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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 clinical and pathologic features in 18 cases of multilocular thymic cyst (MTC) of the anterior mediastinum unassociated with Hodgkin's disease or seminoma were studied. The majority of cases were asymptomatic and discovered incidentally on routine chest x-ray. Several patients presented with acute symptoms of chest pain or discomfort, sometimes associated with dyspnea. Two cases had an incidental thymoma, and two had an incidental thymic carcinoma. The main histologic features of MTC included the following: multiple cystic cavities partially lined by squamous, columnar, or cuboidal epithelium (some having features of Hassall's corpuscles); scattered nests and islands of non-neoplastic thymic tissue within the cyst walls, often continuous with the cyst lining; severe acute and chronic inflammation accompanied by fibrovascular proliferation, necrosis, hemorrhage, and cholesterol granuloma formation; and reactive lymphoid hyperplasia with prominent germinal centers. These features suggest that MTC most likely results from the cystic transformation of medullary duct epithelium-derived structures (including Hassall's corpuscles) induced by an acquired inflammatory process. The changes are similar to those sometimes seen in association with thymic Hodgkin's disease and thymic seminoma, which are also probably due to the inflammation that accompanies these tumors rather than to the tumors themselves. We believe that MTC is pathogenetically analogous to a variety of cystic conditions of the head and neck region, for which the common denominator seems to be the induction of cystic transformation in ductular epithelial formations of branchial pouch or related derivation by an acquired inflammatory process.
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PMID:Multilocular thymic cyst: an acquired reactive process. Study of 18 cases. 172 99

The authors verified the hypothesis regarding an unawareness of possible febrile alterations during night sleep in patients with Hodgkin's disease who complain of night sweats as their only symptom. In these patients, body temperature was monitored by means of a 0.01 degrees C-sensitive linear transducer coupled with a digital multimeter. The palm of the hand (after it was passively closed in a fist by a full bandage) was the body site where temperature measurement was found to be most comfortable for a sleeping patient and independent of movements during sleep. A good correlation was found between the hand temperature taken with this technique and oral temperature. Of six patients with sweating as their only symptom, sweating recurred during the night in four and during the afternoon in the other two. In all patients sweating was preceded by a critical 0.5 to 1.5 degrees C increase in hand temperature, which took place no more than 30 minutes before sweating. Those with nocturnal sweats awakened during the subsequent sweating-related, rapid temperature decrease. These results are consistent with the occurrence of slight unperceived febrile pulses that precede sweating. The only peculiarity of night sweats consists in the higher probability that a preceding slight temperature rise may not be perceived by a sleeping patient, who is more likely to be awakened by the discomfort of the subsequent sweating. This would also explain the small prognostic significance of these sweats, which is the same as that of the preceding fever. These results are discussed in light of the increasing clinical evidence that patients with Hodgkin's disease are often affected by an instability of the thermoregulatory hypothalamic centers.
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PMID:Night sweats in Hodgkin's disease. A manifestation of preceding minor febrile pulses. 237 72

A 42-year-old patient with hemophilia A developed acute left hypochondrial pain 8 days postnephrolithotomy. A colloidal scan indicated multiple hematomas, and conservative management was given. Postoperatively, recurrent discomfort necessitated splenectomy. Multiple space-occupying lesions were found, and the histology was that of a large, noncleaved lymphoma. Contiguous spread outside of the capsule was evident, but abdominal nodes and liver appeared normal. Chemotherapy was administered, with evidence of tumor response, but refractoriness supervened, and the patient died 4 months after the diagnosis. Space-occupying lesions in a hemophiliac are generally ascribed to hematomas. The exposure of this population to the human immunodeficiency virus (HIV) should raise the consideration of a non-Hodgkin lymphoma in any situation where rapid clinical resolution of a hematoma is not occurring.
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PMID:Intrasplenic lymphoma resembling multiple hematomas in a hemophiliac. 340 37

