Cases reported "Hodgkin Disease"

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11/271. Classical Hodgkin's disease and follicular lymphoma originating from the same germinal center B cell.

    PURPOSE: Classical Hodgkin's disease and non-Hodgkin's B-cell lymphoma occasionally occur in the same patient. To clarify whether these different diseases share a common precursor cell, we analyzed the immunoglobulin rearrangements in tumor cells of the classical Hodgkin's disease and the follicular lymphoma that developed in the same patient 2 years apart. patients AND methods: polymerase chain reaction (PCR) for the detection of rearranged immunoglobulin genes was carried out on single reed-sternberg cells and on whole tissue dna extracted from the follicular lymphoma. PCR products were sequenced and compared with each other and with germ line immunoglobulin variable segments. Immunoglobulin heavy- and light-chain transcripts were analyzed by radioactive in-situ hybridization. RESULTS: The same monoclonal immunoglobulin gene rearrangement was found in both neoplasms. The variable region of the immunoglobulin heavy-chain genes of the Reed-Sternberg and of the follicular lymphoma cells were differently mutated, but six somatic mutations were shared by both lymphoma cells. Although the coding capacity of the immunoglobulin genes was preserved in both neoplastic cell populations, immunoglobulin heavy- (mu) and light- (kappa) chain expression was restricted to the follicular lymphoma cells, except for small amounts of kappa light-chain mRNA in some reed-sternberg cells. CONCLUSIONS: The neoplastic cells of the Hodgkin's disease and the follicular lymphoma that occurred in this patient derived from a common precursor B cell. Its differentiation stage could be identified as that of a germinal center B cell. Thus, transforming events can be more important than the cell of origin in determining a disease entity.
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12/271. Hodgkin's disease and myelomonocytic leukemia: an ultrastructural and immunocytochemical study.

    The ultrastructual and immunologic features of the initial Reed-Sternberg and Hodgkin cells are compared with the ultimate leukemic cell type in a child with Hodgkin's disease who subsequently developed acute myelomonocytic leukemia (AMML) following 29 months of chemotherapy. Hodgkin tumor cells contained cytoplasmic IgG and ultrastructurally resembled large immunoblasts, containing one or two round nuclei with large bizarre nucleoli, many polyribosomes, sparase endoplasmic reticulum, underdeveloped Golgi lamellae, and few cytoplasmic granules. The Hodgkin tumor cells displayed no evidence of phagocytosis. The leukemic monocytic cells did not contain cytoplasmic IgG and, ultrastrucally, exhibited and indented and irregular nuclear profile with less prominent nucleoli, numerous pleomorphic granules, a moderate number of free ribosomes, short segments of endoplasmic reticulum, and stacked Golgi lamellae. The cell surface was irregular and occasionally appeared involved in endocytic activity. These results indicate that the Hodgkin tumor cells originated from B lymphocytes rather than tissue macrophages, whereas the leukemic monocytes arose from the bone marrow-derived monocyte-macrophage series. The findings suggest further that AMML developing after Hodgkin's disease consitutes a second neoplasm rather than a leukemic transformation of Hodgkin tumor cells.
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13/271. Using beliefs and magical thinking to fight cancer distress-a case study.

    This case relates to the way in which a young patient developed serious difficulties in coping with her life in the years following a successful bone-marrow transplant. By means of an illustrative metaphor, she revealed her existential position and the way in which she attempted to deal with her anxiety. Being diseased implied that life's order was replaced by disorder and a loss of basic trust. She tried to re-establish order by establishing beliefs that attributed specific regularities to life, and to influence the risk of recurrence by living according to these beliefs. Unfortunately, this meant that she had to tread a very thin line over a course mined with anxiety and eventually, she became a prisoner of her own creation. The author claims that we can learn from this case, as it clearly illustrates psychological dimensions commonly seen in cancer patients: the way anxiety is related to disorder and the way patients try to regain control of their lives through constructing belief-systems. The case also features a discussion of how we, as clinicians, may be able to help these patients.
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keywords = cancer
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14/271. Pancreatic carcinoma as a sequel to therapy of lymphoma.

    Development of a carcinoma in the pancreas of a young man who had five years previously undergone intensive radiotherapy and subsequent chemotherapy for treatment of a lymphoma suggests that induction of the second neoplasm occurred as the result of the therapy of the first. While definite proof of causality is lacking, a review of recent literature strongly suggests that the association noted in the patient described is more than serendipitous. Increased usage of high-dose radiotherapy, particularly in conjunction with chemotherapy, may be directly related, and it is imperative that such an association be kept in mind when such patients are seen in follow-up.
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15/271. Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia: mimic of hodgkin disease in nodal metastases.

    We present the clinical and pathologic findings of a case of sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid in a 39-year-old woman. This particular case is notable because it initially presented as a cervical lymph node metastasis, and the initial clinical and histologic impression was hodgkin disease, nodular sclerosis type. Sclerosing mucoepidermoid carcinoma with eosinophilia is a differentiated malignant neoplasm of the thyroid that can be confused with anaplastic carcinoma, medullary carcinoma, squamous cell carcinoma, or, as in this case, hodgkin disease. A correct diagnosis of sclerosing mucoepidermoid carcinoma with eosinophilia involves awareness of this entity and appropriate immunohistochemical analysis. In this article, we briefly review the literature and stress the histologic and cytologic findings characteristic of sclerosing mucoepidermoid with eosinophilia of the thyroid.
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16/271. An unusual cutaneous presentation of Hodgkin's disease.

