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Volume 22, Issue 6
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[in Japanese], [in Japanese]1981 Volume 22 Issue 6 Pages 753-756
Published: 1981
Released on J-STAGE: January 26, 2009
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Isao TAKAHASHI, Fumikazu KOHI1981 Volume 22 Issue 6 Pages 757-765
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIn this paper, clinical and hematological characteristics of hypoplastic acute myelocytic leukemia (Hypoplastic AML) were studied and following were obtained as conclusions.
(1) Hypoplastic AML was more frequently observed in male and elder patients and its increase during these years was suspected to be due to the increase of aged persons in population.
(2) Some of hypoplastic AML showed hypoplastic preleukemic stage for relatively long time, therefore, it appears that there are some relationships between hypoplastic preleukemic stage and hypoplastic AML.
(3) Hypoplastic AML was characterized by mild physical findings such as fever, bleeding tendency and organomegaly. It was also characterized by pancytopenia with relative lymphocytosis and lack or low percentage of leukemic cells in peripheral blood.
(4) Leukemic cells in bone marrow were not always in low percentage. Relative erythroid hyperplasia and increase in III type sideroblasts were thought to be one of hematological characteristics in hypoplastic AML.
(5) Hypoplastic AML was frequently observed in elderly patients, however, it was quantitatively different from typical AML in elderly patients.
(6) The clinical course of hypoplastic AML, particularly in elderly patients, was relatively slow and stational, therefore, it appears that there are some relationships between hypoplastic AML and smouldering acute leukemia.
(7) Host factors such as age, sex and immune response and cellular factors such as cell kinetics are thought to contribute clinical and hematological characteristics of hypoplastic AML.
(8) Chemotherapeutic response of hypoplastic AML appeared to be different between elderly and non-elderly patients, therefore, stratification by age should be done in clinical management of hypoplastic AML.View full abstractDownload PDF (660K) -
Hitoshi WADA, Hideyo KATSUNUMA1981 Volume 22 Issue 6 Pages 766-767
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIt is thought that leukemia of the elderly seems to be somewhat different from that of the young, clinically as well as hematologically. In order to elucidate characteristic features and hematological findings, a study of 73 cases of leukemia in patients aged over 60 were examined and compared with younger cases aged below 50. Among the 73, 37 cases were acute myelocytic leukemia, with 26 of the 37 were typical, while the rest were atypical types. Clinically, the younger group complains of distinct anemia, fever, and bleeding tendency with acute onset within two months, while in the aged group, marked fatigue with obscure onset of more than two months prior to diagnosis was made. However, most of the atypical type group had anemia.
Hematologically, the aged group was more anemic than the younger group, but no difference between atypical and typical types was found. Most of the atypical types showed leukopenia with thrombopenia less than 3,000 and 50,000, respectively.
Bone marrow findings revealed outstanding hypoplasia with a low percentage of myeloblasts, some present as aplastic anemia, or progress smouldering course (smouldering leukemia).
Morphologically, blasts in these typical types were multifaceted having monocytoid, or micromyeloblastic and megaloblastoid cells as well as giant erythroblasts. Regarding the treatment and survival time, the atypical type group treated with more than two antileukemic agent survival a shorter time than the group giving a single drug.
Concerning the complications, infection and bleeding were of a higher incidence and the younger group tended to have GI bleeding; on the contrary, the aged group displayed cerebro-vascular bleeding.
Knowing these characteristic findings as compared with the young, in the treatment of the aged it is necessary to consider the effects of leukemic cells and the regeneration of hemopoiesis.
Further, new treat methods of the elderly with leukemia, especially the atypical type, are discussed.View full abstractDownload PDF (152K) -
Jun TSUCHIYA, Shogo SHINONOME, Masamichi TAKAKUWA, Hirokazu MURAKAMI, ...1981 Volume 22 Issue 6 Pages 768-777
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIn order to elucidate the cytokinetic characteristics of blast cells in atypical leukemia, the clinicopathological analysis of refractory anemia with an excess of myeloblasts (RAEM) was carried out with special reference to blast cell kinetics.
