ABSTRACT
Primary lymphoma of the central nervous system, until recently representing about 1% of all brain tumours, shows a dramatically increased incidence in the general population as well as in high-risk groups (immunocompromised, AIDS), and may rise up to 6% in a population of AIDS patients. The clinical presentation is variable and cannot reliably be distinguished from other intracerebral tumours. At present, CT and MRI are the methods of choice for diagnosing cerebral lymphomas. However, their characteristics are not specific. The radiological picture may suggest glioma, meningioma, metastatic carcinoma or even a cerebrovascular accident. A labelled somatostatin analogue (pentetreotide) has been proposed as a new tracer for the imaging of somatostatin receptors, which have been identified by immunocytochemical or radioimmunoassay techniques in several organ systems. Somatostatin receptors were also identified in surgical biopsy samples from patients with Hodgkin and non-Hodgkin lymphoma and extracerebral lymphoma has already been visualised in vivo by means of In-111-labelled pentetreotide. While CT images of the brain showed a regression of the tumour after radiotherapeutic treatment, the scintigraphic images showed persistence of the tumoural tissue, corresponding with the clinical evolution and outcome. Furthermore, the absence of extra-cerebral lymphoma tissue, seen on the whole body images, was confirmed by post-mortem examination. To our knowledge, this is the first report of a primary intracerebral lymphoma visualised by means In-111-pentetreotide.
Subject(s)
Brain Neoplasms/diagnostic imaging , Frontal Lobe/diagnostic imaging , Indium Radioisotopes , Lymphoma, B-Cell/diagnostic imaging , Somatostatin/analogs & derivatives , Tomography, Emission-Computed , Aged , Diagnosis, Differential , Fatal Outcome , Humans , Indium Radioisotopes/pharmacokinetics , Male , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Nerve Tissue Proteins/metabolism , Receptors, Somatostatin/metabolism , Somatostatin/pharmacokinetics , Tomography, X-Ray ComputedSubject(s)
Adult , Middle Aged , Humans , Male , Female , Adrenal Cortex Hormones/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Arthritis, Rheumatoid/drug therapy , Aspirin/adverse effects , Gastric Mucosa/drug effects , Clinical Trials as Topic , Peptic Ulcer/chemically induced , Peptic Ulcer/drug therapy , Prospective Studies , Random Allocation , Ranitidine/administration & dosageSubject(s)
Adult , Middle Aged , Aged , Humans , Male , Female , Arthritis, Rheumatoid/drug therapy , Aspirin/adverse effects , Adrenal Cortex Hormones/adverse effects , /adverse effects , Gastric Mucosa/drug effects , Peptic Ulcer/chemically induced , Ranitidine/administration & dosage , Clinical Trials as Topic , Random Allocation , Prospective Studies , Peptic Ulcer/drug therapyABSTRACT
In a group of 70 patients of both sexes been treated with antiinflammatory drugs, affected by Rheumatoid Arthritis in activity, we have found the presence of lesions, erosions and gastroduodenal ulcers in 40% by endoscopic examination (26% erosions and 14% ulcers), without any relation with clinical symptoms. Those patients who received larger doses than 30mgr./kg./day of AAS suffered most frequently lesions (43.8%). These 28 patients with lesions have been studied prospectively in a double blind method, and treated twice a day with 150 mgs. doses of Ranitidine or Placebo, throughout a period of 5 weeks without discontinuing the treatment with anti-inflammatories (AAS, Indomethacin, steroids). At the end of the trial those patients who failed in healing their lesions were treated with Ranitidine in the same doses for another period of 5 weeks. The treatment with Ranitidine in doses of 300 mgr/day has resulted curative of the gastroduodenal lesions, although maintaining the aggressive drugs, in the 87% of the patients. We have observed that the treatment with Placebo is less effective and that difference has high statistical significance (p 0.005).
Subject(s)
Adrenal Cortex Hormones/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Arthritis, Rheumatoid/drug therapy , Aspirin/adverse effects , Gastric Mucosa/drug effects , Adult , Aged , Clinical Trials as Topic , Female , Humans , Male , Middle Aged , Peptic Ulcer/chemically induced , Peptic Ulcer/drug therapy , Prospective Studies , Random Allocation , Ranitidine/administration & dosageABSTRACT
In a group of 70 patients of both sexes been treated with antiinflammatory drugs, affected by Rheumatoid Arthritis in activity, we have found the presence of lesions, erosions and gastroduodenal ulcers in 40
by endoscopic examination (26
erosions and 14
ulcers), without any relation with clinical symptoms. Those patients who received larger doses than 30mgr./kg./day of AAS suffered most frequently lesions (43.8
). These 28 patients with lesions have been studied prospectively in a double blind method, and treated twice a day with 150 mgs. doses of Ranitidine or Placebo, throughout a period of 5 weeks without discontinuing the treatment with anti-inflammatories (AAS, Indomethacin, steroids). At the end of the trial those patients who failed in healing their lesions were treated with Ranitidine in the same doses for another period of 5 weeks. The treatment with Ranitidine in doses of 300 mgr/day has resulted curative of the gastroduodenal lesions, although maintaining the aggressive drugs, in the 87
of the patients. We have observed that the treatment with Placebo is less effective and that difference has high statistical significance (p 0.005).
