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Volume 24, Issue 2
Displaying 1-19 of 19 articles from this issue
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—Comparison Between Single and Dual Stage Channel—Ichiro TSUKIMOTO, Masahiro TSUCHIDA, Ken KOBAYASHI, Katsuyoshi SHIGETA ...1983 Volume 24 Issue 2 Pages 81-88
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis study was designed to determine yield of platelets and adverse effects for healthy donors of the platelet collection with new “dual stage” channel (DSC) developed for IBM 2997 continuous blood cell separator, in comparison with the single stage channel (SSC).
A mean yields of platelets leukocytes per ml blood processed were 1.07×108 and 1,200×104 respectively with SSC, and 1.14×108 and 7×104 respectively with DSC.
The adverse effects such as numbness fingers were observed in 10% of donors of SSC, and 46.7% of DSC. A significant decrease of hematocrit, WBC, platelets, total protein, BUN, creatinine, Ca, P was observed in the donor blood after both platelet collection methods, more evidently in SSC than DSC.
The ADP-, epinephrine- and collagen-induced platelet aggregation was markedly impaired in the platletes collected with SSC and DSC. However, aggregation of the platelets obtained from patients after transfusion, improved markedly. This study indicated that the platelet dysfunction in vitro was reversible and these platelets collected with IBM 2997 were hemostatically effective in vivo.View full abstractDownload PDF (539K) -
Munehiro YAMAZAKI, Kozo YASUI, Fumio MOROHASHI, Hironori MOROSAWA, Ats ...1983 Volume 24 Issue 2 Pages 89-95
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSClinical observations were performed in 7 patients with defective neutrophil chemotaxis and hyper-IgE, with special emphasis on the hematologic and immunologic findings such as neutrophil and monocyte chemotaxis. The patients ranged in age from 7(2/12) to 23 years old, and 5 were male and 2 female. In vitro neutrophil chemotaxis was studied by the agarose plate method and by a modification of the Boyden's method. In vitro monocyte chemotaxis was examined by the agarose plate method. The patients had suffered from chronic severe dermatitis and recurrent pyogenic infections since infancy. Major infections included pneumonia, bronchitis, superficial abscess, lymphadenitis and otitis media. The frequency and severity of their infections varied widely from patient to patient. Neutrophil chemotaxis was impaired in all of the patients. In some patients, however, there was a tendency for neutrophil chemotaxis to improve during the observation period. Monocyte chemotaxis was defective in two of the 7 patients. Eosinophilia was observed in most of them. Serum IgG levels were normal to elevated, and IgA and IgM were normal. Serum IgE levels were elevated, ranging from 677 to 11,000 IU/ml. Lymphocyte subpopulation was normal. In our patients, chronic dermatitis and hyper-IgE were persistent abnormalities, but there was no apparent relationship between any pairs of dermatitis, neutrophil chemotaxis defect, and serum IgE level. Our observations indicate that this disorder is heterogeneous not only in the clinical features but also in the hematologic and immunologic findings.View full abstractDownload PDF (538K) -
Kuniaki SASAKI, Takeo FUJIMOTO, Yoshikiyo SHINGAKI, Toshiro HARA1983 Volume 24 Issue 2 Pages 96-103
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSFrom 1972 to 1982, 13 children with non-Hodgkin's lymphoma (NHL) were treated. Only one out of five patients who were treated before 1976 was survived 69+months. Intensive chemotherapy “Regimen 1” with high-dose methotrexate (50-150mg/kg, 6 hours intravenous infusion) followed by citrovorum factor rescue (H-D-MTX) was initiated on seven cases scince 1976. Complete remission was obtained in four cases (57%) with “Regimen 1”. All of these four cases were in long-term remission ranging from 22+ to 46+ months with cyclic maintenance therapy consisting of vincristine, prednisolone, adriamycin, 6-MP, and H-D-MTX. One of three patients treated by modified LSA2L2 protocol because of resistant to H-D-MTX was survived 23+months with no evidence of disease.
The peak serum concentration of MTX was linearly increased to 10-4∼10-3 M with dosage of 50-300mg/kg. The CSF MTX concentration was also dose dependent increment and achieved 10-6M level with dosage over than 100mg/kg.
