[Coincidence of multiple myeloma and renal clear cell adenocarcinoma]. / Wspólistnienie szpiczaka plazmocytowego i raka jasnokomórkowego nerki.

There are only casuistic reports about the coincidence of renal carcinoma and lymphoproliferative diseases. We report a case of 59-year old patient who simultaneously developed renal clear cell carcinoma and IgG kappa multiple myeloma. After nephrectomy the progression of multiple myeloma was observed. The renal failure occurred and, as a consequence, the introduction of full doses of chemotherapy for multiple myeloma was unable.

[A case of primary thyroid lymphoma with Hashimoto thyroiditis]. / Przypadek pierwotnego chloniaka tarczycy na podlozu autoimmunologicznego zapalenia tarczycy typu Hashimoto.

A seventy four year old man presented with a mass of the thyroid which was diagnosed as a lymphoma arising from the thyroid gland with Hashimoto thyroiditis. Postoperative course was complicated by the tumor reoccurence presenting as invasion of the larynx with a critical narrowing of the lumen of the larynx. With chemotherapy complete remission has been achieved. This case illustrates common aetiology of the thyroid lymphoma of MALT type and Hashimoto thyroiditis.

[A case of massive chylothorax during the course of malignant lymphoma]. / Przypadek masywnego chlonkotoku do jam oplucnowych w przebiegu chloniaka zlosliwego.

A 65 year old man with low grade malignant B cell lymphoma developed bilateral chylothorax, which reached the volume of 52.1. Chylothorax arised most probably as a result of pleural infiltration in the course of the disease. Chemotherapy and repeated drainage of chylus was successful. The resolution of massive bilateral chylothorax in our patient shows, that conservative measures (chemotherapy and repeated pleural drainage) should be tried even in very extensive chylothorax in the course of neoplastic disease.

[Massive pericardial effusion during the course of hematological diseases]. / Masywne wysieki osierdziowe w przebiegu chorób hematologicznych.

7 patients, 4F/3M aged 20-63 years (x = 39.5 yrs) with high grade non-Hodgkin lymphoma (4 pts), Hodgkin's disease (1), acute leukaemia (1) and blastic crisis of CML (1), complicated by massive pericardial effusion with impending cardiac tamponade were presented. Symptoms of neoplastic pericardium infiltration have appeared at the diagnosis of underlying disease in 2 pts, in the remaining 5.5-24.5 months (mean = 12.5 months) since the diagnosis and onset of cytostatic treatment was established. In 6 pts pericadiocentesis or pericardium drainage have been applied, resulting in evacuation of 100-1450 ml (mean = 680 ml) of fluid. In 3 pts pericardial effusion was bloody and in two some neoplastic cells were found. In 4 pts intrapericardially 5-20 mg mitoxantrone, 5-20 mg, was administered 7 times. The survival time since the diagnosis of a massive pericardial effusion ranged 0.5-10 months. One person remains alive 7 months after diagnosis of cardiac effusion and 19 months from the diagnosis of n-HL. The authors conclude that pericardiac involvement in the course of haematologic malignancies is a very unfavorable event.

[Hematologic changes in stomach cancer]. / Zmiany hematologiczne w raku zoladka.

Haematologic disturbances in 13 cases of gastric cancer are described. All the patients had anemia of different origin. Increased leukocytosis was observed in half of the cases, leukemic reaction in one third. Hemolysis was present in 50% of cases. Thrombocytopenia coexisted most frequently with disseminated intravascular coagulation in 4 patients. Bone metastases were visualised as osteolytic foci with radiological methods or increased capture of isotopic marker in the bones under scintigraphic examination. Under the microscope neoplastic metastases were found in bone marrow smears of 5 patients. All patients displayed symptoms of gastric ulcer disease acute or chronic phase. In some cases only repeated gastroscopic examination and mucosa biopsy was the only way to confirm cancer. In other cases the diagnosis was made after the histopathologic examination of the resected stomach, in still others by a section.

[Preliminary results of conservative combination radiotherapy and chemotherapy in early stages of Hodgkin's disease]. / Wstepne wyniki oszczednej, kombinowanej radioterapii i chemioterapii wczesnych stadiów choroby Hodgkina.

20 patients in early stages (I-IIB) Hodgkin's disease were treated with smaller than commonly used doses of cytostatics and radiation. Men were given EBVD-CVPP-EBVD (epirubicin, bleomycin, vinblastine, DTIC, cyclophosphamide, vinblastine, procarbazine, prednisone) and women: CVPP-EBVD-CVPP. Radiotherapy was limited to involved and adjacent fields. In all patients complete remission was achieved lasting now 9 to 107 months (mean 55 months). Two patients relapsed. No undesirable early side effects were observed. Further observations will show if such therapeutic option in non-advanced Hodgkin's disease is sufficient.

