Primary cutaneous marginal zone B-cell lymphoma: a clinical, histopathological, immunophenotypic and molecular genetic study of 22 cases

BACKGROUND

Primary cutaneous marginal zone B-cell lymphoma (MZCL) has recently been described. Differentiation from follicular centre cell lymphomas and lymphocytomas is often difficult due to insufficient experience and a lack of large series of patients.

OBJECTIVES

To characterize primary cutaneous MZCL better, we report clinical, histopathological, immunophenotypic and molecular genetics features in a series of 22 patients.

METHODS

All patients were treated and followed up at the same institution. Diagnosis of MZCL was based on the World Health Organization classification criteria. All samples were routinely tested with a wide panel of monoclonal antibodies. DNA was extracted from every sample following standard methods. IgH rearrangement and t(14;18)(q32;q21) studies were performed in all samples.

RESULTS

Twenty-two patients (20 men, two women; mean age 50 years, range 24-77) were included. The mean follow-up was 43 months. Seventy per cent of patients presented with characteristic skin lesions on the trunk or extremities, consisting of deep red to violaceous infiltrated plaques, nodules or tumours frequently surrounded by diffuse or annular erythema. Four patients presented with lesions on the head and neck area. Two patients had disseminated skin lesions. The main histopathological features were non-epidermotropic, dense lymphocytic infiltrates mainly distributed in a nodular pattern. Adnexal involvement was usually present, with eventual formation of lymphoepithelial complexes. Cytologically, the infiltrate was polymorphous with marginal zone B cells and B-monocytoid cells. Blastoid CD30+ cells were often observed. Colonized reactive germinal centres and lymphoplasmocytoid differentiation were frequently present. Neoplastic cells were CD20+, CD79a+, CD5- and CD10-. Monotypic expression of light chains was observed in 18 cases (13 kappa; five lambda). Clonal IgH rearrangements were detected in 14 cases. The bcl-2 mutation t(14;18)(q32;q21) was demonstrated in two cases. Most patients were treated with local radiotherapy. Complete response rate with this approach was 100%. Six patients (27%) had skin recurrences from 6 months to 8 years after first treatment. Five patients (23%) had extracutaneous involvement. Two of them had a large cell transformation and one died of lymphoma. Three of four patients with head and neck presentation developed extracutaneous disease.

CONCLUSIONS

MZCL appears to be a well recognizable entity, clinically, histologically and immunophenotypically. Although prognosis is generally good, the disease has potential for skin as well as extracutaneous recurrences. Large cell transformation and head and neck presentation may be associated with a worse prognosis.

[Anterior sacral meningocele with Currarino's syndrome: report of two cases]

The anterior sacral meningocele is the congenital hernia of the thecal sac into the pelvis through a bone defect of the anterior wall of the sacrum. The association of anorectal anomaly, anterior sacral defect and presacral mass, known as Currarino's triad, can be diagnosed during the first decade of life in the eighty per cent of the cases However, in the incomplete syndrome, the symptoms appear in adults. In order to avoid late complications and due to the clear genetic origin of this uncommon pathology, the investigation of the family is of paramount importance for the early diagnosis and treatment. We review the literature and add two cases of anterior sacral meningocele with rectal fistula and incomplete Currarino's syndrome. In one of the cases the pathology is also present in another member of the same family and is complicated with meningitis. The importance of early diagnosis and treatment of these malformations and the need for fammily genetic investigation are discussed.

[Spinal meningeal melanocytoma simulating neurinoma: case report]

Meningeal melanocytomas are infrequent tumors that when located in the spinal cord and because of their close relationship to the nerve root can resemble a neurinoma. The MRl can help to differentiate them from the neurinomas preoperatively. The case of a female patient harboring a cervical meningeal melanocytoma involving the C7 nerve root, and diagnosed preoperatively as an hourglass neurinoma is presented.

