Search PubMed⌕ Search

Biomedical subjects

J B Cousar

Publications and source records attributed to J B Cousar.

71 records · Page 4Linked to original sources
PubMed1984

Malignant lymphomas of follicular center cell origin in humans. V. Incidence, clinical features, and prognostic implications of transformation of small cleaved cell nodular lymphoma.

Seventy-five cases of small cleaved cell nodular lymphoma (SCC-N) were reviewed. Thirty-four cases underwent repeat biopsy a median of 54 months after diagnosis (range, 7-116 months) because of progressive or recurrent disease. Histologic conversion to a transformed (noncleaved) cell lymphoma was found at re-biopsy in 13 of 34 cases (38%). Neither age, gender, stage, visceral sites of disease, nor symptoms at presentation were predictive of subsequent conversion. Similarly, none of the clinical features analyzed at the time of rebiopsy were predictive of whether the rebiopsy would show stable histology or transformation. Documentation of transformation was of significant prognostic value. Although rebiopsies were performed at the time of progressive disease, survival following re-biopsy was 37.5 months for patients found to have cleaved cell lymphoma at re-biopsy, and only 2.5 months for those with transformed cell lymphoma at re-biopsy. Two of the cases which had immunoglobulin surface markers studied at diagnosis and at transformation, showed retention of heavy and light chain markers. This implies that the change in appearance involves the original neoplastic clone and was not due to a second neoplasm. Development of transformed cell lymphoma is one of the most common features of the aggressive phase of indolent lymphoma. Repeat biopsy in all patients with indolent lymphoma who have relapsing or progressive disease is recommended.

Adult↗
PubMed1984

Plasma cell iron--clinical and morphologic features.

In order to identify the major clinical features and laboratory findings in patients with plasma cell iron, the authors reviewed the medical records and marrow aspirates of 53 consecutive patients with plasma cell iron hospitalized at Nashville Veterans Administration Hospital over a seven-year period. Plasma cell iron was associated most commonly with alcoholism and occurred in marrows with increased, normal, and decreased iron stores. In patients with decreased marrow iron, plasma cells were the major site of stainable iron. Plasma cell iron was found in patients without other morphologic changes of alcoholism such as megaloblastosis, erythroid vacuolization, and ringed sideroblasts. Plasma cell iron could be demonstrated in biopsy and autopsy material from extra-marrow sites. Ultrastructural studies showed iron always was located in membrane bound lysosomal vesicles of plasma cells.

Adult↗
PubMed1984

Death due to splenic rupture in suppressor cell mycosis fungoides: a case report.

A case of mycosis fungoides in which pathologic rupture of the spleen led to intraperitoneal hemorrhage and death is described. To our knowledge, splenic rupture has not been reported previously as a cause of death in mycosis fungoides. Immunologic studies demonstrated that the neoplastic cell was a suppressor/cytotoxic T-cell. In most cases of mycosis fungoides or the Sézary syndrome, the neoplastic cell has been a helper/inducer T-cell. This case was very aggressive clinically with prominent visceral involvement and suggests that mycosis fungoides may be clinically diverse as well as immunologically heterogeneous.

Aged↗
PubMed1984

Reproducibility in morphologic classification of non-Hodgkin's lymphomas using the Lukes-Collins system. The Southeastern Cancer Study Group experience.

Five pathologists of the Southeastern Cancer Study Group reviewed routinely prepared histologic sections from 249 cases of non-Hodgkin's lymphoma. They classified these cases morphologically, using criteria of the Lukes-Collins classification system. To evaluate reproducibility in classification, the individual interpretations of each pathologist were compared with a consensus interpretation. The pathologists recognized general morphologic features of follicular center cell lymphomas in 87-94% of such cases, but they identified specific morphologic types much less consistently. Significant differences of interpretation were encountered with respect to small cleaved follicular center cell, large cleaved follicular center cell, and large transformed (large noncleaved) follicular center cell types. Inadequacies of routine histologic sections contributed substantially to these disagreements. Ancillary immunologic technics may be required to improve consistency in recognition of some morphologic types, as well as to characterize cases that are not classified easily by morphology alone.

Evaluation Studies as Topic↗
PubMed1984

Peripheral T-cell lymphoma: a clinicopathologic study of 42 cases.

