Biomedical subjects
B Schnitzer
Publications and source records attributed to B Schnitzer.
T-and B-cell lymphomas look alike.
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Bone destruction in myelogenous marrow crisis.
Sudden appearance of bone destruction in chronic myelogenous leukemia may herald a blastic bone marrow crisis.
Extramedullary haematopoiesis in thrombotic thrombocytopenic purpura.
Extramedullary hematopoiesis was detected in routine sections of spleen and liver from two patients with thrombotic thrombocytopenic purpura (TTP). In patients with other types of hemolytic anemia and in normal persons, extramedullary hematopoiesis was not found in spleen or liver. The results of this study raise the possibility that TTP may fit within the myeloproliferative category, perhaps representing an acute variant of Di-Guglielmo Syndrome.
Thymoma: an immunologic and electron microscopic study.
Ultrastructural features, surface morphology and immunologic surface markers were examined on the cells of three human thymomas. The vast majority of the lymphocytes from the thymomas formed spontaneous rosettes with unsensitized sheep erythrocytes in both cell suspension and frozen tissue section and were, therefore, T cells. In addition to the lymphocytes, epithelial cells and macrophages were observed within the thymomas by transmission electron microscopy. When examined by scanning electron microscopy, most lymphocytes had virtually smooth surfaces, whereas cells believed to be epithelial in origin had surface projections.
Coexistence of two lymphomas with distinctive histologic, ultrastructural, and immunologic features.
The unusual coexistence of two distinct lymphomas in 44-year-old woman is described. Nodular, poorly differentiated lymphocytic lymphoma and diffuse histiocytic lymphoma were present in separate sites and were readily distinguished both histologically and ultrastructurally. In addition, the lymphocytic lymphoma was shown to be derived from complement receptor B lymphocytes of follicular center cell type, whereas the histiocytic lymphoma cells were devoid of complement receptors, receptors for IgG (Fc receptors), and surface immunoglobulin. Despite intensive chemotherapy and radiation therapy, the patient died within eight months of the initial diagnosis. Although histiocytic lymphoma was widely disseminated at autopsy, lymphocytic lymphoma was not found. Presumably the histiocytic lymphoma was refractory to therapy, in contrast to the lymphocytic lymphoma, which was selectively eradicated.
Classification of lymphomas.
Malignant lymphomas are neoplasms of cells of the lymphoreticular or immune system. Classification of these neoplasms has long been controversial and confusing. In recent years, considerable progress has been made in establishing useful and prognostically significant classifications of lymphomas. Currently, lymphomas may be divided into two main groups: Hodgkin's disease and non-Hodgkin's lymphomas. The Rye classification of Hodgkin's disease is now widely accepted and used throughout most of the world. In contrast, considerable conflict exists about the schemes of non-Hodgkin's lymphomas. The traditional classifications of non-Hodgkin's lymphomas currently used by most pathologists are based purely on morphologic grounds, and, despite the fact that they may be conceptually incorrect, they have often been shown to be useful for clinicopathologic studies. New or modern but yet untested schemes based not only on morphologic criteria, but also on recent immunologic techniques, have been proposed. This work will review the classifications of Hodgkin's disease and the non-Hodgkin's lymphomas, emphasizing the currently used schemes, describe the major modern classifications of lymphomas, and discuss and illustrate the subclasses of lymphomas and the differential diagnoses of the various types of lymphomas from nonlymphomatous proliferations which may mimic them.
Palmerston North mice, a new animal model of systemic lupus erythematosus.
This report describes a previously unrecognized animal model of SLE, the PN mouse. Although outbred PN mice were studied originally as models of polyarteritis nodosa, their inbred descendants have autoimmune disease which closely resembles SLE. In the current study, positive indirect immunofluorescence tests for ANA appeared when the mice were 5 months old, and 80% of mice were ANA-positive at 10 months of age. Anti-DNA were detected in sera from newborn mice and from 53% of mice under 2 months of age. Seventy-six percent of PN mice developed anti-DNA at the age of 10 months. Glomerular deposits of IgG, IgM, IgA, and complement appeared at 2 to 4 weeks of age, and examination of renal tissue by electron microscopy showed basement membrane thickening and dense intramembranous deposits. Neoplasms arose in 14% of PN mice. Female mice died earlier than male mice, and the most common causes of death were glomerulonephritis and arteritis. It was concluded that the serologic and histologic characteristics of disease in PN mice resembled SLE.
