[Clinical conference: Acute transformation in 45 cases of chronic myeloid leukemia].
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Biomedical subjects
Publications and source records attributed to A Najman.
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Bone marrow biopsy in Waldenstrom's macroglobulinemia shows three types of lesions: lympho-plasmocytic and reticular infiltration, which is the most common, reticular infiltration, and aplastic marrow, more seldom. In all cases the reticulinic network is increased and thickened. These lesions are diffuse or nodular. Diffuse infiltration is more severe and has a median duration of 62 months instead of 82 months in nodular infiltration.
Many nodular primitive non-Hodgkin's lymphomas of the spleen have a favourable course after splenectomy or chemotherapy. Several observations of this type have been reported in the literature, in which the concept of malignancy is discussed, authors referring to a presarcomatous state or to an idiopathic splenomegaly. The evaluation of the extension of those sarcomas, however, very often show hepatic lesions, and always an increase in the lymphoid marrow nodules. The significance of these nodules is discussed here, with reference to 14 personal observations. These nodules may not always reflect a real extension of the sarcoma to the marrow. From a practical point of view, the presence of lymphoid marrow nodules, when associated with an isolated splenomegaly, is a strong argument to suspect a sarcoma of the spleen, and indicates a splenectomy.
A 53 years old female patient with plasma cell leukemia (more than 90% plasma cells in the peripheral blood, and an absolute plasma cell count reaching 147,000/mm3) is described. Electrophoresis and immunoelectrophoresis of serum and concentrated urine did not reveal any paraprotein. No surface immunoglobin has been detected on plasma cell cytoplasmic membranes. The presence of intracytoplasmic kappa light chains has been demonstrated by immunofluorescence and electron microscopy using the immunoperoxydase technique.
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