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R J Lukes

Publications and source records attributed to R J Lukes.

At least 55 records · Page 3Linked to original sources
PubMed1982

HLA typing in non-Hodgkin's lymphomas. Comparative study in Caucasoids, Mexican-Americans and Negroids.

Over 200 cases of non-Hodgkin's lymphoma were typed for HLA-A, B, C and DR antigens, and typing was correlated with the morphologic diagnosis according to the Lukes-Collins classification system of non-Hodgkin's lymphomas. Three major racial groups were represented: Caucasoids, Mexican-Americans and Negroids. Significant associations were observed between HLA-AW33 and Caucasoid B-cell lymphomas, and for HLA AW24, HLA-B37 and HLA-B40 and B cell lymphomas in Negroids. No significant correlations were found within the Mexican-American patient population. The number of T cell lymphomas was insufficient to draw any conclusions. The DR antigens were not significantly associated with any of the diagnostic subgroups.

B-Lymphocytes↗
PubMed1982

Immunoblastic sarcoma: morphologic criteria and the distinction of B and T cell types.

Immunologic concepts have facilitated the recognition within the histiocytic lymphoma group of the Rappaport classification of five diagnostic categories of lymphoma (follicular center cell lymphoma large cleaved and large non-cleaved types, immunoblastic sarcoma B cell type, immunoblastic sarcoma T cell type and 'true histiocytic lymphoma'). The first four of these 'large cell lymphomas' are closely related biologically and are difficult to distinguish histologically. This paper purports to examine the morphologic criteria employed in the differential diagnosis of these four large cell lymphomas in an objective manner, utilizing carefully prepared histologic sections from 24 cases of lymphoma that had been subjected to detailed B and T cell characterization by surface marker methods. 18 morphologic criteria were evaluated by four observers independently. The results show that reliable histologic distinctions can be made on histologic grounds in a proportion of cases only and that individual criteria show more overlap within diagnostic criteria than previously recognized. This is attributed in part to the close biologic relationship of these neoplasms. It is also recognized that the morphologic criteria are subtle and that the pathologist should have the advantage of auxiliary techniques--cytochemistry, immunohistology, surface marker techniques--to achieve reliable distinction of functional types within the diffuse histiocytic group of Rappaport.

B-Lymphocytes↗
PubMed1982

Emergence of B-immunoblastic sarcoma in patients with multiple myeloma: a clinicopathologic study of 10 cases.

Immunologic and histologic studies were performed in 10 cases of myeloma that showed progression to a more aggressive proliferation, designated as immunoblastic sarcoma of B-cell type (B-IBS). Several patterns of clinical presentation were observed: eight patients showed typical multiple myeloma, four developed B-IBS within the bone marrow, and four developed B-IBS in multiple extramedullary sites; the remaining two patients had relatively localized myeloma, but also showed development of extramedullary B-IBS. The implications of these findings are discussed with regard to their prognostic import and their relationship to current concepts of plasma cell development.

Adult↗
PubMed1982

Biopsy of peripheral lymph nodes.

This retrospective study reviews 653 patients who had peripheral lymph node biopsies for purposes of diagnosis from 1973 to 1977. Overall, 56 per cent of the nodes had benign lesions, 29 per cent had carcinoma, and 15 per cent had lymphoma. Supraclavicular nodes had the highest incidence of metastatic carcinoma (54%), and inguinal nodes had the highest incidence of reactive hyperplasia or lymphadenitis (71%). Detailed distribution according to histological subtypes, age, and sex of patients are presented. Statistically, age is the most useful factor in estimating the probability of whether the lymphadenopathy is due to benign or malignant process. The chance that lymph adenopathy is due to malignant lymphoma is relatively constant among all age groups (11-16). However, the majority of patients younger than 30 years old had Hodgkin's disease, while older patients were more likely to have non-Hodgkin's lymphomas.

Biopsy↗
PubMed1981

Immunoblastic sarcoma of T-cell versus B-cell origin: I. Clinical features.