Cases with RAEM were tentatively divided into two groups according to blast cells (myeloblasts and promyelocytes) percentage; group A ≤20% and group B>20% of total marrow nucleated cells. The cytokinetic data of blast cells were compared with those of blast cells in overt acute myelocytic leukemia. The results herein are as follows: (1) the proportion of abnormal circulating neutrophils lacking myeloperoxidase and/or naphthol-ASD-chloroacetate-esterase activities were increased significantly in RAEM. This indicates that the capability of blast cells in RAEM for differentiation and maturation may be one of contributing factors to smoldering nature of the disease. (2) the lowed proliferative activity of blast cells, in spite of low percentage in the marrow, appears to be an additional significant factor. (3) since the blast cells in RAEM group B showed similar proliferative characteristics with that of overt leukemia, it is the problem to be solved in the future whether RAEM group A is to be included in the same category to group B. (4) the serum level of lysozyme was higher in RAEM than in acute myelocytic leukemia, suggesting the presence of significant ineffective granulopoiesis. But this awaits the better quantitative approach for analysis of ineffective granulopoiesis.View full abstractDownload PDF (692K) -
Masahiro MIKI1981 Volume 22 Issue 6 Pages 778-780
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe bone marrow scintigraphy utilizing Tc-99m sulfur colloid was performed. The studied cases were 73 cases, including 20 of aplastic anemias, 6 of atypical aplastic anemias, 4 of hypoplastic leukemias, 1 of smoldering leukemia and 42 of leukemic related disorders.
In hematologically normal subjects, active bone marrow was visualized in the skull, sternum, vertebrae, pelves and in the head of the humeri and femurs.
Abnormal islands like spots accumulations of Tc-99m sulfur colloid in the tibiae and humeri were visualized in the cases of hypoplastic leukemias and the same features were also observed in the cases of atypical aplastic anemias. These findings were not observed in other leukemias and aplastic anemias, but in the latter cases these islands like spots in the pelves were often seen. These abnormal features seem to indicate clonal relation ships between these two disorders.
The bone marrow scintigraphy utilizing Tc-99m sulfur colloid may be of great value as a differential diagnostic procedure in the hypoplastic hematopoietic disorders.View full abstractDownload PDF (592K) -
Yoshiko SAITO, Yoshiro UZUKA1981 Volume 22 Issue 6 Pages 781-788
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSBone marrow from 10 patients with atypical leukemia was cultured with conventional agar culture method using PHA-LCM and feeding culture method. Qualitative studies of CFC and cluster forming cells were performed. They include cytological, cytochemical and immunological examination of all colonies and determination of the fraction of CFU-c in S phase. The results showed an absence of colony formation in one and decreases colony formation in 7 patients with atypical leukemia. All colonies developed were granulocytic and/or macrophagic colonies. At the seventh day of incubation, almost all CFC were already matured with a predominance of metamyelocytes and mature granulocytes. Blast cell colony was never seen despite extensive studies.
Some of the patients showed markedly disordered CFC and CSA and lowering suicide index, suggesting impaired proliferation and differentiation of pluripotent stem cells. In some patients, early degeneration and premature death of CFC was observed, suggesting the possibility that there might exist defects of cellular maturation.
These qualitative culture studies may serve to define more precisely the true nature of the disease.View full abstractDownload PDF (513K) -
Masuko TAGAWA, Yu TOMONAGA1981 Volume 22 Issue 6 Pages 789-791
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSCytogenetic study on bone marrow cells of 13 patients with atypical leukemia was performed at the initial examination of the patients using banding technique. Chromosomal abnormalities were observed in 3 patients; respectively missing Y, t (8; 21) and? 5p-with multiple change. In all of the 3 patients the abnormal cells coexisted with normal diploid cells. The missing Y was probably associated with cellular aging process. Clonal evolution of the karyotype could not be observed in 11 patients for whom serial cytogenetic analysis were obtained.View full abstractDownload PDF (176K) -
Takayuki TAKAHASHI, Shiro NAKAYAMA, Takashi HOSHINO1981 Volume 22 Issue 6 Pages 792-800
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSCharacteristics of cellular immunity in atypical leukemia was investigated in order to clarify the role of immunocompetent cells to the development of unusual and unique hematological features of this particular type of leukemia. The results are summarized as follows.
