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[Calcifications in mediastinal lymphoma after radiation therapy of Hodgkin's disease. (author's transl)].

One case of calcifications in mediastihal lymphoma after radiation therapy of Hodgkin's disease is reported. The incidence of these calcifications is remarkably low. They are mostly localized in the anterior mediastinum showing a characteristical pattern which is initially stippled, later confluent and coral-shaped. An open interval after radiation therapy is typical for this phenomenon. The cause of the calcifications is discussed.

Calcinosis

Targeted variant analysis of feline mediastinal lymphoma using MassARRAY and clinical associations.

Lymphoma is the most commonly diagnosed cancer in cats. This study used the Agena MassARRAY to genotype 40 variants across 17 genes in feline mediastinal lymphoma. These variants have previously been identified in tumors, including T- and B-cell lymphomas, acute and chronic lymphocytic leukemias, and mast cell tumors, in humans, dogs, and cats, using various methods. They were selected based on high prevalence reported in prior oncology studies, potential relevance to targeted therapy, and suitability for multiplex PCR amplification. Pleural fluid samples were collected from 76 cats with mediastinal lymphoma, including 69 domestic shorthairs, two Persians, two Siamese, two Wichienmaat, and one Scottish Fold. The most prevalent variants were found in the BCL2, KIT, STAT3, and ZEB1 genes. Specifically, BCL2 c.83275986G&#xa0;>&#xa0;A and c.83275992G&#xa0;>&#xa0;T were present in 71.1% and 57.9%, respectively. In cats with variant-positive in KIT c.163965724C&#xa0;>&#xa0;CT significantly reduced (11&#xa0;days) compared to wild-type cats (94&#xa0;days) (p&#xa0;<&#xa0;0.001). In cats with variant-positive in STAT3 c.42942437C&#xa0;>&#xa0;CA, resulted in shorter median survival compared to wild-type cats (18&#xa0;days vs. 77&#xa0;days, p&#xa0;=&#xa0;0.006). The findings suggest that the variant panel could be useful for the genomic landscape of feline mediastinal lymphoma and warrant further validation.

Animals

Surgical diagnosis of mediastinal lymphoma of childhood.

Lymphoma was found in 40 of 72 children with a mediastinal mass who had had an intrathoracic or extrathoracic biopsy or excision of the tumor performed at the Yale-New Haven (Conn) Medical Center between 1964 and 1977. The lymphomas were typically located in the anterior or middle compartment in children 2 years of age or older, and they were usually accompanied by fever, nocturnal sweating, weight loss, or pruritus. Thirty (75%) of the children with lymphoma had enlarged supraclavicular or cervical lymph nodes available for biopsy, whereas the other ten without palpable lymphadenopathy required a limited anterior thoractomy to obtain tissue for diagnosis. Careful preoperative selection makes extensive thoracotomy or attempts at excision of mediastinal lymphoma unnecessary. The findings in this retrospective study also emphasize the prevalence of lymphoma among mediastinal tumors seen in children older than 2 years of age.

Adolescent

Improved prognosis for patients with mediastinal lymphoblastic lymphoma.

Patients with diffuse lymphoblastic lymphoma (which includes convoluted lymphocytic lymphoma) with mediastinal involvement have predictable progression of disease to a leukemic phase that is cytologically indistinguishable from acute lymphoblastic leukemia (ALL). Therefore we treated 12 patients with diffuse lymphoblastic lymphoma involving the mediastinum with therapy that is effective in ALL. Treatment consisted of intermittent combination chemotherapy with adriamycin and preventive central nervous system therapy (craniocervical irradiation and intrathecal methotrexate). Mediastinal irradiation was given either for initial respiratory distress or to patients who had incomplete regression of disease following induction chemotherapy. Eleven patients achieve complete remission. With a median follow-up of 41 mo, and using life table analysis, 86% of these patients have remained in continuous complete remission. The results of this study demonstrate the efficacy of treating diffuse lymphoblastic lymphoma with mediastinal presentation as a disseminated lymphoid malignancy.

Adolescent

Acute myeloblastic leukemia developing in patients with mediastinal lymphoblastic lymphoma.

