Value of prednimustine in treating non Hodgkin's lymphomas of favourable histological type

24 patients with non-Hodgkin's lymphomas of low-grade malignancy (stage III and IV) were treated either with a single drug (prednimustine) or with combination chemotherapy (cyclophosphamide, vincristine and prednisone). Response to therapy was similar in both groups. Prednimustine induced complete remission in 6 from 13 patients, while in that group treated with combination chemotherapy a complete remission was recorded in 4 from 11 patients. Both regimens were well tolerated. Therapy with prednimustin has an advantage in oral administration enabling it to be used in out-patient practice.     

Monocyte production in Hodgkin's disease and non-Hodgkin's lymphoma.

Monocytopoietic proliferation activity was investigated in patients with untreated Hodgkin's disease, Hodgkin's disease in long-term complete remission, and untreated non-Hodgkin's lymphoma of the lymphosarcoma and reticulosarcoma type. Untreated Hodgkin's disease was found to be associated with a rise in medullary monocyte production which returned to normal during long-term complete remissions. In contrast, monocyte production was increased in only 5 out of 14 patients with lymphosarcoma and reticulum cell sarcoma, normal in 3, and reduced in 6. In neither of these lymphomas was any relation between monocyte production and stage or histology of the disease detectable.     

Cutaneous manifestations in non-Hodgkin's lymphoma

OBJECTIVE: To examine and subtype cutaneous lymphoma specimens for diagnosis. STUDY DESIGN: Aspiration smears from skin lesions and lymph nodes diagnosed as non-Hodgkin's lymphoma (NHL) on cytology in 6 cases over a period of 1 year were reviewed. Two were follow-up cases of nodal lymphoma and were receiving chemotherapy, during which they developed skin lesions. In 4, the patients had cutaneous lesions as a presenting manifestation. Cytologic findings were correlated with histologic and hematologic findings and immunocytochemical markers for subtyping. RESULTS: Patients ranged from 14 to 50 years, with equal sex ratio. All presented with 0.5-5 cm multiple nodular, ulcerated and fungating skin lesions at various body sites. The aspirate was satisfactory in all cases. Cytologically, all cases were diagnosed as NHL. They were then immunocytochemistry subtyped as various lymphomas. CONCLUSION: Cutaneous lymphoma should always be considered in the presence of predominantly atypical lymphoid cells in smears from nodular and fungating skin lesions, even in the absence of a definitive clinical diagnosis.     

Immune-mediated interactions during macrophage development in non-Hodgkin's lymphoma.

As part of an investigation of mononuclear phagocytes in malignant lymphoma, measurement of immune-mediated erythrophagocytosis and rosette formation was carried out on cells grown in suspension culture at the monocyte (Day 0) and macrophage (Day 6) stages; the culture medium contained autologous serum. Cells were derived from 10 patients with untreated non-Hodgkin's lymphoma (NHL) and from 12 normal individuals. The results were subjected to Analysis of Variance and demonstrated a significant difference between the two groups with respect to erythrophagocytosis but not to rosette formation. In the NHL group, the proportion of erythrophagocytic cells showed no significant increase between the monocyte and macrophage stages (0.07 to 0.09), in contrast to the marked increase seen in the normal group (0.09 to 0.24). In a pilot investigation to examine the possible role of factors in the serum, cells derived from the NHL patients were cultured with serum from healthy donors; they showed no significant difference in the immune-mediated functions from those grown in autologous serum. Overall, the results provide further quantitative evidence of defective macrophage maturation in NHL, presumably reflecting the compromise of host defence mechanisms.     

Localized non-Hodgkin's lymphoma of the adrenal and thyroid glands.

A case of immunoblastic lymphoma, involving only the thyroid and the adrenal glands, is presented. The patient had clinical symptoms and findings of Addison's disease, and computed tomography (CT) demonstrated bilateral adrenal tumoral enlargement. He also had euthyroid diffuse multinodular goiter. The diagnosis of the patient was based on the cytological examination of the aspiration materials from both endocrine glands. The patient received "m-BNCOD" chemotherapy regimen and replacement therapy for Addison's disease. At the end of three courses, a partial response was obtained.     

Management of localized non-Hodgkin's lymphoma

Non-Hodgkin''s lymphomas (NHLs) are a heterogeneous group of disorders that vary widely in response to therapy. In Canada the modified Rappaport classification is used to categorize NHL. To facilitate the reporting and comparison of treatment results all cases should also be categorized in the terminology of the National Cancer Institute''s working formulation. The choice of therapy should be guided by specific prognostic factors: stage and bulk of the disease, patient''s age, presence of systemic symptoms and histologic subtype. Of these, the last appears to be the most important. Radiotherapy (RT) is the treatment of choice in localized low-grade lymphomas with favourable prognoses, while bimodal therapy (RT and chemotherapy [CT]) is warranted in presentations with unfavourable prognoses. Regional irradiation alone is indicated in intermediate-grade lymphomas with good prognoses (i.e., pathological stage I or II or clinical stage IA or IIA localized disease of small bulk in young patients). All other patients require CT followed by RT. The results of CT alone are encouraging but remain experimental. Aggressive therapy with multidrug regimens that include central nervous system prophylaxis is the foundation for successful treatment of high-grade NHL such as lymphoblastic lymphoma and diffuse small-noncleaved-cell lymphomas. Low-dose RT should be given to sites of bulky disease.     

