巻号一覧
31 巻, 1 号
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総説
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服部 晃, 水戸 将郎1990 年 31 巻 1 号 p. 1-9
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありPDF形式でダウンロード (745K)
臨床研究
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—免疫学的パラメーターの検討—川内 喜代隆, 杉山 始, 渡辺 晴雄, 浦部 晶夫, 高久 史麿1990 年 31 巻 1 号 p. 10-15
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありFour patients with severe aplastic anemia and one patient with pure red cell aplasia (PRCA) were treated with antilymphocyte and antithymocyte globulins. One patient in aplastic anemia who achieved good response by ALG administration had a possible diagnosis of myelodysplastic syndrome. ATG was administered to only one case of aplastic anemia and ALG was administered to the remainder. In the result, three out of 4 patients with aplastic anemia and one patient with PRCA achieved good response without severe side effects. Three patients with aplastic anemia had high CD4/CD8 ratio in their peripheral lymphocytes. This ratio normalized after ALG therapy in effective cases, but not in ineffective case. Natural killer activity elevated after ALG therapy in two effective cases of aplastic anemia and PRCA, but not in one ineffective case of aplastic anemia.抄録全体を表示PDF形式でダウンロード (467K) -
沢田 美彦, 苅谷 克俊, 工藤 育男, 高見 秀樹, 相原 守夫, 吉田 豊1990 年 31 巻 1 号 p. 16-22
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe tested an in vitro system simulating bleeding time reported by Kratzer et al. Primary hemostasis was studied perfusing an artificial vessel with citrated blood under a constant pressure of 40 mmHg, measuring the blood volume perfused (bleeding volume) and the time until blood flow stopped (bleeding time). The artificial vessel consists of a glass capillary simulating arteriole and a filter covered with collagen type I to provide a surface for the adhesion of platelets.
The bleeding volume (mean±SD μl) was 317.7±93.8 in controls (n=19), 487.3±242.1 in idiopathic thrombocytopenic purpura (n=9), 666.8±224.1 in aplastic anemia and paroxysmal nocturnal hemoglobinuria (n=4), >820 in von Willebrand's disease (n=3), 231.0±74.5 in hemophilia A (n=3), 499.0±269.4 in liver cirrhosis (n=6), and 457.7±229.0 in myeloproliferative disorders (n=11). When citrated blood was applied to this system after incubation with monoclonal antibodies (MoAb) to von Willebrand factor or platelet membrane glycoprotein Ib (GPIb), bleeding volume was significantly increased while no effects were observed after incubation with MoAb to GPIIb/IIIa, factor VIII: CAg and factor XIIIa.
These data suggest that in vitro model of primary hemostasis could be used for not only diagnosing bleeding disorders although ‘time’ is not reliable, but also investigating the mechanisms of hemostasis.抄録全体を表示PDF形式でダウンロード (506K) -
津田 忠昭, 藤井 万吉, 清水 映二, 辻本 真人, 岡本 幸春, 大田 喜一郎, 前田 次郎1990 年 31 巻 1 号 p. 23-28
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありSpuriously low electronic white-cell count was obtained on EDTA-anticoagulated blood from a 54-year-old male suffering from liver cell carcinoma. In an attempt to understand better the phenomenon, in vitro studies were performed. The blood smear anticoagulated with EDTA revealed remarkable agglutinations of leukocytes, mainly neutrophils but not lymphocytes. The EDTA-treated blood showed maximal leukocytes-agglutinations at room temperature but no agglutination at 37°C. The agglutinated leukocytes, moreover, were dispersed by incubating the blood at 37°C. Although agglutination occurred in some degree in the blood anticoagulated with Na-heparin or Na3-citrate, it was much less pronounced compared to the EDTA-treated blood. Remarkable leukocytes-agglutinations were induced when EDTA-anticoagulated blood from healthy donor was mixed with serum from the patient at room temperature. These results suggest that the phenomenon of in vitro leukocyte agglutination and consequent pseudoleukocytopenia is due to leukocyte agglutinin in serum from the patient. The mechanisms were discussed comparing with pseudothrombocytopenia caused by platelet agglutinin.抄録全体を表示PDF形式でダウンロード (722K) -
至適幹細胞培養法の検討とその臨床的意義二宮 恒夫, 高上 洋一, 渡辺 力, 阿瀬川 聡美, 平尾 敦, 斉藤 慎一, 阿部 孝典, 中西 純子, 河野 嘉文, 黒田 泰弘, 小 ...1990 年 31 巻 1 号 p. 29-34
