RESUMEN
A case of lymph node biopsy with a peculiar histological aspect is described. The clinical data suggest a malignant lymphoid disease. The histological picture is that of a malignant histiocytosis but, among the majority of small histiocytes, there are some large cells like the large lacunar cells from Hodgkin's disease. These large cells (and some small cells) contain the CD 30 antigen of Reed-Sternberg cells. It is discussed whether the appropriate diagnosis is Hodgkin's disease, malignant histiocytosis, or non-Hodgkin's malignant lymphoma. Our diagnosis is Hodgkin's disease, the nodular sclerosing form.
Asunto(s)
Linfoma de Células B Grandes Difuso/patología , Adulto , Biopsia , Médula Ósea/patología , Diagnóstico Diferencial , Femenino , Enfermedad de Hodgkin/patología , Humanos , Ganglios Linfáticos/patología , CuelloRESUMEN
The actual knowledge concerning the main physiological and histological data of AIDS are presented. The pictures are of lymph node biopsies from patients with AIDS, admitted in the Clinic of Hematology, Fundeni Hospital, Bucharest.
Asunto(s)
Infecciones por VIH/patología , VIH-1 , Ganglios Linfáticos/patología , Complejo Relacionado con el SIDA/inmunología , Complejo Relacionado con el SIDA/patología , Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adulto , Infecciones por VIH/inmunología , Humanos , Ganglios Linfáticos/inmunología , Linfoma Relacionado con SIDA/inmunología , Linfoma Relacionado con SIDA/patología , Masculino , Sarcoma de Kaposi/inmunología , Sarcoma de Kaposi/patologíaRESUMEN
Two cases with coexistent chronic lymphocytic leukemia and Hodgkin's disease are reported. The first appeared disease was the chronic lymphocytic leukemia. The eventual influence of this disease on the development of the Hodgkin's disease is discussed.
Asunto(s)
Enfermedad de Hodgkin , Leucemia Linfocítica Crónica de Células B , Neoplasias Primarias Múltiples , Anciano , Femenino , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/patología , Humanos , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Leucemia Linfocítica Crónica de Células B/patología , Masculino , Persona de Mediana EdadRESUMEN
A patient with non-cutaneous lymphocytic lymphoma with leukaemic spread is reported. The large majority of the peripheral blood mononuclear cells formed rosettes with sheep erythrocytes (E), had receptors for the Fc portion of IgG (Fc gamma R) and displayed an unusual enzymatic profile. Part of these cells had also labile bound surface membrane IgG. The leukaemic cells were morphologically characterized as large granular lymphocytes (LGL) and consisted of two different types of cells: lymphoid cells and monocytoid cells. The histopathological diagnosis was T-cell lymphoma, pleomorphic type, diffuse. Despite their morphological heterogeneity, all the proliferative cells had the same immunological phenotype, showed normal ADCC activity but no NK activity. After three months, without specific treatment, the surface pattern changed: the cells resembled mature LGL and the NK activity increased. The cytochemical study of the leukaemic cells revealed an enzymatical peculiarity: besides an enzymatic profile characteristic for relatively mature LGL, the cells also displayed peroxidase activity. This unusual aspect--the expression by an individual malignant cell of markers believed to be restricted to a single cellular lineage--might be interpreted as a lineage infidelity or lineage promiscuity. The observation that this lymphoma developed in a patient with a long history of hypogammaglobulinaemia is of particular interest.