1) Higher positive rate of tuberculin test was demonstrated than that in overt leukemia, which suggested a well-preserved hypersensitivity reaction to recall antigen.
2) Circulating lymphocytes showed normal subpopulation constitutions, normal rate of T-cell subsets and normal phytomitogen responsiveness, despite a presence of lymphocytopenia. These results indicated a well-maintenance of lymphocyte populations and constitutions.
3) An increase in phytomitogen response of lymphocytes following 7 days' unstimulated preincubation was within the normal range, which meaned a presence of residual physiological suppressor cells.
4) Suppressive effects by co-cultured patients' circulating lymphocytes was demonstrated on the growth of allogeneic normal CFU-C and PWM-induced Ig production of allogeneic normal lymphocytes. The results suggested a well-preserved ability to induce suppressor lymphocytes in response to various immunological stimulations including blood transfusion.
5) A slight suppressive effect on the own abnormal CFU-C colony and cluster formations (leukemic growth) was shown by co-cultured autologous T-cells. The results suggested surviving of intercellular control mechanism between immunocompetent cells and leukemic clone in this type of leukemia.
6) NK cell activity against cultured cell line of human origin (K-562) was within or close to the normal ranges. The results indicated a persistence of NK effector activity in contrast to its nearly absence in overt leukemia.View full abstractDownload PDF (625K) -
Kunihiko ISHITANI1981 Volume 22 Issue 6 Pages 801-804
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSLevels of each class of serum immunoglobulin were studied in 9 patients with hypoplastic leukemia in order to clarify the immunologic capability of those patient in comparison with overt leukemia. Levels of γ-globulin and IgG were within normal range with the mean of 1.32g/dl and 1,120mg/dl respectively. The mean value of IgA and IgE were also within normal limits. Therefore serum immunoglobulin have yielded no specific abnormalities. In addition to this, serum immunosuppresive activity and serum blocking factor were studied. Sera from the patients with hypoplastic leukemia have weak immunosuppressive activity as compared with overt leukemia. Alpha-2-macroglobulin, alpha-1-antitrypsin consist of part of immuno-suppressive factors. Serial estimation of serum blocking factor revealed unique fluctuation in the course of atypical leukemia.
It is postulated that assay of humoral immunosuppressive factors could be useful to evaluate the status of immunological conditions in the patients with hypoplastic leukemia.View full abstractDownload PDF (272K) -
(a) How to be treatedYukio KATO, Hisamitsu SUZUKI, Kazumasa YAMADA1981 Volume 22 Issue 6 Pages 805-813
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe clinical course and management of 141 cases of atypical leukemia were examined. Their median age was 58 years, and about two-thirds of them were male. On the basis of the cellularity in the bone marrow, atypical leukemia could be subdivided into three types; hypocellular, normocellular and hypercellular. The cellularity of 136 cases were judged from their bone marrow films; hypocellular type were 30 cases, normocellular type 48 cases and hypercellular type 58 cases. The median survival length was not so much different among these three types. But in case of hypocellular type, both neutrophil counts less than 500/cmm and platelet counts less than 8.0×104/cmm were very poor risk factors. Their median survival was only four months.
Once the percentage of leukemic cells reached 30 percent or more, the subsequent median survival was only 3∼5 months irrespective of type of atypical leukemia, even if they were on chemotherapy. However, concerning the cases who had intensive chemotherapy such as DCMP, COAP or VEMP etc., 20∼30 per cent achieved complete remission, and their median remission duration was eight months, comparable with that of the typical acute non-lymphocytic leukemia. These findings suggest that intensive chemotherapy should be attempted when the percentage of leukemic cells exceeds 30 per cent in the bone marrow.View full abstractDownload PDF (562K) -
Masafumi KAWATO, Ryuichi TAKAHASHI1981 Volume 22 Issue 6 Pages 814-822
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe management and clinical course of our 29 cases of atypical leukemia were analyzed.
