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Biomedical subjects

K Foucar

Publications and source records attributed to K Foucar.

67 records · Page 4Linked to original sources
PubMed1983

Postleukemic dysmyelopoiesis.

The morphologic and clinical features of four patients who developed significant bone marrow and blood dyspoiesis after successful chemotherapy for acute nonlymphocytic leukemia (ANLL) are described. This postleukemic dyspoiesis developed 1-6 months after leukemia induction therapy and persisted for 5-20 months in a relatively stable state. This period of prolonged dyspoiesis was not associated with rising myeloblast counts or clinical evidence of relapse. Dyspoietic abnormalities developed while two patients were receiving maintenance chemotherapy; the other two patients received no maintenance therapy. The dyspoietic changes in these four patients greatly exceeded those noted in a control group of ANLL patients on maintenance chemotherapy. The morphologic features of postleukemic dysmyelopoiesis were similar to those described in preleukemic dysmyelopoietic disorders. Erythroid abnormalities included hyperplasia with ring sideroblasts, megaloblastic changes, and cytoplasmic PAS reactivity. Myeloid abnormalities consisted of left-shifted granulopoiesis with hyper- and hyposegmentation; megakaryocytic abnormalities included hyperplasia with a predominance of hypolobulated forms. Three of the four patients eventually suffered relapse and have died. The fourth patient died of sepsis after 20 months of pancytopenia and dysmyelopoiesis. Theories to explain the development of postleukemic dysmyelopoiesis are presented which emphasize the possibility of drug-induced leukemia cell differentiation. Cytogenetic studies will be necessary to establish any relationship between ANLL and the subsequent postleukemic dysmyelopoiesis.

Acute Disease↗
PubMed1982

Tubular complexes of endoplasmic reticulum in lymphoblastic lymphoma: case report.

Distinctive intracytoplasmic tubular complexes have been identified occasionally by electron microscopy in a wide variety of hematologic and nonhematologic disorders. The mechanism of induction and significance of these tubular complexes are unknown. Tubular complexes were identified in the majority of bone marrow lymphoma-leukemia cells in a patient with documented lymphoblastic lymphoma in lymph node. These complexes varied in size but in general ranged from 800--1500 nm, and consisted of masses of nonparallel, twisted, smooth, 40-nm tubules. Continuity with adjacent endoplasmic reticulum was evident in some of the complexes. Cytochemical characteristics of the malignant cells included strong, focal, paranuclear acid phosphatase reactivity and strong, stippled nuclear terminal deoxynucleotidyl transferase positivity. Flow cytometric analysis showed a DNA-RNA content pattern consistent with acute lymphoblastic leukemia and typical of T-cell lymphoma. This represents the first report of such tubular complexes in a presumed T-cell malignancy.

Acid Phosphatase↗
PubMed1982

Bone marrow and blood involvement by lymphoma in relationship to the Lukes--Collins classification.

The incidence, pattern, extent, and morphology of bone marrow involvement in 176 cases of non-Hodgkin's lymphoma (NHL) were studied in relationship to the Lukes--Collins classification. Ninety percent of the cases were B-cell lymphomas; 10% were T-cell lymphomas. In 53% of cases there was bone marrow involvement by lymphoma at diagnosis. Marrow involvement was most frequently found in the small lymphocyte (B), small cleaved follicular center cell (FCC), and convoluted lymphocyte lymphomas. Frequently, the extent of bone marrow biopsy replacement by lymphoma was less than 30%; the pattern of infiltration was predominantly focal (70%). Cytologic agreement between lymph node and bone marrow specimens was always present in small lymphocyte (B), small noncleaved FCC, convoluted lymphocyte, and lymphoepithelioid cell lymphomas. Cytologic diversity between lymph node and marrow was noted in 20% of small cleaved FCC, 40% (2/5) of large cleaved FCC, and 38% (3/8) of large noncleaved FCC lymphomas. In 79% of all involved cases, both bone marrow biopsy sections and aspirate smears were diagnostic of NHL; only biopsy sections were positive in 18%, and only smears were positive in 3%. The Lukes--Collins classification predicts a high incidence of bone marrow involvement for small lymphocyte (B), small cleaved FCC, and convoluted lymphocyte lymphomas.

