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Marc D Smith

Publications and source records attributed to Marc D Smith.

4 recordsLinked to original sources
PubMed2004

Case report: mantle cell lymphoma, prolymphocytoid variant, with leukostasis syndrome.

A 76-year-old man presented with leukostasis syndrome, including oculodynia, blurred vision, and visual field defects, due to mantle cell lymphoma, prolymphocytoid variant, with marked leukocytosis, 1227 x 10(9)/l. He had splenomegaly but no lymphadenopathy or hepatomegaly. The tumor cells were CD5+, CD19+, CD20+, FMC-7+, and kappa light chain restricted. Immunohistochemistry showed expression of p53 and of cyclin D1. Fluorescent in situ hybridization demonstrated t(11;14) with translocation between CYCLIN D1 and the immunoglobulin heavy-chain genes. The patient received leukapheresis and aggressive chemotherapy, but the leukocyte count remained above 100 x 10(9)/l. The patient's condition rapidly deteriorated with lymphomatous infiltration of his lungs and soft tissues, and he expired 6 months after diagnosis. While it is known that mantle cell lymphoma may have a leukemic phase, the degree of leukocytosis in this case exceeds that previously reported in the literature and resulted in a clinical syndrome of leukostasis.

Aged↗
PubMed2002

Typical histologic features of Tunga penetrans in skin biopsies.

CONTEXT: Tunga penetrans is a flea that burrows into human skin, causing the disease tungiasis. Although the parasite is not endemic in the United States, patients may present with this disease upon returning from tropical locales. Histologic sections contain a variety of flea parts that may present a diagnostic dilemma for pathologists unfamiliar with this disease. OBJECTIVE: To determine the typical histologic features of T penetrans in biopsies from patients with tungiasis. METHODS: We reviewed biopsy specimens from 7 patients with tungiasis and sought 8 distinct structures: the exoskeleton, hypodermal layer, respiratory tract (tracheae), digestive tract, striated muscle, head, posterior end, and developing eggs. RESULTS: The exoskeleton, hypodermal layer, tracheae, digestive tract, and developing eggs were present in all biopsy specimens reviewed. Striated muscle, the posterior end, and head, however, were present in 57%, 43%, and 0% of the biopsies, respectively. In addition, we noted a unique, pale-staining layer in the exoskeleton at the posterior end of the organism that, to the best of our knowledge, has not previously been described and that may be of diagnostic value. CONCLUSIONS: Despite the absence of 3 key morphologic features in many (posterior end and striated muscle) or all (head) of our biopsies, the exoskeleton with a hypodermal layer, tracheae, and developing eggs were uniformly present, and together these features are sufficient for a diagnosis of tungiasis.

Adult↗