Malignant histiocytic lymphoma with large lacunar cells.

A case of lymph node biopsy with a peculiar histological aspect is described. The clinical data suggest a malignant lymphoid disease. The histological picture is that of a malignant histiocytosis but, among the majority of small histiocytes, there are some large cells like the large lacunar cells from Hodgkin's disease. These large cells (and some small cells) contain the CD 30 antigen of Reed-Sternberg cells. It is discussed whether the appropriate diagnosis is Hodgkin's disease, malignant histiocytosis, or non-Hodgkin's malignant lymphoma. Our diagnosis is Hodgkin's disease, the nodular sclerosing form.

Pathology of lymph nodes in human immunodeficiency virus (HIV) infection.

The actual knowledge concerning the main physiological and histological data of AIDS are presented. The pictures are of lymph node biopsies from patients with AIDS, admitted in the Clinic of Hematology, Fundeni Hospital, Bucharest.

Chronic lymphocytic leukemia and Hodgkin's disease in the same patient: a report of two cases.

Two cases with coexistent chronic lymphocytic leukemia and Hodgkin's disease are reported. The first appeared disease was the chronic lymphocytic leukemia. The eventual influence of this disease on the development of the Hodgkin's disease is discussed.

A particular case of large granular lymphocytes lymphoma.

A patient with non-cutaneous lymphocytic lymphoma with leukaemic spread is reported. The large majority of the peripheral blood mononuclear cells formed rosettes with sheep erythrocytes (E), had receptors for the Fc portion of IgG (Fc gamma R) and displayed an unusual enzymatic profile. Part of these cells had also labile bound surface membrane IgG. The leukaemic cells were morphologically characterized as large granular lymphocytes (LGL) and consisted of two different types of cells: lymphoid cells and monocytoid cells. The histopathological diagnosis was T-cell lymphoma, pleomorphic type, diffuse. Despite their morphological heterogeneity, all the proliferative cells had the same immunological phenotype, showed normal ADCC activity but no NK activity. After three months, without specific treatment, the surface pattern changed: the cells resembled mature LGL and the NK activity increased. The cytochemical study of the leukaemic cells revealed an enzymatical peculiarity: besides an enzymatic profile characteristic for relatively mature LGL, the cells also displayed peroxidase activity. This unusual aspect--the expression by an individual malignant cell of markers believed to be restricted to a single cellular lineage--might be interpreted as a lineage infidelity or lineage promiscuity. The observation that this lymphoma developed in a patient with a long history of hypogammaglobulinaemia is of particular interest.

The "large cell" malignant lymphomas. A retrospective morphological analysis.

A series of 69 cases of "large cell" non-Hodgkin's malignant lymphomas is reviewed. Based only on morphological criteria, eight groups of such lymphomas are described: four of them with a highly reproducible diagnosis and other four more difficult to compare with categories described by other authors. The importance of morphological classifications of malignant lymphomas is discussed.

Study of mediastinal and lung involvements in Hodgkin's disease.

Clinical, biological, radiological and radioisotope investigations in 224 patients with Hodgkin's disease revealed a great frequency (100 cases, i.e. 44%) of mediastinal and pleuro-pulmonary involvements, most of them in advanced stages of the disease. The predominant histologic types in these cases were mixed cellularity or nodular sclerosis. Evolution and prognosis were improved by combination chemotherapy in COOP courses; X-ray therapy was associated after drug therapy only if absolutely necessary, on limited areas.

[Contrast medium persistence in lymph nodes as a prognostic criterion in Hodgkin's disease (author's transl)]. / Die Persistenzdauer des Röntgenkontrastmittels in den Lymphknoten als prognostisches Kriterium des Morbus Hodgkin.

The persistence of contrast medium in the inguinal and retroperitoneal lymph nodes was observed in 104 cases of Hodgkin's disease. Systematic observations were continued until the contrast medium had disappeared completely. The maximum period of observation was 36 months. The following conclusions were reached: a) There is a difference in the behaviour in the contrast medium in normal and abnormal lymph nodes. b) There is a difference in behaviour between various groups of lymph nodes in patients with negative lymphographic findings. c) In patients with positive lymphographic findings the behaviour of the contrast medium varies depending on the histology and radiological appearances of the lymph nodes. An attempt to correlate the persistence of contrast medium with survival time has shown that there is a shorter period of survival in those patients in whom the contrast medium disappeared most quickly from the abnormal nodes. The persistence of contrast medium in the lymph nodes should be borne in mind during treatment planning.

Relationships between lymphography and the histologic nodal and splenic types in Hodgkin's disease. Considerations on clinical evolution.

Trying to establish the eventual interrelations of the initial histologic nodal type and the splenic one, the general lymphographic picture, the histologic nodal type and spleen involvement, lymphographic and histologic examinations were carried out in 151 patients with Hodgkin's disease. Lympographies were performed in 139 cases, and splenectomy (followed by splenic, hepatic and abdominal lymph node biopsies) in 32. Lymphocyte depletion was found in 72.7% of the patients with lymph node obstruction diagnosed lymphographically. Splenic involvement was more frequent in cases with pathologic lymphographic picture and histologic aspects of lymphocyte predominance or nodular sclerosis. In patients with initial nodal histologic types of nodular sclerosis or lymphocyte depletion, the splenic histopathologic types were the same, but they got more severe in cases with lymphocyte predominance or mixed cellularity. Splenic biopsy might be unconclusive after protracted cytostatic treatment or splenic X-ray therapy. In the authors' opinion, early routine splenectomy is rather more advisable than differentiated splenectomy.

Comparative cytogenetic and cytologic study in malignant lymphomas.

The possibility of a cytogenetic-cytologic correlation with implications in the diagnosis, evolutivity and prognosis of malignant lymphomas was studied. Cytogenetic investigations were carried out comparatively in the lymph node and spleen lymphoid cells from 25 patients with malignant lymphomas and in normal subjects or patients with malignant tumors. The dominant malignant cellular type was found to correspond genotypically to the abnormal clone. In lymphomas with more differentiated cells the chormosomal abnormalities were limited to a single chromosomal group, while in those with less differentiated cells there were many clonal chromozomal abnormalities. The pathogenic significance of an extra-chromosome in the C-group (observed in most of the cases) is discussed.

Clinical evolution, histologic type and general lymphographic picture in Hodgkin's disease.

In 88 patients with Hodgkin's disease the clinical value of the general lymphographic picture (lymphodynamic aspects plus nodal patterns) is analysed. The survival times are also reported according to the different pre- and postlymphographic evolution. Histologic types and prelymphographic therapy are correlated with the general lymphographic picture. The predominance of foamy and/or spotty lymphographic patterns of lymph nodes as well as the lymphatic blockages have a severe prognosis (mean intervals between lymphography and exitus 8.3 and respectively 6.2 months). In such cases lymphocytic depletion represents the most frequent histologic type.