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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although musculoskeletal lesions are not reported as commonly as pulmonary or central nervous system abnormalities in human immunodeficiency virus (HIV)-positive individuals, a wide variety of osseous and soft-tissue changes are seen in these patients. We describe the case of a 35-year-old injection drug user with acquired immune deficiency syndrome (AIDS) who presented with diffuse adenopathy, lower extremity pain and swelling, subcutaneous nodules, and constitutional symptoms. Radiographic images showed bilateral lytic lesions of the tibia and accompanying soft-tissue masses. Biopsy of the bone and soft-tissue abnormalities established a diagnosis of Burkitt's-like non-Hodgkin's lymphoma (NHL). By recognizing the heterogeneity of AIDS-associated NHL presentations, and the potential clinical overlap between malignancy, infection, and other rheumatologic abnormalities, physicians may obtain appropriate diagnostic studies and offer treatment recommendations.
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PMID:AIDS-associated secondary lymphoma of bone: a case report with review of the literature. 950 98

A very unusual clinical presentation of non-Hodgkin's lymphoma (NHL) of the liver is reported herein. The patient was a 35-year-old male who had been HIV-positive since 1987. Following an episode of acute pain in the right upper abdominal quadrant, ultrasonography (US) and computed tomography (CT) were performed, revealing a nodular lesion, 2.5 cm in diameter, localized in the eighth segment of the liver. Despite the fact that the lesion became significantly enlarged over a 6-month period, three repeated percutaneous biopsies proved negative. Finally, his increasing pain and the lack of a definitive diagnosis prompted us to perform a right hepatectomy. The patient had an uneventful postoperative course and is well 1 year after his operation. Establishing a diagnosis of extranodal lymphoma can be difficult, especially in HIV-positive or AIDS patients. Thus, performing a laparotomy is justified to confirm a diagnosis and decide upon the most appropriate treatment. However, in about 10% of these patients, only surgical resection allows for the diagnosis. In accordance with other reports, our experience confirms that, in contrast with AIDS patients, HIV-positive patients have a similar prognosis as non-HIV patients, and are suitable candidates for even major surgical procedures.
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PMID:Major liver resection for non-Hodgkin's lymphoma in an HIV-positive patient: report of a case. 987 44

A 50-year-old man noticed a mass in the right cervical region and presented to our hospital. He underwent biopsy of a cervical lymph node, which revealed non-Hodgkin's lymphoma (diffuse large B cell, lymphoblastic type) histologically. He was treated with chemotherapy (CHOP) and radiation, and achieved complete remission. Two months later, he was admitted because of distal pain and extensive numbness of the lower limb as well as weakness of the left leg. Lumbar MRI showed an area of abnormal intensity in the cauda equina. Cytological examination of cerebrospinal fluid showed class V (lymphoma cells), so he was diagnosed as having recurrent malignant lymphoma of the spinal cord. He was treated with intrathecal chemotherapy and irradiation. After the treatment the mass in the cauda equina disappeared and the neurological symptoms in his legs resolved. It is rare for malignant lymphoma to recur in the spinal cord, particularly the cauda equina. It is well known that cauda equina syndrome can be caused by vertebral lesions and primary spinal cord tumors, but it is also necessary to keep malignant lymphoma of the cauda equina in mind.
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PMID:[Cauda equina syndrome due to recurrent malignant lymphoma of the spinal cord. A case report]. 1065 73

We report on our experience in the use of transdermal fentanyl in management of acute pain due to mucositis WHO-grade IV during high-dose chemotherapy (HDC) and autologous stem cell support (APBSCT). Between 8/96 and 12/98 74 patients received HDC and PBSCT for progressive disease or relapse of non-Hodgkin's lymphoma (n=32), multiple myeloma (n=37), Hodgkin's lymphoma (n=5). All patients suffered from mucositis WHO-grade IV with a need for continuous pain management. Instead of pethidine i.v. fentanyl TTS was used. Sufficient analgesia was achieved mostly with a dose of 50 microg/h. There was no need of supplementary analgesia. Relevant fentanyl-associated side effects were not seen. Patient compliance and acceptance were excellent. The results suggest that transdermal fentanyl is reliable in pain management of chemotherapy-associated mucositis grade IV.
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PMID:Transdermal fentanyl during high-dose chemotherapy and autologous stem cell support. 1076 86

Many articles pertaining to quality of life (QOL) following stem cell transplantation have been published in the US and western Europe. However, since the actions of health insurance systems and overall cultural aspects are strongly associated with QOL, investigations into QOL should be carried out within all countries. Therefore, we have investigated the QOL of adult patients following stem cell transplantation at 31 hospitals in Japan. The survivors, who were surveyed by mail questionnaire, were 20 years or older at the time of this study. The underlying diseases were acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, myelodysplastic syndrome, and multiple myeloma. Median age at the time of the study was 36 years, and median interval after transplantation was 35.3 months. Of 383 patients surveyed, 282 (73.6%) responded to the questionnaire. One hundred and ninety-two patients were treated with an allogeneic-related transplantation, 52 with allogeneic-unrelated, and 38 with an autologous transplantation. Our data revealed that the length of time since transplantation and the diagnosis of chronic GVHD were associated with QOL. When unrelated and related transplantation recipients were compared, ratings on relief from pain, stability in weight, and confidence in dealing with daily life were lower among unrelated transplantation patients.
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PMID:Quality of life in adult patients after stem cell transplantation. 1084 37

