Extra Nodal Research Articles

強度び漫性浸潤型（４Ｄ型）口腔へん平上皮癌に関する検討

Histological findings of squamous ell carcinoma in the oral cavity vary in each case. Among them, mode of invasion in the tumor-host borderline is a most important factor related with prognoses of the patients. Tumor cells of Grade 4D, that was subclassified from Jacobssons Grade 4 by us in 1982, invade diffusely with a single or a few cells group. At present, cases with Grade 4D were re-evaluated clinicopathologically and the following results were obtained. Cases with Grade 4D were observed in only 16 out of 161 cases (9.9%) with tumor sites of 8 in tongue, 4 in buccal mucosa, 3 in lower gum and one in floor of the mouth. Objective response by preoperative administration of 90 mg of BLM only or 1, 000mg of MTX and 60mg of BLM was obtained in 5 cases (31.3%). Regional lymph node metastases were found in 13 with 8 cases of extra nodal spread. Postoperative course of these cases showed a highest maligancy with 8 local recurrences, 4 secondary metastases and 11 deaths from tumor. Survival rate was, therefore, only 21.4%(3/14). It was judged from these results that, if surgical procedure was chosen, wide local excision and prophylactic neck dissection were neccessary for these cases.

The mechanism of A-V conduction delay in A-V nodal gap

Initial block in the His-Purkinje system was demonstrated in 17 of 71 patients during atrial extrastimulus testing. Of the 17 patients who demonstrated initial block in the His-Purkinje system, ten patients had A-V nodal gap (a type 1 gap). Of these ten patients, progressive increase in A-V nodal conduction was responsible for a resumption of A-V conduction in six patients, dual pathways within the A-V node was responsible in three patients, and the presence of an extra nodal pathway of the A-V node was responsible in one patient.

Five-year results of the E.O.R.T.C. randomized study of splenectomy and spleen irradiation in clinical stages I and II of Hodgkin's disease

A controlled clinical trial was carried out on patients with clinical stages I and II of Hodgkin's disease by the E.O.R.T.C. from 1972 to 1976. Three hundred patients with supradiaphragmatic presentation were assigned at random into two groups, one treated by spleen irradiation, the other by splenectomy. All patients received a mantle field irradiation as well as a para-aortic lymph node irradiation. The actuarial survival rates and relapse-free survival rates at five years were, respectively, 90 and 62% in the group treated by spleen irradiation and 90 and 67% in the group splenectomized. The efficiency of the two treatments is therefore identical. In the group submitted to staging laparotomy, all patients received the same treatment without taking into account the results of the splenectomy and of the lymph node biopsy. Of 107 patients without spleen or lymph node involvement 18 relapsed (17%); of 33 patients with spleen involvement 14 relapsed (42%). Relapse in non-irradiated lymph node territories (iliac and inguinal areas) were fifteen-fold more frequent in patients with spleen involvement, whereas extra nodal relapses were about twice as frequent in patients with spleen involvement than in patients without spleen involvement. Patients with mixed cellularity or lymphoid depletion histological types received long term adjuvant chemotherapy either by Vinblastine + Procarbazine or by Vinblastine alone. The 5-year relapse rate was 12% with both chemotherapeutic regimens.

Seminoma: Improved Imaging and Tumor Characterization with Computed Tomography

We report 2 cases of metastatic seminoma to emphasize the use of computed tomography in defining accurately the extent and volume of tumor before treatment. Computed tomography permits more direct visualization of the retroperitoneum, mesenteric and abdominal lymph nodes, and extra nodal extension of the tumor to other organ systems. Additionally, characteristic tissue densities are displayed (that is cyst and hemorrhage), which may serve as an index to the dynamics of tumor growth and change. Lymphography and venacavography are invasive studies and both share inherent limitations in imaging for seminoma. Cross-sectional imaging is more precise in describing treatment fields for radiation therapy. Results of treatment are monitored more confidently with computed tomography.

A Case of extranodal lymphoma (reticulum cell sar coma) originated from uterine cervix

This paper presents an extremely rare case of extra nodal lymphoma of the uterine cervix in a 57year-old multiparous woman. The histology of this case should be classified into histiocytic malignant lymphoma (re ticulum cell sarcoma) by the Rappaport classification of malignant lymphomas. Cytology in this case was a poor ly differentiated reticulum cell sarcoma whose cells it was necessary to differentiate from those of lympho sarcoma.The patient was treated by external radiation therapy with the telecobalt unit up to 1, 000 rads, following a simple hysterectomy. Unfortunately, she died in a rapid course of two month duration after onset of the disease. Perhaps, her acute death may be explained by the fact that she had already been in the advanced stage in view of the clinical and laboratory findings, and also of the studies of the removed specimens.

Extensions of disease, complications of therapy, and deaths in localized Hodgkin's disease; preliminary report of a clinical trial.

EXTENSIONS OF DISEASE, COMPLICATIONS OF THERAPY, AND DEATHS IN LOCALIZED HODGKIN'S DISEASE; PRELIMINARY REPORT OF A CLINICAL TRIALJAMES J. NICKSON and G. B. HUTCHISONAudio Available | Share

Extra nodal spread of Hodgkin's disease.

EXTRA NODAL SPREAD OF HODGKIN’S DISEASEANTONIO MEDINA, M.D., D. L. BENNINGHOFF, M.D. and M. R. CAMIEL, M.D.Audio Available | Share

A 25 Years Old Male with Primary Duodenal Lymphoma

Primary duodenal lymphoma is very atypical, although the gastrointestinal (GI) tract is the most prominent site of extra nodal lymphoma. Here we present a case of 25 years old male, presented with upper abdominal pain and vomiting and eventually diagnosed as a case of duodenal non Hodgkin's lymphoma. The particular interest in this report is the fact that, it is important to have a high index of suspicion to diagnose primary intestinal lymphoma as it has high mortality which requires early diagnosis and treatment. doi: 10.3329/jom.v10i2.2829 J MEDICINE 2009; 10 : 124-127