ABSTRACT
Currently, there is limited data available comparing Primary Mediastinal Large B-cell Lymphoma (PMBL) and mediastinal Hodgkin disease, nodular sclerosis type (HDNS). This is a retrospective cohort study that compares the clinical features, histology through immunohistochemistry (IHC) and treatment outcomes of 19 cases of PMBL and 39 cases of HDNS diagnosed over 13 years at a single institution in San Juan, PR. Superior Vena Cava syndrome (SVCS) and elevated Lactate Dehydrogenase (LDH) levels were more frequently seen in the PMBL cohort. At the median follow-up visit, of 74 months, no significant difference was seen in overall survival or progression free survival between PMBL and HDNS. Almost all of the relapses in the PMBL group occurred within 12 months of diagnosis. Our data suggests that PMBL and HDNS differ in their clinical presentation and have a favorable prognosis.
Subject(s)
Hodgkin Disease , Lymphoma, Large B-Cell, Diffuse , Mediastinal Neoplasms , Humans , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/therapy , Retrospective Studies , Hodgkin Disease/pathology , Hodgkin Disease/diagnosis , Hodgkin Disease/therapy , Male , Female , Adult , Middle Aged , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/therapy , Young Adult , Aged , Cohort Studies , Treatment Outcome , Follow-Up Studies , Prognosis , Adolescent , Superior Vena Cava Syndrome/etiology , Progression-Free Survival , Survival RateABSTRACT
BACKGROUND AND PURPOSE: To predict treatment-related cardiovascular disease (CVD) and second cancer 30-year absolute mortality risks (AMR30) for patients with mediastinal Hodgkin lymphoma in a large multicentre radiation oncology network in Ireland. MATERIAL AND METHODS: This study includes consecutive patients treated for mediastinal lymphoma using chemotherapy and involved site radiotherapy (RT) 2016-2019. Radiation doses to heart, left ventricle, cardiac valves, lungs, oesophagus, carotid arteries and female breasts were calculated. Individual CVD and second cancer AMR30 were predicted using Irish background population rates and dose-response relationships. RESULTS: Forty-four patients with Hodgkin lymphoma were identified, 23 females, median age 28 years. Ninety-eight percent received anthracycline, 80% received 4-6 cycles ABVD. Volumetric modulated arc therapy (VMAT) ± deep inspiration breath hold (DIBH) was delivered, median total prescribed dose 30 Gy. Average mean heart dose 9.8 Gy (range 0.2-23.8 Gy). Excess treatment-related mean AMR30 from CVD was 2.18% (0.79, 0.90, 0.01, 0.13 and 0.35% for coronary disease, heart failure, valvular disease, stroke and other cardiac diseases), 1.07% due to chemotherapy and a further 1.11% from RT. Excess mean AMR30 for second cancers following RT were: lung cancer 2.20%, breast cancer in females 0.34%, and oesophageal cancer 0.28%. CONCLUSION: For patients with mediastinal lymphoma excess mortality risks from CVD and second cancers remain clinically significant despite contemporary chemotherapy and photon-RT. Efforts to reduce the toxicity of combined modality treatment, for example, using DIBH, reduced margins and advanced RT, e.g. proton beam therapy, should be continued to further reduce potentially fatal treatment effects.
Subject(s)
Cardiovascular Diseases , Hodgkin Disease , Lymphoma , Mediastinal Neoplasms , Neoplasms, Second Primary , Radiotherapy, Intensity-Modulated , Humans , Female , Adult , Radiotherapy, Intensity-Modulated/adverse effects , Hodgkin Disease/drug therapy , Hodgkin Disease/radiotherapy , Neoplasms, Second Primary/epidemiology , Neoplasms, Second Primary/etiology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breath Holding , Radiotherapy Dosage , Organs at Risk/radiation effects , Bleomycin , Dacarbazine , Doxorubicin , Vinblastine , Heart/radiation effects , Mediastinal Neoplasms/etiology , Mediastinal Neoplasms/radiotherapy , Cardiovascular Diseases/etiology , Radiotherapy Planning, Computer-AssistedABSTRACT
Objetivo: determinar la sensibilidad y especificidad de la mediastinoscopia para diagnóstico y estadiaje de enfermedades del tórax. Métodos: se revisó la información general incluida en la base de datos del servicio de Cirugía de Tórax del Hospital Dr. R. A. Calderón Guardia, de 140 pacientes sometidos a mediastinoscopia durante el periodo comprendido entre 1989 y 2013, la cual se complementó con datos específicos obtenidos de los expedientes clínicos...