Asunto(s)
Leucemia Linfocítica Crónica de Células B/complicaciones , Leucemia/etiología , Adulto , Agammaglobulinemia/complicaciones , Anticuerpos Monoclonales , Antígenos de Superficie , Pruebas Inmunológicas de Citotoxicidad , Humanos , Leucemia/inmunología , Leucemia/patología , Leucemia Linfocítica Crónica de Células B/inmunología , Leucemia Linfocítica Crónica de Células B/patología , MasculinoAsunto(s)
Linfoma/patología , Neoplasias Primarias Múltiples/patología , Adulto , Anciano , Biopsia , Femenino , Enfermedad de Hodgkin/patología , Humanos , Leucemia Linfocítica Crónica de Células B/patología , Ganglios Linfáticos/patología , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Piel/patología , Linfocitos TAsunto(s)
Leucemia de Células Pilosas/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Humanos , Leucemia de Células Pilosas/mortalidad , Leucemia de Células Pilosas/patología , Leucemia de Células Pilosas/terapia , Masculino , Persona de Mediana Edad , Fenotipo , Pronóstico , Estudios Prospectivos , EsplenectomíaAsunto(s)
Infarto/patología , Ganglios Linfáticos/patología , Linfoma/patología , Adulto , Biopsia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Trombosis/patologíaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfoma no Hodgkin/tratamiento farmacológico , Adolescente , Adulto , Anciano , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Evaluación de Medicamentos , Femenino , Humanos , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Prednisona/administración & dosificación , Inducción de Remisión , Vincristina/administración & dosificaciónAsunto(s)
Linfoma no Hodgkin/clasificación , Linfocitos B/patología , Linfoma de Burkitt/clasificación , Linfoma de Burkitt/patología , Hematología , Hospitales Especializados , Humanos , Linfoma de Células B Grandes Difuso/clasificación , Linfoma de Células B Grandes Difuso/patología , Linfoma no Hodgkin/patología , Rumanía , Linfocitos T/patologíaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Linfoma/tratamiento farmacológico , Radioisótopos de Cobalto/uso terapéutico , Ciclofosfamida/uso terapéutico , Humanos , Linfoma/patología , Linfoma/radioterapia , Mecloretamina/uso terapéutico , Estadificación de Neoplasias , Prednisona/uso terapéutico , Procarbazina/uso terapéutico , Pronóstico , Vincristina/uso terapéuticoRESUMEN
A series of 69 cases of "large cell" non-Hodgkin's malignant lymphomas is reviewed. Based only on morphological criteria, eight groups of such lymphomas are described: four of them with a highly reproducible diagnosis and other four more difficult to compare with categories described by other authors. The importance of morphological classifications of malignant lymphomas is discussed.
Asunto(s)
Linfoma/patología , Adolescente , Adulto , Anciano , Linfoma de Burkitt/diagnóstico , Linfoma de Burkitt/patología , Femenino , Humanos , Ganglios Linfáticos/patología , Linfoma/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/patología , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Micosis Fungoide/diagnóstico , Micosis Fungoide/patologíaRESUMEN
Clinical, biological, radiological and radioisotope investigations in 224 patients with Hodgkin's disease revealed a great frequency (100 cases, i.e. 44%) of mediastinal and pleuro-pulmonary involvements, most of them in advanced stages of the disease. The predominant histologic types in these cases were mixed cellularity or nodular sclerosis. Evolution and prognosis were improved by combination chemotherapy in COOP courses; X-ray therapy was associated after drug therapy only if absolutely necessary, on limited areas.
Asunto(s)
Enfermedad de Hodgkin/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias del Mediastino/diagnóstico , Enfermedad de Hodgkin/terapia , Humanos , Neoplasias Pleurales/diagnóstico , PronósticoRESUMEN
The persistence of contrast medium in the inguinal and retroperitoneal lymph nodes was observed in 104 cases of Hodgkin's disease. Systematic observations were continued until the contrast medium had disappeared completely. The maximum period of observation was 36 months. The following conclusions were reached: a) There is a difference in the behaviour in the contrast medium in normal and abnormal lymph nodes. b) There is a difference in behaviour between various groups of lymph nodes in patients with negative lymphographic findings. c) In patients with positive lymphographic findings the behaviour of the contrast medium varies depending on the histology and radiological appearances of the lymph nodes. An attempt to correlate the persistence of contrast medium with survival time has shown that there is a shorter period of survival in those patients in whom the contrast medium disappeared most quickly from the abnormal nodes. The persistence of contrast medium in the lymph nodes should be borne in mind during treatment planning.
