Asymptomatic eyebrow mass. A rare presenting sign of malignant non-Hodgkin's lymphoma.

A 60-year-old woman had a solitary mass in her left eyebrow that was first thought to be a dermoid cyst and following excision and histological examination was found to be a localized, malignant, non-Hodgkin's lymphoma of the mixed lymphocytic and histiocytic type. Subsequent lymphangiography after excisional biopsy of the left eyebrow mass demonstrated extensive para-aortic and inguinal lymph node involvement.     

A unique presentation of non-Hodgkin's lymphoma in the foot.

Non-Hodgkin's lymphoma of the foot is a relatively uncommon pedal neoplasm. The authors discuss the etiology, incidence, histology, morphology, metastatic rate, and treatment of this entity. Non-Hodgkin's lymphomas rarely present as destructive lesions of bone; when they do, they usually involve the axial skeleton or proximal long bones. Additionally, the authors present a clinical case reporting findings of Non-Hodgkin's lymphoma after surgical correction of a hammertoe deformity and subungual exostosis. The pathologic microscopic evaluation of the resected bone assisted in diagnosis of this condition.     

Prognostic parameters in patients with advanced non-Hodgkin's lymphoma

Ninety-five patients with advanced non-Hodgkin's lymphoma (NHL) were studied to evaluate parameters affecting their survival. The median survival time was 52 months (range 3-107 months). The log-rank test was used to analyse the data. Favourable parameters that significantly influenced actuarial survival were nodular histology (P = 0.01), age less than 50 years (P = 0.002), good performance status (P = 0.006), and normal serum lactate dehydrogenase, SGOT and alkaline phosphatase levels. The absence of systemic symptoms, namely weight loss in excess of 10%, fever or night sweats, had less prognostic implication. Sex and stage (III or IV) did not significantly affect survival.     

Abdominal non-Hodgkin's lymphoma in children

Study of the clinical manifestations and the results of treatment of abdominal lymphomas in 58 children showed that the poor results of therapy were due first of all to the high proportion (67.2%) of generalized forms by the time of their detection. Among the patients who were under observation, the 3-5-year survival was 41.3%. Late recognition of the disease was linked with the absence of proper oncological alertness among the physicians. Profound preventive examinations with the wide use of modern diagnostic techniques will be conducive to an early diagnosis of this pathological condition and improvement of the results of treatment.     

Pleural mesothelioma associated with non-Hodgkin's lymphoma.

Occupational exposure to asbestos has been associated with an increased incidence of lung and gastric cancers, mesotheliomas, and myelolymphoid malignancies. A new observation of a patient with indirect exposure to asbestos who developed mesothelioma and plasmacytoid lymphocytic non-Hodgkin's lymphoma is described. This report and the previously described stimulation of B lymphocytes by asbestos suggests that the association of mesothelioma with lymphoid and plasma cell malignancies is not merely a coincidence.     

Primary non-Hodgkin's lymphoma of the lung

BACKGROUND: Primary non-Hodgkin's lymphoma of the lung is a rare entity. Although the prognosis is favorable, clinical features, prognostic factors, and patient management have not been clearly defined. METHODS: We reviewed retrospectively the records of 48 patients operated on for primary pulmonary non-Hodgkin's lymphoma. The study group consisted of 21 male (44%) and 27 female (56%) patients with a mean age of 61.8 years. Thirty-seven and a half percent of patients were asymptomatic, and 62.5% were seen with pulmonary symptoms, systemic symptoms, or both. A definitive diagnosis was obtained by thoracotomy in 90% of patients, thoracoscopy in 8%, and anterior mediastinotomy in 2%. RESULTS: Complete surgical resection was possible in 19 patients (40%). A mucosa-associated lymphoid tissue lymphoma (MALT) was found in 35 patients and lymphoma that was not of this type, in 13. The 1-year, 5-year, and 10-year survival rates were 91%, 68%, and 53%, respectively in the group with mucosa-associated lymphoid tissue lymphoma and 85%, 65%, and 64% in the group with lymphoma that was not of the mucosa-associated lymphoid tissue type. None of the prognostic factors studied (mode of presentation, smoking history, bilateral disease, postoperative stage, complete resection, adjuvant chemotherapy, histology) significantly influenced patient survival. CONCLUSIONS: Primary non-Hodgkin's lymphoma of the lung occurs with nonspecific clinical features. Although patient survival is good, prognostic factors could not be identified.     