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありMethylcellulose culture study revealed that the potency of recombinant granulocyte-colony stimulating factor (G-CSF) or granulocyte/macrophage (GM)-CSF to support the growth of purified target cell populations from peripheral blood of patients undergoing peripheral blood stem cell (PBSC) autotransplantation was inferior to that of PHA-stimulated lymphocyte conditioned medium (PHA-LCM) or interleukin-3 (IL-3). In liquid-suspension limiting dilution assay the cells responded directly to IL-3 by proliferation with single-hit kinetics. Hence, optimal culture for PBSC should include the use of PHA-LCM or IL-3. Further study disclosed a linear relationship between the number of CFU-GM infused into the patients and days required to achieve a granulocyte count above 0.5×109/l.抄録全体を表示PDF形式でダウンロード (489K) -
—「Ph1を伴う本態性血小板血症」との巨核球動態の比較—小島 寛, 長谷川 雄一, 池上 正, 長澤 俊郎, 阿部 帥1990 年 31 巻 1 号 p. 35-40
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA case of chronic myelogenous leukemia (CML) with marked thrombocytosis and its megakaryo-kinetics were reported. Patient was 57-year old woman who had a marked thrombocytosis (1,413×103/μl) and a bone marrow megakaryocytosis. Bone marrow karyotype demonstrated Ph1 chromosome in all cells examined. However, on physical examination, there was no splenomegaly. CBC showed no immature myeloid cells, and neutrophil alkaline phosphatase was elevated. These manifestations were consistent with so called essential thrombocythemia (ET) with Ph1 chromosome reported by Nissenblatt. To know the megakaryokinetics of this case, we examined the number of colony forming unit-megakaryocyte (CFU-M), platelet glycoprotein (PGP) IIb/IIIa positive cells, cytoplasmic area, and DNA content, comparing with those of normal subjects, CML, and ET. We found a marked increase of CFU-M and PGP IIb/IIIa positive cells, but in contrast, decreased DNA content and cytoplasmic area. This pattern of megakaryokinetics was consistent with that of CML. We conclude that ET with Ph1 chromosome may be a variant of CML rather than ET itself.抄録全体を表示PDF形式でダウンロード (415K)
症例
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倉田 寛一, 三輪 哲義, 加藤 洋一, 平井 真希子, 村井 善郎, 森 真由美1990 年 31 巻 1 号 p. 41-45
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 77-year-old man was diagnosed as having acute myelomonocytic leukemia (M4) with increased ringed sideroblasts in the bone marrow (BM) in October, 1979. Complete remission was achieved and ringed sideroblasts disappeated after two courses of CMP (cytarabine, 6-mercaptopurine, prednisolone) therapy. Following remission, there was no increase of blasts during the course of the disease, but monocytosis and dysmyelopoiesis persisted for about seven years. The monocytosis was controlled by 6-mercaptopurine.
In June, 1986, however, monocytosis in peripheral blood (PB) and BM developed again, and there was severe pancytopenia and reappearance of ringed sideroblasts without increase of blasts. The patient died of pneumonia on September, 1986. Postmortum examination revealed hypercellular marrow with a few blasts, leukemic cell infiltration into spleen, liver and lymph nodes, ad lung cancer.
His clinical and hematological features after remission of acute leukemia accorded with those of CMMoL.
The dysmyelopoiesis observed in this case in not induced by anti-leukemic agents, but originated from the same clone as the initial AMMoL, and his disease was thought to be CMMoL converted from blastic crisis to chronic phase.抄録全体を表示PDF形式でダウンロード (476K) -
結城 伸泰, 青木 定夫, 帯刀 亘, 服部 晃, 品田 章二, 柴田 昭1990 年 31 巻 1 号 p. 46-51
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 51-year-old female with systemic lupus erythematosus (SLE) was admitted in November 1987 because of general fatigue and muscular weakness. She was treated with prednisolone (PSL) 30 mg and azathioprine (AZP) 50 mg after failure in the management of thrombocytopenia by PSL 15 mg. She exhibited no splenomegaly. Muscular atrophy and weakness were seen in the proximal muscles. Her platelet count was 44,000/μl. A bone marrow aspiration revealed an increase in megakaryocytes. The blood chemistry revealed a normal CPK level and an elevated LDH level, indicating a presense of steroid myopathy.