[Involvement of the larynx during the course of plasmocytoma]. / Zajecie krtani w przebiegu szpiczaka plazmocytowego.

A case is reported of 63 year old male with disseminated multiple myeloma treated for more than 2.5 year with chemotherapy and radiotherapy. After partial remission lasting for 8 months secondary myeloma infiltration closing nearly the whole hypoglottical part of the larynx and upper part of the trachea developed. Surgical excision of the infiltration was technically impossible to perform. An intensive cytostatic treatment was ineffective but radiotherapy seemed to give some results. Patient suddenly died during morning toilet.

[Evaluation of early treatment results in Hodgkin's disease during the cytostatic protocol containing methotrexate]. / Ocena wczesnych wyników leczenia choroby Hodgkina wedlug protokolu cytostatycznego zawierajacego metotreksat.

28 patients suffering from advanced Hodgkin's disease were treated according to protocol containing 7 cytostatic drugs including methotrexate and corticosteroids, but not cyclophosphamide, chlormethine or procarbazine. 22 patients i.e. 78.5% attained complete remission and 5 i.e. 17.8% a partial one. Drug tolerance was satisfactory: out of side-effects the most common was myelosuppression, especially granulocytopenia. Our early results were similar to those obtained with MOPP-like protocols, but early undesirable effects less often and of a smaller degree. Because the protocol has been aimed at avoiding late toxicity of cytostatics, its final evaluation will be possible in the future.

[Hypothermia during chemotherapy for lymphomas]. / Hipotermia w przebiegu chemioterapii chloniaków zlosliwych.

There are only few reports in the literature on the occurrence of hypothermia after chemotherapy. It occurred after various cytostatics and lasted for few hours to several days. Our material consisted of 11 patients with malignant lymphoma who were given chemotherapy protocols including cisplatin. In 5 patients (2 with Hodgkin's disease and 3 with non-Hodgkin's lymphoma) who had high fever, after treatment the temperature decreased down to 34.3 degrees C. Hypothermia disappeared spontaneously after few days. The drug responsible for this effect in our patients was cisplatin.

[Haematologic changes in gastritic cancer]. / Zmiany hematologiczne w raku zoladka.

Haematologic disturbances in 13 cases of gastric cancer are described. All the patients had anemia of different origin. Increased leukocytosis was observed in half of the cases, leukaemia reaction in one third. Haemolysis was present in 50% of cases. Thrombocytopenia coexisted most frequently with disseminated intravascular coagulation in 4 patients. Bone metastases were visualised as osteolytic foci with radiological methods or increased capture of isotopic marker in the bones under scintigraphic examination. Under the microscope neoplastic metastases were found in bone marrow smears of 5 patients. All patients displayed symptoms of gastric ulcer disease acute or chronic phase. In some cases only repeated gastroscopic examination and mucosa biopsy was the only way to confirm cancer. In other cases the diagnosis was made after the histopathologic examination of the resected stomach, in still others by a section.

[Neurologic complications of neoplasms]. / Neurologiczne powiklania nowotworów.

In course of many neoplastic diseases the variety of the neurological syndromes many appear. They may precede the primary disease or appear during its follow up. They originate from the tumor itself or may be caused by secondary metabolic disturbances in electrolytes, lesions of the kidneys or liver. Infections in the central nervous system, conditioned frequently by immunodeficiency, could also cause the onset of various, neurological symptoms. In some cases they simply may happen as the toxic side effects of applied cytostatics.

[Neurologic complications of disseminated intravascular coagulation in a patient with a stomach neoplasm]. / Powiklania neurologiczne rozsianego wewnatrznaczyniowego krzepniecia u chorej na raka zoladka.

A case of the female patient with gastric carcinoma with metastases into lymph nodes and vertebrae is presented. Generalized DIC with subarachnoid haemorrhage confirmed by CSF examination has occurred in the course of the disease. Applied treatment failed.

[Long-term (over 10-years) survival in Hodgkin's disease]. / Dlugotrwale (ponad 10-letnie) przezycie w chorobie Hodgkina.

61 patients with Hodgkin's disease, i.e., 40.9% of all HD pts hospitalized in the years 1970-1981 are more than 10 years survivors: 46 are alive and 15 died of underlying disease or its complications. The most important prognostic factor at diagnosis was clinical advancement and the form A or B of HD. Age and sex also influenced survival but to a lesser degree. Patients living in CCR were more likely to have MC histology than those with relapsing disease, who more often showed LD and LP type. Among 5 persons with second neoplasms four disclosed NS type of HD. No statistical differences in clinical prognostic factors were encountered between further alive and those who died after more than 10-yrs. Almost all patients were able to normally continue their familial and professional lives.

