Email this article Differential diagnosis of thymic hyperplasia and mediastinal tumor in patients with Hodgkin's lymphoma after chemotherapy
- Authors: Moiseeva T.N.1, Al'-Radi L.S.1, Shitareva I.V.1, Shevelev A.A.1, Kostina I.E.1, Kravchenko SK1, Kremenetskaya AM1, Tsyba NN1, Moiseeva TN2, Al-Radi LS2, Shitareva IV2, Shevelev AA2, Kostina IE2, Kravchenko SK2, Kremenetskaya AM2, Tsyba NN2
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Affiliations:
- ФГБУ Гематологический научный центр Минздравсоцразвития России
- Hematological Research Center, Moscow
- Issue: Vol 83, No 7 (2011)
- Pages: 47-50
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30882
- ID: 30882
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Abstract
Material and methods. The examination of 182 HD patients aged 16-71 years (median 28 years) included chest x-ray computed tomography (XCT) at baseline, during treatment, each 3 months, ultrasound investigation of the chest and abdominal cavity. All the patients received 6-8 courses of the treatment according to the program BEACOPP-14 followed by radiotherapy on the residual tumor in 137 patients, or not followed in 45 patients.
Results. Soft tissue tumor in the anterior mediastinum was detected in 14 (31%) from 45 unirradiated patients (age 19-31 years, median 24 years) 1 to 10 months (median 3.5 months) after chemotherapy. The analysis of the data of ultrasound investigation and tomography identified a mediastinal lesion as thymic hyperplasia. The patients are now in remission with follow-up median 21 months (13-36 months). No recurrence was registered.
Conclusion. Young HD patients with unirradiated mediastinum develop thymic hyperplasia in 31% cases within one year after chemotherapy. In view of this, detection of the lesion in the anterior mediastinum after CT demands complex examination for differential diagnosis of thymic hyperplasia with tumor recurrence to avoid unwanted intensification of the treatment.
About the authors
Tat'yana Nikolaevna Moiseeva
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: taniamoiseeva@mail.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- канд. мед. наук, ст. науч. сотр. ГНЦ; ФГБУ Гематологический научный центр Минздравсоцразвития России
Lyubov' Sattarovna Al'-Radi
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: alradi@blood.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- канд. мед. наук, науч. сотр. ГНЦ; ФГБУ Гематологический научный центр Минздравсоцразвития России
Irina Vadimovna Shitareva
ФГБУ Гематологический научный центр Минздравсоцразвития РоссииОтделение химиотерапии гематологических заболеваний и интенсивной терапии- врач-гематолог, тел.: 8-495-613-24-94; ФГБУ Гематологический научный центр Минздравсоцразвития России
Aleksandr Abramovich Shevelev
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: asw_99@mail.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- врач, зав. отд-нием УЗИ-диагностики; ФГБУ Гематологический научный центр Минздравсоцразвития России
Irina Eduardovna Kostina
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: ikost@list.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- канд. мед. наук, врач-рентгенолог; ФГБУ Гематологический научный центр Минздравсоцразвития России
S K Kravchenko
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: krav@blood.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- канд. мед. наук, зав. отд-нием гематологии; ФГБУ Гематологический научный центр Минздравсоцразвития России
A M Kremenetskaya
ФГБУ Гематологический научный центр Минздравсоцразвития РоссииОтделение химиотерапии гематологических заболеваний и интенсивной терапии- зав. отд-нием гематологии, тел.: 8-495-613-26-43; ФГБУ Гематологический научный центр Минздравсоцразвития России
N N Tsyba
ФГБУ Гематологический научный центр Минздравсоцразвития России
Email: tsyba@blood.ru
Отделение химиотерапии гематологических заболеваний и интенсивной терапии- канд. мед. наук, зав. дневным стационаром; ФГБУ Гематологический научный центр Минздравсоцразвития России
T N Moiseeva
Hematological Research Center, MoscowHematological Research Center, Moscow
L S Al-Radi
Hematological Research Center, MoscowHematological Research Center, Moscow
I V Shitareva
Hematological Research Center, MoscowHematological Research Center, Moscow
A A Shevelev
Hematological Research Center, MoscowHematological Research Center, Moscow
I E Kostina
Hematological Research Center, MoscowHematological Research Center, Moscow
S K Kravchenko
Hematological Research Center, MoscowHematological Research Center, Moscow
A M Kremenetskaya
Hematological Research Center, MoscowHematological Research Center, Moscow
N N Tsyba
Hematological Research Center, MoscowHematological Research Center, Moscow
References
- Castleman В. Tumors of the thymus gland. In: Atlas of tumor pathology. Fasc. l9: Armed forces Institute of Pathology. Washington; 1955.