    Hodgkin's disease is a neoplasm of lymphoid tissue defined histopathologically by the presence of reed-sternberg cells in an appropriate cellular background. Hodgkin's disease extends only rarely into the skin. Sinus and fistula formation has been reported in very occasional cases. We now report a case of a 34-year-old woman presenting with a cutaneous lesion surrounding a discharging blind-ending sinus in the neck, subsequently diagnosed as Hodgkin's disease. To our knowledge this form of presentation of Hodgkin's disease has not been reported in the English literature before, and at the same time we would like to outline the difficulties in diagnosis encountered with these cutaneous lymphoid lesions.
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17/271. paraneoplastic cerebellar degeneration in pediatric hodgkin disease.

    paraneoplastic cerebellar degeneration (PCD) is a rare neurological complication in adults with extracerebral neoplasms. It is characterized by a diffuse cerebellar dysfunction, usually leading to severe neurological sequelae. In childhood, this complication is extremely rare. We report on PCD as primary manifestation of hodgkin disease (HD) in a thirteen-year old boy. On magnetic resonance imaging, irreversible atrophy of the cerebellum developed within three months. antibodies against purkinje cells were detectable at diagnosis and normalised after successful treatment of the lymphoma. Cerebellar symptoms, however, only partially resolved. The necessity of a search for a malignant tumour is emphasised in the presence of an otherwise unexplained, subacutely developing, diffuse cerebellar dysfunction.
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18/271. Composite prolymphocytoid and hodgkin transformation of chronic lymphocytic leukemia.

    The indolent course of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is occasionally altered by transformation to a histologically distinct, rapidly progressive, and clinically unresponsive hematologic malignant neoplasm. We report a case of CLL that, after 3 years of slowly progressive disease and treatment with single-agent chemotherapy (fludarabine phosphate), underwent a composite prolymphocytoid and classic Hodgkin lymphoma transformation. The diagnosis of classic Hodgkin lymphoma was based on the presence of reed-sternberg cells with typical morphologic structure and immunophenotype (CD15( ), CD30( ), CD45(-), CD20(-)) associated with the characteristic polymorphous inflammatory background consisting of numerous eosinophils, plasma cells, and reactive T lymphocytes. The remainder of the lymph node and the peripheral blood showed increased numbers of prolymphocytes admixed with typical small CLL cells. Recognition of such a transformation is of the utmost importance, since histologically similar Reed-Sternberg-like cells may be seen in Richter transformation. In contrast to prolymphocytoid transformation of CLL, Richter syndrome is rapidly fatal, with a median survival of 4 to 5 months. The patient pursued a clinical course similar to pure prolymphocytoid transformation and died with disease after 30 months following treatment with combination chemotherapy.
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19/271. Subclinical thyroid disease after radiation therapy detected by radionuclide scanning.

    PURPOSE: The actuarial risk for developing benign or malignant thyroid disease following radiation therapy (RT) is controversial, but may be as high as 50% at 20 years. An effective screening modality should be specific but not overly sensitive, a limitation of ultrasound. We questioned whether technetium-99 m pertechnetate ((99m)Tc TcO(4)(-)) scanning could detect clinically significant disease in ostensibly disease-free cancer survivors. methods AND MATERIALS: Eligibility criteria included an interval of at least 5 years after RT to the cervical region, a thyroid gland that was normal to palpation, euthyroid status determined by clinical examination, free T4 and TSH. The 34 patients scanned included 16 children (<18 years old) and 18 adults at the time of RT, 16 females and 18 males. The mean age at RT was 20 years (range, 2.1-50.3 years), and the mean age at (99m)Tc TcO(4)-scanning was 33 years (range, 13.6-58 years), providing a mean interval of 13 years (range, 5.3-26.6 years). The mean RT dose to the thyroid was 36.4 Gy (range, 19.5-52.5). Thyroid scanning was performed with a 5 mCi dose of (99m)Tc TcO(4)(-) obtaining flow, immediate and delayed static, and pinhole collimator images. RESULTS: Seven patients (21.6%) had abnormal scans, and the percentage was higher among children (25%) and females (25%) compared to adults (16.7%) and males (16.7%), respectively. Two of 34 patients (5.9%) were discovered to have a thyroid cancer; histopathologies were papillary and follicular carcinoma. CONCLUSION: In this population of clinically normal cancer survivors who had been irradiated to the cervical region, subclinical thyroid disease, of potential clinical significance, was detected by (99m)Tc TcO(4)(-) in about 20%. Children may be more commonly affected. Although the cost effectiveness of screening will require a larger sample number, we propose a surveillance schema for this patient population.
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keywords = cancer
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20/271. An unusual variant of composite lymphoma: a short case report and review of the literature.

    We recently encountered an unusual case of composite lymphoma arising in a 73-year-old man with a history of follicular small cleaved cell lymphoma. The neoplasm was composed of follicular small cleaved cell lymphoma and nodular sclerosing hodgkin disease within a single groin lymph node. In addition to morphologic evidence, the immunologic studies performed in this case demonstrated the simultaneous occurrence of 2 separate lymphocytic proliferations. To the best of our knowledge, only one such histologic type has been reported in the literature.1 Hodgkin lymphoma can develop in patients with non-hodgkin disease and vice versa, especially after treatment. The simultaneous occurrence of hodgkin disease and non-Hodgkin lymphoma in a single lymph node is extremely rare. In this article, the relationship between hodgkin disease and non-Hodgkin lymphoma is explored, possible explanations for the occurrence of composite lymphoma are discussed, and the literature is reviewed.
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