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

A case of spinal cord compression secondary to steroid-induced epidural lipomatosis is reported. The epidural lipomatosis developed in a setting of spinal lymphomatous leptomeningitis secondary to adult T-cell leukemia/lymphoma, an unusual type of non-Hodgkin lymphoma with a high frequency of leptomeningeal involvement. Computed tomography was invaluable in diagnosing epidural lipomatosis, despite the concomitant spinal lymphomatous leptomeningitis. To our knowledge this is the first case of epidural lipomatosis following chemotherapy for a malignancy.
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PMID:Lymphomatous meningitis and steroid-induced epidural lipomatosis: CT evaluation. 387 95

During a 10-year period, 28 patients with spinal cord compression due to epidural malignant lymphoma and 47 patients with cerebral involvement of lymphoma were treated with radiation at our institution. Fifty-four percent of the patients with spinal cord compression had this complication at the time of initial presentation of the disease, whereas only 4% with cerebral involvement presented with CNS symptoms. Only one patient had primary lymphoma solely located in the brain. Characteristically, a majority of the patients with spinal cord compression complained of back pain several months before developing neurological symptoms. Because only one-third of the patients had positive spine roentgenograms at the time of spinal cord compression, a CT scan is suggested in patients with malignant lymphoma suffering from back pain in order to verify a paraspinal lymphoma. Thus spinal cord compression may be avoided by early diagnosis and treatment. Among the patients with spinal cord compression, Hodgkin's and non-Hodgkin's histology were equally represented, whereas only 6% had Hodgkin's lymphoma among the patients with cerebral involvement of lymphoma. The response to treatment defined as improvement in neurological deficit in the patients with spinal cord compression was approximately 90% in both the Hodgkin's and the non-Hodgkin's group. No difference in response was found among patients who had laminectomy compared to patients who did not. Patients receiving high dose, short-term treatment (5 Gy X 5-6) responded equally to patients receiving low dose, long-term treatment (2 Gy X 18-20). The median survival from initiation of radiation therapy in patients developing spinal cord compression or cerebral involvement during relapse was 30 months. In patients with spinal cord compression at initial presentation of the disease, median survival had not been reached after 5 years. Among patients with cerebral involvement 50% had improvement of neurological symptoms with no difference between patients receiving high dose, short-term and patients receiving low dose, long-term treatment. It is concluded that high dose, short-term irradiation is as effective as low dose treatment. Especially in patients with neurological complications at relapse, this treatment schedule is preferred because of the extremely short survival of these patients.
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PMID:Central nervous system complications by malignant lymphomas: radiation schedule and treatment results. 394 70

Eleven patients with spinal cord compression due to metastatic epidural tumors were analyzed. Primary tumors were Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma (two patients each), cervical cancer, malignant melanoma, gastric cancer, lung cancer, and neuroblastoma (one patient each). It was felt that myelography is the most important diagnostic test, although CT scan and bone scan may give further diagnostic information in some patients. Six patients were treated with decompressive laminectomy and postoperative radiotherapy, and five with radiotherapy alone. Regardless of the pretreatment neurological status and the type of treatment given, the functional prognosis in our small series of patients appeared to be favorable for radiosensitive tumors such as malignant lymphoma and multiple myeloma.
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PMID:[Clinical study of spinal cord compression due to metastatic epidural tumors]. 395 Nov 27

We encountered 7 non-Hodgkin's lymphomas involving the central nervous system (CNS) among 78 cases of lymphomas seen at the 3rd Dept. of Internal Med. between 1965 and 1980; 5 cases were diffuse histiocytic lymphomas (DH) and 2 were diffuse poorly differentiated lymphomas (DPDL). The age ranged from 27 to 66 years, there were 6 males and 1 female. In 4 cases, CNS involvement was the presenting symptom at the time of diagnosis of lymphoma. The diagnostic procedures in CNS lymphoma included complete neurological physical examination by a neurologist, spinal fluid cytology, surface marker study on lymphocytes of spinal fluid, if possible, computed tomography scan, and myelogram if spinal cord compression was suspected. The prognosis of patients with CNS involvement by lymphoma was poor even if early diagnosis was made. The conventional therapy for CNS lymphoma included cranial irradiation, systemic chemotherapy, and intrathecal instillation of methotrexate and/or cytosine arabinoside, or a combined modality; however, these treatments were only effective temporarily.
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PMID:[Non-Hodgkin's malignant lymphoma with central nervous involvement--report of 7 cases]. 687 52

Spinal cord compression is a rare but serious complication of malignant diseases in children. Epidural cord compression was noted in 81 patients within the past 17 years at this center. The complication developed at different times during the course of the primary disease. For 29 of our patients, cord dysfunction was one of the initial signs of cancer--Ewing sarcoma, neuroblastoma, Hodgkin disease, and malignant lymphoma. By contrast, for most of the patients with osteosarcoma and rhabdomyosarcoma, it appeared later in their clinical course. The treatment outcome of patients who were paraplegia with complete loss of sensory function for greater than or equal to 48 hours was poor. Only four of 22 in this group became ambulatory. Ten patients with osteosarcoma did not undergo laminectomies because they all had multiple metastases and terminal disease. Paraplegia developed in all ten. There was no difference in ambulatory rates among other patients, with or without laminectomies.
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PMID:Metastatic epidural tumors in children. 695 58

