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Biomedical subjects

G Lugassy

Publications and source records attributed to G Lugassy.

51 records · Page 3Linked to original sources

Clinical and pathological features of non-Hodgkin's lymphoma of the tonsil. Review of the literature and report of 10 cases.

Ten patients with tonsillar lymphomas diagnosed and treated in our hematology unit from 1979 to 1986 are reported. The heterogeneous histology at presentation, the aggressiveness of the histologic types during relapse, and the relatively low incidence of gastrointestinal tract involvement are discussed. A review of the literature is presented. In view of the better survival rate obtained with chemotherapy or combined chemo- and radiotherapy, we confirm that lymphomas of the tonsil should be aggressively treated, regardless of the staging. Among our 10 cases, 2 are of special interest since they progressed into highly malignant disorders: B-acute lymphoblastic leukemia and Burkitt's lymphoma.

Adult↗

Acute abdomen due to granulocytic sarcoma of the terminal ileum.

A 57-year-old patient with chronic granulocytic leukemia in blast crisis and severe neutropenia is presented. This patient developed right sided peritonitis due to an isolated transmural granulocytic sarcoma of the terminal ileum. The affected segment was resected and the patient survived 4 more months. Thus, despite neutropenia, an aggressive surgical approach should be considered in a leukemic patient presenting with unexplained acute abdomen, since, as demonstrated here, a localized lesion which could not have otherwise been detected, was ultimately found and promptly resected.

Abdomen, Acute↗

Exacerbation of idiopathic pulmonary hemosiderosis in pregnancy.

Idiopathic pulmonary hemosiderosis (IPH) is a very rare disease in adults. Its occurrence in pregnancy has been described only once. A case of a 16-yr-old patient with an exacerbation of IPH during pregnancy resulting in intrauterine fetal death in the 28th week of gestation is described. The deterioration of the IPH is most probably related to the hemodynamic alterations which are at their maximum during the seventh month of pregnancy. Although rare, the case suggests that women with IPH should be followed carefully during pregnancy and, in the case of a deterioration in the patient's condition despite immunosuppressive therapy, termination of pregnancy should be considered.

Adolescent↗

Idiopathic thrombocytopenic purpura presenting as iron-responsive thrombocytopenia.

We describe a patient with iron-deficiency anemia, thrombocytopenia and paucity of marrow megakaryocytes, in whom the anemia and the thrombocytopenia responded to the administration of iron. Thrombocytopenia recurred, despite maintenance of normal hemoglobin and iron levels and adequate marrow megakaryocytes. Corticosteroids and splenectomy were required for the control of the thrombocytopenia. In this patient, the initial manifestations of idiopathic thrombocytopenic purpura were modified by the presence of severe iron deficiency. This case strengthens the contention that iron is essential for megakaryopoiesis and thrombopoiesis.

Anemia↗

Paravertebral extramedullary hematopoiesis associated with improvement of anemia in congenital dyserythropoietic anemia type II.

Thoracic masses resulting from extramedullary hematopoiesis developed in two sisters of Moroccan origin with congenital dyserythropoietic anemia type II (HEMPAS). In one patient, the diagnosis of extramedullary hematopoiesis was confirmed histologically. The appearance of extramedullary foci of hematopoiesis mimicking mediastinal tumors has not been previously described in HEMPAS. These masses result from persistent erythropoietic stimulation associated with chronic hemolytic anemia. In both patients, detection of the asymptomatic masses was preceded by normalization of hemoglobin levels. Thus unexpected correction of a chronic refractory anemia associated with the appearance of mediastinal masses might be the heralding manifestation of an effective extramedullary hemopoiesis.

Anemia, Dyserythropoietic, Congenital↗

Corynebacterium xerosis endocarditis.

Bacterial endocarditis due to Corynebacterium xerosis developed in a previously healthy person. Diphtheroid infection is a rare cause of endocarditis and, when present, it usually affects immunocompromised hosts or prosthetic valves. There are few reports of diphtheroid endocarditis on intact valves, and, to our knowledge, this is the first case in which the offending organism was identified as C xerosis. We call attention to the virulence of C xerosis in a person with no previous valvular disease.

Corynebacterium↗

Carcinocythemia. Report of two cases, one simulating a Burkitt lymphoma.

Carcinocythemia is a rare complication of metastatic carcinoma, characterized by the presence of carcinoma cells in the peripheral blood, which may mimic acute leukemia. Two cases are reported in which the patients developed carcinocythemia several years after being treated for carcinoma of the breast. Cytologic examination of peripheral blood smears in both cases showed the presence of numerous large abnormal cells; in one case the cells simulated those of a Burkitt lymphoma. Cytochemical and/or immunologic marker studies ruled out a hematopoietic origin of the malignant cells in both cases and confirmed a diagnosis of carcinocythemia. The rapidly fatal outcome observed in these two cases was in accordance with the poor prognosis usually encountered with this rare phenomenon.

Adenocarcinoma↗

Diffuse large cell non-Hodgkin's lymphoma: results of M-BACOD combination chemotherapy.

Twenty-seven adult patients with diffuse large cell lymphoma were treated with the M-BACOD regimen during the period 1980-86. Of these, 24 (89%) had advanced Stage III-IV disease by clinical staging and only 3 (11%) had limited disease. CR was achieved in 14 patients (52%), all of whom had advanced disease prior to therapy. The remaining 13 patients (48%) achieved only PR. Of the entire group of 27 patients, 11 (41%) died, 12 (44%) are still in CR, and 4 (15%) have relapsed and are still alive with PR. Of the 14 patients who achieved CR, 1 relapsed, but is currently in PR, showing minimal disease. All of these 14 patients are alive (11 months to 6 years post therapy), and 13 (93%) still remain in CR with a median time of CR of 45 months. Of the 13 patients who only achieved PR, 11 (85%) relapsed and died within a median time of 3.6 months, and 2 patients remain in PR. The above results are similar to those obtained in larger series recorded from other centers. In the light of improved results obtained with new regimens and ABMT, we have now adopted the MACOP-B regimen for treating aggressive lymphoma and have entered an ABMT program for patients with predictable poor prognostic features.

Adolescent↗