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Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 40-48, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364901


Abstract Introduction Knowing the information regarding the panorama of lymphoma diagnosis in patients treated in the Brazilian Public Unified Health System from the last 10 years is a challenge for Strategic Health Planning. Objective To characterize the Brazilian population with lymphoma treated in the Brazilian Public Unified Health System between 2008 and 2017 regarding staging, sex, residence site and mortality. Material and methods A descriptive, retrospective, and longitudinal trial with secondary data from DataSUS (SIA/SUS and SIM/SUS) obtained from patients with ICD-10 C81-85. Results There were 70,850 lymphoma cases between 2008 and 2017, of which 55% were male, the median age was 51 years, and 27% had Hodgkin Lymphoma. Most patients (56%) were treated outside the residence city. São Paulo State accounted for 25% of patients. Treatment initiation took more than 60 days in 27% of cases. A total of 45,601 deaths were due to lymphoma (12% Hodgkin Lymphoma and 88% Non-Hodgkin Lymphoma), with a median age 63 years, and were mainly males (55%). Staging data were inadequate in 23% of patients, and analysis was performed only on the valid records. Advanced disease was diagnosed in 58% of patients (60% male; 57% female) and was more common in Non-Hodgkin Lymphoma (62%) versus Hodgkin Lymphoma (49%). Discussion Late diagnosis interferes with mortality rates. Health promotion and cancer prevention campaigns, especially targeting the male public, and training for early diagnosis and early treatment are needed. Conclusion Effective measures for early diagnosis and treatment are urgently needed for lymphoma control.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Hodgkin Disease/diagnosis , Lymphoma/diagnosis , Mortality , Delayed Diagnosis , Neoplasm Staging
Rev. cuba. med ; 60(3): e2515, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347507


Introducción: El trasplante autólogo de progenitores hematopoyéticos es una terapéutica aplicable en determinadas situaciones a pacientes con Linfoma de Hodgkin. Objetivo: Evaluar la influencia de factores pronósticos seleccionados en los resultados del trasplante autólogo de progenitores hematopoyéticos en pacientes con Linfoma de Hodgkin. Métodos: Se realizó un estudio retrospectivo de 57 pacientes con diagnóstico de Linfoma de Hodgkin trasplantados en el Hospital Clínico Quirúrgico Hermanos Ameijeiras entre 1991 y 2018. La influencia de varios factores desfavorables fue evaluada según sobrevida libre de enfermedad a los cinco años de forma univariada y multivariada. Resultados: Se comprobó una sobrevida libre de enfermedad menor para todos los grupos con las categorías desfavorables. El análisis univariado indicó que el haber recibido tres o más líneas de tratamiento previas, aumentó como promedio 3,48 veces la probabilidad de recaída. En la evaluación múltiple, aumentó de forma significativa la probabilidad de recaída la existencia de enfermedad activa al momento del trasplante (p= 0,023) y el no recibir radioterapia en el tratamiento acondicionante (p= 0,010). Conclusiones: Se demostró la importancia de conocer los factores desfavorables. Notable importancia tuvo evitar enfermedad activa al trasplante y realizar una correcta evaluación de riesgos y beneficios en cuanto a la posible inclusión de la radioterapia en el tratamiento acondicionante(AU)

Introduction: Autologous hematopoietic stem cell transplantation is a therapy used in certain situations to patients with Hodgkin's Lymphoma. Objective: To evaluate the influence of selected prognostic factors on the results of autologous hematopoietic stem cell transplantation in patients with Hodgkin's Lymphoma. Methods: A retrospective study of 57 patients with a diagnosis of Hodgkin Lymphoma transplanted at Hermanos Ameijeiras Clinical Surgical Hospital from 1991 to 2018 was carried out. The influence of several unfavorable factors was evaluated according to univariate and multivariate disease-free survival at five years. Results: A lower disease-free survival was found for all groups with unfavorable categories. Univariate analysis indicated that receiving three or more previous lines of treatment increased the probability of relapse on average 3.48 times. In the multiple evaluation, the probability of relapse was significantly increased by the existence of active disease at the time of transplantation (p = 0.023) and by not receiving radiotherapy in the conditioning treatment (p = 0.010). Conclusions: The importance of knowing the unfavorable factors was established. It was of noteworthy importance to avoid active disease at transplantation and to carry out a correct evaluation of risks and benefits regarding the possible inclusion of radiotherapy in the conditioning treatment(AU)

