Gray-zone lymphoma. Examples of rare clinical manifestation


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Abstract

Mediastinal gray-zone lymphoma (MGZL, lymphoma with features intermediate between classical Hodgkin lymphoma and diffuse large B-cell lymphoma) was declared as a separate entity in WHO classification of Tumors of Haematopoetic and Lymphoid Tissues in 2008 and 2017 years. Despite of similar pathomorphological characteristics between primary mediastinal B-cell lymphoma and Hodgkin lymphoma, clinical features and optimal therapeutic approach to MGZL are not clearly defined. Usually MGZL manifests with mediastinal lymphadenopathy, although extranodal lesions often occur (grey-zone lymphoma, GZL). Patients with MGZL have unfavorable prognosis, taking into account high rate of relapse. This article describes two cases of MGZL. First case manifested by arrhythmias due to primary heart involvement. In spite of cardiac failure antracycline-containing chemotherapy (6 courses of R-DA-EPOCH) it allowed to achieve a complete remission and resolving of arrhythmias. Second case was represented by metachronous tumors: primary mediastinal B-cell lymphoma at the time of disease onset and classical Hodgkin lymphoma, NS II, diagnosed after disease progression. Thus, we demonstrated two examples of MGZL that differ by clinical manifestation, response to chemotherapy, which emphasizes an importance of pathogenesis studying, and using of new therapeutic approaches.

About the authors

A E Misyurina

National Research Center for Hematology of the Ministry of Health of the Russian Federation

Email: anna.lukina1@gmail.com
к.м.н., гематолог отд-ния интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

S K Kravchenko

National Research Center for Hematology of the Ministry of Health of the Russian Federation

к.м.н., зав. отд-нием интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

Ya K Mangasarova

National Research Center for Hematology of the Ministry of Health of the Russian Federation

к.м.н., гематолог отд-ния интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

A U Magomedova

National Research Center for Hematology of the Ministry of Health of the Russian Federation

д.м.н, в.н.с. отд-ния интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

A M Kovrigina

National Research Center for Hematology of the Ministry of Health of the Russian Federation

д.б.н., проф., зав. патологоанатомическим отд-нием ФГБУ «НМИЦ гематологии» Moscow, Russia

L T Shimanovskaya

National Research Center for Hematology of the Ministry of Health of the Russian Federation

клинический ординатор отд-ния интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

E A Fastova

National Research Center for Hematology of the Ministry of Health of the Russian Federation

аспирант отд-ния интенсивной высокодозной химиотерапии гемобластозов с круглосуточным и дневным стационаром ФГБУ «НМИЦ гематологии» Moscow, Russia

V A Misyurin

N.N. Blokhin National Medical Cancer Research Center of the Ministry of Health of the Russian Federation

к.б.н., с.н.с. лаб. экспериментальной диагностики и биотерапии опухолей ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Moscow, Russia

S V Model

National Research Center for Hematology of the Ministry of Health of the Russian Federation

к.м.н., с.н.с., кардиолог отд-ния реанимации и интенсивной терапии ФГБУ «НМИЦ гематологии» Moscow, Russia

D I Chebotarev

National Research Center for Hematology of the Ministry of Health of the Russian Federation

аспирант патологоанатомического отд-ния ФГБУ «НМИЦ гематологии» Moscow, Russia

I E Kostina

National Research Center for Hematology of the Ministry of Health of the Russian Federation

зав. отд-нием рентгенологии и компьютерной томографии ФГБУ «НМИЦ гематологии» Moscow, Russia

V G Savchenko

National Research Center for Hematology of the Ministry of Health of the Russian Federation

