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 41-yr-old man presented with jaundice, night sweats, and weight loss. The patient had been on phenytoin for seizure disorder. The drug was discontinued, and a diminution of bilirubin and transaminases occurred over several weeks. Percutaneous liver biopsy revaled cholestasis at the time of maximal hyperbilirubinemia. Recurrent jaundice ensued several weeks later, and an ERCP revealed a common bile duct lesion. Laparotomy revealed Hodgkin's disease involving the common bile duct and periportal node. This cause represents the first report of extrahepatic biliary obstruction from Hodgkin's disease.
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PMID:Obstructive jaundice secondary to primary biliary involvement with Hodgkin's disease. 151 80

There is an increased frequency of Kaposi's sarcoma and non-Hodgkin's lymphomas in patients with AIDS. These "opportunistic malignancies" establish the diagnosis of AIDS in an HIV-positive patient and are associated with a high likelihood of gastrointestinal and hepatobiliary involvement. Kaposi's sarcoma is a multicentric cutaneous spindle-cell tumor that is associated with luminal lesions in at least 40 per cent of patients. Gastrointestinal KS is usually asymptomatic but may rarely bleed or obstruct. Treatment of KS with either radiation or chemotherapy can reduce tumor bulk, without affecting survival. Non-Hodgkin's lymphomas in AIDS are B-cell neoplasms composed of either noncleaved or blast cells, similar to those seen in Burkitt's lymphoma. The tumors are usually highly aggressive and present in extranodal sites in the majority of cases. Primary or secondary gastrointestinal involvement is frequent, with hepatic and rectal tumors being particularly common. Unlike KS, gastrointestinal lymphomas are usually symptomatic. Obstruction, perforation, and bleeding can occur in patients with luminal involvement. Jaundice due to hepatic infiltration or biliary obstruction may be seen. Treatment with chemotherapy is usually indicated because of the rapid progression of the tumor, although no prolongation of survival has been demonstrated. There may also be an increased incidence of Hodgkin's disease and anorectal neoplasia in patients with AIDS; however, these malignancies do not establish the diagnosis of AIDS in an HIV-positive patient.
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PMID:Gastrointestinal and hepatobiliary neoplasms in AIDS. 304 56

Jaundice due to metastatic tumor involving the extra-hepatic bile ducts is uncommon, and thus, the management of this problem is not standardized. Retrospective analysis of all patients admitted to University Hospitals of Cleveland with malignant biliary obstruction was thus undertaken to identify the incidence, origin, management, and outcome of these metastatic tumors. During a 5-year period, 56 patients with jaundice secondary to biliary, pancreatic, ampullary, or metastatic tumors were identified. Of these, 12 (21%) represented a distant malignant process metastatic to the porta hepatis. Sites of origin were diverse: lymphoma, 2; breast, 3; colon, 2; and 1 each with Hodgkin's, lung, ovary endometrium, and melanoma. Patients ranged in age from 31 to 90 years (mean: 60). Surgical intervention was undertaken in only two patients (cholecystojejunostomy, 1; transhepatic U-tube stenting, 1). The remainder were managed as follows: no procedure, 3 (25%); percutaneous stenting, 5 (42%); and radiation only, 2 (17%). Mortality was as follows: 5 of 12 (42%) died within 30 days and 8 of 12 (67%) within 60 days. The only survivors beyond 60 days were the patients with Hodgkin's (1 of 1), lymphoma (1 of 2), breast (1 of 3) and melanoma (1 of 1). Ten of the patients had obvious extensive metastatic disease, which would explain the poor outcome. Analysis of this data indicates that overall survival is dismal and palliative, nonoperative methods to manage the jaundice should be considered.
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PMID:Metastatic malignant biliary obstruction. 360 55

The finding of epithelioid cell granulomas within liver biopsies is a not uncommon occurrence. We undertook this study to investigate the underlying conditions responsible for a diagnosis of granulomatous hepatitis in Northern Ireland during the thirteen year period 1980-1992. One hundred and sixty-three patients with hepatic granulomas were identified, accounting for 4% of all liver biopsies undertaken during the period of the study. In 145 cases (89%) a definite clinical diagnosis was established. The most common clinical diagnoses were primary biliary cirrhosis which accounted for 90 cases (55%) and sarcoidosis which accounted for 30 cases (18%). Other less common conditions associated with hepatic granulomas included tuberculosis (3 cases), Crohn's disease (3 cases), chronic active hepatitis (2 cases), drug hypersensitivity (2 cases) and extra-hepatic biliary obstruction (2 cases). Six patients were identified with a clinical diagnosis of psoriasis. Other miscellaneous conditions accounting for single examples of granulomatous inflammation were schistosomiasis, gout, Hodgkin's disease, secondary adenocarcinoma, collapse and necrosis of tumour following radiotherapy and chemotherapy, granulomatous inflammation within the wall of an abscess cavity and idiopathic cirrhosis. Only eighteen cases (11%) remained idiopathic with no definite diagnosis established after detailed investigation. The findings confirm the wide range of clinical conditions which can result in hepatic epithelioid cell granulomas. This has been emphasised in several previous major studies which are reviewed in this paper.
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PMID:Hepatic granulomas in Northern Ireland: a thirteen year review. 782 89

