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Biomedical subjects

G Frizzera

Publications and source records attributed to G Frizzera.

At least 91 records · Page 5Linked to original sources
PubMed1986

Diagnostic specificity of histologic features in lymph node biopsy specimens from patients at risk for the acquired immunodeficiency syndrome.

The most common histologic pattern observed in lymph node biopsy specimens from homosexual men with the syndrome of persistent generalized lymphadenopathy is that of florid hyperplasia of germinal centers. This change has been characterized as showing large and irregular germinal centers, mantle zone effacement, follicle lysis, germinal center hemorrhage, granuloma formation, and focal sinusoidal monocytoid cell hyperplasia. Fifty lymph node biopsy specimens coded as nonspecific reactive follicular hyperplasia and antedating the epidemic of the acquired immunodeficiency syndrome (AIDS) (1976 to 1977) were studied to assess the specificity of these features in identifying patients at risk for AIDS. The incidence of these features was as follows: large irregular germinal centers, 10 per cent of the cases; mantle zone effacement, 44 per cent; follicle lysis, 42 per cent; germinal center hemorrhage, 24 per cent; sinus monocytoid cell hyperplasia, 16 per cent; and granuloma formation, 8 per cent. Large irregular germinal centers were seen in five cases, four of which had additional abnormalities. A combination of three germinal center changes was seen in 18 per cent of the cases and a combination of two changes in 16 per cent. Comparison of these data with previously published descriptions of lymph node biopsies from patients with persistent generalized lymphadenopathy indicates that, while some of the reported features may be more common in these patients, none of them, either singly or in combination, can be considered diagnostic of this disorder.

AIDS-Related Complex↗
PubMed1986

Bone marrow manifestations of peripheral T-cell lymphoma. A study of 30 cases.

Morphologic and clinical features of 30 patients with peripheral T-cell lymphoma (PTCL) were studied with particular attention to bone marrow and blood manifestations. Twenty-four (80%) patients had marrow involvement with lymphoma in trephine biopsies at initial diagnosis; two other patients subsequently developed marrow involvement. The bone marrow lesions were diffuse in 58% of the cases and focal, nonparatrabecular in 42%. A morphologic spectrum of lymphoma cells was seen with cases classified into small cell, mixed cell, and large cell/immunoblastic lymphoma. The bone marrow lesions were characterized by a heteromorphous population of lymphocytes, prominent vascularity with endothelial cell proliferation, reticulin fibrosis, and a polycellular infiltrate composed of plasma cells, eosinophils, and histiocytes. The histopathologic features in bone marrow biopsies were not pathognomonic for PTCL; the differential diagnosis may include non-Hodgkin's lymphomas of B-cell type, polymorphous reactive lymphoid lesions, including those from patients with acquired immune deficiency syndrome (AIDS), angioimmunoblastic lymphadenopathy, Hodgkin's disease, and systemic mastocytosis. The patients ranged in age from 13 to 81 years (median, 61 years) and generally presented with constitutional symptoms, lymphadenopathy, and hepatosplenomegaly. Abnormalities in one or more hematologic parameters were common and, in general, related to the degree of bone marrow involvement. Hypocalcemia was found in 40% of the patients studied and hypercalcemia in 4%. The median survival for PTCL patients was 11 months. Patients with small cell lymphoma, large cell/immunoblastic lymphoma, and marked eosinophilia had the shortest median survivals.

Adolescent↗
PubMed1986

Mediastinal diffuse large-cell lymphoma with sclerosis. A clinicopathologic study of 60 cases.

A retrospective analysis was conducted of 60 cases of mediastinal diffuse large-cell lymphoma with sclerosis (MDLLS). The study group consisted of 43 females and 17 males. Eighty-five percent were 35 years of age or younger at time of initial diagnosis. Thirty are alive and well at least 1 year after diagnosis (median: 34.5 months), six are alive with disease (median: 13 months), 20 died of disseminated disease (median: 16.5 months), and four died of other causes. Complete autopsy was performed on eight of the patients who died of disease. The most frequently involved extrathoracic organs were lymph nodes, kidney, liver, pancreas, gastrointestinal tract, and ovary. Fifty-six cases were classified according to the Lukes-Collins scheme: 35 were follicular center cell, 13 immunoblastic T (IBT), seven immunoblastic B (IBB), one a composite of IBB and nodular sclerosing Hodgkin's disease; four cases were unclassifiable. Lymphoreticular origin was proven immunohistochemically in 53 cases, including the four unclassifiable examples and eight cases typed as B-cell tumors. Unfavorable prognostic factors were age less than 25 years at diagnosis, tumor outside the thoracic cavity at presentation, disease recurrence, and IBT or IBB tumor histology. Favorable signs were good response to initial therapy and marked tumor sclerosis. MDLLS is most often mistaken for malignant thymoma, seminoma, and Hodgkin's disease. Criteria helpful for the recognition of MDLLS are discussed.

