MedWorm: Bone Marrow Aspiration and Biopsy

Diffuse pulmonary uptake on FDG-PET with normal CT diagnosed as intravascular large B-cell lymphoma: a case report and a discussion of the causes of diffuse FDG uptake in the lungs.

Cancer Imaging — Wed, 08 Feb 2012 00:30:02 +0100

Authors: Wagner T, Brechemier D, Dugert E, Le Guellec S, Julian A, Hitzel A, Beyne-Rauzy O Abstract A 71-year-old woman was admitted to our hospital with asthenia, weight loss, fever, cognitive impairment and shortness of breath. Physical examination showed hemiparesis and cerebellar ataxia. There was no superficial lymphadenopathy. Blood tests showed raised levels of C-reactive protein and lactate dehydrogenase. Bone marrow aspiration and biopsy were negative. [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) showed intense uptake within a right apical nodule and intense and diffuse uptake of FDG in the lungs without corresponding structural CT abnormality. Lung biopsy showed intravascular large B-cell lymphoma (IVLBCL). FDG-PET findings i...

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Rare case of a primary non-dural central nervous system low grade B-cell lymphoma and literature review.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

We present a case of a 70-year-old HIV negative man with a five-year history of progressive dysnomia and new onset right extremity numbness, dysarthria, and blurry vision. On magnetic resonance imaging (MRI), an infiltrative enhancing tumor was noted. Follow up brain biopsy results revealed a small lymphocytic infiltrate with scattered plasma cells in a predominantly perivascular growth pattern. Flow-cytometric findings revealed a lambda monotypic B-cell population. The morphology and the flow cytometric findings were consistent with involvement by a low grade B-cell lymphoma. Subsequent positron emission tomography (PET) studies along with bone marrow biopsy and serum protein electrophoresis showed no evidence of systemic disease. The above findings are consistent with involvement by a no...

Persistent elevation of peripheral blood myeloid cell counts associated with omalizumab therapy.

American Journal of Health-System Pharmacy : AJHP — Mon, 06 Feb 2012 12:07:01 +0100

Conclusion A patient with asthma and common variable immunodeficiency developed an elevation of peripheral blood myeloid cells that was first noticed 29 months after the initiation of monthly omalizumab injections. Omalizumab was discontinued, and the abnormality persisted for 1 month after the last dose. The patient's blood count results remained within normal limits 3 months after the last dose. PMID: 22302255 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Features of extramedullary myeloma relapse: high proliferation, minimal marrow involvement, adverse cytogenetics: a retrospective single-center study of 24 cases

Annals of Hematology — Mon, 30 Jan 2012 06:32:07 +0100

Abstract Extramedullary (e) relapse in multiple myeloma (MM) has an adverse prognosis, but knowledge concerning biological features and preferred treatment is scarce. We screened the myeloma registry of our institution for eMM relapses and identified 24 cases among 357 patients (pts). Only 8% of eMM relapses occurred after initial therapy, but 54% occurred after third-line or subsequent therapy. Baseline molecular cytogenetics revealed high-risk features in 10 of 19 evaluable patients. Most frequently, eMM presented as soft tissue (67%) and organ involvement (25%) or malignant effusion (12.5%). Incidence of leptomeningeal/CNS involvement was 21%. At eMM relapse, bone marrow infiltration was absent in 46% and low in 21%. Ten eMM biopsies were available showing increased pro...

A case of novel swine influenza A (H1N1) pneumonia complicated with virus-associated hemophagocytic syndrome

Journal of Infection and Chemotherapy — Mon, 30 Jan 2012 06:32:07 +0100

Abstract Influenza related to complications such as pneumonia and encephalitis have sporadically been reported. However, influenza A (H1N1)-virus-associated hemophagocytic syndrome (VAHS) has rarely been reported. A 39-year old woman complained of high fever and was referred to us. Chest infiltrations in both lungs and a positive polymerase chain reaction (PCR) for novel swine-origin influenza A (H1N1) in bronchial alveolar lavage fluid (BALF) specimen was confirmed and she was diagnosed with influenza A (H1N1) pneumonia. Pancytopenia was found, and hemophagocytic syndrome (HPS) was diagnosed by bone marrow aspiration. Following intravenous administration of antiflu drug and combination therapy of steroid pulse and erythromycin IV, the patient’s respiratory dysfunction a...

Immunohistochemical analysis of hepatocyte growth factor and c‐Met in plasma cell disease

Histopathology — Fri, 27 Jan 2012 05:24:15 +0100

Conclusions: Our data point to c‐Met expression as one of the factors that distinguishes normal from malignant plasma cells, and indicate that the HGF/c‐Met system is activated in multiple myeloma patients. (Source: Histopathology)

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20q- clonality in a case of oral sweet syndrome and myelodysplasia.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:54:23 +0100

We report the case of a patient with myelodysplasia who had Sweet syndrome of the oral cavity. An atypical myeloid immunophenotype was present in the gingival biopsy specimen and in a concurrent bone marrow specimen. Fluorescence in situ hybridization performed on the gingival biopsy specimen demonstrated the same del(20q) cytogenetic abnormality present in the bone marrow, confirming the presence of a clonally related myeloid proliferation in both tissues. This is the first reported case of Sweet syndrome and myelodysplasia in which the chromosomal abnormality was identified in the neutrophilic infiltrate, confirming the neutrophilic infiltrate to be clonally related to the underlying myeloid neoplasm. PMID: 22261459 [PubMed - in process] (Source: American Journal of Clinical Patholog...

Renal impairment in multiple myeloma: Presenting features in different departments

Journal of Huazhong University of Science and Technology -- Medical Sciences -- — Thu, 26 Jan 2012 16:50:10 +0100

Summary In order to analyze the cai]ses of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM), the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared. MM patients in our hospital were studied retrospectively. Those who referred renal impairment were divided into two groups: group I presented to nephrologists prior to MM diagnosis (n=29) and group II presented to hematologists directly (n=62). The age, sex, initial symptoms, haematological and biochemical parameters, the phenotype of paraprotein, bone marrow biopsy and cytology were undertaken and analyzed. The results showed that the median time between the initial symptoms and diagnosis in the patients...

Is transiliac bone biopsy a painful procedure?

Clinical Nephrology — Sat, 21 Jan 2012 18:13:59 +0100

Authors: Audran M, Maury E, Bouvard B, Legrand E, Baslé MF, Chappard D Abstract Despite an increased availability of non-invasive procedures to assess bone mass, histological examination of undecalcified transiliac bone biopsies remains a very valuable tool in the diagnosis of metabolic or malignant bone disorders. Nonetheless, clinicians are sometimes reluctant to perform this "invasive" examination, arguing that it might be a painful procedure. The aim of our study was to evaluate pain and anxiety described by patients in the months following the biopsy and to characterize potential early or late side effects. A single interviewer conducted a phone survey (19 items questionnaire) in 117 patients in whom a bone biopsy had been performed by two experienced physicians, with the sam...

Immunoglobulin light chain amyloidosis: 2012 update on diagnosis, prognosis, and treatment

American Journal of Hematology — Tue, 17 Jan 2012 23:03:32 +0100

AbstractDisease Overview: Immunoglobulin (Ig) light chain amyloidosis is a clonal but nonproliferative plasma cell disorder in which fragments of an Ig light chain are deposited in tissues. The clinical features depend on the organs involved but can include restrictive cardiomyopathy, nephrotic syndrome, hepatic failure, and peripheral/autonomic neuropathy.Diagnosis: Tissue biopsy stained with Congo red demonstrating amyloid deposits with apple‐green birefringence is required for diagnosis. Invasive organ biopsy is not required because amyloid deposits can be found in bone marrow biopsy or subcutaneous fat aspirate in 85% of patients. Prognosis: N‐terminal pro–brain natriuretic peptide and serum troponin T values are used to classify patients into three groups of approximately equal ...

Gastric involvement by mantle cell lymphoma observed by magnified endoscopy with narrow-band imaging

Gastrointestinal Endoscopy — Tue, 17 Jan 2012 22:04:55 +0100

An 83-year-old man was admitted to our hospital because of tarry stools. EGD showed a reddish gastric erosion with a linear ulcerated scar (). Magnified endoscopy with narrow-band imaging revealed the area around the scar to have an altered microsurface structure with a lack of epithelium and some abnormal microvessels without caliber changes (, arrows). Endoscopic mucosal biopsy specimens taken from the lesion showed diffuse proliferation of medium-sized abnormal lymphoid cells with dense nuclei (), and immunohistochemical analysis was positive for cyclin D1, CD5, CD20, Bcl-1, and Bcl-2 but negative for CD3 and CD10. Therefore, we speculated that this endoscopic finding represented an abnormal aggregation of lymphoid tissue. When the abdominal CT scan showed multiple enlarged cervical and...

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The assessment of minimal residual disease in chronic lymphocytic leukaemia: comparison of multi-colour flow cytometry and bone marrow trephine biopsy

Journal of Hematopathology — Tue, 17 Jan 2012 07:07:47 +0100

Abstract We investigated the value and degree of agreement between a sensitive four-colour flow cytometry (FC) method and bone marrow trephine (BMT) biopsy for detecting minimal residual disease (MRD) in 82 chronic lymphocytic leukaemia (CLL) cases. Concordance was 85%, with 15% of cases discrepant (six BMT-positive/FC-negative and six BMT-negative/FC-positive cases). FC-positive/BMT-negative cases had a low-level MRD by FC (0.05–0.9%), whereas BMT-positive/FC-negative cases had significant residual nodular disease. We conclude that FC and BMT biopsy are complementary investigations for MRD assessment in CLL, and both should be considered in the routine setting to assess MRD in CLL. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s12308-011-...

A novel immunohistochemical sequential multi‐labelling and erasing technique enables epitope characterization of bone marrow pericytes in primary myelofibrosis

Histopathology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions: To our knowledge, the SE‐technique is the first to multi‐label antigens, identifying vessel and pericyte architecture in bone marrow by light microscopy. This technique may unravel novel aspects of the composition of the microvessel structures in patients with PMF and related neoplasms. (Source: Histopathology)

Atypical Neurofibroma and Osteosclerotic Metastasis

Journal of Biophysics — Mon, 16 Jan 2012 03:35:01 +0100

35-year-old male presented with multiple swellings in left leg, headache, weakness of limbs for 4 months, and blurring of vision for the last 15 days. On examination, he was pale, cachexic with generalized lymphadenopathy and lower motor neuron type weakness of limbs sparing right upper limb. Blood investigations showed anemia with high alkaline phosphatase. Chest radiograph revealed osteosclerotic metastatic lesion in humerus. Biopsy of leg lesion revealed atypical neurofibroma. Computed tomography (CT) of thorax revealed osteoblastic metastasis. Bone marrow aspiration showed cells with round to oval nuclei, fine granular chromatin with large central prominent nucleoli and eosinophilic cytoplasm with acini formation. Magnetic resonance imaging (MRI) of brain and spinal cord defined metast...

Immunohistochemistry in bone marrow biopsy: an important complementary tool for morphology

Jornal Brasileiro de Patologia e Medicina Laboratorial — Sat, 14 Jan 2012 16:50:49 +0100

Por razões técnicas e históricas, a utilização da imuno-histoquímica (IHQ) em biópsias de medula óssea (BMO) levou algum tempo a ocupar espaço na avaliação diagnóstica desse tipo de material. Entretanto, esse cenário vem se modificando graças ao crescimento exponencial do número de anticorpos disponíveis para a utilização em material incluído em parafina, além do aperfeiçoamento das técnicas de recuperação antigênica e descalcificação do material. Este texto tem a finalidade de auxiliar o patologista na seleção/ interpretação de painéis de anticorpos utilizados nos laboratórios de rotina, de acordo com a experiência do autor, assim como de enumerar referências da literatura de grande utilidade para a prática diagnóstica.Due to historical and technical r...

Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia after Hepatitis C Virus Infection Secondary to Glomerular NS3 Viral Antigen Deposits.

American Journal of Nephrology — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions: In patients with hepatitis C-negative viral load, membranoproliferative glomerulonephritis could be induced by the persistence of HCV antigen in the kidney but not in hematopoietic cells. Nonlymphomatous B cell proliferation may also be induced by chronic viral stimulation. PMID: 22248563 [PubMed - as supplied by publisher] (Source: American Journal of Nephrology)

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Blastic Plasmacytoid Dendritic Cell Neoplasm without Cutaneous Lesion at Presentation: Case Report and Literature Review.

Acta Haematologica — Thu, 12 Jan 2012 05:00:00 +0100

Authors: Wang H, Cao J, Hong X Abstract Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and highly aggressive hematological malignancy derived from precursors of plasmacytoid dendritic cells. This disease typically presents with cutaneous involvement as the first manifestation, with subsequent or simultaneous spread to bone marrow and peripheral blood. It is exceedingly rare to diagnose BPDCN without a cutaneous lesion. Here, we report a 21-year-old male who was diagnosed with BPDCN in the absence of cutaneous symptoms. Clinically, left inguinal nodules were noticed for 4 months. The diagnosis of BPDCN was established based on histological and immunohistochemical study of a lymph node biopsy. The patient was classified as stage IVA with bone marrow involvement and un...

