Biomedical subjects

T Papadakis

Publications and source records attributed to T Papadakis.

7 recordsLinked to original sources

PubMed1998

The use of large loop excision of the transformation zone in management problems of cervical intraepithelial neoplasia.

We studied 2 groups of women whose management is controversial: those with cervical intraepithelial neoplasia (CIN) grade 2 or 3 on smear, but only CIN grade 1 or no abnormality on target biopsy (Group 1), and those with persistent CIN grade 1 on smear and up to CIN 1 on biopsy (Group 2). We set out to assess whether large loop excision of the transformation zone (LLETZ) was an acceptable method of treating these 2 groups of women. A review of 100 consecutive patients was undertaken. There were 71 women in Group 1 and 29 women in Group 2. The LLETZ procedures were performed under local analgesia and no immediate problems were encountered. Delayed haemorrhage requiring vaginal packing and admission to hospital occurred in 1 patient. In Group 1, histopathology of the LLETZ biopsies showed CIN 2 or 3 in 29 (40.8%) of the women, CIN 1 in 24 (33.8%) and no CIN in 18 (25.3%), and in Group 2, CIN 2 or 3 was seen in 5 (17.2%) of the women, CIN 1 in 11 (37.9%) and no CIN in 13 (44.8%). At 12 months completed follow-up, 4 patients in Group 1 had recurrent CIN 1 or equivocal CIN 1 and 1 patient from Group 2 had recurrent CIN 1, giving an overall recurrence rate of 5 of the 94 patients who completed follow-up (5%). We concluded that LLETZ was a useful procedure in both groups. In Group 1 the provision of a histological diagnosis on the LLETZ biopsy was a check on the accuracy of the cervical smear report. In Group 2, LLETZ offered the advantage of rapidly returning the smear to normal in most patients, and the diagnosis and treatment of those women who actually had a high-grade lesion.

Adolescent↗

PubMed1996

Secondary malignancies in a child with Hodgkin's disease: T-cell lymphoma and myelodysplastic syndrome evolving into acute nonlymphoblastic leukaemia.

Hodgkin's disease (HD) has been linked to an increase risk of second malignant neoplasms (SMN), especially non-Hodgkin's lymphoma (NHL) and acute nonlymphoblastic leukaemia (ANLL). The mutagenic property of cytotoxic therapy as well as defective immunity have been implicated as playing a major role in the development of SMN in patients previously treated for HD. We report a case of a 14-year-old girl with HD who developed two different second malignancies within a latent period of 28 months following HD diagnosis. The patient presented initially with bilateral cervical and supraclavicular as well as mediastinal and paraaortic lymphadenopathy. She was staged as IIIA, nodular sclerosing type HD, and was given eight alternative cycles of MOPP-ABVD followed by "mantle" field radiotherapy to a total dose of 3.3 Gy plus 0.4 Gy to the upper mediastinum. Within 8 months following the completion of therapy, a period of myelodysplasia and progressive severe immune deficiency, considered as a result of initial treatment, occurred. Eighteen months after HD diagnosis while the patient was continuously neutropenic and heavily immunocompromised, a peripheral T-cell lymphoma of the angiocentric immunoproliferative lesion type (AIL) Grade III, appeared in both lungs within and beyond the radiation field, with no evidence of HD in biopsy specimens. After institution of a new chemotherapy regimen (L17M), a satisfactory response regarding NHL lesions was noted. However, 10 months later the myelodysplastic syndrome (MDS) accompanied by complex chromosomal abnormalities evoluted to frank ANLL with a rapid fatal course. This case supports the hypothesis that combined modality treatment accompanied by severe immunodeficiency may result in the development of multiple second malignancies even within a very short latent period, especially in a subgroup of HD patients who may be particularly increased risk of second cancers.

Acquired Immunodeficiency Syndrome↗

PubMed1987

Persistent active Epstein-Barr virus infection and atypical lymphoproliferation. Report of two cases.

