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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary splenic lymphoma is a relatively infrequent disease; the diagnosis of this entity is currently made with splenectomy. In a 52-year-old female with left upper quadrant abdominal pain, ultrasound showed a normal-sized spleen with an internal hypoechoic focal lesion. Ultrasonically-guided fine-needle aspiration and tissue core biopsy of the splenic lesion showed non-Hodgkin's lymphoma (NHL). At the time of presentation there was no evidence of involvement of lymph nodes, bone marrow or any other organ. A diagnosis of primary splenic non-Hodgkin's lymphoma was made and the patient underwent laparotomy with splenectomy. Histologic examination of the spleen confirmed the diagnosis: low-grade NHL confined to the spleen. The patient is well and in complete remission seven months after diagnosis. The purpose of this paper is to report a rare occurrence of primary splenic lymphoma and to demonstrate the possibility of making this diagnosis by percutaneous guided biopsy.
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PMID:Primary lymphoma of the spleen. Report of a case with diagnosis by fine-needle guided biopsy. 767 17

Primary pancreatic lymphoma is a rare neoplasm that reportedly regresses promptly with aggressive chemotherapy. Recently, the role of surgical management has been relegated to biopsy alone. The aim of this study was to review our experience with primary pancreatic lymphoma and to determine the outcome of patients managed by radiation therapy and/or chemotherapy. From 1952 to 1991, 107 patients with non-Hodgkin's lymphoma involving the pancreas were identified. Twelve patients (11%) had primary pancreatic lymphoma. The presenting symptoms and signs were nonspecific: abdominal pain (83%), weight loss (50%), and a palpable mass (58%). Six of the 12 patients (50%) undergoing celiotomy had a preoperative diagnosis of pancreatic carcinoma. These lymphomas were large (x = 8 +/- 2 cm) and deemed unresectable because of size, alleged mesenteric vessel encroachment, regional lymph node metastasis, or because of an intraoperative diagnosis of lymphoma. Biopsy alone was performed in 50% of patients and biliary bypass and/or gastroenterostomy was performed in 25% of patients. A single resection (pancreatoduodenectomy) was performed 1 year after a full course of chemotherapy had failed. Ten patients, all of whom died of progressive lymphoma, received primary postoperative radiation therapy and/or chemotherapy, and no patient was disease-free at follow-up. Mean survival was 13 months for patients who received chemotherapy alone (n = 2), 22 months for those treated with radiation therapy only (n = 5), and 26 months for those receiving combined radiation therapy and chemotherapy (n = 3).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pancreatic lymphoma: is it a surgical disease? 780 23

A 33 year old patient was admitted to the hospital because of deteriorated general condition, upper abdominal pain and progressive dyspnea. He had a positive HIV-serology associated with i.v. drug abuse. The CDC classification on admission was B1. There was no history of opportunistic infections, the patient had refused all prophylactic treatment. The physical examination showed an elevated central venous pressure, decreased breath-sound and percussible dullness, the liver was enlarged and a tumor was palpable on chest. The x-ray of the thorax confirmed a pleural effusion. Cytology of the effusion revealed blasts of malignant non-Hodgkin's lymphoma of B-cell type. A CT-scan of the thorax and abdomen showed a tumor mass in the right ventricle and superior vena cava, a pleural effusion and multiple lesions in the liver. The patient refused a palliative chemotherapy with vincristine and prednisone and died few days after admission.
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PMID:[Upper influx distension in a patient with HIV; unusual localization of an HIV-associated lymphoma]. 784 32

Preclinical studies of recombinant human interleukin-3 (rhIL-3) and granulocyte-macrophage colony-stimulating factor (rhGM-CSF) have shown enhancement of multilineage hematopoiesis when administered sequentially. This study was designed to evaluate the safety, tolerability, and biologic effects of sequential administration of rhIL-3 and rhGM-CSF after marrow ablative cytotoxic therapy and autologous bone marrow transplantation (ABMT) for patients with malignant lymphoma. Thirty-seven patients (20 patients with non-Hodgkin's lymphoma and 17 patients with Hodgkin's disease) received one of four different treatment regimens before ABMT. Patients were entered in one of four study groups to receive rhIL-3 (2.5 or 5.0 micrograms/kg/day) administered by subcutaneous injection for either 5 or 10 days starting 4 hours after the marrow infusion. Twenty-four hours after the last dose of rhIL-3, rhGM-CSF (250 micrograms/m2/d as a 2-hour intravenous infusion) administration was initiated. rhGM-CSF was administered daily until the absolute neutrophil count (ANC) was > or = 1,500/microL for 3 consecutive days or until day 27 posttransplant. The most frequent adverse events in the trial included nausea, fever, diarrhea, mucositis, vomiting, rash, edema, chills, abdominal pain, and tachycardia. Three patients were removed from the study because of chest, skeletal, and abdominal pain felt to be probably related to study drug. Four patients died during the study period because of complications unrelated to either rhIL-3 or rhGM-CSF. The median time to recovery of neutrophils (ANC > or = 500/microL) and platelets (platelet count > or = 20,000/microL) was 14 and 15 days, respectively. There were fewer days of platelet transfusions than seen in historical control groups using rhGM-CSF, rhG-CSF, or rhIL-3 alone. In addition, there were fewer days of red blood cell transfusions compared with historical controls using no cytokines or rhGM-CSF. These data indicate that the sequential administration of rhIL-3 and rhGM-CSF after ABMT is safe and generally well-tolerated and results in rapid recovery of multilineage hematopoiesis.
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PMID:Sequential administration of recombinant human interleukin-3 and granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for malignant lymphoma: a phase I/II multicenter study. 791 29

