Hematologic Malignancies

 
 

Hematologic Malignancies

  • Treatment Options for Primary Cutaneous Lymphoma? A 76-year-old woman presented with erythematous cutaneous nodules over the scapula. Biopsy confirmed a diagnosis of large B-cell lymphoma. CT scans show no other disease. What would you recommend?
  • Novel Treatment Regimens for Refractory Hodgkin's Disease? A 42-year-old man was diagnosed with Hodgkin's disease. He has had multiple relapses over the years despite autologous BMT and multiple courses of chemo- and radiotherapy. What would you advise?
  • Follow-up Therapy for Large Cell Lymphoma of the Stomach? A 60-year-old woman with large cell lymphoma of the stomach was started on CHOP chemotherapy. CT scans were negative and bone marrow was normal. Would you recommend surgery and/or radiation therapy?
  • Bulky-disease Hodgkin's Lymphoma in a Pregnant Woman? A previously healthy pregnant 28-year-old woman was diagnosed with Hodgkin's lymphoma, nodular sclerosing type.
  • Tonsillar B-Cell Lymphoma With No B Symptoms? What treatment would you recommend for a 16-year-old boy with bilateral tonsillar diffuse large B-cell lymphoma?
  • Ask the Experts - Postsplenectomy Therapy in Diffuse Large B-cell... What is the best treatment for a 51-year-old woman with diffuse large B-cell lymphoma of the spleen who underwent splenectomy? There was no other localization of disease.
  • Ask the Experts - Treatment of Persistent Lymphoma? A 42-year-old female presented with left supraclavicular lymphadenopathy and no clinical symptoms. Biopsy of the lymph node revealed follicular mixed non-Hodgkin's lymphoma with an increased large cell component (> 15/hpf). Immunophenotyping confirmed the diagnosis. Bone marrow is negative. A right breast mass was found on computed tomography (CT); biopsy revealed diffuse large-cell lymphoma. A
  • Ask the Experts - Recurrent Hodgkin's Disease in the Neck? One year ago, a 22-year-old male was diagnosed with Hodgkin's disease, cell type nodular sclerosis, stage IIa. Initial staging showed disease limited to the right neck and mediastinum. He received 8 courses of doxorubicin, bleomycin, vinblastine, and prednisone (ABVP) followed by radiation to the mediastinum; follow-up CT scans of the chest and neck showed considerable shrinkage of the tumor. Gall
  • Ask the Experts - Concurrent Lymphoma and Transitional Cell Carcinoma? A 52-year-old male was diagnosed with bulky right-sided mediastinal diffuse large-cell lymphoma. The right hilar mass envelopes the upper, middle, and lower lobe bronchi; it extends to the subcarina and envelopes the right pulmonary artery and superior vena cava below the azygous. There are multiple nodules at the right upper lobes, with the largest measuring 3x5 cm. Biopsied specimens were all fr
  • Ask the Experts - Treatment of Castleman's Disease? A 34-year-old man presented with a 6-month history of abdominal pain. CT scan showed a 9-cm mesenteric abdominal mass. On laparotomy, an unresectable mesenteric tumor was found, consistent with Castleman's disease, plasma cell variant, localized. The patient had an elevated erythrocyte sedimentation rate and hypergammaglobulinemia. He is asymptomatic after 6 cycles of chemotherapy with cyclophosph
  • Ask the Experts - Hodgkin's Disease in the Larynx? What is the best way to treat a 29-year-old woman with a vocal cord mass? The mass is 2 x 1.5 cm; biopsy results are consistent with Hodgkin's disease. There are no other areas of disease. What is appropriate therapy: 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus radiation or radiation alone?
  • Ask the Experts - Whole Abdominal Radiation for a Non-Hodgkin's... Is there any role for whole abdominal radiation therapy in a 40-year-old woman with primary ovarian non-Hodgkin's lymphoma with massive abdominal disease, who received 6 cycles of CHOP and is in clinical remission?
  • Ask the Experts - Residual Mass in Hodgkin's Disease? Should this patient now receive radiotherapy to the mediastinum to complete the original plan, or should this be considered primary refractory disease, suggesting the use of high-dose chemotherapy and stem-cell rescue followed by consolidative x-ray therapy?