Nephrotic syndrome after cisplatin plus cyclophosphamide for ovarian carcinoma.
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Biomedical subjects
Publications and source records attributed to E Zucca.
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Differential pulse polarographic assay of the antineoplastic agent cis-dichlorodiamineplatinum II and its analogues was performed after acid oxidative hydrolysis (HClO4, HNO3, HCl) of biological samples (plasma, tissue homogenates, urine) and reaction with ethylenediamine. Platinum levels and kinetics were determined in blood and urine of patients with non-oat-cell lung carcinoma. Detection limit of the polarographic assay was 0.5 ng platinum; analytical error was +/- 3%. Levels of free cis-dichlorodiamineplatinum (II) in plasma fell in samples stored at -20 degrees C; the half-life of free drug was 38 h.
We report a case of secondary heart involvement in AIDS-related primary lymphoma of the liver. A worsening dyspnea led to the diagnosis of pericardial effusion, and transesophageal echocardiography revealed the presence of large endocardial ventricular masses. Clinical suspicion of a lymphomatous origin was confirmed at the autopsy, which showed an extranodal dissemination pattern (heart, liver, intestine, and lung). In AIDS patients, both primary and secondary lymphomatous heart involvement are increasing in incidence. Clinical symptoms and signs are vague. Since the hematogenous route is the most common pattern of involvement, even extrathoracic lymphomas can present heart dissemination. Thus, it should be suspected in lymphoma patients who present with even mild aspecific heart symptoms. Appropriate imaging procedures include transesophageal echocardiography and, if possible, ECG-gated MRI. A negative transthoracic echocardiograph does not exclude the presence of myocardial tumor. Chemotherapy is only occasionally beneficial, and the prognosis remains poor.
We report a case of angiotropic (intravascular) large B-cell lymphoma in an 84-year-old woman who underwent diagnostic procedures for progressive, painful induration of the legs. Physical examination and imaging studies revealed only widespread telangiectasias and significant panniculities-like lymphedema of the legs, with no masses or lymphadenopathies. The patient achieved a complete clinical remission after the first three cycles of polychemotherapy. Although angiotropic lymphoma is a rare entity with polymorphic clinical presentations, its early diagnosis appears very important since it may be curable with appropriate chemotherapy regimens.
Approximately one-fourth of non-Hodgkin's lymphomas originate in extranodal sites. True primary involvement of soft tissues is quite uncommon and only a few well-documented cases are reported in the literature. We report four cases of primary skeletal muscle lymphoma. Three of the four cases presented with a diffuse large B-cell lymphoma. The clinical history of two cases confirmed that soft tissue masses should be promptly biopsied, since the differential diagnosis comprises benign lesions, as well as sarcoma, primary or metastatic carcinoma, melanoma and lymphoma. As lymphomas have to be treated primarily according to the tumour histology and disease extent, treatment of primary skeletal muscle lymphomas must be planned with these factors in mind. For patients presenting with diffuse large cell histology, a CHOP-like regimen alone or a combined modality with radiotherapy seem to be proper approaches.
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