Response of a recurrent choroid plexus tumor to combination chemotherapy

Choroid Plexus tumors are rare. Surgery and biopsy is diagnostic, and radiotherapy has been used as the treatment of choice for choroid plexus carcinoma (CPC) and recurrent choroid plexus papilloma (CPP). We report the first case of CPP responding to combination chemotherapy consisting of cisplatin, bleomycin and vinblastine (CBV). This chemotherapy regimen should be considered for future trials in patients with choroid plexus tumors and recurrence after surgery and/or radiotherapy.

Acquired chromosome rearrangements, including fine interstitial deletions, in a patient with Down syndrome and monoblastic leukemia

A female child with Down syndrome who developed acute monoblastic leukemia is reported. Anemia associated with milk leukopenia was first recognized when the patient was 14 months old. Acute monoblastic leukemia was diagnosed 1 year later; cytogenetic studies were performed on circulating leukemic cells at this time. Analysis of elongated, finely banded chromosomes revealed three structural rearrangements, including two rather subtle interstitial deletions, in addition to trisomy 21 which was representative of the patient's constitutional karyotype. The karyotype of the leukemic cells was 47,XX,+21,t(3;18)(p23;q11.2), del(7)(q31.1q31.3), del(9)(p22p24 or p21p23). The patient received no cytostatic chemotherapy and died 4 months after the diagnosis of acute leukemia was made.

Single cell origin of multilineage colonies in culture. Evidence that differentiation of multipotent progenitors and restriction of proliferative potential of monopotent progenitors are stochastic processes

In this paper, we report analysis of differentiation in human hemopoietic colonies derived from a single cell. Cord blood mononulear cells and panned My-10 antigen-positive bone marrow and cord blood cells were plated in methylcellulose medium containing erythropoietin and conditioned medium. Initially, we performed mapping studies to identify candidate colony-forming cells. Subsequently, using a micromanipulator, we transferred single cells individually to 35-mm dishes for analysis of colony formation. Cellular composition of the colony was determined by identifying all of the cells in the May-Grunwald-Giemsa stained preparation. Of 150 single candidate cells replated, 63 produced colonies. The incidences of single lineage colonies included 19 erythroid, 17 monocyte-macrophage, and 9 eosinophil colonies. There were 18 mixed hemopoietic colonies consisting of cells in two, three, four, and five lineages in varying combinations. In some instances, we noted the predominance of one lineage and the presence of very small populations of cells in a second or third lineage. These results provide evidence for the single-cell origin of human multilineage hemopoietic colonies, and are consistent with the stochastic model of stem cell differentiation in man. They also indicate that restriction of the proliferative potential of committed progenitors is a stochastic process.

Antigenic analysis of hematopoiesis. III. A hematopoietic progenitor cell surface antigen defined by a monoclonal antibody raised against KG-1a cells

The anti-My-10 mouse monoclonal antibody was raised against the immature human myeloid cell line KG-1a and was selected for nonreactivity with mature human granulocytes. Anti-My-10 immunoprecipitated a KG-1a cell surface protein with an apparent Mr of approximately 115 kD. We describe the binding of this antibody to human hematopoietic cell types and show that My-10 is expressed specifically on immature normal human marrow cells, including hematopoietic progenitor cells. My-10 is also expressed by leukemic marrow cells from a subpopulation of patients. Thus, this antibody allows the identification and purification of hematopoietic progenitor cells from normal human marrow and the subclassification of leukemia.

Antigenic analysis of hematopoiesis. III. A hematopoietic progenitor cell surface antigen defined by a monoclonal antibody raised against KG-1a cells

The anti-My-10 mouse monoclonal antibody was raised against the immature human myeloid cell line KG-1a and was selected for nonreactivity with mature human granulocytes. Anti-My-10 immunoprecipitated a KG-1a cell surface protein with an apparent Mr of approximately 115 kD. We describe the binding of this antibody to human hematopoietic cell types and show that My-10 is expressed specifically on immature normal human marrow cells, including hematopoietic progenitor cells. My-10 is also expressed by leukemic marrow cells from a subpopulation of patients. Thus, this antibody allows the identification and purification of hematopoietic progenitor cells from normal human marrow and the subclassification of leukemia.

Antigenic analysis of hematopoiesis: II. Expression of human neutrophil antigens on normal and leukemic marrow cells

The binding of five antineutrophil monoclonal antibodies AHN-1, -2, -3, -7, and -8, to normal and leukemic bone marrow cells was studied. AHN-7 bound to many granulocytic precursors, particularly myelocytes, and both lymphoid and blast cells in normal marrow, and to most but not all granulocyte-macrophage progenitors (CFC-GM). AHN-8 bound only to late (band and segmented) neutrophilic cells and not to CFC-GM. AHN-1, -2, -3 bound to morphologically identifiable neutrophil precursors, but not to (day-14) CFC-GM. Approximately half of nonlymphoid leukemia specimens were positive with AHN-1 or AHN-7; by contrast, lymphoid leukemia specimens were rarely positive. AHN-8 was rarely found on leukemic cells. These antineutrophil antibodies appear to detect distinct granulopoietic subsets and may be useful in the analysis of hematologic differentiation and in the subclassification of leukemias.

