Primary extraperitoneal rectum lymphoma in AIDS patient / Linfoma primário de reto extraperitoneal em paciente SIDA

ABSTRACT Introduction The gastrointestinal lymphoma can be classified in primary or secondary, and this is important regarding diagnosis and subsequent treatment. Primary gastrointestinal lymphoma of the rectum is rare and therefore lacks data in medical literature. Its incidence has been increasing and that fact may be related to a higher incidence in immunosuppressive therapy and immunosuppressive diseases (such as AIDS). Metodology 19 articles have been reviewed, searched online on the Scielo and PubMed databases. The goal was to increase data available regarding this pathology and improve its therapy. Discussion Primary GI lymphoma of the rectum presents as hematochezia, rectal pain, change in bowel habits. PET/CT is the first choice exam to pursue investigation; however abdominal CT and MRI reveal sufficient information and are much more available in daily practice. Plasmablastyc lymphoma is an aggressive subtype and is usually associated with AIDS patients. There are no available treatment protocols for this specific type of lymphoma and colonic lymphoma's therapy is usually used for this patient (such as ECHOP and CHOP). Conclusion As rare as this pathology is, this article aims to improve the available data and provide useful information regarding diagnosis and therapy.

RESUMO Introdução O linfoma do TGI pode ser dividido entre primário e secundário, com importância diagnóstica e terapêutica. O linfoma primário de reto é patologia rara, pouco relatada em literatura médica. Sua incidência tem aumentado e possivelmente esse fenômeno esteja associado ao aumento no numero de pacientes com imunossupressão (seja por SIDA ou drogas imunossupressoras). Metodologia Foram revisados 19 artigos nas bases de dados Scielo e PubMed, com o objetivo de aumentar o número de relatos dessa patologia e consequentemente expandir o conhecimento disponível, visando melhorar a terapêutica e, principalmente, o diagnóstico desse tipo de linfoma. Discussão Quando o linfoma tem seu sítio primário no reto, as principais manifestações são sangramento, dor retal, tenesmo e mudança nos hábitos intestinais (diarreia ou constipação). O exame de investigação de escolha é o PET/CT, porém a TC e RNM fornecem as informações necessárias e são mais disponíveis na prática clínica. O linfoma plasmablástico é um subtipo bastante agressivo e associado aos pacientes com SIDA. Não existem ainda protocolos definidos para o tratamento do linfoma primário de reto, sendo optado por seguir a mesma terapêutica dos linfomas de cólon com esquemas EPOCH e CHOP. Conclusão Por se tratar de patologia rara e pouco descrita na literatura, espera-se que este relato contribua na formação de protocolos de tratamento específicos.

Extranodal malignant lymphoma of the upper aerodigestive tract: prevalence of Epstien-Barr virus (EBV) infection in King Chulalongkorn Memorial Hospital.

BACKGROUND: High frequency of Epstein-Barr virus (EBV) in the normal mucosa of the upper aerodigestive tract suggests that it may serve as a reservoir for the virus. Malignant lymphomas arising in this site may be associated with EBV. OBJECTIVES: To determine the prevalence of EBV infection in extranodal malignant lymphomas of the upper aerodigestive tract. SETTING: King Chulalongkorn Memorial Hospital, Thailand. DESIGN: Descriptive study. PATIENTS: 42 Thai patients who presented between 1998 and 2003. MATERIAL AND METHOD: The expression of EBV mRNAs (EBERs) of malignant lymphoma was studied by means of in situ hybridization in formalin-fixed, paraffin-embedded specimens. RESULTS: The recruited subjects were 26 males and 16 females, and their age ranged from 3 to 85 years with the mean of 51.43 years, in 4 of them human immune deficiency virus (HIV) infection was documented. Ten of 42 cases (23.81%) expressed EBER transcripts and were extranodal NK/T-cell lymphomas, nasal type (7 cases), plasmablastic lymphomas (2 cases) and diffuse large B-cell lymphoma (1 case). Three of 4 cases (75%) of known HIV-seropositive cases were EBV-positive (2 plasmablastic lymphomas and 1 diffuse large B-cell lymphoma). CONCLUSION: In the upper aerodigestive tract, EBV was present in some but not all malignant lymphoma. It was associated with extranodal NK/T-cell lymphoma, nasal type and B-cell lymphoma arising in HIV-infected patients, but it was not found in B-cell lymphoma arising in immunocompetent patients.