Humans , Prognosis , Transplantation, Autologous/methods , Hodgkin Disease , Retrospective Studies
Rev. cuba. med ; 60(2): e2509, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280341


Introducción: El trasplante autólogo de progenitores hematopoyéticos es una terapéutica aplicable en determinadas situaciones a pacientes con Linfoma de Hodgkin. Objetivo: Evaluar la respuesta al trasplante autólogo de progenitores hematopoyéticos en los pacientes con Linfoma de Hodgkin. Métodos: Se realizó un estudio de 60 pacientes con Linfoma de Hodgkin trasplantados en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, entre 1991 y 2018. Se estimó el porcentaje de respuesta a los tres meses, la supervivencia global y la supervivencia libre de enfermedad a los cinco años. Resultados: La tasa de respuesta a los tres meses fue de 82,7 por ciento. La supervivencia global y libre de enfermedad a los cinco años fue de 94,7 por ciento y 51,7 por ciento, respectivamente. La mortalidad temprana relacionada con el trasplante fue de 5 por ciento. Conclusiones: La aplicación del trasplante autólogo de progenitores hematopoyéticos constituyó una alternativa terapéutica válida. La baja mortalidad temprana evidenció una realización del procedimiento con un perfil de seguridad satisfactorio(AU)

Introduction: Autologous hematopoietic stem cell transplantation is an applicable therapy in certain situations to patients with Hodgkin's Lymphoma. Objective: To evaluate the response to autologous hematopoietic stem cell transplantation in patients with Hodgkin's Lymphoma. Methods: A study of 60 patients with Hodgkin lymphoma transplanted at Hermanos Ameijeiras Clinical and Surgical Hospital was carried out from 1991 to 2018. The percentage of response at three months, overall survival and disease-free survival period were estimated at five years. Results: The response rate at three months was 82.7 percent. Overall and disease-free survival at five years was 94.7 percent and 51.7 percent, respectively. Early transplant-related mortality was 5 percent. Conclusions: The use of autologous hematopoietic stem cell transplantation was a valid therapeutic alternative. The low early mortality evidenced that the procedure was performed with a satisfactory safety profile(AU)

Humans , Transplantation, Autologous/mortality , Hodgkin Disease/diagnosis , Hodgkin Disease/therapy , Retrospective Studies
Journal of Experimental Hematology ; (6): 1802-1806, 2021.
Article in Chinese | WPRIM | ID: wpr-922338


OBJECTIVE@#To explore the clinical significance of Epstein-Barr virus(EBV) detection and classification in peripheral blood of lymphoma patients.@*METHODS@#101 lymphoma patients were enrolled, the clinical characteristics of the patients were collected, including ages, sex, types of lymphoma, Ann Arbor stages, extranodal infiltration and lactate dehyhrogenase. Fluorescent quantitative PCR technology was used to detect the EBV-DNA. Polymerase chain reaction and Agarose gel electrophoresis was used for determination of EB genotyping. The difference between curative effect in EBV-DNA+ and EBV-DNA- patients, the correlation of adverse factors and EBV infection of the patients were analyzed.@*RESULTS@#68.3% (69/101) of the patients showed EBV-DNA positive. EBV-positive lymphoma patients showed more adverse prognostic factors than the patients with EBV-negative, which may lead to poorer disease outcome. Among the 46 B-cell non-Hodgkin's lymphoma patients, the overall response rate of EBV-positive patients (60.7%) was lower than EBV-negative patients(88.9%) (P<0.05); For 19 patients with Hodgkin's lymphoma, the overall response rate of EBV-positive patients (46.2%) was lower than EBV-negative patients (100%), the differences were statistically significant (P<0.05). Among 69 patients with EBV-infected lymphoma, 98.6% (68/69) showed type-2 EB virus, and 1.4% (1/69) were type-1 and type-2 mixed infections.@*CONCLUSION@#Most of EBV-positive in lymphoma patients were EBV type 2, patients with EBV-DNA+ shows poorer efficacy than EBV-DNA- patients.