Clinical and histopathologic material from 42 patients with peripheral T-cell lymphoma (PTCL) was reviewed. The median age was 63.5 years (range, 11-97 years). The male:female ratio was 2.8:1. Prior immune or lymphoproliferative diseases occurred in 36% of the patients. PTCL was advanced at presentation with B symptoms (67%), generalized adenopathy (69%), and stage III/IV disease (79%). Suspected lung or pleural involvement (21%), hepatomegaly (29%), and splenomegaly (43%) were common; marrow involvement was documented in 37% of the patients at presentation and in 51% of patients during the illness. Hypercalcemia and eosinophilia occurred in 19% and 29% of patients, respectively. Among patients receiving combination chemotherapy (BCOP, CHOP, BACOP, COMLA), eight (24%) of 33 achieved a complete remission and only four (12%) of 33 had a sustained complete remission. The median survival for PTCL was 11 months. Because of the poor response to standard therapy, clinical trials should identify cases of PTCL and evaluate newer regimens in this subset of aggressive lymphoma.

Adolescent↗
PubMed1984

Multiinstitution study of non-Hodgkin's lymphomas using frozen section immunoperoxidase: the Southeastern Cancer Study Group experience.

This report describes the experience of the Southeastern Cancer Study Group (SECSG) with a transport medium used for immunologic phenotyping of non-Hodgkin's lymphomas. In a 2-mo pilot study, portions of 53 specimens of non-Hodgkin's lymphoma from four member institutions of the SECSG and affiliated community hospitals were sent by regular mail to a central laboratory. Immunologic phenotyping was carried out using a frozen section immunoperoxidase technique. In 48 of the cases, a clear-cut immunologic phenotype was obtained. Thirty-four tumors were of B cell origin and 7 had T cell markers. Six of the remaining lymphomas had neither B nor T cell markers, and the seventh had both. In 12 cases, phenotyping was also carried out at the originating institution using conventional cell suspension techniques; agreement between the two methods was excellent. The immunologic results were correlated with histopathologic diagnosis standardized using the Working Formulation for non-Hodgkin's lymphomas. It was found that the low grade tumors were all B cell, but that the intermediate grade tumors were very heterogeneous immunologically. About one-fourth of the diffuse, intermediate grade or miscellaneous tumors had T cell markers. Our results indicate that immunologic phenotyping may be performed satisfactorily on transported material, making multiinstitution studies on the prognostic significance of immunologic phenotype in non-Hodgkin's lymphomas feasible.

B-Lymphocytes↗
PubMed1983

Malignant lymphoma of follicular center cell origin in humans. IV. Small transformed (noncleaved) cell lymphoma of the non-Burkitt's type.

Small transformed cell lymphoma (STC) is the least common follicular center cell neoplasm in the Lukes-Collins classification system. If the cells are homogenous in size and shape, Burkitt's lymphoma (STC-BL) is diagnosed; otherwise STC lymphoma of the non-Burkitt's type (STC-nBL) is present. The authors have reviewed their experience with 17 cases of STC-nBL. This neoplasm affects all ages, both sexes equally, and most commonly is Stage IV based either on a visceral abdominal mass or bone marrow involvement. Surface immunoglobulin analysis revealed IgM in all cases tested. In spite of aggressive treatment protocols, there were only 5 of 17 (29%) clinical complete responses. Four of these five have continuous remission from 8 to 23 months after diagnosis; all four of these patients were treated with regimens containing high-dose cyclophosphamide. Future analyses including viral studies, chromosomal analyses, and uniform treatment protocols will help determine whether STC-nBL and Burkitt's lymphoma are truly distinct entities.

Adolescent↗
PubMed1981

Subcategories of histiocytic lymphoma: associations with survival and reproducibility of classification. The Southeastern Cancer Study Group experience.

Five pathologists reviewed histologic slides from 134 cases of histiocytic lymphoma and subclassified these cases using Lukes-Collins classification system. Of 98 morphologically subclassifiable cases, 85 were distributed among three categories, each presumed to represent a lymphoma of follicular center cell origin. The remaining 12 cases were classified among three additional categories. The cases within the three follicular center cell categories, considered collectively, had a significantly better survival than did the cases within the other three categories considered as a whole. The pathologists classified cases generally as being of a follicular center cell type with a high degree of reproducibility, but their individual classifications varied significantly with respect to more specific morphologic categories. Suboptimal quality of histologic sections was a significant factor contributing to problems in morphologic classification. Ancillary immunologic techniques may be required for definitive subclassification of large cell lymphomas.

Adolescent↗
PubMed1975

A relationship between impaired cellular immunity humoral suppression of lymphocyte function and severity of systemic lupus erythematosus.

