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Poster display session

624 - Rare malignancy rare site - Extranodal lymphomas

Date

11 Sep 2017

Session

Poster display session

Presenters

Sumant Gupta

Citation

Annals of Oncology (2017) 28 (suppl_5): v595-v604. 10.1093/annonc/mdx391

Authors

S. Gupta, A.N. Murali

Author affiliations

  • Oncology, Sarvodaya hospital, 121006 - Faridabad/IN
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Resources

Abstract 624

Background

Extranodal Non Hodgkins Lymphoma (NHL) constitutes one quarter of all NHL cases. Oral cavity and breast represent 2 such uncommon sites.

Methods

Clinical and treatment details of patients with extranodal lymphomas who underwent treatment at our center were collected. Diagnosis was established by excision biopsy or by punch biopsy from the lesion. Histopathological examination (HPE) and immunohistochemistry (IHC) were performed. For staging, patients underwent positron emission tomography (PET) with computed tomography (CT) scan of the whole body.

Results

Case 1: A 32-year old male presented with complaints on the right-side base of tongue and difficulty in swallowing since 20 days. On examination, a nodular swelling was seen over the right side posterior one third of tongue going up to base of tongue. Punch biopsy from the tongue lesion was suggestive of NH. IHC showed CD 3 - positive, CD 30 - positive, ALK 1 - positive and CD 20 - positive with a final report of anaplastic lymphoma kinase (ALK) positive ALCL. Whole body PET-CT showed localized metabolic uptake in the tongue and in the right cervical lymph node - level II. A final diagnosis of ALK positive ALCL - stage IE was made. Case 2: A 22-year old female presented with complaints of lump in the right breast since 10 weeks. On examination there was a lump in the right breast measuring 3 x 2 cm in the lower outer quadrant and no other palpable lymphadenopathy. On evaluation, wide local excision of the lump was suggestive of a round cell tumor. IHC done showed the neoplastic round cells to be positive for CD 20, PAX5, CD 10 with a Ki 67 of 80% and BCL 2, MUM 1 - negative. Bone marrow examination was positive for lymphomatous deposits. Whole body PET-CT showed metabolically active sub-centimetric right axillary lymph node enlargement with diffuse hypermetabolism along axial bone marrow.

Conclusions

Only 11 previous cases of oral ALCL have been reported. Primary breast lymphoma is a rare disease, accounting for only 0.4-0.5% of all breast malignancies, 0.38-0.7% of all NHL. Extranodal NHL can occur at any site and keeping an open mind is the most important pre-requisite for making a diagnosis. Modern diagnostic tools such as IHC is mandatory for diagnosis and management of extranodal NHL.

Clinical trial identification

Not applicable

Legal entity responsible for the study

Haryana Medical Council

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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