Faculty of Medicine

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    Hodgkin lymphoma – lung metastasis - Case report
    (Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
    Baloski Marjan
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    Kochovska Kamchevska Nade
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    Bushev Jane
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    Smileska Snezana
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    Lymphoma is the most common blood cancer. Occurs when lymphocytes grow and multiply uncontrollably in the lymph nodes, spleen, bone marrow, or other organs. Approximately 9,000 new cases of Hodgkin Lyphoma are projected each year, commonly diagnosed in young adults between the ages of 20 and 34 years. Female patient, 33 years old, diagnosed with Hodgkin Lymphoma in 2010. Treated with several cycles of chemotherapy. 2-3 months before hospital admission, she felt shortness of breath, prolonged, dry cough, haemoptysis. On physical examination – swallen lymph nodes in right axilla and neck. Auscultatory normal finding. Other systems without pathological findings. Chest X-ray - right infraclavicular, massive, heterogenous shadowing, separated and connected to right hylus. CT lung scan – in right upper medial segment, stellate, 6sm, cavernous consolidaton. Mediastinal and hilar lymphaednopathy In right axilla enlarged lymph nodes. Bronchoscopy – edematous mucosa. Abdominal and pelvic CT scan – normal. Transthoracic CT guided lung biopsy with histopathological finding - MORBUS HODGKIN PULMONUM. Microscope finding of fragments showed accumulations of mature lymphocytes mixed with macrophages, plasma cells and eosinophilic leukocytes, rare cells with basophilic cytoplasm and hyperchromatic large cores. In several cells binuclearity, in a larger cell multinuclearity. The immunohistochemical analysis conducted further, obtained the following RESULTS: CD-15 (cell marker for Reed-Sternberg cells) positive +, CD-30 (a marker for cell mitosis in cells) is positive focal +, CD-20 (B-grade. marker) positive +, CD-3 (T marker) positive focal +. For further treatment the patient was referred to the Department of Hematology.
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    Treatment approach overpowers IPI sighnificance in Hodgkin`s disease
    (European Hematology Association, 2007)
    S. Trpkovska Terzieva
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    A. Stojanovic
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    S. Sotirova
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    Chronic lymphocytic leukemia following successfull treatment of Hodgkin’s lymphoma: report of two patients
    (Македонско лекарско друштво = Macedonian Medical Association, 2017)
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    Arif Latifi
    Over the past few decades, introducing effective therapy, improved staging procedures, and significant improvement of supportive measures, significantly improved the prospects for patients with Hodgkin's lymphoma, leading to a 75-90% cure rate. Hodgkin's lymphoma survivors are at high risk of developing a large variety of second malignant neoplasms. It is crucial to maintain awareness regarding this issue. The subsequent development of Chronic Lymphocytic Leukemia (CLL) in patients after successful treatment of Hodgkin's lymphoma (HL) is an extremely rare possibility. The relationship between these two lymphoproliferative disorders is unclear. Herein we describe two cases of CLL, developed in previously treated patients with HL, with characterization of two distinct lymphoproliferative disease in these two patients. We also systematically reviewed the existing literature on this very rare occurrence of treatment-induced second hematological malignancies.
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    Preservation of Fertility and of Reproduction Ability in Lymphoma Patients
    (ID-Design, 2013-05-09)
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    Aleksandar Stojanovic
    Aim: The aim of this article is to provide the health professionals with clear, novel and practical guidelines regarding management of fertility in patients with malignant hematological disorders, with special accent on lymphoma. Also, it aims at raising consciousness of all physicians administering chemotherapy, about the undesired effects of many chemotherapy regimens, on the reproductive ability, about available methods for preserving fertility and regarding many other issues in connection with fertility in patients treated for lymphoma. Materials and methods: Online internet databases and publications have been searched, and a systematic literature review has been performed, using the following keywords: fertility, chemotherapy as well as relevant keywords in connection to the subject. Results: Within the search, reports regarding smaller-sized groups, as well as in series of patients and case reports have been found, but relatively few large randomized studies or actual reports regarding the success rate and the influence of methods for fertility preservation in patients treated for Hodgkin's and Non-Hodgkin's lymphoma. We have managed in summarizing a large proportion of the research studies and transferring it into an integral multidisciplinary text, offering valid and applicable options for fertility preservation in patients treated for lymphoma. We use the term lymphoma in general, since the chemotherapy and radiotherapy approaches for Hodgkin's and for Non-Hodgkin's lymphomas are similar, rendering a major part of the fertility preservation guidelines appropriate for both entities. Recommendations: Hematologists should possess fundamental knowledge regarding the late complications of lymphoma treatment. Besides acknowledging the risk of secondary cancer development as well as of non-neoplastic cardiac and pulmonary complications, they should be prepared to raise the issue of infertility as an integral part of the treatment plan, since that is a complication of significant importance for patients treated with chemotherapy within their reproductive life period. Possible methods for preserving fertility should be presented and discussed, and patients should be referred promptly to a reproductive medicine specialist. Cryopreservation of both sperm and embryos are considered standard practice and are generally available, while other methods are still in investigational phase and performed in specialized centers under mandatory professional surveillance and expertise. Conclusion: It is recommended to utilize treatments that are with as little as possible gonadal toxicity, to consider a wide array of options for fertility preservation as soon as possible, and to practice a decision-making process most beneficial for the patient, based on the latest medical accomplishments and most novel prospects.