Cranial nerve palsy in childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma

Article Abstract:

Involvement of the central nervous system is common in many forms of leukemia. About five percent of all children with acute lymphoblastic leukemia (ALL) have leukemic cells in their cerebrospinal fluid at the time of their initial diagnosis. Leukemic cells are commonly found in the cerebrospinal fluid of patients with some forms of non-Hodgkin's lymphoma (NHL) as well. The presence of leukemic cells in the cerebrospinal fluid is often mentioned as a clinical feature in medical reports. However, few of these same reports specifically mention the occurrence of cranial nerve palsy in children with acute lymphoblastic leukemia or non-Hodgkin's lymphoma. While many of the body functions, both voluntary and involuntary, are controlled by nerves from the spinal cord, some functions are controlled by nerves that leave the brain directly. These cranial nerves may be affected by compression, infection, inflammation, and other factors which affect most nerves. Each cranial nerve elicits a distinctive set of symptoms if it becomes paralyzed, and these syndromes are collectively termed cranial nerve palsy (CNP). The authors used a computer-assisted search of medical records to review the cases of 1,895 children with ALL or NHL. The features of 45 cases which were complicated by cranial nerve palsy are tabulated. The condition, which was present at the time of diagnosis in only 3.8 percent of the children with NHL and 0.6 percent of children with ALL, appears to be an indicator of aggressive disease and poor outcome for the patient. Of the 22 children with CNP at the time of diagnosis, only 11 remain in remission. Of the 23 who developed CNP at the time of relapse (recurrence of symptoms of disease), only one was a long-term survivor. Among the patients who had CNP at the time of diagnosis, patients treated since 1979 were more likely to survive, as were males. Radiation was found to be an important part of treatment, and two-year survival was close to double for patients who received radiotherapy. The results indicate that although symptoms of cranial nerve palsy are not common among children with acute lymphoblastic leukemia or non-Hodgkin's lymphoma, symptoms of CNP are an indicator of aggressive disease and should be considered in the evaluation of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Non-Hodgkin's lymphomas, Lymphocytic leukemia, Nervous system diseases

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Two different lymph node metastatic patterns of a prostatic cancer

Article Abstract:

The metastatic spread of cancer to the lymph nodes is of major prognostic significance for many types of malignant tumors, including cancer of the prostate. An examination of 753 autopsy cases of prostatic cancer revealed that there were two distinct patterns of metastasis that differed in their eventual course. The first type of metastasis is from the prostate to both the pelvic lymph nodes and the paraaortic lymph nodes. This type 1 pattern has a greater frequency of metastases to the bladder and rectum. Type 1 metastasis is also more likely to result in hydronephrosis, or distension of the kidney with fluid due to obstruction of the ureter. Type 2 spread, by contrast, affects the paraaortic lymph nodes, but not the pelvic lymph nodes. Type 2 metastasis is more likely to colonize the lungs and liver. Type 1 metastasis is largely invasive, whereas type 2 is likely to also occur through the blood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Prostate cancer, Identification and classification, Metastasis, Cancer invasiveness, Cancer metastasis, Lymphatic metastasis

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