[Low grade non-Hodgkin's lymphoma after combined therapy for Hodgkin's disease]. / Linfoma no Hodgkin de bajo grado tras terapéutica combinada por enfermedad de Hodgkin.

The most serious complication of curative therapy for Hodgkin's disease is the development of a second malignancy. A patient who developed a low grade non-Hodgkin's lymphoma three years and a half after combined-modality therapy for Hodgkin's disease, is described. It is exceptional this type of non-Hodgkin's lymphoma as a second neoplasm after cytotoxic treatment for Hodgkin's disease. Pathogenic relationships between both processes are discussed.

Bone marrow fibrosis: histomorphometric analysis and interobserver reproducibility of a simple optical method of assessing its intensity.

A histomorphometric analysis of the length of reticulin fibres per area of haemopoietic bone marrow was performed on 59 trephine iliac crest biopsies. The values obtained were found to correlate with the degree of fibrosis as determined by a simple optical method based on the degree of microscopic magnification required for recognition of the presence of reticulin fibres. The mean length of fibre (microns/10,000 micron2) for the three degrees of fibrosis defined by the optical method were: 241.8 +/- 16.6 for grade I, 713 +/- 85.6 for grade II, and 1827.9 +/- 230.4 for grade III (P < 0.001). In a series of 67 biopsies, the overall interobserver agreement of the optical method was found to be good (Spearman's r = 0.99; P < 0.001) and there was good individual agreement for each of the three degrees of fibrosis (improved kappa test). There was a small amount of overlap between the extreme values of adjacent optical degrees. These results suggest that the optical method described here can be recommended as a practical technique for the routine evaluation of myelofibrosis.

[Masked Philadelphia chromosome: diagnostic implications in a case of chronic myeloid leukemia presenting in blast crisis]. / Cromosoma Filadelfia enmascarado: implicaciones diagnósticas en un caso de leucemia mieloide crónica de presentación en crisis blástica.

We present a female patient with acute non-lymphoblastic leukemia (ANLL) and with haematologic features suggestive of its evolution from chronic myeloid leukaemia (CML), in which a bone marrow karyotype showing a "masked" Philadelphia (Ph) chromosome due to a variant translocation of complex type t(9;9;22)(q32;q34;q11) was found. We comment the peculiarities of this special Ph chromosome as well as the differential diagnostic problems between ANLL Ph(+) and CML with onset in blastic crisis.

[Bone marrow biopsy in non-Hodgkin's lymphoma: experience with 259 samples]. / Biopsia medular en los linfomas no Hodgkin: experiencia sobre 259 muestras.

A study performed on 259 cases of bone-marrow biopsy specimens from 121 patients with non-Hodgkin's lymphoma (NHL) is presented after an introduction dealing with several well-known facts. Specific involvement of the initial samples was present in 53.45% of the cases. Such involvement was more frequent in stages III and IV, although no difference was found between the clinical forms, A or B. Stage progression due to positive bone-marrow biopsy occurred in 26% of the patients, and in 25% of these it was from stages 0 to II onto stage IV. Low-grade lymphomas showed higher bone-marrow involvement than high-grade ones (p = 0.025); specific involvement significantly influenced survival in only high-grade lymphomas, not in the low-grade ones, when the series was considered as a whole. Absolute compatibility between lymph-node and bone-marrow cellularity was found in 71% of the cases, and in 85% was taken into account. Six possible histological lesions are described herein, while for practical purposes, the use of 5 patterns of involvement is recommended, namely, interstitial, nodular, patchy, mixed nodular-patchy, and diffuse. Patchy pattern associated to low-grade and skin-involvement lymphomas. Although those patterns had non-significant influence on survival, this last was found when comparing diffuse pattern with the remainders; similarly, the diffuse pattern correlated with significantly lower haemoglobin rates. Finally, fibrosis was present in 58% of the positive biopsies and in 94% of the lesions, it being thus considered as a marker of bone-marrow involvement.

[Prevalence of ferropenia and iron deficiency anemia in a rural school population, 4 to 16 years of age]. / Prevalencia de ferropenia y anemia ferropénica en una población escolar rural, entre cuatro y dieciséis años.

The ferropenic, is an important disturbance in the childhood due to its frequency, and the necessity of a permanent increase of iron at this age, other factors can be added, such as the iron demand and hemorrhagic loss in puberty. We studied 214 rural school children, between 4 and 16 years in Tenerife, among who two girls, 13 and 14 years old, and one boy 11 years old showed clear ferropenic (1.4%). Another four (1.8%) 3 girls with 14.14 and 9 years, and one boy with 7 years showed latent ferropenic. Overall the ferropenic incidence was 3.2%. There was not ferropenic anemia in any case. These results are similar to those found in another study in urban school children of the same ages, in the same island.

Sintomatologia de la endometriosis.Estudio de 224 casos. / Endometriosis symptomatology. Study of 224 cases

Este estudio de 224 mujeres con endometriosis mostro que la rica sintomatologia depende de la extension de las lesiones, y por lo tanto, de las alteraciones topograficas y fisiologicas de los organos afectados. Que la dismenorrea tipica debe hacer pensar en el diagnostico de endometriosis. El diagnostico anatomoquirurgico es mas confiable que el clinico. En la laparotomia los hallazgos de adherencias firmes, quistes de "chocolate", senos hematicos, equimosis peritoneal y esclerosis peritoneal, casi confirman el diagnostico de endometriosis. La dispaurenia es un sintoma frecuente (26 por ciento) debido a retraccion cervical e implantes endometriosicos uterosacros