Biomedical subjects
Publications and source records attributed to J Diebold.
The first case of PLC in a nondular pleomorphic lymphoblastosarcoma is reported. The PLC signification is at present unknown. In hematologic pathology, they are usually observed in HCL and scantly in different B-cells malignant proliferations.
Histological examination of the various specimens taken during an exploratory laparotomy for Hodgkin's disease revealed the presence of epithelioid cells in 56 cases out of a total of 235 patients (i.e. 23.8 p. 100). These cells were disseminated throughout the lymphoid tissue or grouped in clumps, in plaques or, more rarely, as true follicles. They were found either in contact with Hodgkin's lesions or at a distance in organs free of disease. They were found in Lukes-Rye histological types 1, 2 and, above all, 3. Their significance remains unknown. The most likely hypotheses would appear to be those of a response to the accumulation of substances to be eliminated (tumour antigens?) or those of a disorder in cellular immunity.
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The term immunoblast created by Dameshek, is useful in routine cytological and histopathological practice, for the diagnosis of lymphadenites and malignant blood diseases. This term designates a group of cells, the appearance of which is quite different from other cells of the lymphoid tissue. Their morphological characteristics are precise and they resemble transformed lymphocytes. These immunoblasts are derived from T and B lymphocytes. Using purely morphological methods the type B of certain immunoblasts may be suggested. Immunoblasts of the clear centers of follicles, immunoblasts undergoing plasma cell transformation, tumour cells constituting nodular immunoblastosarcomas, immunoblasts appearing in the tumor population of the myelomas and of Waldenström's macroglobulinaemia. The term immunoblast which evokes precise morphological criteria, should be maintained. This term cannot designate only B lymphocytes, but also transformed lymphocytes of type B or T.
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The authors describe the various cytological and pathological lesions found in lymph node, spleen, bone marrow and liver in Waldenströms macroglobulinemia. The significance of the discovery of PAS positive intranuclear vacuoles is discussed. The findings are completed by a description of the results obtained in immunofluorescence and under the electron microscope. Unusual forms and the differential pathological diagnosis are then discussed.
Four cases of sarcomatous or leukaemic types of Waldenström's macroglobulinemia are presented. They are characterized by tumoral and compressive localizations of lymph node or spleen, or by a hyper-leukocytosis with many circulating abnormal cells. These cells are different from the lympho-plasma cells regularly observed in Waldenström's macroglobulinemia, and can be assimilated to malignant immunoblasts. They have a proliferative aspect and seem to produce less macroglobulin and to recover some beta-glucuronidase activity. The sarcomatous and leukemic types of Waldenström's macroglobullinemia have a poor prognosis and may appear as terminal transformation of the disease.
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The authors report two cases of multiple myeloma which were typical both clinically and in the laboratory but XRay examination, on the other hand, showed appearances of osteocondensation. In the first case, XRay showed both lesions of osteolysis in the cranial vault and homogeneous condensation of D11 and L1, together with the left iliac crest. In the other case, there was osteolysis of the acetabulum together with areas of osteocondensation distributed throughout the pelvis and upper ends of the femurs, with two areas of annular fibrosis circumscribing the area of osteolysis, finally, homogeneous condensation of the skull. In both cases, bone biopsy confirmed the diagnosis of multiple myeloma showing both osteofibrosis and plasma cell infiltration of the bone marrow. This also permitted the authors to note the absence of any myelofibrosis or metamorphic neo-osteogenesis. Illustrated by these two cases, condensing multiple myeloma is a rare entity, the special clinical characteristics of which reside in its fairly frequent coexistence with peripheral neuritis which is probably similar to a para-neoplastic syndrome. The radiological appearances are mainly of four types: 1) Focal areas of bony condensation. 2) Areas of annular fibrosis circumscribing osteolysis. 3) Appearances of radial spicules, or 4) Osteocondensation extending to a fairly large part of the skeleton. The laboratory signs are identical with those in other types of multiple myeloma with a few exceptions, such as, rareness of hypercalcemia, more frequent tendency to hypocalcemia, rise in alkaline phosphatase, in a few cases. Bone biopsy confirms the diagnosis. The osteofibrosis resulted here from thickening of the osteoid seams by laying down of successive layers of bony substance, irregularly calcified and, also secondarily, metamorphic neo-osteogenesis in a few rare cases which also included myelofibrosis.