Asunto(s)
Enfermedades Gastrointestinales/complicaciones , Enfermedades Hematológicas/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anemia/etiología , Anemia Perniciosa/etiología , Niño , Enfermedad Crónica , Eritropoyesis , Femenino , Gastritis Atrófica/complicaciones , Enfermedades Gastrointestinales/diagnóstico , Hemorragia Gastrointestinal/complicaciones , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiología , Enfermedades Hematológicas/diagnóstico , Humanos , Hierro/metabolismo , Síndromes de Malabsorción/complicaciones , Síndromes de Malabsorción/etiología , MasculinoAsunto(s)
Linfoma de Células B de la Zona Marginal/clasificación , Linfocitos B , Humanos , Mucosa Intestinal/citología , Mucosa Intestinal/fisiología , Tejido Linfoide/citología , Tejido Linfoide/fisiología , Linfoma de Células B de la Zona Marginal/diagnóstico , Linfoma de Células B de la Zona Marginal/inmunología , Ganglios Linfáticos Agregados/citología , Terminología como AsuntoRESUMEN
PURPOSE: To evaluate in retrospect the response to therapy and long-term evolution of a series of primitive intestinal lymphomas. PATIENTS AND METHODS: The series was comprised of 42 patients diagnosed in our hospital during 1960-1962. The mean age was 34.5 years (range, 3-73), the M/F ratio was 21/21, and the histopathology distributes as follows: high grade (HG), 24 cases, low grade (LG), 12 cases, and mixed (LG/HG), 6 cases. B/T immunophenotype: 40/2. Staging: IE1,29 cases, IIE2-IV, 11 cases. The treatment applied in the series was classified in various types: ample surgical resection (aSR), 21 cases; partial surgical resection (pSR), 9 cases; abdominal radiation therapy (RT), 7 cases; monochemotherapy (MCT), 7 cases, and polychemotherapy (PCT), 28 cases. The correlation of clinicobiological variables with immediate response to treatment was evaluated by means of the chi square test, and the acturial post-therapeutic survival curves in accordance to the life tables, differences being calculated by the log rank test. RESULTS: Small intestine was the commonest site of involvement, 31 cases; ileocecal region, 7 cases; colon, 2 cases, and colon plus small intestine, 2 cases. Regardless of therapy type, complete remission (CR) was attained in 20 patients (47.5%), partial remission in 5; 11 cases were unresponsive (26.5%) and early death occurred in 6 instances (14.2%). The acturial post-therapeutic survival offered an 8-year expectancy of 47%. The correlation between immediate complete response and 16 clinico-biologic variables showed favourable significance for tumoral proliferation index (i.e., Pc10-positive cells < 15%) and for therapeutic regimens including PCT+aSR. On the other hand, the necessity of emergency surgery for diagnosis was a poor-risk factor. The correlation between a post-therapeutic survival and 19 other variables showed the following as favorable data: female sex, tumour proliferative index (i.e., Pc10-positive cells < 15%), the use of PCT+aSR, and attaining CR. Poor-risk factors were the need of emergency surgery, multicentric lymphomatous involvement and serum LDH rates 350 UI/L. Although immediate response (CR) and long-term results (survival) were better in the patients with favourable histology (LG+LG/HG) and in those with loco-regional disease (stages IE-IE1), the differences had no statistical significance, possibly due to the low number of cases. CONCLUSIONS: 1) Even though these findings should be carefully evaluated, dut to lack of homogeneity of the series and the fact of being a retrospective study, the rate of CR in this series (47.5%) is similar to that of current studies. 2) Female sex, type of therapy, multifocal involvement, the need of emergency surgery and high LDH levels have significant value in univariate analyses.
Asunto(s)
Neoplasias Intestinales/mortalidad , Linfoma no Hodgkin/mortalidad , Análisis Actuarial , Adolescente , Adulto , Anciano , Alquilantes/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Niño , Preescolar , Terapia Combinada , Servicios Médicos de Urgencia , Femenino , Humanos , Inmunofenotipificación , Neoplasias Intestinales/patología , Neoplasias Intestinales/terapia , Linfoma no Hodgkin/patología , Linfoma no Hodgkin/terapia , Masculino , Persona de Mediana Edad , Pronóstico , Radioterapia , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología , Procedimientos Quirúrgicos Operativos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Clinical and biological features are discussed on a 50 years old female, who suffered a peritonitis with eosinophilic ascites, together with a bilateral pleural effusion with the same cytologic findings, developing in the course of an hypereosinophilia. The clinical situations in which eosinophilic ascites is associated with blood hypereosinophilia are reviewed. The histopathological findings in this case support the diagnosis of eosinophilic gastroenteritis of subserous type.
