Biomedical subjects

C H Dunphy

Publications and source records attributed to C H Dunphy.

70 records · Page 4Linked to original sources

PubMed1995

Natural killer cell acute leukemia with myeloid antigen expression. A previously undescribed form of acute leukemia.

An acute leukemia of natural killer cell origin with myeloid antigen expression has not previously been described in the literature. Although lymphoproliferative disorders of large granular lymphocytes may be of natural killer cell origin and may have an aggressive clinical course, the morphology in the blood and bone marrow is that of large granular lymphocytes. An acute leukemia with blastic morphology is described, which was of natural killer cell origin by flow cytometric immunophenotyping (CD45+, CD2+, CD3, CD7+, CD5+, CD4, CD8, CD56+, CD57, CD16, CD13+, CD33+, CD34+, C-Kit+, HLA-DR, TdT) and histochemical staining. This was supported by the lack of T-cell gene rearrangement. The patient had an aggressive clinical course despite therapy for acute lymphoblastic leukemia. The authors recommend routine flow cytometric immunophenotyping of acute leukemia to identify other similar cases to better clinically define this entity.

Acid Phosphatase↗

PubMed1995

Primary cutaneous angiotropic large-cell lymphoma in a patient with acquired immunodeficiency syndrome.

Patients with acquired immunodeficiency syndrome are at increased risk of developing malignant lymphoma, particularly of the large noncleaved, immunoblastic, and small noncleaved cell types. Angiotropic large-cell lymphoma, a relatively rare high-grade lymphoma, has not previously been described in the setting of acquired immunodeficiency syndrome. Because angiotropic large-cell lymphoma most commonly involves the skin and central nervous system, and because of its relative rarity, its presentation in the skin of a patient with acquired immunodeficiency syndrome may pose a diagnostic dilemma.

Acquired Immunodeficiency Syndrome↗

PubMed1995

B-cell lymphoproliferative disorder complicated by a natural killer cell lymphoproliferative disorder of granular lymphocytes associated with T-cell gene rearrangement: case report and review of the literature.

We report an unusual case of natural killer cell lymphoproliferative disorder of granular lymphocytes associated with a T-cell receptor (TCR)-beta gene rearrangement. The patient developed the disorder 1 month after cessation of fludarabine therapy for a B-cell lymphoproliferative disorder. The B-cell lymphoproliferative disorder was no longer detectable when the natural killer cell lymphoproliferative disorder persisted. Review of the literature reveals only one reported case of natural killer cell lymphoproliferative disorder of granular lymphocytes associated with a TCR-delta gene rearrangement.

B-Lymphocytes↗

PubMed1994

Auer rod-like inclusions in adult common acute lymphoblastic leukemia.

We report a case of adult common acute lymphoblastic leukemia, defined by enzyme histochemistry and immunophenotypic analysis, which had rod-shaped cytoplasmic inclusions that on Wright's-stained peripheral blood smear resembled Auer rods. Electron microscopic analysis of a buffy coat preparation revealed that the inclusions were not characteristic of Auer rods, but rather that they were composed of concentric lamellar structures with no limiting membrane and were closely associated with the nuclear membrane. Therefore, the presence of Auer rod-like inclusions in blasts on a Wright's-stained peripheral blood smear does not preclude a diagnosis of acute lymphoblastic leukemia.

Adult↗

PubMed1994

Paroxysmal nocturnal hemoglobinuria associated with venous thrombosis and papillary endothelial hyperplasia presenting as ulcerated duodenal mass.

Paroxysmal nocturnal hemoglobinuria is an acquired clonal expansion of bone marrow stem cells that are deficient in the decay-accelerating factor, which is a complement regulatory glycoprotein (CD55), as well as in the membrane inhibitor of reactive lysis (CD59) and the C8-binding protein. These proteins are deficient on the membranes of red blood cells, granulocytes, monocytes, and platelets. The disorder is associated with intermittent hemolytic anemia, hemoglobinuria, infection, a tendency toward bone marrow aplasia, and venous thromboses. The thromboses, on resolution, may give rise to endothelial proliferation that may cause ischemia and ulceration, or, alternatively, the thromboses may cause ulceration leading to a granulation tissue response with exaggerated endothelial proliferation. We report a second case of paroxysmal nocturnal hemoglobinuria that presented roentgenographically as an ulcerated circumferential duodenal mass secondary to venous thrombosis accompanied by florid papillary endothelial hyperplasia. We also review the literature concerning this phenomenon.

