Barbara Burroni

Sarcoidosis Occurring After Lymphoma: Report of 14 Patients and Review of the Literature

AbstractSarcoidosis is a granulomatous disease that most frequently affects the lungs with pulmonary infiltrates and/or bilateral hilar and mediastinal lymphadenopathy. An association of sarcoidosis and lymphoproliferative disease has previously been reported as the sarcoidosis-lymphoma syndrome. Although this syndrome is characterized by sarcoidosis preceding lymphoma, very few cases of sarcoidosis following lymphoma have been reported. We describe the clinical, biological, and radiological characteristics and outcome of 39 patients presenting with sarcoidosis following lymphoproliferative disease, including 14 previously unreported cases and 25 additional patients, after performing a literature review. Hodgkin lymphoma and non-Hodgkin lymphoma were equally represented. The median delay between lymphoma and sarcoidosis was 18 months. Only 16 patients (41%) required treatment. Sarcoidosis was of mild intensity or self-healing in most cases, and overall clinical response to sarcoidosis was excellent with complete clinical response in 91% of patients. Sarcoidosis was identified after a follow-up computerized tomography scan (CT-scan) or 18fluorodeoxyglucose-positron emission tomography/computerized tomography (18FDG-PET/CT) evaluation in 18/34 patients (53%). Sarcoidosis is therefore a differential diagnosis to consider when lymphoma relapse is suspected on a CT-scan or 18FDG-PET/CT, emphasizing the necessity to rely on histological confirmation of lymphoma relapse.

Hemophagocytic Lymphohistiocytosis Due to Acute Myeloid LeukemiaRelapse: A Very Unusual Association

Hemophagocytic lymphohistiocytosis (HLH) diagnosed in the course of acute myeloid leukemia (AML) is generally triggered by treatment-induced infections. AML-induced HLH is a very rare situation for which no diagnostic or therapeutic guidelines are available. We report the occurrence of HLH in an AML5 post-transplant relapse. In our case, the absence of detectable pathogen and the parallel evolution between HLH and leukemia burden suggested a direct link between AML and HLH. We suggest that the diagnostic of AML-related HLH should be promptly considered in front of unexplained fever, cytopenia, liver dysfunction or neurological symptoms as therapeutic intervention is urgent in this life-threatening situation.

Prognostic value of early 18F-FDG PET scanning evaluation in immunocompetent primary CNS lymphoma patients

Primary central nervous system lymphoma (PCNSL) is a rare topographic variant of diffuse large B-cell lymphoma (DLBCL). While prognostic scales are useful in clinical trials, no dynamic prognostic marker is available in this disease. We report here the prognostic value of early metabolic response by 18F-FDG PET scanner (PET) in 25 newly diagnosed immunocompetent PCNSL patients. Induction treatment consisted of four cycles of Rituximab, Methotrexate and Temozolamide (RMT). Based on patients general condition, consolidation by high-dose Etoposide and Aracytine was given to responding patients. Brain MRI and PET were performed at diagnosis, after two and four cycles of RMT, and after treatment completion. Two-year progression-free (PFS) and overall survival (OS) were 62% and 74%, respectively for the whole cohort. Best responses after RMT induction were 18 (72%) complete response (CR)/CR undetermined (CRu), 4 (16%) partial response, 1 (4%) progressive disease and 2 (8%) stable disease. Response evaluation was concordant between MRI and PET at the end of induction therapy. Nineteen patients (76%) had a negative PET2. Predictive positive and negative values of PET2 on end-of-treatment (ETR) CR were 66.67% and 94.74%, respectively. We observed a significant association between PET2 negativity and ETR (p = 0.001) and longer PFS (p = 0.02), while having no impact on OS (p = 0.32). Two years PFS was 72% and 33% for PET2– and PET2+ patients, respectively (p < 0.02). PET2 evaluation may help to early define a subgroup of CR PCNSL patients with a favorable outcome.

The role of radiotherapy as salvage and/or consolidation treatment in relapsed/refractory and high-risk diffuse large B-cell lymphoma

Many salvage therapies have been proposed for relapsed/refractory (R/R) diffuse large B‐cell lymphomas or for consolidation in the case of suboptimal response. Radiotherapy (RT) is one modality of salvage therapy, but its place is currently not well defined.

Unusual location of a follicular lymphoma with features of pediatric-type follicular lymphoma

![Figure][1] An 18-year-old man presented with a rapidly growing conjunctival tumor without satellite lesions. Incisional biopsy showed infiltration by a lymphoid proliferation with nodular architecture (panel A; hematoxylin, eosin, and saffron [HE&S] stain), partially ulcerating the mucosa.

Diagnostic anatomopathologique des néoplasies myéloprolifératives chroniques Ph

Resume Dans les classifications de l’OMS des neoplasies myeloproliferatives, l’analyse d’une biopsie osteo-medullaire est un examen de premier plan necessaire au diagnostic et a l’evaluation du pronostic. L’entite « pre-fibrose », decrite depuis plusieurs annees comme distincte de la myelofibrose primitive avec myelofibrose franche, fait son entree dans la version la plus recente de ces classifications, publiee en 2016. La place de la biopsie dans le diagnostic de maladie de Vaquez est egalement renforcee. Des comites de relecture regroupant des hemato-pathologistes se mettent en place afin d’ameliorer la reproductibilite des criteres histologiques.

Spinal cord involvement in a Burkitt lymphoma patient

We report a case of acute myelopathy in a patient with Burkitt lymphoma successfully treated by high-dose therapy (TBuCy) and autologous stem cell transplantation. Lymphoma involvement and methotrexate toxicity are discussed as potential causal mechanisms for neurological symptoms. Correspondence to: Jerome Tamburini, Service d’Hématologie Clinique, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75014 Paris, France, Tel: 33158412121; Fax: 33184106322; E-mail: jerome.tamburini@aphp.fr