Periprostatic or paravaginal venous thromboses are rarely considered clinically as sites of clot origin in patients with pulmonary thromboembolism. The majority of emboli have been demonstrated to originate in the veins of the legs. This report raises awareness of pelvic vein thrombosis as a potential source of pulmonary embolism that is rarely considered or detected clinically, and which usually requires postmortem examination for recognition. It also reviews the possible routes emboli may take to reach the lungs.
From the categories of lymphoma, Hodgkin lymphoma is considered to have a benign course. A significant percentage of patients respond very well to treatment, achieving relapse-free survival. However, despite effective treatments, as many as 20% of patients die of this disease, and prognostic models to predict outcome are still erratic and inaccurate. Immunohistochemical analysis of the tumor-associated macrophages, assessed via CD68 staining, was performed in paraffin-embedded tissue obtained at the time of diagnosis of 25 pediatric cases of Hodgkin lymphoma. The association with CD68+ histiocytes and the patient response to treatment and survival were retrospectively analyzed with further correlation of this biomarker with the patient outcome. An increased number of tumor-associated CD68+ macrophages strongly correlated with a significant probability of relapsing from complete response (P = .001) and with an increased likelihood of death of lymphoma (P = .012). Survival analysis demonstrated a shorted progression-free survival (P = .028) and disease-specific survival (P = .023) in patients with an elevated number of CD68+ macrophages in the tumor microenvironment. The presence of an increased number of CD68+ macrophages was found to be associated with a worse prognosis in pediatric patients with Hodgkin lymphoma. This study may contribute to the establishment of a new use of this biomarker, which will help in the process of discrimination among patients who will have a satisfactory response to standard treatment from patients at higher risk of treatment failure and also might provide the basis for individualized patient treatment.
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