Clinical and morphological features of cases of trisomy 13 in acute non-lymphocytic leukemia

Trisomy 13 has been infrequently reported as a primary non-random karyotypic change in myeloid leukemias. To elucidate its clinical significance we examined the clinical and hematological data in nine ANLL patients in whom we found this change, in a series of 175 cytogenetically abnormal ANLL patients. Morphologically, six of the patients were FAB-M1, two were FAB-M4 and one was FAB-M5. Bone marrow aspirates contained more than 90% blasts in eight of the patients. By immunophenotype, TdT was present in four of the patients, CD34 was present in four of five patients tested and CD5 was present in one of five patients tested. Blast cells in all patients expressed two or more myeloid surface antigens. These data suggest the proliferation of an immature myeloid cell in these patients. Complete remission was achieved in seven patients; however, remissions were short-lived. Eight patients expired between 1 and 13 months from diagnosis (median survival 5 months). Combining our findings with data in the published literature on trisomy 13 in ANLL, a larger data set consisting of 29 patients was established to determine better the clinical significance of this cytogenetic entity in ANLL. We found that this cytogenetic change has been reported in all subsets of FAB classification excepting M6 and M7. Median age at presentation was 60 years and no association with gender was noted. Median WBC was 29.5 x 10(9)/l, the majority of patients were thrombocytopenic (median platelet count 86 x 10(9)/l) and median survival was 5.2 months. This study associates trisomy 13 with malignant transformation of myeloid progenitor cells. These patients respond well to induction therapy, but relapse occurs quickly and the survival duration is poor.

Deletion of cyclin-dependent kinase 4 inhibitor genes P15 and P16 in non-Hodgkin's lymphoma

B-cell non-Hodgkin's lymphoma (NHL) is a heterogeneous lymphoid malignancy consisting of several histologic types. Alterations in proto-oncogenes caused by reciprocal chromosome translocations have been implicated in the etiology of specific histologic groups. In this study, we examined the contribution of the cell cycle inhibitor genes P15, P16, and P18 to pathogenesis in a large panel of 209 cytogenetically characterized B-cell NHL tumors representing varied histologic groups. We identified the homozygous deletion of P15 and P16 genes in 13 tumors from 12 patients, all belonging to diffuse large-cell histology; 10 had this diagnosis made on presentation, 1 had transformed from small lymphocytic lymphoma, and 1 had transformed from Hodgkin's disease. Tumor-specific point mutations were not identified in the coding regions of these genes. Cytogenetically, chromosome 9p was normal in all but one tumor. On the other hand, eight tumors hemizygous for 9p by cytogenetic analysis showed wild-type configuration of these genes. Our study, therefore, indicates that deletion of P15 and P16 occurs in about 15% of diffuse large-cell NHL and is not usually detected by cytogenetic analysis. P18 was wild-type in all tumors including the 13 tumors hemizygous for 1p.

Normal parameters of ventricular system in healthy infants

Six hundred healthy inborn newborns and infants upto the age of 18 months were studied. Cranial sonography was performed by real time 2D scanner with 5 MHz transducer and images were obtained through anterior fontanelle and temporo-squamal suture. Various parameters related to ventricular system were measured for different ages till the fontanelle remained open. These values will prove useful for diagnosing hydrocephalus at an early stage of the disease and also to find out the blocks at various levels in ventricular system.

Ultrasonic diagnosis of intracranial hemorrhage in high risk neonates

One hundred and eleven high risk neonates were subjected to (cranial ultrasound (CR-USG) Caranial sonography was performed by 2D realtime scanner with 5 MHz transducer through anterior and posterior fontanelle and temporo-squamal suture. One quarter of these neonates developed intracranial hemorrhage (ICH) within 120 hours of birth. Of them 42.8% neonates recovered completely, 21.4% developed ventriculomegaly, 21.4% neonates expired, 10.4% developed pseudo-porencephalic cysts and 3.5% developed aqueductal block. It is concluded that CR-USG is a useful technique for detection and monitoring of complications of ICH and at least one screening sonogram is essential in the first week of life of all high risk neonates.

