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PubMedDate not supplied

Special histochemical stains in ocular pathology: agnogenic myeloid metaplasia with leukemic transformation.

With the use of special immune and enzymatic histochemical techniques, ocular pathologists are able to detect and localize certain cytoplasmic antigens and proteins in tissue section. An immunoperoxidase stain and special enzyme histochemical technique were used to confirm leukemic ocular involvement in a patient who suffered from agnogenic myeloid metaplasia (AMM). Although the transformation of AMM to acute leukemia can be heralded by ocular symptoms, diffuse leukemic infiltration of the choroid may be difficult to detect clinically. Special stains to detect immature myeloid cells may be of particular importance in establishing the diagnosis of granulocytic sarcoma of the orbit in children and certain forms of leukemia having a predilection for cutaneous and conjunctival involvement in adults.

Choroid↗

PubMed1981

Prostatectomy in patient with leukemia.

We have reviewed our experience with 10 patients who had leukemia and prostatic obstruction. Most of these patients had chronic lymphocytic leukemia, and all were stable. Following routine preoperative evaluation all underwent transurethral resection of the prostate (TURP). Two patients (20 per cent) had leukemic infiltration of the prostate. Our series confirms that TURP does not present undue risk to the patient with leukemia if the disease is stable and preoperative evaluation normal.

Aged↗

PubMed1983

Acute leukemia: diagnosis and management of testicular involvement.

Contemporary therapy of acute leukemia frequently achieves long-term continued complete remission (CCR) of bone marrow disease and prevents central nervous system relapse. However, accompanying improved survival is an increasing incidence of overt testicular relapse either during CCR or associated with bone marrow relapse. In 7 boys testicular abnormalities developed during CCR, 6 had open biopsy and 5 had histologically confirmed leukemic infiltration. Despite local therapy of orchiectomy or irradiation and chemotherapy reinduction, 2 of 6 had testicular relapse and 4 of 6 died. Three boys with coexistent overt testicular and systemic relapse died. Nine boys with normal testes had testicular biopsy during CCR prior to discontinuation of chemotherapy. Results of all biopsies were benign, but one boy had a relapse. The diagnosis of occult testicular leukemia prior to discontinuation of chemotherapy allows selection of high-risk boys requiring prolonged, intensive, and possibly alternative therapy. The indication for testicular biopsy in boys with acute leukemia is documented, and appropriate clinical management of testicular leukemia is presented.

Antineoplastic Agents↗

PubMed1983

Testicular biopsy and occult tumor in acute lymphocytic leukemia.

Testicular biopsy has become a routine procedure before discontinuing chemotherapy in male children being treated for acute lymphocytic leukemia (ALL). Before a decision can be made to discontinue multiple drug therapy, all possible sites of occult tumor such as the testis, cerebrospinal fluid, and bone marrow must be sampled. Between December, 1978, and November, 1981, 25 male children underwent testicular biopsies after two or more years of combination chemotherapy at the Babies Hospital, Columbia-Presbyterian Medical Center. Only 3 of the 25 patients (12%) were found to have leukemic infiltrates on histologic sections. Two of 3 patients, however, were noted preoperatively to have either irregular testicular contours or testicular enlargement and induration. Occult testicular infiltration discovered after two or more years of chemotherapy is rare. Most children with a histologically positive biopsy result were at least suspected preoperatively to have testicular involvement.

Adolescent↗

PubMed1987

Isolated testicular leukemic relapse. Response to radiation therapy.

Between January, 1975, and December, 1984, at the University of Michigan Medical Center, 17 boys with leukemia presented with overt or occult isolated testicular relapse. Diagnosis was obtained by bilateral open-wedge biopsies of the testes. All the patients were treated with combined local testicular irradiation and systemic chemotherapy. In only 1 of the 17 patients (6%) testicular leukemia developed as the only site of relapse. It appears that doses in the range of 2,000 to 2,400 cGy in 10 to 12 fractions achieve optimum control of leukemic infiltration of the testes.

Adolescent↗

PubMed1982

Acute lymphocytic leukemia of the ovary: the value of sonography.

