CASE REPORT
Same Disease, Different Approaches: A Report on Six Lymphoma Cases with Extranodal Marginal Zones in Rare Sites
Received Date : 06 Oct 2020
Accepted Date : 20 Jan 2021
Available Online : 18 Feb 2021
Metin DEMİRa, Deniz Can GÜVENa, Saadettin KILIÇKAPb
aDepartment of Medical Oncology, Hacettepe University Cancer Institute, Ankara, TURKEY
bDepartment of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, TURKEY
Doi: 10.37047/jos.2020-79452 - Article's Language: EN
J Oncol Sci. 2021;7(1):34-8
ABSTRACT
Marginal zone lymphoma (MZL) is a heterogeneous disease with the most common form being extranodal marginal zone lymphoma
(EMZL). It mostly involves the glandular epithelial surfaces such as the stomach, ocular adnexa, lacrimal and salivary glands, thyroid,
breast, and lungs. Gastric and ocular adnexal EMZL are related to specific infectious agents and can be treated with antibiotics especially during
the early stages. Surgery, radiotherapy, rituximab, rituximab with chemotherapy, and observation are the other approaches available for
the treatment of EMZL. Here, we presented several cases of EMZL with varying stages of involvements of rather extraordinary tissues along
with our systemic treatment approaches. Additionally, we have also described the successful implementation of local treatment options.
Keywords: Marginal zone lymphoma; rituximab; extranodal
REFERENCES
- A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. The Non-Hodgkin's Lymphoma Classification Project. Blood. 1997;89(11):3909-3918. [Crossref]
- Perrone S, D'Elia GM, Annechini G, Pulsoni A. Infectious aetiology of marginal zone lymphoma and role of anti-infective therapy. Mediterr J Hematol Infect Dis. 2016;8(1):e2016006. [Crossref] [PubMed] [PMC]
- Ekström Smedby K, Vajdic CM, Falster M, et al. Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium. Blood. 2008;111(8):4029-4038. [Crossref] [PubMed] [PMC]
- Schreuder MI, van den Brand M, Hebeda KM, Groenen PJTA, van Krieken JH, Scheijen B. Novel developments in the pathogenesis and diagnosis of extranodal marginal zone lymphoma. J Hematop. 2017;10(3-4):91-107. [Crossref] [PubMed] [PMC]
- van den Brand M, van Krieken JH. Recognizing nodal marginal zone lymphoma: recent advances and pitfalls. A systematic review. Haematologica. 2013;98(7):1003-1013. [Crossref] [PubMed] [PMC]
- Khoudoli GA, Gillespie PJ, Stewart G, Andersen JS, Swedlow JR, Blow JJ. Temporal profiling of the chromatin proteome reveals system-wide responses to replication inhibition. Curr Biol. 2008;18(11):838-843. [Crossref] [PubMed] [PMC]
- Kamdar MK, Smith SM. Extranodal marginal zone lymphoma: no longer just a sidekick. J Clin Oncol. 2017;35(17):1872-1878. [Crossref] [PubMed]
- Raderer M, Kiesewetter B, Ferreri AJ. Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). CA Cancer J Clin. 2016;66(2):153-171. [Crossref] [PubMed]
- Wenzel C, Fiebiger W, Dieckmann K, Formanek M, Chott A, Raderer M. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue of the head and neck area: high rate of disease recurrence following local therapy. Cancer. 2003;97(9):2236-2241. [Crossref] [PubMed]
- Thieblemont C, Molina T, Davi F. Optimizing therapy for nodal marginal zone lymphoma. Blood. 2016;127(17):2064-2071. [Crossref] [PubMed]
- Rummel MJ, Niederle N, Maschmeyer G, et al; Study group indolent Lymphomas (StiL). Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet. 2013;381(9873):1203-1210. Erratum in: Lancet. 2013;381(9873):1184. [Crossref]
- Flinn IW, van der Jagt R, Kahl BS, et al. Randomized trial of bendamustine-rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood. 2014;123(19):2944-2952. [Crossref] [PubMed] [PMC]
- Girinsky T, Paumier A, Ferme C, et al. Low-dose radiation treatment in pulmonary mucosa-associated lymphoid tissue lymphoma: a plausible approach? A single-institution experience in 10 patients. Int J Radiat Oncol Biol Phys. 2012;83(3):e385-e389. [Crossref] [PubMed]
- Troch M, Streubel B, Petkov V, Turetschek K, Chott A, Raderer M. Does MALT lymphoma of the lung require immediate treatment? An analysis of 11 untreated cases with long-term follow-up. Anticancer Res. 2007;27(5B):3633-3637.
- Wang L, Xia ZJ, Zhang YJ, Huang HQ, Lin TY, Lu Y. Radical surgery may be not an optimal treatment approach for pulmonary MALT lymphoma. Tumour Biol. 2015;36(8):6409-6416. [Crossref] [PubMed]
- Zinzani PL, Pellegrini C, Gandolfi L, et al. Extranodal marginal zone B-cell lymphoma of the lung: experience with fludarabine and mitoxantrone-containing regimens. Hematol Oncol. 2013;31(4):183-188. [Crossref] [PubMed]
- Lee H, Yang B, Nam B, et al. Treatment outcomes in patients with extranodal marginal zone B-cell lymphoma of the lung. J Thorac Cardiovasc Surg. 2017;154(1):342-349. [Crossref] [PubMed]
- Oh SY, Kim WS, Kim JS, et al. Pulmonary marginal zone B-cell lymphoma of MALT type--what is a prognostic factor and which is the optimal treatment, operation, or chemotherapy?: Consortium for Improving Survival of Lymphoma (CISL) study. Ann Hematol. 2010;89(6):563-568. [Crossref] [PubMed]
- Tsang RW, Gospodarowicz MK, Pintilie M, et al. Stage I and II MALT lymphoma: results of treatment with radiotherapy. Int J Radiat Oncol Biol Phys. 2001;50(5):1258-1264. [Crossref]
- Tsang RW, Gospodarowicz MK, Pintilie M, et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003;21(22):4157-4164. [Crossref] [PubMed]
- Suarez F, Lortholary O, Hermine O, Lecuit M. Infection-associated lymphomas derived from marginal zone B cells: a model of antigen-driven lymphoproliferation. Blood. 2006;107(8):3034-3044. [Crossref] [PubMed]
- Pelstring RJ, Essell JH, Kurtin PJ, Cohen AR, Banks PM. Diversity of organ site involvement among malignant lymphomas of mucosa-associated tissues. Am J Clin Pathol. 1991;96(6):738-745. [Crossref] [PubMed]
- Parveen T, Navarro-Roman L, Medeiros LJ, Raffeld M, Jaffe ES. Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue arising in the kidney. Arch Pathol Lab Med. 1993;117(8):780-783.
- Garcia M, Konoplev S, Morosan C, Abruzzo LV, Bueso-Ramos CE, Medeiros LJ. MALT lymphoma involving the kidney: a report of 10 cases and review of the literature. Am J Clin Pathol. 2007;128(3):464-473. [Crossref] [PubMed]
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