Biomedical subjects
Publications and source records attributed to C Simopoulos.
This case report describes a patient with multicentric mixed type Castleman's disease and concomitant non-Hodgkin's lymphoma of diffuse large B cell type in the neck. Multicentric CD is a systemic illness with disseminated lymphadenopathy; its aggressive and usually fatal course is associated with infectious complications and risk for malignant tumors, such as lymphoma or Kaposi sarcoma.
We report a case of a patient with inflammatory pseudotumor (IPT) of the spleen. IPTs can appear at many sites and represent rear lesions of uncertain etiopathogenesis. Usually they present as mass lesions, so the clinical and radiologic features often suggest malignancy. However, the microscopic findings are quite characteristic, and the diagnosis can be made readily by identifying the reactive nature of the cells. Diagnostic problems can arise when these lesions occur in lymphoid organs or the spleen.
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Prognosis of colonic carcinoma is poor. The two most important factors having the greatest effect on survival are pathologic stage of disease and histologic grade of the tumor. Our study points towards the value of HLA-DR antigen in the prognosis of colonic carcinoma. We studied 31 cases of normal colonic mucosa, 12 cases of tubulo-villous adenoma, and 39 cases of invasive carcinoma for the detection of HLA-DR monoclonal antigen. Yet, we investigated the association of HLA-DR and DQ genes and adenoma and carcinoma by PCR. We also studied the T helper (TH) marker (CD4) in the lamina propria of the relevant cases, given that the dependence of immune responsiveness on the class II antigens reflects the central role of these molecules in presenting antigen to TH cells. HLA-DR was expressed in 20 of 31 normal colonic mucosa (64.5%), 4 of 12 adenomas (33.3%), and in 10 of 39 invasive carcinomas (25.6%). No significant correlation between HLA-DR and DQ genes and adenoma or cancer of the colon was found. CD4 was expressed in 9 of 31 normal colonic mucosa (29%), 5 of 12 adenomas (42%), and in 26 of 39 invasive carcinomas (67%). The results showed decreased expression of HLA-DR and increased expression of CD4 as the lesion progressed to malignancy. HLA-DR and DQ genes do not contribute to a susceptibility to adenoma or carcinoma. The immune attract mechanism by low HLA-DR signaling seems to be of minor importance in the malignant and metastatic potential of the colonic carcinoma.