Adolescent↗
PubMed1986

Primary neuroendocrine carcinoma and small-cell malignant lymphoma of the skin. A discriminant immunohistochemical comparison.

In selected instances, primary cutaneous neuroendocrine carcinoma (PCNEC) and small-cell malignant lymphoma (SCML) of the skin may display similar clinical presentations and microscopic appearances, leading to diagnostic uncertainty. We applied monoclonal antibodies to epithelial membrane antigen (EMA), Ia antigen, and leukocyte common antigen (LCA) to 31 cases of PCNEC and 12 of small-cell lymphoma cutis, using a combined PAP and ABC procedure, to determine whether or not such stains were capable of separating the two neoplasms. All cases of SCML were reactive for LCA, while this determinants was not seen in any example of PCNEC. Anti-Ia antigen labelled 11 of 12 cases of SCML, and also failed to stain neuroendocrine carcinomas. Lastly, EMA was observed in 25 of 31 cases of PCNEC, but it was found in one lymphoplasmacytoid lymphoma as well. Bayes' univariate statistical analysis of these data indicates that anti-LCA, anti-EMA, and anti-Ia antigen are capable of discriminating between the tumors in question, with anti-LCA being the most effective.

Adenocarcinoma↗
PubMed1986

Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy. A prospectively randomized study by the Cancer and Leukemia Group B.

A randomized clinical trial of combination chemotherapy for patients who relapsed following primary radiation therapy for Hodgkin's disease was conducted from 1975 to 1981 by the Cancer and Leukemia Group B (CALGB). One hundred thirteen patients were prospectively randomized to receive 12 cycles of either CVPP (CCNU, vinblastine, procarbazine, and prednisone), ABOS (bleomycin, vincristine [Oncovin; Lilly, Indianapolis], doxorubicin [Adriamycin, Adria Laboratories, Columbus, Ohio], and streptozotocin), or alternating cycles of CVPP and ABOS. The median length of observation for patients in this report is 4 years. Toxicities of the three treatment programs were primarily hematologic. Frequencies of complete response were 72% for CVPP, 70% for ABOS, and 82% for CVPP/ABOS (P = .37). Females and patients who had nodular sclerosing disease at initial diagnosis had significantly higher complete response rates. The 5-year disease-free survival for the complete responders was 55%; the 5-year overall survival was 60%. There were no significant differences among the treatments on disease-free survival (P = .78) or overall survival (P = .18). Age under 40 years was the only significant positive prognostic factor for disease-free survival (P = .095) and overall survival (P = .003). This study demonstrates no statistically significant advantage for alternating cycles of combination chemotherapy in affecting complete response frequency, disease-free survival, or overall survival as compared with therapy with CVPP or ABOS alone. However, the power to detect differences in these outcome parameters is somewhat limited by the sample sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Angiomatoid malignant fibrous histiocytoma with extensive lymphadenopathy simulating Castleman's disease.

We report the association in a 10-year-old boy of an angiomatoid malignant fibrous histiocytoma (AMFH) of the left thigh with ipsilateral inguinal, pelvic and extensive retroperitoneal lymphadenopathy, and severe systemic manifestations. These include growth retardation, fever, severe anemia, hypergammaglobinemia, and hypoalbuminemia. At ultrastructural level the tumor was characterized by an abundance of myofibroblasts, occasional histiocytes, and small vessels with marked reduplication of the basal lamina. Biopsies of the inguinal and abdominal lymph nodes showed follicular hyperplasia and massive plasmacytosis indistinguishable from Castleman's disease (giant lymph node hyperplasia) of plasma cell type. The radical surgical excision of the primary tumor in the thigh resulted in the disappearance of the abdominal lymphadenopathy and a marked reduction in size of the pelvic lymph nodes with marked decrease of the gammaglobulins, thus proving that the nodal lesions were the expression of a reactive process to the tumor rather than a coincidental independent lymphoproliferative disorder. Retroperitoneal and pelvic node dissection was performed 1 year after the radical excision of the thigh tumor because of persistent pelvic lymphadenopathy and failure of serum immunoglobulins M and A to return to normal level, with a recent peak of IgA to twofolds that of normal value. Metastatic AMFH was found in the three pelvic nodes. One month postoperatively IgA returned to near normal level whereas IgM remained slightly elevated.

