Michael L. Friedland

Malignant lymphomas in a population at risk for acquired immune deficiency syndrome

Certain neoplasia are closely associated with acquired immune deficiency syndrome (AIDS). To evaluate this relationship the authors reviewed the occurrence of lymphomas in populations at high risk for AIDS; the study population included prisoners from New York State and nonprisoner intravenous drug abusers (IVDA). Non‐Hodgkins lymphoma was diagnosed in 16 prisoners, all of whom were IVDA, and four nonprisoner IVDA. The observed number of prisoners with non‐Hodgkins lymphoma (11) diagnosed between January 1, 1981 and December 12, 1984, significantly greater than the expected number (2.28) based on age adjusted incidence rates for the US population (P < 0.001). The calculated average incidence rate for non‐Hodgkins lymphoma among New York State prisoners aged 20 to 49 years was 21.5/105 to 67.2/105, which was nearly sixfold to 18‐fold higher than the general population. For prisoner IVDA, specifically, this incidence may be as high as 164/105, which represents a 40‐fold increase in the relative risk compared with the general population. It is concluded that, non‐Hodgkins lymphoma is frequently a manifestation of AIDS among IVDA, and is the most common malignancy seen in IVDA with AIDS.

Spontaneous regression of small cell carcinoma of lung associated with severe neuropathy.

This is a case report of small cell lung cancer (SCLC) that underwent spontaneous regression. This was associated with severe neuropathy, which was unresponsive to therapy, including corticosteroids and plasmapheresis. We present here the case report and a brief review of the literature.

Malignant Eccrine Poroma and Isotretinoin

Excerpt To the editor: A recent article by Roach (1) described a partial response to isotretinoin in a patient with metastatic malignant eccrine poroma. We recently treated a patient with this dise...

Hepatic Abscess Following Hepatic Arterial Infusion Chemotherapy with an Implantable Pump

A patient with an intrahepatic abscess associated with an implantable pump for hepatic arterial infusion for metastatic colonic tumor is described. In view of the increased use of this device, clinicians should be aware of this complication.

Diagnosis and Treatment of Malignant Lymphomas in the Elderly

The process of aging is associated with structural and functional changes occurring in the living organism and often expressed in gradual deterioration and decline in performance. These impairments result in changes in host resistance and are perhaps the major factors in the emergence of neoplasia in those elderly who have survived the ravages of vascular diseases, accidents, and infection. The hematologic neoplasms are generally diseases of higher incidence with advancing age. These disorders are uncommon under the age of 40; although they do not represent a national health hazard, they are not rare. Malignant lymphomas have an incidence of 82 cases per million. The occurrence of the lymphomas and the ability of the host to deal with them as well as responses to therapy are all modified by advanced age and will be discussed in this chapter.

Reversible Deficiency of Serum High Density Lipoproteins in Hodgkin's Disease

An elderly woman with Hodgkins disease and hepatic involvement but without cholestasis presented with markedly depressed levels of serum esterified cholesterol and high density lipoproteins (HDL). Within five days of her first cycle of chemotherapy her serum HDL-cholesterol rose from 8-10 mg/dl to 88 mg/dl, and levels of the major HDL-apoprotein, apoA-I, rose from 60 to 138 mg/dl. The proportion of unesterified serum cholesterol fell from 60-80% to 27-30%. These observations suggest a relatively specific effect of the hepatic lymphoma on synthesis or release of lecithin:cholesterol acyltransferase.

Induction of remission in acute promyelocytic leukemia with mitoxantrone

SummaryTwo patients with acute promyelocytic leukemia in first relapse received mitoxantrone 12 mg/m2/day for 5 days. Both patients received IV heparin with replacement of platelets and coagulation factors for control of disseminated intravascular coagulopathy. Both have achieved a complete remission after one course of treatment. We conclude that mitoxantrone is active in patients with acute promyelocytic leukemia and that these patients should also be included in the planned prospective randomized trials comparing daunorubicin and mitoxantrone in combination with cytarabine in previously untreated patients with acute nonlymphoblastic leukemia.

Education and Training for Primary Care Internal Medicine

Excerpt To the editor: The recent article by Kosecoff and associates (1) and editorial by Huth (2) suggest that the efforts of academic medical centers to promote primary care internal medicine in ...