DNA, Viral , Epstein-Barr Virus Infections , Genotype , Herpesvirus 4, Human/genetics , Hodgkin Disease , Humans
Chinese Journal of Oncology ; (12): 707-735, 2021.
Article in Chinese | WPRIM | ID: wpr-887467


Lymphoma is one of the most common malignancies in China. In China, there were 6 829 new Hodgkin lymphoma cases and 2 807 deaths in 2020, with 92 834 new non-Hodgkin lymphoma cases and 54 351 deaths. Due to the complicated pathological subtypes and heterogeity, the treatment strategies for lymphoma vary largely. In recent years, with the deep understanding for the nature of lymphoma, much research progress has been achieved in the diagnosis and treatment, leading to a remarkable improvement in survival outcome of patients. In order to update the progress in the treatment of lymphoma worldwide timely, and further improve the level of standardized diagnosis and treatment of lymphoma in China, the China Anti-cancer Association Lymphoma Committee, Chinese Association for Clinical Oncologists, and Medical Oncology Branch of Chinese International Exchange and Promotion Association for Medical and Healthcare organized experts to formulate "Clinical practice guideline for lympoma in China (2021 Edition)" .

China/epidemiology , Hodgkin Disease/drug therapy , Humans , Lymphoma/therapy , Lymphoma, Non-Hodgkin/drug therapy , Medical Oncology
Frontiers of Medicine ; (4): 101-107, 2021.
Article in English | WPRIM | ID: wpr-880948


Primary hypothyroidism commonly occurs after radiotherapy (RT), and coincides with increased circulating thyroid-stimulating hormone (TSH) levels.We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma (HL) in a prospective cohort study. From1998 to 2001, a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL, scheduled for craniospinal irradiation and mediastinum/neck radiotherapy, respectively, underwent thyroid ultrasound and free triiodothyronine (FT3), free thyroxine (FT4), and TSH evaluation at the beginning and end of craniospinal iiradiation. From 14 days before and up to the end of radiotherapy, patients were administered L-thyroxine checking every 3 days TSH to ensure a value < 0.3 μIU/mL. During follow-up, blood tests and ultrasound were repeated; primary hypothyroidism was considered an increased TSH level greater than normal range. Twenty-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels < 0.3 μIU/mL and well matched for other variables. Twenty years on, hypothyroidism-free survival rates differed significantly, being 60% ± 15% and 15.6% ± 8.2% in TSH-suppressed vs. not-TSH suppressed patients, respectively (P = 0.001). These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae, but it should be confirmed in a larger cohort.

Cerebellar Neoplasms , Child , Hodgkin Disease/radiotherapy , Humans , Hypothyroidism/prevention & control , Medulloblastoma/radiotherapy , Prospective Studies , Thyrotropin
Article in Chinese | WPRIM | ID: wpr-880035


METHODS@#From January 2005 to December 2013, 83 patients with refractory/recurrent CD20@*RESULTS@#All the patient achieved complete response. The median follow.up time was 39 months. Both the two groups collected peripheral blood stem cells successfully, and had no difference in hematopoietic reconstitution time. Three patients in treatment group and six patients in control group relapsed and the three year overall survival and EFS in treatment group was significantly higher than that in control group, that is(93.0% vs 73.1%, P=0.037) and (89.5% vs 65.4%, P=0.034), respectively. Subgroup analysis showed that: compared with the treatment group in which using R in the whole courses(before and after transplantation, and collection of stem cells) was superior to the control group in both OS and EFS, with the OS 97% vs 87.5% (P>0.05) and EFS 97% vs 76.2% (P=0.05) respectively. While stratified by the different courses of rituximab, the OS was 88.9% (1-2 courses, 9 cases), 93.1% (3-4 courses, 29 cases), 94.7%(more than 5 courses,19 cases), and EFS was 77.8%, 89.7% and 94.7%, respectively.@*CONCLUSION@#For the patients with refractory/recurrent CD20

Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Hodgkin Disease , Humans , Lymphoma, Non-Hodgkin/drug therapy , Rituximab/therapeutic use , Transplantation, Autologous , Treatment Outcome
Rev. ANACEM (Impresa) ; 15(1): 49-54, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1281435


INTRODUCCIÓN: Los tumores de mediastino constituyen una entidad clínica poco frecuente, generalmente asintomática. Se pueden desarrollar desde estructuras que se ubican en el compartimento anterior, medio y posterior, siendo la primera, la ubicación más usual. En los adultos, timomas y linfomas (Hodgkin y no Hodgkin) son las masas más comunes del mediastino anterior, junto al bocio endotorácico y los teratomas; todas en su conjunto son conocidas como las "4 T del Mediastino Anterior". Casos clínicos: Se exponen tres casos clínicos de tumores de mediastino anterior, intervenidos en nuestro centro. Discusión: Las masas mediastínicas constituyen una entidad clínica infrecuente. La tomografía computada de tórax con y sin contraste intravenoso es utilizada para evaluar estas anormalidades descubiertas radiográficamente. El diagnóstico definitivo generalmente requiere una muestra de tejido que se obtiene mediante biopsia antes del tratamiento o como parte de una resección terapéutica planificada de toda la masa. En Chile, existen pocos trabajos recientes que muestren las características clínicas de pacientes que presentan timomas o linfomas; es por esto que se hace importante la presentación de estos casos que constituyen un aporte al conocimiento nacional.

INTRODUCTION: Mediastinal tumours constitute a clinical entity infrequent, generally asymptomatic. It can develop from structures localized on anterior compartment, middle and posterior, where structure localized on anterior compartment is usual. Adults tend to have thymomas and lymphomas more common in anterior mediastinal within intrathoracic goiter and teratomas. They are known as a "4T of anterior mediastinal mass". Clinical cases: Three clinical cases of anterior mediastinal tumours are exposed in our centre. Discussion: Mediastinal mass constitutes a clinical entity infrequent. The computed Tomography of the thorax with intravenous contrast and without intravenous contrast are used to evaluate abnormalities discover by radiography. The final diagnosis requires a fabric sample which is obtained by a biopsy before the treatment or as a part of a planned therapeutic recession. In Chile exist a few recently studies that shows clinical characteristics of patients which presents thymus and lymphomas as a result is important to present this kind of cases due to these cases constitute to the national knowledge.

Humans , Male , Adult , Middle Aged , Thymoma/diagnostic imaging , Lymphoma/diagnostic imaging , Mediastinal Neoplasms/diagnostic imaging , Hodgkin Disease , Thoracotomy , Tomography, X-Ray Computed , Hospitals, Public , Lymphoma/therapy , Mediastinal Neoplasms/surgery
Med. lab ; 25(4): 695-707, 2021. Tabs, Graf
Article in English | LILACS | ID: biblio-1370826


En Colombia, la infección por el virus de la inmunodeficiencia humana (VIH) es una epidemia en aumento. Ante la mejoría de la supervivencia general con la terapia antirretroviral altamente efectiva, la aparición de neoplasias malignas ha ido desplazando las complicaciones infecciosas como principal problema en esta población. Los linfomas no Hodgkin son las neoplasias malignas definitorias de síndrome de inmunodeficiencia adquirida (SIDA) más frecuentes después del sarcoma de Kaposi, siendo el linfoma B difuso de células grandes y el linfoma de Burkitt las variantes más comunes; por otra parte, el riesgo de desarrollar linfoma de Hodgkin clásico es 5 a 20 veces mayor en pacientes positivos para VIH en comparación con la población general. Realizar un diagnóstico temprano es un reto, debido a infecciones oportunistas y a la presentación atípica de la enfermedad en este grupo de pacientes. El tratamiento de la enfermedad también supone un desafío debido a las comorbilidades y el estado funcional de los pacientes al momento del diagnóstico; sin embargo, en conjunto con esquemas combinados de quimioterapia y al uso concomitante de la terapia antirretroviral, se ha mejorado considerablemente el pronóstico, el cual actualmente se acerca al de los pacientes seronegativos. Por medio de esta revisión, se pretende describir las principales características de los linfomas asociados al VIH, de tal forma que permita a los trabajadores en salud, tener mayores elementos para el abordaje integral de esta población en nuestro país

