Problema Diagnostik dan Respons Kemoterapi pada Seorang Penderita Classical Limfoma Hodgkin Tipe Mixed Cellularity dengan Temporary Spontaneus Regression
[Difficult Case of Classical Hodgkin Lymphoma Mixed Cellularity Type with Temporary Spontaneous Regression]
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Background: Mixed cellularity classical hodgkin lymphoma (MCCHL) is the secound subtype of classical hodgkin lymphoma (cHL) which often happens. MCCHL is aggressive but has a relatively high recovery rate. The diagnosis of cHL is sometimes difficult. Spontaneous regression can occur in cHL but is very rare, temporary or permanent. CHL including diseases with a fairly high cure rate, about 80% of patients recover with first-line chemotherapy. Case: Male age 26 years, 9 months cough, shortness of breath, chest pain 8 months, 6 months fever disappear with enlargement of right supraclavicular lymph nodes appearing at 11 days before admission. Chest X-ray shows the presence of mediastinal mass supported by contrast thoracic CT scan. FNAB has been done three times with no meaningful results. In one of the chest radiographs and CT scan of the thoracic with contrast evaluation showed a reduction in tumor size. Open thoracotomy biopsy is performed with Hodgkin's lymphoma results. On immunohistochemical examination obtained MCCHL. Chemotherapy with ABVD regimen was administered for three cycles with partial remission and was continued with 6 cycles with stable disease outcomes. Conclusion: Spontaneous temporary regression in cases with mediastinal tumor suspicion may occur in cHL and may cause difficulties in diagnosing. Open biopsy is required as a gold standard and has to be supported by immunohistochemical test. First-line chemotherapy response in cHL is good.
Al-Tonbary, Y. Epidemiology of hodgkin's lymphoma, hodgkin's lymphoma, Dr. Nima Rezaei (Ed.), ISBN: 978-953-51-0402-5, InTech, (2012) Available from: http://www.intechopen.com/books/ hodgkin-slymphoma/epidemiology-of-hodgkin-s-lymphoma
Leukemia and Lymphoma Society. Hodgkin lymphoma. Leukemia and Lymphoma Society. 2013; 1–44
Eberle FC, Mani H, Jaffe, ES. Histopathology of hodgkin's lymphoma. Cancer J 2009;15: 129–137.
Derenzini E, Younes A. Predicting treatment outcome in classical hodgkin lymphoma: genomic advances. Genome Medicine. 2011(3);26: 1–13.
Union for International Cancer Control. Hodgkin lymphoma(adult) in review of cancer medicines on the WHO list of essential medicines. Union for International Cancer Control. 2014; 1–9.
American Cancer Society. Hodgkin disease. American Cancer Society. 2014. Available from: www.cancer.org
Wendy S, Moreland. MD, Kim R. Utility and outcomes of fine-needle aspiration biopsy in Hodgkin's disease. Diagnostic cytopathology. 2002;26(5): 278–282.
Covarrubias-Espinoza. G, Rivera-Gomez R, Rendon-Garcia H. The use of imprint and fine needle aspiration biopsy in early malignancy diagnosis. Bol Clin Hosp Infant Edo Son. 2012;29(2): 53–57.
Zhang S, Yu X, Zheng Y, Xie J, Zhou X. Value of fine needle aspiration cell blocks in the diagnosis and classification of lymphoma. Int J Clin Exp Pathol. 2014;7(11): 7717–7725.
Mayall F, Darlington A, Harrison B, Fine needle aspiration cytology in the diagnosis of uncommon types of lymphoma. J Clin Pathol. 2013;56: 821–825.
Listinsky CM. A practical approach to the diagnosis of Hodgkin Lymphoma. Am J Clin Pathol. 2002;117: 76–94.
Kappauf HW. Spontaneous remission of cancer-enigma and paradigm. Onkologie. 2006:29: 129–130.
Mohsen A, Ghanem H, El-Bayoumi J, Tabbara I. Spontaneous regression of classical hodgkin lymphoma: A case report and review of the literature. Clinical Advanced in Hematology & Oncology. 2012;10: 763–764.
Thirukonda V, Petrich A, Parekh S. Classical hodgkin lymphoma and spontaneus regression. Clinical Advanced in Hematology & Oncology. 2012;10: 765–766.
Oluwole O, Samaila M. Spontaneus tumour regression. The Internet Journal of Pathology. 2005;8(1): 1–4.
Lymphoma Research Foundation. Understanding hodgkin lymphoma: A guide for patients, survivors and loved ones 3rd ed. Lymphoma Research Foundation. 2009; 1–107.
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