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L D Leder

Publications and source records attributed to L D Leder.

At least 55 records · Page 3Linked to original sources
PubMed1990

Acute megakaryoblastic leukemia: a case report.

We present a case of acute megakaryoblastic leukemia identified by electron microscopy and platelet-specific antibodies. The histological examination of bone marrow showed distinct myelofibrosis. In accordance with recent communications, low-dose cytosine arabinoside treatment (20 mg twice daily s.c. over 21 days) was initiated. The subsequent bone marrow examination showed a severe hypoplasia with persistent blasts. Amsacrine and VP-16 were given without success. Finally the patient died of septicemia without proof of pathogen uninfluenced by antibiotic and antiseptic therapy 6 weeks after diagnosis. Our case report confirms the poor prognosis of acute megakaryoblastic leukemia.

Acid Phosphatase↗
PubMed1989

[Initial symptoms of malignant thyroid tumors: the effect of age and sex in an iodine-deficient region. Experiences with 1116 patients].

Initial symptoms of thyroid cancer were collected and analysed for 1116 patients with thyroid cancer in an iodine-deficient region, retrospectively for the period 1960-80 (604 patients), prospectively for 1981-87 (512). Using the WHO classification, 56.1% of patients had papillary, 32.7% follicular, 4.8% C-cell, 3.7% anaplastic and 2.7% various other malignant tumours. In 40% of all patients the initial sign had been a solitary intrathyroid nodule. Cervical lymph node swelling as initial sign had been significantly more frequent in men (21.1%) than in women (10.3%; P less than 0.003). In patients aged under 40 years the cervical lymph node signs were three times as common as among those over 50 years. Distant metastases as initial sign of papillary carcinoma were seen only in those over 60 years. Tumour stages T3 and T4 were seen significantly more frequently in over 60-year-old (42.2%) than under 40-year-old (25.1%; P less than 0.001), independent of histological type. Composition and initial signs of this patient cohort in an iodine-deficient region differed only slightly from those in an iodine-rich region.

Age Factors↗
PubMed1988

[Ultrastructural findings in tissue mast cells in urticaria pigmentosa].

In a study on 10 patients suffering from urticaria pigmentosa, biopsies of skin lesions were electron microscopically investigated. In contrast to normal skin, the mast cells showed irregular, partly bilobed nuclei, prominent nucleoli, hypogranulation, and rather small granules; giant granules were rarely observed. In addition, we frequently found degranulation, and the development of microvilli was much more prominent than with normal mast cells. These deviations from normal skin represent at least in part functional alterations. However, some of the findings suggest that urticaria pigmentosa may be considered a neoplastic disease of the tissue mast cells, although clear evidence is still lacking. In any case, our findings show that mast cells in mastocytosis are not identical with those in normal skin.

Biopsy↗
PubMed1988

Electron-microscopic characterization of mixed granulated (hybridoid) leucocytes of chronic myeloid leukaemia.

In chronic granulocytic leukaemia, hybridoid leucocytes can regularly be found. Light microscopically they contain a mixture of eosinophilic, basophilic and naphthol AS-D chloroacetate esterase-positive granules. The present study was done to clarify the ultrastructural composition of these cells. It could be clearly shown that in some leukaemic granulocytes primary and secondary eosinophilic as well as basophilic granules occur side by side. There were also basophils with additional tissue mast cell granules. Since normal mast cell granules as well as granules of normal eosinophilic promyelocytes are naphthol AS-D chloroacetate esterase-positive, it would appear possible that mastocytoid as well as primary eosinophilic granules within the leukaemic basophils are responsible for the atypical, granular naphthol AS-D chloroacetate esterase-positivity of these cells. The existence in chronic myeloid leukaemia both of mixed basophilic and eosinophilic granulated leucocytes and of mixed basophilic and mastocytoid granulated leucocytes may suggest a common myeloid precursor of eosinophils, basophils and tissue mast cells. In addition, the hybridoid granulocytes may be considered an expression of a neoplasia-related lineage infidelity.

Basophils↗
PubMed1988

Large bowel cancer risk in cholelithiasis and after cholecystectomy. Postmortem study.

