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Biomedical subjects

M Akerman

Publications and source records attributed to M Akerman.

At least 55 records · Page 3Linked to original sources
PubMed1987

Flow cytometric detection of B-clonal excess in fine needle aspirates for enhanced diagnostic accuracy in non-Hodgkin's lymphoma in adults.

Fine needle aspiration (FNA) cytology is a valuable aid to diagnosis and tumour staging in patients with non-Hodgkin's lymphoma. These tumours are often multicentric and involve sites such as the liver or the spleen which are not easily accessible to surgical biopsy. Particularly with splenic involvement, there is a diagnostic problem of morphologically distinguishing the lymphoma cells in an admixture of normal lymphocytes. Since most lymphomas in adults are of B-cell origin, we studied the diagnostic value of adding a surface immunoglobulin (sIg) light chain analysis to the cytological evaluation of FNAs. B-clonal excess was determined by flow cytometric analysis of the sIg light chain distribution and a monoclonal finding was considered diagnostic of lymphoma. In primary diagnostic procedures the light chain analysis established a diagnosis of lymphoma in 5/14 (36%) aspirates from patients with poorly differentiated tumours. Fine needle aspirates performed as part of staging procedures were morphologically normal or inconclusive in 19 cases; in seven of these (37%) lymphoma involvement was diagnosed by the light chain analysis. Diagnostic precision was enhanced by combining morphological and immunological evaluation of fine needles aspirates in patients with established or suspected non-Hodgkin's lymphoma.

B-Lymphocytes↗
PubMed1987

Relationship between cytogenetic findings and histopathology in non-Hodgkin lymphoma.

The cytogenetic findings in 70 patients with non-Hodgkin lymphoma have been correlated with tumor histopathology according to the Kiel classification. Certain chromosome aberrations displayed a nonrandom association with the grade of malignancy: 4 lymphomas out of 6 with 1p+, 5 out of 7 with del(6)(q15), 7 out of 11 with 14q+, and 5 out of 8 with +18 belonged to the high grade malignancy group, whereas 9 lymphomas out of 10 with t(14;18) were low grade malignant. Two aberration types were closely associated with specific histopathologic subtypes: t(14;18) occurred in 7 cases out of 10 in centroblastic/centrocytic (cb/cc) follicular lymphomas, and 5 cases out of 6 with i(17q) were cb or cb/cc. Although less striking, there was a tendency for del(6)(q15) to occur in cb or cb/cc lymphomas (4 cases out of 7), in contrast to only 1 case out of 5 with the more distal deletion del(6)(q21).

Adolescent↗
PubMed1987

Cytogenetic studies in Hodgkin's disease.

Cytogenetic analysis was attempted in 20 patients with Hodgkin's disease. No mitoses were found in 2 cases, normal metaphases in 7, and normal metaphases with nonclonal aberrations in 7. Of the 4 cases with clonal aberrations, one had +16 as the sole change, whereas the remaining tumors had multiple numerical and structural changes.

Adolescent↗
PubMed1987

Aspiration of musculoskeletal tumors for cytodiagnosis and DNA analysis.

Preoperative fine-needle aspirates of 25 soft tissue tumors and four bone tumors were used for cytodiagnosis and flow cytometric DNA ploidy analysis. The results were compared with the histopathologic diagnosis and flow cytometric DNA ploidy analysis on tissue samples after surgery. There was good agreement between the cytodiagnoses and histopathologic diagnoses with regard to benign tumor or sarcoma. There was good agreement between the ploidy determinations in aspirates and tissue samples in 20 out of the 26 tumors that could be analyzed. Aneuploid cell populations were found in 13 tumors cytologically classified as sarcoma and in one tumor classified as unspecified malignant tumor. These 14 tumors also showed aneuploid cell populations in the tissue samples and were histologically diagnosed as high-grade malignant sarcomas. The combined evaluation of preoperative cytodiagnosis and DNA ploidy on aspirates may give valuable prognostic information.

Adult↗
PubMed1987

Primary localized non-Hodgkin's lymphoma of the thyroid: a retrospective clinicopathological review.

