Biomedical subjects
Publications and source records attributed to A I Pavlovskaia.
A rare case of tumor arising from Langerhans cells in the tongue and neck area in a 37 year-old man is presented. It was a polymorphocellular sarcoma with bean-like twisted nuclei. Electron microscopy identified granules of Langerhans (Bierbeck), multiple tubulo-vesicular structures, ring-like plates, Golgi apparatus, lysosomes and dendritic processes. Total leukocytic antigen was assayed in tumor cells but no expression of S-100 protein found.
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The cells of papillary thyroid carcinoma are shown to have the following characteristic morphological features: oval or oval to roundish shape of nuclei, uneven sinuous, folded border of the nuclear membrane, nuclear fissure, intranuclear cytoplasmic inclusions, optically clean nuclei. None of these features is a marker, only combination of more than four of them represents diagnostic value.
Two cases of clinical diagnosis of tumour of the trachea and tumour of the stomach are described in a 42- and 52-year-old males. Immunohistochemical and ultrastructural methods were used to prove the histiocytic nature of the tumour cells which were morphologically similar to poorly differentiated carcinoma and large cell lymphosarcoma.
The analysis of peculiarities of clinical course and morphology of malignant (acute) histiocytosis in 50 pediatric patients made a case for identification of the disease as separate pathology of histiocytic sarcoma type. Clinical course features include: lymphadenopathy, involvement of bones and--less frequently--lungs, skin and subcutaneous fat, marked fever and weight loss. Cytologic and histologic examination show polymorphic tumor cells of varying degree of differentiation, with blasts predominating. Well-developed Golgi complex, presence of lysosomes, phagosomes and erythrophagocytosis are among the characteristic ultrastructural features of the disease.
The authors described a case of the syndrome of erythrophagocytic histiocytosis in an infant with primary immune deficiency who died at the age of 11 months and 20 days. Microscopic examination revealed focal and diffuse histiocyte proliferation in the bone marrow, lymph nodes, liver, and lung. Histiocytes were found to actively phagocytize erythrocytes and hemosiderin. The changes in the thymus were regarded as congenital primary unclassifiable immunodeficiency. The differential diagnosis of the syndrome was made in comparison with histiocytosis, histiocytosis X and familial erythrophagocytic lymphohistiocytosis.
The authors reported some data on the frequency and spectrum of mycotic infections in 76 adult patients with different types of acute leukemia over the last 3 years. The growth of fungi of various species was noted in 50 (23%) of 213 bacteriological tests, candidomycetes being the most common type. Three patients with aspergillosis were described in detail, in 2 of them intravital diagnosis was established. One of these patients with a complete response received amphotericin B therapy despite the fact that acute leukemia in this case was refractory to therapy. The other patient died of profuse pulmonary hemorrhage. The main nosological types of systemic mycoses, their clinical picture, prevention, therapy and characteristic features in acute leukemias were under consideration.
Evidence obtained at pathological investigation concerns 3 cases of lymphomatoid granulomatosis. The disease pertains to lymphoproliferative affections and is of rare occurrence. In addition to common involvement of the lungs, liver, kidneys, spleen, adrenals, etc., there was an advanced lymph node and brain lesion with abundant atypical cells in the infiltrate in the first and third case, respectively. The diagnosis rested on autopsy findings in 1 case and was intravital, established upon morphological examination of intraoperative specimens in 2 cases. Samples obtained at bronchoscopy are not fit for verification of the diagnosis in view of profound necrotic and necrobiotic processes in lymphomatoid granulomatosis.
Mouse vaccination with alive endogenous N-tropic virus OA-3 inhibited and decreased the development of the Rauscher leukemia in C57B1/6 mice (B-type) and SWR mice (N-type) as well as the development 7,12-dimethyl benzanthracene (DMBA)-induced tumours in mouse hybrids (neither N-, nor B-types). The effect of vaccination was DMBA- or MLV-P-dose-dependent. Vaccination with the same virus did not affect the incidence of gamma-irradiation-induced leukemia in CBA mice (N-type) and C57B1/6 mice while it increased twice the incidence of radiation leukemia in DBA mice (N-type). However, the incidence of thymomas lowered in radiation leukemia-bearing vaccinated mice of all the 3 strains, which may result from inhibition of murine thymotropic endogenous virus reproduction. The data obtained indicate the participation of murine own endogenous viruses in DMBA- or gamma-irradiation induced carcinogenesis.
