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Biomedical subjects

P Kettle

Publications and source records attributed to P Kettle.

17 recordsLinked to original sources

Bronchiolitis obliterans organizing pneumonia in a patient with non-Hodgkin's lymphoma following R-CHOP and pegylated filgrastim.

Bronchiolitis obliterans organizing pneumonia (BOOP) presents with fever, dyspnoea, pleuritic chest pain and hypoxia. The diagnosis can be made from radiological appearances on chest radiograph and CT scan correlated with histological findings following biopsy. We present a 52-year-old gentleman undergoing treatment for high grade non-Hodgkin's lymphoma who developed respiratory symptoms during chemotherapy. BOOP was diagnosed and he responded well to oral prednisolone. The cause of BOOP is often not certain. However, in this case we suspect pegylated filgrastim or rituximab as possible agents.

Antibodies, Monoclonal↗

Quantitation of monoclonal plasma cells in bone marrow biopsies in plasma cell dyscrasia.

Direct measurement of monoclonal plasma cell mass in bone marrow biopsies may be a useful parameter to establish in plasma cell dyscrasia. In this study monoclonal plasma cells/mm in light chain immunoglobulin immunostained archival bone marrow sections from 22 patients in whom a diagnosis of multiple myeloma (MM) had been excluded but who had monoclonal proteins were counted by two observers at light microscopic level. There was good correlation between the counts of the two observers. The levels of monoclonal plasma cells/mm in biopsies were not related to the % counts in the aspirates taken at the same time as the biopsies. Three of seven patients with biopsy levels in excess of the polyclonal levels in patients without plasma cell dyscrasia developed progressive MM within the observation time. Monoclonal plasma cell levels/mm of bone marrow biopsies can be measured and they provide a useful parameter for the assessment of patients with low volume plasma cell dyscrasia.

Bone Marrow↗

KARMEN time anomaly: search for a neutral particle of mass 33.9 MeV in pion decay

We have searched for the pion decay pi(+)-->&mgr;+X, where X is a neutral particle of mass 33.905 MeV. This process was suggested by the KARMEN Collaboration to explain an anomaly in their observed time distribution of neutrino induced reactions. Having measured the muon momentum spectrum of charged pions decaying in flight, we find no evidence for this process and place an upper limit on the branching fraction eta</=6.0x10(-10) of such a decay at a 95% confidence level.

Journal Article↗

Bone marrow granulomas in infiltrating lobular breast cancer.

A 50 year old woman with a history of infiltrating lobular breast carcinoma presented with back pain. Bone scan and magnetic resonance imaging were not conclusive. A bone marrow aspirate appeared normal. A routine trephine biopsy specimen showed granulomas but no obvious infiltration by carcinoma. Immunohistochemical staining with epithelial markers demonstrated carcinoma cells in the trephine specimen. This case illustrates the difficulty of detecting infiltrating lobular carcinoma in bone marrow and the value of immunological techniques in this context. It also describes the development of bone marrow granulomas as a response to infiltration by carcinoma.

Bone Marrow Diseases↗

Late relapse in IgD myeloma: value of immunohistochemistry in trephine biopsy specimens.

IgD myeloma is a rare disorder with a very poor prognosis. An unusual case is reported where prolonged remission was obtained. Immunohistochemical staining of the bone marrow trephine biopsy specimen proved invaluable in documenting early relapse. It is suggested that immunohistochemistry should be adopted more widely in view of the disparities evident in aspirates and trephines.

Biopsy↗

Myeloma--results of treatment 1986-1990.

Sixty-nine patients with multiple myeloma diagnosed during a five year period at the Belfast City Hospital were followed until death or for a minimum of one year in a retrospective study of survival. Although the patients were unselected, survival data was found to be similar to results from trials in which patient selection had occurred. Overall median survival was thirty-two months. Median survival fell with advancing disease and was 47, 27 and 18 months for Durie-Salmon stages I, II and III respectively. Those patients presenting with a platelet count of < 100 x 10(9)/1 had a median survival of eight months in contrast to those with a platelet count > 100 x 10(9)/1 whose median survival was 36 months. Patients presenting in renal failure had a shorter median survival of 28 months compared to 46 months for those with normal renal function.

Adult↗

Tartrate resistant acid phosphatase positive splenic lymphoma: a relatively benign condition occurring in a time-space cluster?

Conventional light and electron microscopic studies, together with cytochemical and immunocytochemical staining procedures, were carried out to ascertain whether the lymphomata of four elderly female patients living within 10 kilometers of each other, who presented within a short space of time with massive splenomegaly and varying cytopenia, belonged to any particular subgroup of lymphoma. In each case the lymphoma had a diffuse pattern and mature B cell phenotype. The malignant cells were of uniform cell type, slightly larger than admixed polymorphonuclear leucocytes, and showed minimal nuclear irregularity and positivity for tartrate resistant acid phosphatase (TRAP) staining. Their clinical and morphological features were compared with those of other lymphoproliferative disorders, but while sharing some features in common with each condition, this small group of patients seemed to have a unique combination of findings. The cytopenias of all four responded well after removal of the spleen and their disease has not been aggressive. It is concluded that these patients have a distinct subgroup of lymphoma, which it is important to recognise so that inappropriate use of aggressive cytotoxic drugs can be avoided.

Acid Phosphatase↗

A bleeding disorder due to deficiency of alpha 2-antiplasmin.

The investigation of a 33 year old man with a lifelong bleeding tendency is described. Defective fibrinolysis was suspected in 1968, when clinical bleeding was corrected by administration of aminocaproic acid. The paper establishes the diagnosis as alpha 2-antiplasmin deficiency and describes its management with oral tranexamic acid.

Adult↗

Herpes simplex lymphadenitis: a case report and review of the published work.

Viral lymphadenitis may lead to a histological appearance that can simulate malignancy. The histological features of herpes simplex lymphadenitis have not previously been described in detail. We report a case of proved herpes simplex lymphadenitis in a 30 year old man which was characterised by a pronounced proliferation of immunoblasts. The microscopical findings are described and the published work is reviewed.

Adult↗