Spontaneous remission of multilobated non‐Hodgkin lymphoma

Abstract

A 67-year-old previously well man was admitted with hypercalcemia after a 7-day history of fever, night sweats, and back pain. The blood showed 5% multilobated lymphoid cells. A multilobated non-Hodgkin lymphoma associated with marked reticulin fibrosis was diagnosed on a bone marrow biopsy. During the next 7 days, in the absence of specific therapy, his symptoms disappeared. Three weeks after admission his biochemical abnormalities had resolved and after 9 weeks his bone marrow examination was normal. He remains in clinical and laboratory remission 16 months after presentation.

Spontaneous Regression of Diffuse Large B-Cell Lymphoma Harbouring Epstein-Barr Virus: A Case Report and Review of the Literature

“…Although spontaneous regression ( SR) in patients with low-grade lymphoma has been reported to occur in 5 to 15 percents of patients 1,2 , aggressive non-Hodgkin's lymphoma (NHL) cases showing SR are extremely rare [3][4][5][6][7][8][9][10][11][12][13][14][15][16] . We report here a case of diffuse large B cell lymphoma (DLBCL) harboring Epstein-Barr virus (EBV) that showed SR in the absence of any anti-neoplastic treatment.…”

Complete Spontaneous Remission of an Aggressive Non-Hodgkin's Lymphoma with Primary Manifestation in the Oral Cavity

“…Three case reports also describe complete spontaneous remissions of highly malignant lymphomas. Poppema et al [9] observed the remission of a lymphoblastic lymphoma in a 12-year-old boy, and Grigg et al [10] reported on a 67-year-old man with NHL. Furthermore Grem et al [11] describe a case where FIGURE 6 Mucous membrane finding in region 037-038 from November 14, 2000: regressive mucous membrane finding.…”

The multilobated morphology is still a better prognosis factor of diffuse large B‐cell lymphoma in the R‐CHOP era

“…During the dramatic advances in histology in the area of lymphoma from 1970 to 1990, many concerns about multilobated B-cell lymphoma were declared although most of the clinicopathological studies of multilobated B-cell lymphoma described a relatively good prognosis in the CHOP era. [12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Few additional reports about ml-DLBCL have appeared afterward. Exceptionally, Shimano et al 39 reported a poor prognosis group of DLBCL with a polyploid chromosomal abnormality that showed histological findings of Hodgkin's-like giant and multilobated cells.…”

“…During the dramatic advances in histology in the area of lymphoma from 1970 to 1990, many concerns about multilobated B‐cell lymphoma were declared although most of the clinicopathological studies of multilobated B‐cell lymphoma described a relatively good prognosis in the CHOP era 12–14,16–29 . Few additional reports about ml‐DLBCL have appeared afterward.…”

“…Common histological variants of DLBCL are of centroblastic, immunoblastic, and anaplastic types, and multilobated DLBCL (ml‐DLBCL) is found in rare instances 1 . Although the multilobated morphology was first reported as a morphologic variant of T‐cell lymphoma, it was also found in B‐cell lymphoma and was reported to relate to better prognosis 11–34 . In the updated Kiel classification, the multilobated subtype of B‐cell lymphoma were defined in detail: (i) more than 10%–20% of tumor cells showed lobated nuclei, (ii) some nuclei having three or four lobations, (iii) fine chromatin, and (iv) unrecognized nucleoli 35 .…”