Brain lymphoma

Small cell carcinoma can be very difficult to distinguish from lymphoma and medulloblastoma or PNET (see Box 20.3). EMA or CK is expressed abundantly by small cell carcinoma, infrequently and focally by medulloblastoma, and not by brain lymphoma. Although either small cell carcinoma or medulloblastoma may express synaptophysin, S-100 protein, or NSE, stains for these substances are valuable discriminators for the trained eye they accentuate the hbrillarity of medulloblastoma, in contrast to the epithelioid cells of small cell carcinoma. 

Table XXXIV The Brain Conunonly Supports Primary or Metastatic Mahgnant Tumors, but Contributes to the Rejeetion by Biotherapy of B Cell Brain Lymphomas...

In an animal study of rats exposed by inhalation to ethylene oxide at 10, 33, or 100 ppm for approximately two years (245), and in a separate chronic rat study in which rats were exposed to 50 or 100 ppm of ethylene oxide (240), increased incidences of mononuclear cell leukemia, peritoneal mesothelioma, and various brain tumors have been reported. In an NTP (246) two-year inhalation study of mice at 50 and 100 ppm, alveolar/bronchiolar carcinomas and adenomas, papillary cystadenomas of the harderian gland, and malignant lymphomas, uterine adenocarcinomas, and mammary gland tumors were increased in one or both exposure groups. 

Vinyl chloride Liver - angiosarcoma Brain Lung - carcinoma Lymphatic system - lymphoma... 

Carmustine is a bicyclohexylnitrosourea (BCNU, Fig. 3) with broad spectrum of antineoplastic activity (e.g., lymphomas, multiple myeloma, sarcomas, brain tumors, gastrointestinal tumors, melanomas). At doses of 80-200 mg/m2 it is given i.v. at 6 week s intervals. 

Lomustine (2-chlorethyl-3 cyclohexyl-1 -nutrosourea, CCNU, Fig 3) is a nitrosourea for oral application. It is used for the treatment of Hodgkin s lymphomas, brain tumors and bronchial carcinomas at a dose of 3.5 mg/kg (130 mg/m2) repeated in 6-8 weeks intervals. 

Kidney renal pelvis 19,600 (3%) Non-Hodgkin lymphoma 9,600 (3%) Brain other nervous system 5,590 (2%)... 

Lymphoma, Burkitt s Lymphoma, immunoblastic Lymphoma, primary, or brain Mycobacterium avium complex or M. kamasii, disseminated or extrapulmonary M. tuberculosis, any site (pulmonary or extrapulmonary) Mycobacterium, other species or unidentified species, disseminated or extrapulmonary Pneumocystis carinii pneumonia Pneumonia, recurrent... 

Lymphomas. Lymphomas are cancers derived from the B cells of the immune system. Reactivation or coinfection in the B lymphocytes with Epstein-Barr virus may be important in the development of lymphomas in AIDS patients. An unusual lymphoma that spreads to the brain also occurs. 

Most tumors are solid. That is, they form a discrete, stable, identifiable structure within some tissue or organ. Tumors of the lung, liver, brain, breast, and so on, are all solid. In contrast, leukemias and lymphomas, cancers of the blood cells, are liquid that is, the tumor is a collection of cancer cells that circulate but do not form a discrete, identifiable structure. 

Inaeased risk of various cancers (e.g., lymphatics, blood, stomach, prostate, testes, brain, and soft tissues) was reported upon exposure to pesticides (Zahm and Blair 1993 Hayes et al. 1995 Zahm et al. 1997). Children s cancer, including brain tumors, leukemia, non-Hodgkin s lymphoma, sarcoma, and Wilms tumor due to direct or parental exposure to pesticides also has been determined (Fear et al. 1998 Kristensen et al. 1996 Pogoda and Preston-Martin 1997 Sharpe et al. 1995 Buckley et al. 1994). Often, the risk of cancer due to exposure to pesticides has been higher in children than in adults (Zahm and Ward 1998). Moreover, birth defects, including limb-reduction defects, have been linked to exposures to pesticides (Restrepo et al. 1990 Schwartz and LoGerfo 1998 Lin et al. 1994), as has a higher-than-normal risk of stillborn births (Pastore et al. 1997). 

Taken together, the various observations suggest that FBXLIO has context-dependent pro- and anti-oncogenic activities. In line with this, FBXLIO expression was reported to be significantly decreased in human glioblastomas relative to normal brain tissue [54], while FBXLIO was found to be overexpressed in lymphomas and mammary adenocarcinomas [56]. 

Two epidemiological studies of workers exposed to ethylene oxide revealed increased rates of leukemia. In one smdy, two cases of leukemia (0.14 expected) and three stomach cancers (0.4 expected) were observed. The other study found three cases of leukemia (0.2 expected). Because these workers had exposures to other potential carcinogens, the findings cannot be linked with certainty to ethylene oxide. The small cohort size, the small number of deaths, and uncertainties about exposure level have also been noted." A number of other studies have not found an increased rate of cancer mortality from ethylene oxide exposure. A mortality study of over 18,000 ethylene oxide workers from 14 plants producing medical supplies and foodstuffs did not find an excess of leukemia or brain, stomach, or pancreatic cancers. There was, however, an increase in non-Hodgkin lymphoma in male workers. A follow-up of 1896 ethylene oxide production workers did not find an increase in mortality from leukemia, non-Hodgkin lymphoma, or brain, pancreatic, or stomach cancers. ... 

It is likely that the IgM in the CSF of patients with Burkitt s lymphoma may be partly derived from subunits of serum IgM crossing the blood-brain barrier, since 4 out of 17 patients with Burkitt s lymphoma had detectable IgM in their urines which emerged from Sephadex G-200 columns in two different peaks, strongly suggesting the occurrence of subunits of the intact molecule (M17). 

Moreover, in view of such an universal activity of MYKO 63, EORTC decided in May 1980 to extend to 1982 the period during which this drug will be tested on animal tumors. To date new results increase still further the spectrum of effectiveness of MYKO 63 successful experiments were performed — or are in progress - on tumors such as lymphomas and lymphosarcomas, either radioresistant or radio-sensitive, on neuroblastomas (acute brain tumors, mainly in children), fibroblastomas (muscles tumors) and HeLa (from Helen Lattimer, the first patient who died from this tumor) cervix carcinoma (uterus tumor). 

The mechanism of action of this drag is analogous to the mechanism of action of lomustine. Carmustine is only used intravenously. It is used for non-Hodgkin s lymphoma, multiple myeloma, and brain tumors. Synonyms of this drag are carmubris, nitrumon, and BICNU. 

Carmustine and lomustine can produce remissions that last from 3 to 6 months in 40 to 50% of patients with primary brain tumors. Both drugs also are used as secondary treatment of Hodgkin s disease and in experimental combination chemotherapy for various types of lung cancer. Other tumors in which remission rates of 10 to 30% have been obtained are non-Hodgkin s lymphomas, multiple myeloma, melanoma, renal cell carcinoma, and colorectal cancer. 

---