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)

Radiotherapy of non-Hodgkin's lymphomas situated in the central nervous system is basically similar to the treatment applied to any other part of the body. There are two requirements: the first is the prophylactic irradiation of the CNS in a systemic disease of the reticuloendothelial system mainly in acute lymphatic leukemia; the second is the treatment of solitary tumors in the CNS. Radiotherapy can improve dramatically the results obtained with intrathecal chemotherapy, particularly in leukemic involvement of the CNS in childhood. The fractionated single radiation dose should be increased slowly and total doses of 2 500 rd should not be exceeded. Prophylactic radiotherapy of the CNS in acute leukemia has to include the entire subarachnoid space. It is therefore necessary to irradiate the entire skull and spinal cord. This treatment schedule and its results will be discussed. There is a tendency to sue prophylactic radiotherapy in other systemic diseases of the RES as well. The indications and contraindications for this will be discussed. The methods and results of treatment of focal lesions with regard to the morphologic tumor pattern are discussed. Rare primary tumors of the CNS which have the histological features of lymphoma-sarcoma or reticulosarcoma have the best prognosis as far as radiotherapy is concerned.
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PMID:Radiotherapy of malignant lymphomas. 105 54

Fifteen of 52 patients (29%) with diffuse histiocytic and undifferentiated pleomorphic lymphoma developed central nervous system (CNS) complications, primarily leptomeningeal lymphoma. Lumbar puncture with cerebrospinal fluid cytology was the most useful test for diagnosis, and for following the response to therapy. Leptomeningitis developed during all stages of the patients' clinical course: at time of diagnosis, during progression of systemic disease, and most importantly as the initial site of relapse within 7 mo of attaining a complete clinical remission. Patients with bone marrow involvement are at high risk for the development of leptomeningeal lymphoma. Pathologic findings suggest that entry into the leptomeninges involves extension from the medullary bone marrow cavity along perforating vessels through dura into the arachnoid space. The leptomeningeal lymphoma has been successfully controlled in all patients receiving intensive central nervous system therapy consisting of a combination of intrathecal drug administration and radiotherapy. The high frequency of this syndrome and the success in its control suggest that a controlled trial of prophylactic CNS therapy be instituted in patients with these histologic types of non-Hodgkin's lymphomas.
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PMID:Central nervous system complications in patients with diffuse histiocytic and undifferentiated lymphoma: leukemia revisited. 110 98

Optic neuropathy during non-Hodgkin lymphoma is a late central nervous system complication of unfavourable prognosis. It appears especially with involvement of the bone marrow. A normal cerebrospinal fluid, lack of any beneficial effect of the chemo-corticotherapy and absence of papilledema suggest paraneoplastic, or iatrogenic (radio and (or) chemotherapeutic) neuropathy with conclusive histopathological proof only at autopsy. More frequently, cerebrospinal fluid containing malignant cells, papilledema and a beneficial effect of the chemocortico-therapy suggests malignant infiltration of the optic nerve as occurs in our case. Optic neuropathy during non-Hodgkin lymphoma may exceptionally precede the systemic disease by several years. Early oculomotor involvement suggests meningeal malignant infiltration as found in meningeal carcinomatosis.
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PMID:[Optic neuritis in non-Hodgkin's lymphoma]. 161 46

The clinical and pathologic features of 15 new cases of the uncommon primary or granulomatous angiitis of the central nervous system (PACNS) are described. To date, only 108 such cases have been reported in the English literature. Clinically, most PACNS patients have been young or middle-aged (mean age, 45 years; range, 3 to 96 years), with men outnumbering women slightly by a ratio of 4 to 3. The most frequent presenting complaints are headache, weakness, and confusion; less common complaints are aphasia, dysphasia, nausea or vomiting, loss of memory, and seizure disorder. There is usually no evidence of a systemic disease; the erythrocyte sedimentation rate is almost invariably normal, and there are no diagnostic laboratory tests. The cerebral angiogram usually shows multifocal, segmental stenosis or irregularity of small and medium-sized leptomeningeal and intracranial blood vessels, often with a beading or aneurysmal appearance, and alterations in blood flow in the affected regions. Anatomically, the angiitis is focal and segmental in distribution. An isolated negative biopsy, therefore, does not rule out the disease. Histologically, PACNS may be granulomatous, necrotizing, or lymphocytic in character, and mixed morphologic types often occur. Large- and small-vessel thrombosis is common. Acute lesions frequently coexist with healing or healed lesions. Involvement of extracranial blood vessels occurs only rarely. Past or current herpes zoster infection and Hodgkin's lymphoma are the most noteworthy clinical associations of PACNS, but whether they are causally related remains uncertain.
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PMID:Primary (granulomatous) angiitis of the central nervous system: a clinicopathologic analysis of 15 new cases and a review of the literature. 174 Mar

