[Complex radiodiagnostics of non-Hodgkin's thoracic or abdominal lymphoma in children].

The clinical manifestations of non-Hodgkin's lymphoma (NHL)-associated lesions of thoracic or abdominal organs and tissues, and the results of application of radiodiagnostic techniques in 414 children with the disease, were analyzed. The results of the analysis of radiological and ultrasonographic manifestations of thoracic and abdominal lesions in children with NHL make it possible to perform more effective early diagnostics of the disease in wide healthcare practice. Also, these results confirm the mandatory character of the general principle of pediatric tumor diagnosis, i.e. complex application of clinical, morphological, endoscopic, laboratory, and radiological techniques, including routine X-ray diagnostics, computed tomography, ultrasound tomography, and radioisotopic examination.

[Clinical manifestations and diagnosis of childhood mediastinal tumors]. / Klinicheskie proiavleniia i diagnostika opukholei sredosteniia v detskom vozraste.

Mediastinal tumors make up as high as 7% of the malignant neoplasms in children and are encountered in all age groups, slightly more commonly in preschool children. Three main groups of common symptoms that are typical of mediastinal tumors are identified. These include 1) symptoms associated with tumor compression of thoracic organs; 2) neurological disorders associated with compression or destruction of ganglionary nodes; 3) general symptoms. Posterior mediastinal tumors are diagnosed by X-ray in 85% of cases. X-ray computed tomography makes it possible to judge of the initial site of a neoplasm, the presence of inclusions, the status of adjacent organs and tissues, the density of a pathological focus. Gallium-67 citrate radionuclide study allows one to make an early differential diagnosis between a solid formation and lymph proliferative disease. The lack of morphological verification of a diagnosis requires the use of transthoracic aspiration biopsy whose diagnostic value enhances when it is made under guidance of ultrasound or X-ray computed tomography.

[Diagnosis of germinogenic ovarian tumors in girls]. / Diagnostika germinogennykh opukholei iaichnikov u devochek.

The paper covers the problems of diagnosis of germinogenic ovarian tumors in girls, which make up as high as 80% of all malignant ovarian tumors. For timely diagnosis, it is necessary to take into account clinical data, the levels of tumor markers (alpha-fetoprotein, chorionic gonadotropin) and ultrasound findings. This all is rather sufficient to verify the diagnosis of ovarian tumor lesions. Other additional studies are aimed at establishing where the process extends.

[Ultrasound tomography in diagnosis of malignant soft tissue tumors in children]. / Ul'trazvukovaia tomografiia v diagnostike zlokachestvennykh opukholei miagkikh tkanei u detei.

Ultrasound findings of 50 children with soft tissue sarcomas of the trunk and limbs were analyzed. There was a high proportion of diagnostic errors (62%), which resulted in the choice of adequate therapeutical measures at early stages of therapy and in advanced disease. The reasons of the errors were as follows: nonspecificity of the first clinical manifestations of soft tissue sarcomas; ignorance of instrumental studies that establishes a diagnosis in time; outpatient physicians' unconcern of cancer, misunderstanding of the nontumor nature of disease; no scientifically grounded algorithm of studies. Echographic signs that characterize malignancy, their changes over a therapy, ultrasound pattern due to posttherapeutical changes are considered.

[Radiologic diagnosis of malignant tumors of the pelvic bones in children]. / Rentgenologicheskaia diagnostika zlokachestvennykh opukholei kostei taza u detei.

An analysis of the data on radiodiagnosis of malignancies of pelvic bones in 50 patients, aged 10-15, is presented. Diagnosis was morphologically confirmed in all the cases: Ewing's sarcoma (41)--82%, primitive neuroectodermal tumor (6)--12% and chondrosarcoma (3)--6%. The leading clinical syndrome was pain in the loin. The significantly most frequent site was the iliac bone. X-ray imaging of tumor site and adjacent areas using standard direct, lateral and oblique projections, ultrasonography, X-ray contrast tomography, radioisotope examination, puncture and open biopsy (when indicated) proved useful.

[Metastatic lung tumors in children (clinical course, diagnosis, prognosis)]. / Metastaticheskie opukholi lëgkikh u detei (klinika, diagnostika, prognoz).

According to data available at the Institute (1985-1999, approx. 1,200 patients), the lung is the most frequent site of cancer dissemination (up to 75%). Such most frequent pediatric children tumors as Wilms' tumor, neuroblastoma, rhabdosarcoma, osteogenic sarcoma and that of Ewing disseminate to lung in 85%, particularly, at advanced stages.