Of three patients with mediastinal malignant lymphoma, lymphoblastic type, at the time of diagnosis one also had acute myeloblastic leukemia (AML), and the other two had blood and bone marrow findings indicative of acute lymphoblastic leukemia (ALL). The latter two patients developed the hematologic picture of AML less than eight months later. In all cases, AML was confirmed by cytochemical studies of peripheral blood and bone marrow cells. Autopsy of two of the patients revealed only AML. The myeloid nature of the proliferative cells was demonstrated with the naphthol-ASD-chloroacetate stain (NCA) on postmortem tissue sections. This study further supports the hypothesis of a common origin of neoplastic lymphoid and myeloid cells from pluripotent bone marrow stem cells.

Adult

[On the pathology of mediastinal tumors (author's transl)].

Review on the mediastinal tumors with a special view to the diverse morphologic expressions of mediastinal lymphomas. These tumors represents three groups: Castleman-Lymphom, Hodgkin's disease and non-Hodgkin lymphomas. The nomenclature of the diversity of the morphologic features in mediastinal lymphomas have been reviewed, the relationship of the histologic findings to the clinical prognosis has been discussed.

Hodgkin Disease

[Malignant mediastinal lymphoblastic lymphoma with t-cell ALL (author's transl)].

29 cases of T-cell derived lymphoblastic lymphoma and T-ALL have been analyzed. There is a striking prevalence of the male sex. In the peripheral blood we often find initially an excessive number of white blood cells combined with normal values for the other constituents in about half of the patients; This may be an expression for the rapid occurrence of leukaemia in T-cell lymphosarcoma. In addition to systemic ALL-therapy we performed X-ray irradiation of the mediastinum in 8 of our patients. This yielded to significantly longer first complete remissions. All patients with T-cell LSA/ALL with or without mediastinal mass should be treated in this manner. Cytochemically a strong focal acid phosphatase reaction was found to be acharacteristic of these cells. It has proved to be a screening method for this disease. The cells are T-cell derived and their pattern of surface markers is similar to that found in fetal thymocytes.

Acid Phosphatase

Acute myelomonocytic leukemia: coexistent cytochemical markers for monocytes and granulocytes in the leukemic cells.

A 22-year-old man presented with mediastinal lymphoma and lymphoblastic leukemia. The leukemic cells in his blood and marrow did not stain positively with Sudan black B, peroxidase, chloroacetate esterase, or nonspecific esterase, and were considered as either lymphoblasts or stem cells. One year after the initial presentation, acute myelomonocytic leukemia developed and he died. The leukemic cells possessed the morphologic and cytochemical characteristics of both monocytes and granulocytes. This case illustrates the close ontogenetic relationship between the monocytes and the granulocytes. It also demonstrates that our present concept of acute myelomonocytic leukemia should be broadened to include cases in which the leukemic cells possess the morphologic and cytochemical characteristics of both the monocytes and the granulocytes.

Adult

Convoluted lymphocytic lymphoma in adults: a clinicopathologic entity.

Twelve adults had a distinct clinicopathologic type of malignant lymphoma that closely resembles the mediastinal lymphomas of childhood. Nine patients presented with mediastinal masses, and seven had symptoms related to intrathoracic compression. Seven patients presented with or developed leukemia, and in four of these patients the central nervous system (CNS) became involved. Structurally, the tumor cells had a distinctive stippled chromatin pattern, in addition to the characteristic nuclear convolutions. Tumor cells from five patients were studied immunologically, and, in each case, the tumor cells formed rosettes with sheep erythrocytes. The response to combination chemotherapy was rapid and dramatic, but usually transient, with relapse in the CNS or previously involved sites. The above data strongly suggest that these cases represent a distinct clinicopathologic entity that should be treated similarly to childhood leukemia and lymphoma, with intensive multiple agent induction, CNS prophylaxis, possibly radiation therapy to initially involved sites, and prolonged maintenance.

Adult

Cytological diagnosis of malignant pleural effusion in myeloma.

The cytological examination of pleural fluid established the malignant etiology of the effusion in two patients with multiple myeloma. In contrast to patients with lymphoma, mediastinal lymph node enlargement in myeloma is an uncommon factor in fluid formation. As in patients with metastatic carcinoma, pleural and underlying lung involvement by myeloma is the main cause of pleural effusion. The two cases in this report, and similar cases in the literature, probably represent distal dissemination from skeletal multiple myeloma.

Aged

Uses of mediastinoscopy.

The value of mediastinoscopy based on experience gained in over 100 patients is reviewed. Reasons for the routine use of mediastinoscopy in the preoperative evaluation of carcinoma of the lung are presented. This modality is useful in the diagnosis of other nonvascular superior mediastinal masses, especially sarcoidosis and the lymphomas.

Adenocarcinoma