Systemic immunoregulatory and proteogenomic effects of tacrolimus to sirolimus conversion in liver transplant recipients

Hepatology — Wed, 11 Jan 2012 05:00:00 +0100

Conclusions:Tacrolimus to sirolimus conversion increases systemic Tregs, DCregs and immunoregulatory proteogenomic signatures in liver transplant recipients and may therefore facilitate immunosuppression minimization or withdrawal. (HEPATOLOGY 2012.) (Source: Hepatology)

Deep vein thrombosis associated with a single dose of romiplostim in a high-risk patient.

American Journal of Health-System Pharmacy : AJHP — Fri, 06 Jan 2012 20:28:58 +0100

Conclusion A 63-year-old man with a history of cardiovascular disease and prior malignancy developed a DVT after receiving a single dose of romiplostim for the treatment of ITP. PMID: 22215358 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Magnetic resonance imaging appearance of scurvy with gelatinous bone marrow transformation

Skeletal Radiology — Thu, 05 Jan 2012 17:08:27 +0100

Abstract Scurvy is a lethal but treatable disease that is rare in industrialized countries. Caused by vitamin C deficiency, it is most prevalent in persons of low socioeconomic status and smokers. Low levels of circulating vitamin C result in poor collagen fiber formation that, in turn, leads to demineralized bones, microfractures, and poor healing. Here we report a case of scurvy in a 5-year-old boy with normal radiographs in whom initial concern for leukemia based upon magnetic resonance imaging and clinical presentation led to a bone marrow biopsy revealing gelatinous transformation. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00256-011-1350-9Authors Christopher M. Brennan, Department of Radiology and Medical Imaging, University of Virgini...

Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma.

The British Journal of Radiology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: (18)F-FDG-PET/CT and BMB are complementary in the evaluation of bone marrow disease. PMID: 22215887 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

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Use of an oblique obturator radiograph in aspiration at anterior iliac crest.

Orthopedics — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Ebraheim NA, Zhang J, Lause GE Abstract The purpose of this study was to evaluate the use of an oblique obturator radiograph in bone marrow aspiration. The authors retrospectively reviewed 22 patients who underwent bone marrow aspiration guided by the real-time oblique obturator radiograph while in a supine position at their institution between November 2009 and August 2010. The mean duration of bone marrow aspiration was 35±9 seconds. According to the visual analog scale, the postoperative pain score at the site of aspiration was an average 1.6 of 10. No complications were observed. The oblique obturator radiograph can improve the accuracy of the aspiration. PMID: 22229917 [PubMed - in process] (Source: Orthopedics)

Bone Marrow Cytologic and Histologic Biopsies: Indications, Technique, and Evaluation

Veterinary Clinics of North America: Small Animal Practice — Sun, 01 Jan 2012 05:00:00 +0100

Bone marrow evaluation is indicated when the routine examination of a blood smear has failed to provide an answer to the question: What is causing an observed hematologic abnormality? If the blood already clearly indicates an immune mediated hemolytic anemia or regenerative anemia for which an etiology is suspected/known, a bone marrow evaluation is likely superfluous. Similarly, an inflammatory response or leukocytosis for which a cause is suspected or known may not warrant a bone marrow evaluation. (Source: Veterinary Clinics of North America: Small Animal Practice)

Metastatic Sarcomatoid Carcinoma to Liver and Bone Marrow in Renal Transplant Recipient: Due to Exacerbation of Quiescent Renal Cancer? A Case Report

Transplantation Proceedings — Sun, 01 Jan 2012 05:00:00 +0100

Abstract: Sarcomatoid carcinoma is a rare tumor with rapid growth and a poor prognosis. A 60-year-old man underwent kidney transplantation. Three months after transplantation, multiple tumors were found in the liver and bone, and the patient died several days later. Pathological examination of liver and bone marrow biopsies revealed metastatic sarcomatoid carcinoma. Pretransplantation, the patient's workup was positive only for mild thrombocytopenia and a complicated cyst with peripheral rim calcification (Bosniak IIF) in the right kidney. Retrospectively, we found the abdominal computed tomography film, which had been examined at another hospital 6 years previously. The calcified complicated cyst was a 3-cm enhancing solid mass in the right kidney, suggesting renal cell cancer. It is pos...

The management of procedural pain at the Italian Centers of Pediatric Hematology–Oncology: state-of-the-art and future directions

Supportive Care in Cancer — Fri, 30 Dec 2011 16:43:30 +0100

Conclusions A nationwide multicentre survey has been conducted for the first time to verify the management of procedural pain in Pediatric Hematology–Oncology patients. The results indicate that many aspects in the management of procedural pain appear consistent with the international guidelines. Some problems still remain, including the inability to ensure adequate sedation–analgesia in all the patients—often due to the lack of adequate staff, the frequent use of the operating room, and an underdeveloped use of non-pharmacological therapies. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00520-011-1347-xAuthors Chiara Po’, Pediatric Pain and Palliative Care Service, Department of Pediatrics, University of Padua, Padua, ItalyFra...

Experimental Models of Developmental Hypothyroidism

Hormone and Metabolic Research — Tue, 27 Dec 2011 05:00:00 +0100

Horm Metab ResDOI: 10.1055/s-0031-1297941Hypothyroidism is a systemic disease resulting from either thyroid gland’s anatomical and functional absence or lack of hypophyseal stimulation, both of which can lead to deficiency in thyroid hormone (TH) production. TH is essential for human and animal development, growth, and function of multiple organs. Children with deficient TH can develop alterations in central nervous system (CNS), striated muscle, bone tissue, liver, bone marrow, and cardiorespiratory system. Among the clinical outlook are signs like breathing difficulty, cardiac insufficiency, dysphagia, and repeated bronchial aspiration, constipation, muscle weakness, cognitive alterations, cochlear dysfunction, reduced height, defects in temperature regulation, anaemia, jaundice, susce...

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4. FDG-PET/CT of extranodal involvement in paediatric Hodgkin lymphoma.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: Our study reiterates that FDG-PET/CT helps in identifying extranodal HL, particularly in the skeleton and liver. CT is advantageous in characterizing lung findings. PMID: 22186086 [PubMed - in process] (Source: Cancer Imaging)

The relationship of the active and latent forms of TGF-β1 with marrow fibrosis in essential thrombocythemia and primary myelofibrosis

Medical Oncology — Mon, 26 Dec 2011 16:45:23 +0100

Abstract The aim of this study was to perform an immunohistochemical analysis from 100 megakaryocytes per sample, analyzing positivity and intensity levels of anti-LAP human TGF-β1 (or Latent TGF-β1) and anti-TGF-β1 (or Active TGF-β1) antibodies from 18 essential thrombocythemia (ET) and 38 primary myelofibrosis (PMF) patients (being 19 pre-fibrotic and 19 fibrotic). Six bone marrow donor biopsies were used as controls. Fibrosis in bone marrow biopsies (BMB) was evaluated according to the European Consensus. The average fibrosis grade differed between each group (P = 0.001 or P = 0.003). Latent TGF-β1 values differed significantly between pre-fibrotic (P = 0.018) and fibrotic (P = 0.031) groups when compared with the control group. The...

Powered Device Hailed as Advance for Bone Marrow BiopsyPowered Device Hailed as Advance for Bone Marrow Biopsy

Medscape Today Headlines — Fri, 23 Dec 2011 00:04:19 +0100

Performing a bone marrow biopsy manually can be physically demanding, especially in young patients with strong bones. Medscape Medical News (Source: Medscape Today Headlines)

ALDH, CA I, and CD2AP: Novel, Diagnostically Useful Immunohistochemical Markers to Identify Erythroid Precursors in Bone Marrow Biopsy Specimens.

American Journal of Clinical Pathology — Tue, 20 Dec 2011 15:15:07 +0100

Authors: Rollins-Raval MA, Fuhrer K, Marafioti T, Roth CG Abstract Neoplastic erythroid proliferations may represent a diagnostic challenge owing to the difficulty in characterizing immature erythroblasts. Immunohistochemical expression of aldehyde dehydrogenase (ALDH), carbonic anhydrase isoenzyme I (CA I), and CD2-associated protein (CD2AP) was assessed in 66 bone marrow biopsy specimens and compared with glycophorin A and E-cadherin. ALDH, CA I, and CD2AP labeled neoplastic erythroblasts in most acute erythroid leukemias (AELs) and myelodysplasias and highlighted benign erythroid precursors within normal marrows, erythroid hyperplasias, acute lymphoblastic leukemias (ALLs), blastic plasmacytoid dendritic cell neoplasm, and most acute myeloid leukemias (AMLs). In 2 AELs, CD2AP wa...

Childhood Immune Thrombocytopenia: A Changing Therapeutic Landscape

Seminars in Thrombosis and Hemostasis — Tue, 20 Dec 2011 05:00:00 +0100

Semin Thromb Hemost 2011; 37: 745-755DOI: 10.1055/s-0031-1297165ABSTRACTChildhood immune thrombocytopenia (ITP) is generally a benign self-limiting disorder of young children with <10% of cases requiring regular platelet enhancing therapy at 1 year following diagnosis. Increasingly, children with newly diagnosed ITP, who have isolated thrombocytopenia and no atypical features in the history or physical examination, are managed with minimal investigation and observation alone. The role of up-front, short-course corticosteroid therapy without bone marrow aspiration in this subgroup of cases merits further investigation. For children with clinically significant chronic ITP, the timing of elective splenectomy and the role of splenectomy-sparing strategies such as rituximab continues to be d...

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Multiple myeloma: 2012 update on diagnosis, risk‐stratification, and management

American Journal of Hematology — Mon, 19 Dec 2011 10:30:59 +0100

AbstractDisease overview: Multiple myeloma accounts for ∼10% of all hematologic malignancies.Diagnosis: The diagnosis requires 10% or more clonal plasma cells on bone marrow examination or a biopsy proven plasmacytoma plus evidence of end‐organ damage felt to be related to the underlying plasma‐cell disorder.Risk stratification: Patients with 17p deletion, t(14;16), t(14;20), or high‐risk gene expression profiling signature have high‐risk myeloma. Patients with t(4;14) translocation, karyotypic deletion 13, or hypodiploidy are considered to have intermediate‐risk disease. All others are considered to have standard‐risk myeloma.Risk‐adapted therapy: Standard‐risk patients are treated with nonalkylator‐based therapy such as lenalidomide plus low‐dose dexamethasone (Rd) ...

Clinical, electrophysiological and immunological study of peripheral nerves in Egyptian patients with monoclonal gammopathies.

International Journal of Hematology — Sat, 17 Dec 2011 05:00:00 +0100

Authors: El-Difrawy MM, Zaki NE, Marouf HM, Ayad MW, Farag AM Abstract Monoclonal antibodies are found in approximately 10% of patients with peripheral neuropathy (PN) of unknown etiology. Several autoantibodies, including anti-MAG (myelin-associated glycoprotein) antibodies, have been reported to induce neuropathy. It has been suggested that over 50% of patients with PN and IgM monoclonal gammopathy (MG) have anti-MAG IgM antibodies in their sera. This work aimed at studying the frequency and characteristics of PN in a group of Egyptian patients with MGs and to estimate the serum level of anti-MAG antibodies and its relationship to peripheral nerve dysfunction. Forty patients with MGs were enrolled in the study. Their mean age was 56.65 ± 8.55 years. There were 17 males and 23...

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors.

Haematologica — Fri, 16 Dec 2011 05:00:00 +0100

Conclusions. The poor reliability of the 10% cut off was partly related to the proximity of the current criteria to the observed cut-off mean values of the normal population. These findings question the current WHO threshold of ≥ 10% necessary for the percentage of cells manifesting dysplasia as significant and suggest that either a higher threshold would be more appropriate or different thresholds should be set for each lineage. PMID: 22180437 [PubMed - as supplied by publisher] (Source: Haematologica)

Atraumatic splenic rupture in patients with myelodysplastic syndromes: Report of a case occurred during treatment with 5-azacitidine and review of the literature

Leukemia Research — Thu, 15 Dec 2011 05:00:00 +0100

A 62-year old Caucasian woman with a previous history of arterial hypertension, dilative cardiomyopathy and cerebral transient ischemic attack, was admitted to our Department because of marked fatigue, in the absence of fever or hemorrhage. The complete blood count (CBC) revealed pancytopenia, with white blood cell (WBC) count 0.8×109/L in the absence of circulating blasts, hemoglobin (Hb) level 5.4g/dl and platelet (Plt) count 78×109/L, without signs of coagulopathy. Neither hepatomegaly nor splenomegaly were observed on abdominal ultrasonography. The morphological, cytochemical and immunophenotypic analyses performed on peripheral blood and bone marrow aspirate and trephine biopsy documented features consistent with a myelodysplastic syndrome (MDS). Conventional G-banding showed a norm...

Identity and ranking of colonic mesenchymal stromal cells

Journal of Cellular Physiology — Wed, 14 Dec 2011 05:00:00 +0100

AbstractAlthough ongoing clinical trials utilize systemic administration of bone‐marrow mesenchymal stromal cells (BM‐MSCs) in Crohn's disease (CD), nothing is known about the presence and the function of MSCs in the normal human bowel. MSCs are bone marrow multipotent cells supporting haematopoiesis with the potential to differentiate into multiple skeletal phenotypes. A recently identified new marker, CD146, allowing to prospectively isolate MSCs from bone marrow, renders also possible their identification in different tissues. In order to elucidate the presence and functional role of MSCs in human bowel we analyzed normal adult colon sections and isolated MSCs from them. In colon (C) sections, resident MSCs form a net enveloping crypts in lamina propria, coinciding with structural m...

