The need for prophylactic treatment to the central nervous system in patients with aggressive non-Hodgkin's lymphoma

During 2 years, 6 out of 34 patients presenting with newly diagnosed non-Hodgkin's lymphoma developed central nervous system (CNS) complications. All were male and had diffuse, undifferentiated lymphomas. In all 6 patients, CNS disease developed during, or shortly after, treatment. We suggest that a group at high risk from these complications can be identified and should be considered for a trial of prophylaxis.     

卵巢原发非霍奇金淋巴瘤的临床病理分析

目的观察卵巢原发非霍奇金淋巴瘤的临床病理表现,探讨该类肿瘤的临床病理特征及病理诊断。方法对15例卵巢原发非霍奇金淋巴瘤作临床病理观察及随访,按WHO关于淋巴造血组织肿瘤分类（2001）进行组织学分型和诊断。采用SP法进行免疫表型检测。结果该类肿瘤占同期收治的非霍奇金淋巴瘤的0．56%（15／2679）,其中,临床Ⅲ期或Ⅳ期者有12例（80%）,临床Ⅰ期或Ⅱ期者3例（20%）。组织学分型：15例（100％）均为弥漫大B细胞淋巴瘤,中心母细胞性或免疫母细胞性。所有病例均接受了手术治疗,3例术后分别用CHOP或COMP方案治疗。4例有随访资料者均死亡,生存时间为21d～18月。结论卵巢原发非霍奇金淋巴瘤少见,预后差。肿瘤的确诊依赖病理学检查和免疫表型检测。     

Non Burkitt's non-Hodgkin's lymphoma in Ile-Ife

To determine the frequency, age and sex patterns of non-Burkitt's non-Hodgkin's lymphoma among cases of lymphoma seen at the histopathology department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The records of patients with histologically diagnosed non-Burkitt's non-Hodgkin's lymphoma seen over a period of five years were studied. The classification was based on the Working Formulation. The sex and the age at diagnosis as well as the sites of the lesions were noted. Of the fifty three cases of non-Burkitt's non-Hodgkin's lymphoma seen during the study period 54.7% had intermediate grade tumours; 24.5% has low grade and 20.8% had high grade tumours. 92.5% of the cases occurred in adults over the age of 20 years. There was also a male predominance. Nodal as well as extranodal sites were involved and peripheral lymph node involvement most often affected the cervical group of lymph nodes. The results showed that non-Burkitt's non-Hodgkin's lymphoma is predominantly a disease of adults which more often affected males than females. The intermediate grade type with the possibility of cure is the type most often seen in this study. Therefore, early diagnosis and preventive measures against known risk factors in our environment, where possible, are strongly recommended.     

Primary malignant lymphoma of the gastro-intestinal tract: a clinicopathological study of 24 cases.

Twenty-four cases of primary lymphoma of the gastro-intestinal tract were diagnosed during the period 1970 to 1991. There was a preponderance of males and the male to female ratio being 1.4:1. Age ranged from 9-70 years, mean 32.2 years. Small intestine was involved in 50% cases, large bowel in 9 cases (37.5%) and stomach in 3 cases (12.5%). There were 5 cases (20.8%) of Hodgkin's disease and 19 cases (79.2%) were of non-Hodgkin's lymphoma. All cases of gastric lymphoma complained of epigastric pain, weight loss and vomiting. In lymphoma of small intestine, 8 patients complained of pain associated with vomiting and 6 patients complained of distension of abdomen. In large bowel lymphoma, pain in right iliac fossa was complained by 4 patients and bleeding per rectum by 3 patients. Out of all the 24 cases, changes in bowel habit were noted in 15 patients and occult blood was positive in 13 cases. Palpable abdominal mass was noted in 14 patients. Histomorphologically, all the 3 cases in the stomach were of lymphocytic lymphoma diffuse type. Out of 19 non-Hodgkin's lymphoma, 15 were of lymphocytic lymphoma and 4 were of histiocytic lymphoma.     

反应停联合化疗治疗中高恶度非霍奇金淋巴瘤的临床疗效观察

目的探讨反应停联合化疗治疗中高恶度非霍奇金淋巴瘤的疗效。方法采用反应停联合化疗治疗30例中高恶度非霍奇金淋巴瘤,初发患者22例,复发患者8例。其中:中恶度24例,18例为初发患者,复发性6例;高恶度6例,4例为初发患者,2例为复发患者。结果:23例达完全缓解(CR76.7%,其中初发患者19例,复发4例),4例部分缓解(PR13.3%,其中初发患者2例,复发2例),总有效率为90%。结果到目前为止生存时间最长达13个月(2例),仍处于CR期。毒副作用主要为消化道症状、轻度肝功能异常以及骨髓抑制。结论反应停联合化疗治疗中高恶度非霍奇金淋巴瘤患者效果好,毒副作用较轻,值得推广使用。     

