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Biomedical subjects

G B Schumann

Publications and source records attributed to G B Schumann.

At least 37 records · Page 2Linked to original sources
PubMed1988

Leukocyturia in cyclosporine-treated renal allograft recipients.

Five hundred eighty-seven daily urine specimens were examined from 179 consecutive renal allograft recipients with the use of quantitative cytodiagnostic urinalysis. Specimens were divided between those patients receiving cyclosporine (CyA) and steroid immunotherapy (73 patients) and those receiving standard azathioprine (Aza) and steroid immunotherapy (106 patients). When patients with urinary tract infections were excluded, an increase in leukocyturia was observed in the CyA-treated patients. Ninety-three percent of the CyA-treated patients had at least one specimen with more than 1,000 neutrophils/10 high-power fields (HPFs) versus 62% of the 106 Aza-treated patients. Sixty-four percent of the specimens examined from the CyA-treated group had more than 1,000 neutrophils/10 HPFs compared with only 18% of specimens from Aza-treated patients. It appears that CyA is a cause of sterile leukocyturia in renal allograft recipients. The significance of leukocyturia in CyA nephrotoxicity needs further definition.

Azathioprine↗
PubMed1987

Cytologic diagnosis and monitoring of Hodgkin's disease in cerebrospinal fluid: a case report.

Central nervous system (CNS) involvement in Hodgkin's disease is rare, but when the tumor extends into the CNS the route of tumor spread is similar to that seen in non-Hodgkin's lymphoma. Reed-Sternberg cells were identified in the cerebrospinal fluid (CSF) of a patient with Hodgkin's disease involving the CNS. Sequential cytologic examination of the CSF proved valuable in evaluating the efficacy of therapy. The ability to identify Reed-Sternberg cells in the CSF makes CSF cytology a useful adjunct in the management of patients with established or suspected CNS involvement of Hodgkin's disease.

Adult↗
PubMed1987

Cytodiagnosis and monitoring of acute lymphocytic leukemia and eosinophilia in cerebrospinal fluid.

A case of adult aleukemic leukemia with an isolated CNS relapse diagnosed by cytologic examination of the CSF is reported. CSF hypereosinophilia of uncertain significance was documented. Immunologic marker studies (CALLA, HTA, Tdt) were performed on the CSF and showed a null cell acute lymphocytic leukemia. Sequential CSF specimens were obtained to determine the continued presence of lymphoblasts. Cytologic monitoring of the CSF in acute leukemia is a useful technique to determine disease status and efficacy of therapy. We advocate the use of cell morphology for monitoring, reserving the use of cell markers for initial identification of malignant cells and for use when the cell morphology is altered.

Adult↗
PubMed1986

Semiquantitative approach to CSF cytopathology.

During the past two years, our laboratory has introduced a semiquantitative membrane filter approach to cerebrospinal fluid (CSF) cytology. Five hundred and thirty-five CSF specimens, averaging 3 ml in volume, were placed over 25-mm diameter Millipore filters (5-mu pore size) and stained using a modified Papanicolaou method. Each microscopic evaluation consisted of a cell count per milliliter, a 100-cell differential, and a diagnostic or interpretive statement. Seventy-four (13.8%) positive, 17 (3.2%) atypical, 439 (82%) negative, and 4 (1%) unsatisfactory specimens were evaluated. Seventy-four percent of the positive or atypical CSF specimens had mononuclear cell counts within the medically accepted normal range of five mononuclear cells per cubic millimeter (chamber count method) or 5,000 cells per millimeter (cytologic method). The small-filter technique offered advantages because it maximized cell retrieval, localized cells, and shortened the time required for microscopic evaluation.

Cell Count↗
PubMed1986

Primary cytodiagnosis of peritoneal extramedullary hematopoiesis.

Cytologic examination of peritoneal fluid in a patient with known myelofibrosis and previous splenectomy revealed megakaryocytes along with erythroid and myeloid precursors. These findings were consistent with extramedullary hematopoietic (EMH) implants of the peritoneum. A few similar cases have been occasionally reported in the literature. This case represents an additional example of a primary diagnosis of peritoneal EMH in which therapy was based on the cytologic findings and sequential cytologic observations were made.

