[The 150th birthday of Moriz Kaposi (1837-1902)].
Explore the source record for details and available documents.
Austria↗
Biomedical subjects
R Pappenberger
Publications and source records attributed to R Pappenberger.
Lymphoproliferations in the bone marrow: identification and evolution, classification and staging.
Bone marrow biopsies from 3229 patients with lymphoproliferative disorders and 1156 patients with benign or reactive lymphoproliferations were investigated and criteria for distinguishing between them are given. Bone marrow involvement was found in 89% of multiple myeloma, 64% of non-Hodgkin's lymphomas and 8% of Hodgkin's disease. According to the predominant proliferative cell type there were five major entities in multiple myeloma and non-Hodgkin's lymphomas: (1) plasmacytic; (2) lymphocytic; (3) hairy cell; (4) immunocytic; (5) centrocytic. These were further classified into distinct subtypes each of which had independent prognostic significance. The mode of spread of the lymphoproliferative disorders in the bone marrow showed one of six architectural patterns, which together with the quantity of infiltration in the biopsy (reflecting the tumour cell burden) had significant predictive value. These results demonstrate the value of bone marrow biopsies in the identification, classification and staging of lymphoproliferative disorders, as well as in monitoring the course of disease and the response to therapy.
Bone Marrow↗
Bone marrow histology in Waldenström's macroglobulinaemia. Clinical relevance of subtype recognition.
Bone marrow biopsies of 137 patients with Waldenström's macroglobulinaemia (WM), 26 with non-secretory immunocytoma and 32 with benign monoclonal gammopathy were processed for histologic evaluation. Bone marrow involvement was found in 110 (80%) initially, and in 24 (18%) in sequential biopsies. 3 types were distinguished: lymphoplasmacytoid (47%), lymphoplasmacytic (42%) and polymorphous (11%) with median survivals of 74, 25 and 12 months, respectively. When grouped according to the tumour cell mass in the biopsies, the median survivals were 55, 21 and 8 months for less than 20 vol%, 20-50 vol% and greater than 50 vol% respectively; in each subtype, the tumour cell mass correlated with the disease progression. 6 clinical variables were also found prognostically significant. These results demonstrate that (i) 98% of patients with WM have bone marrow involvement; (ii) the lymph node sub-classification is applicable to the bone marrow and has both clinical and prognostic significance; (iii) patients may be staged according to the tumour cell burden in the bone marrow biopsy.
Adult↗
Assessment of bone marrow histology in Hodgkin's disease: correlation with clinical factors.
Bone marrow biopsies of 491 untreated and 170 treated patients with Hodgkin's disease (HD) were investigated. Marrow involvement was found in 10% and 25% respectively. Positive biopsies were rare in clinical stages I and II (1% and 2%), but the incidence rose to 25% and 45% in stages III and IV. HD patients with nodular sclerosis in lymph node histology had a low incidence of bone marrow involvement (4%), while those with lymphocytic depletion had a high incidence (22%). Of nine clinical and six histological parameters tested, bone marrow involvement proved to be the most significant predictive factor indicating an unfavourable course. Moreover, classification of the bone marrow manifestations according to the degree of lymphocytic infiltration, proved to be simple, reproducible and prognostically significant. Normal haematopoietic tissue was found in only 20% of the negative biopsies of untreated patients. The remaining 80% were characterized by a variety of non-specific reactions. These included marrow hypoplasia and leukaemoid and exudative reactions each of which indicated a poor prognosis; and epithelioid-cell granulomas and lymphoid nodules which predicted favourable survival curves. Adequate bone marrow biopsy is a valuable part of the investigation of patients with HD, as both positive and negative biopsies provide information of prognostic significance.
Adolescent↗