Intracranial histiocytic lymphoma with rheumatoid arthritis.
A patient with classical rheumatoid arthritis presented with a primary intracranial histiocytic lymphoma. He had not received cytotoxic drugs and had no evidence for Sjögren's syndrome or immunodeficiency. Previous radiation therapy to the shoulders is regarded as a possible, though unlikely, risk factor.
Megakaryocytes in the giant platelet syndrome. A cytochemical and ultrastructural study.
When compared to normal megakaryocytes, those from a patient with the giant platelet syndrome exhibited numerous cytochemical abnormalities. These reflected disturbances in the metabolism of RNA, glycogen, arginine-rich histone, and various glycolytic enzymes. Ultrastructural studies of the abnormal megakaryocytes also showed decreased glycogen and RNA (ribosomes) as well as aberrations of nuclear lobulation.
Complement receptor B lymphocytes in nodular sclerosing Hodgkin's disease.
Infiltrated tissues from nine cases of nodular sclerosing Hodgkin's disease (NSHD) were examined for immunologic cell surface markers. In all nine cases a large population of complement receptor B-lymphocytes were present within the nodular infiltrates. B-lymphocytes were identified in frozen sections by adherence of sheep red blood cells (E) coated with IgM antibody (A) and complement (C) IgMEAC). IgMEAC attached to both small lymphocytes and to Reed-Sternberg cells and their variants. Red cells coated with IgG (IgGEA) attached to histiocytes associated with the internodular fibrous bands and only sparsely with the nodular infiltrates. The population of complement receptor lymphocytes appears to be an integral component of NSHD.
Immunologic surface markers in non-Hodgkin's lymphomas.
Tissues from 21 patients with non-Hodgkin's lymphomas were examined for immunologic cell surface markers. Patterns of distribution of complement receptor (CR) B lymphocytes and Fc receptor (FcR)-bearing histiocytes in tumor tissue were evaluated and compared to routine histologic preparations of the tumors and to normal tissue. The lymphomatous infiltrates from all 6 cases of nodular, poorly differentiated lymphocytic lymphoma (NPDLL) consisted of dense populations of CR B lymphocytes. Involved tissue from 7 of 8 patients with diffuse, poorly differentiated lymphocytic lymphoma (DPDLL) was predominately comprised of CR B lymphocytes. Discrete nodules of CR B cells were present in a lymph node replaced by DPDLL. FcR were identified on the cells from 1 of 3 cases of histiocytic lymphoma. None of the 4 cases of undifferentiated lymphoma possessed demonstrable surface markers in tissue section; however, the cell suspension from 1 case contained a high percentage of CR B cells. Both CR and T cell markers were present on the cells of DPDLL of childhood.
Letter: Sinusoidal hepatic infiltrates.
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Hairy cell leukemia. An immunologic and ultrastructural study.
A case of hairy cell leukemia in a 39-year-old man is reported. Hairy cells from the peripheral blood, spleen, and bone marrow had lambda-type immunoglobulin on their surfaces; those from the peripheral blood and bone marrow also had IgD on their cell membranes. Frozen sections of spleen reacted with IgGEA, but not IgMEA or IgMEAC markers. Transmission electron microscopy revealed ribosome-lamella complexes in cells from the spleen, but not the peripheral blood. Scanning electron microscopy demonstrated a spectrum of cell surface morphology with many cells characterized by ridges and ruffles. The significance of these findings is considered and it is suggested that the hairy cell is a B lymphocyte.
Acinar pancreatic tumor with metastatic fat necrosis: report of a case and review of rheumatic manifestations.
This report deals with a pancreatic tumor associated with metastatic fat necrosis. Our patient displayed the full gamut of nodular panniculitis, polyarthritis, fever, eosinophilia, hyperlipasemia, lytic bones lesions, and marrow fat necrosis. The rheumatologic features are reviewed. Elevated serum lipase is a most helpful laboratory confirmation. The tumor in our patient presented a difficult problem in classification. Although the appearance under light microscopy was most compatible with islet cell carcinoma or islet cell carcinoid, the ultrastructural characteristics were those of acinar carcinoma.
Letter: Nature of the hairy cell.
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Letter: Classification of non-Hodgkin lymphomas.
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Letter: Surface characteristics of Hodgkin's lymphoma cells.
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