[Non-Hodgkin's primary intestinal lymphoma - a cause of acute abdominal manifestation in children].

AIM: Lymphomas of the gastrointestinal tract are the most common type of primary extranodal lymphomas, accounting for 5 to 10% of all non-Hodgkin's lymphomas (NHL). PATIENTS AND METHODS: From January 1996 to November 2005, 10 patients with primary intestinal lymphomas were submitted with clinical signs of acute abdomen to the Pediatric surgical department in Sofia. The children presented with radiologically proven intussusception, ileal obstruction or peritonitis due to bowel perforation. RESULTS: At exploration the tumor was located in the ileum in 4 cases, in the terminal ileum and coecum in 3 cases, appendix in one and multiple sites were found in 2 cases. Children with localized disease underwent radical resection of the tumor mass with ileo - transverso anastomosis (3), partial bowel resection (4), and appendectomy (1) whereas in 2 children with advanced disease diagnostic biopsy alone with temporary ileostomy in one were accomplished. According to histology, 5 patients had Burkitt lymphoma and 5 lymphoblast NHL. The children were treated according CHOP. Over five - years relapse - free survival for localized disease accounts 6 children. CONCLUSION: Primary NHL in children often presents with acute abdominal condition requiring surgical exploration. Prognosis depends of adequacy of surgical resection and the adjuvant chemotherapy.

[Pleuropulmonary blastoma in children: diagnosis and results of surgery and complex treatment]. / Plevropulmonalen blastom v detckata v'zrast - diagnostika i rezultati ot khirurgichnoto i kompleksnoto lechenie.

This is a report on a retrospective study of experience had with complex treatment of pleuropulmonary blastoma in ten children aged 2-11 years, covering a 27-year period. In all patients diagnosis is made on the ground of clinical symptomatology, imaging methods and histological findings. All patients undergo surgery, as follows: tumor extirpation (n = 3), lobectomy (n = 2) and pneumonectomy (n = 5). Three deaths occur in the early postoperative period (30%). In the remainder postoperative chemotherapy is conducted. Histologically the solid variant (type 3 according to Dehner's classification) is predominant. There are three recurrences (42.8%) among the cases with simple tumor extirpation (2) and lobectomy (1), followed by successful pneumonectomy (two patients) and atypical pulmonary resection (one patient). At long-term follow-up, five patients (50%) are still alive for periods ranging from 1 to 11 years postoperatively. Pleuropulmonary blastoma is a surgical rarity in children. The most important factors for long-term survivorship are both radical surgery, and adequate chemotherapy.

[Malignant neoplasms and intestinal obstruction in children 3 to 15 years old]. / Zlokachestveni novoobrazuvaniia i chrevna neprokhodimost pri detsa ot 3 do 15 godini.

Observations on one of the rare complications in children presenting malignant neoplasms of the abdominal cavity and retroperitoneal space are described. Over a 7-year period, operative treatment is undertaken in 42 children aged 3 to 15 years. In eleven of them (26.42 per cent) it is a matter of mechanical ileus. The type of bowel obstruction in the series of children under study is a follows: obturation-in three and adhesion-in five cases. The obturation involves the large intestine, and is due to pressure of a neoplastic process in advanced stage of development on the colon. Ileus due to adhesions occurs after operative removal of the neoplastic formation. The essential differences in type of intestinal obstruction in children with malignant neoformation in the abdominal region from the one in adult patients justify the report on the observations.