Twenty-two patients were managed conservatively. Eleven of 22 patients remained atypical leukemia, while the remainders developed overt leukemia. Three patients were treated with combined administration of two drugs, 6-mercaptopurine and cyclophosphamide or methotrexate. None of them entered remission and one patient developed overt leukemia. Four patients were treated with VEMP-therapy. Among them, one patient entered complete remission and one entered partial remission.
The incidence of infection in the patients with atypical leukemia treated with anti-leukemic drugs was more frequent than that in the patients with typical acute myelogenous leukemia treated with DCMP-therapy.
As the result of review of literatures on 35 cases of atypical leukemia reported in Japan, 32 cases were treated with conservative therapy, two cases with small doses of 6-mercaptopurine and one case with combination chemotherapy.
Atypical leukemia often attacks the aged, the marrow is frequently hypoplastic and intensive combination chemotherapy is also frequently associated with severe infection and hemorrhage. Therefore, conservative therapy or mild anti-leukemic chemotherapy seems to be better in the treatment for such patients.View full abstractDownload PDF (606K) -
—Pathological Characteristics—Keiichi NEMOTO, Yoshihisa OHNISHI1981 Volume 22 Issue 6 Pages 823-826
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe authors studied 56 autopsy cases of atypical leukemia and classified them clinicopathologically.
I: Hypoplastic or moderate cellular type
A. Atypical aplastic anemia
B. Hypoplastic leukemia
C. Others
II: Hyperplastic type
A. Aplastic anemia which terminated in overt leukemia
B. Hypoplastic leukemia which terminated in overt leukemia
C. Myeloproliferative type
a. Panmyelosis
b. CML-like condition
c. Others
Though there were 28 cases which terminated in overt leukemia, histologically severe leukemic cell infiltration was recognized in only 9 cases and mitotic figures were scanty. The authors consider the proliferated ability of leukemic cells in atypical leukemia to be poor except in a few cases.
Pathologically severe fungus infection was frequently noticed in the hypoplastic type.
In therapy, it is important to grasp the nature of the sickness sufficiently.View full abstractDownload PDF (239K) -
[in Japanese], [in Japanese]1981 Volume 22 Issue 6 Pages 827-831
Published: 1981
Released on J-STAGE: January 26, 2009
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—Two Autopsied Cases and a Revew of the Literature—Manabu MUSASHI, Junichi KATAHIRA, Riichi KURANE, Sachie ONO, Tamotsu M ...1981 Volume 22 Issue 6 Pages 832-843
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTwo autopsied cases of Philadelphia chromosome (Ph1)-positive acute myelogenous leukemia (AML) are reported, and the pertinent literature is reviewed. The cases, a 69-year old Japanese male and a 60-year-old Irishman, were admitted for further examination of leukocytosis.
On admission, either marked splenomegaly or basophilia was not found, while the proliferation of blasts in peripheral blood and bone marrow was remarkable. These blasts were positive to peroxidase and sudan black B staining. Neutrophile alkaline phosphatase score remained within normal range in one patient and slightly decreased in another.
Chromosomal analyses of bone marrow cells showed hypodiploidy with Ph1 in almost all metaphases, and the karyotypes were [45, XY, -7, t (9; 22)] and [45, XY, -18, t (9; 22)], respectively. It might be suggested that both of them could be diagnosed as Ph1-positive AML, whereas these monosomies were very rare in the blastic crisis of chronic myelogenous leukemia (CML).
One survived for 4 months instead of no response to therapy, while 10 weeks' complete remission was induced in the other by combination chemotherapy consisting of vincristin, cytosine arabinoside, 6-mercaptopurine and prednisolone. During the remission, no characteristic features of chronic phase in CML were observed. The normal karyotype could not be identified during the remission, because of no bone marrow cells in metaphase. He survived for 7 months after diagnosis.
