Cutaneous mastocytosis after autologous bone marrow transplantation.

A 41-year-old male patient developed cutaneous mastocytosis 3 months after autologous bone marrow transplantation (ABMT). The ABMT was performed as part of consolidation treatment for a high-grade malignant non-Hodgkin's lymphoma. There was no evidence for systemic mastocytosis. Recurrence of the lymphoma could not be shown. Mast cell proliferation frequently coexists with dysplastic and neoplastic disorders of myeloid and, more rarely, of lymphoid cells. Mast cells are growth factor responsive and ultimately originate from the pluripotent hematopoietic stem cell. After autologous bone marrow transplantation, hematological reconstitution may in rare cases lead to an abnormal proliferation of mast cells possibly due to unbalanced production of growth factors.

Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature.

Leukaemic and lymphomatous infiltration of the appendix is rare and even rarer is acute appendicitis as the initial manifestation. From our routine biopsy material we collected four cases of haematological malignancies presenting as acute appendicitis or acute abdomen, caused or accompanied by tumoral infiltration of the appendix. Appendicitis was the initial manifestation that allowed diagnosis of the underlying disease. The clinical histories and histological examinations of the appendices and of one autopsy are described. We report the first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis, and give an overview of the literature. In these days of budgetary cuts in national health services, where one may be tempted not to have seemingly commonplace cases of appendicitis histologically verified, our cases emphasize that careful histopathological examination of all appendectomy specimens should be mandatory. Despite the fact that leukaemia and lymphoma of the appendix are rare, our cases illustrate that these must be included in the differential diagnosis of acute appendicitis and that physicians and surgeons have to be aware of these conditions.

Discordances of cytoplasmic immunoglobulin G staining with the immunoperoxidase technic in plasma cells from bone marrow, tonsils, and appendix.

Plasma cell cytoplasmic immunoglobulin was stained using the peroxidase-antiperoxidase technic in Bouin-fixed, paraffin-embedded human tissues from different origins. Bone marrow (BM), tonsils, and appendices were examined. IgA-, IgD-, and IgM-secreting plasmocytes were easily studied using highly diluted rabbit antihuman antisera in all tissues, including BM. IgG plasmocytes showed good stainability in tonsils and appendices, but variable results were obtained in BM. Bone marrow IgG plasmocytes from persons without infection required a tenfold higher concentration of rabbit antihuman IgG than plasmocytes derived from patients with infection. Stainability of BM plasmocytes from patients with infection was equal to BM plasmocytes from myeloma patients. Because the same rabbit antihuman IgG concentration could be applied for staining plasmocytes derived from tonsils and appendices, it is most probable that the difference in staining ability is due to a difference in activity of the plasmocytes, i.e., a different IgG concentration in the plasmocytes.

Epithelioid angiosarcoma of the splenic capsule. Report of a case reiterating the concept of inert foreign body tumorigenesis.

We report an epithelioid angiosarcoma involving the splenic capsule. This neoplasm developed because of a gauze sponge, retained for 38 years following left-sided nephrectomy. Clinical, radiological, and histological features of this angiosarcoma add to the validity of the concept of inert foreign body tumorigenesis in humans.

Production of immunohistochemical reactivity of mouse anti-epithelial monoclonal antibodies raised against human breast cancer cells.

Mouse monoclonal antibodies (Mabs) against the human breast cancer cell line MCF-7 were obtained by fusing spleen cells from immunized mice with SP2/0 myeloma cells. The Mabs obtained show a high degree of specificity for epithelial cells. They react in a heterogeneous way with neoplastic and non-neoplastic tissues. Mabs 5D10, 2B4, and 3B7 recognize the same antigen (MW 80,000-90,000) in fresh tissue and in paraffin embedded sections. Mab 11F9 recognizes another antigen which can only be detected in unfixed tissue and not in paraffin sections. A preliminary study suggests a glycolipid nature of all recognized antigens. At least one of the monoclonal antibodies (5D10) developed can be used in an in vitro and in vivo model for the study of the invasiveness of MCF-7 cells.

An uncommon breast tumour: the malignant eccrine spiradenoma. A case report.

Eccrine spiradenoma is a benign tumour originating from cutaneous sweat glands. It rarely develops into a malignant tumour. A long-standing cutaneous nodule begins to enlarge rapidly. The growth is often associated with an ulceration and a change in colour. The definitive diagnosis is made after a biopsy with examination of the entire specimen in search for foci of malignant development. The appropriate therapy consists in a wide local excision, with resection of the clinically suspicious lymph nodes. Irradiation of the resection site can be useful to prevent local recurrences. The role of chemotherapy is not yet clearly defined.