Cytomorphologic characteristics of non-Hodgkin's lymphoma

The cytologic samples of 84 non-Hodgkin's lymphomas, classified according to the Rappaport system, were reviewed, with particular attention to the cell pattern, the size of the cells and other morphologic characteristics. The analysis revealed that: (1) the subgroups of malignant lymphoma in the Rappaport classification display a heterogeneous cytologic picture; (2) cytology cannot make the differentiation between nodular and diffuse non-Hodgkin's malignant lymphomas; and (3) reliable cytologic classification is possible only in certain cases of well-differentiated lymphocytic and diffuse histiocytic lymphomas. Well-differentiated lymphocytic lymphoma is characterized by a uniform cell picture consisting of mature lymphocytes, prolymphocytes or centrocytes up to 12 micron in size, by the presence of paraimmunoblasts and by the absence of reticulum cells. The diffuse histiocytic lymphoma contains over 48% centroblasts or over 8% immunoblasts or multinucleated giant blast cells.     

Rituximab induced hypoglycemia in non-Hodgkin's lymphoma

Background

Patients with aero-digestive malignancy will often require a feeding gastrostomy during their treatment to maintain their nutritional status. These are usually placed percutaneously using an endoscopic technique.

Case presentation

A fifty-six year old male underwent placement of a percutaneous gastrostomy (PEG) prior to commencement of his treatment for an oral squamous cell carcinoma. The treatment for this was locally curative. However, he developed a metastasis at the site of his PEG tube. This was excised en-bloc with the anterior gastric and abdominal walls.

Conclusion

Tumour implantation into wounds has been previously reported. In this case the direct trauma of passing the PEG tube through the oropharynx led to implantation of cells in the anterior abdominal wall. In these cases laparoscopic placement may be more beneficial to avoid this problem.     

Histopathology of the spleen in non-Hodgkin's lymphoma

The human spleen has several different lymphoid compartments, which may be preferentially involved by non-Hodgkin's lymphomas. Low grade B-cell lymphomas tend to involve the compartments of the spleen where their normal physiological counterparts are found. High grade B-cell lymphomas grow more destructively without respecting lymphoid compartments. T-cell lymphomas involve mainly the T-cell areas, but may also involve follicles and the red pulp. Since non-Hodgkin's lymphomas can be regarded as clonal proliferations of lymphocytes frozen at a stage in differentiation, one possible conclusion is that low grade lymphomas are governed by normal homing mechanisms. High grade lymphomas may have lost their homing properties.     

Disordered development of macrophages in non-Hodgkin's lymphoma

Macrophage development in 20 untreated patients with non-Hodgkin's lymphoma (NHL) has been studied and compared with that in 20 normal subjects. Morphometric measurements were carried out on ultrastructural features of cell, nucleus and mitochondria during 6 days suspension culture of blood monocytes in the presence of autologous serum and lymphocytes. The results were subjected to multivariate and univariate analysis of variance. Statistically significant differences were found between the subject groups with respect to the volumes and surface areas of cell, nucleus and mitochondria, to the excess surface membrane of cell and nucleus (as compared with equivalent spheres) and to the number of mitochondrial profiles per section. It would appear that the patients' cell grew less, showed less elaboration of surface features and had reduced nuclear and mitochondrial development, the latter affecting mitochondrial numbers rather than individual size. The findings provide further evidence that mononuclear phagocytes are deranged in NHL.     

Transfer factor immunotherapy in Hodgkin's and non-Hodgkin's lymphoma

Summary Human dialyzable transfer factor was administered in a double-blind fashion to patients with Hodgkin's disease and non-Hodgkin's lymphoma. Two groups were examined; patients with active disease and patients in remission. Parameters of cellular and humoral immunity were studied. The effect of transfer factor on the clinical condition was not evaluated.Transfer factor tended to intensify the skin test reactions of patients in remission to several recall antigens, but had no effect on the other parameters or the other patient group.     

Ultrasonic diagnosis of non-Hodgkin's lymphoma]

Analyzes the results of ultrasonic examinations of 111 patients with various forms of non-Hodgkin's lymphomas. Reviews ultrasonic semeiotics of non-Hodgkin's lymphadenopathy of the abdominal cavity and retroperitoneal space and of extranodal variants of lymphoma course (with involvement of the spleen and stomach). Suggests the most safe method for precision diagnostic aspiration biopsy of the spleen monitored by ultrasound. The author considers ultrasonic examination to be a valuable method for the diagnosis of non-Hodgkin's lymphomas; it is economic, rapid, safe, permits a simultaneous assessment of the status of many organs and systems. The results of ultrasonic examinations should be assessed in complex with the results of other diagnostic methods. Ultrasonic examination should be considered as a method of choice for monitoring patients with diagnosed non-Hodgkin's lymphoma.