ONCOLYSIS BY CLOSTRIDIA. II. EXPERIMENTS ON A TUMOR SPECTRUM WITH A VARIETY OF CLOSTRIDIA IN COMBINATION WITH HEAVY METAL.
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Of the 6,067 malignant laryngeal tumors treated at the Ear, Nose and Throat Clinical Hospitals in Yugoslavia, a total of 20 were sarcoma. Eighteen of these patients were men. The most frequent forms were chondrosarcoma and fusocellular sarcoma - four cases of each. A survival rate of more than five years was seen in only four patients (one fibrosarcoma, two lymphosarcomas, and one chondrosarcoma).
17 patients with non-Hodgkin lymphomas were treated by total body irradiation (TBI). 94% went into remission. Response in lymphosarcomas was found to be extremely good with long periods of unmaintained remission. Reticulumcell sarcomas responded poorly.
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There has been made a comparison between a total of 121 primary lymphatic sarcomas of the lungs with 314 other histomorphological forms of primary sarcomas of the lungs found in the literature from 1957 to 1972. Histomorphology, clinic and prognosis are discussed. Beside a higher average age and a predominating right-hand localization, the favourable postoperative prognose is impressing.
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The authors report 8 cases of lympho-reticulosarcoma of the colon and emphasize the rareness of this tumour (10 percent of cases) compared with other localisations in the stomach and small intestine. Whether primary or secondary, lymphosarcoma of the colon has various radiological appearances, depending on the mode of development of the sarcoma in the wall of the colon. Mainly sub-mucosal, it may remain localised or extend to the whole of the colon, predominating in the ileo-coecal and recto-sigmoid regions. Localised tumour forms present either in the form of large polycyclic lacunae, sometimes invaginated or as vast ulcerations with irregular nodular margin, or as due to parietal infiltration and exoluminal development of the tumour mass and neighbouring adenopathy. It is sometimes confused with carcinoma of the colon, e.g. vegetating carcinoma, colloid carcinoma, or peritoneal metastases, or with a regional abscess, e.g. appendix abscess or diverticulosis. The correct diagnosis is made on operation. The extensive colonic forms rarely take on the appearance of lymphoid pseudopolyposis, more often that of a very unusual nodular form formed of hazy lenticular lacunae. It may be confused with nodular colitis, it differs from this, however, by the absence of ulceration, changes in caliber and the persistance of normal haustration, a reticulated appearance of the mucosal outline during evacuation of the barium. In all cases, the discovery of a colonic lympho-reticulosarcoma implies complete digestive radiological investigation in order to seek gastric, duodenal or intestinal localisations, together with a search for other extra-digestive localisations. In fact, the great diffusion of the lesions modifies the prognosis and the therapeutic attitude. These lymphosarcomas and reticulosarcomas of the colon have a similar pathological and radiological appearance but differ by their sensitivity to treatment with cobalt, as reticulosarcomas are more resistant.
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In a collection of 11 cases, the benign lymphoepithelial lesion presented clinically in every case as a tumour of a salivary gland. In eight cases the parotid was affected, in two a palatal salivary gland, and in one the submandibular gland was affected. Microscopically the lesion consisted of a mixture of lymphoid and epithelial components and, although the appearances in several cases suggested lymphosarcoma or reticulosarcoma, the arrangement of the epithelial component in characteristic islands (epi-myoepithelial islands) indicated the benign nature of the lesion. In one case incomplete excision of a lesion of the palate was followed by a recurrence that was cured by a radium mould. The microscopical appearances of the benign lymphoepithelial lesion were identical with those of the salivary lesions of Sjögren's syndrome but in all the cases the lesion was an isolated one and the sicca syndrome was absent.
An analysis of the types of tumour in children in the Manchester hospital region indicates that approximately two-thirds arose in the reticuloendothelial or nervous systems. The high mortality is largely due to the nature or site of the tumours, the majority of which cannot be eradicated by purely local measures. The most likely means of causing any significant improvement would be by greater centralization in the treatment of these children.
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