Ascites↗
PubMed1986

Prevalence of hematuria in urothelial neoplasia.

Voided urine specimens from 82 cases of histologically verified urothelial neoplasia (transitional cell carcinoma grades I, II, III, and carcinoma in situ [CIS] ) were evaluated for the presence of gross and microhematuria (MH). Microhematuria was assessed macroscopically with the reagent-strip blood test and evaluated microscopically with enumeration of erythrocytes using a standardized semiquantitative Papanicolaou-stained urine sediment examination. The authors' retrospective study indicated that gross hematuria rarely was present in urothelial neoplasia, however, occult blood (greater than 5 RBC/HPF) was present in four out of five cases when one sample was examined. In some cases there was an overlap between the number of erythrocytes excreted by control population and those with urothelial neoplasms. Urine sediment examination was more sensitive than reagent-strip testing for MH in patients with urothelial neoplasia.

Adult↗
PubMed1986

Comparison of dysmorphic erythrocytes with other urinary sediment parameters of renal bleeding.

Dysmorphic erythrocytes have been described in the urine sediment of patients with renal parenchymal bleeding. This study compares the prevalence of dysmorphic erythrocytes in 5,128 urine specimens with blood, erythrocytic, or fibrin casts, proteinuria, and significant numbers of exfoliated renal tubular cells (RTCs). Of the 510 samples containing pathologic casts, 15% had dysmorphic erythrocytes, 60% had proteinuria, 71% had RTCs, and 12% had no other urinalysis abnormality. Of the 186 samples containing dysmorphic erythrocytes, 55% had pathologic casts, 42% had proteinuria, 71% had RTCs, and 13% had no other abnormality. Renal hematuria can best be evaluated by examination of all four of these urinalysis abnormalities rather than using a single entity for diagnosis. Patients with urinalysis evidence of renal hematuria should be evaluated further for renal disease rather than lower urinary tract disorders.

Erythrocytes, Abnormal↗
PubMed1985

Reliability of urinary cytodiagnosis in urothelial neoplasms.

A retrospective study was done to explore the reliability of urinary cytologic examination of 117 cases of transitional cell carcinoma seen at this institution for the period 1980 to 1984. A specificity of 99%, sensitivity of 85%, false-positive rate of 11%, and false-negative rate of 10% were obtained. A single blind review of cytologic and histologic material from 66 of the cases was also performed for evaluation of the cytologic criteria employed for the grading of tumors. Cytohistologic correlation of grade I lesions was poor, whereas correlation of grades II and III was reasonably good. Carcinoma in situ was cytologically recognized in all instances but was difficult to distinguish from grade III carcinoma.

Carcinoma in Situ↗
PubMed1985

The urinary myeloma cast. Frequency of detection and clinical correlations in 30 patients with multiple myeloma.

The authors examined urine specimens from 30 patients with multiple myeloma (MM) to determine the usefulness of cytodiagnostic urinalysis in evaluating such patients. Nine patients had clinical evidence of renal failure. In six of these nine patients (67%), or 20% of all patients, the urine sediment contained unique "MM-casts." These were characterized by a waxy to granular matrix surrounded by reactive, syncytial, giant cells with occasional renal cells embedded in the cast matrix. These casts were not observed in urine specimens from patients with normal renal function. Renal biopsy in two patients with MM-casts confirmed that cytologic diagnosis of "MM-kidney." The patient groups with or without MM-casts were comparable with respect to age, sex, and clinical stage of disease. In contrast, those with MM-casts were more likely to have clinical evidence of renal disease (100% vs. 13%), Bence Jones proteinuria (100% vs. 35%), hypercalcemia (50% vs. 8%), and hyperuricemia (50% vs. 4%). The two groups could not be distinguished reliably by urine physicochemical determinations. However, there were marked differences in the frequency of microscopic abnormalities. All patients with MM-cast formation excreted other pathologic casts as well and had evidence of tubular injury, while five of six had evidence of ischemic necrosis. This compared with 17%, 13%, and 21%, respectively, of those without MM-casts. Thus, cytodiagnostic urinalysis is of value in distinguishing MM-kidney from the numerous other causes of renal failure in patients with MM.

