Cancer
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The relationship between tobacco and alcohol consumption and the development of additional primary cancers of the upper alimentary tract is reviewed. The chance of developing a second primary is dependent principally on the intensity (i.e., quantity and duration) of the smoking and drinking habit prior to the onset of the first neoplasm. ⋯ While tobacco smoking is considered the primary risk factor associated with cancers in this area, its interaction with alcohol creates a powerful carcinogenic effect. It is agreed that multiple primaries are selective on a site-specific basis and that risk varies with anatomic location of the first primary.
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Fourteen cases of primary malignant lymphomas of the breast were found in the pathology files of the M. D. Anderson Hospital and Tumor Institute from 1944 to 1975. ⋯ Patients with histiocytic lymphoma appeared to have a more favorable prognosis than those with the undifferentiated type. Six of the latter patients are dead with a median survival of seven months, comparable to the reported survival of patients with American Burkitt's lymphoma. The patient with the convoluted cell type has developed acute blastic leukemia and is currently under therapy.
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The authors modified and refined the Leukocyte Adherence Inhibition Assay (LAI) first described by Halliday, et al. in 1972 by standardizing the protein concentration of tumor-associated antigens (TAA) and by utilizing paired normal tissue extracts as controls to eliminate interference of HL-A histocompatibility antigens and organ-associated antigens. When dose response studies were performed, a progressively larger percentage of patients reacted to the LAI test with increasing concentration of tumor extracts, but the optimal concentration was found to be 200 mug/ml, where 42 out of 66 (63%) leukocytes from 54 breast cancer patients reacted to the breast cancer extracts. ⋯ Although a higher response rate (72%) was noted in Stage II disease, this was not statistically different from Stage I and Stage III disease. Likewise, no difference was noted in LAI at varying phases following the mastectomy.
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Comparative Study
Preliminary report of the lung cancer detection program in New York.
The early lung cancer detection program in New York is described, and preliminary prevalence rate data are reported. Cigarette-smoking men over the age of 45, who are considered at high risk, are encouraged to enroll in the program and, to date, 6,612 have done so. These men receive PA and lateral chest x-rays annually, while a randomly selected sub-population of about half also have sputum cytology every four months. ⋯ The early lung cancers detected by x-ray were peripheral and most were bronchiolar or adenocarcinoma; the early cancers detected by cytology were central epidermoid carcinoma of major bronchi. No early carcinomas were detected by both techniques. These findings suggest that a combination of chest x-rays and sputum cytology can be more effective than either one alone in detecting early lung cancer.
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Spontaneous (pathologic) rupture of the spleen in lymphoma is a rare event. A 38-year-old man with a 6-week history of fever, night sweats, and weight loss, and with known splenomegaly presented in shock as a result of a ruptured spleen. ⋯ Review of the literature failed to reveal any previous report of spontaneous rupture of the spleen due to undiagnosed Hodgkin's disease. Only one survivor of spontaneous rupture of the lymphomatous spleen has been reported previously.