Computed Tomography as an Adjunct in the Staging of Hodgkin's Disease and Non-Hodgkin's Lymphomas

PURPOSE: Computed tomography (CT) scans of the neck and chest are obtained at diagnosis of Hodgkin's disease to establish disease extent, plan radiotherapy, and serve as baseline studies for subsequent evaluation of response to therapy. However, differences in interpretation may occur even among experienced radiologists. This study was designed to test the extent of variation among expert radiologists' interpretations and to assess how their interpretations differed from that of the primary (institutional) radiologists. MATERIALS AND METHODS: Five radiologists independently reviewed randomly selected CT scans of 59 patients enrolled onto two Pediatric Oncology Group Hodgkin's disease treatment protocols. For each patient, 31 potential disease sites were scored as positive, negative, uncertain, or unassessable. Agreement among the reviewers and between the reviewers and the primary readers was analyzed. RESULTS: For 58% of the sites, at least four of the five reviewers agreed in ≥ 80% of the cases. Kappa analysis showed moderate agreement in approximately two thirds of the sites and poor agreement in the remainder. There was moderate agreement between a majority of the expert readers and the primary radiologist reports for approximately one third of the sites, and agreement was poor in two thirds. CONCLUSION: There are disparities among radiologists' interpretations of cervical-thoracic CT imaging of patients with Hodgkin's disease. This variability may affect patient care and the performance and results of multi-institutional clinical trials. We propose that a standardized method of reporting might improve the consistency of interpretation of CT scans in these patients.

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Absence of the t(2;5) in Hodgkin's disease [see comments]

Blood ◽

10.1182/blood.v85.10.2845.bloodjournal85102845 ◽

1995 ◽

Vol 85 (10) ◽

pp. 2845-2847 ◽

Cited By ~ 32

Author(s):

LM Weiss ◽

JR Lopategui ◽

LH Sun ◽

OW Kamel ◽

CH Koo ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Blot Hybridization ◽

Southern Blot Hybridization ◽

Large Cell ◽

Common Finding ◽

Chain Reaction ◽

Polymerase Chain ◽

Hodgkin's Lymphomas

The cytogenetics of Hodgkin's disease (HD) is poorly understood. However, a t(2;5) is a common finding in CD30+ anaplastic large cell lymphoma (ALCL), a neoplasm thought by some to be closely related to HD. Recently, the t(2;5) has been cloned and found to represent fusion of the NPM gene with the ALK gene. Using Southern blot hybridization, one group has reported finding rearrangements of NPM in a proportion of cases of both ALCL and HD. In the current study, we used a highly sensitive reverse transcriptase-polymerase chain reaction methodology to analyze 34 cases of HD for the t(2;5). We were unable to find polymerase chain reaction evidence for the t(2;5) in any of the cases of HD, a result significantly different from our previous study of CD30+ non-Hodgkin's lymphomas (P < .02) including ALCL (P < .04), using identical methods. Our results do not support the hypothesis that the t(2;5) represents a common chromosomal abnormality for both HD and ALCL.

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Non-Hodgkin's lymphomas after treatment of Hodgkin's disease

Archives of Internal Medicine ◽

10.1001/archinte.143.3.427 ◽

1983 ◽

Vol 143 (3) ◽

pp. 427-427 ◽

Cited By ~ 5

Author(s):

R. I. Fisher

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Hodgkin's Lymphomas

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The bcl-2 oncogene in Hodgkin's disease arising in the setting of follicular non-Hodgkin's lymphoma

Blood ◽

10.1182/blood.v83.1.223.223 ◽

1994 ◽

Vol 83 (1) ◽

pp. 223-230 ◽

Cited By ~ 25

Author(s):

DP LeBrun ◽

BY Ngan ◽

LM Weiss ◽

P Huie ◽

RA Warnke ◽

...

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Chromosomal Translocation ◽

Prior History ◽

Barr Virus ◽

Molecular Events ◽

Chromosomal Breakpoints ◽

High Level ◽

Hodgkin's Lymphomas ◽

Hodgkin Cells

Abstract Expression of the bcl-2 proto-oncogene on chromosome 18 is deregulated by the 14; 18 chromosomal translocation, an abnormality that is consistently associated with follicular non-Hodgkin's lymphomas (NHL). Because bcl-2 is believed to function by prolonging cell survival rather than by increasing proliferation, the presence of t(14; 18) in Hodgkin's disease (HD) would have profound implications for the pathogenesis of this neoplasm. We evaluated 32 cases of HD for t(14; 18) by polymerase chain reaction (PCR). These results were correlated with expression of bcl-2 oncogenic protein by Hodgkin cells and with the presence of Epstein-Barr virus (EBV), as determined by immunohistochemistry or in situ hybridization. PCR provided evidence of t(14; 18) in only 2 HD cases (6%), both of which were associated with a prior history of follicular lymphoma, and both of which were among the 7 cases (22%) with strong bcl-2 expression in Hodgkin cells. In at least 1 of the cases, the translocation involved identical chromosomal breakpoints in both types of lymphoma. Furthermore, 7 additional cases of combined follicular NHL and HD showed strong bcl-2 staining in Hodgkin cells. Although EBV was detected in 6 of 30 cases, it was not associated with t(14; 18) and usually not with strong bcl-2 expression. These results suggest that a small proportion of HD cases might evolve from follicular NHL, possibly through molecular events superimposed on the t(14; 18). High-level bcl-2 expression in Hodgkin cells is a potentially useful but not definitive marker for these cases.