The clinical toxicities of H-D-MTX were limted in nausea and vomiting. No life-threating toxicity was observed.View full abstractDownload PDF (552K) -
—Annulate Lamellae, Unusual Membranous Structures and Intranuclear Inclusion Bodies—Masaru KAWABUCHI, Harumi SADAMOTO1983 Volume 24 Issue 2 Pages 104-110
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA fourty-one year old male from Oita Pref. was critically ill with fever, generalized ery thematous rash, lymphadenopathy, and hepatosplenomegaly on admission when ninetysix per cent of peripheral WBC (18×104/mm3) was found to be E+ RFC, with convoluted nuclei and pleomorphic morphology of these abnormal lymphocytes. These lymphocytes were positive to surface immunoglobulin test. ATLA antibody was positive. The diagnosis was made readily as ATL. Skin biopsy to the erythematous rash showed infiltrations of the leukemic cells in the dermis, also in the epidermis with scattered Pautriér's microabscesses. Right inguinal lymphnode biopsy was diagnosed of diffuse, pleomorphic cell type lymphoma. An electron microscopic study of ATL cells from this patient revealed peculiar features, such a sannulate lamellae, membranous aggregates and intranuclear inclusion bodies. Such Structures, which have not yet been reported in ATL cells, seem to be related to an accelerated rate of metabolic activities of leukemic T-cells undergoing abrupt cell proliferation.View full abstractDownload PDF (2180K) -
Part I. Detection of Anti-ATLA Antibody in Patients with Various Conditions and Healthy Controls with Special Reference to Blood TransfusionMasatoshi FUJISHITA1983 Volume 24 Issue 2 Pages 111-118
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSSera from patients with various diseases and healthy controls were tested for antibodies to adult T-cell leukemia (ATL)-associated antigens (ATLA). In T-cell maligancy, 25 of 27 cases of ATL, 4 of 7 cases of mycosis fungoides, 1 of 2 cases of Sézary syndrome, 4 of 11 cases of T-lymphoma and 1 of 1 case of T-CLL were anti-ATLA positive with titers of 1:10 to 1:1, 280. Of these 35 anti-ATLA positive cases, 2 had received blood transfusion, while there was no history of blood transfusion in 23 and no information of blood transfusion in 10. On the other hand, in non-T-cell malignancy, 9 of 130 cases of hematologic malignancy, 1 of 28 cases of hematologic non-malignancy, 6 of 50 cases of non-hematologic diseases and 4 of 454 healthy controls were anti-ATLA positive with titers of 1:10 to 1:1, 280. Of these 20 anti-ATLA positive cases, 15 had been given blood transfusion, massive in most of them, and the other 5 had no history of blood transfusion. One of AML patients seroconverted from anti-ATLA negative to positive after 2 months while receiving massive blood transfusion. Therefore, anti-ATLA positivity in persons other than patients with T-cell malignancy is likely to be transfusion-related seroconversion.View full abstractDownload PDF (546K) -
—Increasing Incidence of Gastrointestinal Bleeding—Hiroyoshi SAWADA, Masaru NISHIKORI, Toshihiro MOCHIZUKI, Hiroto ISHIKU ...1983 Volume 24 Issue 2 Pages 119-125
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe causes of death in 85 patients with hematopoietic malignancies, admitted to the First Division of Internal Medicine, Kyoto University, from 1977 through 1981, were analyzed and the results were compared with our previous report.
The following results were obtained:
1) In leukemic patients, two major causes of death were bleeding and infection. The incidence of death by infections was decreased, and massive hemorrhage in the gastrointestinal tract was significantly increased as compared with the previous study.
2) Cachexia was the most frequent cause of death in malignant lymphoma, and either cachexia or renal failure in multiple myeloma.View full abstractDownload PDF (472K) -
Masanori UMEDA, Tatsuo SHIRAI1983 Volume 24 Issue 2 Pages 126-132
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe % S-phase CFU-c, both in bone marrow and peripheral blood was measured using Iscove's suicide test in 20 patients with chronic myelocytic leukemia, 18 in chronic phase and 2 in blastic crisis. Bone marrow % S-phase CFU-c was low or normal in the patients in chronic phase. It was elevated in 2 patients in blastic crisis. Circulating % S-phase CFU-c in the patients in chronic phase was elevated or normal, and its range was relatively wide.
Fourteen patients in chronic phase were studied during the course of therapy. In remission, circulating % phase CFU-c decreased to normal in 8 out of 11 patients and remained 0% throughout the course of 3 patients, while that in bone marrow increased in 7 out of 10 patients and decresed in 3 patients. This relation between those variables became converse in 7 patients. In a 28-year-old female patient, who was thought to be in accelerated phase, circulating % S-phase CFU-c was high even when the leukocyte count was under 10,000/μl.