Asunto(s)
Medios de Contraste/metabolismo , Enfermedad de Hodgkin/diagnóstico por imagen , Ganglios Linfáticos/diagnóstico por imagen , Enfermedad de Hodgkin/metabolismo , Humanos , Inmunidad , Ganglios Linfáticos/metabolismo , Ganglios Linfáticos/fisiopatología , Pelvis , Pronóstico , Radiografía , Dosificación Radioterapéutica , Espacio Retroperitoneal , Factores de TiempoRESUMEN
Trying to establish the eventual interrelations of the initial histologic nodal type and the splenic one, the general lymphographic picture, the histologic nodal type and spleen involvement, lymphographic and histologic examinations were carried out in 151 patients with Hodgkin's disease. Lympographies were performed in 139 cases, and splenectomy (followed by splenic, hepatic and abdominal lymph node biopsies) in 32. Lymphocyte depletion was found in 72.7% of the patients with lymph node obstruction diagnosed lymphographically. Splenic involvement was more frequent in cases with pathologic lymphographic picture and histologic aspects of lymphocyte predominance or nodular sclerosis. In patients with initial nodal histologic types of nodular sclerosis or lymphocyte depletion, the splenic histopathologic types were the same, but they got more severe in cases with lymphocyte predominance or mixed cellularity. Splenic biopsy might be unconclusive after protracted cytostatic treatment or splenic X-ray therapy. In the authors' opinion, early routine splenectomy is rather more advisable than differentiated splenectomy.
Asunto(s)
Enfermedad de Hodgkin/patología , Ganglios Linfáticos/patología , Enfermedad de Hodgkin/diagnóstico por imagen , Humanos , Linfografía , Bazo/patología , Esplenectomía , Neoplasias del Bazo/patologíaRESUMEN
The possibility of a cytogenetic-cytologic correlation with implications in the diagnosis, evolutivity and prognosis of malignant lymphomas was studied. Cytogenetic investigations were carried out comparatively in the lymph node and spleen lymphoid cells from 25 patients with malignant lymphomas and in normal subjects or patients with malignant tumors. The dominant malignant cellular type was found to correspond genotypically to the abnormal clone. In lymphomas with more differentiated cells the chormosomal abnormalities were limited to a single chromosomal group, while in those with less differentiated cells there were many clonal chromozomal abnormalities. The pathogenic significance of an extra-chromosome in the C-group (observed in most of the cases) is discussed.
Asunto(s)
Aberraciones Cromosómicas , Leucemia Linfoide/genética , Ganglios Linfáticos/patología , Linfoma/patología , Mitosis , Enfermedad de Hodgkin/genética , Enfermedad de Hodgkin/patología , Humanos , Leucemia Linfoide/patología , Linfoma/genética , Linfoma Folicular/genética , Linfoma de Células B Grandes Difuso/genética , Linfoma no Hodgkin/genética , Bazo/patologíaRESUMEN
The persistence of Lipiodol in various lymph node groups was followed up by systematic lymphographic control. Assuming a certain relationship between the barrier function of the lymph nodes and the persistence of their image on the film the authors have tried to find out whether the duration of Lipiodol persistence may be a test for the estimation of prognosis in Hodgkin's disease. The observation of such cases has shown that Lipiodol is retained for a longer period in the external iliac and lombo-aortic lymph nodes as well as in the pathologic ones, except those with lymphocyte depletion, whereas it is very rapidly eliminated from the inguinal nodes. These findings seem to prove that Hodgkin's disease is more severe in patients in whom the barrier function of the lymph nodes is defective i.e. unable to retain the foreign substances introduced in the organism. These conclusions should be further verified by comparison with other clinical and biologic factors.