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Biomedical subjects

R D Collins

Publications and source records attributed to R D Collins.

At least 73 records · Page 4Linked to original sources
PubMed1987

Report of an unusual lymphoma arising from parafollicular B-lymphocytes (PBLs) or so-called "monocytoid" lymphocytes.

A distinctive B-cell has been recognized recently in reactive lymph nodes, especially those of toxoplasmic lymphadenitis. Previously designated as "immature sinus histiocytes" or "monocytoid" cells, these B-lymphocytes proliferate in subcapsular and parenchymal sinuses and the parafollicular area of nodes. The authors now report a 55-year-old male who developed a malignant lymphoma composed of cells with light microscopic, immunologic, and ultrastructural characteristics identical with these newly described B-cells. The term parafollicular B-lymphocytes (PBLs) is recommended herein to emphasize their morphologic and immunologic features. An unusual feature of this PBL lymphoma is the numerous benign-appearing hyperplastic follicles surrounded by the neoplastic infiltrate, mimicking the cytologic appearance and distribution of PBLs seen in toxoplasmic lymphadenitis. The function of these recently recognized B-cells is unknown; their anatomic relationship with hyperplastic follicular centers in reactive states and the lymphoma herein described suggests a role in follicular function.

B-Lymphocytes↗
PubMed1986

Malignant histiocytoses developing in patients with B-cell lymphomas. Report of two cases.

Two patients with indolent B-cell lymphomas (small B-cell and small cleaved cell) developed a coexistent malignant histiocytosis 3 and 6 years after diagnosis of their lymphomas. In both patients, malignant histiocytosis presented as new onset of fever, weight loss, and rapidly progressive bulky disease super-imposed on a previously stable clinical course without constitutional symptoms. Both patients failed to respond to combination chemotherapy. The terminal aggressive phase of indolent B-cell lymphomas usually represents transformation of the original neoplasm to a large non-cleaved or immunoblastic B-cell histology. Malignant histiocytosis has not previously been reported as a second neoplasm in patients with B-cell lymphomas.

Adult↗
PubMed1986

Lymphocyte-depleted Hodgkin's disease. Clinicopathologic review of 25 patients.

Clinicopathologic material from 25 patients with lymphocyte-depleted Hodgkin's disease was reviewed. The median age of the patients was 57 years. The patients had no prior diagnosis of Hodgkin's disease and were divided according to pathologic subtype of lymphocyte-depleted Hodgkin's disease: 11 diffuse fibrosis, 10 reticular, and four not otherwise specified. The clinical presentation included B symptoms of fever, weight loss, or night sweats (92 percent), subdiaphragmatic disease (88 percent), frequent marrow involvement (56 percent), and advanced-stage disease (100 percent). Four of 11 patients with diffuse fibrosis had peripheral adenopathy as compared with seven of 10 patients with the reticular subtype (p = 0.3); 10 of 11 patients with diffuse fibrosis had marrow involvement compared with two of nine patients with the reticular subtype (p = 0.006). Among patients who received chemotherapy, median survival was longer in the diffuse fibrosis subtype (nine patients, 39 months) than in the reticular subtype (10 patients, 10 months), p = 0.005. Of the 17 patients who received more than one cycle of combination chemotherapy with mechlorethiamine, vincristine, procarbazine, and prednisone, the median survival was 36 months with 11 (65 percent) complete remissions. In eight patients, disease remains in remission (12 to 127 months) with five patients surviving beyond five years. These results indicate that lymphocyte-depleted Hodgkin's disease has at least two clinicopathologic subtypes and is curable if adequate therapy can be given.

Adult↗
PubMed1986

The phenotypic diversity of peripheral T-cell lymphomas: the Southeastern Cancer Study Group experience.

Four member institutions of the Southeastern Cancer Study Group (SECSG) investigated 27 cases of malignant lymphoma proved to be of T-cell origin by a frozen section immunoperoxidase technique. The specimens were sent to one central laboratory in Michel's transport medium, where phenotyping studies were performed with a large number of monoclonal antibodies. The phenotypes encountered differed as a group from that reported for lymphoblastic lymphoma, but there was significant diversity within the peripheral T-cell lymphomas. Most tumors were of a mature helper/inducer phenotype (Leu-3+, Leu-2-), but nine of the 27 lymphomas expressed Leu-3 and Leu-2 in other combinations. Half of the lymphomas expressed abnormal T-cell phenotypes in that one or more pan-T-cell markers usually present in nonneoplastic T-cell proliferations were absent. Antibody 3A1 was the pan-T marker that was most frequently lacking in the peripheral T-cell lymphomas. The tumors were also studied for their expression of three markers associated with T-cell activation--HLA-DR, transferrin receptor, and interleukin 2 receptor. The majority of the lymphomas expressed one or more activation markers. However, these three markers appear to be expressed independently. In general, there was no simple correlation between the phenotype of the tumor and the histologic appearance, although neoplasms of morphologically higher grades were somewhat more likely to express T-cell activation markers.