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A case of successful management of HHV-8(+), EBV (+) germinotropic lymphoproliferative disorder (GLD).

International Journal of Hematology — Wed, 14 Dec 2011 05:00:00 +0100

A case of successful management of HHV-8(+), EBV (+) germinotropic lymphoproliferative disorder (GLD). Int J Hematol. 2011 Dec 14; Authors: Oh J, Yoon H, Shin DK, Jang MJ, Kim GI, Chong SY, Oh D Abstract Human herpesvirus 8-positive (HHV-8(+)) and Epstein-Barr virus-positive (EBV(+)) germinotropic lymphoproliferative disorder (GLD) is extremely rare and occurs most commonly in immunocompetent persons who are human immunodeficiency virus (HIV)-seronegative. It is also recognized as a favorable response to conventional chemotherapy. Here, we report a case of a 75-year-old man with an incidentally found mass in the neck, compatible with GLD, which was detected by positron emission tomography (PET). Computed tomography (CT) scan, PET, and bone marrow studies showed only the...

Impaired regulatory T cell reconstitution in patients with acute graft-versus-host disease and cytomegalovirus infection after allogeneic bone marrow transplantation.

International Journal of Hematology — Wed, 14 Dec 2011 05:00:00 +0100

Authors: Ngoma AM, Ikeda K, Hashimoto Y, Mochizuki K, Takahashi H, Sano H, Matsumoto H, Noji H, Saito S, Kikuta A, Ogawa K, Ohtsuka M, Abe M, Nollet KE, Ohto H Abstract To elucidate the correlation between regulatory T cells (Tregs) and acute graft-versus-host disease (aGVHD) or cytomegalovirus infection following allogeneic bone marrow transplantation (allo-BMT), we evaluated either CD4(+)CD25(high) or FOXP3(+) Treg-enriched cells in peripheral blood (PB) from 20 patients who received allo-BMT, and in biopsies of skin with aGVHD. Proportions of CD4(+)CD25(high)FOXP3(+) cells in total lymphocytes, but not other types of T cells, were lower in patients who eventually developed grades II-IV aGVHD (n = 13) than in others (n = 7, P < 0.001). Proportions of CD62L(+) cells in CD...

Highlights from this issue

Archives of Disease in Childhood — Tue, 13 Dec 2011 05:00:00 +0100

Skinning cats for a living Let's kick off with an aphorism fit for this most ascetic of months. The scholar who cherishes the love of comfort is not fit to be deemed a scholar (Confucius c 500 BC). Surely, ‘the love of comfort’ Confucius alludes to is dogma. I’m allergic to the ‘it must be so’ school of thought (more on IgE-related matters later), which plagues medicine as much as any other walk of life. How refreshing, therefore, to introduce a crop of papers that either challenge dogma or chronicle its demise. Idiopathic thrombocytopenic purpura Little more than 20 years ago, any child with, even mild, idiopathic thrombocytopenic purpura (ITP) would have been subjected to not only invasive investigation (a bone marrow aspiration at least) but also to a prolo...

Burkitt-Like Lymphoma Arising in the Thyroid Gland.

The American Journal of the Medical Sciences — Fri, 02 Dec 2011 05:00:00 +0100

CONCLUSIONS: In patients with lymphoma diagnosed on fine needle aspiration, an incisional thyroid and bone marrow biopsies are required to aid in the diagnosis and assure the appropriate chemotherapy protocol. PMID: 22143121 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

UCLA researchers identify new method for generating stem cell-like cells from human skin

UCLA Newsroom: Health Sciences — Thu, 01 Dec 2011 18:55:33 +0100

Researchers from the UCLA School of Dentistry investigating how stem cells can be used to regenerate dental tissue have discovered a way to produce cells with stem cell–like characteristics from the most common type of human skin cell in the epidermis. These skin cells, called keratinocytes, form the outermost layer of skin and can be cultured from discarded skin tissues or biopsy specimens. The findings, published in the Nov. 4 edition of the peer-reviewed Journal of Biological Chemistry, may be beneficial for individuals with limited sources of endogenous stem cells. The gene known as ∆Np63α is highly synthesized in regenerating cells of various tissues. The UCLA researchers found that introducing ∆Np63α into skin keratinocytes makes them lose ...

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Is a nadir bone marrow required and, if so, what to do with residual disease?

Best Practice and Research. Clinical Haematology — Thu, 01 Dec 2011 05:00:00 +0100

Current National Comprehensive Cancer Network guidelines for acute myeloid leukemia (AML) treatment state that bone marrow biopsies should be completed 7–10 days after completion of chemotherapy. Treatment decisions change based on cellularity of that biopsy. Several studies show that bone marrow aspirates at nadir can be used to predict complete remission (CR) and overall survival. Many groups have attempted to modify induction regimens based on results of bone marrow biopsies with mixed results. This paper will review the current literature on using bone marrow biopsy to prognosticate and guide treatment for AML patients. (Source: Best Practice and Research. Clinical Haematology)

Association of acute lymphoblastic leukaemia and visceral leishmaniasis.

Annales de Biologie Clinique — Thu, 01 Dec 2011 05:00:00 +0100

We report the case of a 20-year-old woman treated for ALL. During maintenance treatment, the patient presents with pallor, prolonged fever and asthenia. The examination objective splenomegaly and blood counts showed pancytopenia. The bone marrow aspiration confirmed the diagnosis of VL. The patient was treated with antimoniate of meglumine with good evolution. PMID: 22123576 [PubMed - as supplied by publisher] (Source: Annales de Biologie Clinique)

Iliac Fracture After a Bone Marrow Biopsy

PM and R — Thu, 01 Dec 2011 05:00:00 +0100

Rehabilitation care and consultations for oncology patients are expanding as both patients and physicians determine which ongoing therapies may be appropriate, and consultations for these patients will continue to increase as quality-of-life expectations and optimal post-treatment function are addressed. Physiatrists are consulted to facilitate the diagnosis and treatment of multiple issues that may be contributing to a patient's failure to progress in therapy or recover from an illness, as well as to aid in the patient's transition to the next level of care. It is important to realize that iatrogenic complications are a consideration for this population, given the variety of treatments and invasive procedures to which they are subjected. (Source: PM and R)

Clinicohematologic analysis of pancytopenia: Study in a tertiary care centre

Basic and Applied Pathology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: A thorough evaluation of the pancytopenic patients is necessary as it has varied causes. (Source: Basic and Applied Pathology)

Brucella infection with pancytopenia after pediatric liver transplantation

Transplant Infectious Disease — Thu, 01 Dec 2011 05:00:00 +0100

We present a case of brucellosis after pediatric liver transplantation. A 15‐year‐old boy with the diagnosis of neuro Wilson's disease underwent deceased‐donor liver transplantation. The postoperative immunosuppressive protocol consisted of steroids and tacrolimus. Two months after the operation the patient experienced fever to 40°C. The patient complained of poor appetite, headache, and diarrhea. He had had pancytopenia. Despite administration of appropriate antibiotics, antiviral and antifungal agents, fever persisted for > 1 month. Multiple blood, urine, stool, and sputum cultures were negative. Bone marrow aspirate revealed hypocellularity. Liver biopsy was performed, but rejection was not observed on biopsy specimen. Brucella serology was positive and Brucella agglutinatio...

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Clinical features of extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue

Hematological Oncology — Thu, 01 Dec 2011 05:00:00 +0100

AbstractWe newly diagnosed 131 patients with extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue lymphoma between 1998 and 2010. We retrospectively studied 124 patients for whom complete clinical data were available at presentation and who had minimally undergone tumour staging by physical examination, computed tomography (CT), bone marrow aspiration, and biopsy. A slight female predominance (men, 58; women, 66) was observed in the study population; the median age was 67 years. The primary locations at presentation were the stomach (38%), orbita (20%), lung (12%), intestinal tract (8%), thyroid gland (6%), others (14%), and unknown (2%). Seventy per cent of patients had localized disease. Of the 124 patients, 14 (11%) had lymph node involvement, and 5 (4%) had bone m...

Danvers Mother, Infant Daughter Struggle With Heartbreaking Cancer Fight

Thu, 01 Dec 2011 04:59:33 +0100

DANVERS (CBS) - 2011 hasn’t been kind to Mike and Kezia Fitzgerald. In January, Kezia was diagnosed with stage 3 Hodgkin’s Lymphoma. Less than 4 months later, a bigger shock rocked the family when their 11-month-old daughter, Saoirse, was diagnosed with Stage 4, nMYC amplified, Neuroblastoma. Summer brought a glimmer of hope for the Fitzgeralds. Kezia responded well to her cancer treatment and was in remission by the beginning of September. WBZ NewsRadio 1030′s Mark Katic reports Saoirse turned one in June and by September had completed her first six rounds of chemotherapy. Her body was re-scanned and the doctors at Children’s Hospital Boston declared her cancer free. Through it all, Saoirse dealt with her treatment as any toddler would, oblivious to the gravity and hap...

[Aman with persisting fever, night sweats and high sedimentation rate].

Tidsskrift for den Norske Laegeforening — Tue, 29 Nov 2011 05:00:00 +0100

[Aman with persisting fever, night sweats and high sedimentation rate]. Tidsskr Nor Laegeforen. 2011 Nov 29;131(23):2362-5 Authors: Kildahl-Andersen O, Murbræch K, Skudal H, Stalsberg H Abstract Background. Fever of unknown origin and high sedimentation rate are common clinical problems. Material and methods. A middle-aged man with fever of unknown origin, night sweats and high sedimentation rate was referred to our hospital for investigation. Results and interpretation.The patient was suspected to have mononucleosis or reactivation of infectious mononucleosis because of mild anaemia and thrombocytopenia, a weakly postive IgM antibody test for Epstein-Barr virus and monocytosis (in peripheral blood). Because monocytosis, elevated sedimentation rate and fever persisted, bon...

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Pharmacovigilance and PML in the oncology setting

Cleveland Clinic Journal of Medicine — Mon, 28 Nov 2011 05:00:00 +0100

Methods developed by the Southern Network on Adverse Reactions project, the only state-funded pharmacovigilance program in the nation, are invaluable in identifying rare and serious drug events and in disseminating related safety reports quickly throughout the medical community. An important discovery was identification and reporting of an association of rituximab and progressive multifocal leukoencephalopathy (PML) in patients without human immunodeficiency virus (HIV). A recent investigation identified 57 patients with rituximab-associated PML, including bone marrow samples, brain biopsies, and autopsy materials from patients with lymphoma and PML who tested positive for JC virus. The investigation identified an association of rituximab-chemotherapy administration and PML, although a cau...

Positive Response to Trastuzumab in a Case of HER2-Overexpressing Metastatic Gastric Cancer that Presented as Severe Thrombocytopenia.

Onkologie — Fri, 25 Nov 2011 16:00:02 +0100

Conclusion: This is the first report of a positive response to trastuzumab in a patient with HER2-overexpressing metastatic gastric cancer that was accompanied by bone marrow involvement and severe thrombocytopenia. This finding is of considerable relevance for difficult cases of metastatic gastric cancer that preclude the administration of aggressive antineoplastic regimens. PMID: 22104159 [PubMed - in process] (Source: Onkologie)

A very rare presentation of miliary tuberculosis in mid-trimester pregnancy masquerading as sepsis and severe acute respiratory syndrome: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

We report a rare presentation of miliary tuberculosis (TB) in an HIV-negative pregnant Bangladeshi woman masquerading as acute sepsis with rapid progression to respiratory failure and acute respiratory distress syndrome (ARDS) and subsequent acute renal failure (ARF). The absence of any typical systemic prodromal symptoms, the short duration of illness and initially normal chest x-ray (CXR) with rapidly evolving radiological changes made ascertainment of the diagnosis of TB infection difficult. Aggressive investigation including liver and bone marrow biopsy lead to diagnostic confirmation, appropriate therapy, and, despite foetal loss at 22 weeks gestation, to a successful outcome. (Source: Journal of Infection)

Relevance of deep decortication and vascularization in a case of post-traumatic femoral non-union treated with grafts, platelet gel and bone marrow stromal cells

Knee Surgery, Sports Traumatology, Arthroscopy — Wed, 23 Nov 2011 17:36:32 +0100

Conclusions These findings support the concept, until now evidenced only by imaging, that bone chips added with PG and BMSCs are effective in shortening the healing time in fracture non-union. The clinical relevance of deep decortication and vascularization is emphasized. Level of evidence Therapeutic studies—investigating the results of treatment, Level V. Content Type Journal ArticleCategory KneePages 1-5DOI 10.1007/s00167-011-1790-8Authors Dante Dallari, Orthopaedic and Traumathological Department I, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, ItalyLucia Savarino, Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, ItalyMichelina Greco, La...

Primary Plasma Cell Leukemia Associated with t(6;14)(p21;q32) and IGH Rearrangement: A Case Study and Review of the Literature.

