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R J Lukes

Publications and source records attributed to R J Lukes.

At least 19 recordsLinked to original sources
PubMed1979

[A new functional interpretation of malignant lymphomas. The Lukes-Collins classification and its basis].

The revolutionary developments in immunology have profoundly altered our understanding of malignant lymphomas as tumors of the immune system. The current commonly used classifications of non-Hodgkin's lymphomas do not take this new evidence into account and often contain cytologically heterogenous types. The new functional approach to lymphomas and the classification proposed by LUKES and COLLINS in 1974 separate the malignant lymphomas into better defined cytologic types and relate them to the presently known functional lymphocyte subtypes. It is therefore morphologically more accurate and biologically more meaningful than the present Rappaport nomenclature. This review discusses the morphologic and immunologic foundation of the Lukes-Collins concept and compares their classification with the other major currently used nomenclatures, mainly the one of RAPPAPORT. Special reference is made to the Kiel nomenclature which is very similar to the Lukes-Collins approach and is better known in Europe. Technical methods necessary to apply the Lukes-Collins concept are briefly discussed.

B-Lymphocytes↗
PubMed1979

Immunoblastic sarcoma: a clinical description.

We reviewed the clinical records of 33 patients with Immunoblastic Sarcoma in order to further describe this disease clinically. Several common features were found. Thirty percent of the patients had a history of a prior immune disease or lymphoproliferative malignancy. Forty-four percent of the patients tested had a diffuse hypergammaglobulinemia. Lymphopenia (less than 1,000/mm3) was found in 45%, and anemia occurred in 73%. At initial presentation, 30% of the cases were clinically staged as either stage I or II, whereas 70% were found to be stage III or IV. Forty-nine percent of the patients had systemic symptoms at presentation. The median survival was 14 months. Advanced stage of disease, lymphopenia, and presence of systemic symptomatology were associated with significantly decreased survival times (p less than .05). We conclude that IBS is a clinical entity often associated with prior immune disease and/or diffuse hypergammaglobulinemia.

Adolescent↗
PubMed1979

Childhood leukemia and lymphoma: correlation of clinical features with immunological and morphological studies.

Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.

Adolescent↗
PubMed1979

The immunologic approach to the pathology of malignant lymphomas.

Presentations of malignant lymphomas in the past did not have the benefit of modern developments in immunology and do not bear any relationship to our modern understanding of immunology. The malignant lymphomas in our immunologic approach are regarded as neoplasms of the immune system and involve principally the T- and B-cell systems and alterations in lymphocyte transformation. The cytologic types of our new classification are an attempt to identify specific functional subtypes of the T- and B-cell systems as defective expressions of their normal counterparts. The results of our multiparameter studies on large case series of non-Hodgkin's lymphomas and those of others have demonstrated that the malignant lymphomas for the most part mark as T- or B-cell types, with the exception of a rare lymphoma of true histiocytic type and the unmarked portion of acute lymphocytic leukemia (ALL) of childhood. They have demonstrated the heterogeneity of the cytologic types of the past that possibly account for the diversity of their clinical manifestations and responses to therapy. The immunologic approach has permitted the identification of homogeneous cytologic types that are emerging as clinical morphologic immunologic entities.

B-Lymphocytes↗
PubMed1978

An immunohistological study of immunoglobulin content of primary central nervous system lymphomas.

Paraffin sections of surgical and autopsy material from 24 cases of primary CNS lymphoma were examined for the presence of cytoplasmic immunoglobulin by an immunoperoxidase technique. Definite staining for cytoplasmic immunoglobulin was observed in 13 cases, and in eight of these the pattern of staining was consistent with current concepts of monoclonality. In every case the histological diagnosis of malignant lymphoma was confirmed, and cases were subclassified by both the Lukes-Collins and the Rappaport classifications. Morphologically 12 of the 24 cases resembled immunoblastic sarcoma occurring outside the CNS. Other cases showed features of follicular center cell lymphoma or plasmacytoid lymphocytic lymphoma. Of those cases with positive immunoglobulin staining of tumor cells, the majority showed some plasmacytoid features. It was concluded that the primary CNS lymphomas resemble their counterparts occurring outside the CNS, and that at least a proportion are derived from the B lymphocyte.

Adolescent↗
PubMed1978

Immunoglobulin inclusions in non-Hodgkin's lymphomas.

The occurrence and characteristics of intracellular immunoglobulin inclusions in non-Hodgkin's lymphomas are described. Lymphoma cells from three patients with immunoblastic sarcoma contained classic cytoplasmic, periodic acid-Schiff (PAS)-positive Russell bodies. Immunoperoxidase staining revealed monoclonal IgG (k) in two cases and a polyclonal pattern in the third case, where the tumor evolved from a reactive lesion. Unusual cytoplasmic inclusions were observed in the neoplastic cells of two patients with follicular center cell lymphoma. In one case large globular structures lacking a distinct limiting membrane were seen, while the cells of the other patient contained "signet-ring-like" vacuoles filled with microvesicles. Both were PAS-negative and showed monoclonal immunglobulin staining. In two other cases PAS-positive intranuclear inclusions consisting of monoclonal immunoglobulin IgM(k) could be demonstrated. The possible significance of these findings in B-lymphocyte derived neoplasms is discussed.