To assess the large bowel cancer risk in cholelithiasis (CL) and after cholecystectomy (CE), the results of 11,828 autopsies were analyzed. 1,705 cases with CL and 380 with CE could be identified. Randomly selected cases matched for sex and age were used as controls. In CL and CE 61 cancers were observed compared with 53 in controls, the relative risk (RR) being 1.2. The risk ratio for the subgroups (CL, CE) was also 1.2. In contrast to women, there was a positive association (RR 1.7) between cancer and CL in men, in whom no risk increase was found after CE. In cases with CL and CE an elevated risk of developing proximal large bowel cancer was observed for both sexes (RR 1.7 in males and 1.4 in females). As regards distal cancer, no such relationship was observed in women (RR 0.83) whereas an increased risk was found in men (RR 2.3). The results of this study are in favor of a positive association between CL and CE and the risk of developing large bowel cancer.

Aged↗
PubMed1986

Lineage infidelity in chronic myeloid leukemia. Demonstration and significance of hybridoid leukocytes.

Blood smears from 13 cases of chronic myeloid leukemia (CML) were examined for bigranulated (basophil/eosinophil) cells. The cells were stained with May-Grünwald-Giemsa, toluidine blue, Biebrich scarlet, Adams' reaction, and were reacted for KCN-resistant peroxidase in two cases. A sequential stain (toluidine blue/Biebrich scarlet/Adams' reaction) was applied to 50 cells in each case. Hybridoid cells occurred in all cases with varying frequency. Double granulation was not only found in immature, non-segmented cells but often in mature segmented cells. The chimeric cells were difficult to detect with May-Grünwald-Giemsa. Biebrich scarlet and Adams' reaction being superior in this respect to Biebrich scarlet. Some granules that were positive by Adams' reaction did not stain with Biebrich scarlet. This is in sharp contrast to the normal and is, therefore, interpreted as a granule atypicality. Since under normal circumstances, eosinophilic and basophilic granules can be viewed as mutually exclusive markers of the respective granulocytic lineages, the simultaneous occurrence in CML cells of both markers demonstrates lineage infidelity. Until now lineage infidelity has been reported only in immature cells. However, our results show that lineage infidelity also occurs in mature segmented cells. This indicates that the progenitors of these chimeric granulocytes follow false genetic programs producing cells with profound irreversible neoplastic aberrations.

Basophils↗
PubMed1986

Epidemiology of gallstones in a German industrial town (Essen) from 1940-1975.

The prevalence of gallstones was studied in 11,840 consecutive autopsies from 1940 to 1975 in the University hospitals of Essen. The total prevalence was 20.7%: 13.1% for men and 33.7% for women. The male to female sex ratio is 1:2.6. The crude prevalence for three 12-year periods showed a significant increase from 8.2 to 15% in men and from 25.7 to 36.3% in women (p less than 0.001). A detailed analysis showed that this increase occurred only in the age groups over 60 and was the consequence of the fact that a greater proportion of women over 60 came to autopsy. The age- and sex-specific morbidity ratio was calculated to standardize the data. This demonstrated considerable fluctuations in 3-year periods since 1940. It can be concluded that no real increase in the prevalence of gallstones occurred in the last 30 years.

Adult↗
PubMed1986

[Individuality of malignant neoplasms].

The article concerns the implication of the tumor cell heterogeneity, which is caused by the genetic instability of tumor cells. Thereby, within a given tumor, subpopulations with differing marker profiles may appear in a very irregular fashion. For instance, some populations may show criteria which under normal circumstances are mutually exclusive. In so far, the tumor cell heterogeneity can be viewed as responsible for the fact that tumor classifications are never scientific classifications which are defined by reliable and stable criteria. Furthermore, the tumor cell heterogeneity must be born in mind when malignant tumors are graded. Grading provides usually only statistical results which must not necessarily be valid for the individual case. It is concluded that malignant neoplasias should be considered much more individually if we were to take their biologic behaviour properly into account. This, however, bears considerable difficulties, especially with respect to diagnostic and therapeutic conclusions.

Humans↗
PubMed1985

Mucin in carcinomas of the thyroid.

One hundred forty-two cases of thyroid carcinomas were studied to assess the frequency with which mucinous deposits occur within the neoplastic cells. In contrast to the literature, which contains only a few scattered reports on this topic, the production of mucin by carcinomas of the thyroid was relatively frequently observed in our material. Almost one half of the cases displayed mucinous substances, which occurred in about 50% of the papillary and the medullary carcinomas, 35% of the follicular types, and about 21% of the anaplastic varieties. The amount of mucinous substances varied considerably: 28 cases were weakly positive, 30 cases were moderately positive, and 6 cases were strongly positive. These findings are discussed with respect to diagnostic and differential diagnostic problems, especially with respect to the interpretation of mucinous deposits that occur in metastatic carcinomata.