Tracheo- and bronchoesophageal fistulas in Hodgkin's disease.

Among 330 patients with Hodgkin's disease, in five development of fistula between the respiratory and alimentary tract was observed; tracheoesophageal in three and bronchoesophageal in two patients. Generalization of the disease was the cause of fistula in three patients; it appeared as a result of necrosis of the neoplastic infiltration during cytostatic treatment or radiotherapy. In the fourth patient the fistula was of iatrogenic origin (radiation induced damage), and in the fifth it was the result of secondary neoplasm (bronchial anaplastic cancer).

[Early results of the treatment of Hodgkin's disease in adults using the seven-drug cytostatic protocol]. / Wczesne wyniki leczenia choroby Hodgkina u doroslych wedlug siedmiolekowego protokólu cytostatycznego.

65 adult patients with Hodgkin's disease were treated acc. to multidrug protocol proposed by I. Koza et al. including doxorubicin, vincristine, vinblastine, bleomycin, procarbazine, lomustine and prednisone. 4 drugs (3 cytostatics and prednisone) including cycles were given repeatedly every 4 weeks. In the group of first line therapy (39 persons) 61.5% CR and 23% PR was obtained i.e. 84.5% therapeutic responses. The protocol used as salvage therapy resulted in 30% CR and 23% PR. Undesirable gastrointestinal effects were observed less commonly than after ABVD and CVPP schemes but myelosuppressive effect was more often seen and required attenuation of cytostatic drugs doses in the further cycles of therapy. The considered protocol seems to be a valuable one approaching to -but not achieving- the results of MOPP and ABVD schemes: is better tolerated because of elimination of strong emetic cytostatics (chlormethine and decarbazine) but late toxicity could be evaluable only after several years.

[Secondary polycythemia as an example of the paraneoplastic syndromes]. / Czerwienica wtórna jako przyklad zespolu paraneoplastycznego.

The modern views on the coexistence of secondary polycythaemia with benign and malignant tumours of varying origin are reviewed describing certain mechanisms determining this association. The diagnostic management of secondary polycythaemia is outlined calling attention to the necessity of ruling out coexistence of a neoplasm.

[Analysis of the prognostic significance of serum immunoglobulins in Hodgkin's disease]. / Analiza prognostycznej wartosci stezen glównych klas immunoglobulin w surowicy na chorobe Hodgkina.

Main classes of serum immunoglobulins have been studied in plasma of patients with untreated Hodgkin's disease and correlations have been analyzed between their levels and the clinical stage of the disease, its histological type and the patient's age and survival. In the Hematology Department, Wroclaw, in the years 1979-1989 to the study 115 cases were qualified, 59 were female, 56 male, 75 are still under treatment, whereas 40 died. Stage III B and IV B and histological type NS and MC prevailed. Mathematical analysis resulted in the following: In untreated Hodgkin's disease plasma levels of IgA, IgG, IgM were elevated compared to the controls. No correlation was found of the immunoglobulins elevations to the patients age, histological type, clinical stage and survival.

[Comparison of the effectiveness of metoclopramide and dexamethasone in the prevention of cytostatic-induced vomiting]. / Porównanie skutecznosci metoklopramidu i deksametazonu w zapobieganiu wymiotom po cytostatykach.

Efficiency of anti-emetic properties of metoclopramide and dexamethasone was compared. Both drugs were administered to 22 patients with newly diagnosed untreated previously Hodgkin's disease during ABVD therapy. Number of vomiting episodes, nausea intensity and everyday patients' activity on the day of cytostatics administration were evaluated. Metoclopramide prevented vomiting in 55% of patients while dexamethasone in 65%. This difference was statistically insignificant. Patients' everyday activity was statistically significantly more frequently normal in patients receiving dexamethasone in comparison with placebo and decreased in patients receiving metoclopramide. Therefore, patients preferred dexamethasone.

[Secondary erythrocytosis in 3 cases of neoplastic disease]. / Nadkrwistosc wtórna w 3 róznych przypadkach choroby nowotworowej.

Three cases of tumor-associated (so called "paraneoplastic") erythrocytosis are described. In a 24 year old man with adrenal gland cancer hematological parameters normalized shortly after surgery, but he died 8 weeks later because of the dissemination of the disease. In a 48 year old man with hypernephroma of the left kidney and in a 49 year old woman with the left cerebral hemisphere meningioma Hb level, hematocrit and red blood cell count normalized after tumor removal and remained within normal range 39 and 7 months respectively. It is suggested that a probability of the neoplastic disease as a cause of erythrocytosis should be taken into account.