[Morphological study of 4 cases of T lymphoma]. / Etude morphologique de quatre cas de lymphome T.

Modern physiopathological studies of the lymphoid system have enabled accurate immunological identification of the different B lymphopathies. Concurrently, the categorization of T proliferations is evolving. In addition to the morphologically well known categories of T lymphomas, three different histological entities are at present termed T lymphomas by anglo-saxon authors: lymphoma with pleiomorphic cytology, or large cell lymphoma, whose identification seems to be the most difficult; Pinkus lymphoma, with subcutaneous clinical localizations which differ from the initial sites of lymphomas, composed of lymphoid cells whose morphology is very characteristic; Lennert lymphoma, whose precise nature is still under debate, but that has been immunologically identified as a T neoplasm by some American authors. We report four observations that exemplify the complex identification of these lymphomas. One case is a Lennert lymphoma which developed into T immunoblastic lymphoma rising the problem of the relationships between these two diseases. The link between these diverse histological pictures is the T immunological identification of the proliferation for which the routine use of monoclonal antibodies should prove helpful.

[Idiopathic thrombopenic purpura and pregnancy]. / Purpura thrombopénique idiopathique et grossesse.

Idiopathic thrombocytopenic purpura occurring in pregnancy has a risk for the fetus of severe thrombocytopenia. The handling of these cases obstetrically is controversial. Our experience and that derived from reading the literature suggests that counting the number of maternal platelets does not reflect on the risk for the fetus and the neonate. On the other hand it does seem that estimating the levels of circulating platelet antibodies in the maternal plasma does give an indication of platelet destruction in the fetus. Corticosteroid treatment improves greatly the number of maternal platelets and is probably good treatment for the fetus in utero. Giving gamma-globulins intravenously to the pregnant woman or to the newborn is an interesting therapeutic measure seeing how it is free of danger. How useful this treatment is in pregnancy has yet to be determined.

[Richter's syndrome. A morphological study apropos of 3 cases]. / Le syndrome de Richter. Etude morphologique à propos de trois cas.

The occurrence of a large cell lymphoma in the course of chronic lymphocytic leukemia is rare and its evolution is fatal at short term. This is the definition of Richter's syndrome. The authors report three cases documented by cytology, histology. The immunological study was performed for one of these by typing on a suspension of fresh bone marrow and lymph node cells. It showed the immunological identity of the chronic phase and the transformation phase (Richter's syndrome). These findings are in line with recent studies showing the immunocellular filiation of the two hemopathies despite the morphological differences, the transformation phase showing the differentiation of the B clone of the chronic phase.

[Acute leukaemia during immunosuppressive treatment. One case (author's transl)]. / Naissance d'une leucémie aiguë au décours d'un traitement immunosuppresseur par le chlorambucil. Une observation.

A 55-year-old man was treated during 22 months with chlorambucil (total dose : 4 218 g) for glomerulonephritis. Towards the end of the treatment, he developed acute myelomonocytic leukaemia and died of this complication. The authors underline the oncogenetic dangers of the association dysimmune disease/immunosuppressive treatment and draw attention to the almost regular preleukaemic phase with its well-known cytological, biochemical, immunological, cytogenetic and evolutive criteria.

[Malignant blood dyscrasias occurring during immunosuppressive treatment. 4 New cases (author's transl)]. / Hémopathies malignes survenant au cours d'un triatement immunosuppresseur. Quatre nouvelles observations.

In the first 3 cases, the initial disorder was a renal problem (glomerulonephritis, renal homograft). The development of secondary neoplasms appeared to be related to long term immunosuppressive therapy. By contrast, in the fourth case the primary disease was already malignant in nature (breast neoplasm) and treatment was mixed (radiotherapy and chemotherapy). In the light of these cases, the risks of treatment using immunosuppressive chemotherapy should not be neglected.