Biomedical subjects

B M Osborne

Publications and source records attributed to B M Osborne.

At least 37 records · Page 2Linked to original sources

PubMed1990

Lymphoreticular disease masquerading as or associated with an inguinal or femoral hernia.

Twelve patients (eight men and four women) had previously undiagnosed lymphoreticular disease associated with or simulating an inguinal (nine) or femoral (three) hernia. The disease was present on the left side in eight. Four patients (three women and one man) did not have an actual hernia. Two of these women had a preoperative diagnosis of femoral hernia. Seven of the patients, including all of the women, had non-Hodgkin's lymphoma (three diffuse large cell, two follicular mixed cell and two follicular small cleaved cell) and one patient had lymphocytic predominance (nodular lymphocytic and histiocytic) Hodgkin's disease. No stage predominated. Inguinal lymph nodes from two patients showed, histologically, Kaposi's sarcoma and type I human immunodeficiency virus (HIV) associated disease. Each patient was homosexual and HIV seropositive. Changes suggestive of viral cause were present in the lymph node of one patient. The enlarged lymph nodes of the 12th patient showed stellate suppurative granulomas containing cat-scratch bacilli demonstrated by Warthin-Starry stain. Because of the special processing needs for lymphoreticular diseases and potential for misdiagnosis, surgeons, clinicians and pathologists should be aware of the spectrum of lymphoreticular processes occurring in lymph nodes associated with or masquerading as a hernia, particularly in women.

Adult↗

PubMed1989

Granulomatous mastitis caused by histoplasma and mimicking inflammatory breast carcinoma.

Two cases of a lobular, necrotizing granulomatous process causing a unilateral painful breast mass mimicking carcinoma are presented for comparison. While the morphologic appearance in each case was that of lobular granulomatous mastitis, the etiologic agent in one case appeared to be Histoplasma capsulatum, based on Grocott methenamine silver staining, and represents the second reported case of histoplasmosis involving only breast parenchyma. Awareness of the rare entity, granulomatous mastitis, is important for the pathologist because the definitive diagnosis is made microscopically. Thorough evaluation of the breast tissue is essential for its management and should eventually contribute to the clarification of its etiology.

Adult↗

PubMed1989

Unexpected splenic nodules in leukemic patients.

We reviewed a series of five splenectomy specimens from patients with various leukemias (three cases of chronic myelocytic leukemia, one case of acute myelocytic leukemia, and one case of hairy cell leukemia). In addition to diffuse red pulp disease, we unexpectedly encountered nodules grossly in each of the specimens. These represented sea blue histiocytosis (one case), focal hairy cell leukemia (one case), localized blast transformation (one case), and concentrated foci of treated leukemia (two cases), with a prominence of immature granulocytic precursors on a background of trilineage hyperplasia. These cases are reported because they are unusual and because they furnish interesting correlates of gross and microscopic anatomy.

Adult↗

PubMed1989

Hypocellular paratrabecular foci of treated small cleaved cell lymphoma in bone marrow biopsies.

Because of the new drug combinations being used to treat follicular lymphomas, the small cleaved cell lymphomatous foci in bone marrow biopsies appear to be altered. They become progressively hypocellular and contain a few and sometimes no small cleaved cells within oligocellular paratrabecular fibrous foci. These hypocellular paratrabecular foci (HPF) (a) are a clue that deeper sectioning is necessary to determine whether there are diagnostic foci of residual involvement by small cleaved cell lymphoma, (b) may indicate that other portions of the patient's bone marrow still contain viable foci of small cleaved cell lymphoma, and further, (c) should alert the clinician to the possibility of recurrence of small cleaved cell lymphoma in subsequent bone marrow biopsies. A comparison of patients who developed HPF in one or more of their bone marrow biopsy specimens with those who did not indicates that the changes are related to combinations of chemotherapy other than CHOP-Bleo (cyclophosphamide, adriamycin, vincristine, prednisone, bleomycin). Eighty-one percent of patients who developed HPF had received additional chemotherapeutic regimens, whereas 75% of patients whose bone marrows did not contain HPF had received only CHOP-B. The older age of the HPF-negative patients (median age 64 versus median age 43 for HPF-positive cases) may reflect more aggressive chemotherapy in the younger age group. While HPF appear to reflect some increased chemotherapeutic cytotoxicity affecting the lymphomatous foci in bone marrow, they do not appear to predict for a longer survival or cure.

Bone Marrow↗

PubMed1988

Nucleic acid flow cytometry in large cell lymphoma.

