An early relapse of Hodgkin´s lymphoma that is demonstrated as
a paraneoplastic cerebellar degeneration

a 2008

An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration

ŠMARDOVÁ, Lenka; Zdeněk KRÁL; Pavel ŠTOURAČ; Ingrid VÁŠOVÁ; Martina TOŠKOVÁ et al.

Základní údaje

Originální název

An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration

Název česky

Časný relaps Hodgkinova lymfomu manifestující se jako paraneoplastická cerebellární degenerace

Autoři

ŠMARDOVÁ, Lenka; Zdeněk KRÁL; Pavel ŠTOURAČ; Ingrid VÁŠOVÁ; Martina TOŠKOVÁ a Jiří MAYER

Vydání

Annals of Oncology (Supplement), 2008

Další údaje

Jazyk

angličtina

Typ výsledku

Konferenční abstrakt

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.935

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

ISSN

UT WoS

000256693500551

Klíčová slova anglicky

Hodgkins lymphoma; paraneoplastic syndrome

Štítky

Hodgkins lymphoma, paraneoplastic syndrome

Změněno: 27. 6. 2009 15:11, MUDr. Lenka Šmardová

Anotace

ORIG CZ

V originále

Background: Paraneoplastic cerebellar degeneration (PCD) represents the most described paraneoplastic neurological syndrome occurring, in addition to Hodgkins lymphoma (HL), especially at small cell lung cancer and ovary cancer. We always have to distinguish a primary infliction of CNS by imaging and examination of the liquor, which is at HL very rare (incidence of 0,2%) and means a late symptom of an already advanced disease with a worse prognosis. Material and methods: In 11/2005 a 30-year-old man was diagnosed with nodular sclerosis HL stages II B at our clinic. The pt was treated with 4 cycles of the chemotherapy ABVD and the IF radiotherapy (30 Gy) of the retroperitoneum and the mesenteric lymph nodes. According to the CT scan a complete remission was achieved. After 11 months the pt was hospitalized for a gradually progressive ataxia, vertigo, dysartria and nystagmus. Imaging of CNS including MRI and the cytology of the liquor was negative. By the CT scan the mediastinal lymphadenopathy was found out and completing FDG-PET examination confirms the suspicion for an early relapse of HL, which was eventually confirmed by the thoracoscopy. Results: With regard to an early relapse of HL salvage chemotherapy DHAP was indicated. Yet after the 1st cycle of the chemotherapy a distinctive regression of the neurological symptoms which, consequently, went off completely. After the 2nd cycle of the chemotherapy a successful separation of the PBSC came through. Afterwards, the pt took high-dose chemotherapy BEAM with an autologous PBSC support (10/2007). Considering CT scan examinations including whole body FDG-PET showed a complete remission again. Conclusions: The occurrence of an early relapse of HL carried out by the symptoms PCD is presented in the case report. Differential diagnostics can be facilitated by the identification of the HL specific paraneoplastic anti-Tr antibodies (named after its inventor J. Trotter in 1976), that are made against Purkinjes cells in the cerebellum. Their determination in the time of the relapse of our patient was impossible because of the inaccessibility of this method in the Czech Republic.

Česky

Časný relaps Hodgkinova lymfomu manifestující se jako paraneoplastická cerebellární degenerace.

Citovat

ŠMARDOVÁ, Lenka; Zdeněk KRÁL; Pavel ŠTOURAČ; Ingrid VÁŠOVÁ; Martina TOŠKOVÁ a Jiří MAYER. An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration. In Annals of Oncology (Supplement). 2008. ISSN 0923-7534.

@proceedings{778575,
   author = {Šmardová, Lenka and Král, Zdeněk and Štourač, Pavel and Vášová, Ingrid and Tošková, Martina and Mayer, Jiří},
   booktitle = {Annals of Oncology (Supplement)},
   keywords = {Hodgkins lymphoma; paraneoplastic syndrome},
   language = {eng},
   title = {An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration},
   year = {2008}
}

TY  - CONF
ID  - 778575
AU  - Šmardová, Lenka - Král, Zdeněk - Štourač, Pavel - Vášová, Ingrid - Tošková, Martina - Mayer, Jiří
PY  - 2008
TI  - An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration
KW  - Hodgkins lymphoma
KW  - paraneoplastic syndrome
N2  - Background: Paraneoplastic cerebellar degeneration (PCD) represents the most described paraneoplastic neurological syndrome occurring, in addition to Hodgkins lymphoma (HL), especially at small cell lung cancer and ovary cancer. We always have to distinguish a primary infliction of CNS by imaging and examination of the liquor, which is at HL very rare (incidence of 0,2%) and means a late symptom of an already advanced disease with a worse prognosis. Material and methods: In 11/2005 a 30-year-old man was diagnosed with nodular sclerosis HL stages II B at our clinic. The pt was treated with 4 cycles of the chemotherapy ABVD and the IF radiotherapy (30 Gy) of the retroperitoneum and the mesenteric lymph nodes. According to the CT scan a complete remission was achieved. After 11 months the pt was hospitalized for a gradually progressive ataxia, vertigo, dysartria and nystagmus. Imaging of CNS including MRI and the cytology of the liquor was negative. By the CT scan the mediastinal lymphadenopathy was found out and completing FDG-PET examination confirms the suspicion for an early relapse of HL, which was eventually confirmed by the thoracoscopy. Results: With regard to an early relapse of HL salvage chemotherapy DHAP was indicated. Yet after the 1st cycle of the chemotherapy a distinctive regression of the neurological symptoms which, consequently, went off completely. After the 2nd cycle of the chemotherapy a successful separation of the PBSC came through. Afterwards, the pt took high-dose chemotherapy BEAM with an autologous PBSC support (10/2007). Considering CT scan examinations including whole body FDG-PET showed a complete remission again. Conclusions: The occurrence of an early relapse of HL carried out by the symptoms PCD is presented in the case report. Differential diagnostics can be facilitated by the identification of the HL specific paraneoplastic anti-Tr antibodies (named after its inventor J. Trotter in 1976), that are made against Purkinjes cells in the cerebellum. Their determination in the time of the relapse of our patient was impossible because of the inaccessibility of this method in the Czech Republic.
ER  -

ŠMARDOVÁ, Lenka; Zdeněk KRÁL; Pavel ŠTOURAČ; Ingrid VÁŠOVÁ; Martina TOŠKOVÁ a Jiří MAYER. An early relapse of Hodgkin´s lymphoma that is demonstrated as a paraneoplastic cerebellar degeneration. In \textit{Annals of Oncology (Supplement)}. 2008. ISSN~0923-7534.

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