Adult↗
PubMed1986

The extracellular matrix in "sclerosing" follicular center cell lymphomas: an immunohistochemical and ultrastructural study.

"Sclerosis" is frequently seen in follicular center cell (FCC) lymphomas. The mechanism of its deposition, as well as its composition and significance, are unknown. Several clinical studies have suggested that the course of these lymphomas is more indolent than that of lymphomas of the same histologic type without sclerosis. Nine immunologically characterized cleaved FCC lymphomas with sclerosis and 14 reactive lymph nodes with follicular hyperplasia were investigated by special staining methods, electron microscopy, and immunohistochemical studies with antibodies to types I, III, IV, and V collagen, laminin, and fibronectin. The sclerotic tissue in FCC lymphomas stained uniformly with periodic acid-Schiff (PAS) and Masson's stain, with the patterns ranging from delicate filamentous strands to dense doubly refractile bands. Ultrastructurally, the bands of connective tissue were continuous with the adventitia of vessels and composed of varying amounts of banded collagen (types I and III) admixed with filamentous and flocculent material. In all cases the neoplastic lymphocytes were separated from the extra-cellular matrix by fibroblasts and myofibroblasts with long cell processes. Immunohistochemical studies demonstrated intense staining of sclerotic bands with antibodies to fibronectin and type I collagen and, usually, weaker marking with antibodies to types III and V collagen. No significant staining of sclerotic bands was found with antibodies to type IV collagen or with laminin. Weak pericellular staining for type V collagen was present in eight of nine lymphomas and half of the control lymph nodes. These studies suggest that the increased amounts of extracellular matrix in cleaved FCC lymphomas are produced primarily by fibroblasts and myofibroblasts and represent predominantly fibronectin and types I, III, and V collagen. The composition of the sclerotic areas of FCC lymphomas is similar immunohistochemically to that of the capsule and trabeculae of reactive lymph nodes, which are also intimately associated with fibroblasts and myofibroblasts.

Extracellular Matrix↗
PubMed1986

Lymphocyte-depletion Hodgkin's disease. Histopathologic diagnosis of marrow involvement.

Lymphocyte-depletion Hodgkin's disease (LDHD) is a rare and often misdiagnosed form of HD. Although marrow involvement is frequent in this disease, most pathologists are not familiar with the marrow lesion of LDHD, since the underlying disease is so unusual. In order to characterize the marrow lesion produced by LDHD, we reviewed biopsies or aspirates from the initial presentation of 22 patients meeting all the clinical and pathologic criteria for LDHD. These included 11 cases of the diffuse fibrosis subtype, eight cases of reticular subtype, and three cases not subclassified. Fifty-four percent of cases, primarily of the diffuse fibrosis subtype, had marrow involvement. Aspirations and biopsies were positive with essentially the same frequency. LDHD produces a characteristic consolidated lesion readily recognized on low-power examination and composed of amorphous, nonbirefringent eosinophilic background material, an inflammatory infiltrate, and Reed-Sternberg (RS) cells. Involvement may be focal and RS cells are generally scarce, requiring examination of multiple sections of well-fixed and stained material. Uninvolved marrow tends to be normocellular and frequently has increased numbers of eosinophils. The original diagnosis of LDHD often may be made from marrow examination alone. Early recognition of marrow involvement is important in facilitating prompt treatment and providing accurate staging without laparotomy.

Adult↗
PubMed1985

Malignant plasmacytic ascites. A report of two cases and a review of the literature.

Two patients with ascites due to peritoneal involvement by multiple myeloma are reported and seven previously described cases of plasmacytic ascites are reviewed. In all nine cases, ascitic fluid contained large numbers of bizzare, immature plasma cells. Although the cells were often difficult to characterize by light microscopy, they could be rapidly identified as malignant plasma cells by immunofluorescent demonstration of monoclonal, intracellular immunoglobulin as performed in one of the patients. This rare extramedullary complication of plasma cell neoplasia has been unresponsive to therapy and rapidly fatal, with a median survival of 2 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Morphologic and immunologic evidence of composite B- and T-cell lymphomas. A report of three cases developing in follicular center cell lymphomas.

