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

A 22-year-old woman was admitted to our hospital complaining of productive cough and dyspnea even at rest, and marked cervical lymphadenopathy. Marked stridor and orthopnea were observed, and auscultation of the chest revealed widespread expiratory wheeze which was not relieved by bronchodilators administered intravenously. Chest X-ray and CT scan revealed hilar lymphadenopathy and invasive tumor of the mediastinum. Bronchoscopy demonstrated narrowing of the trachea anteriorly and posteriorly and a submucosal nodular tumor protruding from the right anterior wall, causing approximately 90% occlusion of the lumen of the lower third of the trachea, but distal bronchi were intact. Microscopic findings of inguinal lymph node biopsy specimen revealed mixed cellular lymphoma compatible with Hodgkin's disease. Systemic chemotherapy resulted in relief of symptoms, and two months later, the endotracheal tumor had disappeared bronchoscopically, with slight residual stenosis of the trachea. Before treatment, pulmonary function tests indicated markedly impaired forced volume in 1 second in both expiratory and inspiratory cycles, especially in the latter phase. After remission, however, obstructive ventilatory dysfunction was observed. The cause of prolonged air flow obstruction was thought to be marked infiltration and almost total involvement of the tracheal wall by tumor with a nodular appearance of the lumen. Endotracheal tumor in Hodgkin's disease is rare, and there are few reports on pulmonary function associated with intrathoracic involvement of malignant lymphoma.
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PMID:[A case of Hodgkin's disease with endotracheal tumor presenting with severe airflow obstruction]. 144 51

Pediatric patients presenting with anterior mediastinal masses between January 1980 and November 1988 were reviewed to assess the correlation between tracheal cross-sectional area and anesthetic risks. Forty-two patients had evaluable computed tomography (CT) scans and underwent a surgical procedure. Thirty-four patients had Hodgkin's disease, six had non-Hodgkin's lymphoma, and two had mediastinal teratoma. Tracheal cross-sectional areas were greater than 75% of expected in 19 cases, greater than 50% to 75% in 16 cases, greater than 25% to 50% in five cases, and less than or equal to 25% in two cases. The presence or extent of symptoms did not correlate well with the degree of tracheal narrowing shown by CT scan except for orthopnea. Local anesthesia was used primarily in patients with significant tracheal narrowing (tracheal size was less than or equal to 56% in 5 of 6 patients). General anesthesia with spontaneous ventilation by mask was performed in four patients with tracheal areas of 33%, 73%, 76%, and 98% of expected. General endotracheal anesthesia was utilized in the remaining 32 patients, only three of whom had tracheal areas of less than 50% of expected (down to 30%, 26%, and 24% of expected) and one received preoperative radiotherapy (26%). None of these 32 patients had symptoms of orthopnea or dyspnea at rest, and only one had dyspnea on exertion. All tolerated anesthesia without difficulty. No patient in this series suffered respiratory or cardiovascular collapse during surgery. Adequate biopsy material was obtained in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:CT quantitation of tracheal cross-sectional area as a guide to the surgical and anesthetic management of children with anterior mediastinal masses. 202 69

Life-threatening airway obstruction from large mediastinal masses in children poses a difficult diagnostic and therapeutic dilemma, requiring the close coordination of a pediatric surgeon, anesthesiologist, radiologist, and oncologist. To focus on this problem, the anesthetic and surgical management of 50 consecutive children with mediastinal masses treated between 1978 and 1984 were reviewed. Thirty children presented with respiratory symptoms; nine had life-threatening respiratory compromise with dyspnea, orthopnea, and stridor. Thirteen of these symptomatic children had marked compression of the trachea and/or mainstem bronchi on radiographic studies. The tracheal cross-sectional area which was measured by computed tomography was decreased by 35% to 93% of the normal tracheal dimensions in these children. Nonresectable malignant neoplasms including lymphoma, Hodgkin's disease, rhabdomyosarcoma, and neuroblastoma were the eventual diagnoses in 10 of these patients. The other 3 patients were less than 4 years old and had benign lesions. General anesthesia was judged to be prohibitively risky in 5 of 13 patients. The diagnosis was established by node or needle biopsy under local anesthesia, and general anesthesia was deferred until the compromised airway was alleviated by radiation and chemotherapy. General anesthesia with endotracheal intubation was administered to 8 patients, 5 of whom developed total airway obstruction. Using a variety of maneuvers, ventilation was reestablished in all 5 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Life-threatening airway obstruction as a complication to the management of mediastinal masses in children. 408 8

A 45 year old man presented with a five week history of worsening exertional dyspnoea and orthopnoea. He had also noted mild, bilateral ankle swelling. The patient had been diagnosed with stage III Hodgkin's lymphoma in 1968 at the age of 21. During the same year he underwent total nodal irradiation followed by chemotherapy in 1971. He had remained entirely asymptomatic over the course of the next 24 years with no evidence of relapse. Cardiac catheterisation undertaken soon after admission revealed a tight left main stem stenosis with a left dominant system. Left ventriculogram showed severe, global hypokinesia, and raised left ventricular end diastolic pressure (22 mm Hg). Urgent coronary artery bypass graft surgery was carried out. He made an uncomplicated recovery and his condition improved sufficiently to allow discharge eight days following the procedure. His heart failure slowly resolved and repeat transthoracic echocardiogram performed six months after surgery showed an unequivocal improvement in left ventricular function. Left ventricular ejection fraction continued to improve and increased from 23% at two months to 42% at two years. He currently remains entirely asymptomatic off all medication.
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PMID:Hibernating myocardium caused by isolated, radiation induced left main stem coronary artery stenosis. 940 63

A 16-year-old girl repeatedly visited a general practitioner during the coronavirus pandemic for progressive shortness of breath. Progressive orthopnoea was found as well. Her neck was swollen for two weeks and there was generalised itching for months. Given the nature of her symptoms, she was assessed at the coronavirus station. A diagnosis of coronavirus disease 2019 (COVID-19) was assumed. Due to limited testing capacity, the diagnosis was not confirmed. She was treated with supportive treatment that had no effect on her dyspnoea. Tunnel vision ensured that the symptoms that did not fit COVID-19, were not recognised. Moreover, a scheduled ultrasound of her neck was cancelled because of the coronavirus restrictions, which did not help matters. She was eventually admitted to the paediatric intensive care unit with respiratory failure associated with cervical and mediastinal Hodgkin lymphoma.
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PMID:[A young lady with shortness of breath during the coronavirus crisis]. 3320 43