ABSTRACT
14q32 rearrangement has been identified as a recurrent hotspot of translocations in multiple myeloma [MM]. The Fluorescence Immunophenotyping and Interphase Cytogenetics as a tool for the Investigation of Neoplasms [known as FICTION technique] for evaluation of chromosomal changes in MM. The aim of this work is to detect 14q32 rearrangement, using FICTION technique, on archival bone marrow [BM] slides of MM patients, and to study its prognostic value. This study was conducted at Ain Shams University Hospital. The FICTION technique, which uses CD138 and dual color, and the break-apart 14q32 rearrangement probe, was performed on archived smears of BM slides for 50 MM patients at the time of diagnosis. A significantly higher percentage of cases were positive for 14q32 rearrangement by FICTION [32%] compared to fluorescence in situ hybridization [FISH] [12%] [p = 0.04]. Cases positive by FICTION for the rearrangement were designated as Group A, while negative cases were designated as Group B. Significantly lower Hb and CRP levels were found among Group B when compared to Group A patients [p = 0.001 and 0.01, respectively]. Serum albumin level and Bence Jones protein [BJP] significantly affect overall survival [OS] [p = 0.01, 0.007, respectively]. However, a statistically non-significant shorter mean survival time was found in positive cases through FICTION versus negative cases. FICTION technique provides a sensitive tool for establishing clonal plasma cells [PC] infiltration of BM aspirates, and is amenable for use on archived as well as fresh smears
ABSTRACT
Portal hypertension is an increase in the hydrostatic pressure within the portal vein or one of its tributaries. The aim of this work was duplex assessment of portal hypertension and duplex evaluation of haemodynamic changes before and after splenectomy and devascularization. The study included 30 persons divided into two groups: 10 normal subjects as controls and 20 patients with portal hypertension. To both groups duplex Doppler was done to assess the portal vein diameter, portal vein caliber variation during respiration, splenic vein diameter, presence of collaterals, measuring portal vein velocity and the cross sectional area and then calculation of portal blood flow using the equation: portal blood flow=velocity x cross sectional area. Of the present work showed that, in the control group, the mean portal vein diameter was 1.1 +/- 0.08 cm and the portal blood flow was 1.5 +/- 0.4 L/M. The pre-operative duplex study showed a mean velocity of 26.4 +/- 8.82 cm/sec. The mean portal blood flow was 1.2 +/- 0.6 L/M. The portal vein diameter ranged between 1.2 and 2.1 cm with mean 1.83 +/- 0.34 cm. The post -operative duplex study showed that the portal vein diameter ranged between 1 and 2 cm with a mean of 1.57 +/- 0.24 cm, the mean velocity ranged from 9 to 35.4 cm/sec with a mean 24.17 +/- 7.81 cm/sec. The portal blood flow ranged from 0.36 to 1.5 L/M with a mean of 0.78 +/- 0.34 L/M. The study of splenectomy and devasculariziation was done on 20 patients and portal blood flow was measured before and after surgery. Of the present work showed decrease in the portal blood flow in 18 patients out of 20 [90%]. This study showed decreased in portal vein diameter in 17 patients [85%] and no change in 3 cases [15%]. This was explained by drop of portal pressure that occurred after operation