Spontaneous regression of an EBV‐associated monoclonal large B cell proliferation in the mastoid of a young child following surgical biopsy

McCabe, Martin G.; Hook, C. Elizabeth; Burke, G A Amos

doi:10.1002/pbc.21637

Cited by 12 publications

(7 citation statements)

References 18 publications

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“…One leading hypothesis involves stimulation of an antitumor response from the host immune system, particularly immune activation secondary to infection or injury. Activation of antitumor immunity subsequent to local tissue injury and inflammation from a biopsy has been suggested previously in the literature, although the temporal relationship between intervention and decreasing lymph node size (as in our patient) may simply be coincidental [20, 21]. Spontaneous remission has also been frequently observed in patients with concomitant viral infections, such as human immunodeficiency virus and Epstein-Barr virus [22–24].…”

Section: Discussionsupporting

confidence: 62%

Spontaneous Remission of an Untreated, MYC and BCL2 Coexpressing, High-Grade B-Cell Lymphoma: A Case Report and Literature Review

Potts

Fromm

Gopal

et al. 2017

Case Reports in Hematology

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Non-Hodgkin lymphomas (NHL) are a heterogeneous group of hematologic malignancies typically treated with multiagent chemotherapy. Rarely, spontaneous remissions can be observed, particularly in more indolent subtypes. The prognosis of aggressive NHL can be predicted using clinical and histopathologic factors. In aggressive B-cell NHL, the importance of MYC and BCL2 proto-oncogene coexpression (as assessed by immunohistochemistry) and high-grade histologic features are particularly noteworthy. We report a unique case of spontaneous remission in a patient with an aggressive B-cell NHL which harbored high-risk histopathologic features, including MYC protein expression at 70–80%, BCL2 protein expression, and morphologic features suggestive of high-grade B-cell lymphoma, NOS (formerly B-cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma [BCLU]). After undergoing a biopsy to confirm this diagnosis, he opted to forego curative-intent chemotherapy. The single, yet relatively large area of involvement noted on 18F-fluorodeoxyglucose positron emission tomography-computed tomography steadily resolved on subsequent follow-up studies. He remained without evidence of recurrence one year later, having never received treatment. This case emphasizes the potential for spontaneous remission in NHL and demonstrates that this phenomenon can be observed despite contemporary high-risk histopathologic features.

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Section: Discussionsupporting

confidence: 62%

Spontaneous Remission of an Untreated, MYC and BCL2 Coexpressing, High-Grade B-Cell Lymphoma: A Case Report and Literature Review

Potts

Fromm

Gopal

et al. 2017

Case Reports in Hematology

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“…One of the present patients with EBVpositive DLBCL-EH showed the spontaneous regression without adjuvant therapy. Spontaneous regressions of EBVpositive DLBCL were reported previously [21,22], but their histologies were not epithelioid rich.…”

Section: Discussionmentioning

confidence: 91%

Diffuse large B-cell lymphoma with a high number of epithelioid histiocytes (lymphoepithelioid B-cell lymphoma): a study of Osaka Lymphoma Study Group

et al. 2009

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The aim of this study was to clarify whether diffuse large B-cell lymphoma (DLBCL) with a high number of epithelioid histiocytes (DLBCL-EH) could have distinctive clinicopathological characteristics. Clinicopathological findings in 22 cases with DLBCL-EH and, as a control, 96 cases with ordinary type of DLBCL were analyzed. There were ten men and 12 women with ages ranging from 38 to 91 (median, 64) years. The primary site was lymph node in 16 cases, extranodal organs in three, and unknown in three. Stage of disease was I in five cases, II in three, III in nine, and IV in five. Histologically, there was a diffuse proliferation of large lymphoid cells admixed with numerous clusters of epithelioid histiocytes sprinkling throughout the lesions. Immunohistochemically, the large lymphoid cells were CD20(+), CD15(-), and CD3(-) and positive for CD10, bcl-6, and MUM1 in nine (41%), eight (36%), and 12 (55%) of 22 cases, respectively. Epstein-Barr virus positive rate was higher in DLBCL-EH (23.8%) than that in ordinary DLBCL (4.5%; P<0.05). Clonality analysis revealed monoclonal bands in all of the examined 20 cases with DLBCL-EH. Multivariate analysis revealed the prominent epithelioid reaction to be an independent factor for favorable prognosis. These findings suggest that DLBCL-EH could be a specific morphological variant of DLBCL associated with a better prognosis.

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“…The microenvironment is different between nodal and extranodal tumors. However, this assumption is based on limited information available in the literature as only one nodal case of DLBCL has been reported to have spontaneously regressed compared to the 17 reported extranodal cases of DLBCL [29], with the most common locations being the head and neck [31,[37][38][39][40][41], breast [32,42,43], and stomach [44][45][46]. Other locations include the lumbar spine [47], chest wall [48], and skin [49].…”

Section: Discussionmentioning

confidence: 99%

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2019

Int J Cancer Clin Res

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Objective/Background: Diffuse large B-cell lymphoma (DLBCL) rarely occurs in the liver. Spontaneous regression of this tumor is extremely rare. We are reporting the first case of hepatic DLBCL, and we are reviewing the English literature for cases of spontaneous regression of DLBCL and cancer in general. Methods: A 60-year-old gentleman with a history of HIV and HCV infections presented with an incidental liver mass. He was diagnosed with DLBCL germinal cell type with high grade features based on the results of pathological/cytogenetics studies. He started HCV and HIV medication but refused lymphoma chemotherapy. Results: Radiological follow up during a four-year period showed a spontaneous regression of his liver mass to a non-detectable size. Review of the English literature revealed 18 cases of DLBCL spontaneous regression, none of which were found in the liver. Here, two mechanisms are proposed to explain this phenomenon; the immunologic and the genetic. Conclusion: Chemoimmunotherapy is recommended for all DLBCL patients. However, this case of DLBCL spontaneous regression in an HIV and HCV positive patient offers a rare platform to understand the immune and genetic mechanisms for cancer and lymphoma in particular.

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Spontaneous regression of an EBV‐associated monoclonal large B cell proliferation in the mastoid of a young child following surgical biopsy

Cited by 12 publications

References 18 publications

Spontaneous Remission of an Untreated, MYC and BCL2 Coexpressing, High-Grade B-Cell Lymphoma: A Case Report and Literature Review

Spontaneous Remission of an Untreated, MYC and BCL2 Coexpressing, High-Grade B-Cell Lymphoma: A Case Report and Literature Review

Diffuse large B-cell lymphoma with a high number of epithelioid histiocytes (lymphoepithelioid B-cell lymphoma): a study of Osaka Lymphoma Study Group

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