Two cases of what is apparently Epstein-Barr virus (EBV)-associated atypical lymphoproliferation which clinically suggested malignant lymphoma are discussed. Immunohistology revealed polyclonal T- and B-cell proliferation resembling progressive infectious mononucleosis. Giant cell formation and marked plasmacytosis was suggestive of Hodgkin's disease. EBV serology was initially not diagnostic, but during the course of the disease, elevated titers against early antigens and EBV-associated nuclear antigen suggested virus replication. EBV DNA was demonstrated in lymphoid cells of both cases by in situ hybridization. One case progressed to overt monoclonal B-cell malignant lymphoma. Atypical polyclonal lymphoproliferation in persistent active EBV infection may thus be considered a prelymphomatous condition.

Antigens, Viral↗

PubMed1984

[Special pathologico-anatomical aspects of AIDS--acquired immune deficiency syndrome].

Data from morphologic and immunologic follow-up studies are presented of ten patients with AIDS. The sequence of morphologic lesions in lymph nodes proceeds from an initial marked hyperplasia of T- and B-zones (follicular hyperplasia with plasmacytosis and diffuse paracortical hyperplasia) to paracortical atrophy with reactive reticulo-histiocytic hyperplasia and to a late irregular B-cell hyperplasia with effacement of lymph node structure. These changes are accompanied immunocytological by a polyclonal increase in B-Lymphocytes while T-helper cells (TH) and T-suppressor cells (TS) initially exhibit a normal 2:1 ratio, an inversion of the TH/TS ratio is observed in advanced stages. Inversion occurs at the time when paracortical atrophy becomes evident in lymph nodes. Pathogenetically, persistent virus infections and a self-sustaining disturbance of immune regulatory mechanisms are discussed.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Classification and differential diagnosis of 20 problem cases of occidental malignant T-cell lymphomas.

Twenty malignant T-cell lymphomas are described in which the initial histological diagnosis was equivocal. Among lymphoma entities initially falsely interpreted on pure morphological grounds were Hodgkin's disease, lymphoepithelioid cellular lymphoma, immunoblastic lymphoma with epithelioid cells, malignant histiocytosis, histiocytosis X, centroblastic lymphoma, undifferentiated carcinoma, and undifferentiated tumour. Variations in the expected mean survival of initially diagnosed tumours and T-cell lymphomas confirm the need for immunohistological cell typing in lymphoma classification.

Adolescent↗

PubMedDate not supplied

Non-Hodgkin's lymphomas: a simplified classification scheme.

1,292 cases of malignant Non-Hodgkin's lymphomas were classified according to the Rappaport and Kiel classifications and to the New Working Formulation for Clinical Usage (NWF). Subsequently, all lymphoma entities were grouped together following the simple criteria of cell size and growth pattern (small cell, large cell, and mixed cellularity; nodular and diffuse growth). Supplementing these morphological criteria, were data from immunological and cytochemical cell marker studies. The accumulated information was correlated to clinical-prognostic parameters. The results show that using above simplified criteria, all Non-Hodgkin's lymphomas can be classified according to a simple scheme which is of clinical relevance. It can further be deduced from all currently used lymphoma classifications, avoids confusion, and offers abbreviated data useful for computer storage.

Humans↗

PubMedDate not supplied

Environmental pollution and malignant lymphomas: a tentative contribution to geographic pathology.

The present study reports of the geographic distribution of 2,878 cases of uniformly classified malignant lymphomas and of 2,349 similar cases from the literature. Data on histological entities are compared with the geographic and socio-economic characteristics of the regions where they preferentially occur. The results provide three patterns in lymphoma distribution: small cell lymphocytic lymphomas are frequent among populations of European extraction and in farming rather than industrial regions. Lymphomas derived from cells of the germinal center are seen preferentially in so-called "underdeveloped countries", and large cell (immunoblastic) lymphomas appear rather characteristic of industrial areas. Besides genetic influences (rare chronic lymphocytic leukemia (CLL) in Asia as compared to Europe), the results suggest environmental cofactors in the pathogenesis of malignant lymphomas. CLL is more frequent in areas with rather low-dose chronic toxic influences such as from the use of fertilizers and pesticides in farming. Germinal center cell lymphomas tend to occur more frequently in countries with nutritional and hygienic deficiencies with frequent infectious diseases. Large cell high malignancy lymphomas apparently prefer highly industrialized regions with pollution of water supplies by more toxic and immunosuppressive substances.

Climate↗