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A peculiar case of the abscopal effect: radioactive iodine therapy incidentally palliating marginal zone lymphoma.

Kornas RC, Shields SK, Goldman LS - Case Rep Oncol Med (2015)

Bottom Line: The abscopal effect is an extremely rare phenomenon occurring when irradiation or treatment of a primary tumor burden not only results in debulking of the targeted site but also reduces tumor size at distant sites from the intended treatment area.Following treatment, her leukocyte and lymphocyte counts were 3,100/μL and 1,100/μL, respectively.Over the next four years, her leukocyte and lymphocyte counts remained within normal limits and she remained symptom free.

View Article: PubMed Central - PubMed

Affiliation: Providence Hospital and Medical Centers, 16001 W. Nine Mile Road, Suite 401, Southfield, MI 48075, USA.

ABSTRACT
The abscopal effect is an extremely rare phenomenon occurring when irradiation or treatment of a primary tumor burden not only results in debulking of the targeted site but also reduces tumor size at distant sites from the intended treatment area. We present the abscopal effect occurring in a patient with low-grade marginal zone lymphoma who subsequently received radioactive iodine therapy for papillary thyroid carcinoma. She was 67 years old when a routine complete blood count at her primary care physician's office yielded a persistent leukocytosis of 14,500/μL with lymphocytosis of 9,870/μL. Immunophenotyping and fluorescence in situ hybridization (FISH) analysis confirmed low-grade marginal zone lymphoma. Over eight years, her peak leukocyte and lymphocyte counts were 24,100/μL and 18,100/μL, respectively. Subsequently, she was diagnosed with papillary thyroid carcinoma after presenting with a new complaint of dysphagia. A total thyroidectomy was performed, followed by 172.1 millicuries of oral I-131 sodium iodine radioactive ablation therapy. Following treatment, her leukocyte and lymphocyte counts were 3,100/μL and 1,100/μL, respectively. Over the next four years, her leukocyte and lymphocyte counts remained within normal limits and she remained symptom free. To our knowledge, there has never been a published report describing the use of radioactive iodine causing abscopal effect benefits for patients with underlying lymphoproliferative diseases.

No MeSH data available.


Related in: MedlinePlus

(a) Contrast enhanced computed tomography (CT) of the thorax. Thin, white arrow indicates the largest nodule in the mid pole of the right thyroid lobe, measuring 1.6 × 1.2 × 1.4 cm. Black, thick arrow demonstrates a calcified nodule in the mid-to-lower left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm. There are multiple scattered calcified nodules noted throughout the thyroid gland. (b) Axial ultrasound of the thyroid gland. There is evidence of a solid isoechoic nodule in the right thyroid lobe measuring 1.6 × 1.2 × 1.4 cm and a peripherally calcified nodule in the left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm.
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fig3: (a) Contrast enhanced computed tomography (CT) of the thorax. Thin, white arrow indicates the largest nodule in the mid pole of the right thyroid lobe, measuring 1.6 × 1.2 × 1.4 cm. Black, thick arrow demonstrates a calcified nodule in the mid-to-lower left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm. There are multiple scattered calcified nodules noted throughout the thyroid gland. (b) Axial ultrasound of the thyroid gland. There is evidence of a solid isoechoic nodule in the right thyroid lobe measuring 1.6 × 1.2 × 1.4 cm and a peripherally calcified nodule in the left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm.

Mentions: Nearly nine years after the initial diagnosis of marginal zone lymphoma and careful monitoring of leukocyte and lymphocyte counts, the patient presented with complaints of dysphagia and persistent sore throat for three weeks. A CT scan of the neck and thorax was ordered and showed evidence of a mass within the thyroid gland (Figure 3(a)). Subsequent ultrasound (Figure 3(b)) and fine needle aspiration ultrasound guided biopsy revealed papillary thyroid carcinoma. She underwent a total thyroidectomy and was treated with 172.1 millicuries (mCi) of oral I-131 sodium iodine radioactive ablation therapy. She responded favorably to treatment and had no complications. Postthyroidectomy ultrasound showed no evidence of residual thyroid tissue.


