Rapidly progressive renal failure in a patient with extranodal non-Hodgkin's lymphoma

A 60-year male was admitted with advanced renal failure and bilaterally enlarged kidneys. Kidney biopsy revealed diffuse interstitial infiltration by CD20 + lymphomatous cells suggestive of diffuse large B-cell, non-Hodgkin's lymphoma. Bone marrow examination was negative for malignant cells. Positron emission tomography-computed tomography showed uniformly diffuse and avid flurodeoxy glucose uptake in both kidneys, multiple hypodense areas of both lobes of liver, and axial and appendicular skeleton. Patient was treated with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine and prednisolone, became afebrile and serum creatinine normalized.

Craniofacial zygomycosis caused by Apophysomyces elegans

A fatal case of craniofacial zygomycosis caused by Apophysomyces elegans in a 52-year-old man was diagnosed by the presence of broad aseptate, branched hyaline hyphae in tissue from paranasal sinuses and surrounding areas, and isolation of the fungus from the same tissue. The patient suffered from idiopathic myelofibrosis as underlying disease, he was thrombocytopenic and was mildly hyperglycaemic. The infection represents the second case of craniofacial zygomycosis due to A. elegans.

Secondary immune defects in non-Hodgkin's lymphoma

Changes in the humoral, cellular and phagocytic components of the immune system were investigated in 44 biopsy proven, untreated patients of non-Hodgkin's lymphoma (NHL). There was significant decrease in the total lymphocyte number, their subsets (T and B) and the T helper (T mu) population. Impaired leukocyte migration inhibition response and DNA synthesis following stimulation by phytohaemagglutinin were noted. Significant reduction of serum IgA was found in patients of both diffuse and nodular NHL. Phagocytic activity and nitroblue tetrazolium (NBT) reduction were unaltered, but chemotaxis was significantly reduced and bactericidal activity showed variable results.

Prolonged undiagnosed fever in northern India

A prospective study for five years along with a retrospective analysis of all patients admitted over 10 years with the diagnosis of prolonged undiagnosed fever was carried out in a referral hospital of North India to determine the specific disorders responsible for it. One hundred and fifty patients (80 prospective and 70 retrospective) were included in the study. Infections, especially tuberculosis, was the most dominant cause (50%), followed by lymphoreticular and haematological disorders (21.32%), collagen vascular disorders and neoplasms (8.67%) each. Miscellaneous causes were responsible in 6.67% and in 4.67% the cause of fever remained undiagnosed.

Generation of reactive oxygen species by blood monocytes in human Plasmodium falciparum and P. vivax infections

Generation of reactive oxygen radicals by peripheral blood monocytes was measured by luminol-dependent chemiluminescence in 23 P. vivax- and 7 P. falciparum-infected patients. The chemiluminescence index (CLI) was not found to be significantly higher in P. vivax-infected cases than in healthy controls. But in patients with P. falciparum infection, the CLI was significantly higher compared to controls as well as to P. vivax-infected patients. In two severe and complicated P. falciparum-infected cases, CLI was found to be higher than in mild cases. As immunosuppression is more marked in falciparum malaria than in vivax cases, the role of oxygen radical generation in immunopathology and causation of immunosuppression in falciparum malaria needs further investigation.

Nuclear morphometric analysis of non-Hodgkin's lymphoma

Nuclear morphometric data on resin-embedded sections have been utilized to classify 50 cases of non Hodgkin's lymphoma (NHL) and to compare with morphological classification. Nuclear morphometric parameters studied were maximum diameter (Dmax), area, perimeter, form factor (FF) and nuclear contour index (NCI). The first three are determinants of the size, and the latter two indicate the shape of nuclei. Based on Dmax, small (4.5-5.5 microns), intermediate (5.5-7.0 microns) and large (7.0-12.0 microns) cell lymphomas were identified, which correlate with the low, intermediate and high grade lymphomas respectively of the Working Formulation. Determination of form factor further helped to subclassify these cases into lymphomas of B cell other than of follicular centre cell origin (FF = 0.7-1.0), follicular centre cell lymphomas (FF = 0.55-0.75) and T-cell lymphomas (FF less than 0.55). Pleomorphism factor is an objective assessment of the degree of morphological pleomorphism and is generally proportional to the grade of malignancy.

Association of von Recklinghausen's neurofibromatosis with adult polycystic disease of kidneys and liver

A case of von Recklinghausen's neurofibromatosis with adult polycystic disease of the kidneys and liver (APDK) is reported. Although neurofibromatosis and APDK have been reported in association with many hereditary disorders, their association together has rarely been described.