Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.
ObjectiveTo summarize the individualized diagnosis and treatment experience in a patient with primary pancreatic diffuse large B-cell lymphoma.MethodsBy muti-disciplinary term (MDT) model, a patient with primary pancreatic diffuse large B-cell lymphoma admitted in the People’s Hospital of Chishui in Dec. 2016 was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT.ResultsThe patient’s general condition was good. After multidisciplinary discussion in the Department of Radiology, Oncology, Interventional, and Hepatobiliary and Pancreatic Surgery, the patient was considered to have surgical indications. After thorough communication with the patient and family, the patient was selected for surgical resection. The whole operation lasted for 5 hours, and the intraoperative blood loss was about 300 mL. The operation was successfully completed and no complications such as pancreatic fistula occurred after operation. Liquid drainage tube was drawn out at 10 days after opertion, and pancreatic tube stent and T tube were retained. The patient discharged on 13 days after surgery. Subsequently, the patient underwent adjuvant chemotherapy. At present, the patient has been followed up for 1 year, no signs of tumor recurrence and metastasis, and continued follow-up.ConclusionsPrimary pancreatic diffuse large B-cell lymphoma is rare and has a poor prognosis. The main treatment is mutli-mode treatment based on surgical resection combined with chemotherapy.
Objectives To investigate contents and clinical significances of CD19+IL-10+ B cell and its subsets in peripheral blood monouclear cell (PBMC) and cancer tissue of patient with colorectal cancer (CRC). Methods Thirty-eight patients with CRC underwent surgery from November 2017 to November 2018 in this hospital were enrolled as a trail group. The proportions of CD19+IL-10+ B cell, CD19+IL-10+CD24hiCD38hi B cell, CD19+IL-10+CD24intCD38int B cell, and CD19+IL-10+CD24hiCD38– B cell in the CD19+ B cells in the PBMC, cancer tissue and paracancer tissue of these patients were detected by the flow cytometry. Thirty-seven healthy volunteers were selected as a control group and the same cell types same as the trail group were detected by the same method in the PBMC only. Results ① The contents of CD19+IL-10+ B cell and CD19+IL-10+CD24hiCD38hi B cell of the PBMC in the trail group were significantly higher than those in the control group (t=9.09, P<0.01; t=9.36, P<0.01, respectively), which of the cancer tissues in the trail group were significantly higher than those in the corresponding paracancer tissues (t=11.67, P<0.01; t=19.64, P<0.01, respectively), while the content of CD19+IL-10+CD24hiCD38– B cell of the PBMC in the trail group was significantly lower than that in the control group (t=6.15, P<0.01). But the CD19+IL-10+CD24intCD38int B cell had no significant difference of the PBMC between these two groups (t=1.78, P=0.08). ② The contents of CD19+IL-10+ B cell and CD19+IL-10+CD24hiCD38hi B cell of the PBMC in the CRC patients with stage Ⅲ+Ⅳ were significantly higher than those in the CRC patients with stage Ⅰ+Ⅱ (t=5.39, P<0.01; t=3.13, P<0.01, respectively). The others all had no significant differences (P>0.05). Conclusion CD19+IL-10+ B cells are significantly increased in PBMC and cancer tissue of patient with CRC and with advanced CRC (TNM stage Ⅲ+Ⅳ), further more, main increasing subgroup of CD19+IL-10+ B cell is CD19+IL-10+CD24hiCD38hi B cell, which indicates that CD19+IL-10+ B cell and CD19+IL-10+CD24hiCD38hi B cell might participate in tumorigenesis and tumor progress of CRC.
ObjectiveTo investigate the clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis of primary diffuse large B cell lymphoma of livers (PDLBCLL), so as to improve understanding and reasonable diagnosis and treatment of this kind of disease.MethodThe clinicopathologic data of a case of PDLBCLL diagnosed in the West China Hospital of Sichuan University in June 2019 were analyzed retrospectively.ResultsIt was very difficult to diagnose PDLBCLL preoperatively and to distinguish PDLBCLL from primary liver cancer and other liver space occupying lesions. It was also easy to ignore the possibility of invasion of liver by lymphopoietic tissue tumor, which was often diagnosed by postoperative pathological diagnosis or puncture biopsy, and after the elimination of hematological diseases by various examinations. This patient was admitted to the hospital as a space occupying in right liver. Preoperative imaging examination considered that may be a tumor. After MDT discussion, considering that the nature of the tumor should be confirmed by surgical resection, and then go to the Department of Oncology. Irregular right hemihepatectomy + cholecystectomy + hilar lymphadenectomy + diaphragmatic repair was performed after MDT discussion. The diagnosis of PDLBCLL was confirmed by postoperative pathological examination. The operation duration was about 230 min, and the intraoperative blood loss was about 200 mL. The patient recovered well without complications and was discharged on the 10th day after operation. The patient was followed up for 9 months. The liver and kidney function, electrolytes and abdominal Doppler ultrasound examination were regularly reviewed every month. No obvious abnormality was found in these results.ConclusionsAt present, there is no unified treatment principle, most of them will undergo surgery, chemotherapy, radiotherapy or combined treatment. Due to its unknown etiology and unclear mechanism, clinicians can only implement individualized treatment according to the characteristics of patients’ conditions.