Subject(s)
Humans , Male , Adolescent , Adult , Female , Middle Aged , Mediastinal Diseases , Mediastinoscopy , Costa RicaABSTRACT
A efusão pleural é uma das principais causas de dispnéia em gatos. Diversas etiologias podem gerar a efusão pleural como neoplasias da pleura e mediastino, neoplasias do parênquima pulmonar, peritonite infecciosa felina (PIF) e cardiomiopatias. Essas doenças alteram o equilíbrio dinâmico da produção ou absorção do fluido pleural, gerando acúmulo patológico. O presente estudo analisou os casos de felinos que apresentaram efusão pleural no Hospital Veterinário da Universidade de Brasília desde de setembro de 2000 a maio de 2009. Os prontuários de vinte e três animais foram analisados e os dados coletados. Dentre as etiologias que ocasionam efusão pleural, o linfoma foi o mais comum, diagnosticado em 34,78% dos casos, seguido por piotórax (21,74%), neoplasias do parênquima pulmonar (17,39%), PIF(8,70%), cardiomiopatia (4,35%), quilotórax idiopático (4,35%) e em dois casos (8,70%) o diagnóstico permaneceu inconclusivo. Esse trabalho teve como objetivo analisar as causas de efusão pleural mais comum de dispnéia, sendo o linfoma, a causa de base mais comumente encontrada
Pleural effusion is one of the main causes of dyspnea in cats. Many diseases can result in pleural effusion such as pleural /mediastinal masses, pulmonary neoplasia, feline infectious peritonitis (FIP); and cardiomyopathy. These diseases affect physiological mechanisms of fluid formation or absorption, resulting in pathologic accumulation. The present study describes cases of cats with pleural effusion in a Veterinary Hospital. The medical records of twenty three patients were reviewed. Among the disorders that result in accumulation of pleural fluid, lymphoma was the most common, diagnosed in 34,78% of cases , followed by pyothorax (21,74%), pulmonary neoplasia (17,39%), FIP (8,70%), cardiomyopathy (4,76%), idiopathic chylothorax (4,35%) and in two cases (8,70%) the diagnosis was inconclusive. This study aimed to analyze the causes of pleural effusion occurred more common in the Veterinary Hospital. Thus, the occurrence of pleural effusion proved to be a common cause of dyspnea, and lymphoma, the underlying cause of most commonly found
Subject(s)
Animals , Cats , Dyspnea , Empyema, Pleural , Cats , Lymphoma, Primary Effusion/diagnosis , Lymphoma, Primary Effusion/physiopathology , Lymphoma, Primary Effusion/veterinary , Mediastinal Neoplasms , ChylothoraxABSTRACT
A efusão pleural é uma das principais causas de dispnéia em gatos. Diversas etiologias podem gerar a efusão pleural como neoplasias da pleura e mediastino, neoplasias do parênquima pulmonar, peritonite infecciosa felina (PIF) e cardiomiopatias. Essas doenças alteram o equilíbrio dinâmico da produção ou absorção do fluido pleural, gerando acúmulo patológico. O presente estudo analisou os casos de felinos que apresentaram efusão pleural no Hospital Veterinário da Universidade de Brasília desde de setembro de 2000 a maio de 2009. Os prontuários de vinte e três animais foram analisados e os dados coletados. Dentre as etiologias que ocasionam efusão pleural, o linfoma foi o mais comum, diagnosticado em 34,78% dos casos, seguido por piotórax (21,74%), neoplasias do parênquima pulmonar (17,39%), PIF(8,70%), cardiomiopatia (4,35%), quilotórax idiopático (4,35%) e em dois casos (8,70%) o diagnóstico permaneceu inconclusivo. Esse trabalho teve como objetivo analisar as causas de efusão pleural mais comum de dispnéia, sendo o linfoma, a causa de base mais comumente encontrada(AU)
Pleural effusion is one of the main causes of dyspnea in cats. Many diseases can result in pleural effusion such as pleural /mediastinal masses, pulmonary neoplasia, feline infectious peritonitis (FIP); and cardiomyopathy. These diseases affect physiological mechanisms of fluid formation or absorption, resulting in pathologic accumulation. The present study describes cases of cats with pleural effusion in a Veterinary Hospital. The medical records of twenty three patients were reviewed. Among the disorders that result in accumulation of pleural fluid, lymphoma was the most common, diagnosed in 34,78% of cases , followed by pyothorax (21,74%), pulmonary neoplasia (17,39%), FIP (8,70%), cardiomyopathy (4,76%), idiopathic chylothorax (4,35%) and in two cases (8,70%) the diagnosis was inconclusive. This study aimed to analyze the causes of pleural effusion occurred more common in the Veterinary Hospital. Thus, the occurrence of pleural effusion proved to be a common cause of dyspnea, and lymphoma, the underlying cause of most commonly found(AU)