Composite lymphoma (CL) may be defined as two lymphomas, differing as to their cell of origin, that occur simultaneously in the same tissue specimen. While CL usually is indicated histopathologically by at least two morphologically distinct lymphomatous proliferations, the proof that these proliferations are separate and distinct neoplasms requires immunologic analysis. Many so-called cases of CL actually represent the well-known phenomenon of lymphoid transformation, in which there is a small cell and a large cell component in the same specimen. Immunologic studies in these cases have shown that the cytologically distinct neoplastic cells represent different stages in the same cell line. While studying a large series of follicular center cell (FCC) lymphomas, the authors recognized three cases in which there was both morphologic and immunologic evidence of a true CL. Following an initial diagnosis of a nodular FCC lymphoma, rebiopsies from 21 to 62 months later showed the coexistence of a nodular FCC (B-cell) component and a diffuse large cell (T-cell) component.

Adult↗
PubMed1985

Plasmacytic differentiation in follicular center cell (FCC) lymphomas.

Although follicular centers are the sites of production of plasma cell precursors, plasmacytic differentiation in follicular center cell (FCC) lymphomas is rarely seen, presumably because of a "block" in differentiation of the large noncleaved FCC. The authors reviewed a large number of these cases to determine the frequency of plasmacytic differentiation in FCC lymphomas. In one hundred ninety-eight, consecutive FCC lymphomas with a follicular pattern from a two-year period, 17 (9%) cases were found in which there were large numbers of plasma cells. Immunoperoxidase studies of paraffin-embedded sections (PIP) for cytoplasmic immunoglobulin showed polytypic marking in ten of these and a monotypic plasma cell population in seven. In this latter group, isotypically identical marking of the plasma cell and FCC populations could be demonstrated in three cases with immunoperoxidase (where the FCCs showed cytoplasmic marking) and in one case (of one tested) with surface typing studies. In addition, three patients had serum paraproteins identical to the plasma cell cytoplasmic immunoglobulins. These findings indicate that a small minority of FCC lymphomas contain sufficient plasma cells to be a diagnostic problem, and that in some of these cases, plasma cells are a differentiated component of the FCC lymphomas.

Cell Differentiation↗
PubMed1985

Lymph node examination. What is an adequate workup?

Lymph node examination has traditionally been difficult to perform satisfactorily. Both pathologists and clinicians often lack confidence in the resulting diagnosis, and repeated biopsy or routine requests for consultative opinion may follow. Artifactual distortion of lymph nodes during removal and processing are partially responsible for these unsatisfactory circumstances. More recently, a developing awareness of the inherent complexity of lymphoproliferative diseases and the availability of more sophisticated studies have further compounded these traditional problems. This article describes the specific methods recommended to allow community pathologists to scale lymph node examination to the diagnostic difficulty of the disease present. In particular, simple and inexpensive procedures allow tissue samples to be saved for immunologic phenotyping and electron microscopy while routine histopathologic sections are being evaluated.

Histocytochemistry↗
PubMed1984

Malignant lymphomas of follicular center cell origin in humans. V. Incidence, clinical features, and prognostic implications of transformation of small cleaved cell nodular lymphoma.

Seventy-five cases of small cleaved cell nodular lymphoma (SCC-N) were reviewed. Thirty-four cases underwent repeat biopsy a median of 54 months after diagnosis (range, 7-116 months) because of progressive or recurrent disease. Histologic conversion to a transformed (noncleaved) cell lymphoma was found at re-biopsy in 13 of 34 cases (38%). Neither age, gender, stage, visceral sites of disease, nor symptoms at presentation were predictive of subsequent conversion. Similarly, none of the clinical features analyzed at the time of rebiopsy were predictive of whether the rebiopsy would show stable histology or transformation. Documentation of transformation was of significant prognostic value. Although rebiopsies were performed at the time of progressive disease, survival following re-biopsy was 37.5 months for patients found to have cleaved cell lymphoma at re-biopsy, and only 2.5 months for those with transformed cell lymphoma at re-biopsy. Two of the cases which had immunoglobulin surface markers studied at diagnosis and at transformation, showed retention of heavy and light chain markers. This implies that the change in appearance involves the original neoplastic clone and was not due to a second neoplasm. Development of transformed cell lymphoma is one of the most common features of the aggressive phase of indolent lymphoma. Repeat biopsy in all patients with indolent lymphoma who have relapsing or progressive disease is recommended.