Objective To investigate the expression and clinical significance of T lymphocyte subsets, natural killer (NK) cells and CD19+ B cells in the elderly with primary immune thrombocytopenia (ITP) before and after treatment. Methods The elderly ITP patients diagnosed and treated in the Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (preparatory stage) between January 2014 and June 2019 were retrospectively selected as the observation group. The healthy elderly in the same period were selected as the control group. According to the treatment, the observation group was divided into effective group and ineffective group. The expression levels of T lymphocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+), NK cells and CD19+ B cells were observed and analyzed. Results A total of 75 subjects were included, including 35 in the observation group and 40 in the control group. The total effective rate was 85.71% (30/35). Before treatment, the expression levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the observation group were lower than those in the control group (P<0.05). There was no significant difference in other indexes between the two groups (P>0.05). After treatment, except for CD8+, the expression levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the observation group were higher than those before treatment (P<0.05). The expression levels of NK cells and CD19+ B cells were lower than those before treatment (P<0.05). The expression levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the effective group were higher than those before treatment (P<0.05), while the expression level of CD19+ B cells was lower than that before treatment (P<0.05). There was no significant difference in other indexes before and after treatment (P>0.05). There was no significant difference in the expression levels of T lymphocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+), NK cells and CD19+ B cells in the ineffective group before and after treatment (P>0.05). Conclusions T lymphocyte subsets are abnormal in elderly ITP patients. The immune abnormality of T lymphocyte may be one of the reasons for elderly patients with ITP. With the improvement of therapeutic effect, immune cell subsets have also been improved.
Interferon regulatory factor 4 (IRF4) is one of the transcription factors in the interferon regulatory factor family. In the normal physiological process, IRF4 protein is a key factor regulating B cell development, such as early B cell development, pre-B cell switch recombination, mature B cell somatic hypermutation, and also a key factor regulating plasma cell differentiation. In addition, in recent years, it has been reported that Irf4 gene abnormalities or abnormal protein expression is closely involved in the occurrence and development of a variety of B cell or plasma cell tumors. This article reviews the physiological role of IRF4 in the differentiation and maturation of B cell or plasma cells, how IRF4 participates in the occurrence and development of B cell or plasma cell tumors, and its potential therapeutic target for B cell or plasma cell tumors.
Objective To evaluate the expression level of nuclear factor kappa B (NF-κB) in patients with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL), and to examine its impact on patients’ clinical characteristics and prognosis. Methods Patients with EBV-positive DLBCL who were diagnosed and treated at West China Hospital of Sichuan University between January 2010 and December 2020 were selected as the research subjects. Clinical data were retrospectively collected. According to the expression of NF-κB, the patients were divided into an NF-κB-positive group and an NF-κB-negative group, and the clinical characteristics were compared between the two groups. Kaplan-Meier method was used for survival analysis. Results A total of 414 patients with DLBCL were collected, and EBV-encoded small RNAs were positive in 37 cases (8.9%). Among the 37 EBV-positive patients, NF-κB positivity was observed in 13 cases (35.1%), while among the 377 EBV-negative patients, NF-κB positivity was observed in 144 cases (38.2%), without statistically significant difference (χ2=0.134, P=0.714). No significant difference in clinical characteristics was found between the NF-κB-positive group and the NF-κB-negative group of EBV-positive patients (P>0.05). The 3-year overall survival (OS) rates for the NF-κB-positive and NF-κB-negative groups were 46.2% and 58.3%, respectively, the 5-year OS rates were 19.2% and 29.2%, respectively, and the median OS was 32 vs. 39 months (P=0.441). The corresponding 3-year and 5-year progression-free survival (PFS) rates were 46.2% vs. 41.7% and 19.2% vs. 20.8%, respectively, and the median PFS was 31 vs. 24 months (P=0.933). Conclusion There is no difference in the expression of NF-κB between EBV-positive and EBV-negative DLBCL patients, and the expression of NF-κB has no impact on the clinical characteristics or the prognosis of EBV-positive DLBCL patients.