PubMed Health⌕ Search

Biomedical subjects

K Donhuijsen

Publications and source records attributed to K Donhuijsen.

At least 19 recordsLinked to original sources
PubMed1995

Primary gastric non-Hodgkin's lymphoma: a clinicopathological study of 41 patients.

Pathological findings in 41 patients (male/female ratio: 1.3/1) with primary localized gastric non-Hodgkin's lymphoma (NHL) were retrospectively studied and correlated with survival. The median observation period after diagnosis was 32 (0-189) months. Nineteen patients were low-grade NHL, all but one B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) type. Twenty-two patients had primary (n = 7) or secondary (n = 15) high-grade lymphomas; Musshoff stage IE was found in 29 and IIE in 12 cases. The median age at diagnosis was 61 years (range, 26-88 years), and proliferation, measured by the number of mitosis and Ki-67 antigen positivity (MIB-1), was high or moderately high in 24 cases and low in 17 cases. Follicular lymphatic hyperplasia could be found in 25 of 34 evaluable cases, more often in low-grade than in high-grade NHL. Most of the patients were treated by resective surgery and additional ratio- or chemotherapy. Thirteen patients (31%) died (median survival: 10 months), 5 of them within 3 months after surgery owing to postoperative complications. Survival was superior, though not statistically significant, in low-grade lymphomas. Our retrospective analysis of heterogeneously treated gastric lymphomas reveals that gastric lymphomas, especially of the low-grade MALT type, often remain a localized disease with a good long-term prognosis. Our study confirms previous reports indicating that lymphomas of the MALT type represent a specific clinicopathological entity.

Adult↗
PubMed1995

[Large nodular, multicenter, juvenile xanthogranuloma with ulceration].

We report on a patient with multicentric juvenile xanthogranuloma, whose unusual clinical and histological pattern initially obscured the diagnosis. Spontaneous remission of the tumour, which has now been maintained for over 2 years, the change from the primary monomorphological fibrocytic appearance to a polymorphological histiocytic picture with multiple fat-storing giant cells, and the lacking dermonstration of specific cell organelles finally allowed the nature of the disease to the definitely diagnosed.

Diagnosis, Differential↗
PubMed1994

[Systemic fungal infections in hematologic neoplasms. An autopsy study of 1,053 patients].

BACKGROUND: Mycoses are common complications of haematological neoplasias. For successful antimycotic treatment, a knowledge of preferential underlying disease, frequency, species and site of the mycosis is of importance. PATIENTS AND METHODS: Postmortem material comprising clinical data, autopsy protocols and histological sections obtained between 1976 and 1990 from 1,053 patients with leukaemia and malignant lymphomas following antineoplastic therapy was analysed retrospectively. RESULTS: Autopsy revealed systemic mycoses in 184 patients (17.5%). Between 1976 and 1990, the incidence of fungal infections increased from 12% to 30%, most being found in acute leukaemia (24%). Myeloproliferative syndrome (18%), non-Hodgkin's lymphomas (16%), Hodgkin's disease (10%) and plasmocytoma (2.5%) were less frequently associated with mycoses. With no preference for any particular malignancy in evidence, aspergillosis predominated at histology (85 cases), while candidosis occurred in 75 cases. A combination of two mycoses (aspergillosis and candidosis) (14 patients), zygomycosis (eight patients) and cryptococcosis (two patients) were much less common. While aspergillosis caused mostly pulmonary (81 cases) and cerebral (18 cases) infections, candidosis most frequently affected the GI tract (83 cases). The fungal infection was regarded as the main cause of death in some 76% of the cases. An analysis of bone marrow of patients with mycosis (184 cases) revealed a predominance of hypoplasia (54%) over tumour infiltration (34%) and normal bone marrow (12%). In malignancies with no mycoses (869 cases) in contrast, hypoplasia was significantly less common (19%) than infiltration (59%) or normal bone marrow (22%) (p < 0.001). CONCLUSION: The incidence of mycoses in haematological neoplasias in our post mortem series has continued to increase. Bone marrow hypoplasia in particular predisposes to fungal infection. The lungs are the organs of predilection, and aspergillosis is likely to be the infection presenting.

Autopsy↗
PubMed1992

[Hemangiosarcoma of the liver. The diagnostic difficulties and therapeutic possibilities].

