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Case Reports
. 2022 Oct 15;61(20):3107-3110.
doi: 10.2169/internalmedicine.8968-21. Epub 2022 Mar 19.

Systemic Abscopal Effect of Low-dose Radiotherapy (2 Gy ×2) against Palatine Tonsil Follicular Lymphoma

Kazuto Togitani  1 , Tadashi Asagiri  2 , Mitsuko Iguchi  3 , Takuro Igawa  4 , Tadashi Yoshino  4 , Kensuke Kojima  1
Affiliations
Case Reports

Systemic Abscopal Effect of Low-dose Radiotherapy (2 Gy ×2) against Palatine Tonsil Follicular Lymphoma

Kazuto Togitani et al. Intern Med. .

Abstract

A 52-year-old man presented with palatine tonsillar swelling caused by follicular lymphoma. His tumor burden was low, but exacerbation of snoring and dysphagia was observed. Considering the first wave of coronavirus disease 2019 (COVID-19) pandemic, he received palliative 4-Gy irradiation to the tonsils in 2 fractions, which induced partial regression of tonsillar swellings and eradication of the circulating lymphoma cells. We suggest that low-dose radiotherapy triggered an abscopal effect of lymphoma, which allowed the patient time to receive COVID-19 vaccination before starting immunosuppressive chemo-immunotherapy.

Keywords: CD5; abscopal effect; follicular lymphoma; low-dose radiotherapy.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Kensuke Kojima: Research funding, Eisai, Daiichi-Sankyo, Kyowa-Kirin, Otsuka Pharmaceutical and Asahi Kasei; Honoraria, Janssen Pharmaceutical, AstraZeneca and AbbVie.

Figures

Figure 1.
Figure 1.
Peripheral blood smear showed circulating lymphoma cells.
Figure 2.
Figure 2.
A biopsy specimen of the tonsil showed follicle-like architecture with lymphoma infiltration. The cells were positive for CD20, BCL2, CD5, and LEF1; Ki-67low; and negative for CD10 and MUM1. CD21-positive follicular dendritic meshworks were observed in follicular areas. HE: Hematoxylin and Eosin staining
Figure 3.
Figure 3.
Clinical course of the patient. COVID-19: coronavirus disease 2019
See this image and copyright information in PMC

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