Castleman Disease↗
PubMed1985

T-helper cell lymphoma involving the lymph nodes and skin. A clinical, morphologic, and immunohistochemical analysis of five cases.

The clinical, morphologic, and immunohistochemical features of 5 cases of peripheral T-cell lymphoma with lymph node and skin involvement are reported. All patients were male and presented with generalized lymphadenopathy and skin lesions. Lymph node biopsy specimens showed a diffusely growing, pleomorphic, atypical lymphoid infiltrate composed of markedly irregular small and large cells. The stroma consisted of plasma cells, eosinophils, epithelioid histiocytes, and an increased number of small blood vessels. A similar neoplastic infiltrate was observed in the cutaneous nodules that developed in three patients. Immunohistochemistry on frozen tissue sections of lymph nodes using a broad panel of monoclonal antibodies revealed that the neoplastic cells were reactive with anti-T-cell antibodies, the majority of them belonging to the helper/inducer T-cell subset. Stromal plasma cells contained polyclonal immunoglobulins. It is concluded that the malignant lymphoma of peripheral helper/inducer T-cell origin observed in these five patients represents a variant of a mixed, blastic/cell T-cell lymphoma, characterized by a peculiar stromal component and skin involvement.

Aged↗
PubMed1985

Extramedullary presentation of the blast crisis of chronic myelogenous leukaemia.

We report the clinical histories and a multiparameter pathological study of the extramedullary lesions of seven patients with chronic myelogenous leukaemia in whom the initial clinical presentation of blast crisis (BC) was in an extramedullary site (lymph nodes in six, mandibular mass in one). Bone marrow BC was demonstrated simultaneously or within a few months in four patients. Three patients received chemotherapy only, four underwent bone marrow transplant. Six patients died within 1 year from diagnosis of extramedullary BC, one is alive without disease. The longest survivals (12+, 12, 11 months) were those of patients who never developed bone marrow BC and were recipients of bone marrow transplant. Studies of extramedullary disease included: histology; histochemistry for chloracetate esterase (CAE) and lysozyme; assays for TdT; electron microscopy; immunofluorescence for Fc-receptors, immunoglobulins and lymphoid and myeloid antigens by a panel of monoclonal antibodies; and cytogenetics. Three cases were classified as myeloid BC based on histochemistry and/or ultrastructure and immunology (OKM1+, MCS2+, IG10+); two as lymphoid BC (CAE-, lysozyme-, TdT+), one of them expressing a T-cell phenotype. Cytogenetic analysis of extramedullary lesions and simultaneous or subsequent bone marrows demonstrated identical karyotypes in three patients and significantly different karyotypes in one.

Adult↗
PubMed1985

A systemic lymphoproliferative disorder with morphologic features of Castleman's disease: clinical findings and clinicopathologic correlations in 15 patients.

Fifteen patients (11 males, four females; median age 57) manifested a disease characterized by (1) the histopathologic features of Castleman's disease, plasma cell type, in lymph node biopsies; (2) predominantly lymphadenopathic disease, involving multiple, preferentially peripheral nodal groups; (3) varied manifestations of multisystemic involvement (such as constitutional symptoms; splenomegaly and hypergammaglobulinemia; elevated ESR, anemia, and thrombocytopenia; hepatomegaly and altered liver function tests (LFTs); signs of renal disease); and (4) idiopathic nature. Two main patterns of evolution were recognized: persistent, with sustained clinical manifestations, and episodic, with recurrent exacerbations and remissions. Seventy-three percent of patients had infectious complications, and 27% developed malignancies. Complete remissions were obtained occasionally with antineoplastic agents and with splenectomy but not with glucocorticosteroids alone. The median survival time is 30 months; 60% of patients have died. Median follow-up in the six surviving patients is 97+ months. A review of 50 cases in the literature revealed similar clinical and laboratory features. Despite some similarities with autoimmune diseases, the main features of this process seem to best fit a hyperplastic-dysplastic lymphoid disorder in a setting of immunoregulatory deficit.

