Document Detail


Granulomatous reactions cause symptoms or clinically imitate treatment resistance in small lymphocytic lymphoma/chronic lymphocytic leukaemia more frequently than in other non-Hodgkin lymphomas.
MedLine Citation:
PMID:  16049282     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The electronic database of the institute of pathology, Medical University of Innsbruck, was reviewed and patient histories studied to analyse systematically the coincidence of granulomatous reactions and lymphomas in a large patient collective, and to find distinct clinicopathological correlations. Five cases of small lymphocytic lymphoma/chronic lymphocytic leukaemia (CLL) associated with granulomatous reactions in lymph nodes and bone marrow were identified, all clinically associated with signs of progressive disease.
METHODS: Cases were acquired by reviewing an electronic database comprising approximately 715,000 patients diagnosed between 1993 and 2003. Histochemical, immunohistochemical, and molecular techniques were used to verify diagnosis and associated infectious diseases. Clinical data were obtained from reviewing the charts.
RESULTS: Of 2044 bone marrow and 411 lymph node non-Hodgkin lymphoma biopsy samples, CLL was most frequently associated with bone marrow (two cases) and lymph node granulomas (three cases). These granulomas were mostly composed of epithelioid cells, with or without giant cells, and in all but one case did not show necrosis. All patients with CLL had clinical symptoms primarily caused by the granulomatous disease: two suffered from acid fast bacilli infections (Mycobacterium tuberculosis and mycobacteria other than tuberculosis) and three presented with clinical manifestations of sarcoidosis (the reason a diagnostic biopsy was performed).
CONCLUSIONS: Granulomatous reactions in patients with CLL might obscure diagnosis and imitate disease progression and Richter's transformation. Careful histological examination, exclusion of infectious agents, and a detailed clinical history are essential for correct diagnosis.
Authors:
A Brunner; J Kantner; A Tzankov
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of clinical pathology     Volume:  58     ISSN:  0021-9746     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-28     Completed Date:  2005-09-26     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  815-9     Citation Subset:  AIM; IM    
Affiliation:
Institute of Pathology, Innsbruck Medical University, Muellerstrasse 44, 6020 Innsbruck, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Marrow Diseases / etiology,  pathology
Diagnosis, Differential
Disease Progression
Female
Granuloma / etiology*,  pathology
Humans
Leukemia, Lymphocytic, Chronic, B-Cell / complications*,  pathology
Leukemic Infiltration / pathology
Lymphatic Diseases / etiology,  pathology
Lymphoma, Non-Hodgkin / complications,  pathology
Male
Middle Aged
Retrospective Studies
Sarcoidosis / etiology,  pathology
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