Small B cell lymphocytic lymphoma presenting as obstructive sleep apnea

Tsou, Yung An; Cheng, Yuan; Lin, Chia Der; Chang, Wen Shin; Tsai, Ming Hsui

doi:10.1186/1477-7819-2-26

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…Research on sleep disorders prior to HCT is limited to case studies of lymphomas presenting as OSA [e.g., (19)]. In addition, a study of polysomnography in 12 multiple myeloma patients receiving high-dose chemotherapy (7) reported greater respiratory events and lower-than-normal levels of arterial oxygen saturation, on average.…”

Section: Sleep Disruption and Disorders Prior To Transplantmentioning

confidence: 99%

Sleep Disruption in Hematopoietic Cell Transplantation Recipients: Prevalence, Severity, and Clinical Management

Jim

Evans

Jeong

et al. 2014

Biology of Blood and Marrow Transplantation

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Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of patients experiencing sleep disruption pre-transplant, up to 82% experiencing moderate to severe sleep disruption during hospitalization for transplant, and up to 43% in the post-transplant period. These rates of sleep disruption are substantially higher than the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption as a clinical problem in HCT in order to facilitate patient education, intervention, and research. The review opens with a discussion of sleep disruption measurement and clinical diagnosis of sleep disorders. An overview of the prevalence, severity, and chronicity of sleep disruption and disorders in patients receiving HCT follows. Current evidence regarding sociodemographic and clinical predictors of sleep disruption and disorders is summarized. The review concludes with suggestions for behavioral and pharmacologic management of sleep disruption and disorders as well as directions for future research.

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Section: Sleep Disruption and Disorders Prior To Transplantmentioning

confidence: 99%

Sleep Disruption in Hematopoietic Cell Transplantation Recipients: Prevalence, Severity, and Clinical Management

Jim

Evans

Jeong

et al. 2014

Biology of Blood and Marrow Transplantation

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“…Thus, the International Lymphoma Study Group proposed the designation CLL/SLL to acknowledge that both CLL and SLL are currently considered to be different manifestations of the same disease entity [11]. Bilateral tonsillar enlargement secondary to CLL infiltration is rare with only 6 cases reported in the English literature (Table 1) [3][4][5][6][7][8]. Three of the reported cases had a working diagnosis of CLL/SLL prior to tonsillectomy, however in the present case diagnosis was made primarily on tonsillar tissue and was later correlated with peripheral blood findings which revealed isolated absolute lymphocytosis with few smudge cells.…”

Section: Discussionmentioning

confidence: 99%

“…Non-Hodgkin lymphoma of the tonsils accounts for less than 1 % of malignant head and neck tumors as a whole, and commonest histologic type is diffuse large B cell lymphoma(DLBCL) [2]. Tonsillar involvement in chronic lymphocytic leukemia (CLL) is rare and has only been reported 6 times previously in the English literature (Table 1) [3][4][5][6][7][8]. We describe a case of an elderly female presenting with bilateral tonsillar enlargement as a first clinical manifestation of CLL/SLL and to best of our knowledge this is the third such description of tonsillar CLL with predominant interfollicular pattern of infiltration.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Tonsillar Enlargement as a First Manifestation of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma with an Unusual Interfollicular Pattern of Infiltration

Duggal

Rana

Vaid

et al. 2015

Indian J Hematol Blood Transfus

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Tonsillar lymphoma usually presents as unilateral or bilateral enlargement or as an ulcerative or fungating lesions. Most lymphomas that involve the tonsils are diffuse large B-cell lymphomas and primary low grade lymphomas are exceptional. We report a case of primary B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) affecting tonsils with interfollicular pattern of infiltration in a 54-year-old female who clinically presented with bilateral tonsillar enlargement, sore throat, dysphagia and respiratory difficulty, unresponsive to the conservative treatment. To the best of our knowledge, till date only six cases of CLL/SLL infiltrating tonsils have been reported in the English literature, three of these were known cases of CLL/SLL prior to tonsillectomy. In the present case diagnosis of CLL/SLL was first time established on tonsillar histomorphology and that too with an unusual interfollicular pattern of infiltration.

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“…A variety of both covid and non-covid atypical pathologies have presented as crops/clusters since the start of Covid-19 pandemic [ 5 , 6 ] with symptomatology masking primary disease. This study helped to determine the importance of establishing clinical suspicion of overt pathologies in selected cases which masquerade as Obstructive sleep apnea (OSA) [ 7 , 8 ]. OSA has emerged as a global disease with causes being multi-factorial [ 9 ] with varied presentations [ 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

Sudarsan

Kumar

Chalamaiahgari

et al. 2023

Indian J Otolaryngol Head Neck Surg

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COVID-19 caused by SARS-CoV2 has reached pandemic proportions. The fear of Covid-19 has deterred many to abandon efforts for seeking timely medical help. In this setting, Obstructive sleep apnea (OSA)-like covid/non-covid cohorts have presented. Atypical pathologies can present like OSA and take the clinician unawares. With this series of misfits suffering silently, it would be unwise to underestimate its impact on quality-of-life (QOL). To determine the effect on quality-of-life by pathologies mimicking OSA and assess Covid-19 as a cause for delayed presentation. This was a prospective cross-sectional study. 127(N). Recent onset of symptoms of OSA. Study duration March 2020 to September 2021. Pittsburgh Sleep Quality Index (PSQI) screening done. Study criteria defined. Sleep parameters calculated. Primary surgical intervention given. Non-responders were put on CPAP therapy. QOL assessment done with sf-36 and SAQLI. Fear of Covid-19 scale (FCV-19S) quantified to study cause for temporal delay. Correlations computed. Level of Evidence—Level 3. 97 candidates completed study. Demographic and anthropometric details noted. Mean range was 43.85 ± 11.39 years. Male predominance. Overall AHI-19.73 ± 8.72. Moderate impact on QOL by sf-36/SAQLI. 78n Primary surgical candidates fared well. Polysomnography (PSG) and Continuous positive airway pressure (CPAP) titration/trial characteristics for 19n available. Statistically significant improvement in QOL after treatment completion. Correlations were meaningful. Body Mass Index (BMI) as a single factor was not influential on OSA-mimickers. Fear of Covid-19 significantly impacted emergency medical aid acquisition. OSA mimicking atypical airway pathologies may need emergent treatment not only from a surgical point-of-view but also from the QOL of the patient. On the contrary, these also unmask sub-clinical OSA, especially in patients with low/normal BMI. This category of recent onset OSA, if fortunately picked up at the earliest possible presentation, may hopefully not go through the significant QOL impact suffered by chronic OSA candidates.

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Small B cell lymphocytic lymphoma presenting as obstructive sleep apnea

Cited by 7 publications

References 7 publications

Sleep Disruption in Hematopoietic Cell Transplantation Recipients: Prevalence, Severity, and Clinical Management

Sleep Disruption in Hematopoietic Cell Transplantation Recipients: Prevalence, Severity, and Clinical Management

Bilateral Tonsillar Enlargement as a First Manifestation of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma with an Unusual Interfollicular Pattern of Infiltration

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact

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