Primary splenic lymphoma is a relatively infrequent disease; the diagnosis of this entity is currently made with splenectomy. In a 52-year-old female with left upper quadrant abdominal pain, ultrasound showed a normal-sized spleen with an internal hypoechoic focal lesion. Ultrasonically-guided fine-needle aspiration and tissue core biopsy of the splenic lesion showed non-Hodgkin's lymphoma (NHL). At the time of presentation there was no evidence of involvement of lymph nodes, bone marrow or any other organ. A diagnosis of primary splenic non-Hodgkin's lymphoma was made and the patient underwent laparotomy with splenectomy. Histologic examination of the spleen confirmed the diagnosis: low-grade NHL confined to the spleen. The patient is well and in complete remission seven months after diagnosis. The purpose of this paper is to report a rare occurrence of primary splenic lymphoma and to demonstrate the possibility of making this diagnosis by percutaneous guided biopsy.

Biopsy, Needle↗

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Simultaneous relapse of liver cell carcinoma and non-Hodgkin's lymphoma in the liver. Report of a case with diagnosis by ultrasonically guided fine needle aspiration biopsy.

A 50-year-old man was diagnosed with non-Hodgkin's lymphoma (NHL) in 1980; he was treated with chemotherapy and achieved complete remission. Six years later he reported upper abdominal pain. Ultrasound (US) showed a 3-cm mass in the right lobe of the liver. Needle aspiration showed hepatocellular carcinoma (HCC). The patient was treated with radical resection of the tumor. Three years later (June 1989), abdominal US showed two lesions in the right lobe of the liver. Needle aspiration and tissue core biopsy showed NHL in one lesion and HCC in the other. The lymphomatous lesion resolved after chemotherapy. The patient died 30 months later (January 1992) from a gastrointestinal hemorrhage; the NHL was in complete remission. This case of the simultaneous presence of HCC and hepatic lymphoma is, to our knowledge, the first diagnosed in vivo.

Antineoplastic Combined Chemotherapy Protocols↗

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Epidoxorubicin vs idarubicin containing regimens in intermediate and high grade non-Hodgkin's lymphoma: preliminary results of a multicentric randomized trial.

BACKGROUND: In recent years many therapeutic regimens have been designed in order to improve response rate and response duration in non-Hodgkin's lymphoma (NHL). In 1991 the Italian Lymphoma Study Group (GISL) started a prospective randomized trial on treatment of aggressive and advanced NHL, focused on the efficacy of two Pro-MACE-CytaBom (P-C) derived protocols. METHODS: From April 1991 to March 1993, 243 cases of intermediate and high grade NHL (Groups D-H according to the Working Formulation) in stage I bulky, II-IV have been registered from 19 institutions and randomized to receive 6 courses of either epidoxorubicin, 30 mg/m2 (P-E) or idarubicin, 6 mg/m2 (P-I) containing P-C. The present study deals with the results of an interim analysis of the first 96 cases enrolled up to December 1991 (median follow up of surviving cases 19 months, range 15-23), in terms of overall response rate, toxicity and dose intensity of the two schedules, and overall survival. RESULTS: The overall response rate was: 55 CR (64.0%), 15 PR (17.4%), 5 NR (5.8%) and 11 PG (12.8%). The actuarial survival rate was 61% at 24 months. Hematological and non-hematological toxicity was comparable in the two arms. Dose intensity was high and similar for the two schedules (90% vs 89%). CONCLUSION: This interim analysis demonstrates that in aggressive NHL both P-C derived schedules with epidoxorubicin or idarubicin are effective, safe and well tolerated, also when used in a large multicentric setting.

Adolescent↗

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High prevalence of antibodies to hepatitis C virus in patients with lymphoproliferative disorders.

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Cohort Studies↗

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Low-dose interferon alpha treatment in essential thrombocythemia.

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Acetaminophen↗

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Diagnostic imaging of primary hepatic leiomyosarcoma: a case report.

Primary hepatic leiomyosarcoma is a very rare tumour only eighteen cases having been reported in the literature. A new case of this tumour is reported here, in which a complete diagnostic imaging work-up was performed, leading to the pathologic diagnosis, obtained with ultrasonically-guided coarse needle biopsy. Transarterial chemoembolisation, a new therapeutic option for this disease, was attempted without success.

Biopsy↗

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CCNU, vinblastine, procarbazine and prednisone (CVPP) with extended-field radiotherapy in the treatment of early unfavorable Hodgkin's disease. A prospective study on behalf of the Gruppo Italiano per lo Studio dei Linfomi (GISL).

PURPOSE: To test the adequacy of the CVPP four-drug regimen as ancillary chemotherapy associated with extended-field radiotherapy in the treatment of early, unfavorable, clinically staged Hodgkin's disease. PATIENTS AND METHODS: The population of this prospective, multicenter study consisted of 49 patients with stage I-II disease, associated with bulky involvement or unfavorable histology (lymphocyte-depleted nodular sclerosis or lymphocyte depletion), systemic symptoms or extranodal involvement, or presenting with stage III A favorable-histology disease, with or without extranodal involvement. RESULTS: Complete remission was achieved in 39 patients, partial remission in 2, while 8 patients did not respond. Four patients have relapsed so far (median follow-up: 43 months), all of whom were subsequently rescued with different salvage treatments. Dose intensity (mean +/- SD: 0.83 +/- 0.12) and hematological toxicity (including 2 deaths from infection) were higher when RT followed CT than when it was interposed in the middle of the 6 cycles. No growth factors were used. Nonhematological toxicity was very low and fully tolerable. CONCLUSIONS: Results confirmed the mild neurological and gastroenteric side effects of CVPP that make it an interesting MOPP-variant regimen. This combination seems most indicated when a regimen devoid of cardiac and pulmonary toxicity is required for association with full-dosage mediastinal radiotherapy, as is often the case in early, unfavorable Hodgkin's disease. The optimal sequence consists of radiotherapy administered after completion of the chemotherapy program. The use of growth factors for correction (or prevention) of marked leukopenia seems appropriate.

Adult↗

PubMedDate not supplied

Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma.

PURPOSE: Very few patients affected by hepatocellular carcinoma can undergo surgery, though it is considered the only curative therapy. We evaluated minimally invasive, percutaneous radiofrequency interstitial thermal ablation for treatment of patients with hepatocellular carcinoma who had no surgical prospects. PATIENTS AND METHODS: Twenty-four patients (16 men and 8 women; age range, 53 to 79 years) with 25 hepatocellular carcinoma nodules of not more than 3.0-cm diameter underwent radiofrequency interstitial thermal ablation treatment with the intent to achieve a cure. In each patient, the thermal necrosis volume achieved was about double the tumor volume. RESULTS: At the end of treatment, destruction of the tumor was achieved in all but two cases in which further thermal lesions were needed. During the mean follow-up interval of 24.8 months (range, 6-64), 13 of 24 patients had recurrences, 9 of whom underwent further radiofrequency thermal ablation treatment. Radiofrequency thermal ablation was again repeated in two patients who showed a second recurrence. A total of 36 hepatocellular carcinoma nodules in 24 patients were treated. No complications were observed. Seven patients died: three due to hepatic failure with advanced cancer, three due to heart failure, and one due to pneumonia. Cumulative survival curves indicated that the median survival time was 44 months and survival rate was 0.95 the first year, 0.84 the second year, 0.67 the third year, and 0.45 the fourth and fifth years. CONCLUSIONS: Percutaneous radiofrequency thermal ablation can be considered a useful new treatment for small hepatocellular carcinoma in patients without surgical prospects. It is simple, effective, and safe, and can be repeated in case of recurrence.

Aged↗