Annals of Clinical and Laboratory Science — Fri, 18 Nov 2011 22:18:03 +0100

Authors: Cho SY, Lim G, Oh SH, Lee HJ, Suh JT, Lee J, Lee WI, Lee HG, Yoon HJ, Park TS Abstract Because plasma cell leukemia (PCL) is a rare and distinct variant among plasma cell dyscrasias, recent clinical and cytogenetic studies have been performed in different ethnic groups to define the characteristics of these PCL patients. As far as we know, IGH rearrangements involving t(11;14) and (14;16) are significantly more frequent in PCL than in myeloma patients. However, PCL cases associated with t(6;14)(p21;q32) or IGH-CCND3 rearrangement are extremely rare in the literature; only one PCL case with t(6;14) has been documented. A 61-year-old female was admitted due to fatigue, weight loss, and exertional dyspnea. Plasmacytoid cells were counted up to 76% at a peripheral blood film, ...

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Diffuse cutaneous mastocytosis: analysis of 10 cases and a brief review of the literature

Journal of the European Academy of Dermatology and Venereology — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions Diffuse cutaneous mastocytosis, DCM is a heterogeneous, severe, cutaneous disease, associated with mediator‐related symptoms and risk of anaphylactic shock. Although our results suggest generally favourable prognosis, the review of the literature indicate that SM may occur. Therefore, more guarded prognosis should be given in DCM patients. (Source: Journal of the European Academy of Dermatology and Venereology)

Endoscopic ultrasound guided fine‐needle aspiration of a splenic hemangioma with extramedullary hematopoiesis

Diagnostic Cytopathology — Fri, 18 Nov 2011 05:00:00 +0100

AbstractExtramedullary hematopoiesis (EMH) is the production of mature blood elements outside of the bone marrow and can occur as a compensatory result of a marrow replacing process or from marrow space occupying lesions such as tumor or marrow fibrosis. EMH can also be induced by factors elicited by neoplasms, such as vascular endothelial growth factor (VEGF). Usually, EMH is a diffuse process most commonly observed in lymph nodes, liver, and spleen. Rarely, EMH can form a mass lesion. Although the spleen is a common site for diffuse EMH, it is a rare location for a mass forming EMH. Hemangiomas are the most common benign tumors of the spleen.A case of a discrete, 8 cm lesion was noted incidentally on CT scan in a 59‐year‐old man with no significant past medical history. Endoscopic ul...

Comprehensive analysis of tumor microenvironment cytokines in Waldenstrom macroglobulinemia identifies CCL5 as a novel modulator of IL-6 activity

Blood — Thu, 17 Nov 2011 05:00:00 +0100

In this study, simultaneous analysis of WM patient sera and bone marrow biopsies identified a set of dysregulated cytokines including CCL5, G-CSF, and soluble IL-2 receptor, that were significantly elevated in WM patients whereas IL-8 and EGF levels were significantly lower in these patients compared with healthy controls. Interestingly, CCL5 levels positively correlated with features of disease aggressiveness such as elevated IgM levels and bone marrow involvement. Functional analysis of tumor microenvironment revealed a functional correlation between CCL5 levels and IL-6 levels, a proinflammatory cytokine with an important role in normal and malignant B-cell biology. Furthermore, CCL5 stimulated IL-6 secretion in WM stromal cells resulting in increased IgM secretion by WM malignant cells...

Effect of Intracoronary Delivery of Autologous Bone Marrow Mononuclear Cells 2 to 3 Weeks Following Acute Myocardial Infarction on Left Ventricular Function: The LateTIME Randomized Trial [Original Contribution]

JAMA — Tue, 15 Nov 2011 05:00:00 +0100

Conclusion Among patients with MI and LV dysfunction following reperfusion with PCI, intracoronary infusion of autologous BMCs vs intracoronary placebo infusion, 2 to 3 weeks after PCI, did not improve global or regional function at 6 months. Trial Registration clinicaltrials.gov Identifier: NCT00684060 (Source: JAMA)

T cell/histiocyte-rich large B-cell lymphoma: an update on its biology and classification

Virchows Archiv — Fri, 11 Nov 2011 12:49:20 +0100

Abstract T cell/histiocyte-rich large B-cell lymphoma (THRLBCL), originally considered an uncommon variant of Diffuse Large B-Cell Lymphoma (DLBCL), is recognized by the World Health Organisation as a separate clinicopathological entity since 2008. It predominantly affects middle aged men often presenting with advanced stage disease frequently involving spleen, liver and bone marrow at time of diagnosis. According to the WHO, this lymphoma is morphologically characterized by less than 10% of large neoplastic B cells in a background of abundant T cells and frequently histiocytes. Differentiating THRLBCL from other lymphoproliferative disorders such as Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) and Lymphocyte-Rich classical Hodgkin lymphoma (LRcHL) is important ...

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[Jugal swelling revealing acute lymphoblastic leukemia.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Mon, 07 Nov 2011 05:00:00 +0100

We report a case of T-ALL revealed by right cheek swelling in a 14-year-old boy. CASE PRESENTATION: A 14-year-old boy had presented with a 6cm right cheek swelling for two months, complicated by pyrexia, cervical adenopathy, and splenomegaly. CT scan revealed a 3×7×8cm swelling surrounded by voluminous sub chin, subclavicular, mediastinal, and paratracheal bilateral adenopathies. The biological analyses revealed normocytic anemia, hyperleukocytosis with 83.6% blast cells, neutropenia, and thrombopenia. The biopsy histology and the immuno-histochemical analysis suggested a diffuse small-cell Non-Hodgkin lymphoma (NHL). The myelogram identified a type 1 ALL and immunophenotyping on bone marrow cells suggested phenotype T ALL. The patient was treated according to the MARALL-06 protocol and ...

Hypocellular acute myeloid leukemia in adults: clinical outcome analysis of 123 patients.

Haematologica — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Outcome of hypocellular acute myeloid leukemia does not differ from that of non-hypocellular acute myeloid leukemia. PMID: 22058194 [PubMed - as supplied by publisher] (Source: Haematologica)

Glomerular hemophagocytic macrophages in a patient with proteinuria and clinical and laboratory features of hemophagocytic lymphohistiocytosis (HLH).

International Journal of Hematology — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Cao L, Wallace WD, Eshaghian S, Linhares Y, Marder VJ Abstract Hemophagocytic lymphohistiocytosis (HLH) is a heterogeneous disorder characterized by excessive activation and proliferation of nonmalignant histiocytes, which are commonly found in bone marrow, lymph nodes, spleen and liver in affected patients. Here, we report the presence of glomerular macrophages, including one showing erythrophagocytosis, on renal biopsy in a 25-year-old patient with clinical presentation and laboratory changes consistent with HLH. The clinical course was marked by persistent fever for 2 months, pleural and pericardial effusion, splenomegaly, lymphadenopathy, pancytopenia, cardiac arrhythmias, multiple organ dysfunction, and proteinuria, with demise after a 2-month hospitalization. Positi...

Osseointegration in periodontitis susceptible individuals

Clinical Oral Implants Research — Tue, 01 Nov 2011 04:00:00 +0100

AbstractObjectivesThe aim of the present study was to examine tissue integration of implants placed (i) in subjects who had lost teeth because of advanced periodontal disease or for other reasons, (ii) in the posterior maxilla exhibiting varying amounts of mineralized bone.Material and methodsThirty‐six subjects were enrolled; 19 had lost teeth because of advanced periodontitis (group P) while the remaining 17 subjects had suffered tooth loss from other reasons (group NP). As part of site preparation for implant placement, a 3 mm trephine drill was used to remove one or more 2 mm wide and 5–6 mm long block of hard tissue [biopsy site; Lindhe et al. (2011). Clinical of Oral Implants Research, DOI: 10.1111/j.1600-0501.2011.02205.x]. Lateral to the biopsy site a twist drill (diameter ...

Coexistent asymptomatic myeloma and hereditary cardiac amyloidosis: an unusual case of heart failure.

British Journal of Hospital Medicine — Tue, 01 Nov 2011 04:00:00 +0100

This article discusses a rare cause of heart failure and uses this case to illustrate that histological confirmation of the amyloid-causing protein is essential. Mistaken assumption of AL amyloid could have resulted in inappropriate cytotoxic therapy targeting the plasma cell clone. PMID: 22083004 [PubMed - in process] (Source: British Journal of Hospital Medicine)

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Th17 cells in systemic lupus erythematosus share functional features with Th17 cells from normal bone marrow and peripheral tissues

Clinical Rheumatology — Mon, 31 Oct 2011 17:00:54 +0100

This study was designed to investigate the functional heterogeneity of human Th17 and how their plasticity shapes the nature of immune cell responses to inflammation and autoimmune diseases, such as systemic lupus erythematosus (SLE). We evaluated functional Th17 cell subsets based on the profile of cytokine production in peripheral blood (PB), bone marrow aspirates (BM) and lymph node biopsies (LN) from healthy individuals (n = 35) and PB from SLE patients (n = 34). Data were analysed by an automated method for merging and calculation of flow cytometric data, allowing us to identify eight Th17 subpopulations. Normal BM presented lower frequencies of Th17 (p = 0.006 and p = 0.05) and lower amount of IL-17 per cell (p = 0.03 and p = 0.02), compared to normal PB a...

Magnetic Resonance evaluation of tubercular lesion in spine

International Orthopaedics — Fri, 28 Oct 2011 16:56:45 +0100

Conclusion The marrow oedema, preservation of disc space, subligamentous extension of abscess, septate paravertebral abscess, epidural extension, endplate erosions and discitis were consistently observed in 83% cases of TB spine on MRI. Content Type Journal ArticleCategory Original PaperPages 1-9DOI 10.1007/s00264-011-1380-xAuthors Anil Kumar Jain, Department of Orthopedics, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, New Delhi, IndiaRavi Sreenivasan, Department of Orthopedics, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, New Delhi, IndiaNamita Singh Saini, Department of Radiology, Institute of Nuclear Medicine and Allied Sciences, New Delhi, IndiaSudhir Kumar, Department o...

Pediatric lymphoma: metabolic tumor burden as a quantitative index for treatment response evaluation

Annals of Nuclear Medicine — Thu, 27 Oct 2011 15:45:44 +0100

Conclusion Whole body MTB appears to be useful quantitative parameter for the assessment of treatment response using PET–CT in pediatric lymphoma patients. Content Type Journal ArticleCategory Original articlePages 1-9DOI 10.1007/s12149-011-0539-2Authors Punit Sharma, Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029 IndiaArun Gupta, Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029 IndiaChetan Patel, Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029 IndiaSameer Bakhshi, Department of Medical Oncology, Institute Rotary Canc...

Gene expression signatures and ex vivo drug sensitivity profiles in children with acute lymphoblastic leukemia.

J Appl Genet — Thu, 27 Oct 2011 04:00:00 +0100

CONCLUSIONS: The exposure of leukemic blasts to drugs initiates a complex cellular response, which reflects global changes in gene expression. Changes in the expression of several genes are highly correlated with drug resistance. PMID: 22038456 [PubMed - as supplied by publisher] (Source: J Appl Genet)

Diagnostic Difficulties of Pure Intrasinusoidal Bone Marrow Infiltration of Non-Hodgkin's Lymphoma: A Report of Eight Cases from India

Japanese Journal of Clinical Oncology — Tue, 25 Oct 2011 04:00:00 +0100

Bone marrow involvement in non-Hodgkin's lymphoma is prognostically important for appropriate management. Intrasinusoidal pattern of bone marrow infiltration is poorly identified on trephine biopsies. We analyzed the clinical, hematological and histopathological spectrum of eight cases of non-Hodgkin's lymphoma showing pure intrasinusoidal bone marrow infiltration. Fever, cytopenias and blasts in circulation were the indications for bone marrow aspiration and trephine biopsies. Flow cytometry on bone marrow and immunohistochemistry on trephine sections were done. There were five cases of T-cell hepatosplenic non-Hodgkin's lymphoma (three T-cell lymphoma) and three B-cell non-Hodgkin's lymphoma (two intravascular large B-cell lymphoma and one splenic marginal zone lymphoma). Except the case...

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Reversible acute kidney injury (AKI) by active removal of serum light chains in an HIV positive patient with myeloma kidney.

Clinical Nephrology — Sat, 22 Oct 2011 19:40:35 +0100

Authors: Sowole L, Burns A, Kaur B, Davenport A Abstract Background: The association of HIV and myeloma has rarely been reported in the literature. This following case discusses the presentation of acute kidney injury (AKI) in a 53-year-old lady with HIV, subsequently diagnosed with myeloma. Furthermore, we describe recovery of renal function and dialysis independence using a combination of light chain removal by dialysis with a high cut-off dialyzer and chemotherapy. Investigations: Physical examination, urine, blood tests, renal biopsy, bone marrow aspirate and trephine, US scan. Diagnosis: Myeloma. Management: Dialysis and chemotherapy. PMID: 22000564 [PubMed - in process] (Source: Clinical Nephrology)

Bone marrow necrosis secondary to imatinib usage, mimicking spinal metastasis on magnetic resonance imaging and FDG-PET/CT.