Primary colonic lymphomas are rare, but we identified 15 cases at our institution between 1973 and 1992. They comprised 5.8% of all cases of gastrointestinal lymphoma (15 of 259) and 0.16% of all cases of colon cancer (15 of 9,193) during the last 20 years. The most common presenting symptoms were abdominal pain and weight loss (40% each). In seven patients (47%), a palpable abdominal mass was noted on the initial physical examination. The most frequent site of involvement was the cecum (73%). Histologically, six (40%) were classified as high-grade and nine (60%) as intermediate-grade non-Hodgkin's lymphoma. The tumors usually presented at an advanced stage: in 13 of 15 patients (87%), the lymphoma had spread to the adjacent mesentery, the regional lymph nodes, or both when first diagnosed. The 5-year survival rate was 27% for all patients and 33% (4 of 12) for patients treated with combination chemotherapy. Two patients relapsed after 8 years of complete remission. Primary colonic lymphomas have an aggressive behavior and only a marginal response to surgery and combination chemotherapy.
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PMID:Primary colonic lymphoma. Clinical presentation, histopathologic features, and outcome with combination chemotherapy. 807 13

Most patients who present with a large solid renal mass and evidence of advanced malignancy will have primary renal cell carcinoma but a small subset with similar features have different and more treatable malignancies. We identified 7 patients with clinical and radiological findings suggestive of metastatic renal cell carcinoma who were ultimately diagnosed as have non-Hodgkin's lymphoma (5), germ cell tumor (1) or transitional cell carcinoma (1). Two of these patients presented with abdominal pain, gross hematuria and a flank mass. Computerized tomography was interpreted as showing renal cell carcinoma in all patients, although lymphoma and sarcoma were included in the differential diagnoses in 2. With the correct diagnosis and appropriate therapy, 4 of the 7 patients are currently disease-free. We emphasize the need for histological documentation in such patients in view of curative therapy available for possible underlying neoplasms simulating renal cell carcinoma.
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PMID:Renal masses simulating primary renal cell carcinoma in patients with advanced malignancies. 818 57

A 50-year-old man was diagnosed with non-Hodgkin's lymphoma (NHL) in 1980; he was treated with chemotherapy and achieved complete remission. Six years later he reported upper abdominal pain. Ultrasound (US) showed a 3-cm mass in the right lobe of the liver. Needle aspiration showed hepatocellular carcinoma (HCC). The patient was treated with radical resection of the tumor. Three years later (June 1989), abdominal US showed two lesions in the right lobe of the liver. Needle aspiration and tissue core biopsy showed NHL in one lesion and HCC in the other. The lymphomatous lesion resolved after chemotherapy. The patient died 30 months later (January 1992) from a gastrointestinal hemorrhage; the NHL was in complete remission. This case of the simultaneous presence of HCC and hepatic lymphoma is, to our knowledge, the first diagnosed in vivo.
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PMID:Simultaneous relapse of liver cell carcinoma and non-Hodgkin's lymphoma in the liver. Report of a case with diagnosis by ultrasonically guided fine needle aspiration biopsy. 819 41