Adult↗
PubMed1984

Plasma cell iron--clinical and morphologic features.

In order to identify the major clinical features and laboratory findings in patients with plasma cell iron, the authors reviewed the medical records and marrow aspirates of 53 consecutive patients with plasma cell iron hospitalized at Nashville Veterans Administration Hospital over a seven-year period. Plasma cell iron was associated most commonly with alcoholism and occurred in marrows with increased, normal, and decreased iron stores. In patients with decreased marrow iron, plasma cells were the major site of stainable iron. Plasma cell iron was found in patients without other morphologic changes of alcoholism such as megaloblastosis, erythroid vacuolization, and ringed sideroblasts. Plasma cell iron could be demonstrated in biopsy and autopsy material from extra-marrow sites. Ultrastructural studies showed iron always was located in membrane bound lysosomal vesicles of plasma cells.

Adult↗
PubMed1984

Death due to splenic rupture in suppressor cell mycosis fungoides: a case report.

A case of mycosis fungoides in which pathologic rupture of the spleen led to intraperitoneal hemorrhage and death is described. To our knowledge, splenic rupture has not been reported previously as a cause of death in mycosis fungoides. Immunologic studies demonstrated that the neoplastic cell was a suppressor/cytotoxic T-cell. In most cases of mycosis fungoides or the Sézary syndrome, the neoplastic cell has been a helper/inducer T-cell. This case was very aggressive clinically with prominent visceral involvement and suggests that mycosis fungoides may be clinically diverse as well as immunologically heterogeneous.

Aged↗
PubMed1984

Reproducibility in morphologic classification of non-Hodgkin's lymphomas using the Lukes-Collins system. The Southeastern Cancer Study Group experience.

Five pathologists of the Southeastern Cancer Study Group reviewed routinely prepared histologic sections from 249 cases of non-Hodgkin's lymphoma. They classified these cases morphologically, using criteria of the Lukes-Collins classification system. To evaluate reproducibility in classification, the individual interpretations of each pathologist were compared with a consensus interpretation. The pathologists recognized general morphologic features of follicular center cell lymphomas in 87-94% of such cases, but they identified specific morphologic types much less consistently. Significant differences of interpretation were encountered with respect to small cleaved follicular center cell, large cleaved follicular center cell, and large transformed (large noncleaved) follicular center cell types. Inadequacies of routine histologic sections contributed substantially to these disagreements. Ancillary immunologic technics may be required to improve consistency in recognition of some morphologic types, as well as to characterize cases that are not classified easily by morphology alone.

Evaluation Studies as Topic↗
PubMed1984

Peripheral T-cell lymphoma: a clinicopathologic study of 42 cases.

Clinical and histopathologic material from 42 patients with peripheral T-cell lymphoma (PTCL) was reviewed. The median age was 63.5 years (range, 11-97 years). The male:female ratio was 2.8:1. Prior immune or lymphoproliferative diseases occurred in 36% of the patients. PTCL was advanced at presentation with B symptoms (67%), generalized adenopathy (69%), and stage III/IV disease (79%). Suspected lung or pleural involvement (21%), hepatomegaly (29%), and splenomegaly (43%) were common; marrow involvement was documented in 37% of the patients at presentation and in 51% of patients during the illness. Hypercalcemia and eosinophilia occurred in 19% and 29% of patients, respectively. Among patients receiving combination chemotherapy (BCOP, CHOP, BACOP, COMLA), eight (24%) of 33 achieved a complete remission and only four (12%) of 33 had a sustained complete remission. The median survival for PTCL was 11 months. Because of the poor response to standard therapy, clinical trials should identify cases of PTCL and evaluate newer regimens in this subset of aggressive lymphoma.

Adolescent↗
PubMed1984

Intestinal infarction in rheumatoid arthritis. Three cases due to unusual obliterative vascular lesions.

During a ten-year period, we observed three patients with complicated rheumatoid arthritis (RA) and bowel infarction in which the distal mesenteric vessels were occluded by proliferative endarteritis characterized by intimal proliferation, without vessel wall necrosis or inflammation. Proliferative endarteritis was originally described in patients with RA and digital infarcts and has only rarely been noted in patients with visceral infarcts. Our three patients' pathologic features suggested that these vascular lesions were progressive and rendered patients vulnerable to bowel infarction during periods of decreased cardiac output. Two of the three patients had intestinal infarction without clinical or pathologic evidence of systemic vasculitis. Proliferative endarteritis of visceral arteries rarely causes morbidity and mortality in patients with RA.

Adult↗