From 31 cases of Ph1-positive AML identified by banding analysis in the literature some characteristic features were deduced as follows; 1) lack of marked splenomegaly, 2) lack of basophilia, 3) mosaic consisting of Ph1-positive and Ph1-negative cells, 4) occasional disappearance of Ph1-positive cells during remission, 5) high incidence of an unusual translocation of Ph1, and 6) characteristic additional chromosomal aberrations.View full abstractDownload PDF (1288K) -
Part 1: Platelet Aggregation, Volume and Microviscosity in Diabetes Mellitus Treated with Diet, Antidiabetic Agent and InsulinKazuko HIRAMATSU, Hiroyuki NOZAKI, Shigeru ARIMORI1981 Volume 22 Issue 6 Pages 844-848
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPlatelet aggregation induced by 10-6M ADP and 1 μg collagen, volume, microviscosity and molar ratio of free cholesterol to phospholipid of platelets were investigated in three groups of 18 diabeic patients treated with diet alone, 6 with antidiabetic agent (glybenclamide) and 6 with insulin.
Platelet volume was larger in insulin group and smaller in antidiabetic group than diet alone. The volume of the platelets correlated significantly to the ADP induced aggregation in total diabetic patients.View full abstractDownload PDF (353K) -
Part 2: Compositional Changes of Lipid in Hyper-aggregation PlateletsKazuko HIRAMATSU, Hiroyuki NOZAKI, Shigeru ARIMORI1981 Volume 22 Issue 6 Pages 849-854
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPatterns of platelet aggregation induced by 10-6M ADP were classified as the normo-aggregation group which demonstrated a primary aggregation curve alone, and the hyper-aggregation group which had primary and secondry curve in 14 and 13 patients with diabetes mellitus, respectively.
Platelet lipid, volume, MDA production, adenine nucleotide release and microviscosity were examined and compared between two groups.
The hyper-aggregation group had a larger volume and higher release of adenine nucleotide than the normo-aggregation group, although there was no significant difference between two groups on incidence of retinopathy and levels of serum lipids and fasting blood sugar.
Higher amount of free cholesterol, higher ratios of phosphatidylethanolamine to phosphatidylcholine and sphingomyelin to phosphatidylcholine and higher molar ratio of free cholesterol to phospholipid were characteristic in the hyper-aggregation group than those of normo-aggregation group.
These results indicate that membrane lipid of the platelets played a main role to activate the platelet function in diabetes mellitus.View full abstractDownload PDF (372K) -
Tomihiro KAWASAKI, Shinzo KUBOTA, Kiyoshi TAKAGI, Genyo TANKE, Yukio Y ...1981 Volume 22 Issue 6 Pages 855-861
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESS(The present investigation deals with the observation of deformability of erythrocytes in normal subjects and patients with hereditary spherocytosis (HS).
Furthermore, the effect of chlorpromazine and anti-sickling agents on erythrocyte deformability was also studied in vitro. We have improved the Reid's filtration technique for the determination of erythrocyte deformability.
It was revealed that the deformability index (D. I.) decreased in patient with HS and the D. I. increased in vitro by the addition of pyridoxal phosphate (PAL-P) to the blood from the patients with HS. When erythrocytes from normal subject were incubated with chlorpromazine for one hour at 37°C, the erythrocytes treated as mentioned above changed to the same shape as well as spherocytes and the D. I. of the treated erythrocyte was decreased.
An addition of PAL-P to the medium with chlorpromazine-induced spherocytes improved their D. I. and these erythrocytes changed into stomatocytes. These results suggested that anti-sickling agents as PAL-P might be clinically useful for the improvement of decreased D. I.View full abstractDownload PDF (719K)
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Yasusuke ONOZAWA, [in Japanese], Yasushi YAHARA, Kiichi SAITO, Keji KI ...1981 Volume 22 Issue 6 Pages 862-870
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 42-year-old female was presented herself with various skin lesions, such as erythema, papules, and subcutanious nodules. Physical examination on admission showed generalized lymphoadenopathy, hepatosplenomegaly, multiple erythematous skin nodules and chylous ascites. And also increased abnormal lymphocytes were noted in peripheral blood. A diagnosis of Sézary Syndrome was made by skin biopsy which revealed Pautrier's microabcess. This patient was treated with prednisolone and cyclophosphamide, but she developed disseminated cryptococcosis. Cryptococci were found in ascites, pleural effusion and cerebrospinal fluid. 5-fluorocytosine and amphotericine B were administered, however, cryptococci were not eradicated throughout the course. Finally she developed diffuse pulmonary lesion on chest x-ray, and suffered from severe respiratory distress without any response to high dose prednisolone, and demised. The cytochemical, chromosomal and electromicroscopic studies of Sézary cell were performed. And immunological examinations, including T and B cells, delayed hypersensitivity and PHA blastogenesis were done.