Tumor infiltration of the bone marrow: comparative study using computed tomography

During the past two years five patients with malignant primary bone tumors undergoing amputation or resection of the involved bone had preoperative computed tomography (CT) examination of the medullary cavity. The contralateral extremity was used as a control in all cases. The positive attenuation coefficient of the marrow indicated the extent of tumor infiltration. The correlation between the preoperative CT and pathologic measurement ranged between 1-8 mm, an accuracy greater than 94%.

Antigenic analysis of hematopoiesis. I. Expression of the My-1 granulocyte surface antigen on human marrow cells and leukemic cell lines

Five monoclonal antibodies that identify the My-1 human granulocyte surface antigen were not reactive with other peripheral blood cells. These antibodies effected complement-dependent cytolysis of a large fraction of normal human marrow leukocytes. This My-1-positive marrow cell population consisted of morphologically identifiable granulocytic precursor cells. Colony-forming cells of the granulocyte-monocyte lineage (CFC-GM) did not express My-1, suggesting that the My-1 antigen is expressed later in normal granulocytic maturation. However, these antibodies did react with myeloid leukemic cell lines. The significance and potential utility of these probes for the understanding of granulopoietic differentiation is discussed.

Benign glandular inclusions in lymph nodes, endosalpingiosis, and salpingitis isthmica nodosa in a young girl with clear cell adenocarcinoma of the cervix

A 12-year-old girl underwent radical surgery for clear cell adenocarcinoma of the endocervix. Bilaterally dilated fallopian tubes with hyperplastic mucosal folds and salpingitis isthmica nodosa were found in association with benign glandular inclusions in a para-aortic lymph node and in the serosa of pelvic organs. Changes in the müllerian-derived epithelium appear to be a common denominator of these unusual lesions in this young girl. A primary growth disturbance of the cells of the müllerian system, which was conditioned during embryonic development and manifested itself later in life in response to appropriate stimuli associated with menarche, is postulated as the underlying abnormality.

The human fetal heart in the second trimester of gestation: a gross morphometric study of normal fetuses

One hundred fifty-three midtrimester fetuses obtained from normal pregnancies terminated for nonmedical reasons were studied to establish normal standard measurements. Mean, standard deviation, range, and percentiles of body weight, foot length, crown-rump length, biparietal diameter, cardiac weight, thickness of ventricles, and ventricular septum were derived by computer analysis. Statistical analysis showed no sex difference. Equations for predicting body weight, cardiac weight, and septal thickness were derived with the use of fetal age and biparietal diameter as variables. The mean ratio of septal to left ventricular wall thickness was 1.14 +/- 0.34; a ratio of 1.3 or greater was found in 25% and a ratio of 1.5 or greater in 10% of this cohort. The results are at variance with the reported high incidence of septal hypertrophy seen in normal developing fetal hearts. We suggest that septal hypertrophy, ratio of 1.5 or greater, may reflect disturbances in fetal or placental circulation and warrants careful monitoring of the pregnancy.

Single-photon emission computed tomography (SPECT) for assessment of hepatic lesions

Single-photon emission computed tomography (SPECT) and conventional scintigraphy were compared in 130 patients examined to assess hepatic involvement in malignant disease. Transmission computed tomography (TCT) served as the reference method against which SPECT and conventional scintigraphy were compared. The sensitivity of SPECT was calculated for lesions grouped according to diameter as well as location. The Bayesian theorem was used to assess the reliability of both SPECT and conventional scintigraphy. SPECT identified only 52% of lesions with a diameter of 1.5-2.0 cm. It was also shown that the sensitivity of SPECT was lowest for small lesions in the middle third of the liver. A comparison of the final diagnosis demonstrated that SPECT had greater sensitivity, specificity, and accuracy than conventional scans, and is superior at low disease prevalence. At high disease prevalence, SPECT has a lower rate of false negatives. SPECT appears to be the superior imaging modality for evaluation of the liver in malignant disease.

Renovascular hypertension associated with a pelvic kidney and multicystic dysplasia

We report on a 9-year-old boy with severe hypertension due to a variant of fibromuscular dysplasia of the renal artery supplying a functioning pelvic kidney. The other kidney proved to be a nonfunctioning multicystic remnant and several other congenital abnormalities of the genitourinary tract were present. Corrective vascular surgery was followed by normalization of arterial pressure and significant reduction of plasma renin activity. This is the first case report of renovascular hypertension due to renal artery stenosis in a single functioning pelvic kidney.