This study suggests that those variables may reflect the clinical state of chronic myelocytic leukemia.View full abstractDownload PDF (506K)
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—With special reference to the examination of IgG and IgM production in vitro—Toru TAKENAKA, Hirokazu NAKAMINE, Iwao OSHIRO, Mankichi FUJII, Jiro MA ...1983 Volume 24 Issue 2 Pages 133-141
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of prolymphocytic leukemia in a 47-year-old man is reported. Physical examination revealed marked splenomegaly, hepatomegaly and lymphadenopathy. The leukocyte count was 181×103/μl with 90.4% of leukemic cells which were morphologically similar to prolymphocytes. The leukemic cells were found to possess the receptor for C3, but neither surface immunoglobulins nor cytoplasmic IgM were detected. The receptor for sheep erythrocytes and TdT activity were not demonstrable in these cells.
As serum IgM level had been preferentially depressed since the onset, in vitro immunoglobulin production was tested to examine the interrelation between the defect of surface immunoglobulins and IgM hypogammaglobulinemia. It was suggested that the leukemic cells turned neoplastic at the stage of differentiation to IgM-bearing lymphocytes, and as a result, IgM hypogammaglobulinemia was induced. Therefore, the leukemic cells in the present case might be B lymphocyte in origin.View full abstractDownload PDF (2010K) -
Naoya EMOTO, Ryoko MIZUTANI, Masako AOYAMA, Toshiko MOTOJI, Kazuo OSHI ...1983 Volume 24 Issue 2 Pages 142-147
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 27-year-old man was re-admitted on October 12, because of rapidly progressive right hemiparesis.
Ten months before admission, a diagnosis of AML (M2) was made and a complete remission was achieved after the treatment combining daunorubicin, cytosine arabinoside (ara-C), 6-thio-guanine and prednisolone. Maintenace chemotherapy and immunotherapy (BCG) were given and no clinical evidence of recurrence was noted until neurological symptoms appeared.
On re-admission, right hemiparesis was present, and neither stiff neck nor papilledema was observed. A computed tomographic scan of the brain revealed two high density masses surrounded by low density area; one, 3cm in diameter, was present in the left parietal area, and another, 1cm in diameter, in the posterior limb of right internal capsule. On lumbar puncture, the cerebrospinal fluid (CSF) showed 1944/3/mm3 of leukemic cells.
A diagnosis of meningeal leukemia with impending marrow relapse was made and the intracerebral tumors were considered to be due to infiltration of leukemic cells. Radiation in a total dose of 2,400 rad was given to the cranium, and four intrathecal injections of 30 mg of ara-C resulted in a complete disappearance of the intracerebral masses and resolution of the neurological symptoms and signs; CSF became free of leukemic cells.
This is a case report of rare complication of AML and its successful treatment.View full abstractDownload PDF (512K) -
Masaru NAKANO, Tomoji KUROSU, Masaru SHIOHIRA, Hidetoshi SHIGEFUKU, Sh ...1983 Volume 24 Issue 2 Pages 148-156
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of leukemic B cell lymphoma with marked polyclonal hyperimmunoglobulinemia is reported.
A 80-year-old man was admitted to our hospital with complaints of fever and increased bowel movements. Physical examination showed generalized lymphadenopathy. Barium enema and endoscopic biopsy revealed multiple nodular lymphoid hyperplasia of the colon. Laboratory findings were as follows: total serum protein 9.35 g/dl (γ-globulin 52.7%; IgG 3,700mg/dl, IgA 1,100mg/dl, IgM 201mg/dl, IgD<2mg/dl, IgE 1,140 IU/ml, κ/λ ratio 1.64), GOT 59.1 U, GPT 33.2 U, Ch-E 0.2 ΔPH, RBC 268×104/mm3, Hb 8.8g/dl, Th 12.8×104/mm3, WBC 9,200/mm3 with 67% lymphocyte (small 7%, cleaved 10%, non-cleaved 42%, plasmacytoid 8%), Coombs' test and ANF positive, ASLO×640, anti-EBV-VCA-IgG×2,560, VCA-IgM×40. Bone marrow aspiration showed NCC 18.8×104/mm3 with 41.2% lymphocytes (cleaved 19.4%) and 6.8% plasma cells.
Pathological diagnosis of a resected cervical lymph node was non-Hodgkin's lymphoma of diffuse and medium-sized cell type based on L.S.G classification.