Before chemotherapy peripheral leukocytes counts increased to 67,000/mm3 and more than 90% of these leukocytes were Sézary cells. 94% of these tumor cells were T-cells and 3% of these were B-cells. These cells were positive with PAS and acid phosphatase staining. Electromicroscopic findings of these tumor cells were characteristic of Sezary cells which demonstrated cerebriform nucleus and clustered dense body. Sézary Syndrome, mycosis fungoides and other related T-cell lymphoma were discussed.View full abstractDownload PDF (962K) -
Yozo SHIMIZU, Shigeru ARIMORI1981 Volume 22 Issue 6 Pages 871-877
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 53-year-old female had been noticed proteinuria and hyper-tension since 1977 and developed renal failure and was treated with hemodialysis since October 19, 1978.
She was admitted to the Tokai University Hospital because of right exophthalmos on November 5, 1979. On admission physical examinations revealed right exophtahlmus, a huge conglomerated tumor sized 21.5×10.5cm. in pelvic cavity. Laboratory examinations demonstrated Hb 5.2Gm./100ml., ESR 160mm/hour, BUN 110mgm./100ml, total protein 8.4Gm./100ml., IgG 404mgm., IgA 24mgm., IgM 18mgm. and IgD 1,900mgm/100ml., positive λ type Bence Jones protein, 15.6% plasma cells in a sternal marrow aspirate, and punched out lesions in the skull X-ray film. Amyloidosis was excluded by intestinal biopsy.
Serum electrophoresis and agar immunoelectrophoresis demonstrated M protein identified as IgD (λ). Solid tumors in the right orbit, right lung and plevic cavity were detected by computer tomography scanning and tomography.
It was interesting that the tumor in the pelvic cavity was the largest in its size so far reported in the patients with IgD multiple myeloma at least in Japan. The tumor in the pelvic cavity was histopathologically confirmed as the extramedullary plasmacytoma. A combined chemotherapy using prednisolone, melphalan, cyclophosphamide and vincristine was begun and it was so effective that the plevic tumor could not be palpable in June 1980.
No report so far has been made in Japan on an orbital tumor in patients with IgD myeloma.View full abstractDownload PDF (1121K) -
Michio KUWAHARA, Namiki IZUMI, Shozo MIYAKE, Wei-Chia CHEN1981 Volume 22 Issue 6 Pages 878-884
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe patient was a 56-year-old man who had been exposed to the atomic bomb within 1km from the hypocenter when he was 22 years old in Hiroshima in 1945. After the expsure, general malaise and nausea were observed for three months. In 1970, non-Hodgkin's lymphoma (NHL) (diffuse, histiocytic) of the cervical lymph node (Stage I) occurred. Radical operation was performed and followed by the radiotherapy (6,000 rad, 200 KV X-ray) for five weeks. Thereafter, the patient had been asymptomatic and hematologically normal except that the radiotherapy (7,000 rad, cobalt-60) was delivered again for a right axillary mass lesion which occurred in 1975. In 1979, however, he was readmitted due to increasing general malaise and anemia. On admission, the hemoglobin was 5.9g/100ml, the platelet count 3.3×104/cmm, and leukocyte count 4,100/cmm with 6% blastoid cells and 43% monocytoid cells. The bone marrow aspirate yielded 39.8% blasts and 16.6% monocytoid cells, which were stained for both non-specific esterase (31%) and naphthol AS-D chloroacetate esterase (45%). Serum lysozyme was slightly elvated. From these data the diagnosis of acute myelomonocytic leukemia (AMMoL) was made.
