Biomedical subjects
Publications and source records attributed to M I Goldwein.
The case of a sixty-five-year-old man with multiple myeloma and a testicular plasmacytoma is described. This represents the thirty fourth reported case of testicular plasmacytoma and the first in which immunoperoxidase histochemistry has been used to demonstrate that the testicular plasma cells contain immunoglobulin of the same isotype as the patient's paraprotein. The clinical and morphologic features of previously reported testicular plasmacytoma are reviewed.
A patient had prolonged survival after renal transplantation was performed for myeloma kidney. Continued function of the allograft without evidence of recurrent myelomatous involvement suggests that transplantation be considered for patients with multiple myeloma in whom renal failure constitutes the major problem.
A patient with Waldenström's macroglubulinemia had the unique feature of having one kidney infiltrated with malignant cells to such an extent as to produce a large palpable abdominal mass. Other unusual aspects of this case include the destruction of renal tubules by the invading cells that resulted in interstitial fibrosis and was probably responsible for the appearance of whole IgM in the urine.
A description of the clinical and biochemical course is given for a patient who developed haemolysis and methaemoglobinaemia following dapsone therapy in high dosage for 2 weeks.
A patient with widespread metastatic breast cancer had thrombocytopenia and severe anemia due to splenic hyperfunction, confirmed by chromium51-labeled red cell survival and sequestration studies. Marked splenic enlargement was produced by metastatic tumor. After she failed to respond to steroids, her hematologic status was improved by splenectomy, and has been stable for 16 months. Hypersplenism may be suspected as a cause of severe hemolytic anemia in advanced carcinoma. If the patient's general status is otherwise compatible with long comfortable survival, appropriate diagnostic studies and consideration of splenectomy are warranted.