A splenectomy was performed after an increase of platelet count by giving gamma-globulin 400 mg/kg for 5 days. The platelet count rose to 368,000/μl on the 46th postoperative day. She was treated with PSL 5 mg and AZP 50 mg as postsplenectomy therapy. The splenectomy did not adversely affect other aspects of SLE, in particular, renal function. She had no major complications in the postoperative period. Her platelet count reached a plateau 4 months later and revealed 115,000/μl 18 months postoperatively.抄録全体を表示PDF形式でダウンロード (426K) -
斎藤 潔, 石山 泰二郎, 橋本 真生, 大沢 秀樹, 小池 道明, 住吉 順子, 杉本 正邦, 堀江 誠一, 若林 芳久, 廣瀬 俊一1990 年 31 巻 1 号 p. 52-56
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 37 year-old female was admitted to our hospital because of hypermenorrhea, prolonged bleeding time, thrombocytopenia and the diagnosis of idiopathic thrombocytopenic purpura (ITP) was made. Though activated partial thromboplastin time (APTT) was markedly prolonged, her coagulation factors were within normal ranges.
Activities of the circulating lupus anticoagulant (LAC) was suggested. Kaolin clotting time of the platelet poor plasma was used as a sensitive screening test using the mixture of normal and patient's plasma for the detect of LAC.
As a result, LAC positive pattern was observed.
The treatment with high-dose gammaglobulin brought out a transient increase of the platelet count, but the prolongation of APTT was not corrected.
Both the platelet count and the prolongation of APTT were significantly improved after the treatment with betamethasone.抄録全体を表示PDF形式でダウンロード (334K) -
濱本 健次郎, 小坂 知也, 岳野 光洋, 安斎 尚之, 手塚 裕章, 小西 博, 矢切 良穂, 上田 恭典1990 年 31 巻 1 号 p. 57-61
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 63-year-old man was admitted to our hospital with a chief complaint of general malaise in March 1986. A diagnosis of Bence Jones protein (κ) type of multiple myeloma was made from increased atypical plasma cells in the bone marrow, urinary BJP (κ) and osteolytic lesions. Urinary BJP (κ) was decreased by MP and VENP therapies. In April 1987, he visited us again with the complaint of pain on the left shoulder. An examination revealed multiple osteolytic lesions and bilateral pleural effusion containing atypical plasma cells. Jaundice was developed at the end of July 1987. An ultrasound examination revealed a hypoechoic mass in the area of pancreatic head. The effusion was gradually increased without response to the treatment. He died of respiratory failure on July 31, 1987.
On autopsy, extramedullary plasmacytoma was found in the head of pancreas. It was a rare case of multiple myeloma in which pleural effusion and multiple plasmacytomas, and finally obstructive jaundice were developed although urinary BJP (κ) was reduced by treatment.抄録全体を表示PDF形式でダウンロード (418K) -
小宮 格, 伊藤 敏治, 緒方 清行, 山田 隆, 檀 和夫, 厨 信一郎, 野村 武夫1990 年 31 巻 1 号 p. 62-65
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 58-year-old female was referred to us because of M-proteinemia and anemia. Bone marrow showed normocellularity with 14.8% of atypical plasma cells. Serum electrophoresis on cellulose acetate membrane revealed a single M-peak (56.9%). Immunoelectrophoresis showed large M-bows against anti-IgA and anti-λ, together with small M-bows against anti-IgG and anti-κ of the same electrophoretic mobility. In the urine, λ type Bence Jones protein was found. The skull X-ray showed multiple punched out lesions. APTT was 61 seconds, fibrinogen 118 mg/dl, factor VIII clotting activity 25% with normal factor VIII related antigen, and factor IX clotting activity 38%. Circulating anticoagulants were not detected. These hemostatic abnormalities were thought ascribable to the interference of clotting activities by paraproteins. On the 33rd hospital day, she suffered from intracerebral hemorrhage, which was possibly due to these hemostatic abnormalities.抄録全体を表示PDF形式でダウンロード (374K) -
中山 志郎, 矢部 博樹, 石川 隆之, 永井 謙一1990 年 31 巻 1 号 p. 66-69
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe encountered a patient who developed intravascular hemolysis while being treated with immunotherapy of bestatin.