Multicentric lymphoma with metastasis in the central nervous system in a dog

Linfoma multicêntrico foi diagnosticado em um cão com dois anos de idade que apresentava insuficiência respiratória, aumento de volume abdominal (ascite) e linfoadenopatia generalizada. O exame imunoistoquímico revelou origem de células T com expressão CD3+ e CD79-. Após cinco semanas, o cão apresentou déficits neurológicos progressivos, sendo identificada a presença de linfócitos neoplásicos no líquor. O exame histopatológico demonstrou invasão de células neoplásicas no baço, linfonodos, cérebro e cerebelo.

Linfoma ósseo em cão / Bone lymphoma in a dog

It was reported one case of primary bone lymphoma in eight year-old bitch, Fila, with history of anterior limbs paralysis and side lied. A cervical vertebrae neoplasm was suspected and in view of the poor prognosis, the animal was euthanatized. Based on the anatomopathological and histological findings it was firmed the diagnosis of primary bone lymphoma.

Bone density in survivors of childhood acute leukemia and malignant lymphomas

This study aimed to assess bone mineral density in survivors of childhood acute leukemia and malignant lymphomas to determine the prevalence of osteoporosis and identify the possible predisposing factors and patients at the greatest risk of reduced bone mineral density. The study included 41 survivors [27 patients had acute lymphoblastic leukemia and 14 patients had malignant lymphomas]. In conclusion, 60.9% of the survivors of childhood leukemias and lymphomas had decreased BMD, osteoporosis being especially severe in 17.1% of these patients. In view of the risk of fractures among patients with osteoporosis, the survivors of childhood malignancy were at an increasing risk of bone fractures later in life irrespective of the underlying cause of osteoporosis, thus the intervention should be considered for prevention and proper management

Linfoma de ceco / Colorectallymphoma

Os linfomas do cólon säo tumores pouco frequentes, constituindo 0,5 por cento das neoplasias colônicas. O local mais acometido é o ceco, seguido do reto. A faixa etária mais atingida é em torno dos 50 anos. O diagnóstico diferencial é difícil, sendo a clínica semelhante a de qualquer tumor do intestino grosso. Após diagnóstico, o estadiamento é importante para afastar comprometimento de outros órgäos. O tratamento de escolha para a doença localizada é cirúrgico e na doença avançada utiliza-se radioterapia e/ou quimioterapia. Os autores relatam um caso de linfoma de ceco diagnosticado após a ressecçäo cirúrgica, seguido de terapia adjuvante com quimioterapia

Linfoma orbital; aspectos na tomografia computadorizada / Orbital lymphoma; CT aspects

Os autores apresentam análise retrospectiva de oito pacientes imunocompetentes, com linfoma orbital, examinados no Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro. Tumoraçäo, diminuiçäo da acuidade visual, exoftalmia e ptose palpebral foram os achados clínicos mais encontrados. A tomografia computadorizada, os achados mais frequentes foram: espessamento da musculatura orbitária e proptose. Outros aspectos observados foram: massa, aumento de volume da glândula lacrimal e espessamento da bainha do nervo óptico

Linfoepitelioma Benigno en ambas parótidas / Benign lymphoepithelioma in each parotid gland

La glándula parótida es el sitio mas frecuente (80 por ciento) en el que se presentan los tumores de glándulas salivales; de ellos, el 70 por ciento son tumores benignos. Para evitar reacciones innecesarias, es importante llegar a un diagnóstico preciso. Se presenta el caso de una pacientes de 45 años con dos tumoraciones de crecimiento lento y progresivo en cada una de las glándulas parótidas. El estudio incluyó sialografía, gamagrafía con tecnecio 99 y tomografía computada que informaron de la extensión de las tumoraciones que involucraban lóbulos superficiales de ambas parótidas y profundo de la derecha, con quistes en ambas. Se estableció preoperatoriamente el diagnóstico de linfoepitelioma benigno bilateral por biopsia con aguja tru-cut. Se realizó parodectomía superficial izquierda y total derecha, preservando anatómica y funcionalmente ambos nervios faciales