DICE方案治疗难治性或复发性NHL

目的观察DICE方案治疗难治或复发性非霍奇金淋巴瘤（NHL）的疗效及不良反应。方法采用地塞米松、异环磷酰胺、美安及顺铂联合治疗21例NHL观察其治疗及不良反应。结果21例中，完全缓解（CR）7例，部分缓解（PR）7例，有效率（RR）66．7％。复发组13例中CR6例、PR5例、RR84.6％，明显高于对照组8例中的1例、2例及37．5％，均P〈0.01。DICE方案的主要不良反应表现为骨髓抑制，恶心呕吐和脱发，患者均可耐受。结论DICE方案治疗复发性NHL比难治性疗效好，提示复发和难治性NHL可能有不同的生物学行为，两者应选择不同的治疗方案。     

影像学表现为双肺弥漫磨玻璃影的肺非霍奇金淋巴瘤的临床特点

目的 分析影像学表现为双肺弥漫磨玻璃影(GGO)的肺非霍奇金淋巴瘤的临床特点,以提高其诊断率.方法 回顾性分析北京协和医院2008年1月至2010年3月,胸部CT表现为双肺GGO的肺非霍奇金淋巴瘤的6例患者的资料.结果 6例患者中男5例,女1例,年龄30～59岁(平均52岁),病程2～36个月(平均14个月).临床表现为胸闷憋气5例,体重下降5例,浅表淋巴结肿大2例,肝脾肿大2例.血红蛋白平均下降25 g/L,血清乳酸脱氢酶平均755 U/L,3例患者肺功能为弥散功能障碍(一氧化碳弥散量平均为70%).影像学表现为单纯双肺GGO 2例、双肺GGO伴双肺实变影3例、伴小叶间隔增宽3例、伴小结节影2例、伴纵膈淋巴结肿大2例.6例患者均经肺组织活检病理确诊,其中4例为B细胞淋巴瘤(血管内淋巴瘤及弥漫大B细胞淋巴瘤各2例),2例为T细胞淋巴瘤.随访2～6个月(平均4个月),4例B细胞淋巴瘤患者化疗后病情平稳;2例T细胞淋巴瘤患者中1例未化疗失访,1例因合并重症肺部感染未能化疗,4个月后死亡.结论 以双肺GGO为首发影像学表现的肺非霍奇金淋巴瘤起病隐匿,少见,临床症状及影像学检查无特异性,肺活检是最终确诊的手段.     

胃非霍奇金淋巴瘤患者幽门螺杆菌检测方法比较

目的比较尿素氮呼气试验和粪便抗原检测胃非霍奇金淋巴瘤患者幽门螺杆菌感染的准确性。方法以病理检测结果为对照,对25例确诊胃非霍奇金淋巴瘤患者分别进行尿素氮呼气试验和粪便抗原检测幽门螺杆菌,比较两者检出的准确度。结果粪便抗原检测敏感性81．3％,特异性88．9％,阳性预测值92．9％,阴性预测值72．7％,准确度84％。尿素氮呼气试验敏感度93．8％,特异度100％,阳性预测值100％,阴性预测值90％,准确度：96％。结论尿素氮呼气试验对幽门螺杆菌检测的准确性高于粪便抗原检测。     

A cluster of cases of lymphoma in an underground colliery

An apparent occupational outbreak of cases of non-Hodgkin's lymphoma among the employees of an underground colliery on the NSW south coast has been investigated. The employment register of the mine recorded that 1004 men had worked at the colliery from its opening in 1946 until December 31, 1986. In this period, this cohort of men had amassed 18,818 person-years. A person-years analysis of the mortality and morbidity of cancer showed a standardized incidence ratio for non-Hodgkin's lymphoma of 3.27 (95% confidence interval [CI], 1.31-6.74) and for Hodgkin's disease of 7.27 (95% CI, 1.98-18.59). All of the cases of non-Hodgkin's lymphoma were diagnosed after 1978. An excess of cases of cancer of the salivary gland also was present (standardized incidence ratio, 10.00; 95% CI, 1.21-36.10). The method of coal extraction, the geology and chemistry of the coal-seams that were mined and the general characteristics of the work-force at the colliery are similar to those at other collieries in the region. Furthermore, an exhaustive work-place environmental study at the colliery has failed to identify any plausible carcinogenic agent to which the findings of this study can be attributed. Coal-miners previously have not been shown to be at a greater risk of developing lymphoma or related malignancies, and the region in which the mine is located has lower prevalence rates of non-Hodgkin's lymphoma and Hodgkin's disease than does New South Wales as a whole.     

