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

Radiographic studies play an important role in the clinical staging of malignant lymphoma (ML). Conventional procedures are plain chest X-ray, lymphangiography, gastrointestinal series, and 67Ga scintigraphy. Gastro-intestinal series is essential in non-Hodgkin's lymphoma (NHL) of Waldeyer's ring and thyroid. 67Ga scintigraphy is a non-invasive procedure useful in the screening of ML. Recently marked improvements have been made in the diagnostic modalities. CT scan and NMR have made it very easy to diagnose ML of the central nervous system and detect the extension of tumors at all sites. In some cases with Hodgkin's disease (HD), staging laparotomy is necessary, but not in cases with NHL. If tumors are localized, subtotal or total nodal irradiation is performed for patients with HD, and generous involved field is employed for NHL with or without combined chemotherapy at our department. Good local control is obtained except for NHL of the central nervous system at a total dose of 40-50 Gy. NHL is prone to relapse outside the radiation field. Therefore we consider that combined chemotherapy is indicated for NHL such as T-cell lymphomas, those with high grade histology classified according to the Working Formulation, and with involvement of lymph nodes larger than 6 cm in diameter.
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PMID:[Radiographic staging procedures and radiotherapy of malignant lymphoma]. 219 93

Sixty-four patients with stages I and II non-Hodgkin's lymphomas (NHL) involving Waldeyer's ring treated between 1970 and 1987 were reviewed. Patients with stage II NHL were subdivided into stage II 1 (limited type) and stage II2 (advanced type) from the state of neck nodes. Stage II1 was defined as involvement of unilateral cervical nodes less than 4 cm in diameter as well as Waldeyer's ring involvement. Other stage II cases were classified as stage II2. All 17 patients with stage I NHL were treated with radiation therapy alone. Their diseases were well controlled, and none of them died of causes related to the lymphoma. Among 14 patients with stage II1 NHL, the 5-year survival rate for the 9 patients treated with radiation therapy alone was 87.5%. Until 1982, 19 of 21 patients with stage II2 NHL treated with radiation therapy alone or radiation therapy and adjuvant chemotherapy (VEMP or COPP) died within 5 years mainly of disseminated diseases. Since 1983, CHOP has been used as the main treatment as well as radiotherapy for the 12 stage II2 NHL patients. So far, only 3 of them relapsed and 2 of them died of causes related to the lymphoma. Only 1 of these 12 patients was T-cell lymphoma compared to 7 of 9 stage II2 patients before 1982. This suggests that patients with stage I and those with limited stage II can be safely treated with radiotherapy. Also aggressive chemotherapy as well as radiotherapy should be used for patients with advanced stage II NHL involving Waldeyer's ring.
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PMID:[Radiotherapy and chemotherapy in stages I and II non-Hodgkin's lymphomas of Waldeyer's ring]. 221 35

Sixty-three children with non Hodgkin's lymphoma involving the ENT zone (Waldeyer's ring) were treated between 1975 and 1985 at the Institut Gustave-Roussy. The tumors were localized in the cavum (32 cases), tonsils (16 cases), mandibles (9 cases) whereas 6 patients had more than one of these sites involved. At the time of diagnosis, 16 (25%) had neuro-meningeal involvement. Distribution, according to stages and histology was as follows: 4 stages I, 27 stages II, 12 stages III, 17 stages IV and 3 were unclassifiable. A Burkitt type of lymphoma was diagnosed in 37 (58%), a convoluted lymphoblastic type in 6 (10%) and 20 (32%) fell in a broad category of "other lymphoblastic variety" (32%). With regard to therapy, two consecutive time periods could be identified: from 1975 to 1980 all patients were given the same treatment and neuro-meningeal prophylaxis consisted of irradiation of the skull and intrathecal injections of methotrexate. Since 1981, the therapeutic regimen is designed according to the histo-immunological classification of the tumors and neuro-meningeal prophylaxis is carried out with the use of high dose methotrexate. With this new approach the survival rate has increased from 45 to 80% and the incidence of neuromeningeal relapses has decreased.
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PMID:[Clinical, anatomo-pathologic aspects and therapeutic results in 63 malignant ORL non-Hodgkin's lymphomas in children]. 260 11