A 65-year-old man complained of decreasing physical capacity and weakness over the preceding six months, associated with marked painless jaundice and subsequently ascites. Despite extensive tests, some invasive, in three different hospitals no cause was found of the patient's symptoms and the marked though nonspecific abnormalities of various biochemical values (raised bilirubin concentration; increased alkaline phosphatase activity). Liver transplantation was performed because of progressive liver failure, without a firm diagnosis being established. At operation the liver was found to contain a haemangiosarcoma. The patient died 14 months after the transplantation of a suppurative cholangitis. At autopsy neither metastases nor recurrences were found.

Aged↗
PubMed1992

Mucoid cytoplasmic inclusions in urothelial carcinomas.

To date, mucoid cytoplasmic inclusions in urothelial carcinomas have rarely been noted. However, we were impressed by the fact that these corpuscles are readily detectable in numerous urothelial neoplasms. Therefore, a histologic analysis of 100 cases of urothelial carcinomas was performed. Overall, 37 cases revealed periodic acid-Schiff-positive cytoplasmic inclusions. These were observed in 14% of grade 1, 49% of grade 2, and 63% of grade 3 carcinomas. The inclusions were histochemically, immunohistochemically, and ultrastructurally identified as cytoplasmic deposits of mucoid materials. Two types of deposits, condensed and noncondensed, could be distinguished. The demonstration of mucoid deposits in otherwise poorly differentiated metastatic carcinomas may be of some differential diagnostic importance insofar as urothelial carcinoma has to be considered as the possible primary tumor.

Carcinoma, Transitional Cell↗
PubMed1992

Mast cell frequency in soft tissue tumors. Relation to type and grade of malignancy.

A high content of mast cells (MC) is considered characteristic of neurofibromas but not of malignant schwannomas and neurilemmomas. We examined the extent and reliability of this finding by counting MC in 61 peripheral nerve sheath tumors and in 103 non-neurogenic soft tissue sarcomas. We furthermore investigated correlations between the amount of MC and various features of the tumors (e.g. grades of malignancy). Neurofibromas had very high mast cell counts. However, this result only applied to about 70% of these tumors. Malignant schwannomas, malignant fibrous histiocytomas and leiomyosarcomas had remarkably high median values of MC counts with a wide dispersion within the histological groups. Synovial sarcomas were the only group that contained MC in every case, though often in small numbers. In univariate analyses the number of MC was negatively correlated to grades of malignancy, cellularity and mitotic activity of the sarcomas and tended to correlate positively to the amount of myxoid and collagenous connective tissue and lymphocytic infiltrates. Multiple linear regression analysis revealed a significant correlation to the grade of malignancy and the amount of connective tissue.

Cell Count↗
PubMed1992

[Angioimmunoblastic lymphadenopathy (AILD): histology and survival time].

In order to identify histological and immunohistochemical criteria of prognostic value in AILD 40 lymph nodes with typical and 15 cases with incomplete features were semiquantitatively analyzed. Their expression were correlated with survival data of all patients. Significant prognostic value could be detected for following parameters: mitoses, immunoblasts, CD 30-positive blasts, multinuclear tumor cells and eosinophilic granulocytes. However residual lymph node structures, venules, PAS-positive material, and reticulum cells did not correlate with survival data. The short median survival time does not justify AILD grouping as low grade malignant lymphoma.

Antigens, CD↗
PubMed1991

[Zygomycoses: clinical aspects and pathology in 10 patients].

Deep fungal infections caused by zygomycetes (so-called mucormycoses) are rare. Whereas in the past rhinocerebral mycosis dominated, today a wide range of clinical manifestations must be expected, especially pulmonary infections and invasion of vessel walls with systemic infarction. On the basis of 10 cases of Mucoraceae mycosis and a review of the literature, the predisposing conditions, clinical symptoms and pathologic-anatomic findings are described. Our observations include 7 patients with leukemia and 2 adults and one newborn without malignant neoplasia. Except for the patient with rhinocerebral mycosis, the diagnosis was not established during the patients' lifetime. 3 patients received systemic antimycotic therapy. Our observations suggest that infarctions of internal organs in immunocompromised patients should direct suspicion towards angio-related mycoses, not only of aspergillosis, but also of zygomycosis.

Adult↗
PubMed1991

[The staging diagnosis of Hodgkin's disease. A comparison of laparotomy and noninvasive methods].