Journal of Neurosurgery.Spine — Fri, 21 Oct 2011 04:00:00 +0100

Authors: Aras Y, Akcakaya MO, Unal SN, Bilgic B, Unal OF Abstract Imatinib mesylate has become the treatment of choice for gastrointestinal stromal tumors (GISTs) and has made a revolutionary impact on survival rates. Bone marrow necrosis is a very rare adverse event in malignant GIST. Bone metastases are also rarely encountered in the setting of this disease. The authors report on a patient with malignant GIST who developed a bone lesion, mimicking spinal metastasis on both MR imaging and FDG-PET/CT. Corpectomy and anterior fusion was performed, but the pathology report was consistent with bone marrow necrosis. Radiological and clinical similarities made the distinction between metastasis and bone marrow necrosis challenging for the treating physicians. Instead of radical surgical...

Granulocytic Sarcoma of the Stomach Presenting as Dysphagia during Pregnancy

Computational Intelligence and Neuroscience — Fri, 21 Oct 2011 03:01:09 +0100

We report a case of a twenty-five-year-old pregnant woman who presented with progressive dysphagia and recurrent postprandial vomiting. Upper GI endoscopy had shown large flat laterally spread nodular lesions in the cardia and proximal body of stomach. Biopsies from the gastric lesion showed granulocytic sarcoma of the stomach. Concurrent peripheral and bone marrow picture was suggestive of acute myeloid leukemia (AML–M4). There is limited reported literature on granulocytic sarcoma of the stomach. Concurrent gastric granulocytic sarcoma involving cardia and AML in pregnancy has not been reported till date. (Source: Computational Intelligence and Neuroscience)

Genome wide single cell analysis of chemotherapy resistant metastatic cells in a case of gastroesophageal adenocarcinoma

BMC Cancer — Thu, 20 Oct 2011 04:00:00 +0100

Conclusion: Global analysis of genetic aberrations, as illustrated by performing array-CGH analysis on genomic DNA from only a few selected tumor cells of interest sampled from a progressing bone metastasis, can identify relevant therapeutic targets and genetic aberrations involved in malignant progression, thus emphasizing the importance and feasibility of this powerful tool on the road to more personalized cancer therapies in the future. (Source: BMC Cancer)

Rare association of Visceral leishmaniasis with Hodgkin's disease: A case report

Infectious Agents and Cancer — Thu, 20 Oct 2011 04:00:00 +0100

We present here a case of young male with complaints of fever and swelling in neck for eight months. History of progressive weakness associated with weight loss was present. Physical examination revealed pallor, multiple enlarged cervical lymph nodes and hepatosplenomegaly. Investigations showed pancytopenia, hyperglobinemia and Leishman-Donovan bodies on bone marrow aspiration. Serological test confirmed diagnosis of visceral leishmaniasis. However, cervical lymph node aspiration and biopsy were suggestive of Mixed cellularity Hodgkin's disease. This made it a very rare case of leishmaniasis as an opportunistic infection in a patient of pre-chemotherapy Hodgkin's disease. There was marked improvement in haematological profile and regression of hepatosplenomegaly with Amphotericin B treatm...

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Prospective Evaluation of Acute Graft-Versus-Host Disease

Digestive Diseases and Sciences — Wed, 19 Oct 2011 15:45:33 +0100

Conclusions In the present study, the majority of cases of acute GVHD demonstrate diffuse upper and lower gastrointestinal involvement with rectal, sigmoid, gastric and duodenal biopsies having similarly diagnostic yield. Based on our findings, we recommend starting with flexible sigmoidoscopy with rectal biopsy alone in patients who are poor candidates to undergo full colonoscopy with sedation or in those in whom GVHD is strongly suspected based on clinical findings. However, more extensive evaluations may be necessary to rule out infection and should be considered in those with no contraindications to sedation and in whom other differential diagnoses are also being considered. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10620-011-19...

Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma

Annals of Hematology — Tue, 18 Oct 2011 15:58:56 +0100

Abstract To evaluate the role of FDG-PET/CT in detecting bone marrow (BM) involvement, pre-treatment bilateral bone marrow biopsies (BMBs) and FDG-PET/CT scans of 89 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab–CHOP were reviewed and analyzed. Fourteen patients (15.7%) had lymphomatous involvement based on BMB (BMB+), and 17 patients (19.1%) had the possibility of BM involvement on FDG-PET/CT (FDG-PET/CT+). Seventy-two patients (80.8%) had concordant results between BMB and FDG-PET/CT (seven patients were positive for both, and 65 patients were negative for both), but 17 patients (19.2%) had a discordant interpretation (seven patients were BMB+ and FDG-PET/CT−, and ten were BMB− and FDG-PET/CT+). Although BMB+ patients had an inferior 2-...

JAK2-V617F-mutated myeloproliferative neoplasms reveal different allele burden within hematopoietic cell lineages: a microdissection study of bone marrow trephine biopsies

Virchows Archiv — Mon, 17 Oct 2011 16:00:45 +0100

Abstract The JAK2-V617F mutation is prevalent in almost all patients with polycythemia vera (PV) and about half of the cases of essential thrombocythaemia (ET) and primary myelofibrosis (PMF). A different allele burden in these entities has long been noticed, but little is known about its distribution among the neoplastic hematopoietic cell lineages within the bone marrow. We conducted a microdissection study of JAK2-V617F-mutated myeloproliferative neoplasms (MPN); 10 cases each of ET, PV, and PMF, with separate analysis of the JAK2 mutation status in three hematopoietic cell lines (i.e., megakaryo-, granulo-, and erythropoiesis). Different numbers of cell lineages harboring the JAK2-V617F mutation were found, being the lowest in ET (17/30), higher in PV (24/30) and in PM...

Deletion of ABL/BCR on der(9) associated with severe basophilia

Indian Journal of Human Genetics — Mon, 17 Oct 2011 04:00:00 +0100

Shantashri Vaidya, Manisha Madkaikar, Kanjaksha Ghosh, Babu Rao VundintiIndian Journal of Human Genetics 2011 17(2):100-103Chronic basophilic leukemia is a rare form in chronic myeloid leukemia patients. Only limited number of reports are available. Herein, we describe a patient who presented with fatigue, weight loss, leucocytosis, prominent basophilia, and mild eosinophilia. On biopsy, bone marrow was hypercellular with marked basophils. The immunophenotype showed abnormal expression of CD7, which is suggestive of basophilic maturation. Chromosomal analysis from GTG-banded metaphases revealed Ph positivity, and fluorescence in situ hybridization (FISH) with BCR/ABL dual color, dual fusion probe showed single fusion on the der(22) chromosome and ABL/BCR fusion was deleted on the der(9) ch...

Decades of progressive red and yellow nodules

Journal of the American Academy of Dermatology — Sat, 15 Oct 2011 05:13:25 +0100

A 72-year-old white man presented to the dermatology clinic with a 23-year history of progressive red, violaceous, and yellow intradermal and subcutaneous nodules. The physical examination revealed nodules on the patient’s head, neck, trunk, arms, and legs (). No lymphadenopathy was appreciated clinically. The patient had previous biopsy specimens that were diagnosed as xanthoma, atypical regressing histiocytosis, and inflammatory xanthogranuloma, respectively. The nodules were previously treated with systemic chemotherapy, excision, local radiation therapy, and intralesional triamcinolone. A biopsy specimen revealed a dense dermal infiltrate of lymphocytes, plasma cells, and neutrophils admixed with histiocytes containing pale vacuolated cytoplasm with emperipolesis (). These histiocyte...

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Rapid Isolation of Human Stem Cells (Connective Progenitor Cells) From the Distal Femur During Arthroscopic Knee Surgery

Arthroscopy — Thu, 13 Oct 2011 04:00:00 +0100

Conclusions: Our intention was to develop a technique for extracting and purifying bone marrow so that the orthopaedic surgeon would have a simple, safe, and efficient process by which to isolate CTPs during arthroscopic knee surgery. This method of aspiration did not lead to a significant increase in complications. Further bone marrow aspirate was successfully purified in the OR, with only a slight increase in surgery time, and resulted in a fractionated layer rich with CTPs. These cells showed osteogenic potential, as evidenced by their osteoblastic differentiation. These CTPs may have future use in enhancing the incorporation of the graft into the bone. Level of Evidence: Level III, matched case-control study. (Source: Arthroscopy)

Internal Iliac Artery Perforation following Bone Marrow Aspiration in a Patient with No Previously Identified Risk Factors: A Case Report and Review of the Literature.

Acta Haematologica — Wed, 12 Oct 2011 04:00:00 +0100

Authors: Martino M, Console G, Russo L, Messina G, D'Arro' BL, Irrera G, Barreca G Abstract No abstract available. PMID: 21996611 [PubMed - as supplied by publisher] (Source: Acta Haematologica)

Disseminated mucormycosis infection after the first course of dose-modified R-EPOCH for advanced-stage lymphoma

Journal of Infection and Chemotherapy — Tue, 11 Oct 2011 15:49:48 +0100

We report the case of a 63-year-old man who presented at our hospital after experiencing fever and dyspnea for more than 1 month. Because his general condition was deteriorating, he was referred to our intensive care unit. He needed critical care and was treated with vasopressors, artificial ventilation, and continuous hemodialysis. Considering his systemic condition, hematological malignancy was suspected. Bone marrow and skin biopsies were performed, and the condition was diagnosed as diffuse large B-cell lymphoma. On the 15th day, suspecting infectious lung disease, we performed bronchoscopy, which showed Rhizopus infection. Thus, the patient was administered high-dose liposomal amphotericin B (10 mg/kg) therapy. On the 54th day, he died of a massive pulmonary hemorrhage....

T‐cell prolymphocytic leukemia (T‐PLL) with overlapping cytomorphological features with T‐CLL and T‐ALL: A Case Initially Diagnosed by Fine‐Needle Aspiration Cytology and Immunocytochemistry

Diagnostic Cytopathology — Tue, 11 Oct 2011 04:00:00 +0100

We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91‐year‐old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium‐sized lymphoid cells with frequent hand‐mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotyp...

Zosteriform B-Cell chronic lymphocytic leukemia infiltration.

Dermatol Online J — Mon, 10 Oct 2011 11:40:02 +0100

Authors: Antunes J, Pacheco D, Travassos R, Filipe P Abstract Cutaneous infiltration by leukemic cells is uncommon and may be associated with progression of disease. The authors present the case of a 77-year-old female patient, referred to the dermatology clinic for red, erythematous, pruritic papules, which had suddenly appeared on her left hemithorax, along the C6 dermatome, with a 4-week duration. She had already been medicated with Valacyclovir and Acyclovir for 4 weeks, without clinical improvement. She also had a diagnosis of B-cell chronic lymphocytic leukemia (B-CLL), type 2 diabetes mellitus, and multinodular goiter. Tzanck smear showed no multinucleated giant cells,and PCR testing for Varicella Zoster Virus (VZV) and Herpes Simplex Virus (HSV) on skin biopsy was negative....

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Avascular Necrosis of the Femoral Head in Children With Acute Lymphoblastic Leukemia: A 4- to 9-year Follow-up Study.

Orthopedics — Thu, 06 Oct 2011 12:30:03 +0100

This study examined the natural history of avascular necrosis of the femoral head in children with leukemia.From 1993 to 2006, a total of 865 children with acute lymphoblastic leukemia were admitted to the hematology-oncology ward of a children's hospital. The diagnosis of acute lymphoblastic leukemia was established by bone marrow aspiration. Based on clinical and radiographic findings, avascular necrosis of the femoral head was found in 7 patients; these patients underwent follow-up for 4 to 9 years. Avascular necrosis of the femoral head was clinically symptomatic in all of the children, and they had advanced radiographic collapse of the femoral head. However, the head of the femur was not at risk in any patient based on clinical and radiographic findings. Patients received supportive t...

Bone marrow versus sentinel lymph node involvement in breast cancer: a comparison of early hematogenous and early lymphatic tumor spread

Breast Cancer Research and Treatment — Wed, 05 Oct 2011 05:47:29 +0100

This study is aimed to compare the DTC status in clinically node-negative (N0) breast cancer patients with their sentinel LN status and to investigate predictors of BM and LN involvement. The DTC status of 1,345 clinically N0 breast cancer patients who underwent SLN biopsy during initial surgery was investigated. BM and LN status were compared and predictors of hematogenous and lymphatic tumor cell spread were investigated. DTCs were present in the BM of 181 (13%) patients. LN involvement was found in 348 (26%) patients. There was no correlation between LN and BM status: 137 of 997 nodal-negative patients (14%) had BM involvement and 44 of 348 nodal-positive patients (13%) were positive for DTCs (P = 0.649). The presence of DTCs was not influenced by tumorbiological factors...

Bone Marrow–Derived Mesenchymal Stem Cells Obtained During Arthroscopic Rotator Cuff Repair Surgery Show Potential for Tendon Cell Differentiation After Treatment With Insulin

Arthroscopy — Wed, 05 Oct 2011 04:00:00 +0100

Conclusions: Bone marrow–derived MSCs treated with a single physiologic dose of insulin differentiated into cells with characteristics consistent with tendon.Clinical Relevance: The potential for MSCs to differentiate into tendon after a 1-time dose of insulin may assist in developing practical biologic options for augmentation of rotator cuff repairs. (Source: Arthroscopy)

Hemophagocytic syndrome after liver transplantation: Report of two cases

Surgery Today — Tue, 04 Oct 2011 05:58:51 +0100

We report two cases of hemophagocytic syndrome (HPS), a rare but fatal complication after living-donor liver transplantation (LDLT). Despite their recovery from pancytopenia following treatment with steroid pulse therapy, granulocyte stimulating factor, and intravenous γ-globulin, both patients died. The outcomes reported in cases published in English are devastating, with only 4 survivors among the total 14 patients including ours. Pancytopenia is frequently recognized postoperatively in liver transplant recipients, although its cause is difficult to establish. When pancytopenia accompanying persistent high fever is recognized in LDLT recipients, HPS should be suspected and bone marrow aspiration performed as promptly as possible because of the poor prognosis of this syndrome. Ther...