Adolescent↗

PubMed1993

Demonstration of coexistent B-cell lymphoma and therapy-related acute myelogenous leukemia in lymph nodes by flow cytometry and immunohistochemistry. Case report and review of the literature.

A 58-yr-old white woman, with a 9-yr history of non-Hodgkin's lymphoma with recurrences and multi-modality therapy, presents with acute leukemia and residual lymphadenopathy. By flow cytometric analysis, cytochemistry, and cytomorphology, the leukemia is classified as acute myelogenous leukemia (AML), M4, and the lymph nodes are found to contain residual NHL in addition to an AML infiltrate. Immunohistochemistry performed on the lymph nodes correlates with the flow cytometric data. A review of the literature of AML secondary to therapy for non-Hodgkin's lymphoma is also conducted. There are no documented cases in the English literature of simultaneous involvement of lymph nodes by residual lymphoma and an AML infiltrate. Thus, this report is unique in the simultaneous involvement of lymph nodes by residual lymphoma and therapy-related AML. It emphasizes the application and usefulness of flow cytometry and immunohistochemistry in such cases.

Female↗

PubMed1989

Identifying patients with low-risk clinical stage I nonseminomatous testicular tumors who should be treated by surveillance.

We examined the records of 82 patients with clinical Stage I nonseminomatous germ cell tumors of the testis who, after radical orchiectomy, were treated by surveillance at M.D. Anderson Cancer Center between October, 1981, and March, 1987. Our purpose was to determine whether or not patients with a low risk of relapse can be identified at the time of the initial staging evaluation. In 30 of 82 patients (Group 1), embryonal carcinoma constituted less than 80 percent of the tumor, no vessel invasion was present, and the preorchiectomy serum AFP level was less than 80 ng/dL. No relapses occurred in this group. Fifty-two patients (Group 2) had more than 80 percent embryonal carcinoma or vessel invasion or a serum AFP level higher than 80 ng/dL. Relapse occurred in 24 (46%) of these patients. The difference in the rate of relapse between patients in Group 1 and Group 2 was statistically significant (P less than 0.00001). A separate analysis of teratoma as a predictor of nonrelapse showed that the orchiectomy specimens of 30 of the 82 patients contained more than 50 percent teratoma. Only 1 relapse occurred among 25 patients with more than 50 percent teratoma and no vessel invasion. Our data show that there is a subgroup of patients with clinical Stage I nonseminomatous germ cell tumor who have a very low rate of relapse. We believe these patients can be effectively treated by surveillance and should be spared the morbidity of an unnecessary retroperitoneal lymph node dissection.

Humans↗

PubMed1989

Leukemic lymphadenopathy: diagnosis by fine needle aspiration.

We report cytologic findings in 6 patients (2 with a history of chronic myelogenous leukemia and 2 with a history of acute lymphoblastic leukemia) who presented with generalized or localized lymphadenopathy of undetermined etiology. Fine needle aspiration of enlarged lymph nodes resulted in the initial diagnosis of leukemia (1 case) or blast crisis of leukemia (2 cases), confirmation of involvement by leukemia at presentation (1 case), or confirmation of relapse of leukemia (2 cases). The average number of cells in the aspirates was 20 million, sufficient for performing immunophenotypic studies, flow cytometry, cytogenetic studies, and electron microscopy. The cytological features, combined with the ancillary studies, resulted in the diagnosis and subclassification of the leukemias as follows: chronic myelogenous leukemia, blast crisis (lymphoid); chronic myelogenous leukemia, blast crisis (undifferentiated); common acute lymphoblastic leukemia; acute lymphoblastic leukemia (T-cell), acute lymphoblastic leukemia (T-cell); and malignant lymphoma, small lymphocytic type.

Adolescent↗

PubMed1988

Clinical stage I nonseminomatous and mixed germ cell tumors of the testis. A clinicopathologic study of 93 patients on a surveillance protocol after orchiectomy alone.

This study of 93 patients with Stage I nonseminomatous and mixed germ cell testicular tumors who were placed in a surveillance study following orchiectomy was designed to evaluate pathologic prognostic factors. Follow-up was at least 12 months post-orchiectomy except for one patient who was followed for 9 months. Lymphatic invasion was identified in 26 patients, 62% of whom developed distant metastases; metastasis developed in only 18% of 67 patients without lymphatic invasion (P less than 0.01). Relapse was also associated with the presence of embryonal carcinoma. Of 81 patients with an embryonal carcinoma component, 35% developed metastases, whereas none of those without an embryonal carcinoma developed metastasis (P = 0.05). Effects of other histologic features and tumor size were not significant. Lymphatic invasion appeared to be a significant poor prognostic factor, and embryonal carcinoma was an independent poor prognostic factor.

