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Biomedical subjects

E Kaiserling

Publications and source records attributed to E Kaiserling.

At least 145 records · Page 8Linked to original sources
PubMed1992

Primary splenic presentation of plasma cell dyscrasia: report of two cases.

Primary splenic presentation of plasma cell tumors is extremely rare. Recently we observed two female patients with primary (initially solitary) plasmacytoma of the spleen. While the pathoanatomical diagnosis of plasmacytoma could be established easily, the clinical picture in both cases was puzzling and allowed no definitive diagnosis to be made. One of the patients exhibited a long-standing monoclonal gammopathy. Repeated bone marrow examinations in both patients revealed slight increase in plasma cells (between 5 and 10% of all nucleated cells), but no infiltrates of multiple myeloma. The leading clinical feature in both cases was pronounced splenomegaly (780 g and 1600 g). Histologically both spleens exhibited marked infiltration by pleomorphic plasma cells, with monotypic expression of IgG kappa in one case and of the light chain lambda in the other. A broad panel of monoclonal antibodies detecting various hemopoietic and nonhemopoietic antigens was used to determine the immunophenotype of the neoplastic plasma cells, but in both cases they reacted only with a minority of the antibodies applied. The bone marrow in both cases remained free of tumorous infiltrates, but the disease progressed a few months after splenectomy with infiltration of the liver in one case and of lymph nodes in the other. To summarize, these two cases are definitely not multiple myelomas but could represent a distinct entity among the plasma cell dyscrasias for which the preliminary term "disseminated plasmacytoma with primary splenic presentation" is proposed.

Adult↗
PubMed1991

[A fistula between the rectosigmoid junction and the ileum as a complication of highly malignant AIDS-associated lymphoma].

A 29-year-old man, a known heroin addict until 1984 in whom HIV antibodies had been first demonstrated in 1985, was hospitalized because of fever, nocturnal sweating, weight loss and treatment-resistant diarrhoea. An opportunistic infection of the gastrointestinal tract was excluded microbiologically and serologically. Coloscopy and biopsy revealed a highly malignant gastrointestinal B-cell lymphoma, which had caused a spontaneous rectosigmoid-ileum fistula. Lymphoma infiltrations were also found in the duodenum, jejunum, left lung and brain. Because the underlying disease was far progressed (CD4/CD8 ratio: 0.04) and the patient was in a poor general condition neither surgery nor chemotherapy was undertaken. He died of cerebral lymphoma involvement. Gastrointestinal lymphoma should be included in the differential diagnosis of chronic diarrhoea in HIV-positive patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Paraproteinemic corneal deposits in plasma cell myeloma.

We treated two patients who had IgG-kappa-light chain monoclonal gammopathy with partially crystalline and partially amorphic corneal deposits. Impairment of vision made keratoplasty necessary for each patient. Histologic examination of the corneal specimens showed deposits that stained positively for Masson's trichrome in all corneal cells. Immunohistochemical tests identified these deposits as IgG-kappa-light chain immunoglobulin fragments. Electron microscopy showed intracellular, rhomboid-shaped deposits enveloped by a membrane. The same deposits appeared in the conjunctival epithelium, within subconjunctival fibrocytes, and in the plasma cells of the bone marrow. Immunoelectrophoresis showed IgG-kappa-light chain fragments in the blood serum, the lacrimal film, and the aqueous humor. This suggests that the intracellular immunoglobulin fragments may have entered the corneal and conjunctival epithelium by way of the lacrimal film, the keratocytes by way of the corneo-scleral limbus vasculature, and the endothelial cells from the aqueous humor.

Aged↗
PubMed1991

Primary extraskeletal mesenchymal chondrosarcoma of the lid.