In Colombia, human immunodeficiency virus (HIV) infection is a growing epidemic. Given the improvement in overall survival with highly effective antiretroviral therapy, cancer has been displacing infectious complications in this population. Non-Hodgkin's lymphoma is the most common AIDS defining malignancy after Kaposi's sarcoma. Diffuse large B-cell lymphoma and Burkitt's lymphoma are the most common variants; meanwhile, the risk of developing classical Hodgkin lymphoma is 5 to 20-fold higher compared to HIV-negative individuals. Making an early diagnosis is a challenge, due to opportunistic infections and the atypical presentation of the disease in this group of patients. Treatment of the disease is also a challenge given the comorbidities and patient condition at diagnosis; however, in conjunction with combined chemotherapy regimens and the concomitant use of antiretroviral therapy, the outcome of patients with AIDS-related lymphomas has significantly improved, currently approaching that of seronegative patients. The aim of this review article is to describe the main characteristics of the disease, in such a way that it allows health workers to have more elements for a comprehensive approach in patients with AIDS-related lymphomas in our country

Humans , HIV , Lymphoma, Non-Hodgkin , Hodgkin Disease , HIV Infections , Acquired Immunodeficiency Syndrome , Lymphoma, AIDS-Related
Rev. bras. cancerol ; 67(2): e-09825, 2021.
Article in Portuguese | LILACS | ID: biblio-1223491


Introdução: A capacidade do vírus da imunodeficiência humana (HIV) de invadir células do sistema imunológico, principalmente células T CD4+, para se multiplicar e manter-se vivo, quando não revertido, possui, como desfecho inevitável, a síndrome da imunodeficiência adquirida (SIDA), evento no qual os pacientes começam a apresentar doenças secundárias como infecções oportunistas e câncer. Objetivo:Identificar casos de linfoma de Hodgkin em pacientes HIV+ em uso dos antirretrovirais de alta efetividade. Método: Estudo do tipo observacional transversal com delineamento exploratório e descritivo e abordagem quali-quantitativa, realizado durante o mês de outubro de 2018, a partir da análise de 57prontuários de pacientes HIV+ diagnosticados com câncer e internados em um hospital localizado em Fortaleza, CE. Resultados: Foi identificado um total de 21 cânceres não definidores de SIDA. Destes, os mais comuns foram o câncer de pele com 14,3% (3); seguido do câncer de mama com 9,5% (2); linfoma de Hodgkin com 9,5% (2); e o câncer de estômago com 9,5% (2) dos casos. Conclusão: Os dados obtidos no presente estudo colocam o linfoma de Hodgkin em segundo lugar entre os cânceres não definidores de SIDA encontrados. Contudo, ao considerar o baixo número de casos, resultante das limitações da pesquisa, essas informações não permitem concluir sobre a real quantidade de linfomas de Hodgkin entre os demais cânceres não definidores de SIDA ocorridos em pacientes HIV+ na localidade, tampouco estimar a participação do HIV, carga viral, condição imunológica e coinfecções como fatores de risco.

