoplasm Proteins; Nose; Reference Values; Tumor Cells, Cultured

To investigate the clinicopathologic features of cytotoxic natural killer (NK)/T-cell lymphomas of the lymph nodes.. Clinicopathologic observations and follow up on 5 cases of cytotoxic NK/T-cell lymphomas of the lymph nodes, immunohistochemical staining for CD45RO, CD8, CD56, CD30, CD20, TIA-1 and in situ hybridization for EBER1/2 were performed.. (1) The clinicopathologic features of cytotoxic NK-T-cell lymphomas of the lymph nodes were summarized; (2) The tumor cells were positive for CD45RO in 4 of the 5 cases, in which 3 cases were also positive for CD56. One case was of null cell type. The tumor cells were positive for TIA-1 and EBER1/2 in all 5 cases.. The clinicopathological features and special immunophenotypes of cytotoxic NK/T-cell lymphomas of the lymph nodes were present in all 5 cases. Clinically, this entity tends to be an aggressive process with poor prognosis.

Topics: Adult; Aged; CD56 Antigen; Follow-Up Studies; Herpesvirus 4, Human; Humans; Killer Cells, Natural; Leukocyte Common Antigens; Lymph Nodes; Lymphoma, T-Cell; Male; Middle Aged; Nose; Nose Neoplasms; Poly(A)-Binding Proteins; Prognosis; Proteins; RNA-Binding Proteins; RNA, Viral; T-Cell Intracellular Antigen-1

Destructive lesions of the sinonasal tract, lacking a discernible etiology and referred to as midline destructive disease, have been pathologically classified in accordance with a variety of confusing terms. Development of new pathologic concepts and immunohistochemical techniques has provided a fresh understanding of these lesions, and, as a result, they can be unified into two distinct pathologic groups: Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma.. We retrospectively reviewed the imaging studies and pathologic specimens of seven patients with prior diagnoses included in the midline destructive disease group. The specimens were reviewed by an oral pathologist using currently accepted pathologic criteria and the newly available immunohistochemical markers CD20, CD45, and CD45RO. Lesions were classified as non-Hodgkin's T-cell lymphomas when positive for CD45 and CD45RO and negative for CD20, and as Wegener's granulomatosis in the presence of noncaseating multinucleated giant cell granulomas and necrotizing vasculitis.. Three of the lesions were reclassified as Wegener's granulomatosis and four as T-cell lymphomas after applying these pathologic criteria. There were no distinguishing imaging findings between Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma.. The current pathologic classification for midline destructive disease should be incorporated into the radiologic lexicon and the use of terms from the old classification system, such as idiopathic midline granuloma and lethal midline granuloma, should be abandoned and no longer be used in radiologic reports.

Topics: Antigens, CD20; Diagnosis, Differential; Granuloma, Lethal Midline; Granulomatosis with Polyangiitis; Humans; Leukocyte Common Antigens; Lymphoma, T-Cell; Magnetic Resonance Imaging; Nose; Nose Diseases; Nose Neoplasms; Retrospective Studies; Sensitivity and Specificity; Terminology as Topic; Tomography, X-Ray Computed

Whether particular Epstein-Barr virus (EBV) strains are preferentially selected in malignant diseases remains controversial. Assessment of the importance of strain variation in the pathogenicity of EBV has been hampered principally by the lack of accurate data on the prevalence of virus variants in the normal population. To clarify this issue, a detailed comparative analysis of the EBV genomes contained in normal nasal and nasopharyngeal mucosal tissues and in nasal T/NK-cell lymphoma, which originates at these anatomic sites, was carried out by PCR amplification across the 30-bp deletion and the 33-bp repeat loci in the LMP1 gene and the type-specific polymorphic loci in the EBNA2 and EBNA3C genes and by sequence analysis of the 3' C-terminal region of the LMP1 gene. Whilst the majority of EBV strains in either normal or tumour tissues were type 1 viruses with similar numbers of LMP1 repeats, a marked predominance of LMP1 deletion (del-LMP1) over non-deleted/wild-type LMP1 (wt-LMP1) variants was observed in nasal T/NK-cell lymphoma. Although del-LMP1 variants were also prevalent in the normal carriers of our population, wt-LMP1 was detected at a significantly higher frequency in normal vs. tumour tissues (p = 0.036). More critically, wt-LMP1 variants were found frequently in mixed infection with del-LMP1 variants in the normal carriers. Sequence analysis identified 2 major del-LMP1 (and several wt-LMP1) variants containing signatory nucleotide changes in relation to the prototype B95-8 sequence in both normal and neoplastic nasal tissues. Together, our data provide strong evidence for a selection mechanism for del-LMP1 over the wt-LMP1 variants in tumours.

Topics: Antigens, Viral; Gene Deletion; Genes, Viral; Herpesvirus 4, Human; Humans; Killer Cells, Natural; Lymphoma, T-Cell; Nose; Nose Neoplasms; Polymorphism, Genetic; Viral Matrix Proteins

Lethal midline granuloma (LMG) is characterized by progressive ulceration and destruction of the midfacial tissue. It occurs more frequently in Oriental than in Western populations. Because of the progress in clinical pathology and immunohistochemistry, most cases have been proven to be malignant lymphomas, especially of T-cell lineage. We describe 92 cases of lethal midline granuloma or centrofacial malignant lymphoma in the period 1959-1993. All received complete courses of radiotherapy. Twenty of them also received combination chemotherapy. Thirty-six cases had specimens available for immunohistochemical study; 25 (69%) of these had a T-cell phenotype, and 6 (17%) were of B-cell lineage. The dose to the nasal region was in the range of 3000-7500 cGy in 11-58 days, and to the neck 3000-6400 cGy in 11-48 days. The overall survival rate for the LMGs was 59.5% at 5 years and 56.2% at 10 years (Kaplan-Meier). Combined chemotherapy seemed not to improve the overall survival in this study (p = 0.63), but the patient number was too small to make a firm conclusion. Based on the results of this study, we recommend a dose of 4500-5000 cGy to the midfacial region, since a higher dosage did not improve the treatment results (p = 0.88). Irradiation has a definite role in good locoregional control of this disease. The recent clarification of the disease nature and the recognition of the background clinicopathological features should provide valuable information for future patient management and prospective studies.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; B-Lymphocytes; Cell Lineage; Child; Combined Modality Therapy; Disease-Free Survival; Facial Neoplasms; Female; Follow-Up Studies; Granuloma, Lethal Midline; Humans; Immunohistochemistry; Immunophenotyping; Lymphoma, T-Cell; Male; Middle Aged; Neck; Nose; Radiotherapy Dosage; Radiotherapy, High-Energy; Retrospective Studies; Survival Rate; T-Lymphocytes; Treatment Outcome