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Biomedical subjects

K Thorling

Publications and source records attributed to K Thorling.

33 records · Page 2Linked to original sources
PubMed1984

Breast tumour as a first manifestation of extramedullary relapse in acute lymphoblastic leukaemia.

After 2 years of maintained complete remission, a 17-year old girl suffering from common acute lymphoblastic leukaemia (C-ALL) developed a mass in the right breast. Determination of the tumour cell phenotype using a panel of monoclonal antibodies demonstrated the presence of leukaemic blasts. At this stage no other sign of relapse could be demonstrated. Later, however, when the leukaemia progressed despite aggressive treatment, blasts with the same surface phenotype as the ones in the breast were obtained both from repeated biopsies from a mediastinal mass and from a lower abdominal mass. Manifestation of first relapse in ALL presenting as a breast tumour has never been described before and may be added to other unusual extramedullary sites of relapse. The significance of immunologically defined phenotyping of cells from tissue biopsies is underlined.

Adolescent↗
PubMed1984

Gastric lymphomas. Clinical features, treatment and prognosis.

A retrospective analysis of 48 patients with primary, gastric lymphoma was performed. The clinical features, early symptoms and signs were found to be similar to cases of gastric carcinoma. Often surgery was necessary to confirm diagnosis. The treatment modalities surgery, radiation therapy and chemotherapy are discussed. The prognosis for this limited group of patients was a 5-year survival rate of 62 per cent, and a 10-year survival rate of 48 per cent (crude survival). Survival data from comparable series are presented.

Adult↗
PubMed1982

Otological manifestations of Wegener's granulomatosis.

The otological manifestations of Wegener's granulomatosis were studied in 13 patients; diagnosis was confirmed histologically in 10, and in 1 patient periarteritis nodosa presented similar appearances. One patient had destruction of the external ear, and several had refractory otitis externa, usually associated with otitis media: 3 patients had serous otitis media, 4 had purulent otitis media of a fairly mild course, while 6 had otitis media of a fulminant and long-lasting course, accompanied in 5 cases by cranial nerve palsy and in 2 by widespread destruction. Most patients had major sensory hearing loss. Two had short-lasting anacusis during exacerbation of the pulmonary lesions. Often, otological manifestations were the initial signs of the disease. It is important to bear this diagnosis in mind in cases of long-lasting and atypical inflammations and in the presence of peculiar constellations of symptoms from several different organ systems.

Adult↗
PubMed1980

Epstein-Barr-virus-induced lymphoproliferative disorder converting to fatal Burkitt-like lymphoma in a boy with interferon-inducible chromosomal defect.

A 6-year-old boy presenting with swelling of cervical and axillary lymph-nodes was diagnosed as having an Epstein-Barr virus infection because of EBV-nuclear-antigen-positive B-lymphocytes in blood and lymph nodes and high antibody titres to EBV antigens. The natural killer activity of blood-lymphocytes was low, and so was the percentage of T-lymphocytes with Fc receptors for IgG (T-gamma cells). Chromosomal studies revealed a defect in the long arms of one of the chromosomes in pair no. 16 (16q22). The defect only appeared after addition of interferon to the lymphocyte cultures and preferentially in T-gamma lymphocytes. The disease progressed despite attempts to restore the patient's immune reactivity by interferon, transfer factor, and blood transfusions. Necropsy showed that the severe hyperplasia of lymph nodes found during life had become a Burkitt-like lymphoma. The possible connection between an interferon-induced chromosomal defect (break at 16q22) and reduced level of natural killer activity, reduced T-gamma lymphocytes, and proliferation of EBV-positive B-lymphocytes is discussed.

Burkitt Lymphoma↗
PubMed1976

The clinical usefulness of serum copper determinations in Hodgkin's disease. A retrospective study of 241 patients from 1963-1973.

Serum copper determinations were routinely performed in 141 men and 100 women with histologically verified Hodgkin's disease, admitted to the Radium Centre for Jutland over a 10-year-period from January 1, 1963, to January 1, 1973. The previously described variations in serum copper with the activity of the disease, increasing with progression and decreasing with improvement, were amply substantiated. Furthermore, the present study showed that the serum copper value at the first admission, before treatment, is statistically significantly correlated to the stage of the disease and consequently probably to the amount of tumor tissue. In men there was also a statistically significant correlation of se Cu to the histologic grade of the bioptic material (classification according to Lukes 1966). In women the correlation was blurred by the effect on serum copper of estrogen, mainly from contraceptive pills and pregnancy. The serum copper is regularly reduced to within normal limits at complete remission; thus, it is proposed that this parameter be included in the criteria for complete remission.

Adolescent↗
PubMedDate not supplied

In B-cell chronic lymphocytic leukaemia chromosome 17 abnormalities and not trisomy 12 are the single most important cytogenetic abnormalities for the prognosis: a cytogenetic and immunophenotypic study of 480 unselected newly diagnosed patients.