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Adriamycin in Combination and in Combined Treatment Modalities.

Tumori Journal ◽

10.1177/030089167406000505 ◽

1974 ◽

Vol 60 (5) ◽

pp. 393-416 ◽

Cited By ~ 2

Author(s):

Gianni Bonadonna ◽

Gianni Beretta ◽

Gabriele Tancini ◽

Mario De Lena ◽

Silvio Monfardini ◽

...

Keyword(s):

Combination Chemotherapy ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Combined Treatment ◽

Treatment Modalities ◽

Random Allocation ◽

Malignant Lymphomas ◽

Carcinoma Of The Breast ◽

Acute Leukemias ◽

Hodgkin's Lymphomas

The paper reviews the current strategic approach of the Istituto Nazionale Tumori of Milan with adriamycin (ADM) in combination with other drugs as well as in combined treatment modalities for various neoplasias of adults and children. The preliminary results obtained during the past four years in malignant lymphomas, acute leukemias, carcinoma of the breast, and neuroblastoma are reported. With the exception of the group of malignant lymphomas treated with a quintuple drug regimen (MABOP), none of the patients admitted the different trials had received chemotherapy. Most studies were controlled with random allocation to two different combinations. Cross over was carried out on relapse. In advanced Hodgkin's disease, non-Hodgkin's lymphomas, mammary carcinoma, soft tissue sarcomas, embryonal carcinoma of testicle, ovarian carcinoma, and multiple myeloma the main purpose of the study was to develop two independent non cross resistant combinations to be used sequentially in subsequent trials. There is a preliminary evidence that this is being obtained in Hodgkin's disease (ABVD vs. MOPP), in non Hodgkin's lymphomas (ABP vs. CVP) and carcinoma of the breast (ADM + VCR vs. CMF). In the other groups the patients were too few to permit conclusions. In acute lymphoblastic leukemia, in the leukemic phase of non-Hodgkin's lymphomas as well as in the group of solid tumors of children, combination chemotherapy and combined treatment modalities were not designed in a controlled fashion. ADM was introduced in all treatments because of its definite activity when employed as a single agent in refractory disease. Few therapeutic results are as yet available since most studies were started in 1974. However, the remission rate observed in the limited group of acute leukemias treated with ADM + VCR + prednisone is worth noting. The wide spectrum of activity of ADM justifies its use in several protocols of combination chemotherapy and in combined treatment modalities. With both full and reduced regimens drug tolerance was good, and in practically all studies more than 80 % of the optimal dose of ADM could be administered. All trials were properly designed to avoid a total dose of ADM exceeding 550–600 mg/m2 since cardiomyopathy (reversible) was observed in 2 patients after 600 mg/m2.

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Expression of functional CD40 antigen on Reed-Sternberg cells and Hodgkin's disease cell lines

Blood ◽

10.1182/blood.v85.3.780.bloodjournal853780 ◽

1995 ◽

Vol 85 (3) ◽

pp. 780-789 ◽

Cited By ~ 151

Author(s):

A Carbone ◽

A Gloghini ◽

V Gattei ◽

D Aldinucci ◽

M Degan ◽

...

Keyword(s):

Flow Cytometry ◽

Cell Lines ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Growth Factor Receptor ◽

Large Cell ◽

Distinct Pattern ◽

Histologic Subtype ◽

Hodgkin's Lymphomas

CD40 is a member of the nerve growth factor receptor family, showing a significant homology to the Hodgkin's disease (HD)-associated antigen CD30 and is capable of transduce growth signals in a number of cell types. A series of 312 lymphoma samples, including 139 cases of HD, 32 cases of CD30+ anaplastic large cell (ALC) lymphomas, 141 cases of other non-Hodgkin's lymphomas (NHLs), and a panel of HD- or NHL-derived cell lines, were evaluated for CD40 expression by immunostaining of paraffin embedded sections, cell smears and flow cytometry. CD40 was strongly expressed with a highly distinct pattern of staining on Reed- Sternberg (RS) cells and variants in 100% (139/139) of HD cases, irrespective of their antigenic phenotype (T, B, non T-non B) and histologic subtype of HD. Conversely, CD40 was immunodetected on only one third (12/32; 37%) of ALC lymphoma cases and on 105 of 127 B-cell NHLs. The relative cell density of CD40 on HD cell lines (L-428, KM-H2, HDLM-2) as assessed by flow cytometry was significantly higher than on all other lymphoma cells analyzed. Engagement of CD40 by its soluble ligand (CD40L) enhanced both clonogenic capacity and colony cell survival of HD cell lines. Such effect was potentiated by interleukin-9 costimulation in KM-H2 cells. Finally, we have shown that in vitro rosetting of activated CD4+ T cells to HD cells (L-428) is mediated in part by the CD40/CD40L adhesion pathway. Our data indicate that CD40 is a useful antigen for immunodetection and identification of tumor cells in all subtypes of HD, and suggest that it may play a role in the regulation of RS cell expansion and the contact-dependent interactions of these cells with cytokine-producing T lymphocytes.

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