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  • A recent analysis recommended axillary staging by sentinel l

    2019-05-29

    A recent analysis recommended axillary staging by sentinel lymph node biopsy, and administration of adjuvant radiotherapy and endocrine therapy after breast conserving surgery for mucinous carcinoma. Park et al. concluded that adjuvant chemotherapy could potentially be omitted in cases with favorable risk factors. In the present study, 32% of patients had a positive SC 144 Supplier of hormone receptors, which were frequently associated with a well-differentiated histology pattern and were sensitive to adjuvant hormonal therapy. Our results were consistent with previous reports. The HER-2/neu proto-oncogene is amplified and/or overexpressed in approximately 25% of breast carcinomas, and is associated with poor prognosis. In our study, only 1.7% of patients were HER-2/neu-positive, which is consistent with other series. Ultimately, we have confirmed that PMBC is associated with outstanding overall and disease-free survival both in the literature and in our review.
    Limitations
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    Authors\' contributions
    Conflict of interest
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    Acknowledgements
    Introduction Mantle cell lymphoma (MCL) is a distinct type of B-cell lymphoma that comprises only 4% of non- Hodgkin\'s lymphomas in the US and 8% in Europe. It affects middle-aged to older individuals with a median age of about 60, with marked male predominance. Most patients present with stage III or IV disease, initially respond to rituximab-CHOP therapy but the remission period is short, which leads to a poor overall survival of 3–4 years. The diagnosis of MCL is usually through immunophenotype over expression, and cyclin-D1 (also known as CCND1, BCL-1, B-cell lymphoma 1) is the most specific marker for confirmation. Gastrointestinal involvement is common in most MCL patients, usually at a microscopic level under negative endoscopic results. Inflammation, ulceration, multiple lymphomatous polyposis (MLP) and mucosal thickening may also present endoscopically in MCL patients. To date, there were only four cases of intussusception reported related to MCL, and most of them were related to complications from chemotherapy. We herein report a previously healthy patient who initially presented to emergency department due to ileocecal intussusception related to a small bowel obstruction, and for whom the final diagnosis, following laparoscopic right hemicolectomy and cholecystectomy, was mantle cell lymphoma involving the ileum, large intestine, appendix and gallbladder.
    Case report Computed tomography scan of the chest, abdomen, and pelvis showed intussusceptions at the ileocecal area, small bowel dilatation, and multiple hyperplastic mesentery lymph nodes in the intussuscepted area (Fig. 1). An immediate colonscopy was conducted but failed to pass through the obstructed level at the ascending colon, and showed normal mucosal findings at the distal colon and rectum. Laparoscopic examination was performed soon after, and a retrograde intussusception was noted at the terminal ileum and two-thirds of the ascending colon (Fig. 2C). After reduction, the leading point was two adjacent solid masses at the ileum about 15 cm proximal to ileocecal valve. Another 1.5 cm whitish mass was also noted at the fundus of gallbladder (Fig. 2D). Finally, the patient underwent laparoscopic right hemicolectomy and cholecystectomy. The recovery period was smooth without further events, and the patient discharged six days after the operation. Microscopic sections of the ileal tumors showed mucosal ulceration and ill-demarcated aggregation lymphoma cells: small to medium-sized lymphoid cells with irregular nuclear contours, reminiscent of centrocytes. Lamina propria is also expanded by the lymphoma cells. On immunohistochemical study, the tumor cells were CD20(+), CD5(+), cyclinD1(+), bcl-2(+), CD3(−), CD10(−), CD23(−), and bcl-6(−) (Fig. 3). Proliferation marker MIB1 is presented in approximately 15%–18% of cells.