CTNP方案治疗复发性或难治性非霍奇金淋巴瘤效果观察

目的:观察CTNP方案治疗复发性或难治性非霍奇金淋巴瘤(NHL)的疗效及毒副反应。方法:采用CTNP方案治疗复发性或难治性非霍奇金淋巴瘤33例,每28天重复疗程,全部患者重复3～4个周期治疗。结果:33例患者中,24例获得缓解,占72.73%,其中完全缓解(CR)7例,部分缓解(PR)17例,稳定(SD)7例,进展(PD)2例。15例具有B症状的患者中,10例症状消失,2例明显改善,3例无改善。化疗毒副反应主要为轻度的胃肠道反应和骨髓抑制,少数患者出现心电图异常,极少数出现严重的骨髓抑制。结论:CTNP方案治疗复发或难治进展型非霍奇金淋巴瘤有较好的近期疗效,能明显改善患者症状,且大部分患者可以承受其毒性,可作为补救性化疗方案治疗复发性或难治性非霍奇金淋巴瘤。     

利妥昔单抗鞘内注射治疗中枢神经系统淋巴瘤

目的探讨中枢神经系统淋巴瘤（CNSL）的治疗方法。方法报道利妥昔单抗（商品名：美罗华）鞘内注射三例中枢神经系统淋巴瘤患者,分析治疗过程并复习相关文献。结果 2例原发性中枢神经系统淋巴瘤患者临床症状达到完全缓解并无病生存超过5年,1例继发性中枢神经系统淋巴瘤患者获部分缓解,十个月后死亡。结论美罗华鞘内注射治疗效果肯定,毒副作用轻微。为治疗原发中枢神经系统淋巴瘤提供了一种有效的方法。     

Primary testicular non-Hodgkin's lymphoma--a review article.

Primary testicular non-Hodgkin's lymphoma was first described as a clinical entity in 1866. It is a rare disease and accounts for 1% of all non-Hodgkin's lymphoma, 2% of all extranodal lymphomas and 5% of all testicular neoplasms. It is the most common testicular tumor in males between sixty and eighty years of age. Testicular non-Hodgkin's lymphoma is unique in its high incidence of bilateral involvement (8-38%), and it is also the most common bilateral testicular tumor. Testicular non-Hodgkin's lymphoma has a predilection for spreading to non-contiguous extranodal sites, especially the central nervous system. Advanced-stage disease is usually managed with doxorubicin-based chemotherapy. For early-stage disease, opinion is divided regarding systemic chemotherapy following orchidectomy. The high incidence of spreading, especially to the central nervous system, leads to advocacy of the use of central nervous system prophylaxis with intrathecal chemotherapy. Prospective multicenter trials incorporating a large number of patients may lead to better guidelines for optimal management of this subtype of non-Hodgkin's lymphoma.     

非霍奇金淋巴瘤端粒酶活性的研究

目的 探讨端粒酶活性与非霍奇金淋巴瘤（NHL）这一恶性血液病发生发展的关系。方法 采用PCR－TRAP方法检测34例非霍奇金淋巴瘤和 6例霍奇金病的端粒酶活性。结果 在34例非霍奇金淋巴瘤中,29例端粒酶活性阳性;6例霍奇金病中,有一便端粒酶活性阳性。结论 端粒酶激活与非霍奇金淋巴瘤的发生发展有密切关系,并有可能成为非霍奇金淋巴瘤的临床肿瘤标志物;而非霍奇金病可能不依赖于端粒酶系统而进展。     

二甲基亚砜在耐药非霍奇金淋巴瘤的临床应用研究

①目的 探索一种治疗耐药非霍奇金淋巴瘤的新方法。②方法 在非霍奇金淋巴瘤患对化疗药物产生耐药性后，用二甲基亚砜(DMSO)加原化疗方案治疗。③结果 在14例耐药非霍奇金淋巴瘤患中，10例恢复疗效，其中2例完全缓解．8例部分缓解．4例无效，有效率71．39％。④结论 DMSO能在很大程度上恢复化疗药物的疗效，消除非霍奇金淋巴瘤对化疗药物的耐药性，是一种有效的抗耐药剂。     

38例非霍奇金淋巴瘤并发白血病临床分析

目的:探讨非霍奇金淋巴瘤并发白血病的临床特点、诊断及治疗。方法:分析38例非霍奇金淋巴瘤并发白血病的临床资料。结果:38例非霍奇金淋巴瘤性白血病患者主要表现为发热、贫血、出血、淋巴结无痛性肿大、肝脾肿大。恶性淋巴瘤患者出现上述症状及体征伴白细胞增高或减少、血小板下降时,应高度警惕白血病的发生,要尽早作骨髓检查,力争早期诊断,以防漏诊。结论:非霍奇金淋巴瘤性白血病晚期,病情发展迅速,生存期短,应进一步探索更佳治疗方案,以提高疗效。     

