2 articles
Psoriasis is a chronic immune-mediated inflammatory condition and is considered a potential risk factor for the development of hematologic malignancies, particularly in the context of immunosuppressive therapy and T-cell dysfunction. B-cell non-Hodgkin lymphomas are neoplasms of the lymphatic system with variable clinical manifestations, most commonly presenting with peripheral lymphadenopathy. Primary localization in the soft tissues of the head, with bone invasion, is rare.
We report a rare case of cephalic aggressive NHL Not Otherwise Specified (NOS) in a 63-year-old patient with a history of psoriasis vulgaris and Clear cell carcinoma (T1N0M0, treated in 2021 at the Oncology Institute in Chișinău), who presented with a painless right temporo-parietal mass. MRI revealed a 48×19×50 mm lesion in the temporal soft tissues with extension into the frontal bone. Surgical biopsy and immunohistochemistry (CD20+, CD79a+, CD45+, BCL6-) confirmed the diagnosis of B-cell NHL NOS. In 2022, the patient received 8 induction cycles of immunochemotherapy followed by maintenance therapy with Rituximab. PET/CT evaluation showed a Deauville score of 3, indicating a partial favorable response. Associated comorbidities (psoriasis, type 2 diabetes mellitus, hypertension) required multidisciplinary monitoring.
This case illustrates an unusual cranial localization of aggressive B-cell lymphoma NOS and highlights the potential link between psoriasis and lymphoproliferative risk, as previously suggested in the medical literature.
Non-Hodgkin lymphoma (NHL) encompasses a diverse group of malignancies arising from malignant proliferation of lymphocytes, each subtype characterized by unique epidemiological, etiological, and clinical features. Prognostication is essential for guiding treatment decisions and improving patient outcomes. Prognostic scores, including traditional and molecular systems, offer insights into survival prediction. The aim of the present study was to evaluate the applicability of traditional prognostic scores based on clinical markers and laboratory biomarkers in predicting the outcomes of patients with primary nodal NHL.
This study included 78 NHL patients treated at the Chisinau Oncological Institute from 2017 to 2021. Clinical and biological data were collected, and the following prognostic scores were calculated: International Prognostic Index (IPI), The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP score), Platelet to Lymphocyte Ratio (PLR), Neutrophil to Lymphocyte Ratio (NLR), Albumin/Globulin ratio (AG), and Charlson comorbidity index (CCI). Statistical analyses, including descriptive statistics, ROC curve analysis, and Kaplan-Meier survival curves, were conducted.
Of the patients, 40 (51.2%) were female, with a mean age of 57.1 ± 10.2 years. Peripheral lymph nodes were predominantly affected (84.6%), with diffuse large B-cell lymphoma being the most prevalent subtype (59.0%). Prognostic scores, including the International Prognostic Index (IPI), Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, and Charlson Comorbidity Index (CCI), demonstrated varying levels of discriminatory ability in predicting overall survival (OS). Notably, the HALP score (AUC = 0.650; p = 0.026), IPI (AUC = 0.745; p = 0.0002), and CCI (AUC = 0.636; p = 0.043) were statistically significant predictors of OS.
Traditional prognostic scores (IPI. HALP score, CCI) offer valuable prognostic information for NHL patients. Further research is needed to validate these findings and explore cost-effective prognostic strategies.