Adolescent↗

PubMed1984

Human neutrophil N-acetyl-beta-D-glucosaminidase: granule localization. Further evidence for two azurophil granules.

The heterogeneity of human neutrophil granules, particularly of azurophil granules, defined as peroxidase containing, was examined by measuring N-acetyl-beta-D-glucosaminidase in fractions of isopycnic sucrose gradients of such granules. Neutrophil granules were prepared from normal human blood, monodispersed in heparinized sucrose, and centrifuged by established methods. N-Acetyl-beta-D-glucosaminidase was previously shown to be exquisitely sensitive to small amounts of heparin; paradoxically, larger amounts restore activity. The inhibition is reversed with protamine. N-Acetyl-beta-D-glucosaminidase activity had its peak at density 1.20 gm/ml (band B) and a lesser peak at density 1.22 gm/ml (band A). Mean specific enzyme activity was 899 +/- 217 nmol p-nitrophenol released per minute per milligram protein in gradient fraction 12 (band B), and 507 +/- 149 nmol p-nitrophenol released per minute per milligram protein in fraction 8 (band A) (p less than 0.01), which correlated in part to the significantly higher protein content in band A. These specific activities are 31-fold and 17-fold greater, respectively, then mean neutrophil lysate specific activity of 28.8 +/- 7.0 nmol p-nitrophenol released per minute per milligram protein, indicating a considerable concentration of granule enzyme activity in these gradient bands. The gradient distribution of N-acetyl-beta-D-glucosaminidase is nearly identical to that of myeloperoxidase and beta-glucuronidase, thus providing another enzyme marking the existence of two populations of azurophil granules, separable by density. Of total gradient enzyme activity, the mean percentage distribution of N-acetyl-beta-D-glucosaminidase in the pellet was 0.3%. Because the mean percentage of total gradient activity in the pellet was on an order of magnitude higher for myeloperoxidase (4.7%), beta-glucuronidase (3.7%), lysozyme (3.9%), and protein (2.8%), our data suggest that N-acetyl-beta-D-glucosaminidase has a possibly unique site within or an affinity to one or both of the two populations of azurophilic granules that is distinct from that for myeloperoxidase and beta-glucuronidase.

Acetylglucosaminidase↗

PubMed1983

Human neutrophil N-acetyl-beta-D-glucosaminidase: heparin inhibition.

To determine N-acetyl-beta-D-glucosaminidase (EC 3.2.1.30) in human neutrophil granules separated by a method requiring heparin, the inhibition of this enzyme by heparin was studied. Neutrophils were purified from blood of five donors by modifications of the Hypaque-Ficoll and dextran separation methods resulting in a suspension which was 96% neutrophils. Neutrophil lysates were assayed for N-acetyl-beta-D-glucosaminidase by measuring the amount of p-nitrophenol released from p-nitrophenyl-N-acetyl-beta-D-glucosaminide. The reaction showed first-order kinetics with regard to enzyme concentration. Triton X-100, 0.1% v/v, enhanced enzyme activity. Heparin was shown to reduce neutrophil lysate N-acetyl-beta-D-glucosaminidase to a specific activity of 46% at a heparin concentration of 2 units per assay and to 43% (maximal inhibition) at 17 and 50 units of heparin per assay. Substantially higher heparin concentrations partially restored the inhibited activity, the maximal restoration being a return to 80% of the original activity at 1700 units of heparin per assay. Protamine sulfate was assessed for its ability to restore N-acetyl-beta-D-glucosaminidase activity in the presence of heparin. At 1.0 mg/10 units of heparin, protamine restores enzyme activity to its heparin-free activity. These studies of human neutrophil N-acetyl-beta-D-glucosaminidase demonstrate: (1) specific enzyme activity is 28.8 +/- 7.0 nmole p-nitrophenol released per minute per milligram of protein or 1.7 +/- 0.5 nmole p-nitrophenol released per minute per 10(6) neutrophils; (2) heparin rapidly but finitely inhibits enzyme activity at very low concentrations and paradoxically restores it toward normal at high concentrations; and (3) protamine sulfate restores enzyme activity inhibited by heparin.

Acetylglucosaminidase↗

PubMedDate not supplied

Changes in quality-of-life scores in a population of patients treated for squamous cell carcinoma of the head and neck.