A nationwide multi-center cooperative phase II clinical study of irinotecan hydrochloride (CPT-11) was conducted to evaluate its efficacy in intractable malignant lymphoma and acute leukemia. In malignant lymphoma, one course of CPT-11 consisted of intravenous drip infusion at a dose of 40 mg/m2 once daily for 3 consecutive days, performed once a week. In acute leukemia, one course of CPT-11 consisted of intravenous drip infusion at a dose of 15 to 20 mg/m2 a day twice daily for 7 consecutive days (1 cycle), performed every 2 to 4 weeks. Among the 79 patients with malignant lymphoma and 50 patients with acute leukemia enrolled in the study, 66 and 41 patients, respectively, completed treatment. These patients had all undergone chemotherapy prior to treatment. Among the malignant lymphomas, the response rate in non-Hodgkin's lymphoma (NHL), including 9 CRs, was 42% (26/62, 95% CI: 30-54%); of these there was a response rate of 39% (5/13), including 1 CR, in adult T-cell leukemia (ATL) as well. In Hodgkin's disease (HD), on the other hand, there were no cases in which efficacy was demonstrated (0/4). The overall response rate in malignant lymphoma was 39% (26/66), and the response rate even among the recurrent intransigent cases was 42% (16/38). The 50% survival time (MST) in the 74 eligible cases of malignant lymphoma was 153 days. In acute leukemia, on the other hand, partial remission was observed in 2 of 17 cases (12%) of acute lymphocytic leukemia (ALL), but no cases of remission were observed in the 24 patients with acute myelogenous leukemia (AML). The overall remission rate in acute leukemia was 5% (2/41, 95% CI: 1-14%). The principal adverse effects were myelosuppression in malignant lymphoma and gastrointestinal symptoms, including diarrhea, nausea/vomiting, anorexia and abdominal pain, in both malignant lymphoma and acute leukemia, and there was little organ damage to the heart, liver or kidney. Myelosuppression and gastrointestinal adverse effects were severe in some of the patients, so caution is required. Based on the above findings, CPT-11 appears to be efficacious in the treatment of non-Hodgkin's lymphoma.
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PMID:[Late phase II clinical study of irinotecan hydrochloride (CPT-11) in the treatment of malignant lymphoma and acute leukemia. The CPT-11 Research Group for Hematological Malignancies]. 821 Feb 56

During the period of 1978-1988, 36 patients were treated for primary gastrointestinal non-Hodgkin's lymphoma (PGIL) at the Second Department of Surgery, Helsinki University Central Hospital. There were 16 gastric, 15 small intestinal, four large bowel lymphomas, and one case of diffuse multiple lymphomatous polyposis (MLP) of the gastrointestinal tract. Most frequently the disease occurred in middle-aged patients equally in both sexes. Symptoms were non-specific. Abdominal pain was the most common symptom occurring in 30 patients (83%), followed by nausea in 17 patients (47%). Fever occurred in seven patients (20%). Bleeding occurred in ten patients (28%), obstruction in five (14%), and perforation in three patients (8%). An abdominal mass was felt in ten patients (28%). Radiological findings were mostly non-specific but suggested malignant tumour. A definitive diagnosis was difficult to confirm by endoscopic examination. Thirty-five patients underwent surgery, curative in 19 (12 gastric, five small intestine lymphomas (SIL), two large intestine lymphomas (LIL)), and palliative in 12 patients (two gastric, eight SIL, one LIL, and one case of MLP). One patient (gastric) underwent exploration and three had other procedures (two SIL, one LIL). 89% of the patients who had a curative resection survived five years, compared with 28% of those who had palliative resection. The stage of the disease was a very important prognostic factor: the five-year survival was 92% for patients with Stage I disease, while none of the patients with Stage IV disease survived five years. Also, adjuvant therapy was a statistically significant variable affecting survival, and the site of the tumour. Patients with gastric lymphoma had better survival than those with small and large intestinal lymphoma.
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PMID:Primary gastrointestinal non-Hodgkin's lymphomas. Clinical presentation and results of treatment. 832 33

Even though the close association between AIDS and non-Hodgkin's lymphoma (NHL) is widely known, few studies have evaluated the frequency of gastrointestinal involvement in a large series of AIDS patients with heterogeneous risk factors. We therefore reviewed the demographic and clinical features of patients with AIDS and NHL seen at our institution over a period of 5 years. NHLs complicated AIDS in 70 of 786 (9%) cases in our study. All but one of the tumours were of high- or intermediate-grade histologic subtype, and 80% of 56 patients with diagnosis made during lifetime had disease stages III or IV, most with extranodal localization. The gastrointestinal tract was involved in 23 cases (33%), 13 of whom had an antemortem diagnosis. All these patients complained of significant symptoms, the most frequent being GI bleeding followed by recurrent abdominal pain with or without masses. Three patients had evidence of lymphomatous disease along both the upper and lower GI tract, but more often a single localization was present. Prognosis of patients with NHLs was very poor, and there was no significant difference in survival between patients with and without GI localization at the time of initial diagnosis.
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PMID:Non-Hodgkin's lymphoma and AIDS: frequency of gastrointestinal involvement in a large Italian series. 848 64


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