Treatment results in renal transplant recipients with non-Hodgkin's lymphoma

The purpose of this study was to investigate the incidence of non-Hodgkin's lymphoma (NHL), response to treatment, and survival time in renal transplant recipients at our center who developed this form of neoplasia. Between October 1985 and August 2002, 1077 renal transplantations were carried out at our center. The incidence of NHL after transplantation was 1.1% (12/1077). All patients had their immunosuppressive doses reduced after they were diagnosed with NHL. Complete remission was achieved in eight cases, and five of these individuals were still alive at the time of writing. The circumstances for each of the three deaths in this group were as follows: (1) progressive gastric adenocarcinoma 9 years after being diagnosed with NHL, (2) stage III NHL cured with chemotherapy, but died of infection 2 years after NHL diagnosis, and (3) recurrent intestinal lymphoma, with death during second line chemotherapy. Of the five survivors in the remission group, one had to return to hemodialysis. The four patients who did not enter remission all died. The median time from transplantation to diagnosis of NHL was 66 months. At the time of writing, the median survival time for the eight patients who achieved complete remission was 41.5 months. The study showed that treatment of localized disease (skin or intestinal NHL) with surgery and/or radiotherapy/chemotherapy leads to complete remission and long survival times; however, patients in remission are at risk for other causes of death.     

Pleuropericardial effusions in children with non-Hodgkin's lymphoma. A report of 2 cases

Two children with non-Hodgkin's lymphoma (NHL) who presented with pleuropericardial effusions are reported on. Pericardial effusions are very unusual in children with mediastinal nodal NHL. In the first patient, who presented with a pleural effusion and pericardial tamponade, the diagnosis of NHL was obscured by a false-positive report of acid-fast bacilli in the pleural fluid. The second patient presented with a pleural effusion and a pericardial effusion with superior vena cava obstruction. Rapid filling of the serous cavities was a striking feature in both cases. Cytological and biochemical investigation of the pleural fluid and pleural biopsy are of limited diagnostic value. Pleuropericardial effusions in NHL are reviewed. The patients have been in disease-free remission for 18 and 16 months respectively.     

Acquired angioedema in non-Hodgkin's lymphoma.

This paper describes a middle-aged patient who developed repeated episodes of swelling of the orofacial tissues after dental treatment. On investigation, C1 inhibitor, C1q, C2, and C4 levels were all markedly reduced, and a diagnosis of acquired C1 inhibitor deficiency was made. The patient had been diagnosed with non-Hodgkin's lymphoma (NHL) 2 years previously and had undergone a successful course of chemotherapy. The development of her episodes of angioedema prompted thorough reinvestigation and a recurrence of NHL was identified. Therefore, acquired C1 inhibitor deficiency heralded a recurrence, although this had not been a manifestation when NHL was first diagnosed. The patient underwent a further course of chemotherapy and remains well, although C1 inhibitor, C1q, C2, and C4 levels remain reduced.     

Primary non-Hodgkin's lymphoma of vagina associated with pregnancy

We report a case of non-Hodgkin's lymphoma (NHL) in 23 years old, 36 weeks pregnant female, who presented with a swelling in the vagina. Biopsy of the lesion led to profuse haemorrhage and emergency caesarean-section along with bilateral ligation of internal iliac arteries were required. Recovery was smooth and she was discharged from the hospital on the 5th postoperative day. Histopathology revealed non-Hodgkin's lymphoma, diffuse large B cell type (DLBCL). Further treatment by medical oncologist led to complete resolution of the tumour at three months.     