The diagnostic efficiency of modern noninvasive methods more and more puts into question the need for exploratory laparotomy to determine the stage of Hodgkin's disease. In 208 patients (122 men and 86 women; mean age 29 [14-62] years) pre- and postoperative findings as to stage of the abdominal disease were compared. All patients had first been examined by ultrasound and computed tomography, followed by laparotomy with splenectomy. Findings of lymphography were available for 171 patients. Gross and microscopic examination of the tissues obtained by splenectomy and lymphadenectomy, as well as liver biopsy provided different stages from the preoperative ones, which in 46 had been false-negative, and in 16 false-positive. Spleen weight and involvement of the spleen with Hodgkin infiltration correlated only weakly with one another. In 38 of 41 patients with parapancreatic and splenohilar lymphnode involvement the spleen was also affected. These results indicate that regarding the stage of Hodgkin's disease, noninvasive methods so far do not achieve the validity of pathological examination obtained at exploratory laparotomy with splenectomy.

Adolescent↗
PubMed1991

Nuclear grading of renal cell carcinomas--is morphometry necessary?

Comparative investigations of subjective with objective nuclear grading methods of renal cell carcinomas are almost completely lacking. Therefore, we graded 94 cases of this carcinomas by a simple, subjective microscopical estimation as well as by a morphogenetic measurement of nuclear area. Both procedures proved prognostically useful, but the best results were achieved by morphometry. By this method three prognostic groups of renal cell carcinoma were found, provided that the borderlines were drawn at 28 microns 2 and 60 microns 2, respectively. Particularly favourable and unfavourable cases could be separated from average ones, if the means and standard deviations of both the nuclear areas and the diameters were evaluated. Overall, morphometric nuclear analyses are highly desirable, if, for example, morphological data are to be used in the context of prognostic or therapeutic studies on renal cell carcinoma. However, there is a broad distribution of the values for individual cases so that, tumour-biologically, no exact demarcation of prognostically different groups can be expected.

Adult↗
PubMed1991

[Deep mycoses in leukemia and malignant lymphoma].

1053 autopsies were performed from 1976 to 1990 in patients with leukemia and malignant lymphomas. At autopsy 184 of these (17.4%) presented with deep seated mycoses. There was an increasing percentage of mycoses per year with a maximum of 30% in 1990. Today deep seated mycoses are the most frequent letal complication in hematologic neoplasias. As expected their number was especially high in patients with acute leukemia but in recent years they were nearly just as numerous in myeloproliferative disorders. Among NHL they were twice as frequent in low grade cases as in high grade cases possibly due to a different extent of bone marrow infiltration. In contrast to former years more aspergilloses than candida infections are found, probably as a result of antimycotic therapy.

Acute Disease↗
PubMed1991

[Autopsy results of deep mycoses in hematologic neoplasms (1053 patients].

1053 autopsies were performed during the period from 1976 to 1990 in patients with leukaemia and malignant lymphomas. At autopsy 184 of these (17.4%) presented with deep-seated mycoses. There was an increasing percentage of mycoses per year with a maximum of 30% in 1990. Today deep-seated mycoses are the most frequent lethal complication in haematologic neoplasias. As expected their number was especially high in patients with acute leukaemia but in recent years they were nearly just as frequent in myeloproliferative disorders. Among Non-Hodgkin lymphomas (NHL) they were twice as frequent in low-grade cases as in high-grade cases possibly due to a different extent of bone marrow infiltration. In contrast to former years more aspergillosis than Candida infections are found, probably as a result of antimycotic therapy.

Autopsy↗
PubMed1991

[Mucoraceae mycoses: clinical aspects and pathology in ten patients].

Zygomycosis is characterized by a very high lethality, often favoured by rapid fungal growth in blood vessels causing the formation of thrombi and infarcts in several organs, a disease poor in symptoms. A disseminated mycosis normally is a complication of a granulocytopenia which is in our days more frequently observed as localized manifestation, whereas the typical rhinocerebral manifestation complicating diabetic ketoacidosis has become more rare. The diagnosis of zygomycosis can apparently be obtained easier by histology than by culture. The prognosis of zygomycosis can be improved by: 1. an early examination by biopsy, 2. if possible a rapid correction of predisposing factors (e.g. correction of acidosis), 3. an early antimycotic therapy by amphotericin B in risk patients, even if no causative agent can be cultured.

Acidosis↗