Laboratory methods for the diagnosis of asthenozoospermia

Human sperm samples from 46 men were evaluated for standard semen parameters by two trained technicians, according to WHO criteria. A computer-aided semen analyzer (CASA, HTM-IVOS) was employed. The overall mean coefficient of variation for the 2 participants and the 46 samples studied was 17% for the percentage of progressive motile spermatozoa (r = 0.77). Twenty-nine (63%) samples were classified as asthenozoospermia by both methods. From the studied samples, 12 (26%) were classified as asthenozoospermia by the subjective method and 2 (4.3%) by CASA (p =.01). The two methods do not provide directly comparable data.

Testicular damage from anabolic treatments with the beta(2)-adrenergic agonist clenbuterol in pigs: a light and electron microscope study

The morphological consequences of anabolic clenbuterol treatment on the testicular parenchyma were investigated in 30 pigs at morphological and ultrastructural levels. Clenbuterol was given with food (1 ppm). In the first group (n=10), treatment was maintained until slaughter (experimental period 3 months). In the second group (n=10), clenbuterol was withdrawn 2 weeks before slaughter (experimental period 2.5 months). A third group (n=10) of pigs not fed with clenbuterol served as controls. Animals were slaughtered at 9 months of age and samples of testicular parenchyma were collected for light and electron microscope studies. In the clenbuterol-treated groups, the interstitial cells showed a considerable increase in the organelles involved in testosterone production, with an increased development of the mitochondria, smooth endoplasmic reticulum, Golgi apparatus and lipid droplets compared to the control group. The seminal epithelium displayed many lipid vacuoles and evident signs of tubular involution, such as degenerating and multinucleate germ cells. Sertoli cells gave evidence of metabolic alterations such as large lipid deposits and cytolysosomes.

Detection of grain protein content QTLs across environments in tetraploid wheats

Grain protein content (GPC) is an important quality factor in both durum and bread wheats. GPC is considered to be a polygenic trait influenced by environmental factors and management practice. The objectives of this study were both to compare the quantitative trait loci (QTL) for GPC in a population of 65 recombinant inbred lines of tetraploid wheats evaluated in three locations for several years (eight data sets), and to investigate the genetic relationship among GPC and grain yield. QTLs were determined based on the Messapia x dicoccoides linkage map which covers 217 linked loci on the 14 chromosomes with 42 additional loci as yet unassigned to linkage groups. The map extends to 1352 cM; the average distance between adjacent markers was 6.3 cM. Seven QTLs for GPC, located on the chromosome arms 4BS, 5AL, 6AS (two loci), 6BS, 7AS and 7BS, were detected that were significant in at least one environment at P<0.001 or in at least two environments at P<0.01. One QTL was significant in all but one environment, two were significant in four or five environments, and four were significant in two out of eight environments. Six out of seven protein content QTLs had pleiotropic effects or were associated to QTLs for grain yield and explained the negative correlation among GPC and yield components. The present results support the concept that studies conducted in a single environment are likely to underestimate the number of QTLs that can influence a trait and that the phenotypic data for a quantitative trait should be collected over a range of locations to identify putative QTLs and determine their phenotypic effects.

Size of the collateral intercostal artery in adults: anatomical considerations in relation to thoracocentesis and thoracoscopy

No detailed descriptions exist of the collateral intercostal artery which can provide an accurate anatomical basis for ensuring a low rate of vascular complications during thoracocentesis and thoracoscopy. Consequently the present study was undertaken to provide information on the origin, size and topographic relationships of the collateral intercostal artery. Ninety cadaveric adult intercostal spaces were dissected using standard procedures. The collateral intercostal arteries were exposed throughout their full length and measured at the points within the intercostal spaces considered to be the most important for clinical purposes. The posterior intercostal arteries and their collateral branches were observed to decrease in size from posterior to anterior; however, no significant differences were present in their size in the first four intercostal spaces. Based on these findings the usual thoracocentesis or thoracoscopy technique, in which it is recommended that puncture is done as close as possible to the superior margin of the inferior rib, may lead to collateral intercostal artery laceration and considerable bleeding. A subtle, but important, modification to this technique is suggested aimed at achieving safer access to the intercostal space. In the modified technique, the puncture should be made in the middle of the intercostal space, thereby reducing the possibility of laceration of the collateral intercostal artery.