Between 1978 and 1985, 140 patients with large cell lymphoma (27 follicular, 92 diffuse, 5 immunoblastic, and 16 transformed) had DNA-RNA cytometry performed on involved tissue. DNA-RNA features were correlated with treatment outcome and compared to other established prognostic factors in 63 newly diagnosed patients who received uniformly intensive therapy. Significantly better outcome was noted for previously untreated patients with intermediate RNA content (RNA index, 1.0-1.8), diploid DNA content, and (during the initial 12-month follow-up) low proliferative activity. Of patients followed beyond 12-24 months, those with high proliferative activity appeared to have the most durable remissions, although this was not statistically significant. These findings suggested a preferential impact of intensive chemotherapy on patients with intermediate RNA content and possibly those with high proliferative activity, since previous studies and our own experience with relapsing patients have indicated a progressively worse outlook with higher proliferative activity and RNA index values. In newly diagnosed patients, multivariate analysis identified RNA content as the most important prognostic factor, followed by proliferative activity and serum lactate dehydrogenase. Thus, for patients with large cell lymphoma, DNA-RNA cytometry appears to be a valuable prognostic parameter for identifying a subset of patients who have a high likelihood of cure with intensive chemotherapy.

Analysis of Variance↗

PubMed1988

Lymph node enlargement in patients with unsuspected human immunodeficiency virus infections.

The histologic findings in lymph nodes were used to identify eight patients, who are not in a high-risk group, with human immunodeficiency virus (HIV) infection. In order to determine the specificity of these findings, the histologic and clinical findings in these patients were compared with the histologic and clinical findings in 40 patients whose lymph nodes exhibited reactive follicular hyperplasia and who received biopsies before 1981. While a definitive diagnosis of HIV infection cannot be made from the histologic changes in lymph nodes because the organisms cannot be identified, our findings indicate that HIV infection can be suggested, and appropriate testing warranted, when marked reactive follicular hyperplasia with mononuclear cells (and a small number of neutrophils) in parafollicular sinuses is found in a patient with unexplained lymph node enlargement at two or more noncontiguous, noninguinal sites for several months, with or without systemic symptoms.

Adolescent↗

PubMed1988

Pancreatic acinar ectasia and intraoperative needle biopsy.

Intraoperative needle biopsy of the pancreas showing pancreatic acinar ectasia can present a problem in differential diagnosis from pancreatic carcinoma. Although this event has previously been described as an incidental postmortem finding, with the increasing use of intraoperative pancreatic biopsy, it is probable that it will be encountered more frequently. The surgical pathologist must be able to distinguish this entity from well-differentiated primary pancreatic adenocarcinoma on frozen section.

Biopsy, Needle↗

PubMed1987

Residual fibrous masses in treated Hodgkin's disease.

Of nine patients with residual masses following therapy for Hodgkin's disease (HD), eight had nodular sclerosing HD, and one had mixed cellularity HD. One patient had Stage II disease, seven had Stage III, and one had Stage IV. Seven patients presented with bulky mediastinal disease. Regardless of the initial therapy used residual masses in the mediastinum and/or peripheral locations stabilized in 1 to 8 months. Between 5 and 10 months after initiation of therapy, five patients underwent resection of mediastinal or paratracheal masses; three patients had resection of peripheral masses, and one patient underwent laparatomy. Microscopically, the resected masses were hyalinized tissue showing a characteristic nodular configuration without evidence of active HD. Stable residual mass lesions occurring after therapy for HD should not be assumed to represent recalcitrant malignancy, as they may show only fibrosis.

Adolescent↗

PubMed1987

Solitary plasmacytomas of bone and extramedullary plasmacytomas. A clinicopathologic and immunohistochemical study.

Twenty-two patients with solitary plasmacytoma of bone (SPB) and 13 with extramedullary plasmacytomas (EMP) were studied. The average follow-up period for SPB was 90 months and 86 months for EMP. Thirty-six percent of patients with SPB developed multiple myeloma (MM) in an average of 39 months, and 23% of patients with EMP developed MM in an average of 23 months. No significant differences in survival, incidence of MM, or interval to the development of MM were found between the two groups. The 11 cases of EMP with evaluable tissue for immunohistochemical study were either monotypic kappa or lambda, as were 9 of 10 SPB. Presence of monoclonality did not predict the development of MM. The histologic parameters of nuclear immaturity and presence of prominent nucleoli seem to be the best indicators of which patients will develop MM. Solitary plasmacytoma of bone and EMP appear to be more closely related than has been previously recognized.

Adult↗

PubMed1987

Idiopathic retroperitoneal fibrosis (sclerosing retroperitonitis).

Three cases of idiopathic retroperitoneal fibrosis, one of which was localized to the perirenal area, are presented. The predominance of plasma cells, which may be difficult to recognize because of distortion unless methyl green-pyronine staining is done, and the character of the fibrous tissue indicated the non-neoplastic nature of the processes. This diagnosis was confirmed by immunoperoxidase studies that demonstrated polyclonality of the lymphoplasmacytic component. Immunologic studies, which may be performed on paraffin-embedded tissue, are helpful in differentiating this lesion from the sclerosing lymphomas that also occur in the retroperitoneal area.