Adrenal Cortex Hormones↗
PubMed1985

Rosette formation in malignant lymphoma.

Lymph node biopsies in a patient with follicular lymphoma showed rosette structures as seen in neuroepithelial neoplasms. These specimens were studied by histologic, immunoperoxidase (for immunoglobulins, intermediate filaments (IF), actin and neuron-specific enolase), immunofluorescence (for immunoglobulins, and with a panel of monoclonal antibodies), and electron-microscopic examination. The rosettes were formed by neoplastic lymphocytes arranged around eosinophilic fibrillary material. Ultrastructurally, this was composed of cytoplasmic processes, projecting from the lymphocytes and containing thin and intermediate filaments. Immunohistochemically, it stained for monoclonal IgM lambda, all other antigens present on the neoplastic cells, and weakly for vimentin and actin. Based on recent information about lymphocyte surface changes, it is speculated that the rosettes might represent an aggregation of neoplastic lymphocytes activated by a microenvironmental stimulus, perhaps antigen-antibody binding at the cell membrane. The practical implication of this hitherto unreported finding is that the presence of rosettes cannot be used to rule out a lymphoma.

Aged↗
PubMed1985

There are differences in cytogenetic abnormalities among histologic subtypes of the non-Hodgkin's lymphomas.

Although many recurring chromosome abnormalities have been found in malignant lymphoma (ML) in recent years, their relationship to histology remains largely undefined. We have correlated, in the same tumor mass, chromosome findings with histology, defined by the International Working Formulation for Clinical Usage, in 120 patients. We find differences among histologies in the frequency of normal metaphases and the modal number of the predominant abnormal clone. In addition, most histologies have been significantly (P less than .01) associated with specific chromosome abnormalities. In particular, ML, follicular, predominantly small cleaved cell was associated with t(14;18)(q32;q21); ML, follicular, mixed small cleaved cell and large cell with t(14;18)(q32;q21) and trisomy 8; ML, follicular, predominantly large cell with trisomy 7 and breaks in 17q21-q25; ML, diffuse, mixed small cell and large cell with breaks in 11p; ML, diffuse, large cell with trisomy 21 and breaks in 2q and 9q; ML, large cell, immunoblastic with breaks at 6q21; and ML, small noncleaved cell with t(8;14)(q24;q32). Only the associations with t(14;18) and t(8;14) have been previously reported. The associated chromosome abnormality usually occurred in 30% to 70% of a given histology, raising the possibility that cytogenetics may add important prognostic information in lymphoma as it does in the acute leukemias.

Adolescent↗
PubMed1984

Systemic lymphoproliferative disorder with morphologic features of Castleman's disease. Immunoperoxidase study of cytoplasmic immunoglobulins.

Lymph node biopsy specimens from nine patients with a systemic lymphoproliferative disorder morphologically resembling Castleman's disease were studied for the presence of cytoplasmic immunoglobulins. After trypsinization of tissue sections, the avidin-biotin-peroxidase method was used to stain for IgG, IgA, and IgM heavy chains and kappa and lambda light chains. All cases showed polyclonal proliferation of plasma cells. The predominant immunoglobulin class observed was IgG. The IgM-containing cells tended to be localized concentrically around germinal centers. No notable changes were seen in multiple biopsy specimens from five patients. Polyclonal staining was also observed in lymph nodes obtained at autopsy from a patient who died of a disseminated atypical immunoproliferative process. The polyclonal staining pattern in these cases confirms the reactive nature of this systemic lymphoproliferative disorder.

Adult↗
PubMed1983

A systemic lymphoproliferative disorder with morphologic features of Castleman's disease. Pathological findings in 15 patients.

