High prevalence of hepatitis B virus infection in patients with B-cell non-Hodgkin's lymphoma in Korea.

This study assessed the association of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection with non-Hodgkin's lymphoma in a highly HBV-endemic area. The prevalence of either HBV or HCV infection in 235 patients with non-Hodgkin's lymphoma was compared with that of an age- and sex-matched hospital control group of 235 patients. The prevalence of HBV infection was higher in B-cell non-Hodgkin's lymphoma (15.5%) than control (8.1%), but the prevalence of HCV infection in the non-Hodgkin's lymphoma patients (2.1%) and control group (3%) was similar. HBV prevalence increased significantly with age in the B-cell non-Hodgkin's lymphoma patients. The presence of HBV proteins and DNA in lymphoma tissues and peripheral blood mononuclear cells (PBMCs) from HBV-infected non-Hodgkin's lymphoma patients was also investigated using immunohistochemistry and PCR. HBV DNA was frequently detected in PBMCs from HBV-infected non-Hodgkin's lymphoma patients, but HBV antigens were not. Therefore, HBV infection, but not HCV infection, was associated with B-cell non-Hodgkin's lymphoma in Korea, suggesting a possible role for HBV in the development of non-Hodgkin's lymphoma.

The usefulness of colonoscopy as a screening test for detecting colorectal polyps.

BACKGROUND/AIMS: Colonic polyps are the most common lesions encountered during screening colonoscopy. The purpose of this study is to evaluate the usefulness of colonoscopy to detect colonic polyps in adults. METHODOLOGY: From January 2003 to September 2005, a total of 4,629 adults underwent colonoscopic screening as a part of a health evaluation program. We analyzed the completed questionnaires, and the colonoscopic and pathologic findings. RESULTS: Complete colonic evaluation was possible in 4,491 (97.0%) subjects, and 804 (17.9%) had adenomatous polyps, including 153 subjects (3.4%) with advanced adenomas. There were no significant complications such as bowel perforation or massive bleeding requiring transfusion in relation to the procedure. There was a trend toward an increased prevalence of adenomatous polyps with age. Among the subjects with polyps, 72.1% of the subjects had distal polyps and the relative risk for proximal polyp, according to the distal findings, was 5.4 (95% CI: 4.5-6.3) for adenomatous polyp, 5.1 (95% CI 3.6-7.0) for advanced adenoma as compared to the finding of no adenomatous polyp. CONCLUSIONS: Colonoscopy performed by experienced colonoscopists as a screening test is feasible for detecting subjects with colorectal polyps.

The Effect of Intensified Induction Using Vanderbilt Regimen in Patients with an Intermediate Grade Non-Hodgkin's Lymphoma Having 2 or 3 Adverse Factors on the Age-adjusted International Prognostic Index.

PURPOSE: The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group. RESULTS: Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure. CONCLUSION: Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.

A Case of Extraskeletal Ewing's Sarcoma Arising from Duodenum.

Extraskeletal Ewing's sarcomas (EES) are rare. Recently, Ewing's sarcoma of the bone, primitive neuroectodermal tumor (PNET), Askin tumor and EES have been included into the family of Ewing's tumors, due to the overlapping features relating to their clinico-pathological and cytogenetic appearance. We experienced a case of an EES arising from the duodenum in a 14-year-old girl who presented with hematemesis and epigastric discomfort. A duodenal biopsy specimen revealed the infiltration of small round cells and rich vasculatures, with immunohistochemical finding of MIC-2 (CD99) (+), vimentin (+), CD56 (NCAM) (+), LCA (-), T-cell (-), B-cell (-), CD43 (-) and CD68 (-). She was treated with several cycles of multiagent chemotherapy, and achieved an initial partial response, but rapid progression of tumor followed, so she was treated with surgical excision. This is the first case report of an EES arising from the duodenum in the literature.