ABSTRACT
Primary cutaneous lymphomas have different clinical behavior and prognosis than systemic lymphomas of similar histological subtype. About 30% of non-Hodgkin lymphomas involve extranodal tissues, the skin being the second most affected body organ after the gastrointestinal tract (approximately 18%). According to the EORTC (European Organization for Research and Treatment of Cancer) classification, the lymphoma centrofollicular is indolent, since the lesions increase in size slowly over the years and spread to extracutaneous sites is uncommon. Based on this, radiotherapy has been considered the treatment of choice by many studies. We present the case of a patient who had cutaneous centrofollicular scalp lymphoma for 1 year and showed good response to radiotherapy.
Os linfomas cutâneos primários têm comportamento clínico e prognóstico diferente dos linfomas sistêmicos de subtipo histológico semelhante. Cerca de 30% dos linfomas não-Hodgkin acometem tecidos extranodais, sendo a pele o segundo órgão mais envolvido após o trato gastrointestinal (aproximadamente 18%). De acordo com a classificação EORTC (European Organization for Research and Treatment of Cancer), o linfoma centrofolicular cutâneo é indolente, uma vez que as lesões aumentam de tamanho lentamente ao longo dos anos e a disseminação para sitios extracutâneos é incomum. Com base nisso, a radioterapia tem sido apontada como o tratamento de primeira escolha por muitos estudos. Apresentamos um caso de paciente com linfoma cutâneo centrofolicular no couro cabeludo há 1 ano e que apresentou boa resposta à radioterapia.
Subject(s)
Humans , Male , Middle Aged , Head and Neck Neoplasms/radiotherapy , Lymphoma, B-Cell/radiotherapy , Scalp , Skin Neoplasms/radiotherapy , Head and Neck Neoplasms/pathology , Lymphoma, B-Cell/pathology , Scalp/pathology , Skin Neoplasms/pathology , Treatment OutcomeABSTRACT
OBJETIVO: Relatar tratamento de retinopatia por radiação em paciente submetido à radioterapia por linfoma em órbita direita com injeção intravítrea de bevacizumab (Avastin®). Paciente de 55 anos, diabético, com diagnóstico de linfoma MALT orbitário há três anos, tratado com radioterapia local (dose: 35Gy) há dois anos, com queixa de redução da acuidade visual do olho direito há quatro meses. Ao exame oftalmológico, apresentava alterações sugestivas de retinopatia por radiação, bem como espessura macular à tomografia de coerência óptica de 480 µm. Paciente foi submetido à injeção intravítrea (0,05 ml) de bevacizumab (Avastin®) no olho direito, apresentando redução do edema macular, bem como melhora discreta da acuidade visual. Neste caso, o tratamento da retinopatia por radiação com injeção intravítrea de bevacizumab (Avastin®) foi relativamente útil, com melhora discreta da acuidade visual, devido à regressão do edema macular.
PURPOSE: To report a case of radiation retinopathy treatment with intravitreal injection of bevacizumab (Avastin®) in a patient undergoing radiotherapy for lymphoma in the right orbit. Patient of 55 years-old male, diabetic, diagnosed with an orbital MALT lymphoma three years ago, treated with local radiotherapy (dose: 35Gy) two years ago, complaining of reduced visual acuity of the right eye for about four months. During the ophthalmologic evaluation, he had an exam suggestive of radiation retinopathy. Macular thickness at the optical coherence tomography was 480 µm. Patient was referred to intravitreal injection (0.05 ml) of bevacizumab (Avastin®) in the right eye, showing reduction of macular edema and mild improvement of visual acuity. In this case, the treatment of radiation retinopathy with intravitreal injection of bevacizumab (Avastin®) was relatively useful, with mild improvement of visual acuity due to the regression of macular edema.
Subject(s)
Humans , Male , Middle Aged , Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Macular Edema/drug therapy , Radiation Injuries/drug therapy , Intravitreal Injections , Lymphoma, B-Cell/radiotherapy , Treatment Outcome , Visual AcuityABSTRACT
La Medicina Nuclear clínica se apoya tradicionalmente en tres grandes pilares básicos, estos son las imágenes, la terapia con radionucleidos y las técnicas "in vitro". En los últimos años, tanto con el desarrollo de las imágenes moleculares como con el surgimiento de nuevas aplicaciones terapéuticas con radionucleidos, se nos abren insospechadas oportunidades para que nuestra especialidad ocupe un valioso sitial en las nuevas aplicaciones oncológicas. En este artículo se revisa nuestra experiencia en dos novedosas áreas en las cuales hemos tenido la oportunidad de desarrollarlas en nuestro centro. Estas son la terapia con 90Y-DOTATOC en tumores con sobre-expresión de receptores de somatostatina[1] (carcinoides, neuroendocrinos y otros) y el uso de 90Y-Ibritumomab-Tiuxetan en Linfomas No Hodgkin de células B con presencia de antígeno CD20+[2].
Subject(s)
Humans , Lymphoma, Non-Hodgkin/radiotherapy , Nuclear Medicine/trends , Yttrium Radioisotopes/therapeutic use , Radiotherapy/trends , Carcinoid Tumor/radiotherapy , Neuroendocrine Tumors/radiotherapy , Antibodies, Monoclonal , Lymphoma, B-Cell/radiotherapy , Radiopharmaceuticals/therapeutic use , Radioimmunotherapy/trends , Yttrium Radioisotopes/administration & dosageABSTRACT
Combination chemotherapy and radiation therapy have contributed to the successful treatment of various cancer patients. But the development of second malignancies is an inevitable complication of long-term cytotoxic treatment. The most serious and frequent of such complications is acute myelogenous leukemia (AML). Therapy-related leukemia is generally fatal. Since the number of patients exposed to chemotherapy is increasing each year, the clinical significance of this entity cannot be underestimated. There have been many investigations of therapy-related leukemia, but in Korea published reports are rare. We describe four such cases, involving one older female with lung cancer and three children with acute lymphoblastic leukemia (ALL) and malignant lymphoma. Alkylating agents were used for chemotherapy, and in one case, topoisomerase II inhibitor. Irrespective of the causative agents, the latency periods were relatively short, and despite induction chemotherapy in two, all survived for only a few months. During the follow-up of patients treated for primary malignancies, the possibility of therapy-related leukemia should always be borne in mind.
Subject(s)
Aged , Child , Female , Humans , Male , Adolescent , Antineoplastic Agents, Alkylating/therapeutic use , Antineoplastic Agents, Alkylating/adverse effects , Carcinoma, Small Cell/radiotherapy , Carcinoma, Small Cell/drug therapy , DNA Topoisomerases, Type II/antagonists & inhibitors , Fatal Outcome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Leukemia, Monocytic, Acute/etiology , Leukemia, Myeloid, Acute/etiology , Leukemia, Myelomonocytic, Acute/etiology , Lung Neoplasms/radiotherapy , Lung Neoplasms/drug therapy , Lymphoma, B-Cell/radiotherapy , Lymphoma, B-Cell/drug therapy , Neoplasms, Second Primary/etiologyABSTRACT
Linfomas cutâneos de células B fazem parte de um grupo heterogêneo de alteraçöes do sistema linforreticular que que podem acometer a pele. Nesta apresentaçäo relatamos o caso de um paciente que apresentava dados clínicos, histopatológicos e imunoistoquímicos compatíveis com o diagnóstico de linfoma cutâneo de células B. Durante o estadiamento se encontrou comprometimento da medula óssea. O paciente foi tratado com quimioterapia sistêmica e radioterapia localizada, havendo a regressäo das lesöes.