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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The preferred histopathological classification of Hodgkin's disease (HD) is that suggested by Lukes and Butler as modified at the Rye Symposium; the histologic subtypes are highly reproducible and correlate well with the anatomic sites of involvement, clinical stage, and survival. The accuracy of the bipedal lymphangiogram, 67gallium scan, and ultrasonography in predicting abdominal involvement by HD is 90% , 50%, and 88%, respectively. Staging laparotomy remains the most accurate method of detecting intra-abdominal disease and has added immensely to new concepts in the management of HD. These concepts suggest that patients with nodal disease limited to the celiac axis or upper para-aortic areas (substage III1) or pathologic stage (PS) IIIS+N-A, when treated with extended field radiotherapy alone have survival rates comparable to PS IIA patients. In contrast, patients in PS IIIA with lower abdominal nodal disease (substage III2), regardless of splenic involvement, have a prognosis comparable to PS IV disease. Thus, there may only be two stages of HD, those curable with extended mantle or smaller radiotherapy fields alone, and those requiring chemotherapy with or without supplemental radiotherapy.
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PMID:Hodgkin's disease: problems of staging. 15 Sep 39

An etiologic study was made of 107 cases of granulomatous hepatitis which were observed in a Department of Internal Medicine between January, 1971 and December, 1977 (excluding the hepatobiliary diseases). The most common etiology was tuberculosis (30 cases, 28 percent) followed by sarcoidosis (19 cases, 17.7 percent), Mediterranean exanthematous fever (13 cases, 12.1 percent), brucellosis (8 cases, 7.4 percent) typhoid fever (7 cases, 6.5 percent) and the idiopathic forms (8 cases, 7.4 percent). A lower rate of incidence was among Hodgkin's disease, toxoplasmosis, adenocarcinomas, leprosy, and those of unknown etiology, classified in this way because the study and follow-up of the patients could not be completed. There were, moreover, individual cases caused by mononucleosis, BCG reaction, hypogammaglobulinemia, celiac disease, and temporal arteritis. From a clinical point of view 50 percent of the patients had hepatomegaly and moderate disturbance of the liver enzymes. The most important enzymatic increases were detected in the cases caused by brucellosis; in the cases which were secondary to sarcoidosis the liver enzymes were normal. A comparison is established between the etiologic incidence of the present series and of others published in the literature. The causes and diagnostic problems of this type of lesion are discussed.
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PMID:[Granulomatous hepatitis. Etiologic study of 107 cases (author's transl)]. 45 94

In this series, the commonest aetiology was tuberculosis (30 cases, 28%), followed by sarcoidosis (18 cases, 17,7%), mediterranean fever (Olmer's disease) (13 cases, 12,1%), brucellosis (8 cases, 7,4%), typhoid fever (7 cases, 6,6%) and idiopathic forms (8 cases, 7,4%). These were followed by Hodgkin's disease, toxoplasmosis, adenosarcoma, and leprosy. Finally, there were single cases due to infectious mononucleosis, B.C.G. reaction, hypogammaglobulinaemia, coeliac disease and temporal arteritis. Half of the patients had hepatomegaly and an increase, in general moderate, in hepatic enzymes (transaminases, alkaline phosphatase). The highest enzyme levels were seen in cases of brucellosis, hepatic enzymes being normal in patients with sarcoidosis.
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PMID:[Granulomatous hepatitis: aetiological study of 107 cases (author's transl)]. 73 1

Fifty-two patients with pathologic stage III Hodgkin disease were studied in an effort to determine whether location of involved abdominal nodes influenced survival. Treatment consisted of total nodal radiotherapy with or without subsequent combination chemotherapy. Th initial radiation field was the "extended mantle," which included supradiaphragmatic nodes, the splenic hilar area, and paraaortic nodes to the level of L2-L4. Subsequently, lower paraaortic and iliac regions were treated ("lower inverted Y"). Patients with disease limited to the spleen and/or splenic, celiac, or portal nodes ("anatomic substage" III1) had a more favorable 5-yr survival than did patients with involvement of paraaortic, iliac, or mesenteric nodes ("anatomic substage" III2): 93% versus 57%, respectively (p less than 0.05). The addition of combination chemotherapy to total nodal irradiation was associated with improved survival of patients in stage III2, but not of those in stage III1.
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PMID:Prognostic classification of Hodgkin disease in pathologic stage III, based on anatomic considerations. 86 75