A 43-year-old man was admitted to our hospital because of hemophagocytic syndrome (HPS) in August, 1998. A CT scan, gallium scintigraphy, gastrofiberscopy and colonofiberscopy showed no evidence of malignant lymphoma. Virus-associated HPS was suspected because of an increased titer of anti-Epstein-Barr (EB) virus antibody (EBV VCA IgG 2,560x, EBV EA IgG 40x, EBNA 20x). The HPS resolved spontaneously for 40 hospital days, but two weeks into the period of HPS remission, the patient developed pain and marked swelling of the right thigh muscle, and pectoral, biceps brachii, quadriceps femoralis and masseter muscles. Otherwise, CT scan and gallium scintigraphy showed no abnormal findings. A biopsy of the right quadriceps femoralis muscle revealed non-Hodgkin's lymphoma with muscle infiltration. Immunohistologic examination confirmed T-cell type (CD3, CD43, CD45, CD45RO) lymphoma, and Southern blot analysis for T-cell receptor revealed a rearranged band. The lymphoma cells were negative for EBV genome monoclonality. The patient responded well to CHOP therapy and achieved a complete remission. This is considered a very rare case of T-cell lymphoma infiltrating multiple skeletal muscles following an episode of hemophagocytic syndrome.
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PMID:[Skeletal muscle T-cell lymphoma following hemophagocytic syndrome]. 1107 Sep 31

A case of a primary malignant lymphoma of the prostate is presented. An 82-year-old man visited our hospital complaining of anal pain. Digital rectal examination revealed an enlarged prostate gland, which caused a rectal stricture. A computed tomographic scan and magnetic resonance imaging (MRI) showed a large mass arising from the prostate and protruding to the rectum. According to the Working Formulation, he was diagnosed with non-Hodgkin's lymphoma of B-cell origin, diffuse, mixed, small and large cell. The results of bone marrow puncture and imaging studies led to the diagnosis of primary malignant lymphoma of the prostate. Because of poor performance status deriving from severe anal pain, radiation therapy was performed to control the pain. After improvement of his performance status, he received combination chemotherapy consisting of cyclophosphamide, adriamycin, vincristine and predonisone (CHOP regimen). His prostate markedly diminished in size, but pneumonia developed. His respiratory condition rapidly deteriorated, and he died of respiratory failure about two and a half months after the onset of his illness. Malignant lymphoma involving the prostate, whether primary or secondary, is very rare. In our understanding, this case is thought to be the 28th clinical case of a malignant lymphoma of the prostate in Japan.
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PMID:[Malignant lymphoma of the prostate: a case report]. 1143 56

Cancer is an increasing cause of disease-related death in childhood within developing countries, where the great majority of the world's children reside. The improving prospects for survival in such children, and the corresponding challenge of undertaking economic evaluations of related health interventions, provide a stimulus to study the health-status and health-related quality of life in survivors of cancer in childhood in Latin America. Spanish language versions of questionnaires for proxy assessors, based on the Health Utilities Index (HUI), were used to elicit responses from parents and physicians. The HUI is a family of multi-attribute, generic, preference-linked measures of health status and health-related quality of life that are reliable, responsive and valid, and have been used previously in pediatric oncology. Valid responses were received from 178 parents and 144 physicians in 6 centres in 4 countries (Cuba, Honduras, Colombia and Uruguay). For children with acute lymphoblastic leukemia the major morbidity burdens were in the attributes of emotion, cognition and pain. The overall burden of morbidity was greater in children with non-Hodgkin's lymphoma. In survivors of Hodgkin's disease and Wilms' tumor the attributes most affected were emotion and pain. In general, there was considerable agreement between the assessments provided independently by parents and physicians. This study demonstrates the feasibility of conducting such measurements in developing countries, and reveals similarities in health status and health-related quality of life to comparable populations in more privileged societies.
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PMID:Health status and health-related quality of life in survivors of cancer in childhood in Latin America: a MISPHO feasibility study. 1144 61

Case vignette: Henry, age 19, has been under medical care struggling for 5 months with a non-Hodgkin's lymphoma that has been resistant to treatment. Proven chemotherapy protocols have failed to sustain a remission, and it is evident that his condition is terminal, although not immediately so. When not in temporary remissions he is in extreme pain. The quantity of analgesic medication needed to control the pain also leaves him feeling, in his own words, "too snowed out to do anything." During his last hospital admission, a week ago, he had talked obliquely about ending his life when signs of another painful relapse become evident. Today he appeared in the outpatient clinic, although he had no appointment scheduled. He sought out several of the people who had cared for him over the past few months to thank them and to "say good-bye." He gave some prized personal possessions to one or two of the staff with whom he felt especially close. As this was happening, some of the staff members realized that Henry had a sufficient stock of narcotics at home to end his life. Our commentators are Sanford Leikin, MD, and Richard A. McCormick, SJ.
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PMID:Terminal illness and suicide. 1164 52

Examination of the records of 88 consecutive patients with extranodal maxillofacial non-Hodgkin's lymphoma (ENHL) was undertaken. Each patient's complete record was reviewed. Males outnumbered females by 1.7:1. Age at diagnosis ranged from 22 to 94 years (median 60.0). Affected anatomic sites included: maxillary sinus (22), nasal cavity (8), maxilla (13), mandible (8), salivary glands (14), and other (23). The most common presenting symptom was a non-painful mass. Associated dental symptoms were present in 72 patients and included intraoral swelling, pain, and loose teeth. Treatment included chemotherapy and radiation with a follow-up of 1-25 years. Treatment trends indicate a shift towards multimodal therapy. Non-Hodgkin's lymphoma of the head and neck, if discovered early, has an excellent prognosis.
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PMID:Extranodal non-Hodgkin's lymphoma of the maxillofacial region: analysis of 88 consecutive cases. 1188 30


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