[Ultrasonography in the comprehensive diagnosis and evaluation of treatment effectiveness in retroperitoneal neuroblastoma in children]. / Ekhografiia v kompleksnoi diagnostike i otsenke éffektivnosti lecheniia zabriushinnoi neiroblastomy u detei.

Neuroblastoma and ganglioneuroblastoma of adrenal (17) and extra-organ (60) origin and retroperitoneal extra-organ neoplasia (18), infrequent in childhood, were identified in 109 children referred to the Institute's Clinic with diagnosis of retroperitoneal tumor. Ultrasound characteristics of retroperitoneal tumors of the sympathetic nervous system and predictive value of ultrasound for involvement of adjacent organs and vessels were defined and classified. Similar criteria for differential diagnosis between retroperitoneal neuro- and ganglioblastoma and rare pediatric retroperitoneal tumors were worked out. Dynamics of evidence in the course of conservative treatment of tumors and the role of ultrasound tomography in evaluating retroperitoneal neuroblastoma were established. Predictive value of sonography, computed tomography and angiography in certain applications was compared.

[Diagnostic criteria and prognosis of mediastinal lesions in children with lymphosarcoma]. / Kriterii diagnostiki i prognoza pri porazhenii sredosteniia u detei, bol'nykh limfosarkomoi.

Treatment for mediastinal lymphosarcoma was given to 71 patients, aged 3-14 years, at the Institute's Clinics during 1982-1991. In that group, there were more males than females (3.4:1), mean duration of the condition of 3 months, T-cell immunity pattern (89.9%), enlarged anterior mediastinal lymph nodes and thymus, pleural lesions including pleuritis, mean mediastinal-thoracic index of 0.5, compression syndrome, elevated concentration of lactate dehydrogenase and presence of tumor cells in the bone marrow and peripheral blood. Among major negative factors of prognosis were inadequate therapy, pleural lesions and stage IV tumor.

[Preliminary results of treatment of solid tumors in children with non-standard radiotherapy]. / Predvaritel'nye rezul'taty lecheniia solidnykh opukholei u detei s ispol'zovaniem netraditsionnogo rezhima luchevoi terapii.

The efficacy and toxicity-related results of non-standard irradiation used in the combined treatment of 129 children with solid tumors were evaluated in 1986-1993. Immediate response (complete or partial regression) was registered in 89.3% of cases of sarcoma of Ewing, 76.8%--rhabdomyosarcoma and 76.7%--other tumors. Local recurrence was observed in 4 and late-onset complication of radiation injury in 10 patients. The actuarial 5-year survival was 54.3, 52.1 and 41.2% in Ewing sarcoma, rhabdomyosarcoma and other tumor groups, respectively.

[Management of nephroblastoma in children: current approaches and outlook]. / Lechenie nefroblastomy u detei: sovremennye podkhody i perspektivy.

Nephroblastoma or Wilms' tumor occurs most frequently in children. New approaches to diagnosis and treatment of this malignancy introduced for the last 15 years are reviewed. Current approaches are characterized by advances in computer noninvasive diagnostic techniques and more aggressive chemotherapy. The first line treatment is polychemotherapy (1 or 2 courses) followed by surgical intervention and postoperative drug or drug+radiation treatment. As shown by follow-up, 40% of patients with nephroblastoma stage III and IV are now free of recurrences and metastases for at least five years. Special investigations are needed to elucidate these children's quality of life, physical, social and mental fitness. Serious problems still remain in perfection of programmed treatment of children with prognostically unfavourable factors.

[Lymphosarcoma of the oropharynx and nasopharynx in children]. / Limfosarkoma roto- i nosoglotki u detei.

From 1983 to 1989, 22 patients aged 3 to 15 years with oro- and rhinopharyngeal lymphosarcomas were under observation. This number accounted for 10% of the total children's population with the same disease, with the observation period being the same. As a result of the examination, stage II was diagnosed in 13, stage III in 5, and stage IV in 4 patients. All the patients received chemo- and radiotherapy for 6-18 months. The relapse-free survival amounted to 50 months on the average, the total one to 52 months. It is stressed that early diagnosis and adequate therapy allow the cure of the majority of children with oro- and rhinopharyngeal lymphosarcomas.