Biomedical subjects
Publications and source records attributed to W G Staples.
Lymph node tissue from 2 patients with Hodgkin's disease was studied by light microscopy using the immunoperoxidase technique with a panel of monospecific antisera. Hodgkin's mononuclear and Reed-Sternberg cells were shown to exhibit features characteristic of B cells. The possibility that Hodgkin's disease is a B-cell neoplasm is discussed.
Cytoplasmic immunoglobulins and muramidase (lysozyme) were demonstrated in formalin-fixed tissues by an immunoperoxidase procedure in 3 cases of Burkitt's lymphoma. The Burkitt cells were strongly positive with the full panel of monospecific antisera against human immunoglobulin components (kappa and lambda light chains, gamma, alpha and micron heavy chains). The 'starry-sky' macrophages were weakly positive with antimuramidase antiserum and strongly positive with the antisera against immunoglobulins, thus demonstrating their phagocytic and histiocytic nature. The reasons for the polyclonal increase in immunoglobulins are discussed.
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Tuberculosis often complicates lymphoma, and bone marrow necrosis has been described in disseminated tuberculosis. However, the association of lymphoma, disseminated tuberculosis and bone marrow necrosis is rare. We report a patient with this triple association. After a 3-week influenza-like illness the patient was admitted to hospital semicomatose with pancytopenia and hyponatraemia. During routine examination a bone marrow trephine biopsy revealed diffuse lymphomatous infiltration with scattered necrotic foci. On Ziehl-Neelsen staining these foci exhibited numerous acid-fast bacilli. The patient subsequently died and at autopsy was found to have widely disseminated non-reactive tuberculosis.
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The clinical and haematological features of haemophilia are reviewed and the historical aspects, pathogenesis and genetics are discussed. The problems associated with management, such as factor replacement, home therapy, physiotherapy, surgical intervention and the presence of inhibitors, are fully described. Finally, mention is made of the psychological problems of haemophiliacs and of the help given by the South African Haemophilia Foundation.
Historial aspects of the classification of large-cell lymphomas are described. Immunological characterization of the lymphomas has been made possible by identification of T and B lymphocytes according to their cell membrane surface characteristics. The pathogenesis of lymphomas has been clarified by the germinal (follicular) centre cell concepts of Lennert and Lukes and Collins. The various classifications are presented and compared. Whether these subdivisions will have any relevance in the clinical context remains to be seen.
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Twelve cases of non-Hodgkin's lymphoma and a single case of Hodgkin's disease were first diagnosed on bone marrow biopsy. None of the patients had superficially enlarged lymph nodes, and in 3 patients the histological examination of the biopsy specimen showed normal reactive nodes. Eight patients were over the age of 60. The differential diagnosis from benign nodular lymphoid hyperplasia is discussed, with emphasis on the cytology and the paratrabecular position of the lymphoid infiltrate. Ten patients had focal involvement of the bone marrow and 1 of the 3 patients with diffuse involvement had Hodgkin's disease. Lymphoid nodules occur normally in the bone marrow and we conclude that non-Hodgkin's lymphoma and Hodgkins's disease can arise primarily in the bone marrow.
A patient with Waldenström's macroglobulinaemia, whose father died of the same condition, is presented. The literature on familial occurrence of paraproteinaemia is briefly reviewed.
A tenth case of extramedullary plasmacytoma (EMP) of the colon is reported. The term 'primary isolated extra-medullary plasmacytoma' is preferred to those terms previously used. A broad classification of plasmacytoma of the gastro-intestinal tract is suggested and a management policy, based on this classification, is outlined.
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Newer concepts in the application of cytochemistry to the diagnosis of haematological malignancies are discussed. The underlying physiological principles and location of the various enzymes are indicated. Older stains, once thought to be diagnostic, have been shown to be nonspecific. Newer, more accurate stains are now available.
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A patient with Lennert's lymphoma (malignant lymphoma with a high content of epithelioid histiocytes) is described. The case is unique in that hepatosplenomegaly was the presenting feature, the diagnosis was made on bone marrow biopsy and the disorder appears to have run a benign course.
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