Diagnosis And Therapy Of Malignant Lymphoma Proceedings Of A Symposium Held At The Joint Meeting Of The German Radiological Society And Others Recent Results In Cancer Research

First multi-year cumulation covers six years: 1965-70.

K. MUSSHOFF The group of diseases known as malignant lymphomas are, for a number of reasons, of equal interest to theoretical and clinical medicine. New findings in the fields of virology and immunology could conceivably shed some light on the so far unknown etiology of malignant lymphomas. A viral etiology could explain many of the dis parate findings with such a puzzling disease as lymphogranulomatosis, which shows both all the signs of malignancy, such as the characteristic Reed-Sternberg and Hodgkin cells and chromosome abnormalities, and those of an inflammatory disease, i.e. typical changes in the blood count and bone marrow and in the distribution of serum proteins. So far we have not been able to identify the etiology of this disease. However, clinical observations and pathomorphological investigations involving a joint effort by different branches of medicine have brought us closer to an understanding of the clinical picture. Descriptive anatomy has given us a clear picture of the regional distribution of the lymphatic system, which has long been neglected in the past. The introductory paper by Dr. S. KUBIK (Zurich), who has made valuable contributions to our knowl edge of the anatomy of the lymphatic system, deals with this subject.

Over the years, the management of lymphomatous disease has followed a general trend from the purely empirical and intuitive use of medications to radiation, to surgery, and to chemotherapy with alkylating agents and anti-metabolites. In the 20th century, the treatment of these diseases has been predominantly by radiation. As radiology emerged from ROENTGEN'S original work to the sophisticated science of the present, the radiological equipment, which had been crude and inaccurate, evolved into mechanical and electronic instruments of enormous complexity and capable of great accuracy. The progress and success of radiation therapy for malig nant disease paralleled the technical development of the devices employed. For this reason, the chronology of the parallel development is given in detail. The gross and histologic descriptions of the lymphomas, from 1832 to the present, are voluminous and controversial. Therefore the pathology is reviewed and these diseases classified before reviewing therapy of the lymphomas. I. Hodgkin's Disease 1. Pathology and Classification The current classification of the so-called lymphomata into HODGKIN'S disease, lymphosarcoma, and reticulum cell sarcoma is modern. Any historical or scientific review of ,the subject rightfully begins with a discussion of HODGKIN'S original paper entitled "On Some Morbid Appearances of the Absorbent Glands and Spleen" published in 1832. This classical report describes the clinical and gross pathologic findings in a group of patients whose symptomatology presented striking similarities; notably enlargement of peripheral lymph nodes in the neck, the axillae, and the groin and, frequently, enlargement of the mediastinal nodes.

Malignant lymphomas remain a fascinating research topic for clinicians as well as basic scientists. Rapidly increasing technical sophistication, ex panded knowledge and broader implications of new findings underline the need for a forum to integrate the latest developments in the multiple areas involved in the challenging study of lymphoid malignancies. This volume includes contributions of renowned experts and is based on a selection of papers presented at the Second International Conference on Malignant Lymphomas that was held in Lugano, Switzerland, in June 1984. Updated information is provided on various experimental fields including cell biolo gy, immunology, genetics and cell biochemistry. Particular attention has been given to special clinical entities such as the lymphomas associated with the Acquired Immune Deficiency Syndrome. Recent advances in the treat of Hodgkin's disease, ncin-Hodgkin's lymphomas and childhood lym ment phomas are highlighted with emphasis on growing experience with new therapeutic approaches including monoclonal antibodies and bone marrow transplantation. The contents of the volume reflect and translate numerous avenues of exploration. While there might be some unavoidable overlap, most appear essentially complementary. The intent of the Program Committee of the Second International Conference on Malignant Lymphomas was to promote further interactions between all those who are devoting major efforts to elucidate the nature of these diseases or their optimal therapy. This volume will hopefully amplify this objective. The Editors wish to thank the contributors for delivering the manuscripts on schedule.

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