Leukemic involvement of ovary has been found in up to 30% of patients with acute lymphocytic leukemia (ALL) at autopsy, but is rarely found clinically. Since the ovary may be a sanctuary for ALL to reseed the marrow, early clinical detection of ovarian involvement is important. The use of sonography in evaluating the ovary is suggested as part of the management routine in ALL. It can be used prior to cessation of chemotherapy and on subsequent follow-up to assess the state of the ovary. A case is presented in which a young woman with ALL in remission developed a pelvic mass, documented by ultrasound, subsequently shown to represent leukemic infiltration of the ovary.

Adult↗

PubMed1989

Nitrous oxide selectively reduces the proliferation of the malignant cells in experimental rat leukemia.

A considerable reduction of hepatosplenomegaly and leucocytosis in leukemic rats of the Brown Norway Myeloid Leukemia (BNML) can be achieved by exposure to 50% nitrous oxide/50% oxygen. In this study the differential antiproliferative effect of nitrous oxide, inactivating vitamin B12, on normal and leukemic hemopoiesis was investigated in this rat model. Rats injected with leukemic cells and exposed to nitrous oxide for 10 days showed 30% reduction of hepatosplenomegaly and 50% reduction of leukocytosis. Similarly treated healthy rats showed no signs of impaired hemopoiesis as measured by peripheral blood parameters. Clonogenic assays of erythroid and myeloid progenitors from both healthy and leukemic rats revealed that exposure to nitrous oxide did not suppress normal bone marrow functioning. On the contrary, the reduction of leukemic proliferation by nitrous oxide retarded the leukemic infiltration of the bone marrow compartment.

Animals↗

PubMed1990

Modification of the gluconeogenic/glycolytic balance in isolated perfused liver of myeloproliferative leukemia infected mice: a 13C NMR study.

1. Isolated perfused livers from starved mice inoculated with myeloproliferative leukemia virus exhibited similar rates of consumption of [3-13C]alanine and of synthesis of glutamine and glutamate labeled at the C-2 or C-3 positions as livers from uninfected mice. 2. Leukemic livers also formed glutamine and glutamate labeled at the C-4 position. This is related to their lower content of triglyceride as compared to that of control livers which do not produce these isotopomers. 3. The glucose synthesis rate was much lower in livers from leukemic mice. This is explained by the glycolytic properties of the leukemic infiltrating cells.

Alanine↗

PubMed2005

Visual loss as a first sign of adult-type chronic myeloid leukemia in a child.

PURPOSE: To report the unusual case of retinal leukemic infiltration in a child with adult-type chronic myelocytic leukemia. DESIGN: Interventional case report. METHODS: Complete ophthalmologic examination, including visual acuity measurement and funduscopy. The diagnosis was established by blood cell counts and confirmed by a positive Philadelphia-chromosome translocation (t [9,22]). Treatment consisted of hydroxyurea and stem-cell transplantation. RESULTS: After therapy, complete regression of the retinal lesion was observed with full recovery of visual acuity. CONCLUSION: This case underlines the importance of interdisciplinary cooperation between ophthalmologists and pediatric oncologists in the diagnosis and treatment of this disease.

Blindness↗

PubMedDate not supplied

Prostatic extramedullary leukemia as a first site of relapse of acute nonlymphocytic leukemia.

Extramedullary leukemia (EML) is an uncommon clinical diagnosis in patients with acute nonlymphocytic leukemia (ANLL). Prostatic EML as a first site of ANLL relapse is even more rare. To our knowledge, only three cases have been reported. We describe an additional case of prostatic EML as a site of ANLL relapse. An asymptomatic male in ANLL remission was found to have a normal prostate-specific antigen (PSA) and a myeloid leukemic infiltrate in a newly diagnosed prostate nodule. Staging was negative for ANLL relapse. Local prostate radiation resolved the nodule, and the post-treatment needle biopsies were negative. He subsequently developed clinical relapse in bone marrow, blood, and small bowel and received salvage chemotherapy with mitoxantrone and etoposide.

Aged↗

PubMed2006

A review of perchloroethylene and rat mononuclear cell leukemia.

