exudates and Hodgkin-Disease

Multiple lung cavitations and endobronchial nodules are rare presentations of newly diagnosed and recurrent Hodgkin's disease. The clinical and radiological features can be confused with pulmonary tuberculosis, which can be difficult to exclude in endemic areas. However, the presence of endobronchial nodules point, towards Hodgkin's disease. Differential diagnosis is aided by the fact that these lesions usually respond promptly to specific therapy. We present a case of an adolescent male who had constitutional and pulmonary symptoms associated with pulmonary cavities and endobronchial nodules subsequently confirmed to be Hodgkin's disease.

Topics: Adolescent; Bronchial Neoplasms; Diagnosis, Differential; Hodgkin Disease; Humans; Lung; Malaysia; Male; Neoplasm Recurrence, Local; Radiography

Lymphoma is a relatively common group of neoplasms diagnosed in hospital practice. This study aims to elucidate the pattern of this disease encountered in a public service hospital of the Ministry of Health, Malaysia.. A total of 98 biopsies from 92 patients were retrieved from the archives of Klang General Hospital, from January 1993 to June 1999. The histopathology of these biopsies were reviewed by two pathologists, and confirmed cases were sub-classified according to the WHO proposed scheme. Immunohistochemical staining with a panel of lymphoid antibodies was performed in aid of sub-typing. All cases were screened for Epstein-Barr virus association by in-situ hybridisation technique.. 15 biopsies were excluded from further analysis due to inadequate material for further study or diagnosed as non-lymphoma. The remaining 83 biopsies were from 80 patients. 52 were males and 28 females. The male: female ratio was 1.9:1. There were 64 Malays, 4 Chinese and 12 Indians. The ages of patients ranged from 3 to 86 years with a mean age of 50.5 years. 73.8% of the diagnostic materials were nodal tissue. Fourteen patients had Hodgkin's lymphomas (HL), 6 being mixed-cellularity, 4 nodular-sclerosis, 1 lymphocyte-rich, 2 lymphocyte-depleted, 1 lymphocyte-predominant, and 66 had non-Hodgkin's lymphomas (NHL). The HL: NHL ratio was 1:4.7. Of the 66 cases of NHL, 9 (13.6%) were T- and 57 (86.4%) B-cell types. The most common NHL encountered was diffuse large B-cell type. Follicular-lymphoma constituted 16.7% of these NHL. 77.8% of T-NHL and 10.5% of B-NHL was EBV associated. Double staining of EBER with CD20 and EBER with CD3 in the T-NHL cases showed that in a majority of the cases, EBER-positive large cells did not express the T- or B- cell antigen.. There is a relatively small proportion of T-cell lymphoma in this series of Asian patients. The reason is thought to be the lower utilisation rate of this hospital service by ethnic Chinese, as reflected by the hospital admission data.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Child; Child, Preschool; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Hospitals, Public; Humans; Lymph Nodes; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged; RNA, Viral

Lymphoma is a highly heterogeneous group of malignant disease. This study aimed to elucidate the pattern of lymphoma in the East Malaysian patient population. 107 cases of confirmed lymphomas from East Malaysian biopsy material were retrieved from the files of the Department of Pathology, University of Malaya, in the 3-year period between 1981 to 1983. With the use of a panel of lymphoid antibodies, the disease was sub-classified using the Rye classification for Hodgkin's lymphoma (HL) and the REAL classification for non-Hodgkin's lymphoma (NHL). All of the cases were tested for the presence of the Epstein-Barr virus by EBER-ISH. There were 11 (10.3%) HL, 80 (74.7%) B-NHL and 16 (15%) T-NHL. The HL:NHL ratio was 1:9. The most common tumour in children was Burkitt's lymphoma 7/13 (53.8%). In the adult group, there were 72/94 (76.6%) B-NHL ¿diffuse large cell type 51 (of which 2 were CD30+), Burkitt's lymphoma 8, follicular lymphoma 5, low grade MALT 2, mantle cell type 1 and not otherwise specified due to poor morphology 5¿, 13/94 (13.8%) T-NHL and 9/94 (9.6%) HL. Of the 9 adult HL, the most common subtype was nodular sclerosis (6, 66.7%). The EBER positive rate in classical HL, T-NHL, BL and B-NHL were 33.3%, 56.3%, 60.0% and 3.1% respectively. In conclusion, the spectrum of lymphoma seen in East Malaysia was rather similar to West Malaysia except for the very low prevalence of peripheral T-cell lymphoma (PTCL) in Sarawak (3.3%).

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Herpesvirus 4, Human; Hodgkin Disease; Hospitals, University; Humans; Incidence; Lymphoma; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged

The Epstein-Barr virus (EBV) has been implicated as a contributing factor in the development of Hodgkin's disease. Western cases of Hodgkin's disease have shown the presence of EBV in Hodgkin and Reed-Sternberg cells in approximately 50%. We studied a total of 100 consecutive cases of Hodgkin's disease from Malaysia, with the aim to elucidate its association with EBV in a multi-ethnic Asian population. Of 34 patients (34%) less than 15 years of age (childhood), 25 had classical Hodgkin's disease (eight nodular sclerosis, 16 mixed cellularity, one lymphocyte depleted) and nine had lymphocyte predominance Hodgkin's disease. Of the 66 from patients aged 15 years and above, 33 had nodular sclerosis, 24 mixed cellularity, two lymphocyte depleted, one unclassifiable and six lymphocyte predominance Hodgkin's disease. The ethnic distribution of classical Hodgkin's disease was: Malay 23, Chinese 32 and Indian 30 (Malay:Chinese:Indian = 1:1.4:1.3), and the ethnic distribution in the 15 cases of lymphocyte predominance Hodgkin's disease was: Malay four, Chinese 10 and Indian one. Taking into account the ethnic distribution of the general population and of hospital admissions, there appears to be a significant predilection of classical Hodgkin's disease cases in ethnic Indian compared to non-Indian patients (chi-squared test, 0.025 > P > 0.01). Eighty-one cases were tested for the presence of EBV by in situ hybridization for EBV encoded RNA, and 57 cases by immunostaining for EBV latent membrane protein 1. In the younger age group, all except one of the 15 cases (nine mixed cellularity, six nodular sclerosis) showed the presence of EBV (93%). In the older age group, EBV was detected (52%) in the following proportion: 6/27 nodular sclerosis, 19/22 mixed cellularity, 1/2 lymphocyte depleted, 1/1 unclassifiable. None of the 14 cases of lymphocyte predominance Hodgkin's disease showed the presence of EBV in the Hodgkin and Reed-Sternberg cells. The findings suggest a strong association of EBV with Hodgkin's disease in Malaysians (41/67, 61%), in particular childhood cases (93%). In adults, the association with EBV is significantly higher in the mixed cellularity subtype (86%) compared with the nodular sclerosis subtype (22%).

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Ethnicity; Herpesviridae Infections; Herpesvirus 4, Human; Hodgkin Disease; Humans; Malaysia; Middle Aged; Tumor Virus Infections

Non-Hodgkin's lymphoma has increased in incidence in many countries, particularly in the West. Advances in diagnostic methods and the understanding of the disease over time pose a challenge to the interpretation of these trends. The aim of this study was to determine if the disease has increased in Singapore, a newly industrialized Asian country, and to examine the possible factors that may account for any observed changes.. Data from the population-based Singapore Cancer Registry for the period 1968 to 1992 were reviewed to determine time trends based on sex and ethnic group. The Poisson regression model was fitted to the cross-tabulated data to obtain the adjusted incidence density ratios.. A total of 1988 cases of non-Hodgkin's lymphoma were included in the analysis. There was an overall increase in incidence among both Chinese and Malaysians. However, the rate of increase was greater in females (age-standardized rate from 1.8 per 100,000 in 1968-1972 to 4.5 per 100,000 in 1988-1992) than in males (3.2 per 100,000 to 5.9 per 100,000 in the same time periods). Between ethnic groups, Malay females were at higher overall risk compared with their Chinese counterparts (incidence density ratio 1.32; 95% confidence interval, 1.08-1.61). Although a substantial proportion of patients diagnosed with Hodgkin's disease between 1968 and 1972 were reclassified on review, using present criteria, as having non-Hodgkin's lymphoma, it is unlikely that this, and other recent changes in histologic interpretation, could have accounted for an increase of this magnitude.. Non-Hodgkin's lymphoma has increased in incidence among the Chinese and Malay populations in Singapore. The pattern of increase differs from that of the common cancer sites, and suggests the need to look for environmental and genetic factors that have not yet been elucidated.

Topics: China; Ethnicity; Female; Hodgkin Disease; Humans; Incidence; India; Lymphoma, Non-Hodgkin; Malaysia; Male; Poisson Distribution; Population Surveillance; Registries; Regression Analysis; Risk Factors; Sex Factors; Singapore; Time Factors

In this study, we have sequenced the C-terminal part of the Epstein-Barr virus (EBV)-BNLF-1 gene encoding for the latent membrane protein-1 from tissues of EBV-positive Danish Hodgkin's disease (HD) and of Danish and Malaysian peripheral T-cell lymphomas (PTLs) and from tonsils of Danish infectious mononucleosis (IM). Our study showed that some of the 7 single-base mutations and the 30-bp deletion previously detected between codons of amino acid 322 and 366 in the BNLF-1 gene of the nasopharyngeal carcinoma cell line CAO were present in all Malaysian PTLs and in 60% of the Danish PTLs. In HD and the IM cases, the mutations were present in about 30%. The 30-bp deletion and the single base mutations occurred independently, and mutations were detectable in the majority of EBV type B-positive cases. These findings suggest that the 30-bp deletion and the 7 single-base mutations in the C-terminal part of the CAO-BNLF-1 gene do not characterize a new EBV type A substrain. Rather, some of the positions of single base mutations and the 30-bp deletion are hot spots that may have mutated independently through the evolution of EBV strains.

Topics: Amino Acid Sequence; Antigens, Viral; Base Sequence; Denmark; DNA, Neoplasm; DNA, Viral; Gene Expression Regulation, Viral; Gene Frequency; Genes, Viral; Herpesviridae Infections; Herpesvirus 4, Human; Hodgkin Disease; Humans; Infectious Mononucleosis; Lymphoma, T-Cell, Peripheral; Malaysia; Molecular Sequence Data; Sequence Deletion; Tumor Virus Infections; Viral Matrix Proteins; Viral Structural Proteins

Topics: Adolescent; Adult; Age Factors; Antigens, Surface; Child; Child, Preschool; Ethnicity; Female; Hodgkin Disease; Humans; Infant; Leukemia; Leukemia, Lymphoid; Lymphoma; Malaysia; Male; Middle Aged; Sex Factors; T-Lymphocytes

Topics: Child; Child, Preschool; Female; Hodgkin Disease; Humans; Infant; Lymphoma; Malaysia; Male