Adult↗
PubMed1978

Morphologic and cytochemical comparison of human lymphoblastoid T-cell and B-cell lines: light and electron microscopy.

Human lymphoblastoid cell lines characterized as T- or B-cells by various markers were compared morphologically and cytochemically by light and electron microscopy. Distinct differences in nuclear morphology, amount of cytoplasm, pyroninophilia, and periodic acid-Schiff (PAS) staining enabled us to discriminate between T- and B-cell lines. T-cells had nuclei with an irregular configuration, stippled heterochromatin, and small or absent nucleoli. The scanty cytoplasm of T-cells contained intensely stained, PAS-positive globules and was less pyroninophilic than the cytoplasm of B-cells. B-cells had more rounded, uniform, vesicular nuclei with prominent nucleoli and peripheral heterochromatin. The cytoplasm of B-cells was abundant and strongly pyroninophilic. Transmission electron microscopy generally confirmed these morphologic differences. These findings supported our contention that consistent cytologic features concordant with immunologic markers make it possible to identify certain lymphomas as being of B- or T-cell origin on purely morphologic grounds.

B-Lymphocytes↗
PubMed1978

Convoluted lymphocytic lymphoma in adults: a clinicopathologic entity.

Twelve adults had a distinct clinicopathologic type of malignant lymphoma that closely resembles the mediastinal lymphomas of childhood. Nine patients presented with mediastinal masses, and seven had symptoms related to intrathoracic compression. Seven patients presented with or developed leukemia, and in four of these patients the central nervous system (CNS) became involved. Structurally, the tumor cells had a distinctive stippled chromatin pattern, in addition to the characteristic nuclear convolutions. Tumor cells from five patients were studied immunologically, and, in each case, the tumor cells formed rosettes with sheep erythrocytes. The response to combination chemotherapy was rapid and dramatic, but usually transient, with relapse in the CNS or previously involved sites. The above data strongly suggest that these cases represent a distinct clinicopathologic entity that should be treated similarly to childhood leukemia and lymphoma, with intensive multiple agent induction, CNS prophylaxis, possibly radiation therapy to initially involved sites, and prolonged maintenance.

Adult↗
PubMed1978

A morphologic and immunologic surface marker study of 299 cases of non-Hodgkin lymphomas and related leukemias.

This study relateds the cytologic types of the classification of malignant lymphoma of Lukes and Collins to the results of immunologic surface marker studies as part of a systematic multiparameter study of 299 cases of non-Hodgkin lymphomas. The results support the hypothesis that malignant lymphomas are neoplasms of the immune system and involve the B- and T-cell systems and, rarely, histiocytes. The morphologic features of the cytologic types of Lukes and Collins are predictive of the subtypes of lymphoma and considerably more effective than the immunologic surface marker techniques in identifying homogeneous groups. There are considerable methodologic and interpretive problems that are evaluated in detail. The verification of the B- and T-cell subtypes of the Lukes and Collins classification indicates that the time has come to change from the terminology and classification of lymphomas of the past to a modern immunologic approach.

B-Lymphocytes↗
PubMed1978

Staging laparotomy and splenectomy for Hodgkin's disease.

The major objective of diagnostic laparotomy in Hodgkin's disease is to define the extent of involvement not detectable by nonoperative means. Fifty patients in this institution had operative staging procedures; six for recurrent disease three to 11 years after initial therapy. Twenty-four patients had nodular sclerosis, 23 mixed cellularity, and three had other types. The clinical stages were advanced in 13 patients and decreased in seven patients. Two patients (both had mixed cellularity and systemic symptoms) had positive wedge biopsy of the liver, whereas direct needle biopsy was negative. Nineteen spleens contained Hodgkin's disease but only three could be palpated on physical examination. About half the patients with abnormal lymphangiograms had positive periaortic nodes; lymphangiogram had a false negative rate of 12%. Additional procedures performed included appendectomy, oophoropexy, and resection of Meckel's diverticulum. There was no mortality and only one case had severe postoperative Salmonella septicemia. Our findings are comparable with those reported in the literature.

Adolescent↗
PubMed1977

Hodgkin's disease in siblings.

An incidence survey of Hodgkin's disease in Greater Boston during 1959-1973 detected five sibling pairs under the age of 45. The expected number is 0.7; thus, siblings of young adults with Hodgkin's disease have about a sevenfold excess risk of the disease (P = 0.0008). Eight sibling pairs, not in the incidence series, were also identified. Among all 13 pairs, 12 were sex concordant; the number expected is 6.8 (P = 0.01). The literature includes 46 sibling pairs under 45 of which 30 are sex concordant. The expected number is 23.9 (P = 0.05). Combining the present and the literature series suggests that siblings of the same sex as an affected person have a risk of Hodgkin's disease double that of siblings of the opposite sex. The sex concordance suggests that the excess Hodgkin's disease among siblings of affected persons is due either to inter-personal transmission of an etiologic agent by prolonged or intimate contact or to common-source exposures.

Adult↗