Biomedical subjects
Publications and source records attributed to J Diebold.
Eleven patients (age range 51-65 years) presenting with primary splenic lymphoma of lymphoplasmacytic type are described, together with detailed histological, immunohistochemical, and ultrastructural findings. The subclassification of this type of lymphoma is considered, and the prognosis discussed.
Explore the source record for details and available documents.
The ultrastructural morphology of 4 cases of large anaplastic cell malignant lymphoma (Ana ML) is reported. Three cases were primary Ana ML and one pleomorphic large T cell lymphoma with some Ki-1 positive cells. All were confirmed by immunohistochemistry on frozen and paraffin sections. The Ki-1 and EMA positive tumour cells had an abundant cytoplasm, with no differentiation and large pale nuclei with multiple compact or dispersed nucleoli. The morphology is that of an activated cell engaged in protein synthesis and/or in the mitotic cycle. These tumour cells resemble to the Hodgkin's and monolobated Reed-Sternberg cells described in Hodgkin's disease.
Explore the source record for details and available documents.
Eight cases of AIL-type T-cell malignant lymphoma are reported. The clinical symptoms are the same as those described in AIL: fever, malaise, weight loss, skin rashes, polyadenopathy, and splenomegaly. However, some differences can be noted: the absence of hepatomegaly in all cases but one, the absence of polyclonal hypergammapathy in all cases but one, and predominance in females. The lymph node modifications comprise diffuse infiltrations of lymphoid cells with irregular nuclei and pale cytoplasm, associated with a large number of immunoblasts and plasma cells. Some eosinophilic granulocytes and epithelioid cells can be seen. Hyperplasia of the vessels and remnants of follicles, sometimes with proliferation of follicular dendritic cells, are prominent features. The immunolabelling study demonstrates the presence of an important T-cell population all expressing a high predominance of CD 4 phenotype. These findings are in accordance with those published in Europe and in contrast with those of some of the Japanese cases, particularly the first patients published by Shimoyama et al. The differential diagnosis with AIL is based on the presence of clusters of mainly large cells with a pale cytoplasm, on the loss of expression of one T cell marker, as in 3 cases of our series, and on the presence of a high percentage of lymphoid cells engaged in the mitotic cycle as demonstrated with the Ki 67 monoclonal antibody. However, to draw a clear cut difference between AIL-type T-cell lymphoma and AIL considered as a prelymphomatous dysimmune lymphadenopathy, only the demonstration of cytogenetic abnormalities, as in one of our cases or of rearrangement of the genes coding for beta and/or gamma chain of the antigen receptor of T-cell are valuable criteria. The follow-up of our series is not long enough to appreciate the prognosis. Three patients died, one from a glioma. All the other cases, treated with polychemotherapy show total remission with an evolution of 10 to 39 months.
In 2 patients with a long lasting cortico-dependent chronic idiopathic thrombocytopenic purpura, splenectomy in one and ablation of an accessory spleen in the other, disclosed a complex association of splenoma, peliosis and lipidosis of the spleen, with a secondary sea blue histiocytosis in one case. The relation of this curious association with thrombocytopenia and with the long treatment with corticosteroids is discussed, with a review of the literature.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In the last few years advances in immunopathology have demonstrated the T cell origins of some malignant lymphoma (ML). Histopathological criteria have been suggested for classifying several varieties of T cell ML. Peripheral T cell ML are the result of proliferation of T cell lymphocytes with markers which distinguish between the enhancing-inducer and suppressor-cytotoxic forms. The diagnosis is made from the appearances of the cell, the presence of vascular hyperplasia and associated lesions. The numbers of small, medium and large cells and clinical follow-up of these tumors have provided a means of distinguishing between low and highly malignant tumors. Some peripheral T cell ML have associated lesions due to the secretion of lymphokines which give characteristic histopathological appearances (lympho-epithelioid T cell ML, AIL type T cell ML). The authors discuss the respective places of each variety of peripheral T cell ML in Lennert and Suchi's classification which is an extension of that proposed by Kiel, and their prognostic signification.
We describe an unusual intranodal vascular proliferation following acute toxoplasmosis in a man. This proliferation is distinct from other benign vasoformative nodal lesions. It could be interpreted as a reactive healing process that might be misdiagnosed as nodal Kaposi's sarcoma. Some criteria to avoid such misdiagnosis are presented.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Some cases of idiopathic thrombocytopenic purpura (ITP) may be related to the prodromal phase of the acquired immunodeficiency syndrome (AIDS). The morphologic features of six spleens removed in this context were studied. In the white pulp, lymphoid follicular hyperplasia was constant but hardly distinguishable from that of control ITP on routine light microscopic grounds. Moreover, its bland appearance contrasted with the major histopathologic changes usually described in lymph node biopsy specimens from patients with AIDS-related complex. Immunohistochemistry and electron microscopy demonstrated, respectively, an excess of cytotoxic-suppressor lymphocytes with a decreased CD4/CD8 ratio in the germinal centers and viral particles of the human immunodeficiency virus. The immunohistochemical and ultrastructural studies were more helpful than light microscopy in presenting histopathologic arguments in favor of the human immunodeficiency virus infection.
Explore the source record for details and available documents.
A canary breeder with Waldenström's macroglobulinemia developed a pulmonary disease related to an interstitial infiltration by malignant B cells secreting a monoclonal IgM K. The serum monoclonal IgM was shown to possess an antibody activity to some canary's droppings antigen. This finding may help elucidate the natural course of lymphoid malignancies and the pathogenesis of rare visceral localizations.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The results of a retrospective study of 98 lymph nodes in 89 patients with documented mycosis fungoides (M.F.) are reported. According to the histopathological aspect, three groups are determined: group I of 20 lymph nodes with lesions of dermopathic lymphadenopathy; group II of 27 lymph nodes, presenting variable-sized clusters of atypical cerebriform lymphocytes located in paracortex without homogenization; group III of 51 lymph nodes with partial or total homogenization; according to the different cytologic types, four histopathologic forms are described in group III: small, large, mixed and immunoblastic cellularly type. The paracortical changes of dermopathic lymphadenopathy observed in group I cannot be distinguished from those in patients with unrelated diseases. All histopathological aspects of group III correspond to a specific MF involvement. The most difficulties are caused by lymph nodes from group II; in order to detect an early MF involvement, the histopathologist has to find a partial infiltration of paracortex by atypical large and numerous lymphocytes. Morphometric and immunohistochemical methods previously reported are useful but they are expensive and they cannot be usually carried out. Because of the heterogeneity of the lesions a perfect routine paraffin-embedded with serial sections seems to be the most helpful way for recognition of early MF involvement in lymph nodes. In our series, as in literature, correlations with clinical course show that lymph node involvement classified in group III is pejorative. But it seems that histo-prognostic evaluation based on a suspicion of early involvement has to be carefully established because of the lack of significant difference of clinical behaviour between group I and group II.