Morphological, ultrastructural, and genetic characterization of an unusual T-cell lymphoma in a patient with sinus histiocytosis with massive lymphadenopathy

Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare benign disease of unknown etiology. It is rarely associated with malignant lymphoma. This report documents the first case of a T-cell lymphoma, which developed in a patient with a 10-year history of SHML. The disease was complicated by hypereosinophilia and massive retroperitoneal lymphadenopathy. Histological examination of a cervical lymph node biopsy during the terminal phase identified a lymphoma composed of cells with morphological plasmacytoid features. Ultrastructurally, the tumor cells showed poorly developed cytoplasm, nuclei with peripheral chromatin clumping, and inconspicuous nucleoli. Cytogenetic studies showed two related clones. On immunohistochemical staining tumor cells were positive with monoclonal antibodies (mAb) CD3 and CD45RO. Southern blotting analysis identified clonal rearrangements in the T-cell receptor (TCR) alpha, beta and gamma genes. Thus, T-cell lineage of the tumor cells was established. In situ hybridization of interleukin-2 (IL-2) and interleukin-5 (IL-5) cDNA probes on tissue sections identified the synthesis of IL-5 by the eosinophils, suggesting an autocrine pathway of eosinophilopoiesis leading to hypereosinophilia in this patient.

Cranial ultrasonic assessment of infants with acute bacterial meningitis

A prospective study was performed on 44 patients (newborn to one year old) with acute bacterial meningitis. Sonograms were obtained within 72 hours of diagnosis, and repeated on 7th, 14th or at an early date, if required. The spectrum of sonographic features of meningitis included normal scan (35.4%), echogenic sulci (63.7%) and parenchyma (29.5%), ventriculomegaly (59%), ventriculitis (35%), pseudo-porencephalic cyst (4.4%), extra axial fluid collection (4.4%), encephalomalacia (2.2%) and cerebral abscess (2.2%) in patients.

Intraoperative fine needle aspiration cytology of pancreas: a study of 97 cases

Intraoperative fine needle aspiration cytology (FNAC) for pancreatic and ampullary lesions was carried out under direct vision using transduodenal approach in 97 patients. Cytological findings were classified as follows: positive for malignancy, suspicious for malignancy, benign (normal) cells from duodenum or pancreas, inflammatory and non-representative smears. Suboptimal smears (non-representative, suspicious and inflammatory) were excluded for calculating decision analysis values. Sensitivity for malignancy was 90.5% and specificity 100%. Positive and negative predictive values were 100% and 50% respectively. We conclude that intraoperative FNAC is useful in diagnosing malignant lesions of the pancreas.

Chronic inhalation effects of tetrachloroethylene on hepatic and renal microsomal electron transport components and delta-aminolevulinic acid dehydratase in rats

Hepatic and renal microsomal electron transport components and erythrocyte delta-aminolevulinate dehydratase were investigated in adult male rats exposed to 0, 50, 200 and 600 ppm tetrachloroethylene for 4 weeks. Body weight and liver weight showed a significant decrease only in the 600 ppm group. A dose-dependent decrease in erythrocyte delta-aminolevulinate dehydratase was observed at 200 and 600 ppm. Serum transaminase activity (SGPT) showed an increase in the 600 ppm group only. Hepatic and renal microsomal protein content showed an increase in all groups except in the kidneys of the 600 ppm group. Induction of hepatic cytochrome b5 activity was observed in all groups. However, hepatic cytochrome P-450 showed an induction and slight inhibition at 200 and 600 ppm respectively, without any alteration at 50 ppm. Renal microsomal cytochrome P-450 activity was induced in all groups. Induction of hepatic and renal NADPH cytochrome c reductase activity was observed at 600 ppm, but no alteration was seen at 50 and 200 ppm. These results indicate that chronic inhalation of tetrachloroethylene at higher levels alters mixed-function oxidase and heme metabolism.

Ileal endometriosis (a case report)

A case of endometriosis involving small bowel is reported here. It is the first case reported at our institution in the last 10 years period.