A 18-year-old female, diagnosed as having acute myelocytic leukemia and remained in complete remission for about 18 months by repeated consolidation therapy, was admitted to our hospital because of sudden fall of Hb concentration. Nine days prior to admission, bestatin, 30 mg daily, was resumed following a rest period of 2 weeks. Bestatin was started after the first complete remission had been achieved, Urine was dark brown with positive occult blood, but no red cells were observed. Hb was 7.9 g/dl, the number of reticulocytes 14.1%, WBC 3100/μl with a normal classification, and platelets 6.1×104/μl. The serum total bilirubin was 2.3 mg/dl with a direct component of 0.8 mg/dl. Serum LDH was markedly elevated. Serum Hb was 0.12 g/dl and haptoglobin was less than 10 mg/dl. Direct and indirect Coombs' tests were both negative. Lymphocyte stimulation test by bestatin was positive. Full recovery followed the cessation of bestatin therapy and the initiation of corticosteroid therapy.
It may be speculated from our case that discontinuous administration of bestatin may have been an opportune setting for developing a side effect of severe intravascular hemolysis.抄録全体を表示PDF形式でダウンロード (316K) -
清水 宏之, 宇井 利夫, 川井 進, 金子 安比古, 藤本 孟男1990 年 31 巻 1 号 p. 70-74
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe report a case of infantile acute leukemia with t(16;21)(p11;q22). The patient was a phenotypically normal one-year-old girl without lymphadenopathy or hepatosplenomegaly. Her peripheral blood at diagnosis showed anemia, thrombocytopenia, and many circulating blasts. Bone marrow blasts were monocytoid with fine reticular nuclear chromatin, abundant grayish-blue cytoplasm with occasional pseudopods or cytoplasmic projections and active hemophagocytosis. Serum levels of lysozyme and ferritin were normal. These blasts were not stained with butyrate esterase and immunologic study showed KOR-P77+ (anti-megakaryocyte monoclonal antibody), MY9+, Ia-. Electron microscopic examination failed to show platelet peroxidase activity. Remission was not induced by mini-COAP or VP-16 and the patient died of measles pneumonitis. The patient's blasts took typical appearance of megakaryoblasts later in the course, although some of them retained the ability of hemophagocytosis observed in the original blasts.
This case is considered to be quite atypical since leukemic cells with active hemophagocytosis, megakaryoblastic appearance and t(16;21)(p11;q22) have not been reported in the literature.抄録全体を表示PDF形式でダウンロード (449K) -
長谷川 雄一, 酒井 紀恵, 外山 昌弘, 二宮 治彦, 阿部 帥1990 年 31 巻 1 号 p. 75-79
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe report here a rare transformation from refractory anemia with ring sideroblasts (RARS) to chronic myelomonocytic leukemia (CMML). A rare karyotype, inv (12), was also seen at the phase of CMML. A 76-year-old female consulted a physician because of hoarseness in June, 1983. An anemia was found and blood transfusions were made. In August, 1983, she was referred and admitted to Tsukuba University Hospital for a further examination of anemia. A diagnosis of MDS (RARS) was made by hematological examinations, and pyridoxamine was administered from September, 1983. The monocyte counts in the peripheral blood increased above 1,000/μl continuously from June, 1985, and an exacerbation of anemia was also seen. At the second admission to our hospital in August, 1988, the diagnostic criteria for CMML by the FAB co-operative group was fulfilled. At that time, chromosomal analysis revealed an abnormal karyotype; 46XY, inv (12) (p13.3 q15). Even at the phase of CMML, ringed sideroblasts were also seen in 2.2% of nucleated cell count in the bone marrow. To our knowledge, only 12 cases have been reported as transformation from another type of MDS to CMML. The present case is thought to be a rare case of transformation of MDS. On the other hand, 8 cases with inv (12) associated with malignant hematological disorders have been reported previously. Four of the above 8 cases were MDS. A relationship between development of MDS and inv (12) was suggested.抄録全体を表示PDF形式でダウンロード (421K) -
石井 正夫, 山口 一成, 高月 清1990 年 31 巻 1 号 p. 80-84
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe present a rare case of B-cell malignant lymphoma in whom lymphoma cell infiltration into heart caused sick sinus syndrome (S.S.S) as an initial symptom and premortem diagnosis of heart involvement was made.
