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Biomedical subjects

A Polliack

Publications and source records attributed to A Polliack.

At least 73 records · Page 4Linked to original sources

Myelomonocytic antigens are rarely expressed on B-lymphocytic leukemia cells.

In the light of recent observations reporting that B-lymphocytic leukemia (B-CLL) cells may express a variety of myelomonocytic antigens, 28 patients with B-CLL and B-leukemic lymphocytic lymphoma were studied for the presence of these antigens using monoclonal antibodies to detect CD13, CD33, CD15 and CD14. Analysis of immunofluorescence (IF) was carried out by two procedures; one which employed the standard conventional method of gating used in our laboratory for flow cytometry, while the other procedure increased the sensitivity of the analysis, by moving the marker for IF to the left, so as to widen the gate to include more cells with low IF. Using the conventional methodology, the mean proportion of cells considered positive was less than 3% for any of the 4 markers studied. In only a few patients were 5% or more of the B-CLL cells positive for some of the markers studied (3 patients with 6.2-11.3% CD13+; 2 with 6.0-9.6% CD14+, and one with 11.8% CD15+ cells). No case had more than 2.5% + CD33+ cells. The second procedure with a wider gate to enhance sensitivity for less positive cells, increased the number of positive cells for any of the markers in only 4 patients. These results are contradictory to others reported recently, and some of the possible causes for this discrepancy are discussed. It is suggested that more useful data may be obtained if the level of staining intensity and patterns of positive staining are documented in the future.

Antibodies, Monoclonal↗

Analysis of sweat during soft tissue breakdown following pressure ischaemia.

This paper examines the nature of tissue metabolites collected in thermally induced sweat following the application of different loading regimes on the soft tissues of able-bodied subjects. Loading was produced by 1) external application on the forearm via both a tourniquet and a uniaxial indenter system, and 2) ischial support on a wheelchair and sacral support on an examination bed. In each case sweat pads were attached to the tissue areas of a group of able-bodied subjects and interface pressures were recorded. After a prescribed period, the pads were removed and a quantitative analysis of a range of metabolites was performed. Results indicated that tissues subjected to pressure ischemia produced a general increase in concentrations of lactate, chloride, urea, and urate associated with a decreased sweat rate. In the reperfusion phase, some of these metabolites returned to unloaded levels. It is proposed that specific metabolites may be used as an indicator of soft tissue damage.

Adult↗

Serum soluble interleukin-2 receptor levels are associated with clinical disease status and histopathological grade in non-Hodgkin's lymphoma and chronic lymphocytic leukemia.

Serum soluble Interleukin-2 receptor levels (sIL-2R) were measured in 121 patients (pts) with non-Hodgkin's lymphoma (NHL) and in 30 patients with Chronic lymphocytic leukemia (CLL). Sera collected from 32 normal volunteers and 18 patients with infection or a variety of non malignant hematological disorders served as controls. A small number of patients with Hairy cell leukemia (HCL) and Hodgkin's disease (HD) were also studied. NHL patients were classified according to their clinical status as "active" (82 pts) or "non-active" (39 pts) and CLL according to the stage of their disease. NHL patients were also further classified as low (55 pts), intermediate (38 pts) and high grade malignancy (28 pts), according to the Working formulation scheme. A significant difference was found between the high levels of sIL-2R in patients with "active" disease and the lower levels in patients with quiescent or responsive disease. Significantly different high levels were found in patients with aggressive (intermediate and high grade) lymphoma as opposed to low grade lymphoma and CLL. In CLL itself higher levels of sIL-2R were seen in more advanced disease than in early disease. Thirteen patients with active Hodgkin's disease (HD) had moderately elevated sIL-2R levels, similar to those recorded for patients with infections and some non-malignant hematological disorders while another 13 HD patients in remission, had normal levels comparable to those recorded in normal controls. Extremely high levels of sIL-2R were seen in 2 patients with HD with severe viral infections and levels approaching those seen in HCL, were noted (20-30,000 u/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Obstructive solitary bronchial non-Hodgkin's lymphoma--a rare presentation of primary extranodal disease.

Endobronchial involvement by non-Hodgkin's lymphoma (NHL) is uncommon and usually occurs in the presence of more generalised disease. Solitary endobronchial lymphoma in the absence of disease elsewhere is extremely rare. In this report we describe a patient with an obstructing endobronchial mass which was the initial manifestation of NHL. The patient was treated initially with radiotherapy followed by cyclic combination chemotherapy with initial complete resolution of the endobronchial disease. However, he subsequently developed widespread lymphoma. This unusual presentation of NHL is discussed and the relevant literature is reviewed.

Aged↗

Pulmonary involvement as the major manifestation of chronic lymphocytic leukemia.

