RESUMEN
A 13-year-old boy presented with bilateral retrobulbar neuritis. Three months later he presented with unilateral proptosis and cervical lymphadenopathy. Lymph node biopsy confirmed non-Hodgkin's lymphoma, B-cell type. To the best of our knowledge, this is the first reported case of bilateral retrobulbar neuritis as the presumptive initial presentation of non-Hodgkin's lymphoma.
Asunto(s)
Linfoma de Células B/complicaciones , Neuritis Óptica/etiología , Administración Oral , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclofosfamida/uso terapéutico , Doxorrubicina/uso terapéutico , Potenciales Evocados Visuales , Lateralidad Funcional , Humanos , Infusiones Intravenosas , Pulmón/diagnóstico por imagen , Linfoma de Células B/diagnóstico , Linfoma de Células B/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/diagnóstico , Neoplasias del Mediastino/tratamiento farmacológico , Metilprednisolona/uso terapéutico , Neuritis Óptica/diagnóstico , Neuritis Óptica/tratamiento farmacológico , Estimulación Luminosa , Prednisolona/uso terapéutico , Prednisona/uso terapéutico , Tomografía Computarizada por Rayos X , Vincristina/uso terapéuticoRESUMEN
In a two-year carcinogenicity study with administration of high doses of the partial nicotinic agonist varenicline (recently approved for smoking cessation), mediastinal hibernomas occurred in three male rats. To investigate potential mechanisms for partial and full nicotinic agonists to contribute to development of hibernomas, the effects of nicotine on rat brown adipose tissue (BAT) were studied. Male and female rats were administered nicotine at doses of 0, 0.3, and 1 mg/kg subcutaneously for fourteen days. Intrathoracic (mediastinal periaortic and mediastinal perithymic) BAT and interscapular BAT were examined microscopically, and determinations of uncoupling protein-1 (UCP-1) expression and norepinephrine (NE) content were made. Additionally, NE turnover was measured in mediastinal periaortic and perithymic BAT. Nicotine (1 mg/kg) administration resulted in decreased vacuolation only in mediastinal periaortic and mediastinal perithymic BAT of males and elevated UCP-1 in mediastinal periaortic BAT of males and females. Increased NE content occurred only in mediastinal periaortic BAT of males given 0.3 and 1 mg/kg doses, whereas NE turnover was decreased in both males and females given 1 mg/kg. Together, these data demonstrate that nicotine primarily affects mediastinal BAT in male rats, consistent with the gender and location of the hibernomas observed in the two-year carcinogenicity study.
Asunto(s)
Tejido Adiposo Pardo/efectos de los fármacos , Nicotina/farmacología , Agonistas Nicotínicos/farmacología , Norepinefrina/metabolismo , Cese del Hábito de Fumar , Tejido Adiposo Pardo/metabolismo , Animales , Benzazepinas/toxicidad , Relación Dosis-Respuesta a Droga , Femenino , Lipoma/inducido químicamente , Lipoma/metabolismo , Masculino , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/metabolismo , Nicotina/agonistas , Nicotina/toxicidad , Agonistas Nicotínicos/toxicidad , Quinoxalinas/toxicidad , Ratas , Ratas Sprague-Dawley , Factores Sexuales , Cese del Hábito de Fumar/métodos , VareniclinaRESUMEN
BACKGROUND & OBJECTIVE: Reactive thymic hyperplasia following chemotherapy for malignant tumors is likely to be misdiagnosed as tumor residue or relapse, therefore, leads to unnecessary treatment. This study was to analyze the clinical features of reactive thymic hyperplasia following chemotherapy for childhood malignant lymphoma. METHODS: Clinical data of 13 children with reactive thymic hyperplasia following chemotherapy for malignant lymphoma, treated from Mar. 1999 to Mar. 2004, were retrospectively analyzed. Of the 13 cases, 5 were Hodgkin's disease (HD), and 8 were non-Hodgkin's lymphoma (NHL). All patients received computed tomography (CT) to evaluate the therapeutic effect. When a new thymic mass emerged, positive electron tomography/computed tomography (PET/CT) was performed to identify its quality. RESULTS: At diagnosis, 10 patients had mediastinal involvement. Reactive thymic hyperplasia occurred following the completion of chemotherapy in 9 cases, or during the maintenance of chemotherapy in 4 cases. CT showed that the longest diameters of the new mediastinal masses were 2.2-6.0 cm (mean 3.7 cm). The interval from last chemotherapy cycle to the occurrence of thymic hyperplasia was 2-12 months (mean 4 months). PET/CT was performed to 5 cases, and showed no vital tumors in the mediastinum. Three cases were misdiagnosed as tumor residue or relapse, and received second-line therapy. All patients were followed-up for 1-6 years (median 4 years), and none suffered tumor relapse. CONCLUSIONS: Reactive thymic hyperplasia may occur following intensive chemotherapy for childhood malignant lymphoma. It should not be misdiagnosed as malignant tumors and overtreated.