Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six patients who were referred to the liver unit on account of jaundice are described. A different initial diagnosis has been made in each case, these being fulminant hepatic failure, severe hepatitis with renal failure, toxoplasma hepatitis, extrahepatic obstruction, sclerosing cholangitis, and liver abscess. After delays of four weeks to 12 months from the time of first symptoms all six patients were eventually found to have advanced Hodgkin's disease (stage 4). In four patients the diagnosis was made during life, but in two only at autopsy. In four lymphoma tissue was finally demonstrable in the liver, but in two liver biopsy showed only minor non-specific changes despite grossly abnormal liver function tests. Three of the six patients were treated with chemotherapy, and two of these recovered sufficiently to leave hospital. With the encouraging survival figures now being obtained in Hodgkin's disease, an awareness of the varied hepatic manifestations of the disease may allow treatment to be instituted at an earlier stage.
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PMID:Liver disease as presenting manifestation of Hodgkin's disease. 48 87

Four patients who manifested an association between chronic liver disease and lymphoma are reported. Three of them had nonalcoholic cirrhosis and one had chronic cholangitis. Non-Hodgkin's lymphoma developed long after the presence of liver disease had been established in three of the patients. The fourth patient died of hepatic coma and Hodgkin's disease was discovered incidentally at autopsy. Drugs could not be incriminated in the development of either cirrhosis or lymphoma in any of the patients. A review of the literature is presented, and the view that the association between chronic liver disease and lymphoma is not coincidental is supported.
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PMID:Malignant lymphoproliferative disorders in chronic liver disease. Report of four cases and review of the literature. 71 48

Initial symptoms in a hitherto healthy 23-year-old man were jaundice (bilirubin 21.7 mg/dl) and pruritus, but extensive radiological, endoscopical, microbiological and laboratory investigations failed to reveal the cause. Stool culture positive for Salmonella agona suggested intrahepatic cholestasis resulting from a Salmonella cholangitis. However, antibiotic treatment was not successful. As he was in generally good health the patient declined further investigations. He returned two years later because of fatigue, lack of appetite and weight loss. Further tests now revealed lymphogranulomatosis in stage IVb of the nodular sclerosing type. The case demonstrates that cholestasis as an isolated early symptom of Hodgkin's disease can precede by years any further signs of the disease.
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PMID:[Icteric cholestasis as an early symptom in Hodgkin's disease]. 169 16

Extranodal lymphoma is not uncommon; however, lymphomatous involvement of the wall of the bile duct is rare, with only a few case reports available. Three cases were imaged with computed tomography (CT) and direct cholangiography at our institution. In one, Hodgkin disease recurred in the duct wall, producing a radiographic pattern indistinguishable from sclerosing cholangitis. In another, central sclerosis on cholangiography was associated with a separate liver mass identified by CT. This presentation of non-Hodgkin lymphoma mimicked cholangiocarcinoma. The third patient had multifocal, diffuse histiocytic lymphoma arising in the gallbladder and cystic duct, as well as in the kidneys and pancreas. Although the condition is unusual, the diagnosis of lymphoma in the bile duct wall should be considered, particularly when the cholangiographic picture of diffuse central sclerosis is associated with little or no observable mass on CT.
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PMID:Lymphoma in the wall of the bile ducts: radiologic imaging. 215 95

The hepatic histopathology was studied in 125 patients with Hodgkin's disease to determine whether there are any features other than Reed-Sternberg (RS) cells that might aid in the diagnosis of hepatic involvement by the neoplastic process. Liver biopsy specimens from 41 patients with Hodgkin's disease in the liver were compared with biopsy specimens from 84 patients without hepatic involvement. Patients with hepatic involvement by Hodgkin's disease are much more likely to have histologic evidence of portal infiltrates larger than 1 mm in diameter (78% versus 1%), acute cholangitis (85% versus 4%), portal edema (90% versus 8%), and portal infiltrates with a predominance of atypical lymphocytes (78% versus 12%) than patients with Hodgkin's disease who do not have hepatic involvement. When these features are observed alone or in combination in a liver biopsy specimen from a patient with proven or suspected Hodgkin's disease, a diligent search for RS cells is indicated, with serial sections and repeat biopsy if necessary.
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PMID:Hepatic involvement in Hodgkin's disease. Clues to histologic diagnosis. 280

