Unusual presentation of large B cell lymphoma: a case report and review of literature.

Diffuse large B cell lymphoma (DLBCL) is the largest subtype of non-Hodgkin's lymphomas (NHLs) and is characterized by relatively frequent extranodal presentation. In these cases, the most common extranodal localizations are stomach, CNS, bone, testis and liver. Simultaneous detection of multiple extranodal involvement at presentation is quite uncommon, with the majority of these cases characterized by gastric or intestinal disease localization. Retrospective analysis concerning multifocal extranodal NHLs never pointed out disease features such as those described here. We report a patient with an unusual presentation of DLBCL, characterized by adrenal and renal involvement, associated with symptoms and signs of the cold agglutinin disease and a hypercoagulable state. Subsequently, computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET) scanning disclosed a rapidly extensive spread to nodes and bones. Cytofluorimetric analysis of a renal specimen showed medium-to-large lympho-monocytoid elements positive for CD20 with monoclonal expression of immunoglobulin kappa light chain. Histopathological examination confirmed a renal CD20 positive DLBCL localization.

Ectopic adrenal tissue in the spermatic cord. Case report and review of the literature.

Ectopic adrenal tissue is a not uncommon clinical finding, especially in children. These aberrant rests have been reported in various locations, such as kidney, testis and related structures, female genital tract and supradiaphragmatic region. The most common site in the male genital district is the spermatic cord. We report a case of ectopic adrenal in the spermatic cord, occasionally found in an asymptomatic 42-years-old man. No other pathologic condition of urogenital tract was present. The nodule measured 0.5 cm in diameter and was histologically arranged in three well defined layers, with predominance of the zona fasciculata. No adrenal medullary tissue was observed. The pathogenesis of this ectopic tissue near the testis can be explained by the embryologic relationship between adrenal cortex and the gonad. Finally, we reviewed the relevant literature and the main clinical implications of this condition.

An immunohistochemical analysis of nm23 gene product expression in uveal melanoma.

Uveal melanoma is characterized by an unpredictable clinical course, during which metastatic disease may occur after a prolonged and, at present, undefinable disease-free interval. Because of its relative rarity and the dispersion of cases, the possible genetic alterations implicated in the invasive and metastatic behaviour of this ocular neoplasm have not yet been characterized. The aim of this immunohistochemical retrospective study was to assess the expression of nm23 gene product, proposed to be a metastasis-suppressor gene, in uveal melanoma and to analyse its prognostic significance in relation to the various conventional histopathological parameters, currently considered the major prognostic indicators in this intra-ocular neoplasm. We analysed formalin-fixed paraffin-embedded samples excised from 33 patients with uveal melanoma. Of these, 22 (67%) were positive for monoclonal antibody nm23. This nm23 positivity was inversely associated with scleral invasion level (P = 0.001) and largest tumour diameter (P = 0.02), which represent the two most significant prognostic factors for metastasis. On the other hand, there was no correlation between nm23 expression and other prognostic markers such as cell type, intraocular location or clinical characteristics. These results may suggest a close relationship between nm23 gene expression and metastatic potential of uveal melanomas. In addition, analysis of nm23 gene expression on bioptic tissue may represent an extreme useful prognostic tool for metastatic progression of uveal melanomas.

Local excision of retinal metastasis from cutaneous melanoma.

The incidence of cutaneous melanoma is constantly rising. Ocular involvement is rare and the choroid is the most accessible structure to metastatic emboli. The case described is noteworthy on account of several particular features: 1) the missed diagnosis of the primary malignancy. This might be because either cutaneous melanoma or cutaneous nevi show several common features; 2) the rarity of the retinal metastatic site. Unlike the choroid, the retina is an unusual metastatic site but, regardless of organ blood flow, the metastatic efficiency may be related to interactions between tumor cells and host tissue; 3) the treatment of the retinal metastasis, excised conservatively. As far as we know, this is the first report of a retinal metastasis being treated by local resection.

Effects of polyethylene glycol on reverse transcriptase and other polymerase activities.

Polyethylene glycol enhances reverse transcription, augmenting both the rate and duration of polymerization. The effective mean molecular weight of polyethylene glycol is 6000 and the optimal concentration is 12% (w/w). Polyethylene glycol is effective on the reverse transcriptase reaction of all ten type B, C, and D viruses tested under a variety of exogenous, endogenous, and reconstitution assay systems, including the highly efficient conditions involving calf thymus DNA oligonucleotide primers. By three methods of synthesis, polyethylene glycol increased the yields of complementary [3H]DNA by a factor of 1.8--6.5. Polyethylene glycol does not alter the divalent cation requirements of the specificities of the enzyme. Complementary [3H]DNAs made in the presence of polyethylene glycol are indistinguishable in terms of size and sequence complementarity from those made in the absence of the polymer. The stimulatory effect was partly due to the ability of polyethylene glycol to stabilize reverse transcriptase. Preliminary tests indicate that polyethylene glycol also stimulates other nucleotide polymerases, such as the DNA-dependent DNA and RNA polymerases of Escherichia coli and the terminal transferase of calf thymus.