- Rosai J., Levine G. Tumors of the thymus. In: Atlas of tumor pathology. Fasc. 13. Armed forces Institute of Pathology. Washington; 1976.
- Goldstein G. Thymitis and myasthenia gravis. Lancet 1996; 2: 1164-1167.
- Gelfand D. W., Goldman A. C., Law E. J. et al. Thymic hyperplasia in children recovering from thermal burns. J. Trauma 1972; 12: 813-817.
- Rizk G., Gueto L., Amplatz K. et al. Rebound enlargement of the thymus after successful corrective surgery for transpositions of the great vessels. Am. J. Roentgenol. 1972; 116: 528-530.
- Maiorana A., Reggiani-Bonetti L. Hyperplastic and inflammatory pathology of the thymus. In: Thymus gland pathology - clinical, diagnostic and therapeutic features. Springer-Verlag; Italia. 2008. 39-67.
- Choyke P. L., Zeman R. K., Gootenberg J. E. et al. Thymic athrofy and regrouth in response to chemotherapy: CT evaluation. Am. J. Roentgenol. 1987; 149: 269-272.
- Kissin S. M., Husband J. E., Nicholas D. et al. Begin thymic enlargement in adults after chemotherapy: CT demonstration. Radiology 1987; 163: 67-70.
- Rüther U., Müller H. A., Nunnensiek C. et al. Thymic hyperplasia in patients with malignant testicular tumors. Med. Clin. (Münich) 1990; 85: 72-77.
- Null J. A., Livolsi V. A., Glenn W. W. Hodgkin's disease of the thymus (granulomatous thymoma) and myasthenia gravis: a unique association. Am. J. Clin. Pathol. 1977; 67(6): 521-525.
- Katz A., Lattes R. Granulomatous thymoma or Hodgkin's disease of the thymus? A clinical and histologic study and a reevaluation. Cancer 1969; 23(1): 1-15.
- Nemoto K., Ishikawa H., Ohnishi Y. et al. Hodgkin's disease accompanied with thymoma. Acta Pathol. Jpn 1987; 37(9): 1505-1512.
- Hermann R., Greminger P., Dommann-Scherrer C. et al. Diffuse thymus hyperplasia following chemotherapy for nodular sclerosing Hodgkin lymphoma. Schweiz. Med. Wschr. 1994; 124(38): 1666-1671.
- Zhen Z. J., Sun X. F., Xia Y. et al. Clinical analysis of reactive thymic hyperplasia following chemotherapy for childhood malignant lymphoma. Ai Zheng 2006; 25(4):471-475.
- Zhen Z. J., Sun X. F., Xia Y. et al. Clinical analysis of thymic regrowth following chemotherapy in children and adolescents with malignant lymphoma. Jpn J. Clin. Oncol. 2010; 40(12): 1128-1134.
- Wernecke K., Diederich S. Sonographic features of mediastinal tumors. Am. J. Roentgenol. 1994; 163: 1357-1364.
- Shevelev A. A., Moiseeva T. N. Role of ultrasonography (US) in differential diagnosis of mediastinal mass enlargement after therapy of patients with advanced stages of Hodgkin disease (HD) treated by BEACOPP-14 cycles without subsequent irradiation. Haematologica 2010; 95(s4): 47.