Asunto(s)
Ascitis/diagnóstico , Eosinofilia/diagnóstico , Gastroenteritis/diagnóstico , Ascitis/tratamiento farmacológico , Ascitis/patología , Eosinofilia/tratamiento farmacológico , Eosinofilia/patología , Femenino , Gastroenteritis/tratamiento farmacológico , Gastroenteritis/patología , Humanos , Metilprednisolona/administración & dosificación , Persona de Mediana Edad , Peritonitis/diagnóstico , Peritonitis/tratamiento farmacológico , Peritonitis/patología , Derrame Pleural/diagnóstico , Derrame Pleural/tratamiento farmacológico , Derrame Pleural/patologíaRESUMEN
Sixty three cases of Hodgkin's disease are studied (two with lymphonodular predominance, 15 with diffuse lymphocyte predominance, 26 nodular sclerosis, 15 mixed cell and 5 lymphocyte depletion) with a panel of 8 monoclonal antibodies, material routinely used and included in paraffin: Ber H2 (CD30), Leu M1 (CD15), Common Leukocyte Antigen (CD45), L26 (CD20), MB2, UCHL1 (CD45 RO), MTI (CD43) and Epithelial Membrane Antigen. Ber H2 turned out to be the most usefull marker, positive in 100% of cases, independently of the histologic type. Positiveness with Leu M1 ranged from 100% (2/2 cases) of lymphonodular predominance, to 53.3% (8/15 cases) of diffuse lymphocyte predominance. The reactivity of the rest was variable, 1 though it is note worthy the positiveness of B markers (L26, MB2) in the two cases with lymphonodular predominance. In the other subtypes, reactivity with L26 was greater than that with MB2. T cell marker expression was minimal, except for the positiveness in 40% of cases (2/5) of the lymphocyte depletion type. In addition, the results of other series are revised and as a result the possible histogenesis of Hodgkin's disease is discussed.
Asunto(s)
Anticuerpos Monoclonales , Enfermedad de Hodgkin/inmunología , Enfermedad de Hodgkin/diagnóstico , Humanos , Inmunohistoquímica , Ganglios Linfáticos/inmunología , Células de Reed-Sternberg/inmunología , Coloración y EtiquetadoRESUMEN
There are three types of disorders which may produce jaundice during pregnancy: 1) acute or chronic coexistent or pre-existent liver disease (acute and chronic hepatitis, liver cirrhosis etc.), 2) acute and chronic hemolytic disorders, 3) jaundice directly or indirectly related to pregnancy. Among the later group, intrahepatic cholostasis, gravidic hyperemesis with jaundice represent exacerbations of physiologic gravidic cholostasis. Hepatic steatoses of pregnancy are the result of toxic metabolites or drugs on the liver parenchyma. Severe forms of eclampsia may induce jaundice of hemolytic and parenchymal origin. Hypercoagulability may also induce, in the first post-partum days Budd-Chiari's syndrome with accompanying jaundice.
Asunto(s)
Síndrome de Budd-Chiari , Colestasis Intrahepática , Hepatopatías , Preeclampsia , Complicaciones del Embarazo , Síndrome de Budd-Chiari/diagnóstico , Colestasis Intrahepática/diagnóstico , Colestasis Intrahepática/etiología , Coagulación Intravascular Diseminada/complicaciones , Coagulación Intravascular Diseminada/diagnóstico , Femenino , Humanos , Hepatopatías/diagnóstico , Hepatopatías/etiología , Preeclampsia/diagnóstico , Preeclampsia/etiología , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/etiologíaRESUMEN
A defect of haemoglobin synthesis is the classically recognized mechanism affecting the erythron functionalism in chronic iron deficiency. The poor erythroblastic bone-marrow response, plus a number of dyserythropoietic nuclear features, have led to think of an impairment of the cell cycle of erythroblasts in iron-lack anaemia. The aim of the present work was to study such hypothesis, not proven so far. Ten subjects with normal haemopoiesis and 39 patients with iron-lack anaemia of different aetiologies (namely, 19 with digestive tract bleeding, 16 with gynaecological bleeding, and 4 with haemorrhages on other locations) were included in a previously reported protocol. The scheme of such protocol consisted of: 1) bone-marrow erythroblast quantification; 2) analysis of their maturation gradient; 3) erythroblast mitotic index; 4) measure of the mitotic time in bone-marrow culture; 5) tritiated-thymidine incorporation to short-term bone-marrow culture and quantification of the erythroblastic labelling index. To these were added the degree of nuclear dyserythropoiesis according to Hill and Lewis, and the reticulocyte production index. The following mean values were found in the control group: erythroblasts, 25.5 (+/- 3.63) %; E1-E4, 47.66 (+/- 3.09) %; IDN, 0.67 (+/- 0.27); MI, 2.82 (+/- 0.66) %; MT, 1.05 (+/- 0.15 hr); LI, 34.88 (+/- 5.82) %. The mean values found in iron-lack anaemias were as follows: erythroblasts 39.42 (+/- 9.1) %; E1-E4, 42.25 (+/- 4.11) %; IDN, 7.77 (+/- 4.69); MT, 1.81 (+/- 0.95) hr; LI, 13.08 (+/- 6.51) %. The statistical analysis (Student's t) showed highly significant differences (p less than 0.001) in the increased IDN and decreased MI and LI in iron deficiency patients.(ABSTRACT TRUNCATED AT 250 WORDS)