[Intraparenchymal non-neoplastic residual masses after treatment of large-cell non-Hodgkin's lymphoma with intensive chemotherapy]. / Masas residuales no tumorales intraparenquimatosas después del tratamiento de linfomas no hodgkinianos de célula grande con quimioterapia intensiva.

We report two patients with large-cell non-Hodgkin's lymphomas who were treated with intensive chemotherapy (MACOP-B), and in whom large isolated intraparenchymal masses (splenic in one case, renal in the other) were found with computed tomography after clinical remission. It was found at surgery that both masses were constituted by acellular necrotic material, without tumoral infiltration and limited by fibrous tissue. The finding of these residual masses in patients in remission raises problems of approach, as they may be nontumoral and not require new therapy. At present, until new radiological or biochemical markers are available, a judicious clinical attitude should be taken, with radiological control of the evolution of the masses and reserving surgery only for those cases with progression, diagnostic doubts, or patient's decision to know his real status.

[Neutropenic enterocolitis during treatment of lymphoproliferative neoplasms]. / Enterocolitis neutropénica en el tratamiento de neoplasias linfoproliferativas.

In a series of 320 patients with lymphoid neoplasms treated with polychemotherapy, three patients with non-Hodgkin's lymphoma and one with myeloma were diagnosed as having neutropenic enterocolitis (NEC). All patients were adult, all had received multiple chemotherapeutic drugs and, during neutropenia, they had clinically presented with fever and abdominal pain, generally in the right lower quadrant. The diagnosis was clinical in all cases, and the imaging techniques provided only the suspicion of retro-cecal abscess in one of them. Two patients were operated on because of the development of features of peritoneal involvement, another because of septic shock and another because of retro-cecal abscess. Surgery and pathological study confirmed the diagnosis. The fundamental findings were ileocecal wall edema, mucosa ulceration, local necrosis, hemorrhage and thrombosis, and clusters of bacterial colonies without evidence of granulocytic or tumoral infiltration. NEC can develop with varying types of morphological involvement resulting in a highly variable clinical severity spectrum ranging from nonspecific abdominal symptoms to acute abdomen. Thus, diagnosis is very difficult and is only possible with a high suspicion index. It should rely on clinical data, which are unique, to assess the evolution and to indicate medical or surgical therapy. These therapeutic modalities should be individualized in each patient. All physicians treating neutropenic patients should be familiar with this condition and consider it in the differential diagnosis of abdominal pain.

[Lymphoma of the rectum associated with lymphoid nodular hyperplasia in a common variable immunodeficiency]. / Linfoma rectal asociado a hiperplasia nodular linfoide en el seno de una inmunodeficiencia variable común.

A patient with common variable immunodeficiency developed lymphoid nodular hyperplasia and, subsequently, a follicular non-Hodgkin lymphoma with excellent response to chemotherapy. The patient remained in remission after 4 years. The very unusual type of this lymphoma and its localization are discussed, and the possible relations between these different conditions as a single spectrum of B lymphocyte are analyzed.