This report describes the nodal and extranodal lesions observed in 15 patients with a generalized disorder that had been histologically diagnosed as Castleman's disease. The disorder was characterized by severe constitutional symptoms, constant involvement of multiple peripheral lymph nodes, and frequent hepatosplenomegaly, in association with clinical and laboratory features reminiscent of a "collagen disease." The clinical course was chronic, with remissions and exacerbations in seven patients, and aggressive and fatal in eight. The material examined included multiple lymph node biopsies, four surgical specimens of spleen, one open lung biopsy, and material from four autopsies. The diagnostic morphological findings were observed in the nodes and were represented by the following histologic triad: diffuse marked plasmacytosis, from the medulla to the subcapsular areas; prominence of the germinal centers; and good preservation of the architecture. One variant of this basic pattern featured abundant immunoblasts and blood vessels. The process appears to be a systemic reactive proliferation of B-lymphocytes, perhaps resulting from faulty immune regulation. Morphologic similarities indicate a relationship between this multicentric disorder and Castleman's disease of plasmacellular type. However, there are distinct differences between them in clinical presentation and evolution, and, consequently, in therapeutic approach.

Adult↗
PubMed1983

Epstein-Barr virus (EBV) induced polyclonal and monoclonal B-cell lymphoproliferative diseases occurring after renal transplantation. Clinical, pathologic, and virologic findings and implications for therapy.

Nineteen renal allograft recipients developed B-cell lymphoproliferative diseases. Clinically there were two groups: a) young patients (mean age, 23 years) who presented soon (mean, 9 months) after transplantation or antirejection therapy with fever, pharyngitis, and lymphadenopathy resembling infectious mononucleosis, and b) older patients (mean age, 48 years) who presented later (mean, 6 years) after transplantation with localized tumor masses. Histologically, the diseases were classified as polymorphic diffuse B-cell hyperplasia (PDBH) or polymorphic B-cell lymphoma (PBL). Immunologic cell typing revealed either polyclonal or monoclonal B-cell proliferations. Malignant transformation of polyclonal proliferations in two patients was suggested by the finding of clonal cytogenetic abnormalities. Epstein-Barr virus (EBV) specific serology, staining of biopsy specimens for the Epstein-Barr nuclear antigen, and EBV DNA molecular hybridization studies implicated EBV as the cause of both PDBH and PBL. Acyclovir, an antiviral agent that blocks EBV replication in vitro, inhibited oropharyngeal shedding of EBV and caused complete remission in four patients with polyclonal B-cell proliferations. The monoclonal tumors were acyclovir resistant. We suggest that surgical treatment, radiotherapy, or chemotherapy may be more appropriate therapy in selected patients with acyclovir resistant tumors. Therapeutic decisions require not only documentation of the viral etiology of these tumors, but also immunologic and cytogenetic analysis to determine the stage of tumor evolution in individual patients.

Adolescent↗
PubMed1983

Nonrandom chromosome abnormalities in lymphoma.

G-banded chromosomes were studied from involved lymph nodes or other tumor masses in 94 patients with malignant lymphoma. Clonal chromosome abnormalities were identified in 91 patients including all 81 B-lymphomas but only 6 of 9 T-lymphomas. Many recurring chromosome abnormalities were found. Most common numerical alterations involved gains of chromosomes 12 (19% of patients), 18 (13%), 7 (12%), and 21 (10%). Structural abnormalities, which were more frequent than numerical alterations, most commonly involved chromosome regions 14q (71% of patients), 18q (36%), 6q (31%), 1p (24%), and 8q (19%). Seven recurring translocations were identified, and all except one involved 14q32. The most frequent were t(14;18)(q32;q21) in 22 patients, t(8;14)(q24;q32) in 9 patients, and t(1;14)(q42;q32) in 3 patients. Deletions most frequently involved the long arm of chromosome 6 at band q21 (11 patients) or q23 (7 patients). The common recurring chromosome abnormalities were correlated with histology (International Working Formulation for Clinical Usage) and immunological phenotype. Four abnormalities were significantly associated with specific histologies. Eighteen (82%) patients with t(14;18)(q32;q21) were follicular. Similarly, 82% of patients with del(6)(q21) were large cell lymphomas. Lymphomas with trisomy 7 were either diffuse large cell or follicular, while patients with t(8;14)(q24;q32) were either diffuse large cell or small noncleaved cell. A significant association with immunological phenotype was seen for t(14;18) only. All patients were either B- or complement lymphomas, and the heavy chain(s) was more commonly gamma and less frequently delta mu than among the total B-lymphoma population. We conclude that essentially all lymphomas have cytogenetic abnormalities; further study is required to determine their significance. Particularly, it will be of interest to see if oncogenes are found in the regions of these chromosome abnormalities.

Adolescent↗