Adolescent↗
PubMed1981

Ultrastructural characteristics of therapy-related acute nonlymphocytic leukemia: evidence for a panmyelosis.

Leukemic cells from 13 patients with therapy-related acute nonlymphocytic leukemia (ANLL) were studied by electron microscopy. All of the patients had radiotherapy, and/or alkylating agent chemotherapy for other neoplastic disease 25 to 182 months prior to the diagnosis of ANLL. All cases manifested ultrastructural evidence of a panmyelopathy. All marrow cell lines exhibited nuclear--cytoplasmic asynchrony and abnormalities of cell size. Developing granulocytes exhibited decreased primary and/or secondary granule formation and abnormal granules characterized by irregular shape, large size and internal membranous lamellae. Monocytes showed perinuclear bundles of microfilaments. In some cases, the predominant leukemic blasts showed evidence of early basophil granule development which was not appreciated in light microscopy. Abnormalities in erythroid cells included abundant intracristal mitochondrial iron, large vacuoles, infoldings of redundant membrane and membrane-bound nuclear blebs and intranuclear clefts. Megakaryocytes manifested decreased numbers of granules and demarcation membranes. Excessively large platelets with decreased or abnormal granules were identified; giant compound granules with irregular contour and variable electron density were present. Several of the changes in the developing hematopoietic cells were similar to those described in preleukemia and in certain nonneoplastic disorders. The consistent panmyelosis in therapy-related ANLL together with several uniform clinical features defines a specific clinicopathologic entity.

Adult↗
PubMed1981

Mitotic activity in benign parathyroid disease.

Tissue sections from 17 cases of parathyroid adenoma and ten cases of parathyroid hyperplasia were examined for mitotic activity. Mitoses were identified in 12 of the 17 cases of parathyroid adenoma and in eight of the ten cases of parathyroid hyperplasia. Clinical follow-up of all patients, even the four patients in whom numerous mitoses were present, showed no evidence of recurrent or aggressive disease. Mitotic activity alone is an unreliable indicator of aggressive potential in parathyroid disease.

Adenoma↗
PubMed1981

Bacterial infection stimulating granulocytic sarcoma of the small bowel.

A 57-year-old white man who had abdominal pain and distension, died after a short hospitalization for increasing ascites, anorexia, and deteriorating mental status. At autopsy, the principal gross finding was a dilated, hyperemic, thickened proximal jejunum that by light microscopy consisted of a transmural infiltrate of large mononuclear cells. Intense naphthol AS-D chloroacetate esterase (NASD) positivity was observed within most of the cells, suggesting granulocytic sarcoma. However, bacterial strains and electron-microscopic examination revealed that the massive jejunal infiltrate was composed of macrophages containing numerous phagocytosed bacteria. Although occasional cells had primary and secondary granules characteristic of myeloid precursors present within their cytoplasm, most cells lacked specific granules. Attempts to reproduce this markedly enhanced NASD result experimentally in peritoneal macrophages of mice were unsuccessful. This case shows that intense NASD cytoplasmic staining may occasionally occur macrophages that have phagocytosed large numbers of bacteria.

Animals↗
PubMed1981

Colon ulceration in lethal cytomegalovirus infection.

Six renal transplant recipients with severe cytomegalovirus (CMV) infection developed colonic ulceration and lower gastrointestinal bleeding. All patients died between four and 84 days following onset of bleeding. Four patients required colon resection to control blood loss. In the remaining two cases, there was complete autopsy examination with thorough tissue sampling of the colon. In addition to routine light microscopic examination, all cases were studied with an immunoperoxidase technic for identification of CMV. Electron microscopic examination of the colon was performed on two cases. In this select group of patents, CMV plays an active role in damaging colonic mucosa, primarily as a result of CMC vasculitis. Clinical and pathologic features of our cases are compared to published reports of CMV infection of the colon.

Adult↗
PubMed1981

Fibrofolliculoma: a clinicopathologic study.

