Non-Hodgkin's lymphoma presenting as thyroid enlargement.

From 1969 to 1978, 11 patients with non-Hodgkin's lymphoma presenting as thyroid enlargement were evaluated and treated in the Division of Radiation Therapy at Stanford University Hospital. All patients were staged with lymphangiogram and bone marrow biopsy. Eight patients had Stage I-II disease and three patients had Stage III-IV disease.

Survival of primates following orthotopic cardiac transplantation treated with total lymphoid irradiation and chemical immune suppression.

Fractionated total lymphoid irradiation (TLI) has been used for attempts at induction of a donor-specific tolerant-like state in allograft recipients and for immunosuppressive effects. Cyclosporin A (Cy A) has been shown to suppress rejection of organ grafts in many species including man. The present study was designed to test the effectiveness of TLI in combination with either CY A or rabbit anticynomolgus thymocyte globulin (ATG) and azathioprine.

Treatment of intractable rheumatoid arthritis with total lymphoid irradiation.

Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation (total dose, 2000 rad) in an uncontrolled feasibility study, as an alternative to long-term therapy with cytotoxic drugs such as cyclophosphamide and azathioprine. During a follow-up period of five to 18 months after total lymphoid irradiation, there was a profound and sustained suppression of the absolute lymphocyte count and in vitro lymphocyte function, as well as an increase in the ratio of Leu-2 (suppressor/cytotoxic) to Leu-3 (helper) T cells in the blood. Persistent circulating suppressor cells of the mixed leukocyte response and of pokeweek mitogen-induced immunoglobulin secretion developed in most patients.

The treatment of advanced stage favorable histology non-Hodgkin's lymphoma: a preliminary report of a randomized trial comparing single agent chemotherapy, combination chemotherapy, and whole body irradiation.

Between 1975 and 1978, 51 patients with favorable histology non-Hodgkin's lymphomas, pathologic stage III-IV, were treated prospectively on a randomized treatment protocol. Treatment options were single alkylating agent chemotherapy, combination chemotherapy with cyclophosphamide, vincristine, and prednisone (CVP), or fractionated whole body irradiation followed by low dose involved field irradiation. The median follow-up interval in this group of patients is not 41 mo.

Female reproductive potential after treatment for Hodgkin's disease.

The probability of maintaining ovarian function, becoming pregnant, and delivering a normal child is important to young women anticipating successful therapy for Hodgkin's disease. In this study, reproductive function was retrospectively examined in 103 women 40 years old or younger who had undergone treatment for Hodgkin's disease with total-lymphoid irradiation (TLI) alone, combination chemotherapy, or combined TLI and chemotherapy. Infertility was directly related to gonadal exposure to therapy and to age at treatment.

Hodgkin's disease at autopsy: 1972-1977.

The autopsies of 80 patients with Hodgkin's disease (HD) were reviewed. Nearly one-third of the patients died without evidence of HD at autopsy. Four patients died with clinically unsuspected HD.

PUVA treatment of erythrodermic and plaque type mycosis fungoides.

Five patients with plaque type mycosis fungoides (MF) and five patients with erythrodermic MF responded favorably to oral psoralen photochemotherapy (PUVA). The mean total UVA irradiation dose was less for erythrodermic than for plaque type MF, but the mean number of treatments to achieve clearing was greater in the erythrodermic patients. Histologic examination at clearing revealed persistence of an inflammatory infiltrate in the lower dermis in most cases.

Lymph node biopsy in mycosis fungoides.

Ninety lymph node biopsy specimens from 76 patients with mycosis fungoides (MF) were reviewed. Dermatopathic lymphadenopathy was the most common change found in biopsies of palpable lymph nodes obtained from patients with MF. The paracortical expansion and histiocytes with elongated, folded, and delicate nuclei were characteristic.

Cutaneous malignant lymphoma: a pathologic study of 50 cases with clinical analysis of 37.

Fifty cases of malignant lymphoma, exclusive of mycosis fungoides, with initial involvement of the skin are reported. The head and neck was the most common site of presentation and 44% of the cases were classified as the diffuse histiocytic type. The cases encompassed virtually the entire spectrum of histologic subtypes of non-Hodgkin's lymphomas; these subtypes were a major prognostic factor in predicting the subsequent clinical course.

[Sociomedical aspects of cancer of the uterine cervix (author's transl)].

Statistics on long-term results in the treatment of cancer of the cervix are usually based on clinical data, so that they are not sufficiently randomized. The author attempted to follow up the subsequent fate of patients with cancer of the cervix who had been granted a disability pension from the sickness insurance fund of the workers' compensation board in North-Rhine Westphalia effective 1969/1970. In view of the fact that after a lapse of 8 to 9 years it is no longer possible to obtain medical data as completely as would be desirable, the inquiry was limited to finding out the amount paid out every month, the old-age pension, and the year of death.

Prognostic factors in pathological stage IIIA Hodgkin's disease.

From July 1968 through December 1977, 171 previously untreated patients with pathological stage IIIA Hodgkin's disease were evaluated at Stanford University Medical Center. All patients underwent lymphography, staging laparotomy and splenectomy; 86 patients were treated with total lymphoid irradiation (mantle followed by inverted-Y) to 4400 rad. These patients received prophylactic irradiation to the preauricular region (3600 rad/4-5 wk.

[The life expectancy after cardial infarct regarding the social-insurance company (author's transl)].

German insurance statistics indicate that the age for admission to disablement benefit after myocardial infarct has not increased during the past ten years, which means that there has been no improvement. From among the pensioners in the workers' annuity insurance (Rheinprovinz) as many as 63.0% survived the 7 years' observation period in the case of anterior and 80.

Autologous mixed lymphocyte reaction in patients with Hodgkin's disease. Evidence for a T cell defect.

The proliferative response of T lymphocytes cultured with autologous non-T lymphocytes is known as the autologous mixed lymphocyte reaction (MLR). This reaction can be demonstrated reproducibly in healthy individuals and has been shown to generate specific cytotoxic T cells, as well as T cells that regulate antibody synthesis and cell-mediated immunity. In this study, we demonstrate that the autologous MLR is impaired or absent in most patients with Hodgkin's disease regardless of age, sex, pathologic stage, or histologic classification.

[Social medicine and chronic liver disease (author's transl)].

Reports of 1,033 insured person in file of the Landesversicherungsanstalt Rheinprovinz, a public insurance agency, were evaluated; these individuals had started receiving annuities because of liver disease in the years 1969 and 1970. On evaluation 7-8 years later the following was found: annuities still running 21,3%, stop of annuities 1,3%, time limited annuities 3,5%, change to retirement annuities 34,8%, death 39,1%.

Nodular lymphoma: clinicopathologic correlations of parafollicular small lymphocytes and degree of nodularity.

One hundred thirty-four cases of Stages III and IV nodular non-Hodgkin's lymphoma, subclassified according to the criteria of Rappaport, were assessed for parafollicular small lymphocytes and vascular prominence and degree of nodularity. Statistically significant correlations with survival were found for the groups in the Rappaport classification but not for groups based on the amount of parafollicular small lymphocytes or vascular prominence (PSL grading). In the subgroup of patients with nodular poorly differentiated lymphocytic lymphoma, a significant difference in survival time was found between those with pure nodular patterns and those with 25--60% diffuse areas.