Non-Hodgkin's lymphoma in childhood--five years survey in VGH-Taipei

From January 1981 to January 1986, 34 children between 2 and 14 years of age were diagnosed as non-Hodgkin's lymphoma by the Rapport's classification at the Department of Pediatrics of Veterans General Hospital, Taipei, R.O.C. These patients were retrospectively analysed. There was male predominance with a male to female ratio of 2.4:1. The most common symptom was the palpable mass (29 cases, 85.3%) involved the neck and abdomen equally. All the cases were diffuse patterns, DUL (diffuse undifferentiated lymphoma) and DPDL (diffuse poorly differentiated lymphoma) both were the common subtypes of histological patterns. Twenty-eight cases (82%) were in the advanced stage (stage III and IV). The incidence of BM and CNS involvement was 56% and 29.4%, respectively. CNS involvement demonstrated a higher mortality of 100%. Surgery, radiation, and chemotherapy were mainly used for stage I-II and chemotherapy for stage III-IV. The 3-year survival rate of the whole series was 26.5%, and stage I, II, III, and IV was 100%, 50%, 33%, 9%, respectively. The causes of death were CNS involvement (10 cases, 40%), extensive involvement (7 cases, 28.0%), and sepsis (3 cases, 12.0%). This study shows that NHL in children are usually diffuse rather than follicular in histological patterns, often present a palpable mass involved the cervical or abdominal area, and commonly are widespread and tend to disseminate early.     

Treatment of advanced non-Hodgkin's lymphoma in adults.

Although dramatic progress has been made in the treatment of advanced non-Hodgkin's lymphoma, a majority of patients eventually die from this disease. Improvements in histopathology, staging techniques, immunophenotyping, and knowledge of prognostic factors have improved our ability to choose appropriate treatment. Most low-grade lymphomas can be effectively palliated for many years, but eventually convert to large-cell lymphomas or become resistant to chemotherapy. Intermediate-grade lymphomas, especially diffuse large-cell lymphomas, may be cured in 30% to 60% of the cases with aggressive combination chemotherapy. The high-grade lymphomas require treatment similar to regimens designed to treat acute lymphocytic leukemia, including central nervous system (CNS) prophylaxis. Non-Hodgkin's lymphomas are becoming more common in patients with acquired immunodeficiency syndrome (AIDS), and may be effectively controlled before the immunodeficiency becomes too severe. All patients with high-grade lymphoma and others at high risk should be tested for human immunodeficiency virus (HIV). Patients who relapse may be salvaged with chemotherapy, and their diseases are potentially curable with autologous or allogeneic bone marrow transplantation. New treatments using monoclonal antibodies, biological response modifiers, and growth factors, should improve palliation and survival.     

非何杰金淋巴瘤白血病生存期与病理类型及其它因素的关系(附33例报告)

非何杰金淋巴瘤白血病(NHLL)是非何杰金淋巴瘤(NHL)常见的并发症,其生存期短,预后盖。本文报告了生存1年以上的NHLL病人38例,探讨了与生存期有关的一些因素。结果表明,病理为低度恶性,骨髓细胞形态学分型为小淋巴细胞型(SL)及幼淋巴细胞型(PL),无全身症状,无内脏浸润,初治有效者生存期校长。     

原发性甲状腺非霍奇金淋巴瘤8例并文献复习

目的 探讨原发性甲状腺非霍奇金淋巴瘤的临床特点,诊断及综合治疗方法,以提高其诊治水平.方法 回顾性总结我院2001年～2005年收治的原发性甲状腺非霍奇金淋巴瘤8例,并结合文献对其临床表现、病理特征、诊断及治疗方法进行分析.结果 8例均因无痛性颈部肿块人院.其中5例女性,平均年龄66.3岁(56岁-79岁).均通过手术确诊,均为B细胞性.主要治疗手段为手术辅以化疗、放疗.结论 原发性甲状腺非霍奇金淋巴瘤好发于老年女性,多为B细胞性,主要表现为无痛性甲状腺肿大,术后病理检查确诊,治疗采取手术、化疗和/或放疗综合治疗.     

Adult T-cell leukemia/lymphoma in Brooklyn

Fifteen patients with adult T-cell leukemia/lymphoma (ATLL) were identified in less than a two-year period in the Crown Heights-Bedford Stuyvesant section of Brooklyn, NY. All patients were black; nine patients originated from the Caribbean islands and six from the southern United States. Two of the patients were father and daughter, the first evidence of familial occurrence in the United States. Their clinical course was similar to that of previously described patients with this disorder. To our knowledge, these 15 patients represent the largest series of ATLL reported in the United States. We recommend that ATLL be seriously considered in the differential diagnosis of patients with non-Hodgkin's lymphoma, mycosis fungoides, lymphatic leukemia, or hypercalcemia.