Lymphome de Hodgkin

With approximately 1500 cases per year in France, Hodgkin's lymphoma (HL) represents only 10 to 15 % of new cases of lymphomas, and 0.5 to 1 % of new cases of cancers. The management of this lymphoproliferative disease has undergone profound conceptual changes over time, allowing at present to obtain a cure rate of 75 to 80 % of all confused stage, and up to 90 % in case of early stage HL. If initial treatment consisted in an exclusive extensive (total or sub-total lymphoid) irradiation whatever the stage may be, the place of radiotherapy in the management of HL has evolved over time but remains today one of the cornerstones of the treatment. It becomes integrated within the framework of combined modality therapies associating chemotherapy then irradiation for the early stage HL, and stays a therapeutic alternative in all situations (in advanced stage and\or recurrent disease) which raises the issue of increasing the locoregional tumor control. Despite the undeniable contribution of radiotherapy in controlling the disease, delayed side effects of treatments are not negligible. So the long-term monitoring of treated patients is essential, mainly because of an increased risk of morbi-mortality due to cardiovascular events and/or secondary cancers. It is important to remember that even today the «Involved Field» irradiation type remains the gold standard, even if we witness at present the emergence of new types of irradiation, which aim to reduce the amount of irradiated tissues to try to limit the risks of delayed radio-induced complications. The purpose of this article is to clarify the specific aspects (epidemiological, radio-anatomical and prognostic characteristics) of HL, as well as the practical modalities of the irradiation (illustrated by a clinical case record) when an indication of radiotherapy is placed for its treatment.     

Cerebral metastases in malignant mesothelioma: case report and literature review

Malignant mesothelioma is an uncommon tumour with an inevitably poor outcome. Statistics from the US National Cancer Institute reveal a steady rise in its incidence over the past 25 years. It typically arises from the pleura, but can also originate in the peritoneum, pericardium, genital tracts and tunica vaginalis. Previously considered a local disease with low incidence of metastasis, there is increasing evidence suggesting otherwise. Reported cases of cerebral metastasis are rare and the vast majority are postmortem findings. This report documents a patient with symptomatic cerebral metastasis from malignant mesothelioma, who underwent craniotomy and excision of two cerebral lesions. It is one of a handful of case reports in the literature in which histological confirmation has been obtained ante-mortem and where surgical treatment of the intracranial mesothelioma was undertaken.     

Spinal metastases mimicking low back pain of mechanical origin: a case report

Spinal malignancies are an essential consideration when a patient presents to a chiropractic office with back pain. This single case report exemplifies the importance of patient presentation and physical examination findings. We must also consider the rationale for x-raying patients on an individual case basis. Textbook cases do not always exist and special diagnostic tests do not always provide a definitive diagnosis of underlying pathology. Even though history and examination findings suggest a routine diagnosis, continual re-evaluation and recognition of the need to change the diagnosis on occasion is extremely important. The patient should not only be thoroughly evaluated upon initial presentation, but also each time they present for treatment. The decision to x-ray a patient is considered important. X-ray examination can be used to confirm a diagnosis or to rule out potential pathologies, and not necessarily done as a routine screening procedure.A case report is presented in which the pathologic signs were not evident on plain film x-rays upon initial presentation.     

Isolation and characterization of Pseudomonas pseudomallei flagellin proteins.

Flagellin proteins from several different strains of Pseudomonas pseudomallei have been isolated and purified to homogeneity by mechanical shearing and differential centrifugation techniques. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis yielded flagellin monomer protein bands with an estimated M(r) of 43,400. No lipopolysaccharide contamination of the purified protein preparations was detectable by silver staining of flagellin displayed on polyacrylamide gels and by Western immunoblotting with P. pseudomallei antilipopolysaccharide monoclonal antibody. NH2-terminal amino acid sequence analysis of the flagellin protein of P. pseudomallei 319a revealed significant homology with flagellins from Proteus mirabilis, Bordetella bronchiseptica, and Pseudomonas aeruginosa PAK. Rabbit polyclonal antiserum raised against the 319a flagellin protein reacted with 64 of 65 P. pseudomallei strains tested. The polyclonal antiserum proved effective in inhibiting the motility of these organisms in motility agar plates. Passive immunization studies demonstrated that 319a flagellin-specific antiserum was capable of protecting diabetic rats from challenge with a heterologous P. pseudomallei strain.     

Single CX3CL1-Ig DNA administration enhances T cell priming in vivo

Upon antigenic stimulation, establishment of adaptive immune responses that determines vaccine efficacy is dependent on efficient T cell priming. Here, single CX3CL1-Ig DNA administration, a unique ligand of CX3CR1, together with viral or tumor antigens induced a strong in vivo antigen-specific T cell proliferation and effector function that was enough efficient to protect against a tumor challenge. We also showed that early expression of CX3CL1-Ig and antigens in muscle and lymphoid organs induces an increased in vivo migration of myeloid CD14+CD11c+ DC but not lymphoid CD8alpha+CD11c+ DC at these sites. Thus, by effectively directing DC toward lymphoid organs to encounter T cells, CX3CL1-Ig become a new candidate that augments T cell priming and increases efficiency of vaccination.