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Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
The staging of lymphoma is based on history and physical examination, hematologic and biochemical testing, bone marrow biopsy, and radiologic imaging. Currently, women with stages I and II receive combination modality treatment, so full staging during pregnancy is unlikely to change the recommended treatment during the course of pregnancy and can be delayed to the postpartum period. Image staging in non-pregnant patients includes a chest x-ray and CT. In the pregnant woman, a two-view chest x-ray is suggested. A chest MRI can assess lymphadenopathy, and the information gained is comparable to a CT [59]. MRI can also evaluate the bone marrow and detect splenic involvement that may be undetectable with CT. Abdominal ultrasound can evaluate the spleen depending on size of gravid uterus. Diffusion weighted whole body MRI is a safer alternative during pregnancy [39]. After delivery a PET scan can be performed. Pet scan is avoided in pregnancy as fludeoxyglucose crosses the placenta and involves radiation as well.
Cervical Ectopic Pregnancy
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Methotrexate is an immunosuppressive and chemotherapeutic agent that is often used to treat a wide range of different malignancies; autoimmune diseases, such as rheumatoid arthritis and other inflammatory types of arthritis; and ectopic pregnancies. Common side effects include nausea, fatigue, fever, increased risk of infection, low white blood cell counts, and breakdown of the skin inside the mouth [21]. Other side effects may include liver disease, lung disease, lymphoma, and severe skin rashes [21]. People on long-term treatment should be regularly checked for side effects [21]. It is not safe to use during breastfeeding [21]. In patients with kidney problems, lower doses may be needed; it acts by blocking the body's use of folic acid [21]. During pregnancy, methotrexate is an abortifacient and is commonly used to terminate pregnancies during the early stages, generally in combination with misoprostol. As mentioned earlier, it is also used to treat ectopic pregnancies, provided the fallopian tube has not ruptured [21]. Methotrexate with dilatation and curettage is used to treat molar pregnancy.
An Introduction to Bone Marrow Transplantation and Processing
Published in Adrian P. Gee, BONE MARROW PROCESSING and PURGING, 2020
In man, the evidence for GvL comes from statistical comparisons of relapse probabilities in large patient cohorts receiving different treatments to prevent GvHD, and of comparisons of bone marrow from autologous, syngeneic, or allogeneic sources. The relationship between GvL and both acute and chronic GvHD has also been demonstrated in this manner.16 Horowitz, using IBMTR data, was able to compare GvL effects in individual leukemias.17 In chronic myeloid leukemia (CML), the greatest effect upon relapse was seen in recipients of T-depleted marrow. However, the relapse rate observed in a small number of identical twin transplants was no greater than that seen in recipients of undepleted bone marrow who did not develop GvHD. It therefore appears that in CML, T lymphocytes play a significant role in the GvL process. In acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) the effect of T depletion was less marked, but a protective effect of GvHD upon relapse was more evident than in CML. These findings point towards operation of a number of GvL mechanisms in allotransplants and to the possibility that residual disease is controlled in different ways according to the nature of the malignancy. The clear demonstration of GvL in clinical BMT suggests that similar mechanisms may be important in BMT for other disorders, such as lymphoma and solid tumors. However, this remains to be defined, since comparisons of autologous and allogeneic BMT in lymphoma do not support a graft-vs. -lymphoma effect.18–19
Bell’s palsy with abnormal findings in the ipsilateral parotid gland
Published in Acta Oto-Laryngologica Case Reports, 2023
Takaaki Hijioka, Yoshihiro Aoki, Hideaki Moteki, Naoto Mizushiro
Parotitis can be caused by bacterial or viral infections, sialoliths, or autoimmune diseases [5]. Although immunodeficiency, allergies, upper respiratory tract and mumps infections may be involved, the cause of recurrent parotitis remains largely unknown [6]. Diagnosis of recurrent parotitis can be made based on the criteria of recurrent symptoms, suppurative inflammation, and petechial shadows seen on parotid ductography or MR sialography, along with the exclusion of mumps or bacterial parotitis [5,6]. Ultrasonography shows multiple small circular hypoechoic lesions in the gland. Moreover, T2-weighted-MRI shows parotid swelling with multiple dot-like hyperintense lesions. The imaging findings in our case were consistent with those of recurrent parotitis. However, the absence of pain and failure of this abnormality to resolve within a short period of time could not be explained. Theoretically, further investigation, such as fine-needle biopsy, might be warranted because malignant lymphoma could be a differential diagnosis.
Cardiovascular risk factors, radiation therapy, and myocardial infarction among lymphoma survivors
Published in Acta Oncologica, 2022
Talya Salz, Emily C. Zabor, Peter De Nully Brown, Susanne Oksbjerg Dalton, Nirupa J. Raghunathan, Matthew J. Matasar, Richard Steingart, Henrik Hjalgrim, Lena Specht, Andrew J. Vickers, Kevin C. Oeffinger, Christoffer Johansen
Using linked population registries to ascertain demographics, hospital discharges, outpatient prescriptions, and lymphoma diagnoses and treatments, we identified people diagnosed with aggressive non-Hodgkin lymphoma (NHL) [16–21]. These lymphomas are generally treated with curative intent; after treatment completion, survivors may be free of symptoms but still have an underlying risk of heart disease that could be mitigated with preventive efforts. We included patients diagnosed at age 15 or older with lymphoma between 2000 and 2010, followed from one year (‘landmark’ analysis) after diagnosis until December 2016, death, or migration from Denmark. We excluded patients who had a cancer other than lymphoma, who had an MI between diagnosis and the landmark, or who emigrated prior to the landmark. Additionally, patients with missing data on receipt of mediastinal RT were excluded.
FAM19A5/S1PR1 signaling pathway regulates the viability and proliferation of mantle cell lymphoma
Published in Journal of Receptors and Signal Transduction, 2022
Yanfang Wang, Zhenhao Zhang, Wei Wan, Yan Liu, Hongmei Jing, Fei Dong
Malignant lymphoma includes a group of distinct disease entities not only Hodgkin lymphoma but also non-Hodgkin lymphoma [1]. It has been reported that malignant lymphoma account for 3.37% of all malignancy worldwide. Non-Hodgkin lymphoma is more common in older patients whether Hodgkin lymphoma are often diagnosed in young adults [2]. There are several risk factors have been reported to be associated with the development of malignant lymphoma. For example, infection with human immunodeficiency virus or human T-cell lymphotropic virus, chronic exposure to high levels of ionizing radiation, and family history have been found to be the possible cause underlying the pathogenesis of lymphoma [3]. The primary symptoms of lymphoma include swollen lymph nodes, unexplained fever, night sweats, feeling tired and weight loss. Although many therapies including chemotherapy and radiotherapy have been verified in the treatment of malignant lymphoma, the primary molecular mechanisms underlying the progression of malignant lymphoma have not been completely understood [4].