Linfoma da conjuntiva: relato de caso / Conjuntiva lymphoma: a case report

O linfoma da conjuntiva é bastante raro. Relatamos o caso de paciente portador de linfoma da conjuntiva do tipo linfócito difuso de pequenas células (de baixo grau de malignidade) e que apresentou vários aspectos incomuns desta patologia, tais como: bilateralidade, acometimento sistêmico simultâneo e entrópio palpebral

Manifestaçöes oculares da Síndrome da Imunodeficiência Adquirida (AIDS) / Ocular manifestations of Immunodeficiency Syndrome

Os autores fazem uma revisäo da Síndrome da Imunodeficiência Adquirida em seus aspectos gerais. Focalizam as infecçöes oportunistas, relacionando-as com a contagem dos linfócitos T circulantes, e as afecçöes malignas associadas à doença. Chamam a atençäo para a evoluçäo e os aspectos clínicos para a menor incidência de manifestaçöes oculares

Linfomas intestinales: informe de 10 casos / Intestinal lymphomas: a report of 10 cases

Los linfomas del tubo digestivo son los linfomas extraganglionares más frecuentes y constituyen del 1 al 4 por ciento de las neoplasias malignas del tubo digestivo. En este trabajo se analizan las caracteristicas clínicas y patológicas de 10 linfomas del intestino delgado y grueso en pacientes del Hospital General de México, que se obtuvieron después de revisar 8 años del material quirúrgico y 5 años del de autopsias de los archivos de la Unidad de Patología de este hospital. Seis casos fueron hombres y 4 mujeres. La edad varió de 3 a 94 años, con un promedios de 50.3 años. Las manifestaciones clínicas incluyeron dolor abdominal (83 por ciento), vómito (50 por ciento), pérdida de peso (50 por ciento), pérdida de peso, constipación (33 por ciento) e ictericia (16 por ciento). La perforación intestinal fue la complicación más frecuente (30 por ciento). Seis casos se localizaron en intestino delgado, dos en intestino delgado y colon, uno en colon y uno en recto. Microscópicamente 7 fueron de bajo grado y tres de alto grado, 55 por ciento correspondieron a linfomas B y 45 por ciento a linfomas T. Dos casos se consideraron primarios y cuatro por tener infiltración extraintestinal, fueron secundarios. En ningún caso se encontraron datos sugestivos de linfoma asociado a mucosas ni datos de enteropatía asociada a mala absorción intestinal.

La enfermedad fatal de Napoleón Bonaparte / The fatal disease of Napoleon Bonaparte

Napoleon Bonaparte, soldier, general and emperor, desired the European union. He abdicated twice and in 1814 was confined to Santa Helena Island. From the biographic description of his last exile, we have extracted a description of the disease that lead him to die. We postulate that he had a gastric lymphoma

Value of some tumor markers in CNS infiltration of childhood leukemia and lymphoma

Some tumor markers were evaluated in serum and CSF of thirty-one children with acute lymphoblastic leukemia [ALL] and non-Hodgkin's lymphoma [NHL]. Ten of the patients had clinical sings of central nervous system [CNS] infiltration. Significantly lower levels of carcinoembryonic antigen [CEA]; beta-2-microglobulin [beta-2-MG], beta- glucuronidase lysozyme and immunoglobulins IgG, IgM and IgA were detected in serum and CSF of patients compared with pretherapy levels. Children with clinical evidences of CNS infiltration [32.3%] showed higher level of all studied markers in CSF compared with those without infiltration, but the differences were significant only in beta-2-MG, lysozyme and immunoglobulins. In 29% of patients without clinical evidences of CNS involvement, high levels of these markers in CSF were detected which may indicate early infiltration. Patients with relapses [14.2%] exhibited significant increase of CSF markers. The levels were higher than pretherapy levels. It was concluded that determination of CEA, beta-2-MG, beta- glucuronidase, lysozyme and immunoglobulins in CSF and serum of patients with ALL and NHL are valuable tools in early detection of relapses