Respiratory symptoms and abnormal findings on chest X-ray are frequently noted in patients with chronic lymphocytic leukemia (CLL). However, most of these represent pulmonary infections or mediastinal lymphadenopathy, and leukemic involvement of the lung is seldom diagnosed during life. In this report we describe three patients with non-progressive, responsive CLL who developed biopsy proven pulmonary infiltration with CLL. In one case, pulmonary involvement was the sole manifestation of recurrent disease and a second case had little disease elsewhere with minimal CLL in the blood at the time pulmonary involvement appeared. In all three cases, transbronchial biopsy and bronchoalveolar lavage performed during fibreoptic bronchoscopy provided adequate tissue for diagnosis. We conclude that CLL may involve the lung even in the presence of a low peripheral white blood cell count with responsive disease elsewhere, and can readily be diagnosed by transbronchial biopsy and bronchoalveolar lavage.

Adult↗

Late cardiovascular and pulmonary complications of therapy in Hodgkin's disease: report of three unusual cases, with a review of relevant literature.

With the advent of modern therapeutic approaches, even patients with advanced Hodgkin's disease have high cure rates today. Therefore, more attention is gradually being focused upon the late complications of chemotherapy and irradiation, appearing long after the patient is in remission and thought to be cured. In this report, we review the incidence and presentation of some of the cardiovascular and pulmonary complications which may appear later in the course of the disease. Cardiovascular mishaps reviewed include pericardial manifestations, conduction abnormalities, cardiomyopathy, and premature coronary artery disease. Pulmonary complications discussed are lung fibrosis, spontaneous pneumothorax, pulmonary veno-occlusive disease, and hyperlucent lung. Three instructive cases from our recent experience, are also presented. One fatal case was due to cardiac failure because of radiation-induced pericarditis and coronary artery disease. Another patient with an almost fatal complication required lung transplantation because of severe bilateral radiation fibrosis of the lung and pulmonary veno-occlusive disease. The third instance was also life-threatening in nature, with radiation-induced arterial changes in the major arteries of the chest and neck, resulting in recurrent cerebral and ophthalmic thromboembolic disease. It is suggested that potentially severe cardiopulmonary complications be considered during the planning of the initial and subsequent management of patients with Hodgkin's disease, particularly in an era employing autologous and allogeneic bone marrow transplantation as part of therapy in some cases.

Adult↗

Right ventricular outflow tract obstruction due to extrinsic compression by non-Hodgkin's lymphoma: importance of echocardiographic diagnosis and follow up.

Acquired right ventricular outflow tract obstruction due to extrinsic compression of the pulmonary artery is a rare manifestation of non-Hodgkin's lymphoma (NHL). We report a case of a 17 year old boy who was referred for evaluation of a large anterior mediastinal mass, causing dyspnea and cough and resulting in a harsh systolic murmur. Echocardiography demonstrated compression of the pulmonary artery by the mass, with a severe pressure gradient. Biopsy revealed intermediate grade, diffuse large cell NHL. Systemic chemotherapy rapidly led to a significant decrease in the size of the mass, and virtual disappearance of the pressure gradient. In this report, the use of echocardiography for diagnosis and follow up of extracardiac tumors is reviewed. It is suggested that this technique may also be useful for the routine staging of mediastinal lymphomas because of the potential consequences of clinically undetectable hemodynamic compromise.

Adolescent↗

Systemic lupus erythematosus and chronic lymphocytic leukemia: rare coexistence in three patients, with comments on pathogenesis.

We describe three patients with coexistent chronic lymphatic leukemia (CLL) and systemic lupus erythematosus (SLE). In two patients, the CLL was present before or coexistent with the SLE when the SLE was diagnosed, while in the third, the CLL developed 5 years after the diagnosis of SLE was first made. Although the association of autoimmune diseases and lymphoproliferative disorders is well established, only a few patients with coexistent CLL and concomitant SLE have been reported. The possible pathogenesis of this rare association is discussed.

Adult↗

Autoimmunity and auto-immune syndromes associated with and preceding the development of lymphoproliferative disorders.

In this report the association of autoimmunity and autoimmune syndromes with lymphoproliferative disorders (LPD) is described in 15 patients. Non-Hodgkin's lymphoma (NHL) developed in 10 patients, Hodgkin's disease (HD) in 3 and chronic lymphocytic leukemia (CLL) in two. In most instances clinical and laboratory phenomena preceded the development/diagnosis of these disorders. Manifestations ranged from the presence of autoantibodies in the serum to the presence of both ill defined or incomplete autoimmune syndromes including cold urticaria, Raynaud's phenomenon, cold agglutinin disease, thyroiditis, nephrotic syndrome and vasculitis to typical systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and even one of scleroderma. It is suggested that in some patients (in)complete clinical manifestations of autoimmunity may precede the development of lymphoid neoplasias. The link between autoimmunity and lymphoproliferative disorders is briefly discussed.