Primary localized non-Hodgkin's lymphomas (NHL) of the thyroid are rare. The data presented are derived from 819 consecutive patients with NHL and six patients with anaplastic thyroid carcinomas of small cell type investigated and treated at our department between 1970 and 1981. The present analyses are based on the 19 patients, who were found to have localized primary thyroid lymphomas. Four of these patients were initially considered to have undifferentiated small cell carcinomas of the thyroid but revealed to be lymphomas at re-examination supplemented with immunohistopathologic staining. Prognosis has been evaluated with regard to initial stage, histopathology according to the Kiel classification and therapy. Median follow-up was 5 years. The crude survival was 77% 5 years after diagnosis. This was not significantly less (4.2%) than the overall-survival in an age- and sex-matched population, despite the majority of patients having tumours which were locally advanced, often with spread to regional lymph nodes, and in many cases a histology showing a high-grade malignancy according to Kiel classification. The excellent prognosis in the current study compared to other studies is probably mainly attributed to more extensive staging procedures. The biologic behaviour supports the hypothesis that these lymphomas represent lymphomas of mucosa associated lymphoid tissue (MALT). According to present results anaplastic thyroid carcinoma of small cell type must be extremely rare.

Aged↗
PubMed1986

Is the EORTC prognostic index of thyroid cancer valid in differentiated thyroid carcinoma? Retrospective multivariate analysis of differentiated thyroid carcinoma with long follow-up.

The European Organization for Research on Treatment of Cancer (EORTC) Thyroid Cancer Cooperative Group presented a prognostic index in 1979 that included all histologic groups of thyroid carcinomas, and was based on a multivariate analysis of 507 patients with a median follow-up of 40 months. The current report not only uses a multivariate analysis to study the clinical validity and reproducibility of this index on case material consisting of 226 differentiated thyroid carcinomas with a considerably long follow-up (11 years), but also it investigates possible prognostic factors, other than those proposed by the EORTC. Three EORTC variables could be reproduced as important: age at diagnosis, locally advanced disease, and distant metastases. Of the additional histopathologic variables tested, microscopic tumor invasion beyond thyroid capsule (pT4) and marked cellular atypia (MCA) proved to be significant. When the effect of the age-correlated tumor factors pT4 and MCA of differentiated thyroid carcinomas were taken into consideration, age alone lost its prognostic importance as a guide for treatment.

Adult↗
PubMed1986

Near-haploidy in a case of plasmocytoma.

Chromosome studies of a solitary plasmocytoma in the femoral bone revealed a near-haploid chromosome number of 31-32 with a loss of one homolog of each chromosome pair except #1, #7, #9, #15, #19-21, and the sex chromosomes (XY). The cytogenetic findings have been compared with 16 cases of near-haploid neoplasms from the literature studied using banding techniques. A common feature present in 13 of the 16 cases reported was found to be disomy 21; the only chromosomes consistently present in one copy in all neoplasms were #2, #3, #4, and #5.

Chromosome Aberrations↗
PubMed1986

Pulmonary manifestations of AIDS: review of 106 episodes.

We reviewed the clinical records and chest radiographs of all patients admitted to our institution between 1982 and 1984 who had pulmonary disease and who were later proved to have acquired immunodeficiency syndrome (AIDS) (95 patients). Diffuse parenchymal lung disease was the most common finding. These infiltrates were usually interstitial and caused by Pneumocystis carinii pneumonia or P. carinii combined with cytomegalovirus infection. Focal, multilobar, interstitial infiltrates were also often seen and usually caused by P. carinii or P. carinii and cytomegalovirus infections. Rarely, well-defined, multiple, interstitial nodules less than 10 mm in diameter were the only or predominant characteristic and were seen only in association with Mycobacterium tuberculosis or Cryptococcus neoformans infections or Kaposi sarcoma. Hilar or mediastinal adenopathy occurred in 17 of the 21 patients with M. tuberculosis or C. neoformans infections. In contrast, only 4% of patients with P. carinii infections presented with these findings. We also found that hilar or mediastinal adenopathy was not significantly associated with peripheral adenopathy. Lung cavitation, pleural effusion, or a normal chest radiograph was uncommon.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Ewing's sarcoma of bone. A correlative cytological and histological study of 14 cases.