Hodgkin's disease rarely presents as obstructive jaundice. We report a case of Hodgkin's disease arising in periduodenallymph nodes, presenting with biliary obstruction, definitively diagnosed on cytologic material obtained by endosonographically-guided real-time fine needle aspiration biopsy and confirmed at laparotomy. The medical literature pertaining to the use of endosonography and fine needle aspiration biopsy for pancreatic lesions and abdominal lymphoma is reviewed. Currently available data support the use of fine needle aspiration biopsy in establishing the diagnosis of lymphoma. This case highlights the utility of endoscopic ultrasonography with endosonographically guided real-time fine needle aspiration biopsy in diagnosing and managing patients with extrahepatic biliary obstruction or suspected abdominal lymphoma. Pairing endosonographically guided real-time fine needle aspiration biopsy with on-site cytologic assessment and immediate specimen triage can lead to definitive diagnosis of abdominal lymphoma, avoiding surgical intervention in many cases.
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PMID:Hodgkin's disease diagnosed by endoscopic ultrasound-guided fine needle aspiration of a periduodenal lymph node. 962 41

Only a small percentage of patients with Hodgkin's disease become clinically Jaundiced during their disease. This Jaundice may be secondary to biliary obstruction, hemolysis, direct hepatic infiltration by the disease, drug toxicity or viral hepatitis. Vanishing bile duct syndrome secondary to Hodgkin's disease is a rare cause of cholestasis in these patients, only 13 cases having been reported so far. The authors describe 2 patients who developed severe Jaundice secondary to Hodgkin's disease due to vanishing bile duct syndrome affecting small intrahepatic bile ducts.
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PMID:Cholestasis secondary to Hodgkin's disease: report of 2 cases of vanishing bile duct syndrome. 986 26

Primary lymphoma of the duodenum presenting with obstructive jaundice is a rare entity. We report a case of primary non-Hodgkin lymphoma of the duodenum producing biliary obstruction, definitively diagnosed by ultrasound-guided fine needle biopsy. Complete remission of the disease occurred after chemotherapy.
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PMID:[Cholestatic icterus due to primary duodenal lymphoma]. 1367 29

Obstructive jaundice is an unusual manifestation of non-Hodgkin lymphomas in children. Although surgical drainage is one of the initial treatment choices in some cases, usually lymphomatous masses rapidly response to chemotherapy and jaundice decreases due to regression of the mass, without any surgical procedure. The authors report the case of a 16-year-old girl who presented with biliary obstruction due to a neoplasm involving the duodenum. Histological examination of the specimen, which was taken from the mass by endoscopic biopsy, revealed Burkitt lymphoma infiltrating the duodenum. Chemotherapy including cyclophosphamide was started immediately. In a few days, jaundice decreased rapidly by the shrinkage of the mass. Neither surgery nor percutaneous drainage were needed. In conclusion, biliary tract obstruction due to non-Hodgkin lymphoma can be effectively treated with chemotherapy alone without any surgical procedure.
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PMID:Obstructive jaundice: an unusual initial manifestation of intra-abdominal non-Hodgkin lymphoma in a child. 1632 18

Lymphoma is a rare cause of biliary obstruction and, on cholangiography, may mimic other causes of obstructive jaundice. The optimum treatment for these patients is unclear. The aim of this study is to evaluate the incidence, clinical and imaging findings, management, and outcome of biliary obstruction caused by lymphoma. Our database was searched retrospectively for patients with biliary obstruction due to lymphoma between 1999 and 2005. Biliary obstruction secondary to lymphoma was found in 7 (0.6%) of 1123 patients with malignant biliary obstruction. One patient had benign biliary obstruction related to lymphoma. Of the eight patients (five male, three female; mean age, 34.50 +/- 17.93 years), four had Hodgkin's disease and four had non-Hodgkin's lymphoma. Biliary obstruction occurred as part of the initial or early presentation of lymphoma in two patients. The most common cause of obstruction was compression of the biliary tract by enlarged lymph nodes (six patients). Cholangiographic appearances were diverse: narrowing of the common bile duct (six patients), splayed and narrowed common bile duct (one patient), and multiple strictures and dilatations of the intrahepatic bile ducts (one patient). Biliary drainage was performed in all patients including endoscopic stent placement in six patients, nasobiliary drainage in one, and choledochoduodenostomy in one. Hyperbilirubinemia resolved in all but one of the patients with a stent; however, none could be maintained in a stent-free condition. Five patients died within 1 year after onset of jaundice. One of the surviving patients developed a late benign stricture at the site of the earlier lymphoma. We conclude that lymphoma should be considered in the differential diagnosis of obstructive jaundice, particularly in younger patients. We suggest that biliary drainage by the endoscopic or percutaneous route is necessary for the treatment of these patients. Late benign strictures may develop. Biliary obstruction is a sign of poor prognosis in lymphoma.
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PMID:Biliary tract obstruction secondary to malignant lymphoma: experience at a referral center. 1740 15

Liver involvement in Hodgkin's lymphoma is common and is caused by hepatic infiltration, biliary obstruction by lymphoma, hepatitis, sepsis or complications of chemotherapeutic treatment. Jaundice caused by the vanishing bile duct syndrome related to Hodgkin's lymphoma is very rare. The mechanism is poorly understood but a paraneoplastic effect seems most likely as liver biopsy samples show cholestasis in the absence of lymphoma cells. Despite adequate treatment almost all reported patients died of liver failure or disease progression. Disease progression is explained partly by the difficulties encountered in the administration of potential hepatotoxic chemotherapy in severely cholestatic patients. We describe a 17-year-old man with vanishing bile duct syndrome and Hodgkin's lymphoma who was treated successfully with chemotherapy. The markedly elevated serum bilirubin levels completely normalized. Our case demonstrates that although dosing of chemotherapy in this situation can be very difficult, a good clinical outcome is possible, which makes the attempt at curative treatment worthwhile.
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PMID:Severe jaundice, due to vanishing bile duct syndrome, as presenting symptom of Hodgkin's lymphoma, fully reversible after chemotherapy. 1818 38


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