Introduction: The ability of the human immunodeficiency virus (HIV) of invading immune system cells, especially CD4+ to multiply and stay alive, when not reversed, has as inevitable outcome the acquired immunodeficiency syndrome (AIDS), an event in which patients start to develop secondary diseases such as opportunistic infections and cancer. Objective: To identify cases of Hodgkin's lymphoma in HIV+ patients using highly effective antiretrovirals. Method: Cross-sectional observational study with exploratory and descriptive design and qualitative and quantitative approach, carried out during the month of October 2018 based on the analysis of 57 HIV-infected patients' charts diagnosed with cancer and admitted to a hospital located in Fortaleza, CE. Results: A total of 21 non-AIDS-defining cancers were detected. Of these, skin cancer, with 14.3% (3) followed by breast cancer, with 9.5% (2), Hodgkin's lymphoma, 9.5% (2) and stomach cancer, with 9.5% (2) were the most common cases. Conclusion: The data obtained in the present study rank Hodgkin's lymphoma in second place among the non-AIDS-defining cancers encountered. However, while considering the small number of cases, due to the study limitations, these data are scanty to conclude the actual quantity of Hodgkin's lymphoma among the non-AIDS-defining cancers occurred in HIV-positive patients locally or to estimate the participation of HIV, viral load, immune condition and co-infection as risk factors.

Introducción: La capacidad del virus de inmunodeficiencia humana (VIH) para invadir las células del sistema inmunitario, especialmente las células T CD4 + para multiplicarse y mantenerse con vida, cuando no se revierte, tiene el resultado inevitable del síndrome de inmunodeficiencia adquirida (SIDA), evento en el que los pacientes comienzan a presentar enfermedades secundarias como infecciones oportunistas y cáncer. Objetivo: Identificar los casos de linfoma de Hodgkin en pacientes VIH+ utilizando los antirretrovirales de alta eficacia. Método: Este es un estudio observacional transversal con diseño exploratorio y descriptivo y enfoque cualitativo, realizado durante octubre de 2018 a partir del análisis de 57 registros médicos de pacientes VIH + diagnosticados con cáncer y hospitalizados en un hospital ubicado en Fortaleza, CE. Resultados: Se identificaron un total de 21 cánceres que no definen el SIDA. De estos, los más comunes fueron cáncer de piel con 14,3% (3), seguido de cáncer de seno con 9,5% (2), linfoma de Hodgkin 9,5% (2) y cáncer de estómago con 9,5% (2) de los casos. Conclusión: Los datos obtenidos en el presente estudio colocan al linfoma de Hodgkin en segundo lugar entre los cánceres no definitorios de SIDA encontrados. Sin embargo, considerando el bajo número de casos resultantes de las limitaciones de la investigación, esta información no nos permite concluir acerca de la cantidad real de linfoma de Hodgkin entre los otros cánceres no definitorios de SIDA en pacientes VIH + en la localidad, ni estimar la participación del VIH, la carga viral, la condición inmune y las coinfecciones como factores de riesgo.

Humans , Male , Female , Adult , Middle Aged , Aged , Hodgkin Disease , Acquired Immunodeficiency Syndrome , Anti-Retroviral Agents/therapeutic use , Neoplasms , HIV
Hematol., Transfus. Cell Ther. (Impr.) ; 42(2): 103-110, Apr.-June 2020. ilus
Article in English | LILACS | ID: biblio-1134022


ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.

Leukemia, Lymphoid , Coronavirus , COVID-19 , Lymphoma , Hodgkin Disease , Leukemia, Lymphocytic, Chronic, B-Cell , Lymphoma, B-Cell , Lymphoma, T-Cell, Peripheral , Lymphoma, Mantle-Cell
Rev. inf. cient ; 99(6): 572-576, 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1149989


RESUMEN Se presentó el caso de una adolescente de 12 años de edad que acudió a consulta externa de Cirugía del Hospital Pediátrico Docente Gral. Pedro Agustín Pérez, de Guantánamo; la misma presentó aumento de volumen a nivel del cuadrante superior externo de la mama izquierda, no doloroso. Se palpó tumoración de bordes irregulares, o sea mal definidos, de 3 cm de diámetro aproximadamente, sin signos de inflamación. Se realizó biopsia por aspiración con aguja fina y se informó el diagnóstico de fibroadenoma de mama. La exéresis del nódulo y el estudio histopatológico demostraron el diagnóstico de linfoma no Hodgkin de alto grado de malignidad y se procedió a la atención multidisciplinaria. Al momento del reporte la paciente continúa con quimioterapia y evoluciona satisfactoriamente. Se revisó la literatura médica sobre el tema y se expusieron sus bases esenciales para la familiarización de los médicos generales.