Mononuclear cell leukemia (MNCL) is an extremely common spontaneous disease of ageing F344 rats accompanied by splenomegaly, anemia, thrombocytopenia, and leukemic infiltration (initially of the spleen, liver, and lung). Rare in other rat strains, incidence in F344 rats is variable, has been increasing, and can exceed 70% in controls. MNCL cells possess natural killer (NK) cell characteristics and apparently, the neoplastic cells derive from large granular lymphocytes (LGL), hence the alternative name of LGL leukemia. LGL leukemia is uncommon in man and occurs in two forms: T-LGL leukemia which has a chronic course, and the much rarer NK-LGL leukemia. In addition to cell type, the latter resembles F344 LGL leukemia being acute in course and involving more pronounced splenomegaly and thrombocytopenia. Chemically related increases in MNCL in F344 rats have not been associated with induction of human LGL leukemia. Carcinogenicity studies of perchloroethylene (PERC) in several rat strains have shown moderate, not clearly dose-related, increases in MNCL only in F344 rats (two studies). There was no consistent decrease in latency and the incidence in the PERC treated groups is within the overall control range. As a response in a rat strain highly predisposed to developing MNCL, these results are not considered predictive for human cancer risk.

Animals↗

PubMed2001

New corneal findings in human T-cell lymphotrophic virus type 1 infection.

PURPOSE: Human T-cell lymphotrophic virus type 1 is a RNA retrovirus that primarily affects CD4+ T-cells. Human T-cell lymphotrophic virus type 1 infection is the established cause of adult T-cell leukemia/lymphoma, an aggressive malignancy of CD4+ T-cells, and two nonneoplastic conditions: human T-cell lymphotrophic virus type 1-associated myelopathy/tropical spastic paraparesis and human T-cell lymphotrophic virus type 1 uveitis. Other reported ophthalmic manifestations of human T-cell lymphotrophic virus type 1 infection include lymphomatous and leukemic infiltrates in the eye and ocular adnexa in patients with adult T-cell leukemia/lymphoma, retinal pigmentary degeneration, and neuro-ophthalmic disorders in patients with human T-cell lymphotrophic virus type 1-associated myelopathy/tropical spastic paraparesis and keratoconjunctivitis sicca, episcleritis, and sclerouveitis in asymptomatic human T-cell lymphotrophic virus type 1 carriers. This report describes the ocular findings in three Jamaican patients with human T-cell lymphotrophic virus type 1 infection and adult T-cell leukemia/lymphoma. METHODS: The clinical records of three patients with human T-cell lymphotrophic virus type 1 infection and adult T-cell leukemia/lymphoma examined at the National Eye Institute were reviewed. Each patient had one or more complete ophthalmic evaluations. RESULTS: All three patients had corneal abnormalities, including corneal haze and central opacities with thinning; bilateral immunoprotein keratopathy; and peripheral corneal thinning, scarring, and neovascularization. All three patients had elevated serum immunoglobulin levels. CONCLUSIONS: We believe that the novel corneal findings in these patients are most likely a consequence of the hypergammaglobulinemia induced by the human T-cell lymphotrophic virus type 1 infection or the T-cell malignancy.

Adult↗

PubMed1988

Use of fine needle aspiration cytology for the diagnosis of testicular relapse in patients with acute lymphoblastic leukemia.

The testis frequently is the site of relapse in male patients with acute lymphoblastic leukemia. While many patients with testicular involvement by acute lymphoblastic leukemia have enlarged or firm testes, clinical examination alone is insufficient to establish or exclude the diagnosis completely. Open biopsy generally has been used to document the presence of acute lymphoblastic leukemia. However, this procedure requires general anesthesia and hospitalization. We studied 11 patients with a history and/or physical findings suspicious for testicular acute lymphoblastic leukemia relapse to determine the efficacy of fine needle aspiration cytology in the evaluation of the testes for leukemic infiltration. Of the 11 patients fine needle aspiration cytology correctly identified all 5 patients with histologically proved testicular acute lymphoblastic leukemia, it was negative in 5 with no histological evidence of leukemia and it demonstrated rare atypical cells that were not evident on subsequent histological examination in 1. No adverse effects were encountered in this series. Fine needle aspiration cytology appears to be a safe, reproducible alternative to open biopsy in the evaluation of patients for testicular relapse of acute lymphoblastic leukemia.

Adolescent↗

PubMed1992

A clinical update on chronic lymphocytic leukemia. I. Diagnosis and prognosis.