Fifty consecutive patients with the diagnosis of Hodgkin's disease, confirmed by lymph node biopsy, underwent preoperative clinical assessment and staging laparotomy between 1969 and 1974. Preoperative evaluation consisted of bone marrow examination, liver and spleen scans, intravenous pyelograms, lymphangiograms, and standard chemical laboratory tests. Operative evaluation consisted of splenectomy, liver biopsy, periaortic, mesenteric, and celiac lymph node biopsy, appendectomy, and iliac crest bone biopsy. Twenty-three patients (46 per cent) were improperly staged by preoperative clinical assessment, with twelve patients being overstaged and eleven patients being understaged. Liver and spleen scans, and intravenous pyelograms were of little value in assessing organ involvement with Hodgkin's disease. Lymphangiograms similarly were of questionable value, being interpreted as positive in twenty-one patients but histologically involved in only seven patients (overread, 67 per cent. Fourteen patients had negative lymphangiograms, with five being histologically involved (underread, 36 per cent). There was a 22 per cent incidence of pulmonary complication (atelectasis, pneumonitis) but no deaths or life-threatening complications.
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PMID:The staging of Hodgkin's disease. Preoperative clinical assessment versus operative evaluation. 120 Feb 76

Modern treatment plans for early staged Hodgkin's disease must focus on optimal disease-free survival results without laparotomy, minimal acute toxicity, and reduced long-term complications. We have treated 69 adult patients with stage I-II Hodgkin's disease, 40 of whom had bulky disease, B symptoms, or hilar disease, and 22 with stage III disease with 3 cycles of NOVP (Novantrone, vincristine, vinblastine, prednisone) and radiotherapy. Only patients with stage III1 disease involving the celiac axis without para-aortic or pelvic involvement, had to undergo laparotomy prior to treatment. Three patients did not respond to NOVP: two of these did not respond to MOPP or ABDIC, and two are currently without relapse following bone marrow transplant. With a median follow-up of 18 months, 62 with stage I-II and 19 with stage III remain without relapse, and 91 patients are alive. Tolerance to therapy was excellent with minimal nausea, myalgias, and alopecia. We conclude that this regimen for Hodgkin's disease provides good results for clinically staged I-III disease, but longer follow-up may demonstrate prognostic factors which will influence our results.
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PMID:NOVP and radiotherapy for early-staged Hodgkin's disease: an interim analysis. 145 86

Using a newly established HTLV-1 positive T cell line as an immunogen, a new monoclonal antibody, Ber-ACT8, was produced. It reacts with in vitro activated T cells and a small subset of normal resting T cells, but not with resting B cells or any of the 29 established human permanent cell lines tested. Immunohistological analysis of a wide spectrum of human tissues showed that Ber-ACT8 reactivity is restricted to a few T cells in the peripheral blood, the extrafollicular areas of lymph nodes and tonsils, and splenic red pulp. In the gut Ber-ACT8 labelled most intraepithelial T cells and up to 50% of lamina propria T cells. The antibody also immunostained T cells present in the oral and bronchial mucosa. Double labelling on splenic cells, fresh blood lymphocytes, and in vitro activated T cells showed that most Ber-ACT8 positive cells coexpressed CD8. Ber-ACT8 did not react with any of the 14 Hodgkin's lymphomas nor any of the 172 non-Hodgkin's lymphomas tested, with the exception of 10 cases of T cell lymphomas, five of which were located in the jejunum and associated with coeliac disease, and one B cell lymphoma, and most cases of hairy cell leukaemia tested. Parallel immunostainings with Ber-ACT8, anti-TCR-beta (beta F1), and anti-TCR-delta showed that most Ber-ACT8 positive T cells carry the TCR of alpha beta type. Comparison of Ber-ACT8 with HML-1, B-ly7, and LF61 showed essentially the same reactivity and an identical molecular target. The molecular structure recognised seems to be a trimeric molecule with components of 150, 125 and 105 kilodaltons, with the Ber-ACT8 epitope localised on the 150 kilodalton chain. The 150 kilodalton molecule contains an 0-linked carbohydrate moiety of about 10 kilodaltons. Because of its very selective distribution, the trimeric antigen is a powerful reagent for the diagnosis of gut T cell-derived T cell lymphomas and other extranodal T cell lymphomas, as well as hairy cell leukaemia.
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PMID:Ber-ACT8: new monoclonal antibody to the mucosa lymphocyte antigen. 189 Jan 96