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedad de Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Neoplasias del Mediastino/tratamiento farmacológico , Hiperplasia del Timo/inducido químicamente , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bleomicina/efectos adversos , Bleomicina/uso terapéutico , Niño , Preescolar , Dacarbazina/efectos adversos , Dacarbazina/uso terapéutico , Supervivencia sin Enfermedad , Doxorrubicina/efectos adversos , Doxorrubicina/uso terapéutico , Etopósido/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Ifosfamida/uso terapéutico , Masculino , Mecloretamina/efectos adversos , Mecloretamina/uso terapéutico , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/diagnóstico , Tomografía de Emisión de Positrones , Prednisona/efectos adversos , Prednisona/uso terapéutico , Procarbazina/efectos adversos , Procarbazina/uso terapéutico , Hiperplasia del Timo/diagnóstico , Hiperplasia del Timo/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Vinblastina/efectos adversos , Vinblastina/uso terapéutico , Vincristina/efectos adversos , Vincristina/uso terapéuticoAsunto(s)
Antiinflamatorios/efectos adversos , Asma/tratamiento farmacológico , Lipomatosis/inducido químicamente , Lipomatosis/complicaciones , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/complicaciones , Adulto , Humanos , Lipomatosis/diagnóstico , Masculino , Neoplasias del Mediastino/diagnóstico , Radiografía Torácica , EsteroidesAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Médula Ósea/patología , Neoplasias del Mediastino/patología , Síndromes Mielodisplásicos/patología , Neoplasias Primarias Secundarias/patología , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Rabdomiosarcoma Embrionario/tratamiento farmacológico , Síndrome de la Vena Cava Superior/etiología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Brazo/patología , Niño , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/complicaciones , Neoplasias del Mediastino/diagnóstico por imagen , Síndromes Mielodisplásicos/inducido químicamente , Síndromes Mielodisplásicos/complicaciones , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neoplasias Primarias Secundarias/inducido químicamente , Neoplasias Primarias Secundarias/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Radiografía , Rabdomiosarcoma Embrionario/complicaciones , Rabdomiosarcoma Embrionario/secundarioRESUMEN
Nephrotic syndrome may be associated not only with malignant neoplasia, but also rarely with benign solid tumours. Here we report a case of a young woman suffering from nephrotic syndrome, histologically classed as a minimal change glomerular lesion, associated with a posterior mediastinal neurilemmoma (ancient neurilemmoma). Surgical removal of the tumour led to complete cure of the nephrotic syndrome with total symptomatic improvement within 6 months. Scanning of the literature revealed only one case report of an association of spinal neurilemmoma with nephrotic syndrome.
Asunto(s)
Neoplasias del Mediastino/inducido químicamente , Nefrosis Lipoidea/etiología , Neurilemoma/complicaciones , Adulto , Femenino , Humanos , Neoplasias del Mediastino/cirugía , Neurilemoma/cirugíaAsunto(s)
Leucemia Monocítica Aguda/etiología , Neoplasias del Mediastino/etiología , Neoplasias de Células Germinales y Embrionarias/complicaciones , Neoplasias Primarias Secundarias , Adulto , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Cromosomas Humanos Par 8 , Humanos , Leucemia Monocítica Aguda/inducido químicamente , Leucemia Monocítica Aguda/genética , Masculino , Neoplasias del Mediastino/inducido químicamente , Neoplasias del Mediastino/genética , Neoplasias de Células Germinales y Embrionarias/tratamiento farmacológico , Neoplasias de Células Germinales y Embrionarias/genética , Factores de Tiempo , TrisomíaAsunto(s)
Artritis Reumatoide/tratamiento farmacológico , Azatioprina/efectos adversos , Linfoma de Células B/inducido químicamente , Neoplasias del Mediastino/inducido químicamente , Metotrexato/efectos adversos , Azatioprina/administración & dosificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Humanos , Metotrexato/administración & dosificación , Persona de Mediana EdadRESUMEN
Mediastinal lipomatosis has been described in adults and is a well recognized cause of mediastinal enlargement. Fatty accumulation in the mediastinum has been observed following extended usage of large doses of steroids, generally greater than 60 mg daily. Little documentation of this entity exists in pediatric patients. A 9-year-old male who received large doses of steroids for graft-versus-host disease following bone marrow transplantation for acute myelogenous leukemia developed mediastinal lipomatosis. Early qualification of this diagnosis is especially important in this group of patients, who are also at risk for a second neoplasm.