Effects of anabolic implants of oestradiol alone or in combination with trenbolone acetate on the ultrastructure of mammary glands in female lambs regarding their interference in prolactin secretion

The side-effects of anabolic steroid implants on mammary gland ultrastructure were evaluated in female lambs treated with oestradiol (n = 10) and with oestradiol plus trenbolone acetate (n = 10). Ten non-implanted lambs were used as controls. Apart from the ultrastructural study of the mammary gland, an assessment of the prolactin pituitary cell population was carried out by immunological methods. Our results showed that oestrogenic implants exert stimulating effects on mammary gland development, both by activating the synthesis process at mammary gland cell levels and by increasing prolactin pituitary production. Nevertheless, there was no evidence of secretory products in the lumen of the gland. Implants containing trenbolone acetate counteracted the mammary stimulus of oestrogens showing ultrastructural images of cell autolysis and necrosis.

The decade 1989-1998 in Spanish psychology: an analysis of research in social psychology

In this study, a detailed exploration is carried out of the production of research and theory in social psychology in the Spanish context. The main research areas are: Work and organizational psychology, social health psychology, community and social services psychology, environmental research, judicial and political psychology, psychosocial theory and meta-theory, social psychology of language, research on emotion, group processes and social identity. The growing importance of social psychology within the framework of Spanish psychology is emphasized, and the relation with specific social problems from the national context, and the paradoxically scarce originality of the theoretical perspectives and the leading research, strongly influenced by Anglo Saxon social psychology, is commented upon.

The skin of the medial area of the arm: morphometric study of interest to liposuction

The study of the skin of medial area of the arm in cadavers made it possible to evaluate its regional characteristics. Sex or race were not reported, but the age group most appropriate to liposuction was considered. In this way, authors believed that, as per standards established at the time, results as to skin retraction in liposuction, will be able to be analyzed in a comparative way in the future.

Morphological and quantitative study of the Leydig cells of pigs fed with anabolic doses of clenbuterol

The effects of clenbuterol administered at anabolic doses on the testicular interstitium were studied in 30 pigs allocated to three experimental groups. The diet of two groups was supplemented with clenbuterol (Clb) (1 ppm), but whereas in the Clb+ group the treatment was given until slaughter (treatment period: 3 months), in the Clb- group the clenbuterol was withdrawn 2 weeks before slaughter (treatment period: 2-5 months); in the control group, the pigs were fed without clenbuterol. For histological procedures, a fractional sampling scheme was applied and routine techniques for light and transmission electron microscopy were used. The results of subjective morphology and morphometrics showed slight differences between the treated and the control groups. Conversely, the stereological results identified a prominent hyperplasia of the Leydig cells and ultrastructural analysis of these cells revealed a conspicuous increase in the organelles related to testosterone production, suggesting a functional activation of the interstitial cells in response to the clenbuterol treatment.

[Postsurgical meningitis caused by Acinetobacter baumannii: study of 22 cases and review of the literature]

BACKGROUND

Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied.

METHODS

Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years).

RESULTS

All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients showed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05).

CONCLUSIONS

Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.

Flow cytometry in the bone marrow evaluation of follicular and diffuse large B-cell lymphomas

BACKGROUND AND OBJECTIVES

Bone marrow biopsies are routinely performed in the staging of patients with lymphoma. Despite the lack of evidence for its usefulness, many institutions include flow cytometry (FC) of bone-marrow aspirates in an attempt to increase sensitivity and specificity. The aim of this study is to evaluate the usefulness of FC for the assessment of bone-marrow involvement by lymphoma in follicular (FL) and diffuse large B-cell lymphomas (DLBCL).

