RESUMO
All patients with Hodgkin's disease should at minimum, undergo staging evaluation. The staging system that has developed in an effort to distinguish patients with different prognose in an anatomic staging system that generally corelates with the tumor burden. In this article the authors describe the early lymph nodes involvement,with a study of patients whose disease has spread to the spleen. Special interest has focused in the study of the early lesions for the complete understanding of the concept of the classical Hodgkin lymphoma
Assuntos
Humanos , Células Dendríticas Foliculares/classificação , Doença de Hodgkin , Linfócitos , Linfonodos/fisiopatologiaRESUMO
All patients with Hodgkins disease should at minimum, undergo staging evaluation. The staging system that has developed in an effort to distinguish patients with different prognose in an anatomic staging system that generally corelates with the tumor burden. In this article the authors describe the early lymph nodes involvement,with a study of patients whose disease has spread to the spleen. Special interest has focused in the study of the early lesions for the complete understanding of the concept of the classical Hodgkin lymphoma
Assuntos
Humanos , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/classificação , Doença de Hodgkin/patologia , Linfócitos , Células Dendríticas Foliculares/classificação , Linfonodos/fisiopatologiaRESUMO
We report the case of a 46-year-old woman presenting with a disorder characterized by the association of multicentric Castleman's disease, organomegaly, a solitary IgA lambda myeloma with lytic bone lesions but no serum monoclonal peak, peripheral neuropathy and skin changes. This unusual association resulted in an incomplete form of that peculiar multisystem syndrome described under a variety of names: Crow-Fukase syndrome, Shimpo's syndrome, Takatsuki's syndrome, PEP syndrome or POEMS syndrome. The possible relationship between localized and multicentric Castleman's disease with myeloma or extramedullary plasmacytoma on one hand and on the other hand with polyneuropathy and the other symptoms of the POEMS syndrome is discussed.
Assuntos
Neoplasias Ósseas/complicações , Hiperplasia do Linfonodo Gigante/complicações , Plasmocitoma/complicações , Costelas , Hiperplasia do Linfonodo Gigante/patologia , Feminino , Humanos , Imunoglobulina G , Pessoa de Meia-Idade , SíndromeRESUMO
Two HTLV-I associated adult T cell leukemia cases were observed in patient from Martinique (French West Indies). These case are similar to the clinical entity, described by Takatsuki in 1977 in Japan and by Catovsky in Caribbean patients, characterized by a lymphadenopathy, skin lesions and visceral involvement, hypercalcemia, an aggressive course, and poor prognosis. The malignant cells with T4 phenotype and often suppressive function, were pleomorphic, mature, with prominent nuclear irregularities. Systematic research of HTLV-I virus or antibodies in patients with this clinical picture, to measure the influence of this virus in T cell lymphoproliferative diseases in France and in French West Indies is required.
Assuntos
Anticorpos Antivirais/isolamento & purificação , Deltaretrovirus/imunologia , Leucemia/patologia , Linfócitos T/ultraestrutura , Adulto , Idoso , Medula Óssea/patologia , Ensaio de Imunoadsorção Enzimática , Humanos , Leucemia/imunologia , Linfonodos/patologia , Masculino , Pele/patologia , Linfócitos T/imunologiaRESUMO
The authors present the results of a histopathological study on the lymph-nodes taken from 45 subjects suffering from either an AIDS or from a chronic adenopathy corresponding to the definition of AIDS related complex (ARC). The various aspects observed were classed as type I to type IV. The lymph-node modifications observed in the 29 patients with an ARC could be divided into three principle groups: an extensive follicular hyperplasia associated with other elementary lesions or type IA (25 lymph-nodes from 23 patients); changes resembling a multicentric Castleman syndrome or type IB (1 case); angioimmunoblastic-like (AIL) lesions or type II (2 cases) and an association of lesions of type II (7 lymph-nodes from 6 patients). During AIDS, the adenopathy usually disappears, and the small lymph-nodes removed, especially on autopsy, show an extensive lymphoid depletion (type III) with systematic sclerosis (15 lymph-nodes from 14 patients). When adenopathy persists, it is due to infections complications (tuberculosis, cryptococcosis, avian mycobacteriosis and Whipple's disease like lesions). Of the 10 patients in whom a Kaposi's sarcoma was observed, only 6 showed lymph-node involvement, or type IV. The different histopathological lesions seem to appear according to an evolving succession, proven by certain association of lesions and by successive biopsies. In our series, 17% of subjects with an ARC evolved to AIDS. Lymph-node biopsy allows a possible ARC to be implicated on the association of the following simple lesions: follicular hyperplasia with partial or total destruction of the perifollicular lymphocytic cisterna, infiltration of the germinative centres by streams of small lymphocytes, evolving to an aspect of a "burst" germinative centre and various sinusal reactions with, in particular, the presence of neutrophilic polynuclear cells. The biopsy also allows the forms with bad prognosis to be recognized: those with AIL-like aspect or multicentric Castleman-like syndrome, which seems to represent a particular evolutive form. Finally, it also detects, in certain cases, the localization of a Kaposi syndrome, signalling the passage to AIDS. The immunopathological studies present a double interest. Firstly, they offer arguments in favour of the diagnosis: increase in the number of T8 lymphocytes in the germinative centres with the formation of small clusters and disruption of the network of dendritic reticular cells, and the inversion of the T4/T8 ratio in the extra-follicular cortical regions, by either a decrease in T4 lymphocytes or by an increase in T8 lymphocytes.(ABSTRACT TRUNCATED AT 400 WORDS)