Fifty-five patients with deep neck infections treated consecutively over a period of six and a half years between January 1983 and July 1989 were reviewed. Nine of these patients had abscesses localized to the pharapharyngeal space and form the basis of this study. The aetiology of the parapharyngeal abscess was odontogenic in two patients and remained unknown in the other seven. Five patients had associated systemic disease; four were diabetics and one patient had non-Hodgkin's Lymphoma. High dosage intravenous antibiotics directed towards the causative micro-organisms, airway control and early surgical intervention was the mainstay of treatment. All patients underwent open surgical drainage of the parapharyngeal abscess within 24 h of admission. Bacteriology results showed Klebsiella sp. to be the dominant micro-organism cultured in four patients. Morbidity was low; seven patients had no post-operative complications and were discharged from the hospital between 7-24 d (mean 12.9 d). There were two deaths. Early open surgical drainage remains the most appropriate method of treating parapharyngeal space infections; it avoids life threatening complications with rapid recovery.
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PMID:Parapharyngeal abscesses. 178 55

To investigate the frequency, clinical and anatomopathologic characteristics of non-Hodgkin's Lymphoma (NHL) present in the testicle as primary or secondary disease, we reviewed the files of the Hematology and Pathology Services of the General Hospital of Mexico, from January 1975 to December 1988. We found 681 cases of NHL in the Hematology Service; of these, 388 (57%) were male and 8 (2%) of them presented testicle involvement. Two were considered as primary disease, 4 as systemic disease and 2 as secondary or late complications. The overall mean age was 49 years. According to the New Working Formulation (NWF), 7 cases corresponded to the intermediate grade of malignancy and one to a plasmacytoma. The mean survival time of the whole group was 3.9 months. In the Pathology Department, the files of 203 autopsies of patients with NHL were reviewed; 124 (61%) were male and 11 (8.9%) of them presented testicle infiltration. In two, the testicular involvement was known before death and in 9 it was found at autopsy. In one case the infiltration was located in the epididimus and in other in the spermatic cords. The mean age of these patients was 50.7 years. In 6 cases there was extranodal infiltration other than in the testicle: 1 in the nose, and 1 in the central nervous system. According to the NWF, 1 was classified as of low malignancy grade, 7 were of the intermediate malignancy, and 3 of high malignancy grade.
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PMID:Non-Hodgkin's lymphoma (NHL) of the testicle. A clinicopathologic study of 19 patients. 189 83

Primary central nervous system lymphoma (PCNSL) is a rare neoplasm, but it is occurring with increased frequency even among apparently immunocompetent patients. Although secondary malignancies frequently involve the lymphoreticular system, PCNSL has been reported as a second neoplasm only once previously. Seven patients are discussed who developed PCNSL after successful treatment for a prior neoplasm. The original cancer was colon (one), breast (one), thyroid (one), Hodgkin's disease (two), and non-Hodgkin's lymphoma (two). Patients with systemic non-Hodgkin's lymphoma were thought to have a separate cerebral lymphoma on the basis of a prolonged disease-free interval from their systemic lymphoma, and the absence of systemic disease, when PCNSL was diagnosed and through subsequent follow-up. The PCNSL developed a median of 10 years after the diagnosis of the first tumor and 6 years after the last evidence of systemic disease. The diagnosis of PCNSL was often delayed because of confusion with brain metastases, and initial shrinkage or disappearance of the lesion after corticosteroids. Formation of PCNSL may be a consequence of treatment for the first malignancy, reflect an unidentified inherent predisposition to neoplastic transformation, or result from the changing epidemiology of PCNSL in the general population. These mechanisms are not mutually exclusive, and a single hypothesis cannot account for all these cases.
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PMID:Primary central nervous system lymphoma as a secondary malignancy. 199 9

