vijaya raj bhatt

Immune therapy and graft-versus-tumor effect seen after allogeneic hematopoietic stem cell transplantation provide proof-of-principle of the ability of human immune system to control cancer. Spontaneous regression of cancer is another dramatic evidence of the existence of powerful immune surveillance in human body. We report a 54-year-old man with 13q14 deleted chronic lymphocytic leukemia and diffuse lymphadenopathy, who had spontaneous normalization of leukocytosis and resolution of lymphadenopathy thirteen years after the diagnosis of chronic lymphocytic leukemia. Better understanding of spontaneous regression may help elucidate body’s immune response against tumor cell. This may further enhance the development of immune therapies and provide insight towards tumorigenesis.

The development of fevers, night sweats and weight loss or ‘B-symptoms’ are some of the early indications of possible relapse in lymphoma survivors. However, these symptoms are non-specific and could be the result of many other medical conditions. We report a case of a woman with the prior history of lymphoma who presented with B symptoms (drenching sweats and weight loss) and hypermetabolic cervical lymph node enlargement. This was highly suspicious for recurrent lymphoma, however, the biopsy of the lymph node was negative. Further evaluation revealed the presence of thyrotoxicosis. As illustrated by this case report, what seems like an obvious relapse is not always a lymphoma. Understanding such possibilities is important for the management of lymphoma survivors.