The authors evaluated the psychological distress in 41 parents of children with acute lymphocytic leukaemia or with Hodgkin's disease using the Symptom Distress Checklist (SCL-90). The subjects were tested three times: within the first few days after the child's admission to hospital and 8 months and 20 months later. The experimental population was compared with a control group of 25 subjects matched for age, sex, marital status and social class. At the first evaluation the experimental group had higher mean scores than the controls for obsession, depression, anxiety and sleep disturbances. Seventy-eight % of the subjects (65.8% excluding the sleep disturbances (SlDi) subscale) scored moderate distress on at least one of the SCL-90 subscales. The 8 month and 20 month follow-ups confirmed the presence of high scores of psychological distress particularly in the sleep disturbances and depression subscales, with 78% (58.4% excluding SlDi) and 82.3% (70% excluding SlDi) of the subjects gaining scores of moderate distress in at least one of the subscales of the SCL-90.
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PMID:Longitudinal evaluations of psychological distress in parents of children with malignancies. 345 18

One thousand and five bone marrow biopsies were performed in patients with haematologic or oncologic disorders during a ten year period from 1976 to 1985 according to the method of Jamshidi and Swaim. Indications and method of biopsy are discussed in detail. Major side effects were not observed, however minor accidents (0.2%) as well as problems in yielding biopsy-material (1.6%) are reported. The rate of biopsy-failure, including biopsies with insufficient (crushed) material, was 5%. In our hands the predominant value of the Jamshidi-biopsy for diagnosis of hematologic disorders is given by the following reasons: Bone marrow histology gives a more detailed architectural picture than cytologic smears. Sampling of bone marrow for both methods (cytology and histology) through the same instrument is possible. The procedure is easily performed and gives the patient no more discomfort than a simple sternal puncture. Chronic myeloproliferative disorders (CMPD, 31%), malignant lymphomas (40%) and aplastic (hypoplastic) syndromes (4%) were the most frequent indications for bone marrow biopsy. Clinical and histological findings were compared in 235 patients with CMPD. The histological defined entity of chronic megacaryocytic-granulocytic myelosis could be differentiated easily from chronic granulocytic leukemia (CGL), however it was not always distinguishable from primary thrombocythemia by means of clinical and hematological criteria. Myelofibroses on the basis of CGL were separated from idiopathic or postpolycythemic fibroses by hematological findings. The diagnostic value of bone marrow biopsies was superior to cytology in all CMPD and proved to be an essential diagnostic method in cases with high platelet count. Marrow involvement was found in 59% of 218 previously untreated patients with non Hodgkin's lymphomas and in 9% of 123 patients with Hodgkin's disease. Jamshidi-biopsy proved to be a simple and indispensable procedure in staging of Hodgkin's and non-Hodgkin's lymphomas.
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PMID:[Jamshidi biopsy in clinical hematology. Method, indications and results of over 1,000 completed biopsies with special reference to chronic myeloproliferative diseases]. 347 Oct 9

A 30-year-old man with mild exertional dyspnea of recent (2 months) onset was found to have a massive pericardial effusion. The patient had received mediastinal irradiation for Hodgkin's disease over 9 years previously. No evidence of recurrent lymphoma or other causes of pericarditis could be found. Following subtotal pericardiectomy, the patient developed a syndrome characterized by precordial discomfort, low-grade fever, tachycardia, and friction rubs. The electrocardiogram, normal preoperatively, showed diffusely negative T waves. Antimyocardial antibodies appeared in the serum. The syndrome, a hitherto unrecognized sequela of pericardiectomy, is interpreted as a mediastinoepicarditis, of possibly autoimmune origin.
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PMID:Postpericardiectomy syndrome in a patient with radiation-induced pericardial effusion. 661 11

A study was made of 200 patients with Hodgkin's disease in a prolonged remission (5-12 yrs.) resulting from radiation therapy. In a long-term period after treatment the patients' height and body mass usually correspond to those obtained at examination of the entire population. Late radiation fibrosis of the soft tissues was noted in 26 patients. It was caused by repeated irradiation for recurrences of Hodgkin's disease, excess single focal doses prior to surgical intervention in the zone of irradiation. In some cases (0.9%) while using wide irradiation fields late radiation fibrosis is also observed when radiation exposure did not exceed values that are considered normal for the treatment of patients with Hodgkin's disease. In some of the patients (at the moment of treatment their age ranged between 14-16) at later time pronounced hypotrophy of the neck soft tissues (the "thin neck" syndrome) was observed, accompanied by weakness, boring pain, convulsive muscular twitching in this area, causing cosmetic discomfort.
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PMID:[State of the skin and underlying tissues in late periods following the radiation therapy of lymphogranulomatosis]. 664 23

