ABSTRACT
A 34-year-old man was found to have granulocytopenia with a white blood count of 2.3 x 10(9) l-1, consisting of 10% segmented neutrophils, 50% monocytes and 40% lymphocytes. A bone marrow aspirate showed 20% promyelocytes and 10% blasts with monoblastic features, and a smouldering myelomonocytic leukaemia was considered to be a possible diagnosis. In cold weather the patient experienced cold intolerance with acrocyanosis and small ulcerations on the ears. The test for heparin-precipitable protein ('cryofibrinogen') was strongly positive. During the following year, these signs and symptoms persisted, and the patient also developed constant moderate pain in the epigastric region. Gastroscopy revealed a large lymphoma of the stomach, which was a high-grade malignant centroblastic type of non-Hodgkin's lymphoma. After successful removal of the tumour, and six courses of potent cytostatic combinations, the patient recovered completely, and the granulocytopenia and cold intolerance disappeared.
Subject(s)
Agranulocytosis/etiology , Lymphoma, Non-Hodgkin/complications , Raynaud Disease/etiology , Stomach Neoplasms/complications , Adult , Combined Modality Therapy , Humans , Lymphoma, Non-Hodgkin/therapy , Male , Remission Induction , Stomach Neoplasms/therapyABSTRACT
A patient with primary sideroblastic anaemia was observed for more than 10 years with 50% ring sideroblasts in the bone marrow and a Hb of 84-109 g/l. Iron deficiency then developed with loss of stainable iron in marrow particles (reticuloendothelial iron) and loss of all ring sideroblasts. When iron tablets had brought the iron stores in the bone marrow up to subnormal levels, the Hb was over 110 g/l, somewhat higher than it had been when the iron stores were increased. The ring sideroblasts were again raised to more than 50%.
Subject(s)
Anemia, Sideroblastic/etiology , Erythrocytes/pathology , Iron Deficiencies , Anemia, Sideroblastic/blood , Anemia, Sideroblastic/drug therapy , Erythrocytes/metabolism , Erythropoiesis , Female , Hemoglobins/analysis , Humans , Iron/administration & dosage , Middle AgedSubject(s)
Bone Marrow/ultrastructure , Inclusion Bodies/ultrastructure , Leukemia, Myeloid, Acute/diagnosis , Adult , Blood Coagulation , Disseminated Intravascular Coagulation , Endoplasmic Reticulum/ultrastructure , Humans , Leukemia, Myeloid, Acute/blood , Leukemia, Myeloid, Acute/ultrastructure , Male , Microscopy, ElectronABSTRACT
A 17-year-old woman had acute myeloid leukaemia (AML) with a leucocyte count of about 100 x 10(9)/1. The great majority of the leucocytes were immature. About half of them were without granules; in the other half the granules were usually scanty, but occasionally numerous and rather coarse. A few cells had Auer rods arranged in bundles. The patient had uncompensated disseminated intravascular coagulation (DIC) with a severe tendency to bleed. Everything fitted with variant hypergranular promyelocytic leukaemia, except for the staining of 30% of the immature cells by Löffler's unspecific esterase with alpha-naphthyl acetate. The patient may, therefore, be classified as either a variant of variant form M3, or as a transition between M3 and acute monocytic leukaemia.
Subject(s)
Leukemia, Monocytic, Acute/genetics , Leukemia, Myeloid, Acute/genetics , Adolescent , Diagnosis, Differential , Disseminated Intravascular Coagulation/complications , Genetic Variation , Humans , Leukemia, Monocytic, Acute/diagnosis , Leukemia, Myeloid, Acute/diagnosis , Leukocytes/ultrastructure , MaleABSTRACT
Amyloid deposits aspirated from the bone marrow have a characteristic appearance in May--Grünwald-Giemsa-stained smears, and almost specific fibrillar pattern when viewed in an electron microscope.
Subject(s)
Amyloid/analysis , Amyloidosis/pathology , Bone Marrow/ultrastructure , Amyloidosis/metabolism , Female , Humans , Male , Middle AgedABSTRACT
A patient with IgG myeloma showed a highly abnormal pattern of the rough endoplasmic reticulum (RER) with multiple concentric lamellar bodies and "single sac loops". This abnormal pattern might be due to either a complete rearrangement of the architecture within the cell, and/or a pathology in the wall of the sacs of RER.
Subject(s)
Endoplasmic Reticulum/ultrastructure , Multiple Myeloma/ultrastructure , Organoids/ultrastructure , Plasma Cells/ultrastructure , Female , Humans , Middle AgedSubject(s)
Polycythemia Vera , Busulfan/therapeutic use , Chronic Disease , Diagnosis, Differential , Hemorrhage/etiology , Humans , Phosphorus Radioisotopes , Polycythemia Vera/complications , Polycythemia Vera/diagnosis , Polycythemia Vera/drug therapy , Polycythemia Vera/radiotherapy , Thrombosis/etiologySubject(s)
Autoimmune Diseases , Erythrocytes/immunology , Purpura/diagnosis , Adult , Ecchymosis/etiology , Female , Humans , Pain/etiologyABSTRACT
A multicentre trial from five medical departments in Oslo has been carried out to determine the value in women patients of one year's long-term anticoagulant therapy. Follow-up long-term laboratory control and anticoagulant dosage were performed at one centre (the Rikshospitalet). One hundred and fifty-nine patients were assigned randomly into two similar well-matched groups (control and treatment). Dosage was controlled by Thrombotest, aiming at 10-20% levels, and 50% of the tests were less than 14%. Compared with the control group, the treatment group showed a significant reduction in mortality and in reinfarction rate. No serious bleeding complications occurred. It is concluded that women benefit as much as men from long-term anticoagulant therapy.
