Bone Involvement in Hodgkin's Lymphoma: Clinical Features and Outcome.

Hodgkin's lymphoma (HL) is now a highly curable disease, with an improving 5-year survival rate that has now reached 86%. At the time of presentation, HL is usually almost entirely confined to the lymph nodes. We performed a retrospective single-institution study of 384 cases with a median follow-up of 44 months, with the aim of identifying clinical and radiological characteristics and outcomes of patients with bone HL; 32 patients (8%) had primary bone involvement, always with concurrent nodal disease. These included 22 men (69%) and 10 women (31%) with the median age as 41 years. Advanced stages and nodular sclerosis histology prevailed among the subgroup. Radiographic features of bone HL are not specific but indicate a destructive malignant process with osteosclerosis and/or osteolysis. With current chemotherapeutic regimens, the long-term prognosis of patients with osseous HL appears good. The presence of bone lesions in HL should not be interpreted as implying a worse prognosis than without bone involvement.

Extralymphatic Filariasis.

Filariasis caused by nematodes affects the structure and function of lymphatic vessels. Lymphedema due to lymphatic blockage and lymphadenitis is the usual mode of presentation of filariasis. However, rarely extralymphatic filariasis has been reported in uncommon sites, including skin and soft tissue. Wuchereria (W.) bancrofti is the most common nematode causing extralymphatic filariasis. We report a rare case of a 25-year-old man with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling confirmed by ultrasonography (USG), which revealed the filarial dance sign. Filariasis can present in many different ways and pose a significant dilemma for the clinician. It is essential to be aware of atypical presentations of filariasis for prompt diagnosis and further treatment.

Filariasis of the breast caused by Brugia pahangi: A concomitant finding with invasive ductal carcinoma.

Extralymphatic filariasis is an uncommon phenomenon that can be caused by several lymphatic filarial species, including zoonotic filaria of animal origins. In this study, we report a case of a 64-year-old Thai woman who presented with a lump in her left breast that was diagnosed with invasive ductal carcinoma. At the same time, a small nodule was found in her right breast, via imaging study, without any abnormal symptoms. A core needle biopsy of the right breast nodule revealed a filarial-like nematode compatible with the adult stage of Brugia sp. A molecular identification of the nematode partial mt 12rRNA gene and ITS1 suggested the causative species as closely related to Brugia pahangi, a zoonotic lymphatic filaria of animals such as cats and dogs. The sequence of the partial mt 12rRNA and ITS1 gene in this patient was 94% and 99% identical to the previously reported sequence of mt 12rRNA and ITS1 genes of B. pahangi. The sequence of ITS1 gene is 99% similar to B. pahangi microfilaria from infected dogs in Bangkok, which was highly suspected of having a zoonotic origin. As far as we know, this is the first case report of B. pahangi filariasis presented with a breast mass concomitantly found in a patient with invasive ductal carcinoma. This raised serious concern regarding the zoonotic transmission of filariasis from natural animal reservoirs.

Interdigitating dendritic cell sarcoma located in the adrenal gland: a case report and literature review.

We report a case of interdigitating dendritic cell sarcoma (IDCS) originating from the adrenal gland. A 57-year-old middle-aged woman with no previous history of malignancy came to our hospital after color Doppler ultrasound revealed a right adrenal mass. An abdominal computed tomography scan also showed an adrenal mass. Postoperative pathology confirmed the diagnosis of IDCS. After complete surgical removal of the adrenal tumor, the patient has been disease-free for 1 year. IDCS may have a good prognosis after surgical resection. To our knowledge, this is only the second reported case of IDCS in the adrenal region.

Disseminated microfilaremia associated with lung cyst and empyema: an autopsy report.

Clinical manifestations of extralymphatic disease caused by filariasis are varied and range from symptoms due to tropical pulmonary eosinophilia to hematuria, proteinuria, splenomegaly, and rarely arthritis. Disseminated microfilaremia in association with loculated lung cyst and empyema is of rare occurrence and to the best of our knowledge has not been documented in the literature so far. We report here a case of disseminated microfilaremia due to Wuchereria bancrofti infection accompanied by a lung cyst and empyema in a 21-year-old Indian man.

Oncologic outcomes of extended neck dissections in human papillomavirus-related oropharyngeal squamous cell carcinoma.

BACKGROUND: Oncologic outcomes of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) requiring resection of major muscular or neurovascular tissue during neck dissection for invasive nodal disease remain uncertain. METHODS: Patients with HPV-related oropharyngeal SCC requiring resection of major muscular or neurovascular tissue during their neck dissections were retrospectively identified. RESULTS: Seventy-two patients were included. Regional and distant recurrences occurred in 6% and 17% of patients. Advanced T classification, pathological node number of 5 or more, and omission of adjuvant therapy were associated with decreased disease-free survival (DFS). The addition of adjuvant chemotherapy was not associated with improved survival. CONCLUSION: Patients with invasive nodal disease from HPV-related oropharyngeal SCC can be managed with up-front surgery and adjuvant therapy, as indicated with good regional control. Although distant recurrence was the primary site of failure, adjuvant chemotherapy was not associated with improved outcomes. The T classification, node number, and adjuvant radiotherapy are independent prognostic factors in this patient population.