Placental ferritin is a tumour associated antigen present in the serum of patients with active Hodgkin's and non-Hodgkin's lymphoma, and the serum values fall during remission of the disease. There is no correlation between placental and total blood ferritin values. Because of the strong association between coeliac disease and lymphoma, 19 children with active and 25 with inactive coeliac disease were screened for the presence of placental ferritin. Thirty two children with other intestinal disorders served as controls. Placental ferritin was identified by using a monoclonal antibody in an ELISA procedure. The mean (SEM) placental ferritin value in the control serum was 12.6 (2.4) while the values in serum of patients with active and inactive coeliac disease were 117 (22.8) and 43.8 (10.2) U/ml respectively. Patients with active coeliac disease differed significantly from both control subjects (p = 0.0004) and those with inactive disease (p = 0.03). Peripheral blood lymphocytes contained no placental ferritin. It was present, however, in lamina propria lymphocytes of intestinal biopsy specimens from active coeliacs. Placental ferritin was also found in some of the better differentiated malignant cells in two patients with adult onset enteropathy associated lymphoma. Placental ferritin is known to have an immunosuppressive effect, and this may be one of the necessary steps in the development of malignancy associated with coeliac disease. Gluten free diet, by reversing this state, may have a role in the prevention of lymphoma.
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PMID:Placental ferritin in coeliac disease: relation to clinical stage, origin, and possible role in the pathogenesis of malignancy. 191 5

The authors present a simplified radiographic classification of non-Hodgkin lymphoma involving the small intestine. The classification system is based on radiographic findings in 22 pathologically proved cases of lymphoma involving the small bowel and consists of three major forms: primary, lymphoma complicating celiac disease, and mesenteric nodal. In this series, small bowel lymphoma was evenly distributed in the jejunum and ileum. The most common radiographic patterns were circumferential lesion (seven cases), cavitary lesion (four cases), and mesenteric nodal disease invading the small bowel (seven cases). Obstructive symptoms were usually encountered with the mesenteric nodal form. Lymphoma complicating celiac disease was typified by multiple, thickened, nodular folds involving a segment of proximal small intestine.
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PMID:Non-Hodgkin lymphoma of the small intestine. 225 69

In subdiaphragmatic Hodgkin's disease the most common sites of involvement include the para-aortic region, in particular the celiac trunk, the splenic pedicle, and the spleen. In treatment planning, no imaging modalities (i.e. lymphography, CT, US) have so far been able to realize the need for direct imaging of any of these areas on a simulation film, necessary for individual beam shaping. With intravenous digital subtraction angiography (IV DSA) a new imaging method is available that allows direct imaging of these regions in a frontal view. The way and extent the splenic artery crosses the left kidney can exactly be delineated. By using a subtrascope (as common in angiography) the DSA can exactly be superimposed and documented on a simulation film. The DSA drawn onto the simulation film serves as a base for defining an individual target volume in the upper abdominal region (splenic pedicle etc.). The kidney can be shielded in a highly individualized way by individual beamshaping blocks. From December 1985 to December 1986, we treated 35 patients by using this technique for treatment planning. In 32 evaluable patients the imaging accuracy for all sites was judged as "excellent" in 74%, "reasonable" in 19%, and "poor" in 7%. The course of the splenic artery in relation to the left kidney revealed 78% within or above the upper third. By DSA assisted localization the target volume could be accurately defined in every case with shielding of the kidney as much as possible. Compared to nonindividualized standard definitions ("including L1" and "including upper third of the kidney") DSA assisted individual target volume definition was more precise: "including L1" overestimates in 63%, "including upper third" underestimates in 53%. Compared to the standard definition ("including L1") reduction of up to 25% kidney volume to be irradiated could be achieved in 63%. DSA could be performed on an outpatient basis. The median duration of DSA performance was 20 minutes; superimposing and drawing at the subtrascope took median 20 minutes. There were no severe side effects.
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PMID:Digital subtraction angiography (IV DSA) in treatment planning of subdiaphragmatic Hodgkin's disease. 266 67


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