[Long-term evolution of nodular lymphoma. Outcome in 85 patients treated between 1968 and 1975 (author's transl)]. / Evoluton lointaine des lymphomes noduaires. Devenir de 85 malades traités entre 1968 et 1975.

Eighty-five patients with nodular lymphoma diagnosed between 1968 and 1975 were followed up for long periods and were treated by either conventional methods (local radiotherapy and single drug chemotherapy) or by more intensive therapeutic regimens, such as initial combined M.O.P.P. therapy and maintenance treatment with chlorambucil with or without further courses of M.O.P.P. Long-term follow-ups have brought to light some interesting points concerning the prognosis. Dissemination of the disease and large-cell histological pattern were, as already known, unfavourable factors. Neither age nor sex, nor bone-marrow involvement seemed to have any influence. Obtaining complete remissions improved the prognosis, but intensifying the initial and maintenance treatments proved disappointing: the survival rate remained the same, and the incidence of drug induced leukaemias was high. Indeed, relapses appeared to be less responsive to treatment when the patient had initially received multiple chemotherapy. However, in view of the high death rate of the disease (one-third of the patients in this series died within the first 5 years), trying new therapeutic regimens in the hope of obtaining better results, as has been done in Hodgkin's disease, would be fully justified.

[Iatrogenic medullary deficiencies after gold salt therapy (author's transl)]. / Insuffisances médullaires iatrogènes aux sels d'or.

A 63 year-old patient with pancytopenia aplastic bone marrow of several years duration and incomplete response to anabolic steroids is reported. The bone marrow biopsy reveals within lymphoid areas, a refringent pigment proved by microanalysis to be a gold salt.

[Splenic lesions during benign inoculation lymphoreticulosis]. / Lésions spléniques au cours de la lymphoréticulose bénigne d'inoculation.

The authors describe the fibro-granulomatous lesions with scar formation on a splenectomy specimen removed for familial spherocytosis, eight weeks after the onset of cat scratch disease. This original observation, apparently unique in the literature, is in favour of the blood spread of the agent responsible for benign inoculation lymphoreticulosis, and suggests a pathogenic theory for the unusual visceral manifestations.

[Comments on the WHO Reference Center classification of non-Hodgkin hematosarcomas]. / Commentaires sur la classification du centre de références de l'O.M.S.: les hématosarcomes non hodgkiniens

The authors discuss the W.H.O. classification of neoplastic disorders of lymphatic and haematopoietic tissue proposed by G. Mathé and H. Rappaport. They note the points in common with previously published new classifications and make a number of remarks and criticisms. They stress the point most open to discussion: maintenance of the concept of reticulosarcoma. They propose the parallel use of several classifications, including the old nomenclature of Rappaport, in routine histopathology during the comming years.

[Thoracic and abdominal actinomycoses. Anatomo-pathologic study of 5 cases]. / Actinomycose thoracique et abdominale. Etude anatomo-pathologique de 5 observations

The authors report 5 cases and study the thoracic and abdominal lesions of actinomycosis. This is a rare bacterial disease but not exceptional, discovered usually by chance on operative specimen on autopsy. The clinical and bacteriological diagnosis is very difficult although the lesions are characteristic. Thus it is always necessary to carry out biopsy and seek sulphur granules in the actinomycotic follicle. The differential diagnosis is usually easy with granulomycoses, but it is sometimes more difficult to distinguish the disease from nocardioses.

Membrane markers in "histiocytic" lymphomas (reticulum cell sarcomas).

Neoplastic cells from 9 patients affected with a "histiocytic" lymphoma were studied with 5 membrane markers of B or T lymphocytes. In 2 patients a monoclonal B-cell proliferation was found; they had been affected previously with well documented B-cell proliferations: chronic lymphocytic leukemia or Waldenström's macroglobulinemia. The blast cells of 2 other patients had T-cell features; in a fifth case, the abnormal cells carried only a strong receptor for the Fc fragment of IgG, which suggested their truly monocytic origin. In 4 patients, the cells had no detectable surface markers. These findings demonstrated that this group of lymphomas is heterogenous, that the term "histiocytic" appears to be wrong in most instances, and that the cellular origin of the malignant cells frequently remains unidentified and thus prevents a satisfactory new classification.

Prognosis of myeloid metaplasia with myelofibrosis.