Malignant non Hodgkin lymphomas (NHL) are fairly frequent, but involvement of the bony cavities of the face is less common than invasion of the cervical lymph nodes and the lymphoid components of Waldeyer's ring. In connection with a series of 17 personal observations, the authors discuss the main features of NHL and review the diagnostic problems and therapeutic alternatives. Two histologic-clinical entities can be defined: orbital NHL: generally stage I, with a low or intermediate histoprognostic grade and a good prognosis; naso-sinusal NHL: often locally advanced, these lesions are often associated with other visceral disease sites; the prognosis for these intermediate or high histo-prognostic grade lesions is much more somber.
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PMID:[Malignant non-Hodgkin's lymphoma of the bony cavity of the face. Apropos of 17 cases]. 278 Nov 88

Thirty-eight Ga-67 scintigraphies have been evaluated in regard to patients with an untreated malignant lymphoma or a recurrent lymphoma after a complete remission. Thirty-four studies (89%) showed positive findings. Waldeyer's ring and lymph node involvement were detected in 66% of the cases. The recurrent type was detected less often than the untreated malignant lymphoma, and there was no significant difference in detectability between Hodgkin's disease and non-Hodgkin's lymphoma. Although the malignancy grade for NHL did not affect the detectability, the intermediate and high grade NHLs tended to show a greater uptake than the low grade NHLs. The detectability was particularly good for neck and intrathoracic lymph nodes. Ga-67 scintigraphy tended to downgrade a malignant lymphoma to a lower stage, especially if in recurrence.
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PMID:[Ga-67 scintigraphy for the localization and staging of malignant lymphoma]. 317 11

From 1966 through 1984, 142 patients with early stage non-Hodgkin's lymphoma of the head and neck were treated. Histologic slides were reviewed and reclassified according to Rappaport's classification and the Working Formulation. Patients were clinically staged; 82 Stage I, and 60 Stage II. Five-year freedom from relapse was 53% for Stage I and 48% for Stage II patients with no statistically significant difference. No patients with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation relapsed. By univariate analyses, stage, primary site, the Working Formulation, Rappaport's classification, extent of radiation field, radiation dose, tumor bulkiness and addition of multiple-agent chemotherapy seemed to be prognostic factors for predicting relapse. Multivariate regression analyses (MVA) showed primary site and multiple-agent chemotherapy were independent prognostic factors. Tumor bulkiness provided marginal prognostic significance. Waldeyer's ring lymphomas fared better than nodal or extralymphatic lymphomas; it seems necessary to report Waldeyer's ring lymphomas independently from nodal or extralymphatic lymphomas. Patients receiving more than 3 chemotherapeutic agents had better prognosis than those receiving 3 or less agents, or no chemotherapy. Pathologic grade was another prognostic factor when the Working Formulation was used in MVA. When Rappaport's classification was used, division of unfavorable histologies into histiocytic and non-histiocytic groups provided only marginal significance in MVA. We conclude that Stage I-II non-Hodgkin's lymphomas of the head and neck with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation be treated with radiation therapy only; and patients with other histologies should be treated with multiple-agent chemotherapy and radiation therapy.
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PMID:Prognostic factors of stage I and II non-Hodgkin's lymphomas of the head and neck: the value of the working formulation and need for chemotherapy. 318 43

Childhood non-Hodgkin's lymphomas (NHL) are a heterogeneous group. Biological studies have shown that most mediastinal NHL are lymphoblastic lymphomas which are T-cell tumors. In contrast, most NHL occurring in the gastrointestinal tract, abdominal cavity and Waldeyer's ring are diffuse undifferentiated small non-cleaved lymphomas, mainly Burkitt's or Burkitt-like lymphomas. Different multi-drug combinations have been proposed over the last 20 years. The LSA2-L2 regimen or other protocols, based on acute lymphoblastic leukemia results, have improved the prognosis in T-cell NHL. In extended B-cell NHL, aggressive short term multi-drug chemotherapy given in pulses gives a cure rate above 60%. The use of surgery and radiotherapy in the treatment of childhood NHL has decreased with the realisation that most children can be cured by chemotherapy alone.
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PMID:Childhood non-Hodgkin's lymphomas: clinical and therapeutic aspects. 319 Dec 4

