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Radiographic manifestations of Burkitt's lymphoma in American patients
ABSTRACTS
502
eye was performed and the histologic diagnosis confirmed the presence of a metastasis of the corticoadrenal tumor.-C. A. Montagnani Bilateral Wilms Tumors. R. A. Garrett and J. P. Donohue.
J Urol 120:586-588, (November), 1978. The current management of bilateral Wilms tumor is reviewed and the high incidence of concurrent anomalies with bilateral Wilms tumor is demonstrated in 4 of 5 children. Standardization of management has not been established. Of the 5 patients, 3 survived 30 mo to 11 yr without recurrent tumor. Two had unilateral nephrectomy and partial nephrectomy, while one had bilateral nephrectomy and allotransplant. Three survivors have had adjunctive chemotherapy and radiotherapy.--George Holcomb, Jr. Association of Hydrops Fetalis With Congenital Neuroblas-
T. J. Moss and L. Kaplan. Am J Obstet Gynecol 132:905-906, (December), 1978.
toma.
Hydrops fetalis, usually associated with erythroblastosis fetalis, is also seen with a number of other conditions. One of these, not widely recognized, is congenital neuroblastoma. A newborn infant is presented with severe hydrops at birth with no evidence of Rh or ABO incompatibility. Despite supportive therapy, the course was progressively downhill and the baby died 8 days after birth. Autopsy revealed a neuroblastoma in the right adrenal gland.--George Holcomb, Jr. A Therapeutic Approach to Childhood Pelvic Rhabdomyosarcoma Without Pelvic Exenteration. J. A. Ortega. J
Pediatr 94:205-209, (February), 1979. A therapeutic approach using chemotherapy rather than radical surgery as the initial treatment was employed in 13 children with pelvic rhabdomyosarcoma. One patient failed to respond to chemotherapy and required anterior pelvic exenteration. Eight patients are alive and free of disease 24 to 96 mo after diagnosis. Limited surgery for minimal residual disease was used in two patients. Radiation therapy at lower than conventional doses was used in 7 of 8 patients. The author believes this experience supports a therapeutic approach to childhood pelvic rhabdomyosarcoma with an initial chemotherapy regimen, allowing the use of surgical procedures that are less detrimental to pelvic organs without compromising survival.--George Holcomb, Jr. Rhabdomyosarcoma Complicating Multiple Neurofibromatosis. E. A. McKeen, J. Bodurtha, A. T. Meadows, et al. J
Pediatr 93:992-993, (December), 1978. Malignancy develops commonly in patients with multiple neurofibromatosis (von Recklinghausen disease), usually as transformation of a neurofibroma or other tissue of neural crest origin. These authors have found an association of neurofibromatosis and rhabdomyosarcoma, a third malignancy not clearly derived from the neural crest. They report 5 patients with neurofibromatosis among 84 patients with rhabdomyosarcoma. This observed coincidence is significantly greater than expected by chance.--George Holcomb, Jr.
Surgical Diagnosis of Mediastinal Lymphoma of Childhood.
Jack S. Elder and Robert J. Touloukian. Arch Surg 114:54-58, (January), 1979. Seventy-two children with mediastinal mass were seen at the Yale-New Haven Medical Center between 1964 and 1977. The lymphomas were typically located in the anterior or middle mediastinum in children 2 yr of age or older. Seventy-five percent of the children with lymphoma had enlarged supraclavicular or cervical lymph nodes. When diagnosis could not be made by biopsy of these nodes a limited anterior thoracotomy was utilized. Mediastinoscopy was apparently not used.--Edward J. Berman Treated Stage lib Hodgkin's Disease Complicated by Late Paraplegia. 14. Dayem-Abdel, Y. S. Oh, and R. Sil. Am J
Roentgenol 132:265-266, (February), 1979. A 17-yr-old male with Stage lib Hodgkin's disease in the neck and mediastinum presented 5 yr later with progressive neurologic symptoms and back pain with a myelographie block from T2 to T9. Further work-up revealed no evidence of recurrence of Hodgkin's disease. A combination of vincristine and total thoracic spine irradiation (his initial treatment was also irradiation) was started. After 1600 rad, he became totally paraplegic and at emergency laminectomy an epidural mass was removed with a histopathologic diagnosis of intraspinal lipoma. Neurologic status remained unchanged postoperatively and 5 yr following initial treatment he developed recurrence in the periaortic nodes. In this patient the absence of "B" symptoms, the lack of other areas of recurrence, and negative spine and soft tissue radiographs indicated a lower probability of recurrent Hodgkin's disease as the cause of the symptoms and laminectomy would be indicated prior to radiation of a previously irradiated spinal cord under these circumstances.--Randall W. Powell Radiographic Manifestations of Burkitt's Lymphoma in American Patients. M. R. Dunnick, G. H. Reaman, G. L.