B-cell chronic lymphocytic leukemia (B-CLL) is a relatively indolent hematologic malignant disease that, despite a good response to nonaggressive orally administered chemotherapy, currently remains incurable. The overall median duration of survival is more than 5 years, and the presence of anemia or thrombocytopenia adversely affects prognosis. B-CLL is readily diagnosed because of the characteristic and specific phenotypic expressions of the neoplastic cells. Clinical staging continues to be the best prognostic indicator in B-CLL. In addition, cytogenetic status, pattern of leukemic infiltration in the bone marrow, and lymphocyte doubling time are now considered to have additional prognostic value. In this article, the diagnostic evaluation of lymphocytosis is discussed, and an updated analysis on the prognostic determinants of B-CLL is provided. The second part of this clinical update, which reviews current chemotherapeutic modalities, will be published in the subsequent issue of this journal.

Bone Marrow↗

PubMed1977

Carotid body hypertrophy in patients with cystic fibrosis and cyanotic congenital heart disease.

The carotid bodies from 71 patients ranging in age from 28 weeks' gestation to 30 years were obtained at autopsy. Patients were divided into two groups based on the presence or absence of chronic hypoxemia. There was a high correlation between the weight of individual carotid bodies in each case. Among the 12 patients with chronic hypoxemia, eight patients had carotid bodies heavier than predicted by statistical analysis. Of these eight patients, six had cystic fibrosis and two had cyanotic heart disease. Morphometric and cell population analyses of the carotid bodies from these eight patients and from those of the control population indicated that enlargement of the carotid bodies during normal or abnormal growth results from proportionate increases in lobule parenchyma and stroma. There was also an increase in the width and length of the lobules without an increase in the diameter of the cell cords or a change in the size or proportion of the chief cells. Growth and development of the carotid bodies were studied in a control group of 59 patients without chronic hypoxemia. There were no sex related differences in carotid body weights. The combined weight of the carotid bodies correlated most strongly with body weight, although there was some correlation with age and body length. A regression equation reflecting the data relating to body weight (BW) is: Combined weight of carotid bodies (in mg.) = 0.29 BW (in kg.) +3.0. Leukemic infiltrates were present in two patients with acute lymphocytic leukemia, and diffuse lymphocytic infiltration with nodule formation was present in one patient with mental retardation. Metaplastic cartilage was present in a carotid body of one patient.

Adolescent↗

PubMed1988

Early onset acute orbital involvement in childhood acute lymphoblastic leukemia.

A 5-year-old girl with acute lymphoblastic leukemia undergoing induction chemotherapy experienced acute proptosis while agranulocytotic and febrile. Orbital biopsy showed leukemic infiltration, and complete resolution was achieved with local irradiation and chemotherapy. Early onset orbital involvement is highly unusual in acute lymphoblastic leukemia. In the setting of agranulocytosis and fever, rapidly enlarging intraorbital masses require urgent ophthalmologic attention. Immediate biopsy is indicated to distinguish between several treatable conditions including opportunistic infection, hemorrhage, and neoplastic infiltration.

Acute Disease↗

PubMed2000

Chloroma of the masseteric muscle.

Chloroma (leukemic infiltrate or granulocytic sarcoma) is a localized extramedullary mass of immature granulocytic cells. They are uncommon tumors that usually occur in patients with leukemia, mostly of the myeloid type. Involvement in the head and neck region is rare. Granulocytic sarcomas of the face, maxilla, paranasal sinuses, temporal bone, and pharynx have all been documented in the past. We present the first reported case of a granulocytic sarcoma involving the masseteric muscle in an 8-month-old white male diagnosed with acute myeloid leukemia (AML). The lesion resolved with chemotherapy but the patient subsequently died. This case reaffirms the importance of including chloroma in the differential diagnosis of lesions in patients with AML and the prognostic value they hold.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2004

[Palpebral edema secondary to treatment by a specific inhibitor of tyrosine kinase: Glivec. A case report].

Iatrogenic causes for palpebral edema are rarely suspected and must be specifically sought. The authors report a case of palpebral edema in a patient treated with a specific inhibitor of the BCR-ABL tyrosine kinase (Glivec) for chronic myeloid leukemia. Histopathological analysis of specimens of the excised upper eyelid tissue revealed the absence of leukemic infiltration, suggesting the toxic effect of the treatment. This side effect should be noted so that patients are informed and biopsy is proposed to eliminate tumoral infiltration.

Aged↗