This is a very rare case of an atomic bomb survivor in whom NHL and AMMoL occurred 25 and 34 years later, respectively. On the genesis of these hemopoietic neoplasms, the influence of the exposure to the atomic bomb and/or radiation therapy are presumed.View full abstractDownload PDF (715K) -
Nobutaka IMAMURA, Kenji TOKUMO, Shigeki KOGANEMARU, Nobuo OGUMA, Kosuk ...1981 Volume 22 Issue 6 Pages 885-890
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSRepeated cytapheresis was carried out with the Haemonetics HM 30 Blood Cell Processor in a case of adult T-cell leukemia (ATL).
A rapid clinical course, skin lesion, hepatosplenomegaly, lymph node enlargement and the presence of leukemic cells with indented nuclei possessing T-cell surface antigen of the peripheral T-cell type led to the diagnosis of ATL. Diagnosis of ATL was also supported by pathological finding of lymphnode biopsied. It is noted that the leukemic cells possess Fc receptor and no TdT activity. In addition, we reported the presence of HLA A3, 26, B44, -, C3, -, and normal T-cell level of lysosomal enzyme activity although we could not prove any evidence of oncorna virus implication.
It is well known that ATL is refractory to chemotherapy. Considering the age of patient, repeated cytapheresis must be carried out besides combination chemotherapy. Remarkable improvement of clinical symptoms and normalization of laboratory data followed the treatment. Cytapheresis should be considered as significant and necessary therapy for ATL which is usually resistant to chemotherapy.View full abstractDownload PDF (578K) -
Mitsumoto KOMATSUDA, Tadami NAGAO, Shigeru ARIMORI1981 Volume 22 Issue 6 Pages 891-895
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of malignant lymphoma associated with remarkable infiltration in the skeletal muscle is reported.
A 72-year-old male was admitted to our hospital because of right chest tumor and back pain. Pathological diagnosis of diffuse histiocytic, non-Hodgkin lymphoma was made on a biopsy of the right axillary lymph node. The patient has achieved a complete remission with VENP followed by HOP therapies, but the right chest tumor relapsed after 2 weeks. A biopsy of the right major pectoral muscle revealed massive infiltration of lymphoma cells. Additional chemotherapy was not effective and the patient was died 10 months after diagnosis.
Involved region with lymphoma cells at the autopsy was muscles; mainly right major pectoral, right intercostal, left sternocleidomastoid; lungs, skin, bones and generalized lymph nodes. Extranodal lymphoma was not uncommon, but muscle involvement of malignant lymphoma was rare. In 2147 malignant lymphoma cases of “Annual of Pathological Autopsy Cases in Japan” from 1976 to 1978, the frequency of muscle involvement as 0.32% in Hodgkin's disease, 1.19% in reticulum cell sarcoma, 1.18% in lymphosarcoma and 1.44% in total.View full abstractDownload PDF (616K) -
Shinobu NAKANISHI, Hideaki YAMAZAKI, Yoshio KONO, Tetsuo NAKATA, Akira ...1981 Volume 22 Issue 6 Pages 896-902
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis paper describes a case of leukemic non-Hodgkin lymphoma (diffuse poorly differentiated lymphocytic type). The patient was treated with the combination of daunorubicin, cyclophosphamide, vincristine and prednisolone (DCOP), getting complete remission, and survived for 13 months, although its prognosis has been recognized to be very poor. The effectiveness of daunorubicin was confirmed in the clinical course of this case, therefore daunorubicin was regarded as one of the drugs of choice for the treatment of non-Hodgkin lymphoma, though it required the accumulation of cases.