Malignant cells in both peripheral blood and lymph node possessed surface and cytoplasmic immunoglobulins of each class (IgM, G, A) keeping monoclonality (kappa chain type). Analysis of T cell subsets by OKT series and OKIa1 revealed an increase of activated helper T cells and decrease of suppressor T cells.
Laparoscopy disclosed early liver cirrhosis.
Therefore, it seems that polyclonal hyperimmunoglobulinemia in this case was induced not only by polyclonal normal B cell activation due to liver cirrhosis, EB virus reactivation and aging, but was also a result of secretion from malignant cells with intraclonal class switch and plasmacytoid differentiation.View full abstractDownload PDF (1797K) -
Yuzuru TAKEMURA, Masashi NITTA, Hiroko YOSHITAKE, Toshio FUKUI, Minoru ...1983 Volume 24 Issue 2 Pages 157-162
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA thirty year-old man was admitted to Kawasaki City Ida Hospital on August, 1976, because of pleural effusion. He had no lymphadenopathy, hepatosplenomegaly or significant changes in his eye fundi. Laboratory findings revealed marked elevation of monoclonal IgM of kappa type in his serum and pleural fluid. Lymphoplasmacytoid cells were found in the pleural fluid and the bone marrow, which were stained specifically with fluorescein-conjugated anti-sera to mu and kappa chain. Infiltration of small lymphocyte-like cells in his lung tissue was also observed by transbronchial lung biopsy.
He was treated with VENP regimen under the diagnosis of Waldenström's macroglobulinemia, and pleural effusion disappeared. Twenty-six months later, serum IgM decreased suddenly to the normal range, and generalized lymphadenopathies developed. Cervical lymphnode biopsied before the death showed diffuse, mixed type picture of malignant lymphoma, and the surface Ig of tumor cells was monoclonal IgM(κ).
It was suggested that changes of clinical and pathological pictures in the late course of the disease were brought about by a transition from more mature, IgM producing cells to less mature cells unable to produce immunoglobulin in the same clone of the B cell line.View full abstractDownload PDF (867K) -
Takayuki SUZUKA, Tohru KOIKE, Chihiro SHIMAZAKI, Shinobu NAKANISHI, Ta ...1983 Volume 24 Issue 2 Pages 163-168
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis paper reports a case of malignant lymphoma which was originated from the breast, followed by multiple involvement in the brain, and finally developed intraocular infiltration. These lesions disappeared by irradiation therapy.
A 51 years old housewife was admitted to our hospital for the further evaluation and treatment of decreased bilateral visual acuity on May 1981.
On May 1976, she noticed a solid tumor of the left breast, and total mastectomy disclosed malignant lymphoma (non-Hodgkin lymphoma, lymphocytic type). On August 1980, she developed diplopia and amnesia. CT scan revealed multiple involvements in brain and cobalt therapy resulted in good response.
The ophthalmologic diagnosis was uveitis, but it was impossible to rule out the ophthalmic infiltration of malignant lymphoma and 60Co irradiation (total 2,976 rad) to the bilateral eyes and systemic CHOP therapy were carried out. Consequently, her visual acuity recovered to 0.6, and she is now following ambulatory course.
Although non-Hodgkin lymphomas have been reported to originate frequently from non lymphoid tissues, the breast as the primary site is rare and the intracerebral infiltration as an involvement of central nervous system is quite rare. Furthermore, malignant lymphoma of the eyes, especially intraocular involvement is infrequent in incidence. The diagnosis of uveitis due to malignant lymphoma is considered to be difficult because of lack in specific findings.View full abstractDownload PDF (729K) -
Shigeru SHIONOYA, Masamichi AMANO, Yukio IMAMURA, Kiyomi YAMADA, Hiros ...1983 Volume 24 Issue 2 Pages 169-175
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 50-year-old man was admitted to our hospital in February 1980, because of general malaise, multiple petechiae on the gingivae and skin. Physical examination revealed marked hepatomegaly and generalized lymphadenopathy. Blood count showed: RBC 2.12×1012/l, WBC 7.8×109/l with 21% of atypical plasma cells, platelets 35×109/l. Serum protein reached 14.0 g/dl and immunoelectrophoresis showed monoclonal IgG, γ1-κ type, of 7.67 g/dl with decreased IgA and IgM. A 14q+marker chromosome due to t(8; 14) (q24; q32) was found by analysis in periphral blood mononuclear cells. On skeletal Xrays, no abnormal findings were demonstrated.
