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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 majority of small cell anaplastic tumors of the thyroid gland are generally believed to be non-Hodgkin's lymphomas, including most of those formerly classified as small cell carcinomas. Using a panel of antibodies capable of detecting epithelial, neuroendocrine, and B and T cells in paraffin-embedded tissue sections, we studied 68 thyroid neoplasms in which the original diagnosis was small cell carcinoma or lymphoma. Sixty-three of the tumors were identified as lymphomas of B-cell origin on the basis of L26 reactivity used in conjunction with light chain restriction and MB2 immunostaining. Two additional tumors were classified as lymphomas of indeterminate phenotype. Immunophenotyping indicated an epithelial origin in the remaining three tumors. No cases of medullary carcinoma were detected by immunostaining. Histologic review revealed a predominance of large cell and immunoblastic lymphomas, with low-grade lymphomas of mucosa-associated lymphoid tissue histology accounting for only five cases. Our findings indicate that the majority of small cell anaplastic tumors of the thyroid are B-cell lymphomas. Although primary small cell carcinoma of the thyroid may rarely occur, this diagnosis should not be made without immunohistologic confirmation.
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PMID:Immunohistochemical analysis of small cell tumors of the thyroid gland: an Eastern Cooperative Oncology Group study. 133 Aug 75

Nucleolar organizer region-associated proteins (AgNORs) have been studied in parafin sections of 15 non-Hodgkin's lymphomas by a silver staining technique. On the basis of the Working Formulation of malignant non-Hodgkin's lymphomas all studied cases were divided into three groups. A statistically significant difference was found between number of AgNORs in the nuclei of low-grade lymphomas (mean 2.654 per nucleus), and also between intermediate-grade (mean 1.588 per nucleus) and high-grade malignant lymphomas. Significant difference was also observed between AgNOR area in high-grade and low-grade malignant lymphomas and between high-grade and intermediate-grade malignant lymphomas. However no statistically significant differences between all three studied groups with regard to the size of nucleus were found. It is suggested that this method can be very useful in the diagnosis of malignant non-Hodgkin's lymphomas.
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PMID:[The nucleolar organizer region in malignant non-Hodgkin's lymphoma]. 134 17

Twenty patients with orbital lymphomas were treated and followed over a 14-year period. Ten of these patients had well-differentiated lymphocytic lymphoma (WDL), and all of them were clinical stage IE. Five patients had nodular poorly differentiated lymphocytic lymphomas (NPDL), three patients had diffuse histiocytic lymphomas (DHL), one had nodular mixed-cell lymphoma, and one had diffused mixed-cell lymphoma. The patients with WDL received local radiation therapy, and all of them entered completed remissions. The projected survival at 10 years was 100% for these patients. The patients with low-grade lymphomas with advanced disease were treated with chlorambucil and prednisone or cytoxan and vincristine. The patients with high-grade lymphomas received treatment with methotrexate, cyclophosphamide, doxorubicin, vincristine, bleomycin, dexamethasone (mBACOD) or cyclophosphamide, vincristine, methotrexate, cytosine arabinoside, leucovorin (COMLA). The overall survival estimate for all patients was 63% at 10 years. The disease-free survival was 49% at 10 years. The patients with high-grade lymphomas had a poor prognosis, with no survivors after 4 years. This study suggests that patients with WDL usually present with localized disease to the involved orbit, and have an excellent prognosis with radiation therapy alone. Patients with high-grade orbital non-Hodgkin's lymphomas have a poor outcome despite use of aggressive combination chemotherapy regimens.
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PMID:Treatment and prognosis of orbital non-Hodgkin's lymphomas. 137 64

This brief review of non-Hodgkin's lymphomas emphasizes aspects of clinical research which have led to important improvements in the management of patients, and examines research questions with relevance for the future. In the intermediate- and high-grade lymphomas, strategies to intensify drug regimens have proved successful in raising rates of curative outcome. With the introduction of growth factors and peripheral stem cell transfusion to support nadir cytopenias it becomes possible to further develop dose-intense regimens. Identification and selection of poor prognostic subsets is key to the further application of these approaches, since the therapeutic ratio may be narrow and up to 50% of patients may be cured with less toxic regimens. In the low-grade lymphomas where a curative outcome is less certain, the application of intensive therapy has proved more controversial and results remain preliminary. Nevertheless, durable remissions appear achievable in advanced-stage CR patients utilizing low-dose consolidative irradiation or autologous transplantation. In contrast to intermediate- and high-grade lymphomas where intensive therapy is often reserved for responding poor-risk presentations, in low-grade lymphoma intensive therapy and consolidation is most successfully applied to good-risk patients.
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PMID:Management of non-Hodgkin's lymphoma. 138 Mar 42