Of 560 consecutive, newly diagnosed untreated patients with B CLL submitted for chromosome study, G-banded karyotypes could be obtained in 480 cases (86%). Of these, 345 (72%) had normal karyotypes and 135 (28%) had clonal chromosome abnormalities: trisomy 12 (+12) was found in 40 cases, 20 as +12 alone (+12single), 20 as +12 with additional abnormalities (+12complex). Other frequent findings included abnormalities of 14q, chromosome 17, 13q and 6q. The immunophenotype was typical for CLL in 358 patients (CD5+, Slg(weak), mainly FMC7-) and atypical for CLL in 122 patients (25%) (CD5-, or Slg(strong) or FMC7+). Chromosome abnormalities were found significantly more often in patients with atypical (48%) than in patients with typical CLL phenotype (22%) (P < 0.00005). Also +12complex, 14q+, del6q, and abnormalities of chromosome 17 were significantly more frequent in patients with atypical CLL phenotype, whereas +12single was found equally often in patients with typical and atypical CLL phenotype. The cytomorphology of most of the +12 patients was that of classical CLL irrespective of phenotype. In univariate survival analysis the following cytogenetic findings were significantly correlated to a poor prognosis: chromosome 17 abnormalities, 14q+, an abnormal karyotype, +12complex, more than one cytogenetic event, and the relative number of abnormal mitoses. In multivariate survival analysis chromosome 17 abnormalities were the only cytogenetic findings with independent prognostic value irrespective of immunophenotype. We conclude that in patients with typical CLL immunophenotype, chromosome abnormalities are somewhat less frequent at the time of diagnosis than hitherto believed. +12single is compatible with classical CLL, and has no prognostic influence whereas chromosome 17 abnormalities signify a poor prognosis. In patients with an atypical CLL immunophenotype, chromosome abnormalities including +12complex, 14q+, del 6q and chromosome 17 are found in about 50% of the patients, and in particular chromosome 17 abnormalities suggest a poor prognosis.

Aged↗
PubMedDate not supplied

Wegener's granulomatosis. Long-term results of treatment.

Seventeen patients with Wegener's granulomatosis are presented. The very complex clinical features are outlined. A recently suggested new classification (ELK-classification) is applied. Fourteen patients were treated with cytotoxic agents and steroids, 12 of these receiving 6-mercaptopurine. Of the ten patients still alive, eight are in remission with treatment withdrawn in three cases. The duration of the treatment is discussed. The results are largely satisfactory, but the course of the disease is still capricious. Progression to a higher step in the ELK-classification has been observed in several cases and a number of serious sequelae to the disease are recorded. The initial symptoms of Wegener's granulomatosis are varied and uncharacteristic, and it is important to bear this disease in mind when patients with a long course of apparently trivial infections or peculiar constellations of symptoms from several organs are encountered. Repeated biopsies from the respiratory tract are important in order to establish the diagnosis, but treatment should not be delayed in cases where only a tentative diagnosis can be made on the basis of a reasonably typical clinical picture, even with a negative histological response.

Adult↗
PubMedDate not supplied

Detection of neoplastic lymph nodes in Hodgkin's disease and non-Hodgkin lymphoma. Comparison between tomography and lymphography.

During a period of 17 months, 98 consecutive patients with malignant lymphoma were examined for initial staging before therapy. Both CT and lymphography were performed in 58 patients (19 patients with Hodgkin's disease (HD) and 39 patients with non-Hodgkin lymphoma (NHL], and these were included in the investigation. The results were discrepant in 26 cases where lymph node lesions were detected by only one of the two methods. In 10 patients, 5 with HD and 5 with NHL, the positive finding by one of the methods was taken as determinant of the stage. The conclusion drawn was that CT cannot completely replace lymphography without losing important information. Owing to limited resources for lymphography and CT a reduced staging programme is proposed. Judging by the present results, this reduced programme would probably mean only a minimal loss of information.

Biopsy↗
PubMedDate not supplied

Late nervous system disorders in cured malignant lymphoma: a clinical and neuropathological study.

A 53-year-old woman was treated for and cured of low grade malignant lymphoma, localized to the neck, by irradiation and chemotherapy. One year later she developed signs of damage to the spinal cord with slight paraparesis of the lower extremities, which remained stationary for seven years. Then, new and rapidly progressive central and peripheral neurological symptoms developed. About one year later the patient died. At autopsy a malignant glioma of the right temporal lobe and radiation damage to the spinal cord were found. Lymphocytic infiltrations in the peripheral nerves and muscles of the lower extremities were also seen. A severe neurogenic atrophy was present but no relapse of malignant lymphoma was found. Depressed immune defense is suggested to be the cause of the pathological changes of the nervous system in this case. The inflammation of the peripheral nerves might be due to activation of a latent virus infection.

Female↗