Non-Hodgkin's lymphomas--prognostic analysis and therapeutic recommendations.

The total non-Hodgkin's lymphoma-population between 1960 and 1985 treated by means of radiotherapy or combined radio-chemotherapy in the Medical Academy Dresden was analysed prognostically. 247 patients were classified according to previous scheme, 79 were subdivided on the basis of the recommendations of the Kiel-classification. The remission rates and survival curves achieved bear comparison with international literature (remission rates for the low-malignancy group = 85.3% and for the high-malignancy group = 80.0%; 5-year survival rates for the low-malignancy group = 61.9% and for the high-malignancy group = 41.7%). The influence of histology, clinical stage and involvement of organs is discussed according to our results and information from appropriate reference sources. Our analysis confirms the high importance of a common radiologic-internal outpatient department for coordination of the diagnostic and therapeutic programme. Principles of treatment are presented with special respect to polychemotherapy.

[The unusually favorable prognosis of multiple primary bronchial carcinoma--the consequence of natural killer cell elevation and increased interleukin 2 receptor expression?]. / Ungewöhnlich günstige Prognose eines multiplen primären Bronchialkarzinoms--Folge von Natural-Killer-Zell-Elevation und vermehrter Interleukin-2-Rezeptor-Expression?

It is reported on a 65-years-old man with the metachronous type of multiple primary bronchogenic carcinoma: initial peripheral adenocarcinoma (RUL) was observed; after 7 years developed left central squamous cell carcinoma; within 5 following years no evidence for relapse. The only remaining sign of malignant disease seems to be the increase of copper-level measured in the patients serum. The elevated quantity of natural-killer-cells (CD 16) and the high-grade Interleukin-2-receptor-expression (CD 25) obtained in our patient are discussed as indicators of pathophysiological processes which could possibly lead to the favourable prognosis of this case.

[Primary extranodular non-Hodgkin's lymphomas--observations on etiopathogenesis, histology and prognosis]. / Primär extranoduläre Non-Hodgkin-Lymphome--Betrachtungen zur Atiopathogenese, Histologie und Prognose.

The total non-Hodgkin's lymphoma-population treated between 1978 and 1986 by means of radiotherapy or combined chemo/radiotherapy was analysed as to primary extranodular manifestation. 39 cases, 16 women and 23 men, were observed (stage IE 12, stage IIE 22 and stage IIIE 5). Immunoblastic (10), lymphoblastic (9) and centroblastic (6) lymphomas are the most frequent with respect to histology. Gastroenteron (16) and otorhinolaryngological region (13) are in the lead with regard to localisation. 5-year-survival-rates are determined in dependence on clinical stage: IE 65.8%, IIE 39.2% (low, connected with the proportion of high-malignant histology) and IIIE 25.0%. The 5-year-survival-rate of primary gastrointestinal manifestation amounted to 51.5%. With respect to aetiopathogenesis of primary extranodular lymphomas gut-, mucosa- and bronchial-associated lymphoid tissue, aberrant lymph-nodes and the influence of viral- and immunologic factors seem to be important.

[Hodgkin's disease--immunological aspects]. / Morbus Hodgkin--immunologische Aspekte.

The significance of immunological aspects in lymphogranulomatosis for the pathophysiological understanding of the disease was confirmed recently. Moreover, immunologic knowledge increasingly influences diagnosis, prognosis and treatment of Hodgkin's disease. In this survey cell-markers and cell-function of subpopulations of cells, participating in the disease are described. The origin of Hodgkin's- and Reed-Sternberg-cells as well as the aetiopathogenesis of the disease are discussed.

[Hodgkin and Sternberg-Reed cells--cell origin, cell marker, cell function]. / Hodgkin- und Sternberg-Reed-Zellen--Zellursprung, Zellmarker, Zellfunktion.

The controversy in literature with regard to the origin of Hodgkin's and Reed-Sternberg cells persists, however only two conceptions seem to be plausible at present: the first is based on the relation to histiocytic elements, the second postulates lymphocytic precursors. The significance of surface-markers of these malignant cells in cryostat-sections and in cell-cultures and the relevance of their functional properties are discussed with respect to pathophysiology, clinical appearance, diagnosis and prognosis of Hodgkin's disease. The authors present two tendencies in the classification of malignant lymphomas based on the present knowledge achieved especially by monoclonal antibodies: the first includes aspects of integration between non Hodgkin's lymphomas and Hodgkin's disease, illustrated by the Ki-1-lymphoma, the second is related to separation of entities of the group of Hodgkin's lymphomas (for example the nodular paragranuloma). The aetiopathogenesis of Hodgkin's disease is considered as a causal trinity of virus infection, genetic determination and immunologic predisposition.

[Epidemiology of Hodgkin's disease from the pathophysiologic viewpoint--review]. / Die Epidemiologie des Morbus Hodgkin aus pathophysiologischer Sicht--Ubersicht.

The aetiology of Hodgkin's disease remains unclear, however epidemiological characteristics have led to directive conceptions. The description of the rare familiar appearance of lymphogranulomatosis among other things by two cases of our own population and the presentation of milieu factors influencing incidence and prevalence rates give a extensive basis of discussion to develop pathophysiological ideas and to prove it by clinical, pathological, genetical and immunological knowledge. Genetical determination by an autosomal-dominant allele, with incomplete penetrance, predisposing insufficiency of immune suppression and disease inducing virus infection seems less to be three competing aetiologic systems; they rather form a causing trinity, which internal connexions we are at present not able to understand.

[Prognosis of non-Hodgkin's lymphomas in the Dresden district with special reference to combined radio-/chemotherapy]. / Die Prognose der Non-Hodgkin-Lymphome im Bezirk Dresden unter besonderer Berücksichtigung der kombinierten Radio-/Chemotherapie.

The total population affected with non-Hodgkin's lymphoma and treated by means of radiotherapy or combined radio-chemotherapy between 1960 and 1985 at the Medical Academy Dresden was analysed as to prognosis. 247 patients were classified according to the previous German scheme, 79 were subdivided on the basis of the recommendations laid down in the Kiel classification. The remission rates and survival curves achieved will stand out the comparison with international literature (remission rates of the low malignancy group amounted to 85.3 p.c. and those of the high malignancy group to 80.0 p.c.; the 5-years survival rates of the low malignancy group amounted to 61.9 p.c. and those of the high malignancy group to 41.7 p.c.). The influence of histology, clinical stage and involvement of organs is discussed on the basis of our results and informations obtained in literature. Our analysis confirms the high importance which must be attached to a common radiologic-internal outpatient-department for co-ordinating the diagnostic and therapeutical programme.