A peculiar case of the abscopal effect: radioactive iodine therapy incidentally palliating marginal zone lymphoma.

Kornas RC, Shields SK, Goldman LS - Case Rep Oncol Med (2015)

(a) Contrast enhanced computed tomography (CT) of the thorax. Thin, white arrow indicates the largest nodule in the mid pole of the right thyroid lobe, measuring 1.6 × 1.2 × 1.4 cm. Black, thick arrow demonstrates a calcified nodule in the mid-to-lower left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm. There are multiple scattered calcified nodules noted throughout the thyroid gland. (b) Axial ultrasound of the thyroid gland. There is evidence of a solid isoechoic nodule in the right thyroid lobe measuring 1.6 × 1.2 × 1.4 cm and a peripherally calcified nodule in the left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4332459&req=5

fig3: (a) Contrast enhanced computed tomography (CT) of the thorax. Thin, white arrow indicates the largest nodule in the mid pole of the right thyroid lobe, measuring 1.6 × 1.2 × 1.4 cm. Black, thick arrow demonstrates a calcified nodule in the mid-to-lower left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm. There are multiple scattered calcified nodules noted throughout the thyroid gland. (b) Axial ultrasound of the thyroid gland. There is evidence of a solid isoechoic nodule in the right thyroid lobe measuring 1.6 × 1.2 × 1.4 cm and a peripherally calcified nodule in the left thyroid lobe measuring 1.1 × 0.9 × 0.9 cm.
Mentions: Nearly nine years after the initial diagnosis of marginal zone lymphoma and careful monitoring of leukocyte and lymphocyte counts, the patient presented with complaints of dysphagia and persistent sore throat for three weeks. A CT scan of the neck and thorax was ordered and showed evidence of a mass within the thyroid gland (Figure 3(a)). Subsequent ultrasound (Figure 3(b)) and fine needle aspiration ultrasound guided biopsy revealed papillary thyroid carcinoma. She underwent a total thyroidectomy and was treated with 172.1 millicuries (mCi) of oral I-131 sodium iodine radioactive ablation therapy. She responded favorably to treatment and had no complications. Postthyroidectomy ultrasound showed no evidence of residual thyroid tissue.

Bottom Line: The abscopal effect is an extremely rare phenomenon occurring when irradiation or treatment of a primary tumor burden not only results in debulking of the targeted site but also reduces tumor size at distant sites from the intended treatment area.Following treatment, her leukocyte and lymphocyte counts were 3,100/μL and 1,100/μL, respectively.Over the next four years, her leukocyte and lymphocyte counts remained within normal limits and she remained symptom free.

View Article: PubMed Central - PubMed

Affiliation: Providence Hospital and Medical Centers, 16001 W. Nine Mile Road, Suite 401, Southfield, MI 48075, USA.

ABSTRACT
The abscopal effect is an extremely rare phenomenon occurring when irradiation or treatment of a primary tumor burden not only results in debulking of the targeted site but also reduces tumor size at distant sites from the intended treatment area. We present the abscopal effect occurring in a patient with low-grade marginal zone lymphoma who subsequently received radioactive iodine therapy for papillary thyroid carcinoma. She was 67 years old when a routine complete blood count at her primary care physician's office yielded a persistent leukocytosis of 14,500/μL with lymphocytosis of 9,870/μL. Immunophenotyping and fluorescence in situ hybridization (FISH) analysis confirmed low-grade marginal zone lymphoma. Over eight years, her peak leukocyte and lymphocyte counts were 24,100/μL and 18,100/μL, respectively. Subsequently, she was diagnosed with papillary thyroid carcinoma after presenting with a new complaint of dysphagia. A total thyroidectomy was performed, followed by 172.1 millicuries of oral I-131 sodium iodine radioactive ablation therapy. Following treatment, her leukocyte and lymphocyte counts were 3,100/μL and 1,100/μL, respectively. Over the next four years, her leukocyte and lymphocyte counts remained within normal limits and she remained symptom free. To our knowledge, there has never been a published report describing the use of radioactive iodine causing abscopal effect benefits for patients with underlying lymphoproliferative diseases.

No MeSH data available.


Related in: MedlinePlus