Hemophagocytic lymphohistiocytosis: a potentially underrecognized association with systemic inflammatory response syndrome, severe sepsis, and septic shock in adults.

Chest — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSION: The HLH-2004 treatment protocol is not of proven benefit in critically ill adults, but observational data suggest that aggressive immunosuppressive therapy should not be delayed. Further study of HLH in the critical care setting might provide important insights into the pathogenesis and clinical treatment of sepsis. PMID: 21737492 [PubMed - in process] (Source: Chest)

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CD40 Ligand Deficiency With Grade III Liver Fibrosis, Transplanted by a Treosulphan-based Conditioning Regimen.

Sat, 01 Oct 2011 04:00:00 +0100

In conclusion, treosulphan is a new agent for conditioning regimen with less toxicity in patients with severe liver disease. PMID: 21967264 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

Perfusion method for harvesting bone marrow cells from dogs.

American Journal of Veterinary Research — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions and Clinical Relevance-The perfusion method used in this study can minimize the contamination of bone marrow samples with peripheral blood and was a more efficient means for collecting canine bone marrow progenitor cells than the conventional aspiration method. Therefore, the perfusion method can be more suitable than aspiration for harvesting bone marrow cells for transplantation in dogs. PMID: 21962277 [PubMed - in process] (Source: American Journal of Veterinary Research)

Melanotic neoroectodermal tumor of infancy: report of a case

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

The melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm that affects mainly the anterior aspect of the maxilla during the first year of life. Although the MNTI is accepted as a benign tumor, it often grows rapidly, can invade bone marrow diffusely, and his recurrence rates ranges from 10% to 20%. Clinical features of the tumor are its blue or black appearance and, occasionally, an ulcerated surface. This lesion was reported under a variety of names that reflects the controversy about its origin and histogenesis. Recent studies have made the neural crest origin widely accepted. The aim of this study is to report a case of a MNTI affecting the anterior maxilla of a 5-month-old female child. The patient presented to the department of Oral and Maxillofacial Surgery of the Pedr...

Multiple myeloma with biclonal gammopathy accompanied by prostate cancer.

The Korean Journal of Laboratory Medicine — Sat, 01 Oct 2011 04:00:00 +0100

We report a rare case of multiple myeloma with biclonal gammopathy (IgG kappa and IgA lambda type) in a 58-year-old man with prostate cancer who presented with lower back pain. Through computed tomography (CT) imaging, an osteolytic lesion at the L3 vertebra and an enhancing lesion of the prostate gland with multiple lymphadenopathies were found. In the whole body positron emission tomography-computed tomography (PET-CT), an additional osteoblastic bone lesion was found in the left ischial bone. A prostate biopsy was performed, and adenocarcinoma was confirmed. Decompression surgery of the L3 vertebra was conducted, and the pathologic result indicated that the lesion was a plasma cell neoplasm. Immunofixation electrophoresis showed the presence of biclonal gammopathy (IgG kappa and IgA lam...

The association of Epstein-Barr Virus infection with multiple myeloma.

Indian Journal of Pathology and Microbiology — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Sadeghian MH, Ayatollahi H, Keramati MR, Memar B, Jamedar SA, Avval MM, Sheikhi M, Shaghayegh G Abstract Background: Multiple myeloma is a conventional term for clonal proliferation of plasma cells. It is suggested that viruses may have a significant role in the pathogenesis of multiple myeloma. Aims: The aim of this study was to evaluate whether there is an association between multiple myeloma and Epstein-Barr Virus (EBV) by the polymerase chain reaction (PCR) method. Materials and Methods: This case-control study was performed on 60 paraffin-embedded bone marrow biopsies (30 multiple myeloma and 30 normal bone marrow specimens) in the molecular pathology section of our hospital. The patients and control groups were matched according to gender and age. Several sections we...

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Introduction: Advances in Myelodysplastic Syndromes

Seminars in Oncology — Thu, 29 Sep 2011 01:01:00 +0100

When I was a fellow in hematology in the late 1990s there was little understanding and interest in the study of the myelodysplastic syndromes (MDS). The disease was considered a prodrome to acute myelogenous leukemia (AML) and most patients were observed until death or transformation to AML. Indeed, transformation represented in many instances the first opportunity to treat these patients. This nihilistic approach was not due to lack of interest but to a paucity of therapeutic agents. Drugs available at that time included growth factors and in some cases thalidomide. Supportive care included transfusions, antibiotics, and the use of sex hormones. Patients were still classified with French-American-Bristish (FAB) criteria and the International Prognostic Scoring System (IPSS) just had been ...

Classification and Prognostic Evaluation of Myelodysplastic Syndromes

Seminars in Oncology — Thu, 29 Sep 2011 01:01:00 +0100

Myelodysplastic syndromes (MDS) are myeloid neoplasms characterized by dysplasia in one or more cell lines and increased risk of development of acute myeloid leukemia (AML). The current diagnostic approach to MDS includes peripheral blood and bone marrow morphology to evaluate abnormalities of peripheral blood cells and hematopoietic precursors; bone marrow biopsy to assess marrow cellularity, fibrosis, and topography; and cytogenetics to identify non-random chromosomal abnormalities. The 2008 World Health Organization (WHO) classification currently provides the best diagnostic approach to MDS and also has considerable prognostic relevance. The WHO classification-based prognostic scoring system (WPSS) is able to classify MDS patients into five risk groups showing different survivals and pr...

Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care

Clinical and Developmental Immunology — Wed, 28 Sep 2011 22:55:08 +0100

Conclusions. This preliminary result demonstrates a strong correlation between marrow metabolic changes (as determined by FDG PET) after chemotherapy and bone marrow involvement proven by biopsy. This may provide a retrospective means of personalized management of marrow involvement in deciding whether to deliver more extended therapy or closer followup of lymphoma patients. (Source: Clinical and Developmental Immunology)

Discovery Of Gene Associated With Blood Cancers

Health News from Medical News Today — Wed, 28 Sep 2011 07:00:00 +0100

A genomic study of chronic blood cancer - a precursor to leukaemia - has discovered gene mutations that could enable diagnosis using only a blood test, avoiding the need for an invasive and painful bone marrow biopsy. Researchers at the Wellcome Trust Sanger Institute identified the SF3B1 gene as being frequently mutated in myelodysplasia, one of the most common forms of blood cancer. Myelodysplasia is particularly prevalent among people over the age of 60, and often the only symptom is anaemia, which makes it a challenge to give a positive diagnosis... (Source: Health News from Medical News Today)

Transformation of double-hit large B-cell lymphoma into B-lymphoblastic lymphoma: a case report

Journal of Hematopathology — Wed, 28 Sep 2011 05:51:16 +0100

We describe a 55-year-old male who initially presented in March 2010 with significant ascites and extensive lymphadenopathy. A diagnosis of B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, was made in both peritoneal fluid and bone marrow. The malignant cells expressed CD10, CD19, CD20, CD45 (bright), CD79b, and monotypic kappa light chain, but were negative for TdT. Both IGH/BCL2 and IGL/MYC gene rearrangements were identified by FISH. Following chemotherapy, the patient remained in morphologic and cytogenetic remission for approximately 4 months. At relapse, a precursor B-cell lymphoma was detected in the diaphragm, pleural wall, and pleural effusion. The malignant cells were TdT positive and were negative ...

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Three cases of fever of unknown origin (FUO) with acute multifocal non-bacterial osteitis (NBO) as reactive osteomyelitis

Rheumatology International — Wed, 28 Sep 2011 05:48:27 +0100

We report on 3 cases of FUO with self-limited acute NBO as reactive osteomyelitis and suggest that this unique pattern on PET/CT would be helpful for FUO evaluation. Content Type Journal ArticleCategory Short CommunicationPages 1-5DOI 10.1007/s00296-011-2164-8Authors Young Hoon Hong, Division of Rheumatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyeong 5-Dong, Namgu, Daegu, South Korea Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Immunohistochemical analysis of matrix metalloproteinase‐9, vascular endothelial growth factor, bone sialoprotein and i‐nitric oxide synthase in calvaria vs. iliac crest bone grafts

Clinical Oral Implants Research — Tue, 27 Sep 2011 04:00:00 +0100

ConclusionThese findings suggested that, even though clinically both extraoral sources of autologous bone could be considered suitable for grafting in case of large oral rehabilitation, some differences might be detected microscopically and biologically. Calvaria bone graft seemed to enhance not only the quantity of bone tissue at the defect site, but also its quality, better than iliac crest bone do. Then, while both grafts appeared to promote a suitable neoangiogenesis, as showed by morphological analysis and by MMP9 and VEGF expression, in terms of new bone formation and lack of occurrence of inflammatory events, calvaria could be considered a more suitable donor site for bone grafts. (Source: Clinical Oral Implants Research)

Cyto-morphological features of extramedullary acute megakaryoblastic leukemia on fine needle aspiration and cerebrospinal fluid cytology: A case report

CytoJournal — Tue, 27 Sep 2011 04:00:00 +0100

We present the case of a 25-year-old patient with extramedullary involvement of lymph node and cerebrospinal fluid by AML M7, describing in detail, the morphological features on aspiration as well as exfoliative cytology. (Source: CytoJournal)

Priapism associated with Niemann-Pick disease in a 15-year-old boy

Indian Journal of Urology — Mon, 26 Sep 2011 04:00:00 +0100

MV Krishna Shetty, M Udaya Kumar, TK SenIndian Journal of Urology 2011 27(3):410-412A 15-year-old boy presented with priapism of 46 h duration. There was no known cause of priapism detected in him. During evaluation, biopsy of the lymph node and bone marrow aspiration detected patient to be having Niemann-Pick disease. He was managed with cavernous aspiration, saline irrigation, and intracavernosal phenylephrine injection. Although priapism is associated with many known diseases, about half of the cases are of idiopathic origin. We are reporting the first case of priapism associated with Niemann-Pick disease in the literature. (Source: Indian Journal of Urology)

Aplastic crisis as primary manifestation of systemic lupus erythematosus.

Onkologie — Sat, 24 Sep 2011 10:36:06 +0100

In conclusion, in a case of aplastic crisis, physicians should be aware that SLE can be a rare cause that is accessible to specific treatment. PMID: 21934346 [PubMed - in process] (Source: Onkologie)

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Intravascular Large B-cell Lymphoma of the Kidney: a case report

Diagnostic Pathology — Fri, 23 Sep 2011 04:00:00 +0100

We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months.She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L), serum albumin of 2.89 g/dL (28.9 g/L), urea nitrogen of 2.24 mg/dL (1.6 mmol/L), and serum creatinine of 0.54 mg/dL (48 mumol/L). Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT) showed marked bilateral swelling and enlargement of the renal parenchyma wit...

Monitoring serum levels ELR(+) CXC chemokines and the relationship between microvessel density and angiogenic growth factors in multiple myeloma.

Cytokine — Tue, 20 Sep 2011 04:00:00 +0100

CONCLUSIONS: These findings support the hypothesis that ELR(+) motif CXC chemokines, such as IL-8, ENA-78 and GRO-α correlate with angiogenic growth factors and may play a role in the progression of MM. Further studies are needed to determine their prognostic and predictive significance. PMID: 21940178 [PubMed - as supplied by publisher] (Source: Cytokine)

Multiple extramedullary relapses without bone marrow involvement after second allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia

Pediatric Transplantation — Fri, 16 Sep 2011 04:00:00 +0100

We report a case of diffuse EMR of AML without BM involvement after a second allogeneic HSCT. (Source: Pediatric Transplantation)

Lipopolysaccharide infusion up-regulates hepcidin mRNA expression in equine liver.

Innate Immunity — Fri, 16 Sep 2011 04:00:00 +0100

In this study, hepcidin gene expression was determined in the liver and bone marrow of six healthy horses after iv infusion of Escherichia coli O55:B5 LPS. The IL-6 gene expression was also determined in liver and bone marrow samples. Clinical and laboratory evaluations were measured at multiple time points between 0 and 240 h post-LPS infusion (PI). Liver and bone marrow biopsies were taken immediately before (baseline) and at 6 and 18 h PI. In response to endotoxin infusion, all horses showed characteristic clinical signs of endotoxemia. Plasma iron concentration was decreased significantly from the pre-infusion level at 8 h PI. Hypoferremia peak was observed at 12 h and returned to normal levels at 30 h PI. Relative real-time RT-PCR analysis showed that liver hepcidin and IL-6 mRNA expr...

Severe chronic diarrhea and maculopapular rash: A case report.

