[Myelomatous ascites: apropos of a case].
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Biomedical subjects
Publications and source records attributed to J Bayle.
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A new case of a variant form of the translocation (8;21) in an AML-M2, including in addition involvement of chromosome #15 is reported. The selection of two abnormal lines, probably resulting from two successive rearrangements of the (8;15) translocated segment, is observed. It is suggested that these rearrangements change the cellular morphology and seem to play a part similar to additional autosomal abnormalities in the course of the disease, such as those found in CML.
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We report the outcome of the statistical analysis of 50 myeloma patients, making a comparison of the prognosis value of the staging systems proposed by Durie and Salmon and, more recently by Merlini, Waldenström and Jayakar. Moreover, we studied the relationship between initial percentage of bone marrow plasma cells and prognosis. All patients had a complete follow-up and received the same treatment. We excluded our cases of non excreting and solitary myeloma. The staging system proposed by Durie and Salmon still has the best prognosis significance. The system proposed by Merlini, Waldenström and Jayakar does not allow a staging of the patients in rigourous conditions. The absence of a relationship between initial bone marrow plasmocytosis and prognosis corroborates the poor reliability of this staging system.
A case of acquired dyserythropoiesis with inter-erythroblastic connections is reported in a patient with chronic myeloid leukaemia, developing a terminal acute hepatic failure related to hepatocarcinoma. The erythroblastic series was abundant but only made of clusters grouping 10 to 20 closely adherent cells. The cellular membranes showed linear junctions or were interdigitated and the intercellular space was occupied with electron dense ferritin granules. This non specific aspect of dyserythropoiesis may be related to the hepatic carcinoma, which was probably induced by busulfan therapy.
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The first case of ribosome lamella complex (RLC) is reported in abnormal cells of a Sézary's syndrome, a T cell malignancy. Until now this ultrastructural cytoplasmic inclusion has usually been described in hairy cell leukaemia and other lymphoproliferative syndromes of B cell origin. Since RLC are also observed in abnormal lymphoid T cells, in non lymphoid cells, and moreover in non haematopoietic cells, they lack diagnostic specificity.