A correlative cytological and histological study of 14 cases of Ewing's sarcoma is presented. All smears from the fine needle aspirates were performed during the diagnostic investigation before treatment of the patients. The smears were very cellular with relatively small, round to oval tumour cells which appeared rather uniform. Two cell types could be distinguished, however. There was a predominance of relatively light, so-called principal or chief cells, but smaller and darker cells, so-called dark cells, were also observed. We found that Ewing's sarcoma has a characteristic appearance in smears and that fine needle aspiration cytology can be used in its primary diagnosis. A conclusive diagnosis may be made when the clinical and radiographic findings are also consistent.

Adolescent↗
PubMed1985

Flow cytometric light chain analysis of peripheral blood lymphocytes in patients with non-Hodgkin's lymphoma.

Peripheral blood lymphocytes from 96 patients with non-Hodgkin's lymphoma were studied, either at primary staging, during treatment or in follow up. The amount of surface immunoglobulin light chain per cell was determined by direct immunofluorescence staining analysed by flow cytometry. Discrepancy between kappa and lambda fluorescence profiles in the sample was considered to indicate the presence of monoclonal cells i.e., circulating lymphoma cells. The results were correlated with routine haematological findings, histopathology of the lymphoma and tumour burden. Using routine haematological methods leukaemic spread was evident in 24% of the patients in our study. Using kappa/lambda distribution analysis evidence of circulating lymphoma cells was found in an additional 27%. As expected, the major diagnostic gain was in the low grade malignant group, where 30% of the patients with normal peripheral blood according to standard procedures showed evidence of circulating lymphoma cells in the kappa/lambda distribution analysis. The corresponding gain in the high grade malignant group was 19%. In patients with active disease but without morphological evidence of leukaemia, 37% showed abnormal kappa/lambda distributions. In patients in complete remission the corresponding figure was 18%. The clinical significance of small numbers of circulating lymphoma cells is not yet understood, but a possible outlook is to use kappa/lambda distribution analysis to increase staging precision and in the early detection of relapse.

Flow Cytometry↗
PubMed1985

Aspiration cytology of soft-tissue tumors. The 10-year experience at an orthopedic oncology center.

Since 1972, we have included fine-needle aspiration cytology in the pre-operative evaluation of soft tissue lesions referred to our Orthopedic Oncology Group. In 365 consecutive patients the cytodiagnosis was correctly malignant in 66/74 tumors and correctly benign in 260/271 lesions; cytology was non-diagnostic in four sarcomas and 16 benign lesions. The final pre-operative diagnosis should be based on all pre-operative data to minimize the effect of any misjudgement as regards cytodiagnosis; only two of the 19 false cytodiagnoses were of consequence for the patient. We conclude that aspiration cytology used in this way is a valuable adjunct to determine the further management of soft tissue tumors.

Biopsy, Needle↗
PubMed1984

Malignant lymphoma of the testis.

Lymphoma presenting in the testis was evaluated in 24 patients. The tumours were classified according to both the Rappaport and the Kiel classification. The Rappaport classification yielded only two tumour types--15 diffuse histiocytic and 9 diffuse mixed histiocytic-lymphocytic, with no pure lymphocytic lymphoma. No difference in survival time was found between these two tumour types. According to the Kiel classification there were four histological tumour types--immunoblastic (11 cases), centroblastic (2), centroblastic/centrocytic (6) and polymorphic immunocytic (5). In comparison with the other tumour types, the centroblastic/centrocytic lymphomas seemed to be advantageous as regards survival. It is concluded that systemic treatment with chemotherapy in accordance with current principles for malignant lymphoma is indicated following orchiectomy in localised testicular lymphoma as well as in disseminated disease. The value of post-operative radiotherapy to regional nodes is questionable.

Adult↗
PubMed1984

Kinetics of 201Tl uptake in adenomas and well-differentiated carcinomas of the thyroid. A double isotope investigation with 99Tcm and 201Tl.

A visually increased uptake of 201Tl chloride corresponding to a 'cold' (131I or 99Tcm ) thyroid nodule is mostly seen in well-differentiated carcinomas but also often in follicular adenomas. Since a visually increased uptake of 201Tl can be due to an increased initial uptake and/or a delayed elimination, an extended dynamic investigation was performed in patients with well-differentiated carcinomas or with follicular adenomas. Data were collected in a dynamic simultaneous double isotope ( 99Tcm + 201Tl) study up to 50 min after intravenous administration. Adenomas could be significantly separated from carcinomas by the elimination (p = 0.0001), but not by the initial uptake.

Adenoma↗