Frequent Site Of Disease Research Articles

Non-Hodgkin's lymphomas of the sinonasal region: histologic subtypes and their clinicopathologic features.

The authors describe 11 patients with non-Hodgkin's lymphoma arising in the nasal cavity or paranasal sinuses. Seven were men and four were women. The median age of the women was 76 years; the median age of the men was 45 years. The most common presenting symptoms were nasal obstruction and unilateral facial swelling. The most frequent sites of disease were maxillary antrum (ten cases), nasal cavity (eight cases), and ethmoid sinus (seven cases). Eight patients had involvement of multiple sinuses. Six patients were clinical stage I E, two were II E, one was stage III E, and two were stage IV. Histologic subtypes included diffuse small cleaved cell (1 case), diffuse large cell (4 cases), and diffuse large cell immunoblastic (6 cases). Three patients having immunoblastic lymphoma had longstanding sinusitis, rhinitis, and allergies. Overall, 55% of patients died of disease. Three of four patients with the diffuse large cell subtype were free of tumor (mean follow-up 50 months). Five of six patients having immunoblastic lymphoma died of disease from 1 to 13 months following diagnosis (mean 6.4 months).

Relapse in Burkitt's lymphoma.

Of 109 patients with histologically confirmed Burkitt's lymphoma who completed a course of chemotherapy, 86 (79%) achieved complete remission. Forty-five (52%) of patients with initial complete remission relapsed with tumour over an observation period ranging from 2 years to over 5 years. Relapse was more common in patients who initially presented with abdominal or central nervous system (CNS) involvement than in patients who presented with localized facial tumours (p less than 0.01). Anatomical distribution of tumour on relapse differed from that at presentation. Facial bones were much less frequently involved on relapse; on the other hand, the CNS, cranial nerves, orbits and skin were frequent sites of disease on relapse. CNS involvement occurred in 42% (19/45) of patients at the first relapse and in 73% (11/15) of patients with multiple relapses. Prognosis in these patients was poor. Two relapse types were clinically identifiable. Early relapse (remission duration less than 12 weeks) was associated with frequent involvement of the CNS, drug resistance and a generally unfavourable outcome. Patients with late relapse (remission duration greater than 12 weeks) responded much better to secondary treatment. Possible pathogenic mechanisms underlying these two relapse types are discussed.

Mobility of the rectosigmoid; a new diagnostic sign.

While the rectosigmoid is one of the most frequent sites of disease of the alimentary tract, it is the most difficult to examine roentgenographically. Newer technics (1) have been of considerable assistance in revealing the anatomy of the rectum as well as various pathological conditions not shown by routine methods. Any additional light that can be thrown on the presence or extent of disease in this region should be helpful to both the roentgenologist and the surgeon. It is unfortunate that lateral roentgenograms of the colon before and after evacuation of a barium enema are too infrequently employed, for in our experience they have often given more information than could be obtained from the postero-anterior films. The sigmoid colon begins at the pelvic brim as a continuation of the descending colon and ends at its junction with the rectum at the level of the third sacral vertebra. The rectum extends from the third sacral vertebra to the pelvic diaphragm, where it becomes continuous with the anal canal....