A 15-year-old girl presented with a painless nodule in the nasal lower-lid portion of the left eye at the beginning of 1989. The tumor was excised in March 1989, and the histopathologic diagnosis was - erroneously - a chondromatous choristoma of the lid. The tumor recurred within several weeks. Another excision was performed, which led to the diagnosis of a malignant mesenchymal chondrosarcoma of the lid. Histopathology revealed the typical bimorphic pattern, with well-differentiated chondrocytes being surrounded by small anaplastic cells. The tumor cells stained positive for S100-protein and vimentin, were negative for cytokeratin and were studied ultrastructurally. Radical excision and adjuvant chemotherapy were performed in our patient; at 18 months after the onset of tumor growth, she is free of local or general tumor recurrence. To our knowledge, primary mesenchymal chondrosarcoma has not previously been described in the lid area.

Adolescent↗
PubMed1991

Lectin histochemistry of human bone marrow: investigation of trephine biopsy specimens in normal and reactive states and neoplastic disorders.

The lectin binding pattern of bone marrow cells in normal and reactive states and in various neoplastic disorders was investigated using trephine biopsy specimens taken from the iliac crest. The tissue samples were routinely processed (fixed in formalin and embedded in paraffin wax) and subjected to mild decalcification with EDTA. The following results were obtained. (1) More than half of the 23 fluoresceinated lectins used reacted with normal blood cells and/or their neoplastic derivatives. Inhibition tests with the appropriate sugars confirmed the specificity of binding for the majority, but not all, of the lectins. (2) WGA, Con A, PSA, STA and RCA60 and RCA120 produced a particularly intense reaction with normal, reactive and neoplastic myeloid cells. Erythroblasts exhibited weak staining in a few cases by a few lectins (WGA producing the strongest staining), while megakaryocytes nearly always remained unstained. Neoplastic lymphoid cells in various lymphoproliferative disorders and plasmacytoma cells generally reacted with the same lectins as the myeloid cells. (3) Since neoplastic myeloid cells in various myelodysplastic and myeloproliferative disorders exhibited a lectin binding pattern similar to that of myeloid cells in normal and reactive bone marrow, it is unlikely that lectin histochemistry of the bone marrow will prove of great value in the diagnosis of myelodysplastic-myeloproliferative disorders.

Blood Cells↗
PubMed1991

Freeze-fracture morphology of nuclear pockets.

Nuclear pockets (NP) are found in numerous human tumours and in certain non-neoplastic cells. This study concerns the structure of NP in cells from two malignant rhabdoid tumours, one embryonal rhabdomyosarcoma, two centroblastic/centrocytic lymphomas, one centrocytic lymphoma and one Ki-1 lymphoma, as well as in normal neutrophils. Structures were noted in freeze-fracture replicas that were interpreted as corresponding to the NP seen in ultrathin sections and were classified into four types. A lack of nuclear pores was common to all types. In addition, intramembranous particles were either absent or very scanty on both the E- and the P-faces of areas of the nuclear membrane involved in pocket formation. It can be concluded from the lack of nuclear pores that no interchange between the nucleus and cytoplasm takes place in these areas. The reason for the lack of intramembranous particles is not known. It is suggested that the nuclear lamina (intermediate filaments of the nuclear skeleton) is not in contact with the nuclear membrane here.

Adult↗
PubMed1991

Lectin binding patterns of human tissue mast cells indicate marked phenotypical diversity.

Glycoconjugate expression by human tissue mast cells (MCs) from various sources (including lymph nodes with signs of chronic non-specific lymphadenitis, skin lesions of urticaria pigmentosa, and bone marrow infiltrates associated with systemic mastocytosis) was studied histochemically with a broad panel of fluorescein-labelled lectins. Of the 19 lectins applied, 11 (sugar specificities: fucose, N-acetylgalactosamine and neuraminic acid) did not stain any MCs, while 8 (sugar specificities: mannose, N-acetylglucosamine, and galactose) were found to bind to MCs. These lectins exhibited different binding patterns in various disease entities. Only a few of these 8 lectins (in particular, phythaemagglutinin-L) produced strong staining of the MCs in most or all of the cases. Some (e. g. phythemagglutinin-E) produced only weak staining, and this in only a few cases. The lectins used, however, did not distinguish between reactive and tumorous MCs. Although lectins are therefore unlikely to be of use in resolving problems of differential diagnosis concerning proliferation of MCs, our investigation has shown that tissue MCs exhibit marked phenotypical diversity with regard to their lectin-binding properties.