A diagnosis of plasma cell leukemia was established. After four courses of intermittent chemotherapy with melphalan, cyclophosphamide, vincristine and prednisolone, serum IgG decreased to 1.84 g/dl and a complete remission was attained. However, the relapse occurred in December 1980 and he died from massive hemorrhage in the lung. Autopsy revealed infiltration of plasma cells in the bone marrow, the liver, the spleen and both kidneys.
This is the first case of plasma cell leukemia with an 8; 14 chromosomal translocation of Burkitt type, which seems particularly interesting to study the pathogenesis of lymphoid malignancies.View full abstractDownload PDF (679K) -
Tetsuo OHSHIMA, Yoshikazu AKAHONAI, Haruyasu YOSHIZAKI, Masayuki TSUZI ...1983 Volume 24 Issue 2 Pages 176-183
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 47-year-old man born in Hokkaido showed characteristics of adult T cell leukemia (ATL) in clinical and laboratory features. He was diagnosed as immunoblastic lymphadenopathy from the biopsy of cervical lymph nodes 2 years ago and also was pointed out to have marked eosinophilia and hypergammaglobulinemia including IgE. The biopsy specimens of lymph nodes on this admission, however, disclosed a typical feature of T cell malignancy with pleomorphic nuclei and a compartmentalization of leukemic cells. The white blood cell count was 152,000 including 55% of atypical lymphoid cells that had T cell markers (E rosette: 93%, s-Ig: 2%, Ia: 20%, Leu 1: 70%, Leu 2a: 0%, Leu 3a: 70%). Although the phenotype of leukemic cells showed the helper/inducer type similar to that of previously reported cases, a helper function was not observed in the in vitro production of immunoglobulins in the co-culture of leukemic cells and normal B cells. However, this case showed marked hypergammaglobulinemia, though a level of serum immunoglobulins in patients with ATL was reported to be generally normal or moderately reduced. In addition, ATLA (adult T cell leukemia asociated antigen) and its antibodies were found not only in the patient, but also in his sister and her daughter, suggesting the viral infection in the family members.View full abstractDownload PDF (1359K) -
Atsushi SHIBUYA, Isao KATAYAMA, Akira KUBO1983 Volume 24 Issue 2 Pages 184-190
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis paper describes 2 cases of granulocytic leukemia presenting as tumor in the extramedullary sites. Case 1 presented as a mediastinal mass with unilateral pleural effusion to prompt the discovery of A.M.L.. In case 2, a pericardial mass in disguise of “idiopathic” pericardial effusion preceded the subsequent leukemic minifestation by over 2 months.
The case 2 represents an instance of what Krause called “granulocytic sarcoma preceding leukemia”. Namely, the systemic leukemic manifestations were seen a few months after localized tumefaction was the subject of the differential diagnosis. Unless aware of the possibility, one may misdiagnose the granulocytic sarcoma preceding leukemia as a large cell type malignant lymphoma.View full abstractDownload PDF (1078K) -
Ken-ichi SAWADA, Masato SHIMIZU, Shoki SAKURAMA, Takahiko KONNO, Hidet ...1983 Volume 24 Issue 2 Pages 191-196
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old housewife was admitted to the Kitami Red-Cross Hospital because of chest pain on January 30, 1980. Physical examinations showed hepatosplenomegaly and cyanosis of the lips. Peripheral blood showed as follows: RBC 868×104/mm3, Hb 21.0 g/dl, Ht 71.8%, WBC 16,800/mm3 and platelets 35.8×104/mm3. Arterial oxygen saturation was 95.7%. Serum V. B12 was 1,316.3 pg/ml. ECG showed a pattern of subendocardial infarction. CT scan of the head showed multiple spots with low density in the frontal area.
On the basis of these findings, the diagnosis of polycythemia vera with subendocardial infarction and cerebral thrombosis was made. On the 5-th hospital day, she developed severe chest pain with ST elevation in ECG and elevated values in muscular enzymes. Since the hypotention and deterioration of the chest pain occurred after phlebotomy, the treatment of anticoagulants and vercyte was began, resulting in good control. On the sixth day after the begining of infusion of heparin sodium (1∼3×104 unit a day), thrombocytopenia occurred. Because it was considered to be due to heparin-associated thrombocytopenia, heparin was changed to warfarin treatment. The platelet count returned to normal in a few days.