Primary Hodgkin disease of the ileum complicating Crohn disease.

BACKGROUND: Primary gastrointestinal lymphoma currently is considered to be an uncommon complication of chronic inflammatory bowel disease. All tumors reported in which recently developed techniques, such as immunohistochemical markers, were used for lymphoma classification proved to be non-Hodgkin lymphomas. Gastrointestinal lymphomas developing in Crohn disease are a very heterogeneous group, with tumors of both B-cell and T-cell lineage represented, along with some tumors of equivocal phenotype. By contrast, gastrointestinal lymphomas complicating ulcerative colitis all have proved to be so-called polymorphic B-cell lymphomas. METHODS: The current report describes another case of primary gastrointestinal lymphoma complicating chronic inflammatory bowel disease occurring in the ileum of a 34-year-old man with a 3-year history of Crohn disease. RESULTS: Histopathologic findings were in keeping with nodular sclerosing Hodgkin disease. Broad birefringent collagen bands divided the tumor into well-defined nodules consisting of typical Reed-Sternberg cells and lacunar variants admixed with a polymorphous lymphoid infiltrate. By immunohistochemical studies, Reed-Sternberg cells and lacunar variants stained positively for Leu-M1 (CD15) and Ber H2 (CD30). The background lymphocytes were primarily of T-cell phenotype. CONCLUSIONS: To the knowledge of the authors, this article reports the first case of primary gastrointestinal Hodgkin disease in association with chronic inflammatory bowel disease that has been confirmed by immunohistochemical studies.

[Mesenchymal chondrosarcoma]. / Mesenchymaal chondrosarcoma.

A case is presented of mesenchymal chondrosarcoma. This extremely rare tumor has a characteristic histology. The prognosis is poor. Radical surgery is essential. A lifelong follow-up is recommended.

A modified immunoperoxidase method for the detection of ABH tissue isoantigens in patients with bladder carcinoma.

Detectable ABH blood group antigens (BGAg) on tumor cells from transitional carcinoma of the urinary bladder, used for diagnosis and prognosis may be evidenced with the existing immunoperoxidase methods. In this study, a modification of the immunoperoxidase method was shown to enable the detection of BGAg in deparaffinized tissue section of normal and malignant human urothelium. To detect antigens A and B a peroxidase-conjugated rabbit anti-human IgM was used and antigen H was visualized by biotinylated lectin.

Interstitial pneumonitis and pulmonary vasculitis in a patient taking an L-tryptophan preparation.

A case is presented of interstitial pneumonitis and pulmonary vasculitis ascribed to the ingestion of an L-tryptophan preparation. An unintended rechallenge supported the causal relationship. There was neither myalgia nor peripheral eosinophilia. Bronchoalveolar lavage fluid contained 12% eosinophils but few were present in the surgical lung biopsy specimen. Lung infiltrates receded after withdrawal of the drug and treatment with steroids. Dyspnoea and pulmonary hypertension persisted. Cyclophosphamide had no effect. Sclerodermiform skin lesions appeared as a late sequel. Chromatographic analysis of the L-tryptophan revealed no suspect impurities.

Bone marrow plasmocytosis in acute leukemia.

A quantitative evaluation of IgA, IgD, IgG and IgM plasmocytes in sequential bone marrow aspirates of patients with acute leukemia using the peroxidase-antiperoxidase method was undertaken. Plasmocytosis resembled that of normal controls or was slightly subnormal on admission. When remission was obtained, bone marrow plasmocytosis was similar to normal controls, irrespective of the type of acute leukemia and the cytostatic treatment. Occurrence of infection strongly augmented the number of plasmocytes, with an initial increase in IgM and later in IgG plasmocytes. This suggests that the immune response is preserved in patients with acute leukemia.

[Mandibular fracture: an unusual complication following osteotomy of the chin]. / Mandibulafractuur: een ongewone complicatie na een kinosteotomie.

A case of a median mandibular fracture with extensive osteolysis 8 weeks following a reduction and protrusion genioplasty is reported. A porous hydroxylapatite block, Interpore 200, was used for contour augmentation at the labiomental fold. The weakening effect of the osteotomy, a foreign body-related chronic osteomyelitis, and repetitive angulation of the mandible during mastication play a role in the pathogenesis of this fracture. Treatment consisted of removal of the porous hydroxylapatite block, removal of the screws and plates, surgical debridement of the necrotic tissue, antibiotics, and immobilization with an arch bar on the buccal side and a lingual acrylic splint to prevent rotation of the upper border of the mandible. Healing was uneventful, without loss of teeth.