ABSTRACT A 12 years old young female presented to the surgical outpatient clinic at the Hospital Pediátrico Docente Gral. Pedro Agustín Pérez in Guantanamo. Patient showed swelling in the upper right breast, with no pain. Examination revealed irregular edges (with approximately 3 cm in diameter) and no swollen tissue. Fine-needle aspiration biopsy was performed and breast fibroadenoma was diagnosed. Node exeresis and histopathological study both showed a high risk malignant non-Hodgkin's lymphoma, and a multidisciplinary care team assumed the case. At the time of the report, the patient is still under chemotherapy and prognosis evolves positively. The medical literature on the subject was put on review and a layout of the essentials to familiarize the general practitioners with the topic was set.

Adolescent , Breast Neoplasms/diagnosis , Hodgkin Disease/diagnosis , Drug Therapy , Fibroadenoma , Biopsy, Fine-Needle
Autops. Case Rep ; 10(4): e2020191, 2020. graf
Article in English | LILACS | ID: biblio-1131851


Illustrative cases of diseases that are difficult to suspect and diagnose can serve as useful reminders. Invasive pulmonary aspergillosis and adenovirus hepatitis are two such diseases, both revealed by autopsy in this case of Hodgkin lymphoma refractory to chemotherapy treated with allogeneic hematopoietic stem cell transplantation complicated by these two fatal infections. This patient was cured of Hodgkin lymphoma, Clostridioides difficile colitis and thrombotic thrombocytopenic purpura using the marvels of modern medicine. This case illustrates many features of aspergillosis and adenovirus hepatitis, shows the value of autopsy in revealing diagnoses, and illustrates the limits of modern medicine, which should serve as a mental spur in our efforts to advance medical science, to try to defeat the numerous demons of disease, who seem to keep outwitting us.

Humans , Male , Adult , Hodgkin Disease/complications , Adenoviridae , Invasive Pulmonary Aspergillosis/pathology , Hepatitis , Autopsy
Rev. colomb. cardiol ; 26(6): 354-356, nov.-dic. 2019.
Article in Spanish | LILACS, COLNAL | ID: biblio-1115593


Resumen La radioterapia mediastínica es uno de los tratamientos fundamentales de las enfermedades malignas torácicas, pero también representa una causa potencial de complicaciones, tanto a corto como a largo plazo. Se presenta una serie de casos de rotura de vena innominada durante esternotomía media en pacientes con fibrosis mediastínica. Los tres casos descritos corresponden a pacientes intervenidos de cirugía cardiaca con antecedentes de radioterapia mediastínica, entre 15-30 años antes de la cirugía, por tres diferentes enfermedades malignas (linfoma de Hodgkin, timoma y cáncer de mama). En los tres casos se reporta rotura de la vena innominada, con desinserción de su origen en la vena cava superior debido a fibrosis mediastínica intensa.

Abstract Although mediastinal radiotherapy is one of the basic treatments of malignant thoracic diseases, it is also a potential cause of short and long-term complications. A series of cases of rupture of the innominate vein during sternotomy are presented in patients with mediastinal fibrosis. The three cases described correspond to patients intervened by cardiac surgery, with a history of mediastinal radiotherapy between 15 to 30 years before the surgery, due to three different malignant diseases (Hodgkin lymphoma, thymoma, and breast cancer). In the three cases, a rupture of the innominate vein is reported; with de-insertion of its origin in the superior vena cava sue to intense mediastinal fibrosis.

Humans , Female , Middle Aged , Thoracic Surgery , Fibrosis , Vena Cava, Superior , Breast Neoplasms , Hodgkin Disease , Brachiocephalic Veins