Biopsy↗
PubMed1991

Ultrastructural localization of HMB-45 binding sites.

Three malignant melanomas, two melanoma metastases, two junctional dysplastic nevi, and normal skin were embedded in Lowicryl. Ultrathin sections were incubated with HMB-45 and a gold-labeled anti-mouse antibody. Gold particles indicating the presence of HMB-45 were found in melanosomes Stage 1 and 2 and in the non-melanized portion of melanosomes Stage 3. Melanosomes Stage 4 and melanosome complexes in keratinocytes, as well as in melanophages, were consistently negative. No specific labelling with HMB-45 was seen in eccrine glands of normal skin.

Antibodies, Monoclonal↗
PubMed1991

Lymphoepithelial cyst of the pancreas. Clinical, morphological, and immunohistochemical findings.

Lymphoepithelial cyst of the pancreas, formerly also termed branchial cyst, is an extremely rare tumor of uncertain histogenesis. Our case, that of a 53-year-old man, is the fourth to be described. Fluid aspirated from the cyst exhibited a very high concentration of carcino-embryonic antigen (CEA; 5000 ng/ml), and a high level of carbohydrate antigen 19-9 (CA 19-9; 187 U/l), suggesting a diagnosis of carcinoma of the pancreas. However, the serum CEA and CA 19-9 levels were only slightly elevated (5.5 ng/ml and 125 U/l, respectively). Histologic investigation revealed a cyst lined by squamous epithelium with closely associated lymphoid tissue, without cellular atypia. Numerous lymphocytes, mainly T cells (UCHL1 positive), were present in the lining epithelium. The lymphoid tissue surrounding the lining epithelium was composed of germinal centers and T regions. Epithelial cords contiguous with the squamous epithelium lining the cyst radiated out through the lymphoid tissue towards the pancreatic parenchyma, which suggests that lymphoepithelial cyst of the pancreas is a true pancreatic cyst. Since the excretory ducts of the normal pancreatic tissue and some of the epithelial cells lining the cyst were immunoreactive for CEA and CA 19-9, it can be concluded that CEA and CA 19-9 in the cyst contents are probably produced by cells derived from the exocrine pancreas. The histogenesis of lymphoepithelial cyst of the pancreas remains unclear, but it is probable that it derives from the duct system of the pancreas.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

[Meckel's diverticulum and lower gastrointestinal bleeding. Problems of preoperative diagnosis].

A hitherto perfectly healthy 28-year-old man suddenly passed stools containing bright red blood, and haemoglobin concentration fell at first to 10.1 g/dl. No bleeding source was found on gastroscopy and coloscopy. Nor was the source found by enteroclysis during a bleeding-free interval. Emergency laparotomy was performed after a recurrence of massive bleeding and revealed, 60 cm oral of the ileocaecal (Bauhin's) valve, a Meckel's diverticulum with ulcerated heterotopic gastric mucosa, 5 x 3 x 2 cm in size, and this was resected. 17 red blood cell concentrates had to be infused pre- and postoperatively, but there were no further complications.

Adult↗
PubMed1990

Acute myeloid leukemia: immunohistologic findings in paraffin-embedded bone marrow biopsy specimens.

