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Franke FC, Damek A, Steglich J, Kurch L, Hasenclever D, Georgi TW, Wohlgemuth WA, Mauz-Körholz C, Körholz D, Kluge R, Landman-Parker J, Wallace WH, Fosså A, Vordermark D, Karlen J, Fernández-Teijeiro A, Cepelova M, Klekawka T, Attarbaschi A, Ceppi F, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Moellers M, Buerke B, Stoevesandt D. Differentiation between rebound thymic hyperplasia and thymic relapse after chemotherapy in pediatric Hodgkin lymphoma. Pediatr Blood Cancer 2023; 70:e30421. [PMID: 37243889 DOI: 10.1002/pbc.30421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Rebound thymic hyperplasia (RTH) is a common phenomenon caused by stress factors such as chemotherapy (CTX) or radiotherapy, with an incidence between 44% and 67.7% in pediatric lymphoma. Misinterpretation of RTH and thymic lymphoma relapse (LR) may lead to unnecessary diagnostic procedures including invasive biopsies or treatment intensification. The aim of this study was to identify parameters that differentiate between RTH and thymic LR in the anterior mediastinum. METHODS After completion of CTX, we analyzed computed tomographies (CTs) and magnetic resonance images (MRIs) of 291 patients with classical Hodgkin lymphoma (CHL) and adequate imaging available from the European Network for Pediatric Hodgkin lymphoma C1 trial. In all patients with biopsy-proven LR, an additional fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT was assessed. Structure and morphologic configuration in addition to calcifications and presence of multiple masses in the thymic region and signs of extrathymic LR were evaluated. RESULTS After CTX, a significant volume increase of new or growing masses in the thymic space occurred in 133 of 291 patients. Without biopsy, only 98 patients could be identified as RTH or LR. No single finding related to thymic regrowth allowed differentiation between RTH and LR. However, the vast majority of cases with thymic LR presented with additional increasing tumor masses (33/34). All RTH patients (64/64) presented with isolated thymic growth. CONCLUSION Isolated thymic LR is very uncommon. CHL relapse should be suspected when increasing tumor masses are present in distant sites outside of the thymic area. Conversely, if regrowth of lymphoma in other sites can be excluded, isolated thymic mass after CTX likely represents RTH.
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Affiliation(s)
| | - Adrian Damek
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Jonas Steglich
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Dirk Hasenclever
- Institute of Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Thomas W Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - Christine Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany
| | - Dieter Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - William Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, UK
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Dirk Vordermark
- Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Jonas Karlen
- Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden
| | | | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Tomasz Klekawka
- Pediatric Oncology and Hematology Department, University Children's Hospital of Krakow, Krakow, Poland
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Francesco Ceppi
- Division of Pediatrics, Department of Woman-Mother-Child, Pediatric Hematology-Oncology Unit, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Andrea Hraskova
- Department of Pediatric Hematology and Oncology, National Institute of Paediatric Diseases, Bratislava, Slovakia
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Auke Beishuizen
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Karin Dieckmann
- Department of Radiation Oncology, University Hospital Vienna, Vienna, Austria
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Martin Moellers
- Department Department of Pediatric Radiology, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Boris Buerke
- Department of Clinical Radiology, University Hospital of Münster, Münster, Germany
| | - Dietrich Stoevesandt
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
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Moellers M, Gründahl FR, Hammer K, Braun J, Oelmeier de Murcia K, Köster HA, Steinhard J, Klockenbusch W, Schmitz R. Fetal brain development in diabetic pregnancies and normal controls. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Moellers
- University Hospital Münster, Münster, Deutschland
| | - FR Gründahl
- St. Franziskus-Hospital Münster, Münster, Deutschland
| | - K Hammer
- University Hospital Münster, Münster, Deutschland
| | - J Braun
- University Hospital Münster, Münster, Deutschland
| | | | - HA Köster
- University Hospital Münster, Münster, Deutschland
| | - J Steinhard
- Department of Fetal Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Deutschland