Eighteen newly diagnosed, untreated patients with systemic lupus erythematosus (SLE) were divided into two groups based on the severity of the disease. Patients with very active disease were nonresponsive to skin test antigens used to assess delayed hypersensitivity. Skin test reactivity was intact in most patients with mildly active disease. Lymphocytes from subjects in both groups responded normally to phytohemagglutinin (PHA) when the results were expressed as counts per minute per million small lymphocytes. Serum from patients with severely active disease markedly suppressed lymphocyte responsiveness of autologous and allogeneic lymphocytes. Serum from patients with mild disease had significantly less suppressor activity. Lymphocytotoxic antibodies and suppressor activity were not correlated. Suppressor activity in immunoglobulin G fraction paralleled that found in whole serum. The present studies suggest that impaired delayed whole serum. The present studies suggest that impaired delayed hypersensitivity in SLE is a consequence of disease activity rather than an inherent feature of this disease. The strong correlation between serum suppression of PHA reactivity and anergy suggests that the humoral immunosuppressive effects described may be responsible, in part, for impaired delayed hypersensitivity in this disease.

Adult↗
PubMedDate not supplied

Acute leukemias of childhood: pathologic features.

Major advances have been made in the diagnosis and therapy of childhood leukemia over the last two decades (Zuelzer and Flatz, 1960; Miller, 1980; Steinhorn and Myers, 1981; Kobrinsky et al., 1980). Sophisticated phenotypic analysis of these leukemias has partially revealed their complexity; there are at least three to five distinct clinical pathological entities in the childhood leukemia groups. Improved therapy has resulted in marked increases in survival and cures. Less attention has been given to the pathology of childhood leukemia, although the frequency and complexity of tissue examinations have greatly increased. In particular, the pathologic manifestation of relapses, detection of focal leukemia after treatment and the pathology of complications have not been systematically reviewed. Our goal was to look at all of the pathologic manifestations of leukemia and to relate these manifestations to homogeneous patient populations grouped by their type of leukemia. Therefore all of the cytologic, hematologic, histopathologic, ultrastructural and immunologic materials on a consecutive group of leukemic children seen at Vanderbilt from 1970 to 1981 were reviewed; pathologic manifestations of leukemia were then analysed in relationship to diagnostic categories.

B-Lymphocytes↗
PubMedDate not supplied

Malignant lymphomas of follicular centre cell origin in man. VII. Prognostic features in small cleaved cell lymphoma.

To extend the clinical-pathologic description of small cleaved cell lymphoma (SCCL), we reviewed the records of 106 patients with SCCL who were treated in accordance with a policy of watchful waiting and palliative therapy. Median age was 58 years. A pure diffuse pattern was seen in only 16 per cent of cases. Stage III or IV disease was present in 85 per cent of patients; marrow involvement was noted in 60 per cent of patients. 'B' symptoms were present in 25 per cent of patients. By univariate analysis, age greater than 60, diffuse pattern, stage IV disease, involvement of liver, lung, pleura, or g-i tract, 'B' symptoms, surface heavy chain IgM or IgM-D, and LDH greater than 200 IU/dl were found to be significantly associated with a poor prognosis. Marrow involvement, increased (5-25 per cent) transformed (non-cleaved) cells, and surface light chain had no prognostic significance. By multivariate analysis, only age greater than 60, stage IV disease, and LDH greater than 200 IU/dl were prognostically significant. For patients with all three unfavourable prognostic features, median survival was only 11 months. For patients with age less than or equal to 60, stage I, II, or III disease, and LDH less than or equal to 200 IU/dl, median survival was not reached at 180 months. Recognition of prognostic features in indolent lymphoma can help clarify whether the results of treatment protocols represent true advances or the mere selection of favourable patients.

Aged↗
PubMedDate not supplied

Clinical features associated with transformation of cerebriform T-cell lymphoma to a large cell process.

Some patients with cerebriform T-cell lymphoma (CTCL) undergo morphologic transformation to a large cell lymphoma. From a series of 113 patients with CTCL, 22 patients were identified with transformed CTCL. Stages of involvement at diagnosis were: I (seven), II (four), III (four), IV (seven). Nine patients had transformation at the initial diagnosis while the median time from diagnosis to transformation in the other 13 patients was 16 months (range: 3 months-6 years). Thirteen had transformation extracutaneously: lymph nodes (eight), central nervous system (two), and other extranodal sites (three). T cell markers were identified in all cases; of 15 cases with complete phenotypes, there were eight T-helper, three T-suppressor, and four aberrant T phenotypes. Serology for human T-leukemia virus-I (HTLV-I) was negative in eight patients tested. Median survival from diagnosis was 27 months compared to 53 months in 53 patients without transformation (p = 0.003). Despite combination chemotherapy in 12 patients following transformation, median survival after transformation was 12 months and only 7 months with extracutaneous disease. The likelihood of transformation could not be predicted by the initial histology, immunophenotype, or stage of disease.

Adolescent↗