Immunohistochemical investigations were performed on decalcified, paraffin-embedded iliac crest trephine biopsy specimens from 30 cases of acute myeloid leukemia (AML, as defined by the FAB classification) with antibodies against B cells (L26, 4KB5, MB1, Ki-B3), T cells (UCHL1, MT1), myeloid/histiocytic cells (anti-neutrophil elastase, MAC387, anti-S-100 protein, anti-alpha 1-antichymotrypsin, DAKO-M1), natural killer/killer cells (anti-Leu-7), and megakaryocytes (anti-factor VIII-related antigen). (1) The blast cells of all the cases reacted with from at least two to at most eight different antibodies. Each antibody reacted with blast cells in a minimum of two (maximum 30) cases. (2) MT1, Ki-B3, anti-alpha 1-antichymotrypsin anti-neutrophil elastase, anti-S-100 protein, and MAC387 stained blast cells in more than 50% of the cases; MB1, L26, UCHL1, 4KB5, and DAKO-M1 in 20% to 50% of the cases; and anti-Leu-7 and anti-factor VIII-related antigen in less than 20% of the cases. (3) In the majority of cases many T lymphocytes, a small-to-moderate number of B lymphocytes, and a few Leu-7-positive lymphoid cells were intermingled with the blast cells. In some cases, especially where only a minor proportion of the blast cells was immunostained, it was nearly impossible to distinguish the lymphocytes of the tumor's stromal reaction from small blast cells. Thus, AML exhibits a heterogeneous immunophenotype in trephine biopsy specimens. Immunohistologic diagnosis of this disease in such specimens may be extremely difficult. Since staining of the blast cells with one or more of the antibodies generally used to define B cells, T cells, or their neoplastic derivatives is not uncommon, misinterpretation as non-Hodgkin's lymphoma of high-grade malignancy could easily occur. These findings also suggest that mixed-type (hybrid) acute leukemias with coexpression of myeloid and lymphoid cell markers could be more common than generally realized.

Adolescent↗
PubMed1990

Immunohistology of the human spleen after bone marrow transplantation for leukemia with special reference to the early post-transplantation period.

Immunohistochemical investigations were undertaken on paraffin-embedded tissue from the spleens of seven patients who had died after bone marrow transplantation (BMT) for leukemia. Parallel investigations were undertaken on three surgically resected traumatically ruptured (but otherwise normal) spleens and three spleens removed at autopsy from accident victims. 1) Up to ten weeks after BMT, the splenic lymphoid tissue was extremely atrophic. Lymphoid follicles (LFs) and periarteriolar lymphatic sheaths (PALS) were completely absent. A considerable increase in lymphoid cells in the red pulp and formation of small LFs and PALS occurred only in the longest surviving patient, who had died 50 weeks after BMT. 2) B cells (L26+, 4KB5+, Ki-B3+) were almost completely absent in the early post-transplantation period and thus T cells (UCHL1+) represented the major constituent of the hypoplastic splenic lymphoid tissue. Considerable numbers of T cells were already found two weeks after BMT. T-immune-accessory reticulum cells (S-100 protein+) were found in the PALS of the controls, but were absent in three of the BMT recipients. The findings clearly reflect the marked immunodeficiency in the early post-transplantation period, during which many patients (4/7 in this study) die of opportunistic infections, and are in line with the fact that the earliest signs of reconstitution of the immune system have been found to occur at three months post-transplantation. Since six of our BMT recipients had suffered from graft-versus-host disease our findings probably do not fully correspond to those when the immune system undergoes undisturbed reconstitution.

Adolescent↗
PubMed1990

[Carcinoid tumor of the middle ear. Morphology, immunohistochemistry, clinical aspects and differential diagnosis].

We describe the unusual case of a carcinoid tumour of the middle ear occurring in a woman of 50 years of age. The tumour exhibited both glandular and neuroendocrine differentiation. Immunohistochemical demonstration of chromogranin A is of particular diagnostic importance as evidence of neuroendocrine differentiation. The morphological spectrum of the middle ear tumours with neuroendocrine and/or glandular differentiation reported in the literature is discussed in detail. These tumours are arranged schematically according to the degree of glandular and of neuroendocrine differentiation, and are compared with the tumours of other regions. The data in the literature do not allow unequivocal assertions concerning the prognosis of carcinoid tumours of the middle ear to be made, and very diverse therapeutic measures have been employed in the reported cases. In our case there is no evidence of recurrence six months after local tumour excision.

Biomarkers, Tumor↗