World Journal of Gastroenterology : WJG — Wed, 14 Sep 2011 04:00:00 +0100

We report a case of SM with multi-organ involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal infiltration by large, spindle-shaped MCs with abnormal surface molecule expression (CD2 and CD25), a picture fully consistent with SM, according to the World Health Organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values < 20 ng/mL). The conclusi...

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JNM: MRI bone marrow cellularity images match up with histology

Health Imaging News — Tue, 13 Sep 2011 15:07:03 +0100

Measuring bone marrow cellularity is typically done using a biopsy of the iliac crest, but a recent study published in the Journal of Nuclear Medicine indicates that MRI images may also adequately, and noninvasively, measure in vivo bone marrow cellularity. (Source: Health Imaging News)

Parvovirus B19 infection associated with severe chronic aplastic anaemia—a case report

Journal of Hematopathology — Fri, 09 Sep 2011 05:49:08 +0100

We report a case of parvovirus B19-associated chronic aplastic anaemia in a 34-year-old female patient who presented with gum bleeding and ecchymotic patches over both legs and curdy vaginal discharge. She had pancytopenia on peripheral blood film examination and was subjected to bone marrow biopsy as the marrow aspirate showed peripheral blood only hence was not conclusive. Bone marrow biopsy was reported as AA, severe grade. The serological analysis performed later on revealed parvovirus B19 infection. Acute infection with B19V should be considered as a cause of acquired aplastic anaemia in individuals where other etiological factors are not elucidated. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s12308-011-0113-9Authors Rajeev Sen, Department of Path...

Fibroproliferative activity in patients with immune thrombocytopenia (ITP) treated with thrombopoietic agents

British Journal of Haematology — Fri, 09 Sep 2011 04:00:00 +0100

In conclusion, low‐grade BM reticulin fibrosis is seen in most ITP patients on Tpo‐RA. The novel findings of decreasing PIIINP and elevated HGF need further investigation to explore their significance in BM fibrogenesis. (Source: British Journal of Haematology)

[18F]Fluorodeoxyglucose Positron Emission Tomography for Detection of Bone Marrow Involvement in Children and Adolescents With Hodgkin's Lymphoma [Pediatric Oncology]

Journal of Clinical Oncology — Thu, 08 Sep 2011 04:00:00 +0100

Conclusion FDG-PET is a sensitive and specific method for the detection of BM involvement in pediatric HL. The sensitivity of a BMB appears compromised by the focal pattern of BM involvement. Thus, FDG-PET may safely be substituted for a BMB in routine staging procedures. (Source: Journal of Clinical Oncology)

Equimolar Nitrous Oxide/Oxygen versus Placebo for Procedural Pain in Children: A Randomized Trial: Reinoso-Barbero F, Pascual-Pascual SI, de Lucal R, et al. Pediatrics 2011;127:e1464–70.

The Journal of Emergency Medicine — Thu, 01 Sep 2011 04:00:00 +0100

This Spanish randomized, placebo-controlled, double-blinded study evaluated the effectiveness of oxygen and nitrous oxide inhalation (EMONO) when used for short procedures including nevus excision, laceration repair, skin biopsy, venous cannulation, lumbar puncture, joint aspiration, or bone marrow aspiration. The study enrolled 100 children and randomized them to treatment with EMONO or placebo. For large cutaneous procedures, eutectic mixture of local anesthetic cream was applied. Two scales were used to evaluate the quality of sedation and pain control. Children 6 years of age and older used the faces pain scale-revised (rFPS). Those 6 years of age and younger used the Spanish version of an observational pain scale (LLANTO) based on five behavioral items (crying, psychological attitude,...

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Role of platelet‐derived growth factor‐AB in tumour growth and angiogenesis in relation with other angiogenic cytokines in multiple myeloma

Hematological Oncology — Thu, 01 Sep 2011 04:00:00 +0100

AbstractAngiogenesis is a complex process essential for the growth, invasion, and metastasis of various malignant tumours, including multiple myeloma (MM). Various angiogenic cytokines have been implicated in the angiogenic process. Among them, platelet‐derived growth factor‐AB (PDGF‐AB) has been reported to be a potent stimulator of angiogenesis in many solid tumours and haematological malignancies, including MM. The aim of the study was to investigate the relationship between PDGF‐AB, microvascular density (MVD), and various angiogenic cytokines, such as basic fibroblast growth factor (b‐FGF), angiogenin (ANG), and interleukin‐6 (IL‐6), in MM patients. Forty‐seven MM patients before treatment, 22 of whom were in plateau phase, were studied. We determined the serum levels ...

A novel BMT technique for treatment of various currently intractable diseases

Best Practice and Research. Clinical Haematology — Thu, 01 Sep 2011 04:00:00 +0100

A recently-developed BMT method combines a “Perfusion Method” (PM) for collecting bone marrow cells (BMCs) with the Intra-Bone Marrow (IBM) injection of BMCs (IBM-BMT). As distinct from the conventional aspiration method (AM), the PM allows rapid (within 1 h) collection of BMCs without T cell contamination (T cells (Source: Best Practice and Research. Clinical Haematology)

S302 anxiety and pain associated with bone marrow aspiration and biopsy

European Journal of Pain Supplements — Thu, 01 Sep 2011 04:00:00 +0100

(Source: European Journal of Pain Supplements)

Nodular cutaneous amyloidosis.

Skinmed — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Borowicz J, Shama L, Miller R Abstract A 56-year-old white man presented with a lesion on the right shoulder. The lesion developed during a short period and recently became irritated with occasional bleeding and mild pruritus. The patient denied pain. Medical history included melanoma, nonmelanoma skin cancer, diabetes mellitus type II, hyperlipidemia, multinodular thyroid goiter, and obesity. Medications and family and social history were noncontributory. Review of systems was negative. Examination revealed a slightly raised, friable yellow-pink waxy plaque located on the right shoulder (Figure 1). There was no evidence of excoriation, secondary infection, drainage, scale, crust, atrophy, lichenification, or telangiectasia. The patient had no mucosal or nail changes and t...

Relapsed acute myelogenous leukemia of brachial plexus after marrow transplant

Muscle and Nerve — Wed, 31 Aug 2011 23:00:00 +0100

AbstractThe authors present a detailed description of brachial plexus infiltration by acute myelogenous leukemia (AML) in the setting of a remission bone marrow biopsy, without evidence of leukemia by flow cytometric analysis. This case illustrates the possibility of dormant leukemic cells in the peripheral nervous system (PNS) in a patient in apparent clinical remission. In patients with an unexplained brachial plexopathy and a history of AML, leukemic infiltrate of the PNS must be considered. © 2011 Wiley‐Liss, Inc. (Source: Muscle and Nerve)

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Newly diagnosed immune thrombocytopenia in children and adults, a comparative prospective observational registry of the Intercontinental Cooperative Immune Thrombocytopenia Study Group.

Haematologica — Tue, 30 Aug 2011 23:00:00 +0100

Conclusions. Comparative data of children and adults with newly diagnosed immune thrombocytopenia revealed similarities in presenting platelet counts and in bleeding, whereas differences occurred in co-morbidity, diagnostic procedures and therapy. PMID: 21880634 [PubMed - as supplied by publisher] (Source: Haematologica)

News Beyond Our Pages

Journal of Allergy and Clinical Immunology — Tue, 30 Aug 2011 12:13:01 +0100

This study supports a role for the bone marrow in lung angiogenic changes in allergen-induced asthmatic responses.” (Source: Journal of Allergy and Clinical Immunology)

Splenic Marginal Zone B-Cell Lymphoma With Epidermotropic Skin Involvement.

Actas Dermo-Sifiliograficas — Mon, 29 Aug 2011 23:00:00 +0100

We report the case of a 68-year-old man with erythematous-violaceous plaques and nodules. Skin biopsy showed an epidermotropic lymphocytic infiltration and cytology and immunohistochemistry were consistent with MZL. The workup revealed disease in the peripheral blood and bone marrow and massive splenomegaly. Splenectomy confirmed the diagnosis of splenic MZL and led to resolution of the skin lesions. Cutaneous recurrence was treated successfully with chemotherapy and rituximab but caused fatal hepatitis due to hepatitis B virus reactivation. Skin involvement by splenic MZL is uncommon; this form of the disease can present epidermotropism, a very rare finding in primary cutaneous MZL. Treatment consists of splenectomy, which may be associated with chemotherapy and/or rituximab; this treatme...

Fluorescent in situ hybridization diagnosis of extramedullary nodal blast crisis

Diagnostic Cytopathology — Thu, 25 Aug 2011 23:00:00 +0100

In conclusion, this case is unusual at three levels: first, extramedullary nodal BC as a presenting manifestation of CML is rare and the blasts are of precursor T lymphoblastic lineage, rather than the more common B‐cell lineage; second, this case suggests that extramedullary lymphoid nodal BC of CML can exist independently without the bone marrow developing into BC; and third, FISH analysis on the single neoplastic cell is an accurate way to confirm that the neoplasm is either extramedullary localized blasts of CML or genetically distinct neoplasm. Diagn. Cytopathol. 2011;. © 2011 Wiley‐Liss, Inc. (Source: Diagnostic Cytopathology)

An assessment of the usefulness of immunohistochemical stains in the diagnosis of hairy cell leukemia.

American Journal of Clinical Pathology — Mon, 22 Aug 2011 21:45:03 +0100

Authors: Sherman MJ, Hanson CA, Hoyer JD Abstract Annexin-1 and T-bet are recently described immunohistochemical stains that reportedly assist in the diagnosis of hairy cell leukemia (HCL). Our objective was to assess the sensitivity and specificity of a panel of immunohistochemical stains in distinguishing HCL from other B-cell neoplasms, particularly splenic and extranodal marginal zone lymphomas (SMZL and ENMZL, respectively). The study included 234 bone marrow biopsy specimens: 101 HCL, 13 SMZL, and 10 ENMZL cases were assessed with CD20, tartrate-resistant acid phosphatase (TRAP), DBA.44, a-1, T-bet, and cyclin D1, and 110 control cases were assessed with annexin-1 and T-bet. Our study showed that annexin-1 is a specific and sensitive marker for HCL; however, interpretation is...

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Follicular lymphoma: 2011 update on diagnosis and management

American Journal of Hematology — Sat, 20 Aug 2011 17:05:27 +0100

AbstractDisease overview:Follicular lymphoma (FL) is generally an indolent B‐cell lymphoproliferative disorder of transformed follicular center B cells. FL is characterized by diffuse lymphoadenopathy, bone marrow involvement, splenomegaly, and less commonly other extranodal sites of involvement. In general, cytopenias can occur but constitutional symptoms of fever, nightsweats, and weight loss are uncommon.Diagnosis:Diagnosis is based on histology of preferably biopsy of a lymph node. Immunohistochemical staining is positive in virtually all cases for cell surface CD19, CD20, CD10 and monoclonal immunoglobulin, as well as cytoplasmic expression of bcl‐2 protein. The overwhelming majority of cases have the characteristic t(14;18) translocation involving the IgH/bcl‐2 genes.Risk strat...

The Utility of Fluorescence In Situ Hybridization (FISH) Analysis in Diagnosing Graft Versus Host Disease Following Orthotopic Liver Transplant.

Annals of Clinical and Laboratory Science — Fri, 19 Aug 2011 23:04:06 +0100

We present the case of a 61 year old female who developed skin rash and pancytopenia following sex-mismatched second liver transplant for autoimmune hepatitis. Initial skin biopsies revealed vacuolar interface change, keratinocyte necrosis and a mild mononuclear superficial perivascular infiltrate. The bone marrow was markedly hypocellular with scattered CD8 positive T lymphocytes. FISH analysis revealed chimerism with the presence of male donor cells in the skin and bone marrow biopsies. This case illustrates the diagnostic utility of FISH in detecting the presence of donor-derived cells in tissues affected by GVHD. PMID: 21844579 [PubMed - in process] (Source: Annals of Clinical and Laboratory Science)

Pulmonary Embolization of Fat and Bone Marrow in Cynomolgus Macaques (Macaca fascicularis).

Comparative Medicine — Fri, 19 Aug 2011 17:48:03 +0100

Authors: Fong DL, Murnane RD, Hotchkiss CE, Green DJ, Hukkanen RR Abstract Fat embolization (FE), the introduction of bone marrow elements into circulation, is a known complication of bone fractures. Although FE has been described in other animal models, this study represents the first reported cases of FE and bone marrow embolism in nonhuman primates. Histopathologic findings from cynomolgus macaques (Macaca fascicularis) indicated that in all 5 cases, fat and bone marrow embolization occurred subsequent to multiple bone marrow biopsies. In the most severe case, extensive embolization was associated pulmonary damage consistent with acute respiratory distress syndrome. Fat embolism syndrome (FES) is an infrequent clinical outcome of FE and is triggered by systemic biochemical and m...

A prospective randomised study of a rotary powered device (OnControl) for bone marrow aspiration and biopsy

Journal of Clinical Pathology — Wed, 17 Aug 2011 23:00:00 +0100

Conclusions Results of this trial suggest that the use of a powered bone marrow biopsy device significantly reduces needle insertion pain and procedural time when compared to a manual technique. The superior size and overall quality of core specimens retrieved by the powered device provides more material for pathologic evaluation, thereby increasing diagnostic yield and reducing the need for repeat procedures. (Source: Journal of Clinical Pathology)

Autologous bone marrow stem cell intralesional transplantation repairing bisphosphonate related osteonecrosis of the jaw.

