Sarcoidosis progressing to lymphoma.
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Biomedical subjects
Publications and source records attributed to F Rosenfelt.
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The medical records of all patients with diffuse histiocytic lymphoma (DHL) presenting for treatment at the Stanford University Medical Center between 1970-1978 were reviewed. From this group of 284 patients, 48 were identified with gastrointestinal tract lesions at initial evaluation. Abdominal pain was the most common presenting symptom. Anorexia, weight loss, malaise, and weakness were also common complaints. Twenty percent of these patients noted abdominal masses and 15% experienced gastrointestinal bleeding. Gastric involvement was found in 56% of patients, small intestine in 25%, large intestine in 10%, and pancreas 8%. Following treatment, 83% of Stage IE patients, 43% of Stage IIE patients, and 27% of patients with Stage III and IV DHL achieved durable complete remissions. Considering all stages, a 54% complete remission rate was observed. Of the 26 patients achieving a complete remission, seven have relapsed and the remaining continue free of disease from 6+ to 82+ months. The median survival for patients obtaining a CR was greater than 36 months. Gastrointestinal bleeding or perforation probably as a consequence of therapy was noted 25% of patients. The implications of these findings for improved therapeutic programs and investigations are discussed.
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Bleomycin is an effective drug used in the therapy of many malignant diseases. Such toxicities as fever, chills, and pulmonary fibrosis are well known to occur following administration of this drug. A rare fatal hyperpyrexial response has also been noted with this agent. We describe a case of fatal hyperthermia after an injection of bleomycin. Unlike earlier reported cases, our patient developed her reaction following prior uneventful therapy with bleomycin rather than as a response to initial treatment. Factors that may be related to the hyperpyrexial response to bleomycin are discussed and the relevant literature reviewed.