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Biomedical subjects

J Diebold

Publications and source records attributed to J Diebold.

At least 199 records · Page 11Linked to original sources

[Vertebral trabecular bone in various age groups and in osteoporosis-- morphometry and bone matrix biochemistry].

Vertebral trabecular bone was analysed by morphometry and bone matrix biochemistry. Trabecular bone volume (TBV) and mean trabecular plate thickness (MTPT) decreased with age. TBV was significantly correlated with MTPT and mean trabecular plate density (MTPD). The individual structure of trabecular bone could be described by both MTPT and MTPD together, but changes of these parameters, that were pathognomonic for osteopenia, were not found. By measuring TBV 3 cases of severe osteopenia were identified (TBV less than 2s of controls); 2 of them showed matrix abnormalities so far not described. In one case (a 67 year old woman without risk factors for osteoporosis) an abnormal high content of type III collagen was found, in the other case (a 44 year old woman with acromegaly) bone matrix analysis atypically revealed a significant fraction of type II collagen. Further studies will be needed to assess the pathogenetic or diagnostic importance of these new findings.

Adult↗

[Castleman's disease (giant lymph node hyperplasia): clinical, biological and developing polymorphism. Apropos of 4 cases].

Four cases of plasma cell type Castleman's disease (CD) are described. Two patients had localized forms (one mediastinal and the other mesenteric) and presented systemic manifestations associated with hypergammaglobulinemia and severe anemia. In both cases, the lesions were revealed by computerized tomography scans and cures were obtained by the complete surgical removal of the masses, which led to the rapid disappearance of the systemic manifestations. The other 2 patients had the multicentric form of CD and presented more extensive clinical and biological symptoms. One of these developed severe peripheral neuropathy and endocrine anomalies during the late phase of his disease, which led us to discuss the relationship between multicentric CD and the POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin change) syndrome first described in Japan. Three of our patients presented with hypochromic microcytic anemia too severe to be explained by an inflammatory syndrome alone, and was likely due to several mechanisms. The etiology of CD remains unknown. The histological characteristics of angiofollicular lymph node hyperplasia are among the most important criteria for the diagnosis of localized and multicentric forms of CD, which can easily be made on a lymph node biopsy. However, it must be noted that this lesion can also be observed (but only rarely) in HIV (human immunodeficiency virus) - infected patients. The localized form is always considered to be benign, but, to date, there is no formal argument definitively supporting the malignancy of the multicentric one, in spite of its clinical similarity to a lymphoproliferative syndrome.

Adult↗

[Primary non-Hodgkin's malignant lymphoma of the breast. Anatomopathologic diagnosis of 14 cases].

Fourteen primary non-Hodgkin's malignant lymphoma (ML) of the breast observed between 1985 and 1989 were reviewed. Using the Ann Arbor staging system, 5 of these ML were at clinical stage IE, 2 at stage IIE, and only one was at clinical stage IVE (the ML involved both breasts of a young woman after her third post-partum and she died quickly), staging was not available in 6 cases. At the time of physical examination, the diagnosis of ML was not suspected. When possible, it was done or-suspected before surgery, studying fine needle aspiration cytology (4 cases) or drill biopsy (2 cases). Cytological examination was also useful to make the difference between primary large cells T ML and granulocytic sarcomas which sometimes occur before the acute myeloid leukemia and/or the blast crisis of a myeloproliferative disorder. According to the Kiel histopathological classification (updated in 1988), 78.5% of these ML were of great malignancy, more than half of them being polymorphous centroblastic B ML. Only one of them was an angiocentric pleomorphic T lymphoma of great malignancy. None of the ML of low malignancy, all of the follicular type, was a MALT (Mucosa Associated Lymphoid Tissue) ML, as described by Isaacson. Intra-epithelial lymphocytes were observed in 6 of the ML of great malignancy; but in 2 cases, they were T lymphocytes and these lympho-epithelial lesions could not be interpreted as an argument for the MALT nature of these ML. None of our cases were associated with a ML from another MALT site.

Adult↗

[Intra-scrotal supernumerary spleen. A long silent case of discontinuous spleno-gonadal fusion].

The presence of a supernumerary spleen in the scrotum, situated around or near a more or less atrophic testicle, or replacing a missing testicle in cryptorchidism, represents the most common result of a rare congenital anomaly called splenogonadal fusion. A new case discovered in a 81-year-old patient is reported. The different clinical expressions, the different anatomic varieties and the macroscopic and histologic pattern are described and discussed.