Disseminated intravascular coagulation (DIC) observed in this case was fluctuated in the course of this case, especially of the leukemic state. These phenomena suggested that DIC in malignant lymphoma might be correlated to the pathophysiological situations as exacerbation or remission during chemotherapy with special reference to the presence of the coagulants in lymphoma cells.View full abstractDownload PDF (667K) -
Reiko MIYAMOTO, Teruaki HONGO, Akira TAKEHIRO, Yoshio IGARASHI, Takero ...1981 Volume 22 Issue 6 Pages 903-908
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 7-year-old girl was admitted to the Hamamatsu University Hospital because of anemia and fever. Hematological examinations on admission showed severe anemia, thrombocytopenia and leukocytosis with 17 percent blastic cells. A bone marrow aspiration revealed 69.8 percent blastic cells. The diagnosis of acute myelogenous leukemia (AML) was made, and she was treated with vincristin, prednisolone, and 1-asparaginase.
A complete remission was induced after 5 weeks. During remission induction therapy she suffered from pneumonia, which later developed a pulmonary abscess of the left lower lobe (S10), and pulmonary lobectomy was performed. Histological examination of the resected lobe revealed typical features of tuberculosis and a lot of non-septate hyphae of mucor with invasion into the blood vessels.
She was successfully treated by 5-FC and amphotericine B (inhalation) combined with antileukemic and antituberculosis chemotherapy.View full abstractDownload PDF (584K) -
—Ultracytochemistry of Erythroblasts—Mitsuoki EGUCHI, Setsuo SUGIYAMA, Sakura YAMAMOTO, Toshiharu FURUKAWA1981 Volume 22 Issue 6 Pages 909-916
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSUltrastructural and ultracytochemical studies on a case of juvenile chronic myelocytic leukemia with recurrent erythroblastosis disclosed abnormal erythroblasts at the time of erythroblastosis.
The erythroblasts exhibited irregular-shaped nucleus with nuclear blebs, queer-formed cytoplasm with siderosomes and small and dense mitochondria occasionally iron-loaded. Virus-like particles were observed in erythroblasts and erythrocytes at the last episode of erythroblastosis. The periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) technique of electron microscope, which was identical in principle but more sensitive to PAS staining of light microscope, revealed numerous glycogen particles and periodate reactive granules in the erythroblasts. Perinuclear reactivity of dialysed iron for acid mucosubstance was weak in the erythroblasts in erythroblastosis in contrast with good reactivity in erythroblasts at the onset of the illness or normal condition. Microperoxisomes known as ubiquitous organella in normal cells was not observed in these erythroblasts same as rapidly growing tumor cells.
These findings suggested that the erythroblastosis of juvenile chronic myelocytic leukemia was not simply reactive erythroblastosis but growth of abnormal cells morphologically resembling to but somewhat different from erythroleukemia cells.View full abstractDownload PDF (2100K) -
Kaori NASU, Eiji TATSUMI, Yasuko TAKIUCHI, Shigeru SHIRAKAWA, Haruto U ...1981 Volume 22 Issue 6 Pages 917-924
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 54-year-old female was admitted to our department in September 1978. Two years before admission urticaria developed and left cervical tumor was noted. Both disappeared spontaneously. A few months after she suffered from subcutaneous nodules in anterior chest, left arm and left infraorbital region. The nodules regressed without chemotherapy, but recurred repeatedly. We cound not find the malignant characteristics in the histology of biopsied nodules, because of benign proliferation of lymphocytes, histiocytes and eosinophils without cellular atypism. The diagnosis was “Lymphadenosis Benigna Cutis'.
Two months before admission, generalized lymphadenopathy developed, and she complained of high fever and erythematous skin lesion after admission. The first lymph node biopsy specimen showed chronic lymphadenitis, but the second and the third ones obtained in November and December 1978 revealed the picture of diffuse histiocytic lymphoma. E rosetting cells of lymph nodes were 57% at the last biopsy. Malignant T-cells had minimum nuclear lobulation and significant human Ia-like antigen.
Absence of tumor cell infiltration to the epidermis was different from cutaneous T-cell lymphoma described by Lutzner et al but similar to cutaneous lymphoma demonstrated by Evans et al. The patient did not respond to chemotherapy and died on January 4, 1979.View full abstractDownload PDF (1435K)
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