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5 results

  • Head and neck squamous cell cancer associated with lymphoproliferative malignancies is aggressive

  • L Li, L Hamilton, J Montgomery, M Stewart
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 5 / May 2020
    Published online by Cambridge University Press:
    20 April 2020, pp. 460-462
    Print publication:
    May 2020
  • Background

    Patients with non-Hodgkin's lymphoma and chronic lymphocytic leukaemia are at an elevated risk of further malignancy. Head and neck squamous cell carcinoma often presents with cervical lymph node metastasis, and can pose a diagnostic challenge in patients with non-Hodgkin's lymphoma or chronic lymphocytic leukaemia who may have pre-existing palpable neck nodes.

    Methods

    A retrospective case review of a health board was conducted to identify patients with head and neck squamous cell carcinoma with a previous diagnosis of non-Hodgkin's lymphoma or chronic lymphocytic leukaemia.

    Results

    Four patients with head and neck squamous cell carcinoma that developed after non-Hodgkin's lymphoma or chronic lymphocytic leukaemia were identified. Two patients had a background of non-Hodgkin's lymphoma treated with chemotherapy. The remaining two patients had a background of chronic lymphocytic leukaemia under active surveillance. Three out of the four patients died within 30 months of diagnosis.

    Conclusion

    Head and neck squamous cell carcinoma following non-Hodgkin's lymphoma or chronic lymphocytic leukaemia is aggressive. A heightened clinical suspicion is essential to facilitate early diagnosis and treatment of head and neck squamous cell carcinoma in patients with dual pathology.

  • Synchronous or metachronous lymphoma and metastatic cutaneous squamous cell carcinoma in the head and neck region: a diagnostic and management dilemma

  • I Kader, B Leavers, S Shashinder, B Wylie, K-K Chi, P Sundaresan
  • Journal:
    The Journal of Laryngology & Otology / Volume 130 / Issue S4 / July 2016
    Published online by Cambridge University Press:
    04 August 2016, pp. S45-S49
    Print publication:
    July 2016
  • Objective:

    To review our experience of managing patients with a dual diagnosis of metastatic cutaneous squamous cell carcinoma in the head and neck region and low-grade non-Hodgkin lymphoma. The secondary aim was to evaluate the utility of 18F-fluorodeoxyglucose positron emission tomography during diagnosis.

    Methods:

    Patients diagnosed with metastatic cutaneous squamous cell carcinoma of the head and neck and low-grade non-Hodgkin lymphoma, in a five-year period, were identified. Patient, tumour and treatment characteristics were identified. 18F-fluorodeoxyglucose positron emission tomography imaging was reviewed and correlated with histopathology findings.

    Results:

    Eight patients were identified. There was a delay in diagnosis of metastatic squamous cell carcinoma in two patients. 18F-fluorodeoxyglucose positron emission tomography differentiated metastatic squamous cell carcinoma from low-grade non-Hodgkin lymphoma with a sensitivity of 88.2 per cent and a specificity of 94.7 per cent. In 38 per cent of patients, compromises in management had to be made.

    Conclusion:

    The management of metastatic squamous cell carcinoma can be challenging in patients with low-grade non-Hodgkin lymphoma. 18F-fluorodeoxyglucose positron emission tomography can be useful in the diagnosis of metastatic squamous cell carcinoma in patients with low-grade non-Hodgkin lymphoma.

  • Chapter 18 - Pharmacological and nonpharmacological treatment of chemotherapy-induced nausea and vomiting

  • from Section 3 - Management of maternal complications during treatment
  • Edited by Gideon Koren, University of Toronto, Michael Lishner, Tel-Aviv University
  • Book:
    Cancer in Pregnancy and Lactation
    Published online:
    05 December 2011
    Print publication:
    10 November 2011, pp 134-142

  • Summary

    This chapter describes the diagnosis, treatment, and prognosis for non-Hodgkin's lymphoma (NHL) in pregnancy. Indolent NHL includes follicular lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, which are extremely rare during pregnancy. Aggressive NHL, which includes large B-cell lymphomas, mantle cell lymphoma, and mature T-cell and NK-cell neoplasms, represents the majority of NHL cases diagnosed during gestation. Due to the aggressive course of these lymphomas, most patients should be treated promptly with intensive combination chemotherapy. Aggressive NHL group includes precursor (B or T) lymphoblastic leukemia/lymphoma and Burkitt's lymphoma. Most chemotherapy regimens for very aggressive lymphomas include high-dose methotrexate, which among the currently used anticancer drugs, poses the greatest risk to the developing fetus when administered during the first trimester. Placental involvement in pregnancy associated NHL is extremely rare, but a single case of dissemination to the fetus has been reported.

  • Chapter 15 - Nonobstetrical surgical interventions during pregnancy

  • from Section 2 - Fetal effects of cancer treatments and interventions
  • Edited by Gideon Koren, University of Toronto, Michael Lishner, Tel-Aviv University
  • Book:
    Cancer in Pregnancy and Lactation
    Published online:
    05 December 2011
    Print publication:
    10 November 2011, pp 95-116

  • Summary

    This chapter discusses the treatment of acute and chronic leukemia during pregnancy. Leukemia occurs very rarely during pregnancy. The majority of cases are acute leukemia; of which two-thirds are myeloblastic (AML) and one-third are lymphoblastic (ALL). Chronic myeloid leukemia (CML) is found in less than 10% of leukemia cases during pregnancy, and chronic lymphocytic leukemia (CLL) is extremely rare. The treatment of CML has evolved dramatically since the introduction of tyrosine kinase inhibitors (TKI). There are several options for the treatment of CLL. When treatment is indicated, cytoreduction may be accomplished mechanically with leukapheresis. The most popular drugs are: chlorambucil, which is contra-indicated during the first trimester of pregnancy because of its teratogenicity; and fludarabine, an anti-metabolite. Corticosteroids may be used for the treatment of autoimmune complications, as in nonpregnant patients. Hairy cell leukemia is very rare during pregnancy. Interferon alpha was historically used in the treatment of this disease.

  • Delayed diagnosis of splenic rupture following minor trauma: Beware of comorbid conditions

  • Mohamed Ali Peera, Eddy S. Lang
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 6 / Issue 3 / May 2004
    Published online by Cambridge University Press:
    21 May 2015, pp. 217-219
    Print publication:
    May 2004
    • Article
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  • Although rare, spontaneous splenic rupture has been reported in cases of chronic lymphocytic leukemia (CLL). In contrast, there are no published reports of splenic injury resulting from minor trauma in CLL patients. We report the case of an 81-year-old woman with a history of CLL, who presented with minor trauma to her coccygeal region, and was found to have a splenic rupture. We briefly describe the incidence, pathogenesis, presentation, diagnosis, management and prognosis of splenic injury, especially in cases with a history of splenomegaly.