Adult↗

PubMed1987

Ultrastructural observations in cat scratch disease.

Because the causative bacterium of cat scratch disease has not been definitively cultured or fully characterized, the authors have studied its ultrastructure in lymph node biopsies from two patients using glutaraldehyde-fixed tissue. In both specimens, the organisms were invariably extracellular, forming small groups within bundles of collagen fibrils. Their appearance was similar in necrotic and viable regions of the nodes, although in the latter sites they could not be identified by light microscopic examination with the Warthin-Starry stain. The bacteria were pleomorphic rods, and, despite faint gram-negative staining, their walls were consistently thick and homogeneous.

Adolescent↗

PubMed1987

Follicular lymphoma mimicking progressive transformation of germinal centers.

Three cases of a morphologically distinctive "floral" variant of follicular large cell lymphoma are presented. In each instance, the diagnosis of theoretically "florid" progressive transformation of germinal centers (PTGC) was made or considered. The features that separate this pattern of lymphoma from reactive follicular hyperplasia with PTGC include involvement of all nodules without the presence of any reactive germinal centers, a homogeneous proliferation of large transformed lymphocytes with a markedly decreased or absent population of phagocytic histiocytes, and extension by abnormal cells into the perinodal adipose tissue. If the desirability of frozen section tissue immunophenotyping is anticipated, these lymphomas would be distinguished from PTGC by monotypic staining for light chains.

Adult↗

PubMed1987

Malignant lymphoma presenting as a renal mass: four cases.

Primary lymphoma of the kidney is extremely rare; most lymphomatous renal masses represent extension from adjacent sites of disease or involvement by generalized disease (4,9,12). Three men and one woman, 45 to 71 years of age, presented with solitary renal masses clinically thought to be renal cell carcinoma. Each experienced abdominal pain, one with hematuria and one with "B" symptoms. Physical examination revealed no peripheral lymphadenopathy or hepatosplenomegaly. Lactic dehydrogenase (LDH) was elevated in three cases, and blood urea nitrogen (BUN) and creatinine were slightly increased in two. Two cases were diagnosed correctly from needle biopsy, with ultrastructural confirmation in one case and marker studies, DNA flow cytometry, and cytogenetics in the other. Because of a presumptive diagnosis of renal cell carcinoma, two patients underwent nephrectomy. Three cases were large-cell lymphoma, and one, small noncleaved cell lymphoma.

Aged↗

PubMed1986

Granulocytic sarcoma in nonleukemic patients.

Sixteen patients presenting with granulocytic sarcoma without evidence of acute leukemia were seen and diagnosed at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston from 1962 to 1985. Seven of them (44%) did not develop acute leukemia. Of these seven, four are alive with no evidence of disease 3.5 to 16 years after initial presentation; the remaining three patients died of their disease within 2 to 8 months of presentation. Two of 16 patients were diagnosed within the last 15 months and do not have adequate follow-up. The seven remaining patients developed acute leukemia within 1 week to 13 months of the diagnosis of granulocytic sarcoma. Six of them died 5 weeks to 16 months after diagnosis; one patient has been in complete remission for 8 years. Twelve of these 16 cases (75%) were initially misdiagnosed, most frequently as large cell lymphoma. The remaining four cases were correctly diagnosed as granulocytic sarcoma. The naphthol-ASD-chloroacetate esterase stain was required to make the correct diagnosis in all cases. Contrary to findings in other series, granulocytic sarcoma arising in nonleukemic patients does not necessarily progress to acute leukemia. At least four of 16 (25%) patients in this series did not develop acute leukemia during the 3.5 to 16 years they have been followed. No prognostic factors were identified in this series to predict which patients would develop acute leukemia and which ones would not.

Adolescent↗

PubMed1986

Hodgkin's disease involving the breast and chest wall.

Eighteen patients with Hodgkin's disease involving the breast or chest wall were identified from the M. D. Anderson Hospital and Tumor Institute pathology files from 1962 through 1984. All of these cases were nodular sclerosing Hodgkin's disease. Nine of the 18 patients had Hodgkin's disease involving the breast or chest wall at initial presentation. The remaining nine cases represented recurrences involving the breast or chest wall. Breast or chest wall involvement represented extranodal extension and/or involvement of another supradiaphragmatic lymph node group. No marked difference in survival was found between the initial and recurrent groups. Those patients with breast involvement had a better prognosis than those with chest wall involvement. Hodgkin's disease involving the breast or chest wall as an initial presentation or a recurrence does not necessarily indicate an accelerated phase of the disease. Breast or chest wall involvement is probably due to Hodgkin's disease involving the intramammary or internal mammary lymph nodes, or is due to direct mediastinal extension into the chest wall.

