RESUMEN
A retrospective analysis of 116 primary cases of stage I, II and III-A Hodgkin's disease demonstrated 27 failures, fourteen confirmed by biopsy. Twenty of the 27 (74%) were in lymph node areas only and seven had extranodal extensions. The most frequent site of failure was the hilar nodes and contiguous lung. The majority of failures (78%) occurred within 30 months of treatment and the cause of failure determined in 23 (85%), sixteen of which were due to technical errors of irradiation. Analysis of the dosimetry in the mediastinal, hilar nodes and contiguous lung failures revealed three factors which may have contributed to a low dose. These factors are: 1) the equivalent square, 2) off-axis beam diminution, and 3) the anteroposterior dose profile. Combined radiation therapy and chemotherapy was more effective than either modality alone in the treatment of these failures.
Asunto(s)
Enfermedad de Hodgkin/radioterapia , Femenino , Enfermedad de Hodgkin/patología , Humanos , Ganglios Linfáticos/patología , Masculino , Pronóstico , Dosificación Radioterapéutica , Recurrencia , Estudios RetrospectivosRESUMEN
An asymptomatic skin nodule in a patient with myelofibrosis was shown to consist of extramedullary hematopoiesis. It was a soft bluish nodule that resembled a hemangioma. Microscopically, both erythroid and myeloid cells, but not megakaryocytes, were found. This case demonstrates the ability of the skin to recapitulate dermal hematopoiesis seen in a stage of human fetal development.
Asunto(s)
Hematopoyesis , Mielofibrosis Primaria/patología , Piel/patología , Anciano , Humanos , Masculino , Policitemia/complicaciones , Mielofibrosis Primaria/complicaciones , Mielofibrosis Primaria/fisiopatología , Piel/fisiopatologíaRESUMEN
A staging laparotomy and splenectomy were performed in 41 patients with Hodgkin's disease and 11 with other malignant lymphomas. There was a significant correlation (P = 0.025) between the presence of unexplained anemia and involvement of the spleen or abdominal lymph nodes by tumour. The anemias were of mild degree; hemolysis was documented in three and iron deficiency in four, while 21 cases were unexplained. Bone marrow was not involved by lymphoma in this series. The complication rate in exploratory laparotomy was higher than previously reported. Severe complications were observed in 17% of these patients while another 15% had minor complications. The association we have discovered may be helpful in the staging of patients who cannot tolerate an operative procedure. The absence of infradiaphragmatic involvement is suggested in the presence of normal hemoglobin concentrations.