The histology of 125 cases of primary gastrointestinal lymphomas arising in the stomach and small and large intestine has been reviewed. The material was gathered from the Bland-Sutton Institute of Pathology at the Middlesex Hospital and from the Westminster Hospital. Of the initial total of 143 cases diagnosed, 18 were rejected. Of the acceptable 125 cases, 51 lymphomas were arising in stomach, 53 in the small intestine and 21 in the large intestine including rectum. Excluding the four children in the series, ages ranged from 18 to 82 and were fairly evenly distributed across the decades. There was no significant sex difference in the Middlesex Hospital cases but in the Westminster Hospital series the male to female ratio was approximately 2.6 to 1. One significant finding to emerge from this histological survey, and which forms the basis of this communication, is the proportion of lymphomas considered to be predominantly of plasma cell type. These plasma cell tumours, or extramedullary plasmacytomas, accounted for 49 out of the 125 cases (39%) of gastrointestinal lymphomas. They were less common in stomach and most common in the intestine, the majority occurring in the ileocaecal region. Conversely, Hodgkin's disease, in contrast to some series, was not encountered. Of the non-Hodgkin's lymphomas, grade I tumours were uncommon and true histiocytic lymphomas were distinctly rare. The high incidence of plasma cell tumours were uncommon and true histiocytic lymphomas were distinctly rare. The high incidence of plasma cell tumours in our series is in keeping with the morphological findings of a previous study carried out in patients with alpha-chain disease and in a small series of primary gastrointestinal lymphomas.

Adolescent↗

PubMed1976

The microvasculature of the spleen.

A method for examining the microvasculature of the dog spleen by angiography is described and the findings are related to morphological studies. The marginal sinus of the lymphoid follicle has been shown to be an important part of the vascular pathway in the spleen. It allows intimate mixing of blood elements and spleen cells and it is suggested that this plays an important immunological role. The control of blood flow to the lymphoid follicle is discussed but requires further elucidation.

Angiography↗

PubMed1976

Radiological and histological findings in six patients with alpha-chain disease.

Detailed radiological and histological features of alpha-chain disease are presented against a background of the clinical and biochemical findings. The separation of this syndrome from other varieties of "Mediterranean" lymphoma is emphasized. The radiologist should in some instances be able to suggest the diagnosis in his differential diagnosis of abnormalities seen on examination of the small bowel. The histopathologist should be able to provide a diagnosis from examination of a peroral jejunal biopsy. One patient with this relatively uncommon disease had evidence of a hypertrophic osteoarthropathy. Two of the six patients had a transient episode of acute abdominal distension which resolved on conservative management.

Adolescent↗

PubMed1975

Thrombin-induced disseminated intravascular coagulation. III:Modification by dextran infusion.

The cardiorespiratory effects of thrombin-induced disseminated intravascular coagulation (DIC) were studied in two groups of dogs. The main changes were a reduction in cardiac output and arterial pressure, an increase in pulmonary artery pressure and, an increase in pulmonary artery pressure and an increase in venous admixture. In one group of dogs the reduction in cardiac output was diminished by the infusion of dextran 35 ml/kg body weight. This resulted in an increased pulmonary artery pressure but no significant differences in the indices of the efficiency of gas exchange. However, the haemodilution resulted in a lower mixed venous and arterial PO2 in this group of dogs.

Animals↗

PubMed1975

Thrombin-induced disseminated intravascular coagulation in the dog. II. Cardiorespiratory changes during spontaneous and controlled ventilation.

Disseminated intravascular coagulation (DIC) was induced in anaesthetized dogs by the infusion of a fibrinolytic inhibitor followed by thrombin. The occurrence of DIC was confirmed by haematological and histological examinations. After the thrombin infusion there was a progressive reduction in cardiac index and systemic arterial pressure, only four of the 14 dogs surviving for 4 hr. Pulmonary artery pressure increased after the thrombin infusion, but decreased subsequently in seven animals allowed to breathe spontaneously. In these animals, there was an increase in respiratory rate, minute volume and deadspace/tidal volume ratio, but there were no changes in the arterial-to-alveolar PCO2 difference. Arterial PCO2 and PO2 decreased, but there were no significant changes in total venous admixture. In seven dogs submitted to controlled ventilation, arterial PO2 decreased to the same extent, but there were no significant changes in arterial PCO2, deadspace/tidal volume ratio or venous admixture.

Aminocaproates↗

PubMed1975

Subepithelial collagen in intestinal malabsorption.

Intestinal biopsies from 146 patients with adult coeliac disease and 13 patients with intestinal villous atrophy of different aetiology were assessed for the presence of subepithelial collagen and compared with a group of 20 control subjects. Subepithelial collagen was a common and non-specific finding observed in intestinal biopsies from patients suffering from adult coeliac disease (36%) and tropical sprue. In adult coeliac disease the described subepithelial changes usually regress following treatment, though marked subepithelial collagen deposition may indicate a poor prognosis. The study showed that the presence of marked subepithelial collagen in a flat jejunal biopsy does not define a separate clinical entity.

Adult↗

PubMed1975

Electron microscopy in the non-Hodgkin's lymphomata.

The component cells of peripheral lymphoid tissue have been divided into the lymphocyte and plasma cell lines, mononuclear phagocytic cells, dendritic "reticular cells", the reticular (supporting) cells and endothelial cells, and it is suggested that this system of cells should collectively be referred to as the lymphoreticular monoclear phagocyte system or LRMPS. Seventeen tumours of the LRMPS (excluding Hodgkin's disease) have been studied at ultrastructural level. Of these 17 non-Hodgkin lymphomata 5 were follicular lymphomata and 12 diffuse. It is concluded that electron microscopy plays a valuable role in the diagnosis of this group of tumours. Not only does it allow rejection of a diagnosis of lymphoma in certain anaplastic tumours, but it also enables a more precise identification of the cellular components of a lymphoma as well as indicating the degree of differentiation of the cell line involved. Additional advantages are the visualization of subcellular structures useful as markers, and by means of specialized immunoelectron microscopic techniques the identification of antigens and antibody formation within a given tumour. Two other results of this ultrastructural study are the indication that the dendritic cells of lymphoid follicles are derived from capillary endothelium, and the identification of certain anomalous formations derived from rough endoplasmic reticulum in the case of tumours showing plasmacytoid differentiation.

Cell Line↗