CSF cytokines, nitric oxide and prostaglandins in diagnosis and pathophysiology of childhood CNS leukemia and lymphoma

To clarify the role of cytokines, nitric oxide [NO] and prostaglandin- E2 [PG-E2] in diagnosis and pathogenesis of infiltration of central nervous system [CNS] in cases with leukemia and lymphoma, the levels of these indices in the cerebrospinal fluid [CSF] of those children were determined. Their levels were correlated with other laboratory studies of CSF and clinical criteria. This study included twenty- seven children with acute leukemia [twenty with acute lymphoblastic leukemia [ALL] and seven with acute myeloid leukemia [AML]] and fifteen with non- Hodgkin's lymphoma [NHL]. Clinical evidence of CNS involvement was present in seventeen patients with acute leukemia and seven cases with NHL. The study revealed significantly elevated levels of two types of cytokines [TNF-alpha, IL-6] NO and PG-E2 in CSF of children with acute leukemias and lymphoma compared with control group [children with tension headache or meningism]

Serum atrial natriuretic peptide, lipid profile and lipid peroxidation in adriamycin therapy of leukemia and lymphoma

Serum atrial natriuretic peptide [ANP], triglycerides, cholesterol and lipid peroxides were studied in thirty-one cases of acute lymphoblastic leukemia [ALL] [including fifteen newly diagnosed cases and sixteen relapses cases], twenty-nine cases of non-Hodgkin's lymphoma [NHL] comprised fifteen newly diagnosed cases and fourteen relapsed cases, ten oncogenic controls and ten healthy controls. Adriamycin was included in therapy of studied cases and not in that of oncogenic controls. Beside full clinical examination and routine investigations to diagnose ALL and NHL cases, ECG and echocardiography were done to all cases and controls. Serum ANP, triglyceride, cholesterol and lipid peroxides were measured before adriamycin therapy, three weeks after the first remission, three weeks after the second remission and in serum of the control group. It was concluded that serum ANP in patients treated with adriamycin is helpful diagnostic tool for early detection of myocardial damage and early management even in the absence of echocardiographic changes as the rise in ANP level is related to the drug dose and not related to the malignancy itself. Serial determinations of serum triglyceride, cholesterol and lipid peroxides are helpful for early detection and prevention of myocardial damage

Linfomas primarios intestinales / Primary intestinal lynphoma

Los linfomas son tumores malignos originados en el tejido linfatico, en ocasiones con localizaciones extraganglionares. Tal es el caso de los linfomas no hodkigs. Los linfomas primarios del tracto gastrointestinal corresponden solamente del 1 al 4 por ciento de todas las neoplasias malignas gastrointestinales, observandose una localizacion mas frecuente en estomago seguida por el intestino delgado y el colon. A pesar de su baja frecuencia han concitado la atencion de muchos autores por los avances en citogenetica, histologia, funcion y caracteres inmunoenzimaticos de las celulas linfoideas, y debido a su curabilidad potencial. En el presente trabajo se exponen la experiencia relativa a los linfomas primarios intestinales, tratados en el Departamento de cirugia del Hospital Clinico de la Universidad de Chile.

Malignant lymphoma associated with hanseniasis

There are few reports in the world medical literature concerning association between leprosy and malignant lymphoma. It seams that, although defects in immune system related to leprosy are multiple and complex, no increase in incidence of malignant lymphoma among leprosy patients can be detected. This is also true for Brazil, where leprosy is an endemic disease, which poses an important public health problem. For this reason, the authors report on three cases of malignant lymphoma: one low grade, B-cell lymphoma (immunocytoma): one high grade, T-cell lymphoma and one mixed cellularity Hodgkin's disease in patients previously diagnosed as having leprosy.