DESIGN AND METHODS

Seventy-nine bone marrow biopsies from 65 patients diagnosed with FL or DLBCL were examined to compare histology and FC for the assessment of bone-marrow involvement by lymphoma.

RESULTS

Bone marrow histology showed involvement (BM+) in 16 cases (20.3%), lack of infiltration (BM(-)) in 52 cases (65.8%) and undetermined or undiagnosed for involvement (BMu) in 11 cases (13.9%). FC was positive for involvement in 28 cases (35.4%) and negative in 51 cases (64.6%). 65 cases (95%) showed concordance between the results of morphology and FC (BM(+)/FC(+) or BM(-)/FC(-)). No BM(+)/FC(-) cases were observed. 3 cases showed discrepant results (BM(-)/FC(+)). In these 3 cases the molecular studies (PCR) demonstrated clonal rearrangement of the heavy immunoglobulin chain (IgH) and/or bcl2-IgH in agreement with the flow results. Among the 11 cases with BMu, all but 2 were FC(+) and concordance with the PCR results was seen in 9 cases (81.9%).

INTERPRETATION AND CONCLUSIONS

We conclude that FC is just as sensitive or perhaps slightly more sensitive than histology in the detection of bone marrow involvement in FL and DLBCL. FC studies may be warranted in those cases in which the morphology is not diagnosed. The clinical relevance of the small clonal B-cell population in patients without histologic bone marrow involvement (BM(-)/FC(+) cases) remains an open question.

Gains of chromosome 22 by fluorescence in situ hybridization in the context of an hyperdiploid karyotype are associated with aggressive clinical features in meningioma patients

BACKGROUND

Meningiomas usually are considered to be benign tumors; however, 10-20% of cases recur. Few disease characteristics have proved to have prognostic impact for predicting disease free survival. The objective of the current study was to explore the prognostic value of numeric abnormalities of chromosome 22 for meningioma patients.

METHODS

In this study, the authors prospectively analyzed the incidence of numeric chromosome abnormalities of chromosome 22 by interphase fluorescence in situ hybridization, using a specific probe for the bcr gene located in chromosome 22q11.2, on a total of 88 consecutive meningioma patients. The authors also analyzed its correlation with both the clinicobiologic characteristics at presentation and the patient's outcome.

RESULTS

The authors' results show that monosomy 22 was present in 49% of the cases and that this numeric chromosomal abnormality is not associated with other prognostic features of the disease. In contrast, gains (trisomy/tetrasomy) of chromosome 22 were detected in 8 (9%) cases who simultaneously showed gains for other chromosomes and represent an adverse prognostic factor regarding disease free survival (P = 0.001); in addition, trisomy/tetrasomy 22 was more frequently related to younger patients (P = 0.001), aggressive histopathologic features (P < 0.000), a greater incidence of DNA aneuploidy (P =0.006), and a higher proportion of S-phase tumor cells (P = 0.02).

CONCLUSIONS

In summary, the authors conclude that loss of a copy of chromosome 22 is a frequent finding in meningioma tumors, but it does not affect the clinical outcome of these patients. In contrast, gains (trisomy/tetrasomy) of chromosome 22, in the context of an hyperdiploid karyotype, although much less frequent, are associated with a more aggressive disease course.

Stereological study of normal and apoptotic cell populations in the adrenal gland in calves