д.м.н, проф., академик РАН, ген. директор ФГБУ «НМИЦ гематологии» Moscow, Russia

References

  1. Swerdlow S.H, Campo E, Harris N.L, Jaffe E.S, Pileri S.A, Stein H, Thiele J., Vardiman J.W. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2008.
  2. Swerdlow S.H, Campo E, Harris N.L, Jaffe E.S, Pileri S.A, Stein H, Thiele J. Classification of Tumours of Haematopoietic and Lymphoid Tissues. WHO Classification of Tumours, Revised 4th ed. Vol. 2. Lyon: IARC Press; 2017.
  3. Iwaki N, Sato Y, Kurokawa T, Maeda Y, Ohno K, Takeuchi M, Takata K, Orita Y, Nakao S, Yoshino T. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma without mediastinal disease: mimicking nodular sclerosis classical Hodgkin lymphoma. Med Mol Morphol. 2013;3(46):172-6. doi: 10.1007/s00795-013-0038-8
  4. Hoffmeier A, Sindermann J.R, Scheld H.H, Martens S. Cardiac tumors - diagnosis and surgical treatment. Dtsch Arztebl Int. 2014;111(12):205-11. doi: 10.3238/arztebl.2014.0205
  5. Patel J, Melly L, Sheppard M.N. Primary cardiac lymphoma: B- and T-cell cases at a specialist UK centre. Ann Oncol. 2009;(0):424. https://doi.org/10.1093/annonc/mdp424
  6. Gowda R.M, Khan I.A. Clinical perspectives of primary cardiac lymphoma. Angiology. 2003;54(5):599-604. doi: 10.1177/000331970305400510
  7. Evens A.M, Kanakry J.A, Sehn L.H, Kritharis A, Feldman T, Kroll A, Gascoyne R.D, Abramson J.S, Petrich A.M, Hernandez-Ilizaliturri F.J, Al-Mansour Z, Adeimy C, Hemminger J, Bartlett N.L, Mato A, Caimi P.F, Advani R.H, Klein A.K, Nabhan C, Smith S.M, Fabregas J.C, Lossos I.S, Press O.W, Fenske T.S, Friedberg J.W, Vose J.M, Blum K.A. Gray Zone Lymphoma (GZL) With Features Intermediate Between Classical Hodgkin Lymphoma (cHL) and Diffuse Large B-cell Lymphoma (DLBCL): A Large Retrospective Multicenter Analysis of Clinical Characteristics, Treatment, Outcomes and Prognosis in the Current Era. ASH Annual Meeting Abstracts. 2013;122:847. doi: 10.1002/ajh.24082
  8. Мангасарова Я.К., Ковригина А.М., Мисюрина А.Е., Магомедова А.У., Нестерова Е.С., Кравченко С.К. Медиастинальная лимфома «серой зоны». Гематология и трансфузиология. 2016;61(1):147.
  9. Mangasarova Ya.K, Magomedova A.U, Kovrigina A.M, Misyurina A.E, Nesterova E.S, Kravchenko S.K, Savchenko V.G. Extramediastinal Lesion in Patients with Primary Mediastinal Large B-Cell Lymphoma. Blood. 2017;130:5232.
  10. Eberle F.C, Rodriguez-Canales J, Wei L, Hanson J.C, Killian J.K, Sun H.W, Adams L.G, Hewitt S.M, Wilson W.H, Pittaluga S, Meltzer P.S, Staudt L.M, Emmert-Buck M.R, Jaffe E.S. Methylation profiling of mediastinal gray zone lymphoma reveals a distinctive signature with elements shared by classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma. Haematologica. 2011;96(4):558-66. doi: 10.3324/haematol.2010.033167
  11. Wilson W.H, Pittaluga S, Nicolae A. A prospective study of mediastinal gray - zone lymphoma. Blood. 2014;124(10):1563-9. doi: 10.1182/blood-2014-03-564906
  12. Dunleavy K, Pittaluga S, Tay K, Grant N, Chen C, Shovlin M, Steinberg S, Staudt L.M, Jaffe E.S, Janik J.E, Wilson W.H. Comparative Clinical and Biological Features of Primary Mediastinal B-Cell Lymphoma (PMBL) and Mediastinal Grey Zone Lymphoma (MGZL). Blood. 2009;114:106.
  13. Мангасарова Я.К., Магомедова А.У., Нестерова Е.С., Володичева Е.М., Воробьев В.И., Кравченко С.К. Первые результаты терапии первичной медиастинальной B-крупноклеточной лимфомы по программе R-DA-EPOCH-21. Терапевтический архив. 2016;88(7):37-42. doi: 10.17116/terarkh201688737-42

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