The study of the evolution of 168 cases of idiopathic myeloid splenomegaly allowed to point out the prognostic value of the clinical hematologic, isotopic and radiological parameters. The correlation of these data with the histological type of the osteomedullary lesions at the time of the diagnosis, allows to confirm the long survival of the hyperplastic formes (type I) and the more reserved prognosis in advanced myelofibrosis (type II and III together). Indeed, median survival is of 82 months for type I, and 60 months for type II and type III together. It seems advice to gather the two last types and so, to compare two anatomoclinical entities : one is characterized by hyperplastic marrow with reticulinic fibrosis, usually associated with enlarged spleen and sometimes even with increase red blood cells volume but without radiological bone lesions; the other one is characterized by a marrow of middle importance or marked marrow depletion, fibrosis, with or not osteosclerosis, and shows moderate or marked radiological lesions (respectively 16,9% of the cases) and, often, pancytopenia.

[Lymph node pathology during dermatoses with circulating Sézary cells]. / Pathologie ganglionnaire au cours des dermatoses avec cellules de Sezary circulantes

The authors reported 12 cases of patients with cutaneous involvment associated with the presence of Sezary cells in the peripheral blood and specific lymph node involvment. They classify these cases as partial, early segmentary types, advanced types and diffuse types. either leukemic or sarcomatous. This study, once again, suggests the possibility that the Sezary syndrome and mycosis fu ngoïdes are different expressions, either predominantly leukemic, or predominantly sarcomatous, of the same chronic malignant hemopathy of "T" lymphocytes.

[Prognostic value of bone and bone marrow lesions of primary myeloid metaplasia]. / Valeur pronostique des lésions ostéo-médullaires de la splénomégalie myéloïde primitive

This study of the history of 117 cases of agnogenic myeloid metaplasia with myelofibrosis underlines the importance of anatomo-pathological and radiological parameters for prognosis. Histological staging of bone and bone marrow lesions at time of diagnosis enables one to confirm long survival of cases with hyperplasia (Group I) and more severe prognosis for advanced myelofibrosis (that is both groups II and III considered together) but does not enable to establish a significative difference between medium survival of cach group II and III considered separately. Those medium survivals estimated are the following: 82 months for group I; 60 months for both groups II and III. Thus, it is logical to consider together these two groups among which one can distinguish two anatomoclinical forms. One is characterized by bone marrow hyperplasia with reticulin myelofibrosis and is usually associated with large spleen and even in some cases with polycythemia but without radiologic bone lesions; the other is characterized by bone marrow of medium or hypoplasic constitution fibrosis, with or without osteosclerosis and with radiologic bone lesions of mode-rate or important extension (respectively 16.9 p. cent of cases) and is usually associated with pancytopenia.

[Carcinoma of the liver in a child after seven-year complete remission of acute lymphoblastic leukaemia(author's transl)]. / Leberkarzinom bei einem Kind nach siebenjähriger kompletter Remission einer akuten Lymphoblastenleukämie. Sind Purinethol und Methotrexat karzinogene Substanzen? Ein Beitrag zum Problem der Zweitkarzinome bei hämato-onkologischen Erkrankungen

A malignant hepatoma occurred in a 12-year-old girl who eight years previously had developed an acute lymphoblastic leukaemia which for eight years had been in complete haematological remission. Fourteen months after the last re-induction treatment period had been discontinued, but while on methotrexate and 6-mercaptopurine maintenance, a hepatocellular liver carcinoma developed of which the patient died after a fulminating course, still in complete haematological remission. As far as is known, no direct carcinogenic effect can be ascribed to the two antimetabolites, but it must be assumed that these two drugs, taken by the patient for over seven years, led to cirrhosis of the liver whose malignant transformation was significantly influenced by the immunosuppressive effects of methotrexate and 6-mercaptopurine, given as maintenance therapy according to protocol 02 LA 64, Paris.

[Prognostic factors in idiopathic myeloid splenomegaly]. / Facteurs pronostiques de la splénomégalie myéloïde idiopathique

The study of the evolution of 168 cases of idiopathic myeloid splenomegaly allowed to point out the prognostic value of the clinical, hematologic, isotopic and radiological parameters. The correlation of these data with the histological type of the osteomedullary lesions at the time of the diagnosis, allows to confirm the long survival of the hyperplastic formes (type I), and the more reserved prognosis in advanced myelofibroses (type II and type III together) without it being possible to bring out a significant difference between the average presumption of survival of type II and type III considered each separately. Indeed, average survival is of 82 months for type I, and 60 months for type II and type III together. The regrouping of these two types seems to be justified and allows to individualize two anatomoclinical forms. One is characterized by hyperplastic marrow with reticulinic fibrosis, usually associated with enlarged spleen and sometimes even with polyglobulia but without radiological bone lesions. The other form is characterized by a marrow of middle importance or frankly hypoplastic, fibrous, with or without osteosclerosis, and shows moderate or marked radiological changes (respectively 16,9 p. 100 of the cases, and, as a rule, pancytopenia.