p53 is a tumor suppressor gene that commonly undergoes mutations in human tumors, including lymphomas. Because p53 mutations are not restricted to a single locus, immunohistochemistry is useful to detect p53 expression and correlate this finding with lymphoma phenotype. Cryostat sections from 125 cases of lymphoma were analyzed for p53 expression using three different monoclonal antibodies (pAb 421, 1801, 240) which react with human cellular p53 and a common conformational epitope on mutant p53. A control antibody (pAb 246) reacts only with wild type p53 of murine origin and was negative in all cases. Tissue from 29 cases of lymphoid hyperplasia, including six from human immunodeficiency virus-positive (HIV+) patients, were negative for p53. p53 was predominantly localized in nuclei of high-grade lymphomas, including 14 of 46 cases of B cell immunoblastic lymphomas and two of five T cell immunoblastic lymphomas. p53 expression was relatively common in lymphomas from HIV+ patients, and unusual in intermediate and low-grade lymphomas of follicular center cell type. Low-grade lymphoma of small lymphocytic type disclosed p53+ large cells (paraimmunoblasts) that may play a role in tumor progression in this lymphoma subtype. p53 was also strongly expressed in the nuclei of Reed Sternberg cells from 19 of 37 cases of Hodgkin's disease, including six cases of mixed cellularity, and 13 cases of nodular sclerosing type. Immunohistochemical staining is a rapid method to identify p53 expression in lymphomas.
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PMID:Immunohistochemical analysis of p53 expression in malignant lymphomas. 146 98

Using sequential infusions of two S-phase-specific drugs, iododeoxyuridine and bromodeoxyuridine, we have developed an in vivo method for determining the labeling index (LI), the S-phase duration (Ts), and total cell cycle times (Tc) of non-Hodgkin's lymphomas. In nine non-Hodgkin's lymphomas studied, the LI ranged from 1.5% in a follicular small cleaved-cell lymphoma to 29.6% in a diffuse large-cell lymphoma. The Ts ranged from 16 hr in a large-cell lymphoma (immunoblastic type) to 117 hr in a follicular small cleaved-cell lymphoma. The Tc varied from 69 hr in a large-cell lymphoma (immunoblastic type) to over 1000 hr in all low-grade lymphomas studied. Immunohistochemical methods using anti-BrdU antibodies were used to detect cell incorporation of the two S-phase-specific drugs. In this manner, cell cycle times could be calculated while the architecture of the tumor specimen was preserved. Difficulties in using this methodology, specifically in the calculation of the growth fraction and total cell cycle times, are pointed out. This in vivo method does, however, allow for Ts calculations independent of growth fraction considerations. Correlations of cell cycle data with various biological and clinical factors await further patient follow-up.
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PMID:In vivo determination of cell cycle kinetics of non-Hodgkin's lymphomas using iododeoxyuridine and bromodeoxyuridine. 157 52

Several important new agents are effecting the management of non-Hodgkin lymphoma (NHL) and multiple myeloma. The two selected for review in this article include a biologic-response modifier and a new chemotherapeutic agent. The biologic-response modifiers offer entirely new approaches to these diseases. The most extensively tested agent currently has been recombinant alpha-interferon (alpha-IFN). The IFN are active, albeit weak, remission-induction agents for low-grade NHL and some T-cell lymphomas, but they appear to be ineffective as single agents in most intermediate-grade or high-grade NHL and myeloma. However, an emerging pattern in follicular lymphomas and myeloma is that alpha-IFN in combination with chemotherapy may lead to more complete and durable clinical responses and the increased prospect of prolonged disease control. Fludarabine, a new chemotherapeutic agent, is a promising drug with demonstrated activity in low-grade lymphomas that parallels its impressive activity in chronic lymphocytic leukemia.
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PMID:New agents for the treatment of multiple myeloma and non-Hodgkin lymphoma. 163 66