A 62-year-old woman was admitted to the orthopedic hospital because of pain in the lower extremities and discomfort in the chest. Chest roentgenogram showed an enlarged cardiac shadow and electrocardiogram (ECG) showed a sinus node dysfunction. A diagnosis of S.S.S. was made by the examination of sinus node recovery time. Myelography disclosed complete block between the 3rd and 4th lumbar vertebra. Pacemaker was inserted and laminectomy was done. The diagnosis of malignant lymphoma was made by the cytological study of the resected tissue. Gallium isotope study showed markedly increased isotope uptake in heart and abdomen. After chemotherapy the enlarged shadow of heart reduced in size and the uptake of gallium disappeared. ECG showed a sinus regular rhythm.
Afterwards her general condition got worse and leukemic convergence of malignant lymphoma occurred. Monoclonal antibody study of these cells disclosed positive CD 19 (OK B1), CD 20 (OK B4), and surface IgM-λ.抄録全体を表示PDF形式でダウンロード (389K) -
岡藤 浩一郎, 篠原 健次1990 年 31 巻 1 号 p. 85-88
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA rare case of aplastic anemia which was considered to be induced by allopurinol was reported. A 48-year-old female had suffered from urolithiasis and chronic renal insufficiency. She was administered allopurinol for hyperuricemia for 4 months, and subsequently developed severe pancytopenia and bone marrow suppression. After stopping of allopurinol administration, she was administered prednisolone but died of gastro-intestinal tract bleeding and sepsis on the 21th hospital day, without hematological recovery.抄録全体を表示PDF形式でダウンロード (309K) -
岡田 定, 清水 透, 原田 浩, 三好 保由, 滝沢 芳夫, 萩原 昭二, 森 啓, 新倉 春男, 寺田 秀夫, 藤田 和博, 小林 幸夫 ...1990 年 31 巻 1 号 p. 89-94
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe report two cases of Philadelphia (Ph1) chromosome positive acute mixed lineage leukemia (AMLL) with breakpoint cluster region (bcr) (M-BCR-1) rearrangement.
A 31 year-old-man (case 1) and a 42 year-old-woman (case 2) were admitted to our hospital for further evaluation of leucocytosis with atypical blasts. Each case was diagnosed as having bilineal type of AMLL because: (1) blasts in each case consisted of larger myeloid cells positive for myeloperoxidase and small lymphoid cells positive for PAS, and blasts in case 2 were positive for TdT; (2) blasts in case 1 expressed B lymphoid associated antigen; (3) Southern analysis in each case showed clonal rearrangements of both the immunoglobulin heavy chain and the T cell recepotr β gene. These two cases demonstrated the Ph1 chromosome and rearrangement of the bcr (M-BCR-1) gene, but none of splenomegaly, basophillia, and additional chromosome abnormalities were observed. In addition, after achieving remissions, they didn't revert to chronic phase of chronic myelogenous leukemia (CML) and showed normal neutrophil alkaline phosphatase scores, and the Ph1 chromosome disappeared completely in case 1 and coexisted with the normal chromosome in case 2.
These findings suggest that diagnosis of both cases should not be CML blast crisis (BC) but Ph1 positive acute leukemia, and Ph1 positive AMLL may be a distinct clinical entity to be distinguished from CML-BC.抄録全体を表示PDF形式でダウンロード (479K) -
福島 俊洋, 内田 三千彦, 岩崎 博道, 神谷 健一, 田中 経雄, 吉村 輝夫, 佐々木 欣也, 津谷 寛, 和野 雅治, 高山 博史, ...1990 年 31 巻 1 号 p. 95-99
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありThe patient is a 71-year-old female who underwent splenectomy due to splenomegaly 32 months after diagnosed as having primary myelofibrosis. On examination she was found to have massive skin nodules, lymph nodes swelling and an enlarged liver with an abnormal hematologic profile as follows: RBC count 3.68×106/μl; WBC count 151×103/μl with 11% blasts; and platelet count 42×103/μl. The bone marrow aspirate showed a hypocellular marrow with 19.2% blasts. Histological examination of the skin nodules revealed that they were myeloblastomas, thus suggesting leukemic transformation of primary myelofibrosis. Her WBC count dropped to about 20×103/μl through treatment with vindesine, cyclophosphamide, 6-mercaptopurine and prednisolone, but it did not drop further.