BACKGROUND: Quality of life levels fluctuate depending on treatment type and at various points throughout treatment. In patients with advanced head and neck cancer, quality of life is thought to be treatment dependent. The purpose of this study is to compare levels of patients self-reported quality of life across treatment. PATIENTS AND METHODS: Preliminary data presented here are based on 24 patients enrolled so far in an experimental organ-preservation protocol. The two treatment groups consist of one group treated with chemotherapy (paclitaxel and carboplatin) followed by radiation therapy and the second group which is treated with chemotherapy (paclitaxel and carboplatin) followed by surgery and postoperative radiation. Data is collected pretreatment and at uniform points throughout the course of treatment. RESULTS: Preliminary results suggest that quality of life is significantly higher in the nonsurgical group than in the surgical group at the last treatment point reported. Social distress/avoidance is also lower in the nonsurgical group. Because of the small number of patients represented in this study, results should be interpreted with caution and should be viewed as descriptive at this juncture. CONCLUSION: Quality of life seems to be preserved in patients who experience less invasive and disfiguring treatment, and who also have compromised eating and communication abilities. Data collection in this study is ongoing.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Spontaneous resolution of myelodysplastic cytogenetic abnormality developed during the treatment of leukemia.

PURPOSE: We describe the spontaneous resolution of a myelodysplastic cytogenetic abnormality developing during the treatment of acute lymphocytic leukemia. PATIENTS AND METHODS: A 6-year-old girl with acute lymphocytic leukemia had a clinical picture of myelodysplasia 18 months after diagnosis. The clonal cytogenetic abnormality, 46,XX,del(5)(q12q12), resolved spontaneously 4 months after the discontinuation of chemotherapy. Maintenance chemotherapy was resumed 1 month later and continued for an additional 9 months. Currently, she has been off therapy for 10 months. CONCLUSION: A myelodysplastic clonal cytogenetic abnormality developing during treatment may cause some confusion for management. This study demonstrates that spontaneous resolution is possible and that bone marrow transplantation or other intensive treatment may not be necessary.

Bone Marrow↗

PubMedDate not supplied

Multiple myeloma with monoclonal surface immunoglobulin expression: a case report.

BACKGROUND: Plasma cells from patients with multiple myeloma have been found to express the immunophenotype of normal plasma cells without surface immunoglobulin expression. CASE: A case occurred of multiple myeloma with monoclonal surface immunoglobulin expression, defined by morphology and flow cytometric immunophenotyping of a fine needle aspiration biopsy of an osteolytic rib lesion and a bone marrow aspirate as well as urine and serum protein electrophoresis with immunofixation. CONCLUSION: The clinical significance of monoclonal surface immunoglobulin expression in rare cases of multiple myeloma is uncertain, and other parameters with clinical significance (CD10 positivity, multiple myeloid antigen expression) will continue to be more useful until additional cases accrue.

Antibodies, Monoclonal↗

PubMedDate not supplied

Small noncleaved cell lymphoma presenting as a massive pericardial effusion. A case report.

BACKGROUND: Non-Hodgkin's lymphoma (NHL) is commonly associated with cardiac involvement, especially in cases of advanced stages with mediastinal involvement. Much rarer is the initial presentation of NHL as a pericardial effusion; there are only 12 cases reported. In addition, only 5 of these 12 cases were correctly diagnosed based on examination of pericardial fluid prior to death: 3 were based on routine cytology; 1 on immunoperoxidase staining and 1 on an immunofluorescent slide method. CASE: A 71-year-old, white female presented with a massive pericardial effusion. Small noncleaved cell lymphoma was expeditiously diagnosed by cytologic examination combined with flow cytometric immunophenotyping. No further diagnostic tissue was obtained; the patient was staged and offered treatment with a protocol for high grade lymphoma. CONCLUSION: Combining cytomorphology and flow cytometric immunophenotyping in such cases results in an expeditious, nonsurgical diagnosis, upon which therapeutic decision making may be based.

Aged↗

PubMedDate not supplied

Computed tomography-guided fine needle aspiration biopsy of adrenal myelolipoma. Case report and review of the literature.

A case of adrenal myelolipoma diagnosed by fine needle aspiration (FNA) biopsy is reported. The FNA smears contained the diagnostic picture of mature adipose tissue intermixed with hematopoietic elements, including megakarycytes. The FNA diagnosis was histologically confirmed by study of the resected tumor. This case appears to be the first "giant" adrenal myelolipoma diagnosed by computed tomography-guided FNA biopsy. The literature on adrenal myelolipomas sampled by FNA using imaging guidance is briefly reviewed.

Adrenal Gland Neoplasms↗