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Neoplasia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Once staging is complete, treatment generally should not be compromised because of the pregnancy. In the nonpregnant woman, nodal radiotherapy and combination chemotherapy result in cures for 70% of patients with Hodgkin’s disease and 50% of patients with non-Hodgkin’s lymphoma (256). Patients in the third trimester with localized Hodgkin’s disease can be allowed to deliver prior to therapy (245). Treatment during the first and second trimesters and in patients with advanced disease or high-grade tumors is more complex. Localized disease above the diaphragm can be treated with radiotherapy with abdominal shielding. More extensive disease is best treated with combination chemotherapy to reduce the large fetal radiation exposure. The same considerations concerning combination chemotherapy as discussed with leukemia apply to lymphoma.
Inflammation and the Immune System
Published in Jeremy R. Jass, Understanding Pathology, 2020
Tumours may include secondary deposits of carcinoma or melanoma, or primary neoplasms such as Hodgkin’s disease or non-Hodgkin’s lymphoma. Lymphomas of MALT (MALTomas) are biologically different to nodal lymphomas and are being diagnosed with increasing frequency. Diagnosis of these conditions requires knowledge of the limits of normal lymph node architecture and cytology. Diagnosis of non-Hodgkin’s lymphoma has been aided by developments in new immunology. These include monoclonal antibodies to T and B cell markers and the molecular demonstration of gene rearrangement to prove both clonality (indicative of neoplasia) and cell lineage. Whilst diagnosis of lymphoma is precise, reflects the biological complexity of the immune system and carries prognostic significance, treatment options are still relatively limited.
Lymphoma
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
The main differential diagnosis is between Hodgkin lymphoma and non-Hodgkin lymphoma. Other causes of lymphadenopathy will also be considered including infection, which can be pyogenic, tuberculous or viral, e.g. EBV or CMV (cytomegalovirus), toxoplasmosis and other neoplastic conditions such as leukaemia or carcinoma.
Combining the past and present to advance immuno-radiotherapy of cancer
Published in International Reviews of Immunology, 2023
Ioannis M. Koukourakis, Michael I. Koukourakis
The role of IL-2 in combination with radiotherapy has been poorly investigated. In 1997, Kimura et al. reported a randomized trial on adjuvant, post chemo-radiotherapy, immunotherapy in 174 patients with locally advanced surgically treated patients with lung cancer [114]. Immunotherapy consisted of IL-2 and lymphokine-activated cell administration. No difference in survival was noted. De Stefani et al. published a randomized trial in 2002 in 202 patients with oral/oropharyngeal cancer, treated with IL-2 before surgery and radiotherapy, reporting significantly improved the 5-year overall survival rates (55% in the control group vs. 73% in the IL-2 group) and the 5-year disease free survival rates (51% vs. 64%) [115]. A randomized trial in patients with non-Hodgkins lymphoma treated with Total Body Irradiation and chemotherapy, followed by maintenance IL-2 administration, did not show any survival benefit [116]. An interesting recent randomized phase II trial in 44 patients with metastatic melanoma showed that IL-2 combined with stereotactic body irradiation increased the rate of objective responses (21% complet and 33% partial responses) compared to patients who received IL-2 alone (15% complete and 20% partial responses) [117].
Clinical prognostic risk analysis and progression factor exploration of primary breast lymphoma
Published in Hematology, 2022
Jili Deng, Lan Mi, Xiaopei Wang, Jun Zhu, Chen Zhang, Yuqin Song
Blood test reports were comprehensively collected to explore better this small group of patients’ adverse prognostic factors. Elevated ESR has previously been suggested as a poor prognostic factor for Hodgkin's lymphoma[24]. In our cohort, other general prognostic risk factors, such as ESR, LDH level, B symptoms, and IPI scores, were equally applicable in PB-DLBCL, showing poor prognostic factors for both OS and PFS (P < 0.05). The stage-adjusted IPI can also identify patients with a survival benefit, even if the disease is confined to an early stage. Although B symptoms in patients with non-Hodgkin lymphoma are frequently neither recorded nor accurate, as mentioned in the Lugano classification[25], they are still crucialin lymphoma patients, especially those with weight loss.
The Expression of Matrix Metalloproteinases in Eyes with Intraocular Lymphoma
Published in Ocular Immunology and Inflammation, 2022
Kanae Fukutsu, Satoru Kase, Daiju Iwata, Kayo Suzuki, Kenichi Namba, Susumu Ishida
Malignant lymphoma is a general term for malignant tumors with monoclonal proliferation of lymphoid cells. It is classified into two categories: Hodgkin lymphoma that disturbs lymphatic tissues systemically, and the other is non-Hodgkin lymphoma. Most of the intraocular lymphoma (IOL) cases are Non-Hodgkin lymphoma, in which diffuse large B-cell lymphoma (DLBCL) is the most common histopathological type.1 IOL is often classified into two categories: the primary IOL (PIOL) which means IOL possibly arising from the vitreoretinal tissues, as well as the intraocular involvements from primary central nervous system lymphoma (PCNSL). The secondary IOL (SIOL) is a metastasis of lymphoma outside the central nervous system. PIOL often masquerades as infectious/noninfectious uveitis, while SIOL usually invades the choroid and manifests as thickened choroid. When patients are suspected of IOL, surgically obtained cell-block from vitreous samples is suggested as an advantageous tool to make an accurate diagnosis.2–4