Acute Kidney Injury↗
PubMed1985

Cerebrospinal fluid cytopathology.

Cerebrospinal fluid (CSF) evaluations represent important diagnostic procedures for many pathologic conditions of the central nervous system, such as meningitis, encephalitis, and brain tumors. The authors' discussion of CSF cytopathology includes specimen collection and cytopreparation, microscopic evaluation, cell differential and cell counting methods, and the cellular composition of pathologic CSF. The accuracy of CSF cytopathology is indicated and future trends are noted.

Brain Neoplasms↗
PubMed1984

Urinary cytodiagnostic abnormalities in 50 patients with non-Hodgkin's lymphomas.

Urinary cytodiagnostic evaluation was performed on 50 consecutive patients with non-Hodgkin's lymphomas. In 14 patients (28%) the urine sediment contained characteristic lymphoma cells. The groups with or without a positive urine cytology were comparable with respect to type of lymphoma, stage and course of disease, and recent treatment with chemotherapy. However, those with a positive urine cytology were more likely to have clinical evidence of kidney disease (43% vs 8%), although this was rarely attributed to disseminated lymphoma. In fact, in three patients, a positive urine cytology was the sole or presenting evidence for disseminated lymphoma. Although the groups with or without a positive cytology were similar with regard to physicochemical urinary findings, there were marked differences in the frequency of microscopic abnormalities. All patients with a positive cytology had evidence of renal parenchymal necrosis, renal tubular injury, or pathologic cast formation as compared with only 56% of those with a negative cytology. Thus, urinary cytodiagnostic evaluation may provide an important adjunct in the staging and evaluation of patients with malignant lymphomas.

Humans↗
PubMed1984

Identification of fungal casts in a patient with renal candidiasis.

Since the treatment of fungal infections with amphotericin B may result in significant nephrotoxicity, better methods for discriminating between life-threatening and more benign fungal infections are needed. Recently numerous fungal casts were identified in the urine of a patient who had undergone renal allograft transplantation. The recognition of fungal casts permitted an unequivocal diagnosis of systemic fungal infection. Successive examinations of the patient's urinary sediment provided an excellent monitor of the response to treatment. The cytologic features of fungal casts are described. Since systemic fungal infections often involve the kidney, screening for fungal casts may have significant clinical applicability.

Adult↗
PubMed1984

The clinical significance of candidal casts.

Examination of the urinary sediment for fungal casts is a new and simple approach for assessing renal involvement in fungal infections. Identification of candidal casts was used to diagnose renal fungal involvement in five immunocompromised patients. In three cases, the examination of the urinary sediment permitted the diagnosis of early and presumably noninvasive renal candidal infections that cleared easily with relatively low doses of antifungal therapy. In two other cases, the recognition of candidal casts confirmed renal involvement in patients with disseminated disease.

Adult↗
PubMed1983

Identification of a toxoplasma cyst by fine-needle aspiration.

In the course of evaluating the fine-needle aspiration technic a toxoplasma cyst was identified in a lymph node excised from a patient in whom toxoplasmosis subsequently was confirmed serologically. This is the first reported case in which a cyst was identified by this method. The recognition of a cyst and characteristic cytologic features in the aspirate demonstrates the utility of fine-needle cytologic examination in diagnosing toxoplasmic lymphadenitis.

Adult↗
PubMed1983

Renal epithelial fragments in urine from a nephrostomized patient: a case report.

Renal epithelial fragments, an infrequently reported entity, were observed by cytologists in urine sediment from a patient who underwent nephrostomy for the relief of a ureteral obstruction. This case report describes the occurrence and various cytomorphologic features of exfoliated renal fragments. Urine specimens obtained following the insertion of a nephrostomy tube can provide the cytologist a unique opportunity to study and distinguish renal epithelial fragments from those of urothelial origin.

Epithelium↗