A 68-year old patient presented with flank pain caused by a large renal mass. A nephrectomy was performed because renal cell carcinoma was suspected. Pathological examination showed a diffuse large B‑cell lymphoma. Primary renal manifestation of a lymphoma is rare. The diagnosis is often missed or only recognized after a nephrectomy is performed. A primary renal lymphoma must be considered when radiologically a hypovascular, diffuse growing process is seen, without the characteristic signs of renal cell carcinoma, like calcifications and vascular invasion. Diagnosis can be confirmed by biopsies and, once histologically proven, curative treatment with chemo-immunotherapy...

Treatment of choice for high risk basal cell carcinoma (BCC) of the face is Mohs micrographic surgery. Radiotherapy can be applied when surgery will result in cosmetic and/or functional morbidity. Patients with locally advanced or metastatic BCC can be treated with vismodegib or sonidegib. R-CHOP is used frequently in the treatment of several B-cell non-Hodgkin lymphomas, but effectiveness in the treatment of BCC is unknown. Here we present an impressive clinical and histological response of a locally advanced BCC of the face after treatment with R-CHOP for diffuse...

Central nervous system (CNS) involvement in systemic B-cell non-Hodgkin lymphoma (B-NHL) at diagnosis (sysCNS) is rare. We investigated the outcome of 21 patients with sysCNS, most commonly diffuse large B-cell lymphoma, treated with high dose methotrexate (HD-MTX) and R-CHOP. The median number of cycles of HD-MTX and R-CHOP was 4 (range 1-8) and 6 (range 0-8), respectively. Consolidative whole brain radiotherapy (WBRT) was given to 33% (7/21) patients. With a median follow-up of 44 months the 3-year progression free survival (PFS) and overall survival (OS) were 45% (95%CI...

Antigen presentation by tumor cells in the context of Human Leukocyte Antigen (HLA) is generally considered to be a prerequisite for effective immune checkpoint inhibitor therapy. We evaluated cell surface HLA class I, HLA class II and cytoplasmic HLA-DM staining by immunohistochemistry (IHC) in 389 classical Hodgkin lymphomas (cHL), 22 nodular lymphocyte predominant Hodgkin lymphomas (NLPHL), 137 diffuse large B-cell lymphomas (DLBCL), 39 primary central nervous system lymphomas (PCNSL) and 19 testicular lymphomas. We describe a novel mechanism of immune escape in which loss of HLA-DM expression results...

Immune checkpoint inhibitors are being tested in clinical trials and show great promise in the treatment of classical Hodgkin lymphoma (cHL). The proposed mechanism of action of these inhibitors consists of reactivating T lymphocytes that have become unresponsive as a consequence of inhibitory mechanisms exerted by the tumor cells. These reactivated T cells are expected to kill tumor cells after recognizing tumor cell derived antigens that are presented by Human Leukocyte Antigens (HLA) at the tumor cell surface. Consequently, lack of tumor cell surface expression of HLA may...