Rosai-Dorfman disease (RDD) is a nonmalignant histiocytic disorder of unknown origin
that is extremely rare. By immunohistochemistry, the RDD cells are characteristically
S-100 positive and CD1a negative. Emperipolesis is a common histopathological
finding, although not specific for RDD. Lymph node and cutaneous manifestations are
most frequent, but diverse organs can be affected. The clinical course is
unpredictable regardless of treatment. Here, we present a series of 8 cases
presenting lymph node and/or cutaneous lesions. Lymph node involvement was seen in
diverse regions, including mediastinal and retroperitoneal. The treatment response to
steroids was diversified, and the chemotherapy response was disappointing. Associated
autoimmune diseases (Sjögren syndrome and antiphospholipid syndrome) were observed in
2 patients. Regardless of therapy modality, these patients exhibited a favorable
prognosis in a follow-up duration that ranged from 15 to 80 months.
The expression of CD10 in the low-risk IPI group, and the expression of Bcl-2 in the high-risk IPI group can identify two subgroups of patients who might benefit from new risk-adaptive treatment approaches.
Socioeconomic status (SES) is a determinant of outcome in various types of cancer. The aim of this study is to analyze the impact of the SES in Hodgkin's lymphoma (HL). From 2001From to 2005 consecutive patients were prospectively followed in 5 institutions. Patients answered a questionnaire with a set of items used to determine the SES, and were then divided in 2 groups according to their SES score. There were 151 patients (78%) with a higher SES and 43 patients (22%) with a lower SES. The complete remission (CR) rate was 82%. Patients with a higher SES had a higher CR rate than those with a lower SES (85 vs. 72%, crude odds ratio 5 2.27, p 5 0.046). A lower SES and the performance status >1 were independently associated with a trend towards a lower CR, even when controlled for the other covariables of interest. Ten patients (5%) died during treatment. Death during treatment was associated with a lower SES (16 vs. 2%, p 5 0.001), a performance status >1 (p < 0.0001), a lower lymphocyte count (p 5 0.012) and weakly with a lower albumin level (p 5 0.065). With a median follow-up of 1.7 years, a higher SES was associated with a better 2-year overall survival (93 vs. 79%, p 5 0.01). In underprivileged countries, patients with a lower SES require a more careful monitoring during treatment, possibly with specific support measures. Regimens more intense than doxorubicin, bleomycin, vinblastine and dacarbazine could pose a prohibitive risk of complications in this group of patients. ' 2006 Wiley-Liss, Inc.
Endoscopic evaluation understaged tumors in all clinical stages but really T1. Helicoidal axial CT scan reformatted to 1.0 mm thick played an important role in correctly staging more advanced AVC laryngeal tumors. Radiologic signs, here identified as GRACI, may be very helpful for tomographic staging and patient treatment.
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