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Treatment of diffuse large B-cell lymphoma of the liver with yttrium-90 microsphere embolization

Nature Clinical Practice Oncology volume 5, pages 677–681 (2008)Cite this article

Abstract

Background A 41-year-old male with a 4-year history of chronic hepatitis C presented with a 1-month history of abdominal pain, fatigue, weight loss, and night sweats.

Investigations Laboratory examinations, chest, abdomen, and pelvic CT scans, PET-CT scans, ultrasound-guided needle biopsies of liver lesions, bone-marrow biopsy, flow cytometry, and immunohistochemical staining for B-cell markers including CD20.

Diagnosis Chemoresistant diffuse large B-cell lymphoma, with gradual loss of CD20 antigen expression.

Management Embolization of hepatic tumors using yttrium-90 microspheres (Therasphere®, Theragenics Corporation, Buford, GA).

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Figure 1: Images of liver biopsy samples in a patient with diffuse large B-cell lymphoma.
Figure 2: CT, PET-CT and whole-body PET images obtained prior to yttrium-90 microsphere embolization in a patient with diffuse large B-cell lymphoma.
Figure 3: CT, PET-CT and whole-body PET images obtained 6 weeks after yttrium-90 microsphere embolization in a patient with diffuse large B-cell lymphoma.

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Acknowledgements

Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. TS Fenske is Assistant Professor of Medicine in the Division of Neoplastic Diseases and Related Disorders, H Benjamin is a third-year Resident in Internal Medicine, SH Kroft is Professor of Pathology and Director of Hematopathology, EJ Hohenwalter is Assistant Professor of Radiology, and WS Rilling is Professor of Radiology and Director of Vascular/Interventional Radiology, all at the Medical College of Wisconsin, Milwaukee, WI, USA.,

    Timothy S Fenske, Heather Benjamin, Steven H Kroft, Eric J Hohenwalter & William S Rilling

Authors
  1. Timothy S Fenske
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  2. Heather Benjamin
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  3. Steven H Kroft
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  4. Eric J Hohenwalter
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  5. William S Rilling
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Corresponding author

Correspondence to Timothy S Fenske.

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Competing interests

The authors declared no competing interests.

Erratum

The competing interest details for this Case Study, which appeared online on 16 September 2008, were incorrect. It was declared that the authors had no competing interests, however William S Rilling has declared competing interests with MDS Nordion, from whom he has received grant/research support. The other authors have declared no competing interests. [doi:10.1038/ncponc1257]

Supplementary information

Supplementary Figure 1

Immunohistochemistry and flow-cytometry analyses of the pleural fluid neoplastic cells in a patient with diffuse large B-cell lymphoma. (A) Immunohistochemical staining showing neoplastic cells expressing CD79a, confirming their B-cell lineage. (B) Flow-cytometry analysis of a pleural fluid specimen at the time of relapse showing a kappa-restricted population of large cells (red), which express the B-lineage marker CD22 but not CD20. Additionally, the neoplastic cells fail to express CD19, a very unusual finding in B-cell lineage non-Hodgkin's lymphoma. Normal T cells are illustrated in green. (JPG 72 kb)

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Fenske, T., Benjamin, H., Kroft, S. et al. Treatment of diffuse large B-cell lymphoma of the liver with yttrium-90 microsphere embolization. Nat Rev Clin Oncol 5, 677–681 (2008). https://doi.org/10.1038/ncponc1227

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