title: [Subcutaneous manifestations of a centrocytic non-Hodgkin lymphoma at the injection site of a mistletoe preparation].
abstract: METHODS
  A 73-year-old man, first diagnosed as having centrocytic Non-Hodgkin lymphoma 5 years previously, presented with subcutaneous nodes of the abdominal wall at precisely the sites of previous regular injections of a mistletoe preparation. These nodes had first appeared 5 weeks after the first injection. Injections were stopped and he reported to the out-patient clinic. Except for the visible and easily nodes in the anterior wall no other subcutaneous nodes were palpated. Prominent cervical lymphomas and swelling of the epicranial aponeurosis and lower lip had, according to the patient, been present for some time.
  
  
  METHODS
  There was a T-lymphocytopenia, lactate dehydrogenase activity was raised to 255 U/l. The subcutaneous nodes in the anterior abdominal wall were also demonstrated by ultrasound. Computed tomography showed them as having the density of connective tissue and being up to 5 cm in diameter. The excised nodes histologically revealed to be infiltrations by the centrocytic lymphoma.
  
  
  METHODS
  Once the mistletoe injections had been discontinued no further subcutaneous infiltrates were seen despite the progression of the lymphoma. Six weeks later the patient died of bilateral pneumonia.
  
  
  CONCLUSIONS
  There are pointers that high concentrations of mistletoe preparations subcutaneously injected can have a growth-promoting action on cells of a centrocytic lymphoma. As part of a leukaemic "wash-out", these cells reach the subcutaneous tissue. This proliferative stimulus may have been mediated by a high local concentration of interleukin-6 liberated from the skin by mistletoe lectins.
authors.affiliation: Medizinische Klinik I, Medizinischen Universität zu Lübeck.
authors.forename: W
authors.initials: W
authors.lastname: Hagenah
authors.forename: I
authors.initials: I
authors.lastname: Dörges
authors.forename: E
authors.initials: E
authors.lastname: Gafumbegete
authors.forename: T
authors.initials: T
authors.lastname: Wagner
mesh_terms: D000009:Abdominal Muscles; D000368:Aged; D006801:Humans; D007267:Injections; D037102:Lectins / Q000008:administration & dosage / Q000009:adverse effects; D016393:Lymphoma, B-Cell / Q000209:etiology*; D008297:Male; D014784:Mistletoe; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects; D037121:Plant Lectins; D028321:Plant Preparations; D010940:Plant Proteins; D010946:Plants, Medicinal; D054790:Ribosome Inactivating Proteins, Type 2; D014057:Tomography, X-Ray Computed; D014118:Toxins, Biological / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D037102:Lectins; D010936:Plant Extracts; D037121:Plant Lectins; D028321:Plant Preparations; D010940:Plant Proteins; D054790:Ribosome Inactivating Proteins, Type 2; D014118:Toxins, Biological; C009674:ribosome inactivating protein, Viscum