Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 48, Issue 1
Displaying 1-11 of 11 articles from this issue
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Picture in Clinical Hematology
Review
A Case Report
  • Gastric relapse of stage I ocular adnexal mucosa-associated lymphoid tissue lymphoma
    Tsutomu SATO, Rishu TAKIMOTO, Satoshi IYAMA, Kaoru ONO, Shingo TANAKA, ...
    2007 Volume 48 Issue 1 Pages 56-60
    Published: 2007
    Released on J-STAGE: October 03, 2007
    DOIhttps://doi.org/10.11406/rinketsu.48.56
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    A 57-year-old male with right ocular adnexal mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) was successfully treated with local radiation therapy. The gastroendoscopic examination revealed a slight inflammatory change of the gastric mucosa, and the urease test was positive. Eradication therapy against Helicobacter pylori was successfully done, however, the patient developed gastric MALT lymphoma two years after the initial treatment. Southern blot analysis of the immunoglobulin heavy chain gene rearrangement revealed that the lymphoma cells from the ocular adnexal and gastric MALT lymphomas were identical, indicating that the gastric MALT lymphoma was not the primary but the metastatic region from the ocular adnexal MALT lymphoma. Further, immunohistochemical staining demonstrated the expression of integrin α4β7 on ocular adnexal MALT lymphoma cells, which is essential for the adhesion of lymphocytes to gastrointestinal mucosa. These results indicate that ocular adnexal MALT lymphoma cells can metastasize to the stomach, depending on the adhesional function of integrin α4β7.
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Short Reports
  • Asian variant of intravascular large B-cell lymphoma diagnosed by bone marrow biopsy
    Jiro TADOKORO, Yukihiro ARAI, Katsuya TOKITA, Hisako ISO, Yuko NAKAMUR ...
    2007 Volume 48 Issue 1 Pages 61-63
    Published: 2007
    Released on J-STAGE: October 03, 2007
    DOIhttps://doi.org/10.11406/rinketsu.48.61
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    A 63-year-old male presented with fever and general malaise in June 2004. On admission hepatosplenomegaly was apparent, but without lymphadenopathy. The laboratory examination revealed pancytopenia and increased levels of lactate dehydrogenase, direct bilirubin and soluble interleukin-2 receptor. Histological analysis of the bone marrow biopsy specimen demonstrated proliferation of atypical lymphoid cells positive for CD20 in the small capillaries, leading to the diagnosis of the Asian variant of intravascular large B-cell lymphoma (AIVL). The presence of rearrangement of the immunoglobulin gene confirmed the diagnosis. The patient responded well to CHOP therapy followed by seven courses of rituximab-combined CHOP therapy and has remained in complete remission up to the present. This case implies that bone marrow biopsy could be a useful examination for diagnosing AIVL and that rituximab-combined chemotherapy could improve survival in patients with the disease.
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  • Plasma cell leukemia presenting with cleaved nuclei and a monocytoid appearance
    Nobuhisa HIRASE, Shoichi MUTA, Yasunobu ABE, Koichiro MUTA
    2007 Volume 48 Issue 1 Pages 64-66
    Published: 2007
    Released on J-STAGE: October 03, 2007
    DOIhttps://doi.org/10.11406/rinketsu.48.64
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    A 74-year-old man presented with anemia, thrombocytopenia and leukocytosis with 41% abnormal cells having cleaved and monocytoid nuclei. The bone marrow was infiltrated with 43.6% abnormal cells that were negative for peroxidase staining and positive for PAS staining. Surface antigen analysis revealed no expression of CDs 2, 3, 4, 8, 10, 19, 20, 13 or 33. Serum immunoelectrophoresis detected a monoclonal band, which was identifiable as κ-type IgA protein. Immunostaining also revealed expression of IgA and κ-type in the abnormal cells. The patient was diagnosed as having plasma cell leukemia but the morphological findings were unusual. Surface antigen analysis revealed expression of CD38 later. This case suggests that immunostaining of abnormal cells is required for the differential diagnosis of plasma cell leukemia in leukocytosis.
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  • Pure red cell aplasia successfully treated with rituximab in a patient with relapsed diffuse large B-cell lymphoma
    Takayuki SUZUKI, Takashi KUMAGAI, Asako KITANO, Humito KUBO, Mikio TAB ...
    2007 Volume 48 Issue 1 Pages 67-70
    Published: 2007
    Released on J-STAGE: October 03, 2007
    DOIhttps://doi.org/10.11406/rinketsu.48.67
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    Malignant lymphoma is often accompanied by an autoimmune disorder. Here, we describe a 82-year-old woman with pure red cell aplasia (PRCA) complicated with relapsed diffuse large B-cell lymphoma. Primary treatment involving chemotherapy, continuous oral administration of prednisolone and a single infusion of rituximab was unsuccessful for both diseases, but the following treatments with 3 courses of rituximab alone for once a week dramatically improved the PRCA as well as the lymphoma. As PRCA complicated with lymphoma is rare, the ideal therapeutic strategy has not yet been established for it. Rituximab may be a good alternative for treating such cases.
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