A total of 32 patients of Hodgkin's disease treated mainly by radiotherapy at the Department of Radiology, Osaka University Hospital from 1971 through 1985 were analyzed. Five- and ten-year survival rates for all patients were 91%, 78%; Clinical Stage I (15 patients): 93%, 83%; Stage II (8 pts.): 100%, 100%; Stage III (9 pts.): 78%, 52%, respectively, and 5- and 10-year relapse-free rates for all patients: 72%, 62%; St. I 87%, 76%; St. II: 63%, 63%; St. III: 56%, 42%, respectively. Patients with tumor originated in the upper neck consisted of 7 patients (47%) in Stage I and no relapse was observed outside the irradiated field. However, 2 recurrences (1 within RT field, and another Stage III at margin of the field) were observed around the upper neck in patients treated with only the mantle field encompassing the upper neck area. Treatment portal should be considered to cover Waldeyer's ring and skull base with lateral portals.
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PMID:[Results of the radiotherapy of Hodgkin's disease (Analysis of cases at Osaka University Hospital)]. 338 35

CT findings were reviewed in 68 patients with untreated head and neck lymphoma. More than half of the patients with either Hodgkin's disease or non-Hodgkin's lymphoma were detected in the earlier stages (stage I or II). Four types of abnormalities were identified with CT: nodal involvement alone (type 1), extranodal involvement alone (type 2), a combination of extranodal and nodal disease (type 3), and multifocal extranodal disease with or without nodal involvement (type 4). In the 18 patients with Hodgkin's disease, a subgroup of mixed cellularity was most common; type 1 was the prevailing CT presentation, and no type 2 or 4 lesions were observed. In the 50 patients with non-Hodgkin's lymphoma, diffuse large-cell lymphoma was the most common histologic subtype, and the most common CT presentation was type 2, followed by type 3. Lymphomatous nodes may be extensive and confluent, but often they are smaller than 2 cm and rarely are necrotized. The most frequent extranodal sites of head and neck lymphomas are Waldeyer's ring, paranasal sinuses, and nasal cavity. Extranodal lymphoma cannot be differentiated reliably from the more commonly occurring carcinoma, although it is less often associated with invasion and destruction of adjacent bony structures. Multiple sites of extranodal involvement, with or without neck lymphadenopathy, may suggest a diagnosis of non-Hodgkin's lymphoma.
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PMID:Lymphomas of the head and neck: CT findings at initial presentation. 349 47

Ten cases of non-Hodgkin's lymphomas, mainly composed of large multilobated cells, have been studied. Our results are consistent with the view that they represent a somewhat heterogeneous group of lymphoid tumours displaying different morphological, clinical and immunophenotypic features. In B-cell type the large multilobated cells were histologically characterized by prominent nucleoli and distinctly basophilic cytoplasm whereas in the T-cell type they had indistinct or small nucleoli and ill-defined weakly eosinophilic cytoplasm. These differential features between B- and T-cell type were confirmed by electron microscopy. From a clinical standpoint B-cell type was characterized by a constant involvement of lymphoid tissues (lymph nodes and/or Waldeyer's ring); T-cell type showed, on the contrary, a more frequent involvement of extra-lymphoid sites (mainly bone and subcutaneous tissues). Our study provides some morphological features that may be helpful for a correct differential diagnosis in this heterogeneous group of non-Hodgkin's lymphomas.
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PMID:B- and T-cell non-Hodgkin's lymphomas with large multilobated cells: morphological, phenotypic and clinical heterogeneity. 350 Sep 5


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