Biomedical subjects
Publications and source records attributed to R B Weiss.
A case of lymphocytic lymphoma involving the prostate is reported. Lymphomatous infiltration of the prostate had been mentioned infrequently in the literature, so that the incidence, prognosis, and treatment are not well known. Lymphomatous or leukemic infiltrate should be considered as a causative agent of prostatism, particularly in patients with hematologic abnormalities where chemotherapy may relieve the symptoms.
Although bronchogenic carcinoma generally remains a tumor resistant to treatment, marked progress in the therapy of the small-cell undifferentiated subtype has occurred in the past 5 years. Many aspects of its growth and metastatic spread are such that it is not satisfactorily treated surgically. However, it is sensitive to both radiation and a variety of chemotherapeutic agents. Use of these agents in combination seems to produce a greater antitumor effect than single drugs. The combination of radiation and chemotherapy results in marked tumor regressions. Untreated, this carcinoma has a very short median survival (2 months). Administration of current "aggressive" combination therapy regimens has resulted in median survivals of nearly 1 year with some patients still living 3 years after therapy.
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Multiple myeloma has many unusual manifestations, which may obscure the true cause and delay proper treatment. Physicians in all specialties should be alert to this possibility, since myeloma may be at the root of such diverse disorders as carpal tunnel syndrome, peripheral neuropathy, solitary lytic bone lesions, hypercalcemia, and hyperviscosity syndrome.
A patient who had clinical stage IA Hodgkin's disease involving a single group of epitrochlear nodes is presented. A few patients with this disease have been reported to have involvement of epitrochlear lymph nodes, but none have had disease limited to this nodal site. At staging laparotomy a single focus of Hodgkin's disease was found in the spleen. Theoretical aspects of the mode of spread of Hodgkin's disease are discussed with respect to this case.
A patient in whom a presumptive diagnosis of sarcoidosis was made on the basis of nonspecific symptoms and BHA on chest roentgenogram is described. At necropsy the BHA was found to be due to a metastatic small cell undifferentiated carcinoma of the lung. This tumor is a previously unrecognized cause of BHA.
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Thirty-eight patients with advanced Hodgkin's disease were treated with a combination of cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP). Complete remissions were obtained in 74% of patients. Response rates were similar for previously untreated and previously extensively irradiated patients. Fifty-six percent of patients older than 50 and 50% of patients with bone marrow involvement responded. All patients with mixed cellularity Hodgkin's disease responded compared with 74% of patients with nodular sclerosis. At the present time the median duration of complete remission is 27+ months. However, of the responders, 75% (21 of 28) remain in continous complete remission for 14+ to 49+ months. Only five patients have relapsed but two have died from apparent sepsis without evidence of recurrent disease. The complete remission rate for CVPP is comparable of that for MOPP, CVPP is an easily administered, well-tolerated alternative to MOPP chemotherapy for patients with advanced Hodgkin's disease.
An extragenital metastatic seminoma in a patient with Klinefelter's syndrome is described. The increased incidence of many types of malignancies in patients with this chromosomal abnormality and the increased susceptibility of XXY cells to transformation by oncogenic SV-40 virus are discussed. A relationship is suggested circumstantially by these observations.
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