The monoclonal antibody, 4F2, which reacts with an antigen expressed by activated and proliferating cells, was applied to frozen sections of nine reactive lymphoid lesions, 146 B-cell non-Hodgkin's lymphomas (NHL), and six plasmacytic neoplasms. In reactive cases, the 4F2 antigen was expressed by germinal center cells and interfollicular immunoblasts, the activated or proliferating lymphoid cells, and histiocytes. In the malignant cases, the 4F2 antigen was expressed by 94 (64%) B-cell NHL and all six plasma cell tumors. The incidence of positivity and intensity of expression loosely correlated with the three morphologic grades of NHL identified in the Working Formulation. Approximately one half of all low-grade lymphomas, two thirds of intermediate-grade lymphomas, and all high-grade lymphomas were 4F2 positive. Similarly, the mean intensity of 4F2 antigen expression increased with higher grade. However, for certain histologic subtypes, 4F2 antigen expression did not correlate with morphologic grade. For example, in the intermediate-grade category less than one half of diffuse small cleaved cell lymphomas were 4F2 positive, and expression was weak, similar to that of low-grade lymphomas. In contrast, all other histologic subtypes of lymphoma in the intermediate-grade category were strongly 4F2 positive. Expression of 4F2 antigen also correlated with plasmacytoid differentiation. Seventy-three percent of plasmacytoid small lymphocytic lymphomas (compared with 31% of cases of non-plasmacytoid small lymphocytic lymphoma/chronic lymphocytic leukemia) and all plasma cell neoplasms expressed the 4F2 antigen, the latter cases strongly.
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PMID:Expression of the activation antigen, 4F2, by non-Hodgkin's lymphomas of B-cell phenotype. 191 36

Many of the advances in the management of non-Hodgkin's lymphomas have been based on more precise understanding of the various cell types that constitute these disorders. During the past year, we have seen some dramatic changes in the therapeutic approach to low-grade lymphomas. Until recently, the usual approach to these disorders was a purely palliative one, but a number of publications from the past year describe a more intensive approach with the goal of developing a curative modality. The use of combination chemotherapy in addition to radiation therapy for the early Ann Arbor stages as well as the use of high-dose chemotherapy with bone marrow transplantation in patients with high-risk factors has been reported recently. In the area of intermediate-grade lymphomas, most of the recent publications have described prognostic factors associated with various chemotherapy protocols. One of the most interesting recent developments is related to the dose-intensity issue. A consensus appears to be developing in regard to the correlation of dose intensity with clinical outcome. Despite the fact that new third-generation regimens have been associated with cures in 50% to 66% of the patients, a significant fraction of patients require salvage chemotherapy. Some of the new salvage regimens are discussed, as is the use of calcium channel blockers to reverse multiple-drug resistance. Finally, management of the high-grade lymphomas, specifically the small noncleaved cell type, has been associated with a cure rate in the range of 50% in two recently published studies. Patients who are human immunodeficiency virus-positive with small noncleaved cell lymphoma can be cured of their underlying malignancy, but many of them later develop complications of acquired immunodeficiency syndrome, to which they usually succumb.
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PMID:Treatment of non-Hodgkin's lymphoma. 175 77

Although dramatic progress has been made in the treatment of advanced non-Hodgkin's lymphoma, a majority of patients eventually die from this disease. Improvements in histopathology, staging techniques, immunophenotyping, and knowledge of prognostic factors have improved our ability to choose appropriate treatment. Most low-grade lymphomas can be effectively palliated for many years, but eventually convert to large-cell lymphomas or become resistant to chemotherapy. Intermediate-grade lymphomas, especially diffuse large-cell lymphomas, may be cured in 30% to 60% of the cases with aggressive combination chemotherapy. The high-grade lymphomas require treatment similar to regimens designed to treat acute lymphocytic leukemia, including central nervous system (CNS) prophylaxis. Non-Hodgkin's lymphomas are becoming more common in patients with acquired immunodeficiency syndrome (AIDS), and may be effectively controlled before the immunodeficiency becomes too severe. All patients with high-grade lymphoma and others at high risk should be tested for human immunodeficiency virus (HIV). Patients who relapse may be salvaged with chemotherapy, and their diseases are potentially curable with autologous or allogeneic bone marrow transplantation. New treatments using monoclonal antibodies, biological response modifiers, and growth factors, should improve palliation and survival.
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PMID:Treatment of advanced non-Hodgkin's lymphoma in adults. 184 59


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