She was discharged on the 60-th hospital day with maintenance dosage of warfarin by 2.5 mg a day.View full abstractDownload PDF (400K) -
—With special reference to functional examinations of granulocytes, lymphocytes and platelets—Mankichi FUJII, Iwao OSHIRO, Hirokazu NAKAMINE, Toru TAKENAKA, Jiro MA ...1983 Volume 24 Issue 2 Pages 197-205
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of primary acquired sideroblastic anemia in a 74-year-old male is presented. Biochemical examinations revealed the reduction of δ-ALA synthetase in erythroblasts and of serine protease in granulocytes.
Typical ringed sideroblasts (34.0 to 52.5% of erythroblasts) were observed in bone marrow film with Berlin blue stain and the accumulation of iron micelles was ultrastructurally demonstrated in mitochondria of most erythroblasts.
On the basis of the hypothesis that mitochondrial abnormality in stem cells might participate in the disease, functional examinations of lymphocytes, granulocytes and platelets were performed. Consequently, DNA synthesis of lymphocytes, and both phagocytic and NBT reduction activities of granulocytes were normal, while platelet aggregation to epinephrine was reduced before and after elimination of dipyridamole.
However, it was obscure whether there was any relationship between platelet aggregation and mitochondrial abnormality predicting in primary acquired sideroblastic anemia.View full abstractDownload PDF (1526K) -
Hideyo NATORI, Koichiro EGAMI, Ken TANAKA, Kaori YASUDA, Fumio TANAKA, ...1983 Volume 24 Issue 2 Pages 206-212
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 71-year-old female was admitted to the hospital because of general fatigue and fever. Physical examination revealed an mass in the epigastrium. The liver and spleen were palpable.
Haematological findings revealed hemoglobin, 7.6 g/dl, platelets, 105,000/cmm, and leukocytes, 25,800/cmm with a leukoerythroblastic picture and 30% blasts contained cytoplasmic vacuoles. These blasts were similar to Burkitt's lymphoma cells and negative for PAS, peroxidase and Sudan blak B stain, and positive for Unne-Pappenheim stain. The bone marrow showed massive infiltration with blasts. Cytogenetic studies revealed t(8q-; 14q+) chromosomal abnormalities. Lactic dehydrogenase was markedly elevated (16,214 W. U.).
She was treated as acute lymphoblastic leukemia (Burkitt type) with VEPA (Vincristine, Endoxan, Predonine and Adriamycin), and was complicated with disseminated intravascular coagulation. Examination of the gastrointestinal tract revealed malignant lymphoma of the stomach.
She was diagnosed as leukemic lymphoma (Burkitt type) of the stomach. She responded dramatically and a short complete remission was achieved. However, after 2 months, she died of the central nervous system relapse.
Autopsy findings revealed lymphoma cells infiltrated in the stomch, greater omentum, diaphragum, peritoneum, mesentery, ovaries, uterus, lungs, pleura, liver, spleen, kidneys, suprarenal bodies, bone marrow, menings, brain, and the starry sky appearanse into the cerebellum. The lymphoma cells were positive for Oil red 0 stain.View full abstractDownload PDF (720K) -
Wataru TATEWAKI, Shinichi MORINAGA, Hisomu YAMAGUCHI, Ichitaro ASAI, T ...1983 Volume 24 Issue 2 Pages 213-217
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 33-year-old Korean male, frequently visited the Indonesian jungles for past few years, was first admitted to the Toranomon Hospital on August 3, 1981, because of thrombocytopenia and recurrent febrile attacks.
On admission platelet count was 12,000 per cu. mm., and the results of the bone marrow aspirates and a shortened platelet life span (51Cr T/2=0.42 days) were compatible with idiopathic thrombocytopenic purpura.
Prednisolone, 1 mgm per kg per day, was administered witout any significant effects on the thrombocytopenia. On September 9, he became febrile (37.5°C) accompanied by the appearance of Plasmodium vivax in the erythrocytes of the peripheral blood smears. Treatment with Fancidar and primaquine was successful.
Since his thrombocytopenia was regarded as refractory to drugs such as prednisolone, azathioprine and 6-MP, splenectomy was considered as an absolute indication. Preoperatively intravenous administration of high dose of intact IgG (400mgm per kg per day) for five consecutive days resulted a rise in platelet count up to 90,000per cu. mm., and a spleen, weighing 160Gm., with an accessory spleen, was extirpated on March 8, 1982.
After the operation platelet count rose up to a maximum of 535,000per cu. mm., and gradually declined to the normal range. On September 7, 1982, platelet count was 144,000per cu. mm. with oral prednisolone 10mgm. per day, without any subjective complaints.View full abstractDownload PDF (328K)
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