Bone marrow biopsy (BMB). III. Bone marrow biopsy in Hodgkin's disease (HD).

Bone marrow biopsies have been investigated in 330 cases of Hodgkin's disease totalising 298 patients, out of which 32 with repeated biopsies. Positive biopsies with typical lesions were found in 32% of patients, the majority in stages III and IV (88.6%), rarely in stage I or II (11.4%). Nonspecific lesions were very frequent (75%), either isolated or accompanied by typical lesions. The majority of the positive biopsies were found in patients with lymphocytic predominance and lymphocytic depletion, or in polytreated patients in an advanced stage of the disease. The specific marrow involvement consisted in lymphocytic infiltrations either nodular or diffuse, Reed-Sternberg (R-St) or Hodgkin cells. The lymphocytic depletion is often accompanied by diffuse fibrosis, atypical histiocytes, fibroblasts and R-St cells. Hodgkin typical granulomas are rare. The positive biopsies were associated with nonspecific reactions including hyperplasia of granulopoiesis, megakaryocytes, territories with hyperplasia or aplasia, fibrosis, disruption of sinus walls, oedema, plasmocytosis, necrosis, myelomonoblastic cells, lymphocyte nodes, etc. The bone marrow histology has a prognostic significance.

Bone marrow biopsy (BMB). II. Bone marrow biopsy in myeloproliferative disorders.

The myeloproliferative disorders (MPD) are a domain in which the bone marrow biopsy (BMB) greatly proved its utility. We have studied the histology of the bone marrow (BM) in all the four entities of MPD: chronic myeloid leukemia (CML) with its subtype, chronic megakaryocytic granulocytic myelosis (CMGM), polycythemia vera (PV), hemorrhagic thrombocythemia (HT) and myeloid metaplasia with myelofibrosis (MMM). The work presents in short some of the clinical and hematologic characters of MPD with special stress upon the histologic modifications of BM, either specific or common to all MPD entities, underlying also the criteria for differential diagnosis.

Bone marrow biopsy (BMB). I. Generalities, material and method, normal structure of bone marrow, pathological conditions.

The authors presented in their first note generalities concerning the normal and pathological structure of bone marrow (BM), based on their personal experience (1,500 BMB) and on the literature. A short historical survey and the adopted research method are presented. The advantage of Burkhardt's myelotomy with its technical process by embedding in synthetic resins to avoid decalcification are discussed. The authors have used Jamshidi's cannula (or some other similar needle) with the subsequent embedding in paraffin after decalcification. Further papers will analyse the approach, by BMB, of the myeloproliferative disorders, myelodysplasia, lymphomas and Hodgkin's disease, cancer metastases and medullar aplasia.

Angiosarcoma of the breast. A report of three cases.

The histopathologic and clinical features of 3 breast angiosarcomas were presented. The microscopic patterns were heterogeneous, comprising vascular structures in various degrees of differentiation and solid cellular proliferations, the proportion of which varied from tumor to tumor. All 3 tumors were classified in the third group of angiosarcomas. One widely-excised tumor recurred and developed lung metastases 11 months after mastectomy and during a polychemotherapy. The other 2 patients were well and free from disease 9/11 months after the surgical and radiation therapy.

Ultrasonically guided fine needle aspiration biopsy for the diagnosis of abdominal tumors.

The authors report on the value of ultrasonically guided fine needle (0.6 mm = 23 gauge) biopsy in the morphological diagnosis of abdominal tumors. The method is characterized by a high specificity, resulting from the direct evidencing of the tumoral cells. The accuracy of the method bears on the ultrasonographist's experience, who must puncture the tumor in its peripheral, un-necrotized, zones. The method is rapid and only slightly invasive, involving low risk for the patients. Our results correlate well with the existing literature.

Tubular carcinoma of the breast.

Forty-six tubular carcinomas selected from a series of 434 breast cancers, operated by radical mastectomy, were classified in four types: pure tubular carcinoma--one case, and three mixed types of tubular carcinoma in which the tubular structures decrease progressively in favour of a trabecular, poorly differentiated component. The tumors size and regional lymphatic dissemination increased in parallel with this dynamic change of parenchyma. Tubular carcinoma metastasized less frequently and in lower number of axillary lymph nodes as the other types of invasive breast tumors.

Cytophotometric study of DNA content of cells in type III cervical smears.

Cytophotometric study of suspicious (group III of the Papanicolaou's classification) smears shows the heterogeneity of this group, which includes cases with diploid--tetraploid DNA modes, cases with a wide distribution of DNA values and aneuploid cases. The significance of these findings in relation with the biological properties of cells is briefly discussed.

The lymphoblastic lymphoma: a clinical and morphological entity, two new cases.

There are reported two new cases of lymphoblastic lymphoma in an 8 and a 12 year-old child respectively. The diagnosis is based on cytological features, similar or identical to those of acute lymphoblastic leukemia, the presence of a mediastinal growth and a rapid evolution, and with an early involvement of the bone marrow. The cytohistological pattern was dominated in one case by the proliferation of immature lymphocytes with convoluted nuclei, and in the second one by immature lymphocytes with round nuclei. The T cell origin of these lymphomas and the practical value of their recognition for an early treatment are discussed.

Elastosis in breast carcinoma.

Elastosis, the significant increase of elastic tissue, was identified by histochemical methods in 45 (53.5%) cases of an unselected series of breast cancers. They were all invasive ductal carcinomas with or without tubular differentiation. The highest proportion of tumors with elastosis was found in the "scirrhous" type of carcinomas. Elastosis was preponderantly of the focal variety, periductal and perivenous. The affected ducts were of large calibre, containing a normal, benign hyperplastic or carcinomatous epithelium. There were not observed correlations with the grade of malignancy and the extent of axillary lymph node metastases.

Hematologic and histologic experimental investigations on the therapeutic effect of leukotrophin.

The paper aims at evidencing the stimulating effect on hematopoietic stem cells exerted by the thymus extract "Leukotrophin", prepared by Ellem Laboratory, Milan, Italy. Investigation of the hematologic and histologic parameters allowed the follow up of alterations occurring in bone marrow, blood and tissues of the irradiated animals, treated and untreated as compared with the unirradiated and untreated controls. Regeneration was more active in the groups of animals irradiated and treated with Leukotrophin than in the irradiated and untreated controls. A maximal regeneration of the myeloid series, prevalently of the erythrocytic line, was found 9 days after irradiation.

Diagnostic value of chromosome examination in effusions from cancer patients.

Fifty nine effusions (6 from patients with benign diseases and 53 from cancer patients) were examined cytologically and cytogenetically. Only diploid cells were observed in the benign effusions. The majority of malignant effusions had chromosomal changes, but in three cases where cytologic examination had revealed the presence of malignant cells, only diploid metaphases were found. No false positive diagnoses were made either by the cytologic or by the cytogenetic technique. The concomitant use of cytologic and cytogenetic examinations has substantially improved the correctness of the diagnosis. If by cytologic examination 43 of the 53 effusions from cancer patients were diagnosed as positive, 4 as suspicious and 6 as negative, the combined results of the cytologic and cytogenetic examination can be summarized in 49 positive, 1 suspicious and 3 negative cases. The implications of these data for the medical practice are briefly discussed.