Cyclophosphamide reduces neutrophilic alveolitis in patients with scleroderma lung disease: a retrospective analysis of serial bronchoalveolar lavage investigations.

OBJECTIVES: To determine whether cyclophosphamide is beneficial for patients with scleroderma lung disease (SLD). METHODS: The effect of 6 months' treatment with intravenous cyclophosphamide on the functional capacity of patients, lung function tests, high resolution computed tomography of the lungs, and cytology of bronchoalveolar lavage was evaluated in 21 patients with SLD. RESULTS: The treatment was well tolerated and all patients completed 6 months' treatment. Intravenous cyclophosphamide stabilised or improved the patients' functional status and lung function tests. The extent of the lungs affected remained unchanged, as assessed with HRCT of the lungs. Patients with SLD and neutrophilic alveolitis (NA) showed greater improvement than patients with normal levels of granulocytes in the bronchoalveolar lavage fluid (BALF). Significant reduction of neutrophils was also seen in the patients with SLD and NA, whereas no significant change was seen in the level of granulocytes in patients with SLD and an initially normal percentage of granulocytes. CONCLUSIONS: Previous reports that patients with SLD with increased levels of granulocytes in BALF are more likely to benefit from treatment with intravenous cyclophosphamide are confirmed. Additionally, clinical improvement in this group of patients is accompanied by a significant decrease in the percentage of granulocytes in BALF.

[The value of urine sediment cytomorphology in the ambulatory differential diagnosis of hematuria]. / Wartosc badania cytomorfologicznego osadu moczu w ambulatoryjnej diagnostyce róznicowej krwiomoczu.

In order to improve early diagnosis of urotheliale neoplasms (UN) in nephrology outpatient clinic, 274 patients (221 male and 53 female, mean age 54 yrs), with recurrent hematuria (> 5 E/hpf) were investigated in years 1994-1998. The following examinations of fresh urine sediment were performed: in 114pts (group 1) erythrocytes of urine sediment examined with phase-contrast microscopy (PCM); in 129pts (group II) urine sediment examined with classical oncological cytology; in the III-rd group of 31pts (29M and 2F, aged 61-72), both methods were used because of high suspicion on UN on the ground of initial result of PCM, precisely clinical anamnesis as well as predominance of men in advanced age. Results were as follows. In the I-st group, in 6 from 42pts with urological hematuria in PCM, what means 5.2% of the whole group and 14% of the subgroup with urological hematuria, in further standard urological examination bladder carcinoma was found. In the II-nd group, positive result of urinary cytology (GI to GIII) was found in 7pts, what means 5.4% of the whole group. Results of urine cytology were confirmed later in the standard urological examination, which detected bladder carcinoma in all these patients. In the III-rd group, bladder carcinoma was found in all 22pts with urological hematuria in PCM. In 19 patients from this subgroup, urinary cytology was positive for UN (GI to GIII). In the remaining 3pts results of urinary cytology were false negative. False positive result of urinary cytology occurred in one from 9pts with glomerular hematuria and clinical or morphological (in renal biopsy) evidence of glomerulonephritis. On the results of the study, we propose--as an obligatory--in every case of recurrent hematuria of urological origin in PCM, examination of fresh urinary sediment with classical oncological cytology, especially if the patient belongs to the high risk group for urotheliale neoplasms.

Urine and semen cytomorphology in patients with testicular tumors.

Our original technique of preparing urinary and seminal sediment was modified in order to identify neoplastic cells in cases of testicular malignancies. In a series of 24 patients with testicular tumor-like conditions, 18 tumors were diagnosed, 12 cytologically. In one case, the result of cytological examination was falsely positive since histopathology revealed necrosis of the testicle only. The morphology of neoplastic cells in the seminal sediment is demonstrated.

Detection of testicular neoplasms by cytological examination of seminal fluid.

The technique for detection of neoplastic cells in the seminal fluid of patients with testicular malignancies is presented. This preliminary study of 7 patients with testicular tumors and 50 controls demonstrates the possibility of using cytological examination of the sperm as the screening method for testicular tumors.