The monoclonal antibody Ki-67 has been described in 1983 by Gerdes. Lymphocytes stimulated with PHA as well as a number of human tissues have been studied using the antibody. The results have shown, that the Ki-67 antigen is expressed by all cells in the active phases of the cell cycle not, however, by resting cells or the starting sequences of the cell cycle. Although the nature of the Ki-67 antigen ist not yet known, several studies have demonstrated that the Ki-67 growth fraction is a valuable parameter for characterization of malignant tumors. So far, the so-called "Ki-67 growth fraction" (Ki-67 GF) has been determined on non-Hodgkin-lymphomas and on malignant tumors of the bone, kidney and lung. The most extensive data are available on breast cancer. In the author's studies the APAAP-method (APAAP = "alkaline phosphatase-anti-alkaline phosphatase") is preferred as an immunohistochemical staining method. The median Ki-67 growth fraction of 261 breast carcinomas was 12.5% (range 1 to 65%), being five times higher than in benign breast tissue (n = 126). The Ki-67 GF of breast cancer was correlated to different parameters known to be related to prognosis. Thus, a correlation was found with the age of patients, tumor stage, histological grading and hormone receptor status. These results are similar to those obtained by autoradiography and flow cytometry. Of 141 patients the clinical outcome of disease is known (median follow-up 22 months): 25 patients have developed local recurrence of the chest wall. This group of patients showed no significant correlation to the Ki-67 growth fractions of the primary tumors. However, the Ki-67 GF was significantly higher in 20 patients with early systemic disease and in 19 patients who died from breast cancer. Based on these results a clinical trial on adjuvant chemotherapy of lymphnode-negative patients should be taken into consideration. Thus, the prognosis for early stage breast cancer might be improved.
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PMID:[In situ determination of the Ki-67 growth fraction (Ki-67 GF) in human tumors (studies in breast cancer)]. 208 Feb 54

Primary lymphoma of bone is a rare clinical entity that accounts for less than one per cent of all non-Hodgkin's lymphomas. Although they occasionally present as a solitary lesion in bone, lymphoma involving bone is a manifestation of disseminated disease in many instances. All patients initially found to have a solitary lymphoma of bone need to be thoroughly investigated for systemic disease because more than half of the patients presenting with initially solitary bone lesions are found to have systemic disease involving lymph nodes and/or other organs. Choice of therapeutic management is based on the stage of disease. Stage I-E primary lymphoma of bone can be controlled in 70-90% of cases using local radiation therapy alone if adequate radiation doses are used. Patients with advanced disease should be treated with combination chemotherapy in addition to local radiotherapy. Loeffler et al reported long-term survival results of 90% 8-year actuarial overall survival rate for children with primary lymphoma of bone who received combined therapy with radiation and chemotherapy (adriamycin, prednisone and oncovin). The actuarial lymphoma-free survival rate was 100% at eight years. Regardless of stage of the disease, radiation treatment to the primary tumor appears to be critical for adequate local control of disease as well as rapid symptomatic relief.
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PMID:Primary lymphoma of bone. 225 87

The experience of St Bartholomew's Hospital with a less than full mantle radiation field in the treatment of 31 children with clinically staged Hodgkin's disease is reported over a ten year period (1977-1987). The major indication for this portal was initial bulk, or residual disease after chemotherapy. Primary treatment consisted of radiotherapy alone (two children) or in combination with chemotherapy (29 children). An 'Urn' radiation portal has been used to encompass mediastinal and neck nodes, but with the aim of reducing radiation doses to lung, breast, axilla, lateral end of clavicle and humeral head. More recently, a further modification has employed partial heart shielding when anthracyclines have been part of the chemotherapy schedule. The majority have received 35 Gy in 20 fractions over 4 weeks with 4-6 Mv photons, and no child received in excess of 35 Gy to the mediastinum. An overall 5-year actuarial survival of 85% was achieved, and a 5-year relapse-free survival of 77%. Seven relapses and five deaths have been reported, all of which occurred in children who presented with nodular sclerosing histology. Six children relapsed within the radiation portals, and one with systemic disease alone. Only a single child relapsed in the unirradiated axilla, and this simultaneously with cervical, mediastinal and paraortic nodes. To date no second malignancies have been reported.
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PMID:The 'urn' portal; an alternative to the 'mantle' portal in the chemoradiotherapy management of paediatric Hodgkin's disease. 226 21


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