Radioisotope therapy of cystic craniopharyngomas

Eighteen patients suffering from cystic craniopharyngeoma were treated with intracavitary irradiation. The beta-emitting radioisotope 90y (2.25 MeV) was instilled into the cyst following stereotactic puncture of the space-occupying lesion. The surgical approach was planned using angiograms and reconstructed transmission computer tomography (TCT) coronal and saggital sections. Therapy was devised to deliver 20,000 rad to the cyst's wall. Eleven patients received follow-up TCT examinations after four months. Eight of 11 patients had a significant volume decrease in the craniopharyngeoma cyst. In two patients, the cystic volume remained unchanged; one had progression of disease. It is concluded that the intracavitary treatment of cystic craniopharyngeoma will result in a reduction of the size of the space-occupying lesion.

Histochemical study of Hurler's disease by the use of peroxidase-labelled lectins

Peroxidase-labelled lectins specific for various carbohydrate residues were used as histochemical reagents in the investigation of Hurler's syndrome. Peanut lectin was used to detect terminal D-galactose, wheatgerm lectin for N-acetyl-D-glucosamine, soybean lectin for N-acetyl-D-galactosamine, Tetragonolobus lotus lectin for alpha-L-fucose and Bandeiraea S. lectin for alpha-D-galactose. It was found that Kupffer cells in the liver and splenic reticulo-endothelial cells contain acid mucopolysaccharides which bind lectins in paraffin sections after appropriate fixation. The pattern of lectin binding suggests that such cells contain significant amounts of D-galactose, L-fucose, N-acetyl-D-galactosamine and N-acetyl-D-glucosamine. It is likely that the last named carbohydrate is present as a polymer. Neurones contain a different carbohydrate, rich in galactose and fucose but poor in N-acetyl-D-glucosamine. This compound is resident to lipid extraction. Hepatocytes, as a rule, do not react with lectins, most likely because of loss of the more soluble mucopolysaccharides during fixation. The results are consistent with the biochemical data of Hurler's syndrome and indicate that lectins can be a useful tool for the investigation of the cytochemistry of storage disorders.

Ultrastructural histochemistry of infantile digital fibromatosis

A case of infantile digital fibromatosis was studied by light and electron microscopy histochemistry. Using two different acidic solutions of phosphotungstic acid at varying pHs, the round inclusions characteristic of this tumor were shown to have a high protein content with little or no carbohydrates. The histochemical reactivity of the inclusions was similar to that of the cytoplasmic microfibrils in the tumors cells and consistent with the idea that both the inclusions and the microfibrils represent actin. There is, however, no definite proof that the tumor cells are myofibroblasts. At the present time, this tumor should be viewed as a peculiar expression of deranged assembly or metabolism of filamentous proteins or both.

Light- and electron-microscopic histochemistry of Fabry's disease

A histochemical study was performed on light- and electron-microscopic level in a case of Fabry's disease. The patient underwent kidney transplantation for renal failure and died of heart failure 6 months later. Patient's tissues were studied at the light- and electron-microscopic levels with various embedding and staining techniques for lipids and carbohydrates. Two peroxidase-labeled lectins (from Ricinus communis and from Bandeiraea simplicifolia) known to have affinity for alpha- and beta-D-galactose, were strongly reactive with the storage material on frozen sections. The ultrahistochemical and extraction tests showed that the typical granules had a variable reactivity and morphologic characteristics in different cells, probably reflecting different composition. A small number of typical deposits were also observed in the transplanted kidney. This is the first reported case of recurrence of the storage disease in the allograft. Of interest was also the fact that the patient's blood inhibited normal alpha-galactosidase activity, suggesting a possible inhibitor-related mechanism in the pathogenesis of the recurrence.

[Classification of stages of renal tumors by means of computed tomography scanning (author's transl)]

Fifty-eight patients with malignant renal tumors were submitted to computed tomography scanning. Fifty patients were operated. In eight patients, the disease was too advanced to allow a surgical treatment. The preoperative classification of stages was made according to the Robson scheme and compared with the results of the postoperative histopathological examination. There were identical results in 82% of all operated patients. An analysis of the individual results (fat tissue infiltration, lymph node metastases, infiltration of adjacent organs or veins) shows that the method is limited by the uncertain estimation of the renal vein as well as of the beginning fat tissue infiltration. The good results should give occasion to adopt the computed tomography scanning of the kidney into the staging catalogue of IUCC. Computed tomography scanning should be the basic examination for preoperative staging of renal tumors.