| | | | - R Schmitz
- University Hospital Münster, Münster, Deutschland
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Moellers M, Schmitz J, Schmitz R, Braun J, Amler S, Oelmeier de Murcia K, Kossow A. Desinfektion transvaginaler Ultraschallsonden – Vergleich einer maschinellen Technik mittels UVC und einer Wischtuchdesinfektion im klinischen Alltag. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Moellers
- University Hospital Münster, Münster, Deutschland
| | - J Schmitz
- University Hospital Münster, Münster, Deutschland
| | - R Schmitz
- University Hospital Münster, Münster, Deutschland
| | - J Braun
- University Hospital Münster, Münster, Deutschland
| | - S Amler
- University Hospital Münster, Münster, Deutschland
| | | | - A Kossow
- University Hospital Münster, Münster, Deutschland
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Dietrich U, Wanke I, Mueller T, Wieland R, Moellers M, Forsting M, Stolke D. White matter disease in children treated for malignant brain tumors. Childs Nerv Syst 2001; 17:731-8. [PMID: 11862439 DOI: 10.1007/s00381-001-0526-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2001] [Revised: 09/12/2001] [Indexed: 11/30/2022]
Abstract
OBJECTS The objects of the study reported were to recognize different patterns of white matter disease (WMD) in the follow-up of children after surgery, radiation and/or chemotherapy for malignant primary brain tumors and to evaluate statistical data on the incidence of WMD and various risk factors. METHODS Magnetic resonance imaging (MRI) records were evaluated retrospectively in the routine follow-up (range 6 months to 15 years after surgery) of 44 children with malignant primary brain tumors treated with surgery and radiotherapy and/or chemotherapy. RESULTS WMD was diagnosed in 28 children and subclassified into circumscribed white matter lesions (WML) and diffuse atrophy. WML were the most common finding ( n=13), followed by atrophy ( n=7) and the combination of both ( n=8). Statistical analysis revealed slightly more frequent atrophy in children younger than 5 years. WML could be linked with supratentorial location of the tumor, follow-up longer than 5 years, and the presence of a ventricular shunt. Intrathecal chemotherapy was also a factor, but because of the small sample size of the group this might not be valid. None of the children had neurological deficits attributed to these findings, but the impact on neuropsychological development was not determined.
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Affiliation(s)
- U Dietrich
- Department of Neuroradiology, Gilead Hospital, Burgsteig 13, 33617 Bielefeld, Germany.
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Droemann D, Aries SP, Hansen F, Moellers M, Braun J, Katus HA, Dalhoff K. Decreased apoptosis and increased activation of alveolar neutrophils in bacterial pneumonia. Chest 2000; 117:1679-84. [PMID: 10858402 DOI: 10.1378/chest.117.6.1679] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVES The central role of apoptosis in the regulation of lung inflammation is increasingly recognized. The aim of this study was to determine the parameters of cell activation and apoptosis on neutrophils from the circulation and the pulmonary compartment in patients with community-acquired pneumonia (CAP), and to assess the role of the Fas system and of complement-regulating molecules in this context. DESIGN AND METHODS The study population consisted of nine patients with CAP (group 1) and six age-matched control patients without evidence of bronchopulmonary inflammation (group 2). Apoptosis rate and expression of CD11b, CD16, CD55, CD59, CD95, and CD114 surface molecules on systemic and bronchoalveolar neutrophils were assessed ex vivo using fluorescence-activated cell sorter analysis. RESULTS In patients with CAP, we found a significant decrease of the mean apoptosis rate in pulmonary neutrophils compared to systemic neutrophils, without concomitant changes in Fas expression. In contrast, cell activation markers were significantly increased on pulmonary cells (CD11b, 288 +/- 98.2 relative mean fluorescence intensity [rMFI] vs 53.8 +/- 10.8 rMFI on peripheral cells), and similar changes were observed with respect to the expression of complement-regulating molecules. Pulmonary polymorphonuclear neutrophils of the control group showed analogous changes, compared to systemic neutrophils, but a significantly higher rate of apoptosis and a lower increase of activation-marker expression were found, compared to pulmonary neutrophils of patients with pneumonia. CONCLUSIONS Pulmonary neutrophils from patients with CAP show a decreased rate of apoptosis and increased activation status in the alveolar compartment, which may be important for effective control of pulmonary inflammation.
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Affiliation(s)
- D Droemann
- II. Department of Medicine, Medical University Luebeck, Germany
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