Head, et al. Am J Roentgenol 132:1-6, (January), 1979. Forty consecutive patients ranging in age from 2-38 yr (median 12) presenting for evaluation of Burkitt's lymphoma were retrospectively reviewed for radiographic findings. Twenty-eight patients presented with abdominal pain or a palpable abdominal mass. Other forms of presentation included cervical adenopathy, nasopharyngeal adenopathy, and bone pain. Twelve of 40 patients had abnormal chest films with pleural effusion(s) being most common (9 patients). Effusions were associated with ascites in seven patients. Two patients had mediastinal adenopathy and one had hilar and mediastinal adenopathy. Neither of the latter three had effusions. Plain abdominal films revealed ascites in 9 patients, abdominal masses in 4, pelvic masses in 6, small bowel obstruction in 4, splenomegaly in 3, and hepatosplenomegaly in 1. Nine patients had radiographic findings of intrinsic disease of the GI tract. Locations included stomach (1), small bowel (7), and colon (1). Excretory urograms were abnormal in 14 of 34 studies, revealing intrinsic renal disease (2), ureteral obstruction (6), and extrinsic bladder compression (7). Four of the 40 patients had radiographic bone involvement with the humerus being most commonly involved (3).--Randall W. Powell
502
eye was performed and the histologic diagnosis confirmed the presence of a metastasis of the corticoadrenal tumor.-C. A. Montagnani Bilateral Wilms Tumors. R. A. Garrett and J. P. Donohue.
J Urol 120:586-588, (November), 1978. The current management of bilateral Wilms tumor is reviewed and the high incidence of concurrent anomalies with bilateral Wilms tumor is demonstrated in 4 of 5 children. Standardization of management has not been established. Of the 5 patients, 3 survived 30 mo to 11 yr without recurrent tumor. Two had unilateral nephrectomy and partial nephrectomy, while one had bilateral nephrectomy and allotransplant. Three survivors have had adjunctive chemotherapy and radiotherapy.--George Holcomb, Jr. Association of Hydrops Fetalis With Congenital Neuroblas-
T. J. Moss and L. Kaplan. Am J Obstet Gynecol 132:905-906, (December), 1978.
toma.
Hydrops fetalis, usually associated with erythroblastosis fetalis, is also seen with a number of other conditions. One of these, not widely recognized, is congenital neuroblastoma. A newborn infant is presented with severe hydrops at birth with no evidence of Rh or ABO incompatibility. Despite supportive therapy, the course was progressively downhill and the baby died 8 days after birth. Autopsy revealed a neuroblastoma in the right adrenal gland.--George Holcomb, Jr. A Therapeutic Approach to Childhood Pelvic Rhabdomyosarcoma Without Pelvic Exenteration. J. A. Ortega. J
Pediatr 94:205-209, (February), 1979. A therapeutic approach using chemotherapy rather than radical surgery as the initial treatment was employed in 13 children with pelvic rhabdomyosarcoma. One patient failed to respond to chemotherapy and required anterior pelvic exenteration. Eight patients are alive and free of disease 24 to 96 mo after diagnosis. Limited surgery for minimal residual disease was used in two patients. Radiation therapy at lower than conventional doses was used in 7 of 8 patients. The author believes this experience supports a therapeutic approach to childhood pelvic rhabdomyosarcoma with an initial chemotherapy regimen, allowing the use of surgical procedures that are less detrimental to pelvic organs without compromising survival.--George Holcomb, Jr. Rhabdomyosarcoma Complicating Multiple Neurofibromatosis. E. A. McKeen, J. Bodurtha, A. T. Meadows, et al. J
Pediatr 93:992-993, (December), 1978. Malignancy develops commonly in patients with multiple neurofibromatosis (von Recklinghausen disease), usually as transformation of a neurofibroma or other tissue of neural crest origin. These authors have found an association of neurofibromatosis and rhabdomyosarcoma, a third malignancy not clearly derived from the neural crest. They report 5 patients with neurofibromatosis among 84 patients with rhabdomyosarcoma. This observed coincidence is significantly greater than expected by chance.--George Holcomb, Jr.