We analyzed 168 consecutive patients with Hodgkin's disease who were treated at the University of Nebraska Medical Center between 1985 and 1990 with high-dose chemotherapy followed by autologous bone marrow transplantation (BMT) or peripheral stem-cell transplantation (PSCT), and describe their neurologic complications. All these patients had relapsed or had failed to achieve a remission with initial chemotherapy. Early complications, defined as those occurring during the first 6 weeks following the transplantation, occurred in 65 patients (39%) and included encephalopathy, seizures, psychiatric symptoms, and cerebral hemorrhage; these were mild and reversible in 47 and fatal in 18 patients. The major cause of these early neurologic complications was pulmonary failure. Late neurologic complications, defined as those occurring 6 weeks after the BMT or PSCT was performed, occurred in 21% of patients and included encephalopathy, peripheral neuropathy, cerebral hemorrhage, and spinal cord compression. Serious nervous system complications following autologous BMT or PSCT for Hodgkin's disease are less frequent than those following allogeneic BMT and are usually a result of injury to other organ systems.
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PMID:Neurologic complications after high-dose chemotherapy and autologous bone marrow transplantation for Hodgkin's disease. 816 25

Thirty patients were examined initially because of neurologic problems and later were diagnosed as having systemic malignant disorders. Acute leukemia was the most common malignancy (36.6%), followed by neuroblastoma (33.3%), non-Hodgkin lymphoma (13.3%), rhabdomyosarcoma (10%), Ewing tumor (3.3%), and Hodgkin lymphoma (3.3%). Four of the 11 acute leukemia patients had nervous system involvement due to meningeal, orbital, or cerebellar infiltration. The complaints of the remaining patients included back pain, weakness, and difficulty in walking, all of which were caused by anemia or bone pain. Neurologic involvement in systemic malignancies, other than acute leukemia, mainly appeared as spinal cord compression (7 with neuroblastoma, 3 non-Hodgkin lymphoma, 1 rhabdomyosarcoma, 1 Ewing tumor), orbital or cavernous sinus infiltration (3 with acute leukemia, 1 rhabdomyosarcoma), and VIIth cranial nerve involvement (2 with rhabdomyosarcoma). One patient had skull infiltration without any neurologic deficit. Cerebellar signs were caused by the remote effects of cancer. It is concluded that acute leukemia is the first and neuroblastoma is the second most common malignancy among childhood systemic malignancies presenting with neurologic involvement; however, neuroblastoma is the most common cause of spinal cord compression.
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PMID:Neurologic features as initial presentations of childhood malignancies. 819 71

Eighteen patients with spinal cord compression caused by previously undiagnosed lymphoma were treated at our institution between 1976 and 1991. There were 14 male and 4 female patients (mean age, 58.2 years). The absence of bony involvement on radiographic images was a feature in 16 of the cases. All patients underwent laminectomy for decompression and tissue diagnosis, after which 5 underwent radiotherapy, 3 underwent chemotherapy, and 10 underwent combined-modality treatment. The functional outcome was improvement in 8 patients and no change in 10; no patient worsened after surgery. Eleven had advanced disease at diagnosis, while seven had limited disease, including three patients with localized extradural lymphoma. There were 16 cases of non-Hodgkin's lymphoma and 2 of Hodgkin's disease. Two patients had T-cell lymphoma and were among the longest survivors. DNA flow cytometry identified the low-grade tumors as diploid with very low proliferative indices, while the high-grade tumors all had high indices. At a mean observation time of 41.7 months, five patients have died of their disease, and seven remain in complete remission. Survival is markedly better than that reported for other malignant extradural tumors; however, even limited stage lymphoma can behave aggressively. Similarities in age, sex distribution, histological features, and the results of flow cytometry suggest behavior similar to extranodal lymphoma at other sites. Surgery to provide a tissue diagnosis, followed by combined radiotherapy and chemotherapy, is indicated for all cases.
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PMID:The significance of spinal cord compression as the initial manifestation of lymphoma. 843 51

Spinal cord compression is an infrequent event in patients with non-Hodgkin's lymphomas (NHL) and early diagnosis and therapy are required. The main clinical and histologic characteristics as well as the response to therapy in 10 NHL patients with spinal cord compression diagnosed at a single center in a 7-year period are referred. The main initial clinical manifestations were pain in dorsal or lumbar regions (5 cases) and paraparesia or paraplegia (5 patients). Infection by human immunodeficiency virus (HIV) was present in four cases. In 8 patients spinal cord compression was the initial manifestation of NHL. Pathologic diagnosis showed intermediate or high-grade lymphoma in 8 out of 10 cases and immunologic phenotype was B-cell in all cases. Laminectomy followed by radiation therapy and chemotherapy was performed in 4 cases, radiotherapy and chemotherapy in two, isolated chemotherapy in 3 and radiation therapy was administered to the remaining case. Complete response was observed in 4 cases and 6 cases were resistant to treatment. No patient with HIV infection responded to treatment. Six patients had died, median survival time for the whole series being 4 months, and the actuarial probability of survival was 40% at the first year.
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PMID:[Spinal cord compression in non-Hodgkin's lymphoma. A study of 10 patients]. 937 20

A rare, so far unpublished, case of non-Hodgkin lymphoma in 26-year-old pregnant woman is presented. As X ray examination and other investigations were avoided during her pregnancy, the discrete signs of spinal cord compression led to sudden severe neurological deterioration after delivery. This necessitated emergency decompression and stabilization of the spine. Acute surgical treatment resulted in complete functional recovery. It was followed by chemotherapy and radiotherapy, which led to disease-free survival 7 years after the surgery. Magnetic resonance imaging is the examination of choice when long-lasting back pain during pregnancy does not resolve with bed rest.
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PMID:Rare presentation of non-Hodgkin lymphoma of the thoracolumbar spine in pregnancy with 7 years' survival. 1207 Jun 55


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