ABSTRACT
Se presentan dos casos estudiados en el Centro de Investigaciones Medicoquirúrgicas (CIMEQ), diagnosticados de papilomatosis en esófago uno y en vías respiratorias el otro. Se realiza un breve recuento del diagnóstico, la evolución y el tratamiento tanto médico como quirúrgico aplicado a cada uno. En la actualidad los pacientes se encuentran bajo tratamiento sistémico con interferón α. El paciente con diagnóstico de papilomatosis de las vías respiratorias presenta recidiva de la enfermedad, constatada por broncoscopias posteriormente realizadas(AU)
Two cases are presented studied in the Center of Investigations Medicoquirúrgicas (CIMEQ), diagnosed of papilomatosis in esophagus one and in breathing roads the other one. He/she is carried out a brief recount of the diagnosis, the evolution and the treatment so much medical as surgical applied each one. At the present time the patients are low systemic treatment with interferón to. The patient with diagnosis of papilomatosis of the breathing roads presents relapse of the illness, verified later on by broncoscopias carried out(AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Papilloma/diagnosis , Respiratory Tract Neoplasms/therapy , Esophageal Neoplasms/therapy , Interferons/therapeutic useABSTRACT
Expression of the natural killer (NK) cell antigen CD56 is uncommon in malignant lymphoma, but when it is, it is almost exclusively of the non-B cell lineage and show a preference for the nasal and nasopharyngeal region. T/NK cell lymphoma is known to be aggressive and refractory to treatment. It is highly associated with the Epstein-Barr Virus (EBV), but clinical investigations are rarely reported, that is until recently. We report here, on the clinical features and therapeutic outcomes of patients with T/NK cell lymphomas and its association with EBV. We reviewed fifty-four cases with peripheral T cell lymphomas in the upper aerodigestive tract between Jan. 1987 and Aug. 1998 from the Severance Hospital, Yonsei University College of Medicine. The diagnosis of T/NK cell lymphoma was made according to the expression of the NK cell markers, CD56 antigen and cytoplasmic CD3 epsilon, in tumor specimens, by immunohistochemistry. Epstein-Barr early region (EBER) RNA was detected using in situ hybridization on paraffin-embedded sections. Among the 54 cases with malignant lymphomas occurring in the upper aerodigestive tract, 20 had T/NK cell lymphoma (37%). The primary sites of T/NK cell lymphomas were the nasal cavity, 12 cases (60%), the tonsils, 4 cases (20%), the nasopharynx, 2 cases (10%), and the oropharynx, 2 case (10%). There were no differences between the features, at diagnosis or therapeutic modalities for patients with T/NK cell lymphoma and non-T/NK cell lymphoma. The complete remission rate of T/NK cell lymphomas was lower than non-T/NK cell lymphomas (65% vs 85%, p=0.02). The overall survival of T/NK cell lymphomas was 13 months (1-74 month), which was significantly lower than non-T/NK cell lymphomas [60.6% with a median follow up of 22 months (1-101 month, p=0.02)]. Disease free survival of T/NK cell lymphomas was 22 months (4-66 month), significantly lower than non-T/NK cell lymphomas [73.8% with a median follow up of 22 months (2-95 month), p=0.04]. The overall survival rates for T/NK cell lymphomas were significantly lower than for EBV positive non-T/NK cell lymphomas (p=0.018). EBER RNA was detected in the paraffin-embedded tissue sections of all T/NK cell lymphomas, compared to only 17.6% (6 of 34 cases) for non- T/NK cell lymphomas. In conclusion, as patients with T/NK cell lymphomas showed poor clinical outcomes, and a high association with EBV positivity, clinical trials with more investigational therapeutic strategies, and further research into the relationship of EBV infection with pathogenesis of T/NK cell lymphoma is warranted.
Subject(s)
Adult , Aged , Female , Humans , Male , Digestive System Neoplasms/therapy , Herpesvirus 4, Human/isolation & purification , Killer Cells, Natural , Lymphoma/therapy , Lymphoma, T-Cell/therapy , Middle Aged , Respiratory Tract Neoplasms/therapy , Treatment OutcomeABSTRACT
Resumo: A laringopapilomatose juvenil é o tumor de trato respiratório mais comum em crianças, porém o acometimentodos brônquios e do parênquima pulmonar ocorre em apenas 1 por cento a 2 por cento dos casos. Os autores relatam um caso de disseminaçäo pulmonar na laringopapilomitose juvenil, descrevendo os aspectos radiológicos e tomográficos das lesöes. Säo feitos comentários sobre abrangência clínica dessa doença e discutidos os aspectos diagnósticos, histopatológicos e terapêuticos provenientes dos dados clínicos relatados no caso e da revisäo de literatura realizada.