Adenocarcinoma↗
PubMed1985

Relapsing acute non-lymphatic leukemia with changing phenotypes.

Morphological and cytochemical findings in a case of acute myeloid leukemia (AML) with 3 relapses are described. The disease began as a subtype M4 with atypical eosinophils according to the French-American-British (FAB)-classification. At the time of the first relapse, the phenotype had converted into an M2-subtype, while the second relapse presented the picture of an M1-type of acute myeloid leukemia with non-granulated peroxidase-positive blasts. When the third relapse occurred, the diagnosis was again an M4-type of acute myeloid leukemia. The observed changes of the phenotype can be interpreted as an expression of tumor cell heterogeneity, even though the observed emergence of new leukemic clones would be attributed entirely or in part to effects of the applied cytostatic drugs, because tumor cell heterogeneity concerns also the response to therapy, which may result in a growth advantage for certain leukemic subpopulations. In so far, AML behaves like all other human malignant neoplasias. In addition, morphological changes in leukemias such as are reported here, have been observed long before the introduction of cytostatic drugs. Also, the validity of the FAB-classification is discussed in the light of the presented observation. It is concluded that the FAB-classification is not a classification in a strict sense, but merely a crude and simplistic list of subtypes of acute myeloproliferative diseases that is difficult to reproduce and that disregards major aspects of this group of diseases, for instance tumor cell heterogeneity.

Adult↗
PubMed1985

A case of multiple myeloma with two subclones producing separately kappa and defective gamma chains.

A case of multiple myeloma is described that contained two morphologically identical but immunologically diverse subpopulations. One of the subclones produced only kappa chains, whereas the other contained only gamma chains. Additional immunohistologic investigations revealed production by one of the subpopulations of defective gamma chains that were devoid of demonstrable Fd parts. It could not be decided whether this was due to a structural or an antigenetical defect. Furthermore, only the kappa-producing subclone exhibited J-chains. Based upon these findings and their possible cause and on respective findings concerning other B-cell neoplasias, it is concluded that the consequent application of an ever-increasing number of different immunologic markers, in order to better classify malignant lymphomas, will eventually result in the reverse, namely, in a complete breakup of this group of malignancies into individual cases.

Humans↗
PubMed1985

[Recognition and significance of hybrid granulocytes in chronic myeloid leukemia].

The demonstration and frequency of mixed granulated, hybrid leukocytes in chronic myeloid leukemia are reported. The cells exhibit basophilic granules, and, in addition, variable quantities of eosinophilic and/or azurophilic (chloroesterase-positive) granules. The existence of further subtypes of granules in these cells, such as neutrophilic or tissue mast cell granules, cannot be excluded thus far. All cases under investigation showed such cells, though in varying frequency. Quality and quantities of the granule population in these cells differed considerably. This is interpreted as an expression of tumor cell heterogeneity, which represents a general criterion of malignant neoplasias. The cells under discussion may be termed hybrid or chimeric, since they are characterized by the co-expression in the same cells of markers (granules) normally subject to lineage specificity. Therefore, the cells represent the phenomenon of "lineage infidelity". Thus far, "lineage infidelity" has been found only with blast cell leukemias, but applies also to chronic myeloid leukemias, as our results show. The occurrence of "lineage infidelity" in segmented end stage cells expresses grave irreversible genetic disturbances of the differentiation program in the progenitors of the hybrid leukocytes.

Basophils↗
PubMed1985

[Size of cell nuclei in non-Hodgkin lymphomas. Prognostic and diagnostic significance].

Morphometric analysis of cell-nucleus size was undertaken in 300 cases of malignant non-Hodgkin lymphomas. The results were compared with histological findings and survival time. It was found that the histological lymphoma groups differ significantly only occasionally with regard to nucleus size. Within the groups the values have such wide scatter that in the individual case it is not possible to assign it on morphometric data. This scatter mirrors the difficulties encountered in histological classification which - as the objective data indicate - are due to numerous transitions between different types of lymphoma. Analysis of survival data shows that nucleus size is of considerable prognostic value, if certain exceptions such as lymphoblastic lymphoma are taken into account. The results favour tripartite division of malignant lymphomas for prognostic purposes.

Cell Nucleus↗