Adolescent↗

PubMed1986

A comparative marker study of large cell lymphoma, Hodgkin's disease, and true histiocytic lymphoma in paraffin-embedded tissue.

A comparative study of large cell lymphoma (LCL) (ten B and ten T), Hodgkin's disease (15 cases), and true histiocytic lymphoma (two cases) was undertaken, using formalin-fixed paraffin-embedded tissue sections, a panel of eight antibodies, and one lectin to determine if any particular antibody or immunologic profile could reliably distinguish between these entities. The antibodies used were against Leu-M1, alpha-1-anti-chymotrypsin (alpha-ACT), alpha-anti-trypsin (alpha-AT), lysozyme, kappa, lambda, leukocyte common antigen (LCA), and S-100 protein. The lectin used was peanut agglutinin (PNA). Although Leu-M1 staining was positive in 11 of 15 cases (73%) of Hodgkin's disease, it was also positive in 4 of 10 cases (40%) of T-cell lymphoma, 2 of 10 cases (20%) of B-cell lymphoma, and 1 of 2 cases (50%) of true histiocytic lymphoma. Peanut-agglutinin staining results were similar to Leu-M1. The only staining profile that emerged was the presence of Leu-M1, PNA-, alpha-ACT, and alpha-AT staining in Reed-Sternberg (RS) cells in 11 of 15 cases of Hodgkin's disease. Leu-M1 and its staining pattern is characteristic, but not entirely specific for RS cells, and it was not positive in at least 25% of the cases of Hodgkin's disease in formalin-fixed, paraffin-embedded tissues. The limitations of this antibody and others should be recognized.

Antigens, Neoplasm↗

PubMed1986

Nucleic acid cytometry of homosexual-associated lymphoproliferative disease.

Twenty-six reactive lymph nodes and 5 malignant lymphomas from homosexual males were studied by acridine orange flow cytometry (AO-FCM) for determination of ploidy, proliferation, and RNA characteristics. Two reactive lymph nodes showed ploidy abnormalities as compared with none of 27 reactive lymph nodes from nonhomosexual patients. The homosexual-associated (HA) lymphadenopathy had a higher mean proliferative activity (11.2% versus 5.6%) and higher ribonucleic acid (RNA) content (1.11 versus 0.96) than non-HA counterparts. The proliferative activity of HA lymphadenopathy was also higher than follicular small cleaved cell lymphoma, and not dissimilar to that of follicular large cell lymphoma. These findings indicate that HA-reactive lymphadenopathy is a hyperproliferative state associated with high cellular RNA content and rare DNA-abnormal stemlines. One HA lymphoma had an abnormal stemline by AO-FCM, compared with 9 of 15 (63%) non-HA high grade lymphomas. This lymphoma also demonstrated an abnormal karyotype (47,XY, +12, t[8;22]) by classic cytogenetic studies. The mean proliferative activity and RNA content of HA lymphomas was higher than non-HA counterparts (37% versus 22.5% and 2.48 versus 1.73, respectively). The proliferation and RNA features of HA lymphoma were on higher planes than non-HA lesions histologically comparable. Thus, in addition to differences in clinical presentation, histologic subtype, stage distribution, and therapeutic response, HA lymphomas have DNA/RNA characteristics different from those of counterparts in the general population.

Adult↗

PubMed1985

Primary lymphoma of the liver. Ten cases and a review of the literature.

Ten adult white patients (21-75 years old; six women, four men) presented with large cell lymphoma of the liver. Each complained of abdominal pain and/or an abdominal mass, and five had B-symptomatology of weight loss, fever (one patient), and night sweats (three patients). At laparotomy (eight patients) or by computerized tomography, liver-spleen scan and lymphangiogram (two patients with percutaneous liver biopsy only), the liver was the sole site of involvement, although subsequent staging procedures revealed bone marrow involvement in three patients. Initial biopsy interpretation was incorrect in four cases which were diagnosed as poorly differentiated carcinoma. Although uncommon, the differential diagnosis of primary liver lymphoma should be entertained when patients present with solitary (three cases) or multiple (six cases) liver defects, particularly when alpha-fetoprotein and carcinoembryonic antigen levels are normal. One patient had diffuse hepatomegaly. Treatment included biopsy (eight patients) or resection (two patients) followed by combination chemotherapy. All patients are alive from 0 to over 10 years (mean, 2.4; median, 1.8 years): six in complete remission, two with less than 6-months follow-up, and two with recurrent lymphoma. Examination of this group of patients along with 19 cases identified in the literature suggests that this is a more treatable disease than primary liver carcinoma.

Adult↗