Aged↗

[Fatal hemoptysis during bronchial aspergillosis with multiple pulmonary artery aneurysms].

Aspergillosis with fatal outcome are usually pulmonary invasive aspergillosis with or without dissemination, developed in patients with severe immunosuppression. We report a fatal case of bronchial necrotizing aspergillosis in a young woman with diabetes mellitus, who developed similar lesions to "Semi-invasive Aspergillosis", so-called "Chronic Necrotizing Pulmonary Aspergillosis". This aspergillosis was complicated by large pulmonary artery aneurysms requiring an hemostatic lobectomy. These aneurysms, secondary to the bronchial lesions, contrast with infectious aneurysms (so-called mycotic) secondary to septic embols. They differ from Rasmussen's aneurysms, due to tuberculosis, by their size, fusiform shape and extent. Lesions of vessels' walls and parietal fungal invasion in the vicinity of an endo-bronchial aspergilloma explain the vascular rupture. The multiplicity of these aneurysms, showed on C T Scan, is responsible for death by post-surgical recurrence of hemoptysis.

Adult↗

Relationship of histological subtypes to prognosis in early stage Hodgkin's disease: a review of 312 cases in a controlled clinical trial. The Groupe Pierre et Marie Curie.

To assess the prognostic significance of a newer histologic classification of Hodgkin's disease (HD), microscope slides from the time of diagnosis of 312 clinical stage IA or B, IIA or B and IIIA patients were reviewed in 1987, 6-10 years after their participation in a radiochemotherapeutic trial (1976-1982). Overall, the diagnostic reproducibility of the Rye classification by the same pathologist was confirmed. However, a new analysis showed an improvement in the differential diagnosis between HD and non-Hodgkin's lymphomas (NHL) by the identification of 24 NHL (8%) amongst the patients originally diagnosed as HD. Most of the NHL identified on review had been classified originally as mixed cellularity. On review, none of the new histological subtypes of HD was significant for prognosis of relapse-free survival or overall survival. Only identification of NHL was shown to have an independent prognostic value on relapse rate (P = 0.012) and on overall survival (P = 0.10). It is concluded that diagnosis of HD by itself remains, in 1988, the sole histologic factor influencing the prognosis of these patients.

Adolescent↗

Multicentric angiofollicular lymph node hyperplasia associated with a solitary osteolytic costal IgG lambda myeloma. POEMS syndrome in a South American (Paraguayan) patient.

We report the case of a 46-year-old woman presenting with a disorder characterized by the association of multicentric Castleman's disease, organomegaly, a solitary IgA lambda myeloma with lytic bone lesions but no serum monoclonal peak, peripheral neuropathy and skin changes. This unusual association resulted in an incomplete form of that peculiar multisystem syndrome described under a variety of names: Crow-Fukase syndrome, Shimpo's syndrome, Takatsuki's syndrome, PEP syndrome or POEMS syndrome. The possible relationship between localized and multicentric Castleman's disease with myeloma or extramedullary plasmacytoma on one hand and on the other hand with polyneuropathy and the other symptoms of the POEMS syndrome is discussed.

Bone Neoplasms↗

Detection by in situ hybridization of HIV I RNA in spleens of HIV I sero-positive patients with thrombocytopenic purpura.

In situ hybridization with a 3H labelled probe on cryosections from 6 spleens of HIV I sero-positive patients with thrombocytopenic purpura showed the presence of HIV RNA in 4 of the 6 spleens at the follicular hyperplasia stage. Two patterns of hybridization were observed: first, a diffuse autoradiographic signal, displaying an irregular network, detected in 1 or 2 germinal centres (GC) per section (17%); secondly, the presence of very few distinct radioactive cells in the labelled GC. A similar pattern was observed in an ARC (Acquired immunodeficiency syndrome-Related Complex) lymph node, but with a more intense and frequent hybridization signal. These results indicate that the spleens, like the lymph nodes, are involved in the course of HIV infection but with a less intense tissue-virus interaction, which may explain the minor morphological changes observed in the spleens. In addition, a careful examination of the lymph node tissue indicated that lymphocytes are the predominant cell type infected with the virus. As for the follicular dendritic cells (FDC), a similarity of the hybridization signal observed in the GC and in vitro HIV infected cells suggests that the FDC could also be sensitive to the virus.

AIDS Serodiagnosis↗

A new system for cutting brain tissue preserving vessels: water jet cutting.