Treatment with dexamethasone remarkably regressed the myeloblastomas, but she died of heart failure 4 months after diagnosis of leukemic transformation of primary myelofibrosis. The autopsy findings showed the formation of numbers of myeloblastomas in both the systemic fatty tissue and dura mater as well as extramedullary hematopoiesis in liver and lymph nodes.
A rapid development of splenomegaly in a patient with primary myelofiblosis seems to be associated with leukemic transformation.抄録全体を表示PDF形式でダウンロード (479K) -
木村 晋也, 魚嶋 伸彦, 田中 亨, 小林 裕, 小沢 勝, 丸尾 直幸, 近藤 元治, 阿部 達生, 吉田 弥太郎1990 年 31 巻 1 号 p. 100-104
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 77-year-old male, who had been treated with carboquoe and busulfan for polycythemia vera (PV), developed myelodysplastic syndrome (MDS) 8 years later. On admission the peripheral blood revealed pancytopenia, but blastoid cells were not noted. The bone marrow showed hypercellularity, and functional and morphological abnormalities in trilineages of hemocytes. Cytogenetic study showed complex abnormalities involving chromosomes 5 and 7. We diagnosed this case as secondary MDS to alkylating agents. He was treated with 1, 25 (OH)2 vitamin D3. However, it was not effective and the percentage of myeloblasts increased to 14.4%. In spite of supportive therapy, he died of sepsis due to urinary tract infection.抄録全体を表示PDF形式でダウンロード (407K) -
佐野 雅之, 嶋本 義範, 田中 英彦, 松崎 美和子, 小野 和俊, 山口 雅也1990 年 31 巻 1 号 p. 105-109
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA case of granular lymphocyte proliferative disorder with squamous cell carcinoma of penis is described.
A 77-year-old Japanese male was admitted to our hospital in March, 1989 because of ulceration of penis and lymphocytosis. He had hepatomegaly and lymphadenopathy but not splenomegaly on physical examination. The WBC count was 10800/μl with 83% of granular lymphocytes. Thrombocytopenia (32000/μl) and mild anemia were also demonstrated. Bone marrow aspirate showed hypercellular marrow with 84% of granular lymphocytes. Proliferative granular lymphocytes were CD2+ CD3+ CD4- CD8- CDw29+ and exhibited ADCC activity but not NK activity. On March 15, amputation of penis was performed. But his lymphocytosis didn't change and thrombocytopenia increased. Thus we considered his granular lymphocytosis was neoplastic rather than reactive. Our case seemed to be rare and was compared with previous reports.抄録全体を表示PDF形式でダウンロード (544K) -
笹川 裕, 小山 隆三, 長井 忠則, 田村 升, 佐藤 昌明, 高後 裕, 新津 洋司郎1990 年 31 巻 1 号 p. 110-114
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 56-year-old man was admitted to Sapporo Kitano Hospital on May 30, 1987 because of fever, retention of ascites and pleural effusion, generalized lymphnode swelling and hepatosplenomegaly. Laboratory findings showed Cooms' positive hemolytic anemia, leukocytosis and polyclonal hypergamaglobulinemia. Serological test included positive RA factor, anti-DNA 16 U/ml, thyroglobulin Ab 1600×and microsome Ab 3200×. A cervical lymphnode specimen exhibited typical histologic picture of IBL like T cell lymphoma. The surface markers of lymphhoma cells were CD2 (+), CD8 (+) and CD4 (-). Chromosomal analysis of these cells revealed polyploidy abnormality for all chromosomes except for No. 14's which are disomy. All lymphoma cells have XXY sex chromosome and mar1, mar2, mar3. Gene rearrangement for beta-chain of T cell receptor was proved in these lymphoma cells.
He was treated with prednisolone, vincristine, cyclophosphamide, adriamycin etc, but died of respiratory failure 171 days after admission.
