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H J Ree

Publications and source records attributed to H J Ree.

61 records · Page 4Linked to original sources
PubMed1980

Malignant lymphoma of Waldeyer's ring following gastrointestinal lymphoma.

Gastrointestinal involvement occurs in a greater proportion of patients with malignant lymphoma of Waldeyer's ring than would be accounted for by change alone. In the absence of direct lymphatic connection between these two sites, the association of these tumors has prompted several hypotheses: that the gastrointestinal lymphoma is a concomitant primary tumor; or that it is related to the swallowing and implantation of tumor cells; or that it represents the homing tendency of the gut-associated lymphoid tissue. Five cases are described in which malignant lymphoma of Waldeyer's ring developed ten months to five and half years after an initial diagnosis of gastrointestinal lymphoma was made. All five patients were female, and the original tumors were of the nodular lymphoma, histiocytic type in 4, and Lennert's lymphoma in 1. The tumors of Waldeyer's ring had similar cytologic features. In 1 patient with small intestinal lymphoma and recurrent tonsillar tumor five and half years later, immunoperoxidase staining of the original and recurrent tumors was positive with anti-IgA and anti-kappa antisera, thus establishing the identity of the two tumors. The reverse pattern of involvement, i.e., Waldeyer's ring tumor following gastrointestinal lymphoma, provides evidence against the concomitant primary or swallowing theories. The homing tendencies of gut-associated lymphoid tissue may offer some explanations for this interesting coincidence.

Adolescent↗
PubMed1980

Self-sandwich method. An improved immunoperoxidase technic for the detection of small amounts of antigens.

The unlabeled antibody peroxidase-antiperoxidase (PAP) sequence has been widely accepted as the most sensitive method for demonstrating antigens in paraffin sections. However, the results have been unpredictable in routine surgical specimens, with frequent false-negative stains. In order to amplify the staining reactions a self-sandwich method was used. The amplifier (antigen itself) was added after the application of specific antibody. The procedure may be repeated several times before the application of the bridge antiserum followed by PAP complexes. The method was designed to increase the number of antigen-antibody layers without increasing the number of heteroantisera in the system. Specimens derived from routine tonsillectomy were studied semi-quantitatively. Based on the number of positively stained Ig-containing cells in germinal centers, the sensitivity of the self-sandwich method was estimated to be 20 to 50 times that of the PAP method. In addition, extracellular Ig (reticular staining) and surface Ig were also stained positively in the germinal centers and lymphocytic mantles, respectively, but were not demonstrated by the PAP method. The enhancement of the sensitivity was achieved without compromising the specificity.

Adolescent↗
PubMed1978

Prognostic significance of parafollicular small lymphocytes in follicular lymphoma: clinicopathological studies of 82 cases of primary nodal origin.

Pretreatment biopsy material of 82 cases of follicular lymphoma of lymph node origin was reviewed. According to the amount of small lymphocytes in the parafollicular lymphoid tissue (PSL), tumors were classified: PSL++, abundant lymphocytes with prominent postcapillary venules; PSL+, a number of lymphocytes readily recognizable, postcapillary venules present but not prominent; PSL+/-, lymphocytes barely appreciable or absent. Five-year actuarial survival rates were 82.7% in PSL++, 42.3% in PSL+, and 0% in PSL+/-. Ten-year actuarial survival rates were 51.5% and 4.7% in PSL++ and +, respectively. The PSL++ pattern was often associated with localized disease. Patients surviving more than 5 years with disseminated disease had either PSL++ or +. Survival was better correlated with PSL patterns than histologic tumor types or clinical stages. Transition of the pattern from nodular to diffuse occurred in 17 of 26 cases observed and was concomitant with the progressive loss of parafollicular (or interfollicular) components, namely small lymphocytes and lymphocyte-associated vasculature. Classification of follicular lymphoma based on parafollicular small lymphocytes (PSL) offers a new set of prognostic criteria and a guide to improved clinical management.

Adult↗
PubMedDate not supplied

Aspiration cytology of ectopic cervical thymoma mimicking a thyroid mass. A case report.

BACKGROUND: Ectopic cervical thymoma, first described in 1941 by Boman, is an uncommon tumor of the neck displaying the same histologic features as mediastinal thymoma. Since it is commonly located in the anterolateral part of the neck or is subjacent to or inside the lower pole of the thyroid, the mass is often confused as being of thyroid origin. CASE: A 68-year-old female presented with dyspnea and an anterior neck mass found on routine chest roentgenography. The thyroid scan showed a cold nodule in the lower pole of the left part of the thyroid. Fine needle aspiration (FNA) cytology revealed large numbers of small lymphocytes with hyperchromatic nuclei and frequent clumping pattern in the pale, eosinophilic, fluid background. A few clusters of epithelial cells without atypism were interpreted as thyroid follicular cells. The overall cytologic features were misinterpreted as malignant lymphoma of the thyroid. However, the histologic diagnosis was thymoma, predominantly cortical type. CONCLUSION: The ectopic cervical thymoma is sometimes misdiagnosed as Hashimoto's thyroiditis, anaplastic carcinoma and malignant lymphoma of thyroid on FNA cytology or frozen diagnosis due to its rarity. Therefore, the differential diagnosis of a neck mass showing a variable composition of lymphocyte and epithelial component in a pale, eosinophilic, fluid background should also include ectopic cervical thymoma, especially in elderly females.

Aged↗
PubMedDate not supplied

Rare variant of total anomalous pulmonary venous connection: intrapulmonary drainage of one lung by the other--a case report and review of the literature.

Total anomalous pulmonary venous connection is an uncommon congenital cardiovascular anomaly but one that occurs frequently in the asplenia syndrome. We present a rare type of total anomalous pulmonary venous connection in a 4-month-old baby with the asplenia syndrome. In this patient, all of the left pulmonary veins united to form a common pulmonary vein, which crossed the mediastinum and then proceeded in an intrapulmonary fashion in the right lung. A small pulmonary vein emerged from the right upper lobe and drained into the right superior vena cava. Nine other cases have been reported, four also with asplenia, five with otherwise normal cardiac anatomy apart from an atrial septal defect. The incidence of pulmonary venous obstruction is high, at least 70%. Two cases, both with a normal heart, had corrective surgery. One with no pulmonary venous obstruction was repaired successfully. Embryologically, this type of total anomalous pulmonary venous connection represents a developmental error early in embryonic development before the venous connection between the two lungs and the cardinal veins involute.

Genetic Variation↗