Nodular lymphocyte predominant Hodgkin's lymphoma

To describe the clinicopathological features, treatment, treatment outcome and sequelae of patients with nodular lymphocyte predominant Hodgkin's lymphoma [NLPHL] in a Saudi population. This is a retrospective review of 29 patients with lymphocyte predominant Hodgkin's lymphoma treated at 2 major hospitals [King Khalid University Hospital and Security Forces Hospital] in Riyadh, Kingdom of Saudi Arabia from 1985 to 2000. Histological subtypes were confirmed by review of hematoxylin and eosin paraffin sections and immunochemistry. Details of clinical presentation, stage, treatment and results of treatment were analyzed. On pathological reappraisal of the 29 cases, 3 patients had nodular sclerosis Hodgkin's lymphoma and 4 patients were reclassified as lymphocyte rich classical Hodgkin's lymphoma. Twenty-two patients were identified to have nodular lymphocyte predominant Hodgkin's lymphoma [NLPHL]. These patients comprised of 18 male and 4 female patients with a median age at presentation of 25 years. Nineteen [86%] patients had an early stage [Ann Arbor stage I and II] disease, 2 had stage III and one patient had a stage IV. The majority of the patients presented with peripheral lymphadenopathy and long duration of symptoms. For 16 patients, details of treatment and follow-up were available. All of these achieved a complete response to initial treatment. Four patients relapsed following the primary therapy. Our results are consistent with the previous series reported from Western countries and confirm that patients with NLPHL have a characteristic clinical and pathological profile that distinguish it from other types of Hodgkin's lymphoma. The disease tends to run an unusual course and although most patients achieve an excellent response to therapy there is a tendency to relapse. Treatment remains controversial; however, recent understanding of the molecular pathogenesis of NLPHL could lead to modification of current therapeutic approach to this disease

Intrapericardial chemotherapy for the management of neoplastic cardiac tamponade

A young patient with disseminated osteogenic sarcoma presented with cardiac tamponade. She was successfully managed with pericardiocentesis and intrapericardial instillation of cisplatin. There was no reaccumulation of pericardial fluid or recurrence of tamponade until the patient's death 12 months later. Intrapericardial chemotherapy may be effective in the management of cardiac tamponade secondary to malignancy

changing trends of adult Hodgkin's disease in Saudi Arabia

Hodgkin's disease is one of the most common malignant lymphomas affecting the younger population. This disease has diversified pathologies and clinical stages that necessitate a well optimized clinical management. Regular updating of epidemiological behavior of Hodgkin's disease is obvious from various parts of the world; however, studies from the Kingdom of Saudi Arabia [KSA] in this field are scanty and more than a decade old. The aim of this study was to investigate the current trends in presentation and distribution of Hodgkin's disease with special reference to gender, age, histopathological subtypes, and clinical stages of this disease in Saudi patients. A total of 142 Hodgkin's disease patients attending 2 referral hospitals [King Khalid University Hospital and Security Forces Hospital] in Riyadh, KSA, were included in this study. The records from the questionnaires were analyzed retrospectively for determining the trends of Hodgkin's disease in Saudi adults, over a period of 15 years [1985-2000]. There were 86 males and 56 females, with a male to female ratio of 1.53:1. The mean age of the patients was 28.63 years, while most of the patients were <40 years [80.3%]. Nodular sclerosis was the most frequent pathology. Presence of B symptoms had a significant correlation with histology type as well as clinical stage of Hodgkin's disease. Time course analysis showed the increasing trend of Hodgkin's disease frequency, especially in younger adults. The rate of nodular sclerosis continued to increase during the entire course of study whereas the frequency of other histology types showed a decreasing trend during 1992-2000. To the author's knowledge, this is the largest case series of adult Hodgkin's disease from KSA. The results of this study revealed a different pattern of Hodgkin's disease as compared to earlier studies reported from this region. These findings provide valuable insights in the understanding of current epidemiological features of Hodgkin's disease in KSA