A 63-year-old woman with numerous fibrofolliculomas on the face, neck, ears, and trunk is described. These papular lesions developed at approximately 30 years of age. Various family members have clinically identical lesions suggesting an autosomal dominant disorder. The hamartomatous lesions consisted of a proliferation of the pilar fibrous root sheath which surrounded anastomosing bands of epithelium arising from the hair follicle. The clinical and pathologic features of pilar complex tumors are reviewed.

Female↗
PubMed1980

Richter's syndrome in chronic lymphocytic leukemia.

Over an 18-year period a distinctive large cell lymphoreticular neoplasm (Richter's transformation) developed in 9 patients with chronic lymphocytic leukemia. Clinical findings at the onset of Richter's transformation were remarkably uniform and consisted of the abrupt onset of fever, marked asymmetric lymphadenopathy with the formation of masses, splenomegaly, and hepatomegaly. All patients underwent rapid clinical deterioration followed by death within six and a half months. Earliest infiltrates of large lymphoreticular cells were identified in the lymph nodes in 3 of 4 patients and the bone marrow in 3 of 9 patients, while no patient had peripheral blood involvement. Autopsy examinations revealed extensive infiltrates of large lymphoreticular cells, predominantly in bone marrow, lymph nodes, liver, spleen, but also in kidney, lung, and gastrointestinal tract. In each case, these large lymphoblast-like and pleomorphic lymphoreticular cells were admixed with mature-appearing lymphocytes and intermediate forms (prolymphocytes). Electron microscopic and immunoperoxidase studies provided additional evidence that this highly aggressive lymphoreticular neoplasm represents a transformation or dedifferentiation of chronic lymphocytic leukemia.

Adult↗
PubMed1979

Therapy-related leukemia: a panmyelosis.

Fifteen patients developed acute nonlymphocytic leukemia (ANLL) 31 to 182 months following chemotherapy and/or radiotherapy for various malignancies and one non-neoplastic disorder. The ANLL was commonly heralded by a brief preleukemic phase consisting of cytopenias and a variety of morphologic abnormalities. At diagnosis of ANLL, all of the patients had a panmyelosis with variation in the predominant abnormal cell line. Neutrophilic and erythroid abnormalities were most striking in 12 of the patients, megakaryocytic abnormalities predominated in 2 and monocytic abnormalities in 1. Pancytopenia, marked anisopoikilocytosis, normoblastemia, large hypogranular platelets, hypogranular neutrophils, pseudo-Pelger-Huet nuclei, low myeloblast counts and basophilia were the most common abnormalities in the blood. Bone marrows were hypercellular with increased myeloblasts and basophils, abnormal neutrophil precursors, occasional monocytoid blasts, dyserythropoiesis with PAS positive erythroblasts, ring sideroblasts and micromegakaryocytes. All of the 7 patients who had bone marrow chromosome studies exhibited major chromosomal abnormalities. Response to anti-leukemic therapy was poor. The morphologic and clinical findings of these 15 patients appear to define a clinical-pathologic entity.

Adult↗
PubMed1979

Incidence and patterns of bone marrow and blood involvement by lymphoma in relationship to the Lukes-Collins classification.

Pretreatment lymph nodes, bone marrow, and blood were examined in 176 cases of non-Hodgkin's lymphoma. By the criteria of the Lukes and Collins functional--morphological classification, 158 (90%) were B-cell lymphomas and 17 (10%) were T-cell lymphomas. Bone marrow involvement was present in 53% of cases: 51% of B-cell types and 65% of T-cell types. Marrow involvement was most frequent in small lymphocyte (B) (89%), convoluted lymphocyte (60%), and small cleaved follicular center cell (FCC) lymphomas (55%). The pattern of bone marrow involvement was most frequently focal paratrabecular in B-cell lymphomas and diffuse in T-cell lymphomas. Blood involvement was present in 50% of cases with bone marrow lymphoma and generally reflected extensive bone marrow disease. There was a higher incidence of both bone marrow and blood involvement in pediatric patients than in adults.

Adolescent↗