Primary non-Hodgkin's lymphoma of the spinal cord

STUDY DESIGN: Case report. OBJECTIVE: To report a rare case of primary lymphoma of the spinal cord and to discuss therapeutic options. SUMMARY OF BACKGROUND DATA: Only few cases of primary spinal cord lymphomas are reported. Prognosis is often poor, and therapy is not yet established.METHODS: A primary lymphoplasmacytoid lymphoma of the thoracic cord in a 75-year-old woman was treated with focal radiotherapy (30 Gy) and three cycles of chemotherapy consisting of procarbazine, lomustine, and vincristine. RESULTS: Complete tumor response and partial recovery of neurologic symptoms were achieved. The patient was in complete remission at last follow-up (11 months after diagnosis). CONCLUSIONS: Primary spinal cord lymphomas should be considered in the differential diagnosis of spinal cord tumors, especially in older patients. Combination therapy with radiotherapy and chemotherapy may be superior to radiotherapy alone in these tumors. Rapid initiation of treatment is essential to achieve recovery of neurologic function.     

Undifferentiated primary hepatic non-Hodgkin's lymphoma in childhood

This report describes a case of primary non-Hodgkin's lymphoma occurring in the liver of an 11-year-old boy. Preoperative imaging established a large mass confined to the right lobe of the liver; complete removal was effected by right hepatic lobectomy. At presentation, there was serological evidence of active hepatitis B infection, which was confirmed histologically in the nonneoplastic portion of resected liver. The right lobe of liver was virtually replaced by a multinodular tumor mass that histologically resembled small-cell lymphoma. No evidence of either a B- or T-cell lineage could be established by immunophenotyping. However, immunohistochemical staining for panleukocyte markers demonstrated membrane staining. Gene rearrangement studies were not available. The patient remains well with no evidence of disease 2 1/2 years after surgery.     

Primary non-Hodgkin's lymphoma of bone in children

BACKGROUND: Primary non-Hodgkin's lymphoma of bone, often more simply referred to as primary lymphoma of bone, is a rare subset of non-Hodgkin's lymphoma in children. There are only a few small series of primary lymphoma of bone in children with long-term follow-up, and none have appeared in the orthopaedic literature. METHODS: A review of our institution's Pediatric Tumor Registry identified fifteen cases of primary lymphoma of bone among 306 cases of diagnosed non-Hodgkin's lymphoma between 1970 and 2003. Retrospective evaluation included collection of demographic, clinical, radiographic, treatment, and follow-up data. A univariate analysis was used to assess the prognostic significance of risk factors with respect to survival of patients from this series and in a summary analysis of data collected from similar series in the literature. RESULTS: The patients included ten male and five female patients with a mean age of 11.6 years. Most patients had a presenting complaint of pain and had swelling and/or tenderness on physical examination. Eight children had a solitary bone lesion, and seven had multiple bone lesions. Overall, the mean number of bones involved was 3.1 per patient. The femur and the pelvis were the most frequently involved bones. The ten surviving patients were followed for a mean of 13.6 years. Five patients died: three of disease progression, one of treatment-related complications, and one of an unrelated cause. The mean time from diagnosis to death was 2.1 years. Nine patients received chemotherapy only, whereas six patients received a combination of chemotherapy and radiation therapy. In the present study, an age of nine years or less was predictive of poor survival (p < 0.05). In the summary analysis of cases collected from the literature, advanced stage, young age, non-large-cell histology, and multiple-bone involvement were predictive of poor survival (p < 0.05). CONCLUSIONS: On the basis of the present series and a comprehensive review of similar series in the literature involving patients with primary lymphoma of bone, it appears that younger age, advanced-stage disease, multiple-bone involvement, and non-large-cell histology are associated with decreased survival as compared with older age, localized disease, single-bone involvement, and large-cell histology, respectively.     

A case of retroperitoneal Hodgkin's disease with dysuria

A case of retroperitoneal Hodgkin's disease with dysuria is reported. A 56-year-old man visited our hospital with the complaints of dysuria and lower abdominal mass. On physical examination, an unmovable hard smooth mass of fist size was palpable in the lower abdomen and prostate was slightly swelling by rectal digital examination. Excretory urography demonstrated medial deviation of left lower ureter and bladder deformity. Retrograde urethrocystography showed deviation and compression of prostatic urethra. On CT, tumors were composed of several round masses, which surrounded the left common iliac artery on angiography. Surgical extirpation was carried out and histological examination revealed Hodgkin's disease. As postoperative treatment, chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisolone was performed, and 30 months after the operation the patient was asymptomatic.