Histological and immunohistochemical studies on primary gastrointestinal lymphomas

To study the characteristics and histogenesis of the malignant lymphomas derived from the gastrointestinal mucosa, histologic and immunohistochemical analyses were performed on a series of 28 malignant lymphomas of the gastrointestinal tract. By cytomorphologic classification, there were two small lymphocytic lymphomas, one small cleaved cell lymphoma, two mixed small cleaved and large cell lymphomas, 17 large cell lymphomas, one small noncleaved cell lymphoma, three immunoblastic lymphomas, and two lymphoblastic lymphomas. This distribution of histologic types was compatible with that of nodal lymphoma. The lymphomas with poor prognostic histology (23 cases) outnumbered those with favorable prognosis (five cases). Three of 28 cases (one in the stomach and two in the small intestine) had cytologic features consistent with centrocytoid cell lymphoma of the mucosa associated lymphoid tissue and were large cell lymphomas. Immunophenotypically, 23 cases expressed B-cell markers (82.1%) and three cases reacted with T-cell markers. Two cases did not react with either T-cell or B-cell markers. True histiocytic lymphomas were not identified. Gastric lymphomas (nine cases) and colorectal lymphomas (three cases) were of B-lymphocyte origin whereas T-cell lymphomas were noted in the small intestine (two cases) and ileocecal region (one case). Three cases of centrocytoid lymphoma were of B-lymphocyte origin. Histologically B-cell lineage lymphomas were evenly distributed on various histologic subtypes but all T-lineage lymphomas belonged to the large cell type. The two cases with undetermined phenotype were lymphoblastic lymphomas histologically. This study showed that the primary GIT lymphomas, mostly of B-cell lineage, were not cytomorphologically distinctive from the nodal lymphomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Systolic Interventricular Septal Motion in Secundum Atrial Septal Defect

Little informaition is available concerning the relation between the echocardiographic findings and the pulmonic to systemic flow ratio. Accordingly the author assessed the pattern of the systolic interventricular septal motion and the relation between the type of the systolic interventricular septal motion and the pulmonic to systemic flow ratio in 30 cases with catheterization evidence of secundum atrial septal defect employing the M-mode echocardiographic technique. The results were as follows: 1) Analysis of the pattern of the systolic interventricular septal motion (SESM) allowed classification of cases into 5 groups: Type 1A (4 cases)-Both the right (RS) and left (LS) sides of the interventricular septum move anteriorly during ventricular systole: Type1V (5 cases)-Both RS and LS of the interventricular septum move posteriorly during ventricular systole:Type 2A (9 cases)-LS of the interventricular septum moves posteriorly, while RS fo the interventricular septum remains relatively flat during ventricular systole; Type 2B (8 cases)-RS of the interventricular septum moves anteriorly, while LS of the interventricular septum remains relatively flat during ventricular systole;Type 3(4 cases)-SISM is the same as type 2 and the motion of the left ventricular posterior wall is relatively hyperactive. 2) The pulmonec to systemic flow ratio (Qp/Qs) was statistically different between type 1, 2, and 3 of SISm (Qp/Qs in type 3=2.3+/-0.33;Qp/Qs in type 2=3.4+/-0.79;Qp/Qs in type 3=5.1+/-1.37). 3) Qp/Qs was not different between type 1A and 1B (Qp/Qs in type 1A=2.3+/-0.28;Qp/Qs in type 1B=2.3+/-0.39) and between type 2A and 2B (Qr/Qs in type 2A=2.20+/-0.80; Qp/Qs in type 2B=3.7+/-0.76). 4) Tyep 2 in SISm predicts Qp/Qs> or =2.5(sensitivity=87.5%;specificity=100%;accuracy=90%), and type 3 in SiSm predicts Qp/Qs> or =4.0(sensitivity=40;specificity=100%;accuracy=80%). In conclusion, the pattern of the systolic interventricular septal motion (SISM) in the M-mode echocardiogram may be useful for the semiquantitative assessment of the pulmonic to systemic flow ratio (Qp/Qs) in cases with secundum atrial septal defect.

Clinical Reviews on 28 Patients with Ulcerative Colitis / 대한소화기내시경학회지

The ulcerative colitis is a relatively common disease in the European and North American countries aince Dr. Wilks has first reported the cases in 1895, But in Korea, this disease is a rare entity and only a few case have been reported. However, rescently the diagnoetic methods for ulcerative colitis are much developed we have experienced 28 cases of ulcerative colitis which were diagnosed by endoscopy, barium enema exam and biopsy. Therefore a total of 28 patient with ulcerative colitis diagnosed and treated at the department of internal medicine of HYUH from June 1979 to June 1986 was reviewed. We obtained the results as follows; 1) The sex distribution assumed a ratio of 1 to 1.33 with 12 males and 16 females. 2) The age dietribution was relatively even but the majority of cases were between 5th and 6th decade (32.1%), 3) The most prominent clinical symptoms were rectal bleeding, abdominal pain, diarrhea, fever, wight loss and vomiting. 4) Significant laboratory findins were anemia, eleveited ESR, leukocytosis, positive stool OB, electrolyte imbalance and decreased serum albumin level. 5) As to the extent of disease determined by the barium enema examination and endoscopic exam., rectum or rectosigmoid colon is involved in majority of the cases (92.8%). 6) The endoscopic examination was performed in all 28 cases and showed significant findings such as ulceration, hyperemia, mucosal friability, bleeding etcs. 7) The barium enema examination was performed in 19 cases and showed positive findings such as ulceration, luminal narrowing, bowel shortening and rigidity in 17 cases. 8) 21 of 28 patients treated by medical therapy showed relatively improved but 4 of 28 patients was exacerbated or relapsed and one has expired.

A Case of Leptomeningeal Carcinomatosis on Superficial Spreading Carcinoma of the Stomach / 대한소화기내시경학회지

Meningeal carcinomatosis is an important neurological complication of systemic cancer, and is increasingly being recognized as a cause of reurologic disability in life. Also there is evidenee that the incidence of this form of metastasis is increasing. We reported a case of 52-year-old female patient, who was diagnosed as early gastric cancer by biopsy under gastrofiberscopy. Other Lab. findings were all normal range except high alkaline phosphatase level. And then performed Billroth II operation. On 7th post-operative day, she was encountered severe headache and insomnia. Abnormal neurologic signs and subjective symptoms were developed and progressed, Repeated lumbar punture was done and CSF was examed. There findings were abnormal, but no specific finding of certain disease. She died of severe neurologic deficit and sudden respiratory arrest. Autopsy was done, and confirmed leptomeningeal carcinomatosis.