Within the Lukes-Collins classification system of malignant lymphoma, a tumor of large transformed lymphocytes, termed immunoblastic sarcoma (IBS), is described. This morphological type would have been included within the "histiocytic" category of Rappaport. Immunoblastic sarcoma may be of B-lymphocytic or T-lymphocytic origin. Since differences or similarities of these two variants have not yet been described, we reviewed the case histories of 35 such patients, all of whom had immunologic marker studies performed. Nineteen patients had T-cell IBS (T-IBS), whereas 16 had B-cell IBS (B-IBS). Median age for both groups was approximately 50 yr. A history of prior immune disorder was found in 31% of B-IBS and 16% of T-IBS cases. Prior lymphoproliferative malignancy was noted in 21% of T-IBS and 13% of B-IBS patients. All T-IBS patients first presented because of lymphadenopathy, whereas 56% of B-IBS cases initially presented because of extranodal disease. Systemic "B" symptoms were common in both. Similarly, most patients had widespread disease (stage III or IV) at diagnosis. Clinically suspected hepatic (p = 0.05) and retroperitoneal node (p = 0.01) involvement were more often found in T-IBS. Forty-one percent of T-IBS patients demonstrated polyclonal hypergammaglobulinemia, a finding seen in no B-IBS patient (p = 0.02). Although not statistically significant because of small numbers of patients, data on therapy and survival suggest that IBS of B-cell type may be successfully treated with aggressive, multiagent chemotherapy, while alternative approaches appear warranted in T-cell disease.

Adult↗
PubMed1980

Lymph node biopsy for diagnosis: a statistical study.

This is a retrospective and all inclusive study of 925 patients who had isolated lymph node biopsies for diagnosis from 1973 to 1977. Overall, 60% of the nodes had benign lesions, 28% carcinoma, and 12% lymphoma. The comparable figures for abdominal nodal biopsies were 63%, 33% and 4%; for intrathoracic nodes, 73%, 26% and 1%; for peripheral nodes, 56%, 29% and 15%. Detailed distribution according to specific site of nodal biopsy, histological subtypes, age, and sex of patients are presented. Statistically, age is the most important factor useful in estimating the probability of whether the lymphadenopathy is due to a benign or malignant process.

Abdomen↗
PubMed1980

Primary mediastinal lymphoma in adults.

The incidence of primary mediastinal lymphoma in adults was investigated in 184 patients with non-Hodgkin's lymphoma. This entity was defined as disease within the mediastinum in patients who presented with symptoms due to an enlarging mediastinal mass. Of 184 patients, 17 presented with primary mediastinal lymphoma. All had a diffuse histologic pattern. The most common pathologic type was poorly differentiated lymphocytic lymphoma, diffuse (PDL-D), (11 cases). In nine of these 11 cases the patients had tumors of convoluted lymphocytes. The presentation was rapid in onset, with heart failure, pericarditis, dyspnea and superior vena caval syndrome predominating. Eleven of the 17 were clinical stage I or II, but eight of these had widespread disease on pathologic staging or rapid dissemination soon after diagnosis. In conclusion (1) primary mediastinal lymphoma is always diffuse in histology. (2) The most frequent pathologic type is PDL-D, with convoluted morphology. (3) Compression of vital intra-thoracic structures is common. (4) Although seemingly localized at presentation, this entity usually implies disseminated disease.

Adult↗
PubMed1980

Orbital and adnexal lymphomas. A multiparameter approach.

The application of immunologic, cytochemical, and electron-microscopic technics to the study of lymphoid lesions of the orbit and adnexa was found to enhance the accuracy of diagnoses of malignant lymphoma in five challenging referral cases. Although careful specimen collection, ideal fixation, and processing constitute the cornerstone of the morphologic diagnosis of nodal and extranodal lymphomas, the immunologic characterization of these lymphoproliferative disorders is emphasized as an especially useful diagnostic parameter. The occurrence of false-negative diagnoses of pseudolymphoma of the orbital region may be partially explained by a failure to recognize the relatively frequent plasma-cytoid lymphocytic lymphoma, a distinctive entity that may mimic a reactive inflammatory process. All of the cases of malignant lymphoma reported represented stage I or stage II disease, suggesting that primary lymphoma of the orbital region may be a disease with a favorable prognosis.

Adult↗
PubMed1980

Clinical and immunologic spectrum of plasmacytoid lymphocytic lymphoma without serum monoclonal IgM.

As first suggested by Lukes & Collins (1975), and recently confirmed in the literature, the pathological lesion associated with Waldenström's macroglobulinaemia can be found in patients with serum IgG or IgA monoclonal proteins. To expand upon the clinical and immunologic spectrum of this lesion, we reviewed the records of 12 patients with identical tumour morphology, though lacking an IgM paraprotein. The median age of the patients was 62 years. In five patients the tumour secreted monoclonal IgG, while one secreted monoclonal IgA. One patient had normal serum protein electrophoresis, although monoclonal light chains were demonstrated on urinary protein electrophoresis. The remaining patients had no detectable monoclonal protein. Marker studies demonstrated the B cell origin of tumour, these findings were consistent with the monoclonal protein secreted. Clinically, these cases varied, from peripheral blood involvement resembling chronic lymphocytic leukaemia, to typical lymphomatous processes, to presentations resembling multiple myeloma, reflecting the similarity of all of these conditions as varying expressions of neoplasia of the B cell system.