Autoimmune Diseases↗

"Jumping translocation" in a 17-month-old child with mixed-lineage leukemia.

A 17-month-old child with acute biphenotypic (pre B-ALL/myelomonocytic) leukemia is reported. Extensive cytogenetic analysis performed at various stages of the disease revealed a clonal evolution at the time of initial diagnosis with two types of abnormal clones, one with trisomy 22 and two other related clones with trisomy 22 plus partial trisomy of the long arm of chromosome 1 associated with the telomeric segment of either chromosome 20q or 21p. At the time of relapse the only abnormal clone involved trisomy 22 and partial trisomy of 1q, but this time in association with the telomeric segment of 14p. The unique feature of these translocations is discussed and the possibility of the correlation between the different chromosomal abnormalities and the expression of biphenotypic markers is raised.

Humans↗

Syncytial variant of nodular sclerosing Hodgkin's disease. A new clinicopathologic entity.

The clinicopathologic and histopathologic features of an unusual morphologic variant of nodular sclerosing Hodgkin's Disease (HD) termed the syncytial variant has been reported recently. We report eight new cases with this unique morphology, identified by reviewing the histopathology of 58 patients with nodular sclerosing HD treated in our institute between 1982 and 1988. The clinicopathologic and histopathologic data of these cases are reported and we emphasize this new entity and the difficulties encountered in the morphologic diagnosis. All of the eight patients had a difficult initial clinical course, and were in a clinically advanced stage of the disease at the time of diagnosis. We cite a statistical comparison of the clinical features of the different forms of nodular sclerosing HD.

Adolescent↗

Transient pancytopenia. A report from the International Agranulocytosis and Aplastic Study.

From a population-based study on the incidence of potentially drug-associated blood dyscrasias 28 cases were identified with pancytopenia. Who recovered within 90 days after diagnosis. Early recovery occurred more frequently in patients showing normal or increased cellularity of the bone marrow than in patients with bone marrow hypoplasia. Median recovery times of leukocytes were 14 and 10 days and of platelets 21 and 9 days in patients with and without bone marrow hypoplasia, respectively. Age and sex distribution were similar in both groups. Of 28 patients, 11 reported a period of fever before onset of pancytopenia. Sixteen patients in whom information on drug use was available had taken a median of 4 drugs before the onset of symptoms that were related to pancytopenia. From these results we present the hypothesis that transient pancytopenia with or without marrow hypoplasia can be the expression of the same type of bone marrow injury and that drugs or viral infections should be considered as etiological factors.

Agranulocytosis↗

Oestrogen receptor (ER) analysis in B-cell chronic lymphocytic leukemia: correlation of biochemical and immunocytochemical methods.

Oestrogen receptors (ER) are present in neoplastic lymphoid cells and have been considered a physiological marker of growth rate or differentiation. Tamoxifen, an oestrogen antagonist, has been given in some patients with CLL and Hodgkin's disease, with dramatic response in single cases. Until now, ER status has been assessed using a steroid binding assay (SBA) which has many inherent problems. Recently, the development of monoclonal antibodies directed against ER has been applied to the study of breast carcinomas and results obtained show good correlation with the quantitative SBA. We studied 49 cases of B-cell chronic lymphocytic leukemia (CLL) using immunostaining of cytospin preparations. In 30 of these cases ER enzyme immunoassay (ER-EIA) was also performed. Cultured MCF-7 cells, derived from a pleural effusion of a breast cancer patient, known to contain high levels of ER were used as a positive control (40-48% ER positive cells by immunocytochemistry; 200 fmol/mg protein by EIA). All of the CLL cases except two (96%) were negative for ER (less than 1% staining; less than 4 fmol/mg protein). The two positive cases expressed granular ER staining over the nucleus (9.2 and 12.1% positive cells) and were positive by EIA and SBA. It is concluded that (i) patients with CLL rarely express ER and (ii) immunocytochemical staining of cytospin preparations is a valid technique for the measurement of ER. It is of interest that one of the positive cases was diagnosed as CLL with Richter's transformation confirming earlier findings.

Adult↗

Plasmacytoma of the breast. Unusual initial presentation of myeloma: report of two cases and review of the literature.

Two patients who presented initially with breast masses proven to be plasmacytomas, are described. In both cases the breast masses led to the diagnosis of multiple myeloma, which was retrospectively already present at the time of the breast biopsy. One patient with IgG lambda-type myeloma developed plasma cell leukemia and amyloidosis and failed to respond to radiochemotherapy. The second patient was in complete remission, four years after therapy, but has subsequently relapsed and died. All cases of breast plasmacytoma, described in the medical literatures are reviewed, and guidelines for future therapy are suggested.

Breast Neoplasms↗