CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.
-
Upload
darcy-eaton -
Category
Documents
-
view
225 -
download
0
Transcript of CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.
![Page 1: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/1.jpg)
CPC #5
Pathology
![Page 2: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/2.jpg)
![Page 3: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/3.jpg)
![Page 4: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/4.jpg)
![Page 5: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/5.jpg)
CD3
![Page 6: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/6.jpg)
CD3
![Page 7: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/7.jpg)
CD20
![Page 8: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/8.jpg)
CD20
![Page 9: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/9.jpg)
Ki-67
![Page 10: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/10.jpg)
Ki-67
![Page 11: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/11.jpg)
Diagnosis
Intravascular Large B-Cell Lymphoma
![Page 12: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/12.jpg)
Intravascular Large B Cell Lymphoma
• Extranodal Diffuse Large B Cell Lymphoma characterized by lymphoma cells confined to lumen of small vessels
• Affects adults• Symptoms arise from occlusion of capillaries• Absence of homing recptors on neoplastic cells
– CD29 (B1-integrin)– CD54 (ICAM-1)
![Page 13: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/13.jpg)
Intravascular Lymphoma: Presentation
• Skin-plaques and nodules
• CNS-dementia, focal neurologic deficits– DDX: Vasculitis
• Fever of Unknown Origin
![Page 14: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/14.jpg)
Intravascular Lymphoma: Prognosis
• Thought to have poor prognosis– Delay in diagnosis– Poor response to chemotherapy– Cutaneous-only cases (almost always females) may
be a better prognosis
• DiGiuseppe JA, Nelson WG, Seifter E, Boitnott JK, Mann RB. J Clin Oncol 1994;12: 2573-9.– Aggressive combination chemotherapy can yield
long term survival
![Page 15: CPC #5 Pathology. CD3 CD20 Ki-67 Diagnosis Intravascular Large B-Cell Lymphoma.](https://reader034.fdocuments.in/reader034/viewer/2022050805/56649eb55503460f94bbdc49/html5/thumbnails/15.jpg)
Follow-Up on This Case• On 12/29/2008 the patient was transferred to begin
chemotherapy for intravascular lymphoma. CHOP therapy was initiated and her altered mental status resolved rather quickly.
• As of 10/20/2009 the patient is status post 6 cycles of R-CHOP, the last being in 05/09. Her course has been complicated by a sacral decubitus ulcer with associated osteomyelitis for which she was treated with 6 course of vancomycin and cefepime which was completed on 09/10/09. She also has indwelling foley catheter with chronic contamination of C-candida glabrata.