The water jet cutting system allows transaction and dissection of biological structures with little bleeding. Structures of higher tissue rigidity remain unchanged while softer tissues are mechanically dissected. In brain tissue, all vessels larger than 20 microns are left intact after the passage of the jet stream with a pressure of up to 5 bar, and therefore vessels can be isolated selectively from the surrounding tissue. Oedema is present adjacent to the cut and no increase of temperature occurs.

Animals↗

Immunohistological demonstration of lymph node reticulum cells in the acquired immunodeficiency syndrome related complex. A study in Bouin-fixed tissues.

The results of an immunohistochemical study on paraffin sections of the lymph nodes from 5 patients with the acquired immunodeficiency syndrome (AIDS) related complex (ARC) are presented. The distribution and frequency of follicular dendritic cells (FDC) and of interdigitating cells (IDC) were examined with the monoclonal antibodies J3D3 (directed against the C3b complement receptor, CD 35) and IOB1a (specific for the C3D, CD21) as well as with the polyclonal anti-S-100 protein antiserum in Bouin-fixed, paraffin-embedded sections using a Streptavidin-biotin-peroxidase technique. Disruption of the follicular FDC network was demonstrated. No major alteration of the IDC was noted. The immunomorphological patterns observed in this study were comparable with the previously reported lymph node alterations studied in frozen section.

AIDS-Related Complex↗

[Dermo-hypodermic lymphoid pseudotumors with follicular hyperplasia. Apropos of a case].

We report the case of a female patient with ubiquitously distributed cutaneous and subcutaneous nodules measuring 2 to 6 cm along their long axis. These nodules first developed at the age of 63 years and subsequently appeared in crops separated by spontaneous remissions. Studies of removed nodules demonstrated diffuse lymphoid follicular hyperplasia suggesting a tumor and raising difficult nosologic problems, especially regarding relationships with the extranodal multicentric Castleman syndrome. In march 1987, biopsy of a large scapular nodule spreading into the striated muscle suggested possible transformation into a low grade malignant lymphoma of the lymphoplasmocytoid type.

Biopsy↗

Lymph node interdigitating cell granuloma associated with non-Hodgkin's malignant lymphoma. A case report and review of the literature.

We report a new case of histiocytic proliferation, which histologically resembles histiocytosis X, in a lymph node affected by non-Hodgkin's malignant lymphoma. This brings the total number of such reported cases to 12. Histiocytosis X cells, with folded nuclei, expressed S100 protein and an antigen recognized by anti-CD1 monoclonal antibodies. Ultrastructural study did not show any Birbeck granules and demonstrated a morphology similar to that of interdigitating cells. In the absence of Birbeck granules, the term 'Langerhans' cell granulomatosis' is not correct and should be replaced by either 'interdigitating cell granuloma' according to immunohistochemistry and ultrastructure or 'histiocytosis X-like granuloma' according to optical morphology. The fact that some cells with folded nuclei were positive for lysozyme argues in favor of the existence of transitional cells between histiocytes hnd interdigitating cells. The 11 other reported cases were reviewed. In 6 cases, this type of granuloma was associated with B cell lymphoma. In 3 cases the lymphoma was also probably of B cell type. In 2 cases, no information could be found. We could speculate that these histiocytosis X-like lesions are reactive, resulting from immune disturbances due to the lymphoma and/or the treatment.

Aged↗

Lymphadenopathy in HIV infection: histological classification and staging.

The histological alterations seen in HIV-related lymphadenopathy have been described with different terms by different authors. In order to facilitate comparisons of results from various laboratories, a group of pathologists of the European Lymphoma Study Group (later the European Association for Haematopathology) have proposed a histological classification for the evaluation of HIV related lymphadenopathy. Most observers agree that the morphological and immunohistochemical alterations in the follicles (germinal centres) are the most conspicuous and earliest changes seen. The follicular alterations were therefore used as the basis for the proposed classification. In addition, some features occasionally seen were also included, i.e. angioimmunoblastic hyperplasia, multicentric Castleman-like lesions, and vascular lesions, especially pretumorous and tumorous stages of Kaposi's sarcoma. The proposed classification was used by the members of the group of a collection of lymph nodes compiled from the various centres. The classification was shown to be reproducible and to have clinical relevance in staging of the patients. The prognostic relevance as to the survival of the patients has to be further substantiated by follow-up studies. The proposed classification offers a common terminology for the alterations previously described by different terms by various authors.

AIDS-Related Complex↗