Complex lymphatic malformations: diagnostic and therapeutical implications

Complex lymphatic malformations: diagnostic and therapeutical implications
Cir Pediatr. 2007 Apr
Luis AL, López JC, Encinas JL, Suárez O, Burgos L, Diaz M, Soto C, Ros Z.
Hospital Universitario La Paz, Departamento de Cirugía Pediátrica, Madrid. anacp5555@hotmail.com

BACKGROUND: Complex lymphatic malformations (CLM) consist of disturbances of lymphatic system development, most often with a genetic origin and with mixed vascular system involvement: lymphatic, venous and capillary. They affect a large corporal area or are associated to other syndromes or systemic diseases.

METHODS: We reviewed 21 patients with CLM treated in our hospital during the last 15 years. We used D2-40 monoclonal antibody (by immunohistochemistry) as lymphatic marker to evaluate the level of lymphatic involvement. Furthermore we analysed surgical implications in this group of patients.

RESULTS: Twelve children had only lymphatic involvement and nine mixed lymphatic-capillary or lymphatic-venous one. Two died of: respiratory insufficiency (in the neonatal period) and refractory hypoproteinemia (at 8 years of age). The skin was affected between 10 and 35% of total body surface. Three patients suffered from visceral involvement (lungs and mediastinum) and eighteen musculoskeletal. Severe deformity (20), lymphorhagia (15), repeated lymphangitis and chronic pain (5) were the most common symptoms reported. The immunoreaction intensity with monoclonal antibody D2-40 was related to the severity of the local and systemic involvement as well as to the presence of associated malformations. Fifteen cases underwent sequential surgical treatment, seven were treated with sclerotherapy (OK-432) and four with CO2 laser vaporization. Residual lymphorhagia in patients with total extirpation of the lymphatic malformation stopped after repeated evacuator punctures and healing took place.

CONCLUSIONS: (1) D2-40 monoclonal antibody is a marker of bad prognosis in CLM. (2) The complete excision of the lymphatic malformation lead to healing and the associated lymphorragia should not be considered as a recurrence, which will stop with evacuator punctures in all cases. (3) A multidisciplinary team approach is essential for the proper care of CLM in order to minimize postoperative sequelae and late complications.

PMID: 17650723 [PubMed - in process]

New Medicine for Lymph Node Cancer

Quick cure for lymph node cancer‎

Sun, 29 Apr 2007 06:27:04

A new medicine against lymph node cancer is the latest invention of Czech scientists. The new drug has had very good effects in tests so far. Lab dogs with expanded tumors on their throat and stomachs were treated by the new medicine, after six days, no sign of cancer was discerned. The new medicine is unique in the way that it only affects cancerous cells without destroying healthy tissue of body. Hence, unlike chemotherapy which leaves drastic effects on immunity system, no side effects are caused by this new drug.

The U.S. Company Gilead has already started to test the substance, developed in Prague's Institute for Organic Chemistry and Biochemistry and designed to treat lymph node cancer on several thousands of patients in the U.S If the new medicine is approved it might be available on sale in about six years. The new medicine is effective in the case of lymph node cancer that makes up one-fourth of all cancerous diseases. It affects tumors in abdomen, chest, thymus and spleen, the paper wrote.

MMN/HAR

presstv

Czech scientists develop new anti-cancer medicine -- press

Prague- Czech scientists have developed a new medicine against cancer which has had very good effects in tests so far, the daily Mlada fronta Dnes (MfD) writes today, adding that malignant tumours on tested dogs' throats and stomachs disappeared after six days of treatment.

The U.S. company Gilead has started to test the substance, developed in Prague's Institute for Organic Chemistry and Biochemistry and designed to treat lymph node cancer, on several thousands of patients in the USA, MfD writes.

The researchers are now trying to detect possible side effects of the medicine that could be put on sale in about six years.

Three Czech companies have cooperated on its development, headed by Antonin Holy and Ivan Votruba from the above-mentioned institute and Berta Otova from Charles University's 1st medical faculty.

Holy's team previously won world appreciation for the developed substances against viral diseases and AIDS, MfD recalls.

It says the new medicine is unique as it affects only cancer-hit cells without destroying healthy tissue. Its application is thus not as drastic as, for example, chemotherapy, which destroys the whole immunity system.

"We don't know for the time being why our substance affects only the ill cells and leaves the healthy untouched," the institute director Zdenek Havlas told the daily.

The new medicine is effective in the case of lymph node cancer that makes up one-fourth of all cancerous diseases. It affects tumours in abdomen, chest, thymus and spleen, MfD writes.

Cesknoviny