Asunto(s)
Lipomatosis/inducido químicamente , Neoplasias del Mediastino/inducido químicamente , Prednisona/efectos adversos , Niño , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Humanos , Masculino , Prednisona/administración & dosificaciónAsunto(s)
Neoplasias Encefálicas/inducido químicamente , Etretinato/efectos adversos , Enfermedad de Hodgkin/inducido químicamente , Linfoma/inducido químicamente , Neoplasias del Mediastino/inducido químicamente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/tratamiento farmacológicoRESUMEN
A 44-year-old patient with polycystic kidney disease received a renal transplant in December 1984. Nine months after immunosuppressive therapy with cyclosporin A and prednisolone the patient developed Hodgkin's disease of the mediastinum.
Asunto(s)
Ciclosporinas/efectos adversos , Enfermedad de Hodgkin/inducido químicamente , Trasplante de Riñón , Neoplasias del Mediastino/inducido químicamente , Adulto , Ciclosporinas/uso terapéutico , Quimioterapia Combinada , Enfermedad de Hodgkin/diagnóstico , Humanos , Masculino , Neoplasias del Mediastino/diagnóstico , Metilprednisolona/uso terapéutico , Complicaciones Posoperatorias/diagnósticoRESUMEN
An increased frequency of various genitourinary anomalies, infertility, and testicular cancer among males has been reported to follow intrauterine exposure to diethylstilbestrol, but not all studies have confirmed an association. This study was designed to determine whether a cohort of males exposed in utero to diethylstilbestrol had a higher frequency of urogenital abnormalities than an unexposed cohort. Biases in selection of exposed and control participants were minimized. Of 828 exposed and 676 control men studied by medical-record review, 265 exposed men and 274 controls also underwent a special clinical examination. Overall, the data suggest that diethylstilbestrol exposure of males in utero did not increase their risk of genitourinary abnormalities, infertility, or testicular cancer. Previously reported increased frequencies of these abnormalities in diethylstilbestrol-exposed men may have resulted from selection biases or differences in diethylstilbestrol use, or both.
Asunto(s)
Anomalías Inducidas por Medicamentos/epidemiología , Dietilestilbestrol/efectos adversos , Efectos Tardíos de la Exposición Prenatal , Anomalías Urogenitales , Adulto , Femenino , Fertilidad/efectos de los fármacos , Humanos , Masculino , Neoplasias del Mediastino/inducido químicamente , Examen Físico , Embarazo , Enfermedades de la Próstata/inducido químicamente , Conducta Sexual , Espermatozoides/efectos de los fármacos , Teratoma/inducido químicamente , Neoplasias Testiculares/inducido químicamenteRESUMEN
3 mg/day procarbazine hydrochlorate, in a total dose of 300 mg, provoked tumours or raised their number in a variety of rat organs and tissues. 70.8% males and 92.5% females bore tumors against 16.6 and 33% of the controls. It is suggested that the lack of a specific target organ is due to the metabolic conversion of procarbazine to alkylating agents in the liver. The chemical structure, distribution of these agents within the organism and the different organ-specific enzyme activation and inhibition systems are probably responsible for the variable organotropism.
Asunto(s)
Carcinógenos , Procarbazina/toxicidad , Animales , Carcinoma/inducido químicamente , Femenino , Neoplasias Pulmonares/inducido químicamente , Masculino , Neoplasias Mamarias Experimentales/inducido químicamente , Neoplasias del Mediastino/inducido químicamente , Ratas , Ratas Endogámicas , Sarcoma/inducido químicamente , Factores SexualesRESUMEN
Corticosteroid-induced mediastinal widening with simulated focal lymphadenopathy was found in a patient having myasthenia gravis. To my knowledge, this is the first report of such changes occurring in a patient having myasthenia gravis. As the use of corticosteroids in the treatment of myasthenia gravis becomes more common, this association can be expected to occur more often. Reemphasis of this phenomenon should help to avoid unnecessary surgical intervention in these patients.