Adult↗
PubMed1980

Dual parameter flow cytometry studies in human lymphomas.

Dual parameter flow cytometry studies using Coulter volume and cell DNA content were carried out in monodisperse cell suspensions of 64 samples of human lymphoma, chronic lymphocytic leukemia, hairy cell leukemia, and benign lymphoid proliferations. Differences in mean Coulter volume among the lymphomas were due both to the intrinsic differences in mean G1 cell Coulter volume and to the presence of increased fractions of larger S and G2 cells, especially among the large B cell lymphomas. However, the relative contribution of large non-G1 cells to the overall population Coulter volume distribution was a relatively minor one; the presence of cells in S did not increase mean Coulter volume by more than 10%, even in samples with high S fractions. There was a good correlation between mean G1 cell Coulter volume and the log of the fraction of cells in S among the B cell lymphomas (r = 0.55). Evidence is presented that within individual samples, large cells proliferate more rapidly than small cells. This was seen in every case, both in the normal samples and in the lymphomas, and in the T cell lymphomas as well as in the B cell lymphomas. Aneuploidy was detected by flow cytometry in 11 cases; in 7 cases the aneuploid cell component could be analyzed separately from the diploid cell component on the basis of cell Coulter volume differences. The aneuploid components of diploid-aneuploid mixtures had higher S fractions than the diploid components in six of seven cases (0.16 +/- 0.04 [SE] vs. 0.08 +/- 0.02). These findings are considered in relation to the histopathological classification of the lymphomas, and in relation to the concept of clonal selection and clonal evolution of tumors.

Aneuploidy↗
PubMed1980

Positive Coombs test in Hodgkin's disease: significance and implications.

To clarify the clinicopathologic characteristics of Coombs' positivity in Hodgkin's disease, the records of 71 cases were reviewed. The direct Coombs test was positive in seven. Mean age of the seven was 22 yr (range 11-33). All were males. All had extensive disease (pathologic stage III or IV) and six had systemic (B) symptoms. Four had mixed cellularity; three had nodular sclerosis. The positive Coombs test was detected at original diagnosis in three and at time of relapse in four. Although all were anemic, only three had evidence of overt hemolysis. The antibody responsible for Coombs positivity was characterized in three and fulfilled the criteria for IgG anti-It. The presence of a positive direct Coombs test in the patient with Hodgkin's disease suggests active and advanced disease. The presence of IgG anti-It may represent a unique antibody in the Coombs-positive hemolytic anemia associated with Hodgkin's disease.

Adolescent↗
PubMed1979

[A new functional interpretation of malignant lymphomas. The Lukes-Collins classification and its basis].

The revolutionary developments in immunology have profoundly altered our understanding of malignant lymphomas as tumors of the immune system. The current commonly used classifications of non-Hodgkin's lymphomas do not take this new evidence into account and often contain cytologically heterogenous types. The new functional approach to lymphomas and the classification proposed by LUKES and COLLINS in 1974 separate the malignant lymphomas into better defined cytologic types and relate them to the presently known functional lymphocyte subtypes. It is therefore morphologically more accurate and biologically more meaningful than the present Rappaport nomenclature. This review discusses the morphologic and immunologic foundation of the Lukes-Collins concept and compares their classification with the other major currently used nomenclatures, mainly the one of RAPPAPORT. Special reference is made to the Kiel nomenclature which is very similar to the Lukes-Collins approach and is better known in Europe. Technical methods necessary to apply the Lukes-Collins concept are briefly discussed.

B-Lymphocytes↗
PubMed1979

Immunoblastic sarcoma: a clinical description.

We reviewed the clinical records of 33 patients with Immunoblastic Sarcoma in order to further describe this disease clinically. Several common features were found. Thirty percent of the patients had a history of a prior immune disease or lymphoproliferative malignancy. Forty-four percent of the patients tested had a diffuse hypergammaglobulinemia. Lymphopenia (less than 1,000/mm3) was found in 45%, and anemia occurred in 73%. At initial presentation, 30% of the cases were clinically staged as either stage I or II, whereas 70% were found to be stage III or IV. Forty-nine percent of the patients had systemic symptoms at presentation. The median survival was 14 months. Advanced stage of disease, lymphopenia, and presence of systemic symptomatology were associated with significantly decreased survival times (p less than .05). We conclude that IBS is a clinical entity often associated with prior immune disease and/or diffuse hypergammaglobulinemia.

Adolescent↗
PubMed1979

Childhood leukemia and lymphoma: correlation of clinical features with immunological and morphological studies.

Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.

Adolescent↗