Cancer of unknown primary is a clinical challenge that occurs in about 10% of the cancer patients. The major goal is to identify curable patients, while unnecessary efforts and discomfort should be avoided in intreatable patients. Extensive radiological examinations and serum tumour markers have turned out to be unsatisfactory means to establish the origin of the metastasis in patients with cancer of unknown origin. The crucial step for precise diagnosis is histopathological examination of the malignant tissue. Transmission electron microscopy and immunocytochemistry and genetic analysis are being increasingly used in the diagnostic evaluation of patients with cancer of unknown primary. Once a diagnosis is strongly suggested, specific treatment can be administered according to treatment in advanced known cancer. While regional disease is amenable to surgery and/or radiation therapy, multimodality treatment should be considered in treatable disseminated disease. Subsets of patients with a favourable prognosis include non-Hodgkin's and Hodgkin's lymphoma, germ cell tumours and thyroid cancer. A fair response to combination therapy can be expected in breast, ovarian and prostate cancer, while metastatic gastrointestinal or urogenital tumours remain difficult to treat. If it is not possible to identify the primary, empiric chemotherapy may provide a chance for cure in about 5% of the cases. The most common regimen employs 5-fluorouracil, adriblastin and mitomycin C. All in all, the prognosis of patients with the CUP-syndrome remains poor--the median survival in somewhat less than six months.
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PMID:Cancer of unknown primary site. 805 45

The authors report a case of primary ovarian non Hodgkin malignant lymphoma in a 41-year-old multiparous woman. An ovarian tumor was diagnosed in a context of hypogastric distention and discomfort. A total hysterectomy was performed with bilateral uterine appendectomy. The intra-abdominal organs were not affected and there were no internal adenopathies. The pathology examination concluded that this was a highly malignant, non-Hodgkin lymphoma. The findings of the extension assessment were negative. Five cycles of drastic chemotherapy combining bleomycin, adriamycin, cyclophosphamide, vincristine, methotrexate, iphosphamide, cisplatyl, VP-16 and ara-C have been administered and will be followed by abdominal radiotherapy. The patient is considered to be in a state of complete remission with a follow-up period of four years.
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PMID:[Malignant non-Hodgkins lymphoma with primary ovarian location. Observations apropos of a case]. 846 63

Laparoscopic splenectomy has been reported to be the procedure of choice in selected patients with hematologic disorders. The purpose of this study is to review our experience with laparoscopic splenectomy in this patient population. The charts of all patients with hematologic disorders who presented for laparoscopic splenectomy over a 17-month period were reviewed. Fifteen patients, nine males and six females, aged 12 to 80 years (mean, 49 years) presented for laparoscopic splenectomy. Surgical indications included 13 cases of idiopathic thrombocytopenic purpura and one each of hemolytic anemia and Hodgkin's disease. Splenectomy was performed utilizing a four- or five-puncture laparoscopic technique. For completed laparoscopic splenectomies, the mean operative time was 129 minutes, and the mean estimated blood loss was 232 cc. Mean splenic weight was 210 g. There were no operative deaths. There was a single intraoperative complication, a 1700-cc hemorrhage, and two postoperative complications: pneumonitis and deep venous thrombosis. Overall morbidity was 20 per cent. A single patient (7%) required conversion to laparotomy for completion due to hemorrhage. For patients completed laparoscopically, the mean hospitalization was 1.5 days, and none required parenteral narcotics for pain control after the first 36 hours. Laparoscopic splenectomy for patients with hematologic disorders is a safe and technically feasible procedure. Decreased hospitalization and discomfort are the primary benefits. This technique should be added to the repertoire of surgeons treating patients with hematologic disorders.
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PMID:Elective laparoscopic splenectomy for hematologic disorders. 924 37


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