Morphometrical features of the adrenal gland in calves were assessed using stereological methods for normal and apoptotic cells. Adrenal glands were obtained from calves (n = 16) after they were slaughtered in a commercial abattoir. Quantitative data of nuclear size showed the highest values in the noradrenaline-storing region for all parameters, whereas the nuclei of the zona fasciculata were significantly larger than those of the other cortical regions. Data of nuclear size and shape of apoptotic cells reflected their morphometrical features; as expected, a notable decrease in the nuclear size and a more irregular shape were found in apoptosis with respect to the normal nuclei in all adrenal regions. The volume fraction data supplied the percentage of the adrenal gland occupied by each histological zone, highlighting the zona fasciculata as being the most extensive one. A significant increase in V(V)(nucl/tis), S(V)(nucl/tis), and Nv(nucl/tis) was observed in cortical regions with respect to the medullar regions. A comparison between normal and apoptotic nuclei indicated a highly significant decrease in V(V)(nucl/tis), S(V)(nucl/tis), and Nv(nucl/tis) for the apoptotic nuclei in all the adrenal zones. The apoptotic nuclei figures found in all the adrenal regions suggest that a process of cell renovation occurred in all the zones, although the higher number of apoptosis in zona reticularis is in agreement with previous results that have pointed out this zone as being a cell senescence region. The results of discriminant analyses gave the parameter required and the percentage of correct classifications for discriminating between normal nuclei, between apoptotic nuclei and between normal and apoptotic nuclei.

Genetic relationships among Aedes aegypti (Diptera: Culicidae) populations from Argentina using random amplified polymorphic DNA polymerase chain reaction markers

Random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) polymorphism was analyzed in five Aedes aegypti (L.) populations from Argentina and one from Puerto Rico to estimate levels of intraspecific polymorphism and genetic relatedness. Allele frequencies were estimated assuming that RAPD products segregate as dominants and that genotype frequencies at those loci are in Hardy-Weinberg equilibrium. Mean expected heterozygosity (He) was 0.350; F(ST) values were significant at all loci except one, supporting the usefulness of the fragments used here to discriminate among populations. Rogers' genetic similarity between samples ranged from 0.806 to 0.621. The population from Puerto Rico was the most different from the Argentina populations. Considering that Ae. aegypti eggs, larvae, and pupae can be transported easily, relationships among the Argentinian populations may reflect the routes and intensity of commercial transit.

Solid-phase extraction and high-performance liquid chromatography applied to the determination of quinapril and its metabolite quinaprilat in urine

Quinapril is an antihypertensive drug that belongs to the family of angiotensin-converting enzyme inhibitors. It is metabolized to quinaprilat, which is the compound that is really responsible for the therapeutic action. In this study, a rapid and simple liquid chromatographic method with photometric detection is described and applied to the determination of quinapril and quinaprilat in urine. The cleanup procedure for the urine samples consists of a solid-liquid extraction using C8 cartridges. Under these conditions, both compounds and the internal standard (enalapril maleate) are separated in less than 9 min. Recoveries for quinapril and quinaprilat are greater than 80%. The method is sensitive enough (detection limit of 60 ng/mL for quinapril and 50 ng/mL for quinaprilat) to be applied for the determination of quinapril and quinaprilat in urine samples obtained from four hypertensive patients after the intake of a therapeutic dose.

[Prevalence of anemia, iron and folate deficiency in children 7 years smaller. Costa Rica, 1996]

In 1996, were studied in Costa Rica 961 children with ages between one and six years, with representation for metropolitan, urban and rural zones of the country. The classification approaches applied were emitted by the Pan-American Health Organization and the World Health Organization. The preschooler population presented in the national environment a prevalence of anemia of 26.3% (children from 1 to 4 years with hemoglobin < 11.0 g/dL and those from 5 to 6 years old with hemoglobin < 12.0 g/dL). The prevalence of Iron depletion (Ferritin < 12 ng/mL) and iron deficiency (Ferritin < 24 ng/mL) were 24.4% and 53.8%, respectively. The folate deficiency (< 6.0 ng/mL) was 11.4%. The iron deficiency was higher in children smaller than 4 years, being the maximum deficiency in the 1 year-old (75%). More than 40% of the preschool children presented sub-clinical deficiency of iron; of them, 10% showed severe deficiency of iron without presence of anemia. The children from the rural area presented the highest prevalence of anemia and iron depletion, while the metropolitan area met more frequency with iron deficiency. The nutritional anemias still constitute a moderate problem of public health in Costa Rica. The main cause is iron deficiency, associated in small proportion with folate deficiency and other factors associated with the erythropoiesis.