Surgical Diagnosis of Mediastinal Lymphoma of Childhood.
Jack S. Elder and Robert J. Touloukian. Arch Surg 114:54-58, (January), 1979. Seventy-two children with mediastinal mass were seen at the Yale-New Haven Medical Center between 1964 and 1977. The lymphomas were typically located in the anterior or middle mediastinum in children 2 yr of age or older. Seventy-five percent of the children with lymphoma had enlarged supraclavicular or cervical lymph nodes. When diagnosis could not be made by biopsy of these nodes a limited anterior thoracotomy was utilized. Mediastinoscopy was apparently not used.--Edward J. Berman Treated Stage lib Hodgkin's Disease Complicated by Late Paraplegia. 14. Dayem-Abdel, Y. S. Oh, and R. Sil. Am J
Roentgenol 132:265-266, (February), 1979. A 17-yr-old male with Stage lib Hodgkin's disease in the neck and mediastinum presented 5 yr later with progressive neurologic symptoms and back pain with a myelographie block from T2 to T9. Further work-up revealed no evidence of recurrence of Hodgkin's disease. A combination of vincristine and total thoracic spine irradiation (his initial treatment was also irradiation) was started. After 1600 rad, he became totally paraplegic and at emergency laminectomy an epidural mass was removed with a histopathologic diagnosis of intraspinal lipoma. Neurologic status remained unchanged postoperatively and 5 yr following initial treatment he developed recurrence in the periaortic nodes. In this patient the absence of "B" symptoms, the lack of other areas of recurrence, and negative spine and soft tissue radiographs indicated a lower probability of recurrent Hodgkin's disease as the cause of the symptoms and laminectomy would be indicated prior to radiation of a previously irradiated spinal cord under these circumstances.--Randall W. Powell Radiographic Manifestations of Burkitt's Lymphoma in American Patients. M. R. Dunnick, G. H. Reaman, G. L.
Head, et al. Am J Roentgenol 132:1-6, (January), 1979. Forty consecutive patients ranging in age from 2-38 yr (median 12) presenting for evaluation of Burkitt's lymphoma were retrospectively reviewed for radiographic findings. Twenty-eight patients presented with abdominal pain or a palpable abdominal mass. Other forms of presentation included cervical adenopathy, nasopharyngeal adenopathy, and bone pain. Twelve of 40 patients had abnormal chest films with pleural effusion(s) being most common (9 patients). Effusions were associated with ascites in seven patients. Two patients had mediastinal adenopathy and one had hilar and mediastinal adenopathy. Neither of the latter three had effusions. Plain abdominal films revealed ascites in 9 patients, abdominal masses in 4, pelvic masses in 6, small bowel obstruction in 4, splenomegaly in 3, and hepatosplenomegaly in 1. Nine patients had radiographic findings of intrinsic disease of the GI tract. Locations included stomach (1), small bowel (7), and colon (1). Excretory urograms were abnormal in 14 of 34 studies, revealing intrinsic renal disease (2), ureteral obstruction (6), and extrinsic bladder compression (7). Four of the 40 patients had radiographic bone involvement with the humerus being most commonly involved (3).--Randall W. Powell