BackgroundHepatitis B virus (HBV) is one of the most prevalent and serious infections worldwide. HBV reactivation is a serious complication for lymphoma patients who are being treated with rituximab-containing regimen. Since the impact of HBV has not been fully evaluated on the prognosis of diffuse large B cell lymphoma (DLBCL), this study examined the effect of the hepatitis infection on the progression-free survival (PFS) and overall survival (OS) in patients with DLBCL who received rituximab-containing chemotherapy.MethodsThis retrospective cohort study was conducted at Princess Noorah Oncology Center, Jeddah by reviewing all medical records of 172 DLBCL diagnosed patients and recieved Rituximab-containing chemotherapy dated from January 2009 to February 2016.ResultsOut of 172 patients, 53 were found positive in hepatitis serology. The 12 of those were HBsAg-positive and 41 were HBcAb-positive. Hepatitis reactivation was observed in 1% of the patients (i.e., 2 out of 172) and both of them were HBsAg-positive. Thus, the risk of hepatitis reactivation among the HBsAg-positive patients was 17% (i.e., 2 out of 12). The predicted 3-year PFS for HBsAg-positive and HBcAb-positive were 52% (± 8%), while 76% (± 4) for HBsAg-negative and HBcAb-negative patients. On the other hand, the predicted 3-year OS for HBsAg and HBcAb-negative group is 93% (±3) while for HBsAg-positive and HBcAb-positive is 77% (±7), respectively.ConclusionThe present study demonstrated a low HBV reactivation rate of 1% exclusively in 2 patients with HBsAg-positive status diagnosed with DLBCL and receiving R-CHOP chemotherapy.

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Background Parotid gland tumors are mostly benign with good prognosis. On the other hand, malignant tumors of the parotid gland often have poor prognosis and metastasize. Mucoepidermoid carcinoma is the most common cancer in the parotid gland accounting for nearly 40–50% of the cases. Therefore, it is important to define the role of fine needle aspiration in differentiating between different types of parotid malignancies. Method This is a retrospective chart review study that was done on 49 consecutive patients who underwent parotid surgeries in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, between Jan 2003 and Feb 2020. The records of 49 patients were obtained, fine needle aspiration and pathology reports were reviewed to define the role of fine needle aspiration in diagnosing malignant parotid tumors by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. Results Retrospective analysis of 39 cases revealed that there was one case which was diagnosed for cancer was missed by fine needle aspiration. Meanwhile, six cases were diagnosed as malignant lesions using both fine needle aspiration and histopathology. Furthermore, 30 cases were determined benign based on fine needle aspiration and histopathology. The sensitivity of fine needle aspiration for detecting malignancy was 85.7%, specificity was 93.8%. positive predictive value of 75% and negative predictive value of 96.7%. Conclusion Fine needle aspiration is highly sensitive and specific for parotid tumors. We support the role of pre-operative FNA for all parotid tumors as its accurate in differentiating between benign and malignant lesions.

The majority of thyroid lesions are primary in origin while secondary metastases to thyroid are considered a rare incidence. However, presentation of such cases with no signs of lung cancer can be extremely challenging to diagnose. Here, we present a 64-year-old man, an ex-smoker of 70 pack-years, who presented with a complaint of hoarseness of voice with associated dyspnea, choking episodes, weight loss, and hemoptysis. With no investigation abnormalities indicating lung adenocarcinoma, he was transferred to the Otolaryngology Department as being suspicious of thyroid cancer. A laryngoscopy demonstrated an immobile right vocal cord and pooling of secretions while a computed tomography (CT) scan showed a right thyroid lobe nodule, upper mediastinal lymphadenopathy, and pleural effusion. The patient underwent a total thyroidectomy. Biopsies from the lymph nodes and lung were obtained, and all demonstrated lung adenocarcinoma. Thus, a diagnosis of primary lung adenocarcinoma with thyroid and mediastinal lymph nodes metastases was established. Despite being a rare clinical presentation, thyroid metastasis should be considered and evaluated for a primary origin according to the associated clinical history and presentation.

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