A 28-year-old man with recurrent swelling of both upper eyelids was found to have increased values in several liver function tests (GOT 162 U/l, GPT 356 U/l, gamma-GT 643 U/l, bilirubin 3.0 mg/dl, alkaline phosphatase 925 U/l). Abdominal ultrasonography demonstrated lymph node enlargements up to 3 cm, dilated intra- and extrahepatic bile ducts, as well as a cyst of 3 cm size in the pancreatic tail. Endoscopic retrograde cholangiopancreatography and punch biopsy of the liver revealed sclerosing cholangitis. In addition to the eyelid swellings the patient also had protrusion of the left eyeball, blood eosinophilia (800/microliter) and marked increase in polyclonal IgG (6930 mg/dl) with lymphadenopathy suggesting the diagnosis of angioimmunoblastic lymphadenopathy with dysproteinaemia (AILD, lymphogranulomatosis X), confirmed by lymphocyte surface marker analysis. However, histological examination of a lymph node was more suggestive of a T-zone lymphoma. Treatment with ursodeoxycholic acid (250 mg three times daily) and prednisolone (initially 2 mg/kg daily) quickly led to normal biochemical values and regression of the eye changes. In addition, treatment with interferon alpha-2b (initially 3 mill. U daily for 10 days) was begun. The abnormalities in the bile ducts disappeared 6 months later. The patient has been in full remission for 25 months (prednisolone dosage reduced to 12.5/7.5 mg alternating daily and interferon alpha-2b 3 mill. U three times weekly). This response makes AILD with secondary involvement of the bile ducts the most likely diagnosis.
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PMID:[Angioimmunoblastic lymphadenopathy with dysproteinemia and sclerosing cholangitis]. 812 36

We report the case of a 65-year-old patient who was diagnosed with large-cell lymphoma arising and remaining localized in the porta hepatis, causing obstructive jaundice, and resulting into ascending cholangitis, septicemia, and acute renal failure. We discuss how jaundice can be a manifestation of both Hodgkins and non-Hodgkins lymphoma.
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PMID:Primary large cell lymphoma presenting as hilar mass and obstructive jaundice. 946 61

Hodgkin's disease (HD) usually presents with lymphadenopathy. At the time of diagnosis, mediastinal involvement is present in most patients, and purely extranodal disease is rare. We present a case of HD with disease apparently limited to the liver and spleen, and imaging and biopsy findings compatible with sclerosing cholangitis.
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PMID:Biliary involvement in Hodgkin's disease. 1216 56

This report describes the case of a 74-year-old woman who had previously had a metal stent placed to relieve jaundice resulting from a pancreatic head tumor, suspected to be adenocarcinoma. The tumor was subsequently found to be a non-Hodgkin's large-cell lymphoma, which had shown a rapid response to chemotherapy without tumor recurrence in over 3 years since the diagnosis. She was referred for management of recurrent jaundice and cholangitis resulting from repeated metal stent occlusion, despite multiple endoscopic procedures and failed surgical removal. This report describes experience with the use of an endoscopic suture-cutting device to assist in the removal of the metal stent. It also highlights the need for proper patient selection before placement of biliary metal stents.
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PMID:Endoscopic removal of a biliary Wallstent with a suture-cutting device in a patient with primary pancreatic lymphoma. 1224 8

There are no reports of cholangiocarcinoma complicating post radiotherapy cholangitis. We report the case of a 40 year old patient who had undergone thoracoabdominal radiotherapy for Hodgkin's disease, 22 years ago. This radiotherapy was complicated, many years later, by chronic pancreatitis and cholangitis. Recurrent angiocholangitis led us to schedule a biliodigestive anastomosis. During surgery, cholangiocarcinoma was discovered. The patient died from his carcinoma some months later.
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PMID:[Cholangiocarcinoma due to postradiation therapy cholangitis and chronic pancreatitis]. 1614 9


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