We reported a rare case of IBL like T cell lymphoma with polyploidy chromosomal abnormality accompanied with hemolytic anemia.抄録全体を表示PDF形式でダウンロード (645K) -
斎藤 弘行, 奈良 芳則, 根本 啓一, 柴田 昭1990 年 31 巻 1 号 p. 115-120
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe report a case of myelodysplastic syndrome with peculiar fibril formation in granulocytes shown through electron microscope and complex karyotypic abnormalities including ring chromosomes.
The patient, a 76-years-old male, was consulted for mild pancytopenia in Febrary 1987. After 5 month, his hematological findings showed severe pancytopenia getting worse rapidly and presence of blasts in the peripheral blood. He had slightly hypercellular marrow with marked trilineage dysplasia and increased number of blasts (12.6%).
Chromosome analysis from the bone marrow cells revealed its various structural abnormalities, especially in No. 3, 4, 5, 7, 11 with translocation on 11q11, and large ring chromosomes derived from unknown one.
By electron microscopic study, we observed bizarre structures, which was peculiar fibril formation as bundles of filament resembling actin paracrystals, throughout cytoplasm as well as within nucleus in granulocytes.抄録全体を表示PDF形式でダウンロード (709K) -
—本邦報告例のB-ALLとBurkitt's lymphomaの比較—時岡 剛, 嶋本 義範, 菅 謙司, 末岡 栄三朗, 松崎 美和子, 小野 和俊, 佐野 雅之, 南雲 文夫, 山口 雅也1990 年 31 巻 1 号 p. 121-126
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありTwo patients with acute lymphocytic leukemia of B-cell phenotype (B-ALL) are described. They were 77-year-old female and 34-year-old male.
One patient presented with marked splenomegaly, and the other with rupture of spleen on admission. Leukemic morphology revealed a typical L3 profile by FAB classification system in both cases. Immunologic analysis showed the presence of surface immunoglobulins in both cases, and one phenotype was IgM κappa, whereas the other was IgG κappa. Cytogenetic study revealed the typical translocations (8; 14) in both cases. Following chemotherapy, complete remission was achieved in one case, but the other died 36 days after admission.
Including our two cases, we studied 12 cases of B-ALL and 77 cases of Burkitt's lymphoma reported in Japan, investigating the clinical prognosis as well as the biological features. We concluded that there are no significant difference of survival between B-ALL and Burkitt's lymphoma. We estimated it is due to oncogenesis from the same original cell in despite of the difference in main tumor site between two diseases.抄録全体を表示PDF形式でダウンロード (450K)
短報
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新名主 宏一, 門倉 直子, 糸山 貴浩, 太良 光利, 丸山 征郎, 納 光弘1990 年 31 巻 1 号 p. 127-128
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありThere was a markedly significant increase of plasma levels of tissue-type plasminogen activator, plasminogen activator inhibitor 1 (PAI-1) and PAI activity in 3 patients with hemophagocytic histiocytosis (HPH) as compared with DIC patients with multi-organ failure (MOF). Of particular interest was the peculiar increase of PAI-1 levels, that is, the average PAI-1 level was 2,673 ng/ml, while that in DIC patients with MOF was 66 ng/ml. We conclude that the striking increase of plasma PAI-1 levels may be a pathognomonic feature of HPH and may contribute to the pathogenesis of DIC and/or MOF associated with HPH.抄録全体を表示PDF形式でダウンロード (164K) -
大久保 進, 石田 萠子, 安永 幸二郎1990 年 31 巻 1 号 p. 129-130
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 83-year-old woman, complaining of jaundice and anemia, was diagnosed as autoimmune hemolytic anemia (AIHA) with bilirubin gall stones. Her red blood cell (RBC) group was A, Rh (D)+, but the details were indefinite due to transfusions previously repeated, while anti-C3d serum reacted positively in the direct antiglobulin test. Her serum reacted with RBC other than R2R2 in the albumin (37°C) method and in the bromelin method, the reaction turning out negative after the pretreatment with 2ME.
These findings indicated the autoantibody was anti-e of IgM class, which had been so far rarely reported in Japan.抄録全体を表示PDF形式でダウンロード (147K)
例会
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1990 年 31 巻 1 号 p. 131-142
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありPDF形式でダウンロード (1125K)
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