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Proliferation of the mononuclear phagocyte system cells is the basis for histiocytic proliferative conditions (malignant histiocytosis, histiocytic "reticulosarcoma" histiocytosis X). Cells of the phagocytosing histiocyte type proliferate in malignant histiocytosis and histiocytic "reticulosarcoma), cells of the Langerhans type proliferate in histiocytosis X. According to Rappaport's classification of 1966, histiocytic "reticulosarcoma" is separated from the heterogeneous group of diffuse histiocytic lymphomas. Its morphological picture is non-distinguishable from that of malignant histiocytosis, particularly at the stage of generalization. The Letterer-Siwe disease due to its course, prognosis and special therapeutical approach should be separated from the group of conditions combined under the term "histiocytosis".
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The authors describe a female patient with acute lymphoblastic leukemia. After the first chemotherapy cycle according to the VAMP program the patient developed a complete remission. Further on, repeated extramedullary relapses (neuroleukemia, involvement of the mammary gland tissue and lymph nodes of the mesentery) were observed over 7 years, the data of blood and bone marrow analyses being within normal. At the end of the disease the patient developed a relapse with changes in the blood and bone marrow, however the blast cells were sudan and peroxidase-positive i.e. could be classified as myeloblasts.
A case of sinus histiocytosis with massive lymphadenopathy in a boy of 13 with multiple subcutaneous tumor-like formations 0.5 to 2.5 cm in diameter is described. The general condition of the patient was not changed despite the 7-month course of the disease. Mild anemia and increased ESR were observed. Microscopically the formations presented massive "dense" infiltrates of lymphoid, plasma cells, and histiocytes-macrophages with foci of fibrosis and xanthomatosis. Since the morphological picture of sinus histiocytosis with massive lymphadenopathy may to some extent imitate the substrate of some tumor diseases of the hemopoietic and lymphoid tissues (malignant histiocytosis, histiocytosis X, lymphogranulomatosis, lymphosarcoma), their differential diagnosis is presented.
Malignant histiocytosis is a rare neoplastic disease from the group of acute leukemias. Morphological characteristics of the disease are presented on the basis of histological, histochemical, and electron microscopic examinations of section materials from 16 cases of malignant histiocytosis in children of 6 to 14 years. Systemic focal-diffuse proliferation of tumor cells of histiocytic type of various degrees of differentiation was observed in organs and tissues. Most frequently, typical macro- and/or microscopic lesions were detected in lymph nodes, bone marrow of vertebrae, flat and tubular bones, liver, and spleen. The histiocytic nature of tumor cells was judged primarily from such signs as their capacity for phagocytosis detectable by light and electron microscopy, high diffuse cytoplasmic activity on nonspecific esterase and acid phosphatase, and features of the ultrastructure. In the establishment of the diagnosis, malignant histiocytosis had to be differentiated from Letters-Siwe disease, sinus histiocytosis with massive lymphadenopathy, lymphogranulomatosis, immunoblastic lymphosarcoma, melanoma, undifferentiated cancer.
A tumor of the rectum in a woman of 74 is described. The analysis of the tumor in light microscope suggested a low-differentiated cancer or melanoma. Electron microscopic examination of the tumor metastasis into a lymph node showed most of the tumor cells to have low differentiation and contain no ultrastructural organspecific markers. However, in the tumor cells comprising a small group, typical tonofibrils and desmosomes were found which substantiated the diagnosis of squamous cell carcinoma.
A case of spindle-cell carcinoma of the mammary gland in a young woman is described. The histology of the tumor was rather peculiar and characterized by the presence of two components: epithelial, consisting of polygonal polymorph cells with a trend to squamous-cell differentiation, and sarcoma-like, consisting of spindle-shaped cells. Transitional forms between cells of both components were found. At the ultrastructural level, cells of the epithelial and sarcoma-like components showed signs of their appurtenance to the squamous epithelium: crude bundles of tonofilaments in the cytoplasm combined with well-developed desmosomes between cells. The clinical course of the disease was characterized by a rapid progression, positive Abelev's test for alpha-phetoprotein, the lack of the tumor sensitivity to a broad spectrum of chemotherapy drugs.