Head and Face Medicine — Tue, 16 Aug 2011 23:00:00 +0100

Conclusion: To our knowledge this is the first case of BRONJ successfully treated with outologous stem cells transplantation with a complete response. (Source: Head and Face Medicine)

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High abundance of CD271+ multipotential stromal cells (MSCs) in intramedullary cavities of long bones

Bone — Tue, 16 Aug 2011 04:00:00 +0100

This article is part of a Special Issue entitled: Interactions Between Bone, Adipose Tissue and Metabolism. (Source: Bone)

Clinicopathological features and prognostic significance of CXCL12 in blastic plasmacytoid dendritic cell neoplasm

Journal of the American Academy of Dermatology — Fri, 12 Aug 2011 04:00:00 +0100

Conclusions: We speculate that the presence of CXCL12-positive cells in the skin may be associated with leukemic change and a poor prognosis. (Source: Journal of the American Academy of Dermatology)

Thrombopoietin receptor agonist therapy in primary immune thrombocytopenia is associated with bone marrow hypercellularity and mild reticulin fibrosis but not other stromal abnormalities

Modern Pathology AOP — Thu, 11 Aug 2011 23:00:00 +0100

Authors: Leonardo Boiocchi, Attilio Orazi, Waleed Ghanima, Melissa Arabadjief, James B Bussel & Julia Turbiner Geyer (Source: Modern Pathology AOP)

Tumor kinase activity in locally advanced rectal cancer: angiogenic signaling and early systemic dissemination

Angiogenesis — Thu, 11 Aug 2011 06:56:11 +0100

Abstract Tumor hypoxia is a common determinant of resistance to cytotoxic therapies and metastatic behavior. In rectal cancer patients receiving preoperative chemoradiotherapy, tyrosine kinase activities in tumors with poor and good treatment responses were found to differ. Given that tyrosine kinase signaling mediates hypoxic tissue adaptation, the present study examined whether tumor kinase activity might also correlate with systemic dissemination of rectal cancer. Immunomagnetic selection of disseminated tumor cells (DTC) from bone marrow aspirates was undertaken in 55 patients with locally advanced rectal cancer. Using peptide arrays with 144 tyrosine kinase substrates, phosphopeptide signatures were generated from patients’ baseline tumor biopsies, to study associat...

Impact of PET‐CT on involved field radiotherapy design for pediatric Hodgkin lymphoma

Pediatric Blood and Cancer — Sun, 07 Aug 2011 23:00:00 +0100

ConclusionIncorporation of PET‐CT information was found to influence IFRT design in 17% of patients, with most having more extensive radiotherapy fields. Pediatr Blood Cancer © 2011 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

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Expression, adverse prognostic significance and therapeutic small molecule inhibition of Polo-like kinase 1 in multiple myeloma

Leukemia Research — Thu, 04 Aug 2011 04:00:00 +0100

Highlights: ► We show that increased PLK1 expression in multiple myeloma is a poor prognostic factor. ► The PLK1 inhibitor BI 2536 is toxic to myeloma cell lines and murine myeloma xenografts. ► Further exploration of PLK1 as a therapeutic target in myeloma is warranted.Abstract: The amplified myeloma centrosome has been identified as a therapeutic target. The present study explored the expression and prognostic significance of the centrosome-associated protein PLK1 in myeloma and the effect of BI 2536, a potent and selective inhibitor of PLK1, on myeloma cells. High plasma cell expression of PLK1 protein in myeloma patient bone marrow biopsies is an independent adverse prognostic factor (HR=2.3, p=0.003 unadjusted; HR=1.9, p=0.03 in multivariable model). BI 2536 inhibits myeloma cel...

[Sweet syndrome revealing leukemia.]

Archives de Pediatrie — Mon, 01 Aug 2011 23:00:00 +0100

We report a case of Sweet syndrome revealing acute leukemia at a 13-year-old girl, who had no history of illness. The diagnosis was made in spite of atypical skin lesions and was confirmed by the skin biopsy and the bone marrow examination. In spite of corticosteroid therapy and chemotherapy, the patient died. Sweet syndrome's diagnosis requires an exhaustive etiologic survey. If there is no evidence of underlying disease, patients must be regularly monitored. PMID: 21816591 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)

Potential feasibility of dental stem cells for regenerative therapies: stem cell transplantation and whole-tooth engineering

Odontology — Sat, 30 Jul 2011 15:51:33 +0100

This article provides a short overview of the ongoing studies for the potential application of dental stem cells and suggests the utilization of 2 concepts in future regenerative medicine: (1) dental stem cell-based therapy for hepatic and other systemic diseases and (2) tooth replacement therapy using the bioengineered human whole tooth, called the “test-tube dental implant.” Regenerative therapies will bring new insights and benefits to the fields of clinical medicine and dentistry. Content Type Journal ArticlePages 1-7DOI 10.1007/s10266-011-0037-yAuthors Taka Nakahara, Department of Developmental and Regenerative Dentistry, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159 Japan Journal OdontologyOnline ISSN ...

Spectrin isoforms: differential expression in normal hematopoiesis and alterations in neoplastic bone marrow disorders.

American Journal of Clinical Pathology — Sat, 30 Jul 2011 14:31:08 +0100

Authors: Wolgast LR, Cannizzarro LA, Ramesh KH, Xue X, Wang D, Bhattacharyya PK, Gong JZ, McMahon C, Albanese JM, Sunkara JL, Ratech H Spectrins are large, rod-like, multifunctional molecules that participate in maintaining cell structure, signal transmission, and DNA repair. Because little is known about the role of spectrins in normal hematopoiesis and leukemogenesis, we immunohistochemically stained bone marrow biopsy specimens from 81 patients for αI, αII, βI, and βII spectrin isoforms in normal reactive marrow (NRM), myelodysplastic syndrome, myeloproliferative neoplasm, acute myeloid leukemia (AML) with well-characterized cytogenetic abnormalities, acute erythroid leukemia (EryL), and acute megakaryoblastic leukemia (MegL). In NRM, spectrin isoforms were differentially expres...

Primary hyperoxaluria in an adult presenting with end‐stage renal failure together with hypercalcemia and hypothyroidism

Hemodialysis International — Thu, 28 Jul 2011 23:00:00 +0100

AbstractPrimary hyperoxaluria (PH) is a rare genetic disorder characterized by overproduction of oxalate due to specific enzyme deficiencies in glyoxylate metabolism. The primary clinical presentation is in the form of recurrent urolithiasis, progressive nephrocalcinosis, end‐stage renal disease, and systemic oxalosis. Herein, we present a case of PH who was diagnosed at 47 years of age after 6 years on hemodialysis. He presented with fatigue, anorexia, weight loss, and was found to have cachexia, diffuse edema, hepatomegaly, ascites, hypercalcemia, hyperphosphatemia, hypoalbuminemia, low parathyroid hormone levels, lytic and resorptive areas in the vertebrae, diffusely increased echogenity of the liver, multiple renal stones, and bilateral nephrocalcinosis. Bone marrow biopsy showed...

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Dasatinib-induced rapid regression and complete molecular remission of multiple subcutaneous tumours presenting as relapsed chronic myeloid leukaemia after cord blood transplantation

Leukemia Research — Thu, 28 Jul 2011 04:00:00 +0100

A 47-year-old male in chronic myeloid leukaemia (CML) blast crisis was transferred to our hospital for cord blood transplantation (CBT) in July 2008. His disease began in the chronic phase in July 2002, but his treatment was very unusual because he discontinued medicating himself many times. As an apparent result, an additional chromosomal abnormality of +8, +idem, and +der (12) appeared from March 2007, and the disease entered the accelerated phase. Although dasatinib was administered at 100mg/day from July 2008, there was no response and multiple subcutaneous nodules appeared as extramedullary CML invasions. There were no detectable ABL kinase mutations during the course of his disease. We began idarubicin (12mg/m2/day for 3 days) and cytarabine (100mg/m2/day for 1 week) chemotherapy, wh...

Association of Occult Metastases in Sentinel Lymph Nodes and Bone Marrow With Survival Among Women With Early-Stage Invasive Breast Cancer [Original Contribution]

JAMA — Mon, 25 Jul 2011 23:00:00 +0100

Conclusion Among women receiving breast-conserving therapy and SLN dissection, immunohistochemical evidence of SLN metastasis was not associated with overall survival over a median of 6.3 years, whereas occult bone marrow metastasis, although rare, was associated with decreased survival. Trial Registration clinicaltrials.gov Identifier: NCT00003854 (Source: JAMA)

Diffuse large B-cell lymphoma within a cavernous hemangioma of the cavernous sinus

Brain Tumor Pathology — Thu, 21 Jul 2011 18:16:54 +0100

We report the case of a 72-year-old man with right circumorbital pain and right oculomotor nerve dysfunction because of a mass in the right cavernous sinus. It was removed via a transsphenoidal approach and histological examination revealed the mass was a cavernous hemangioma containing atypical large B cells in some sinusoidal vessels; no other evidence of lymphoma was detected on 18F-2-fluoro-2-deoxy-d-glucose positron-emission tomography or bone marrow biopsy. The patient underwent gamma knife radiosurgery (GKS) of the right cavernous sinus, but no systemic chemotherapy was administered. Although good local control was achieved, the patient developed a systemic diffuse large B-cell lymphoma (DLBCL) 1.5 years after the GKS. The atypical lymphocytes of the cavernous hemangioma ...

Etanercept for the treatment of intractable hemophagocytic syndrome with systemic lupus erythematosus

Modern Rheumatology — Wed, 20 Jul 2011 12:46:17 +0100

Abstract A 41-year-old woman presented with continuous fever, and her laboratory data suggested the recrudescence of systemic lupus erythematosus. She was treated with 60 mg/day prednisolone. With a dose reduction of prednisolone, high fever and pancytopenia were observed again. A bone marrow biopsy revealed hemophagocytosis. The effects of steroid pulse therapy, high-dose intravenous immunoglobulin, cyclosporine A, and methotrexate were insufficient. However, after four injections of etanercept (25 mg, twice a week) subcutaneously, her symptoms had completely resolved. In such cases, therapy with etanercept may be effective. Content Type Journal ArticlePages 1-4DOI 10.1007/s10165-011-0500-1Authors Hirotoshi Kikuchi, Department of Microbiology and Immunology...

Bone marrow trephine biopsy findings in acute promyelocytic leukaemia

American Journal of Hematology — Sat, 16 Jul 2011 17:34:33 +0100

(Source: American Journal of Hematology)

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Therapy-related leukemia cutis with histopathologic changes resembling xanthogranuloma

Journal of the American Academy of Dermatology — Sat, 16 Jul 2011 16:20:00 +0100

We report a rare case of therapy-related leukemia cutis with uncommon histological features. A 41-year-old woman had a 2-year history of stage IV CD30+ nodal anaplastic large T-cell lymphoma. She was treated with 6 courses of cyclophosphamide, epirubicin, vincristine, and prednisolone (CEOP). Six months after treatment, she developed acute myelogenous leukemia (AML), M4 type. Two courses of high-dose cytarabine were given without obvious response. On admission for a third course of chemotherapy for AML, her white blood cell count was 59,300 cells/μL (normal range, 4,000 to 10,000 cells/μL) with 91% blasts, hematocrit 34.8% (normal range, 34%-50%), and platelet count 33 × 103/μL (normal range, 140 × 103/μL to 450 × 103/μL). Analysis of bone marrow cells revealed an abnormal karyot...

MPL immunohistochemical expression as a novel marker for essential thrombocythemia and primary myelofibrosis differential diagnosis

Leukemia Research — Fri, 15 Jul 2011 04:00:00 +0100

Abstract: To evaluate the grading of fibrosis and immunohistochemical expression of MPL in bone marrow biopsies of ET and PMF. Fibrosis in bone marrow biopsies (BMBs) was evaluated according to the European Consensus for grading of fibrosis, according to reticulin proliferation. Immunohistochemical analysis was performed in samples from 18 ET and 38 PMF patients: 19 were classified as pre-fibrotic and 19 were classified as fibrotic according to the World Health Organization (WHO) criteria, by means of the MPL antibody. Six bone marrow donors’ biopsies were used as controls. Average reticulin (p (Source: Leukemia Research)

Isolated intraorbital intravascular large B-cell lymphoma: a case report

Journal of Hematopathology — Thu, 14 Jul 2011 06:00:43 +0100

We report the case of an 88-year-old woman who initially presented with pain, swelling, and loss of vision in her left eye. A left orbital mass was revealed by computed tomography, and a biopsy was performed. On histologic examination, large atypical lymphoid cells were present in blood vessel lumina of the intraorbital adipose tissue. No tumor cells were seen in the surrounding tissue. By immunohistochemistry, the tumor cells were positive for CD20, BCL-2, Bcl-6, and CD5; they were negative for CD10 and cyclin D1. Ki-67 revealed a proliferation rate of approximately 80–90%, and CD31 highlighted the vascular endothelium. These findings confirmed the diagnosis of intravascular large B-cell lymphoma. Results of bone marrow and cerebrospinal fluid examinations were negative for involv...

Bone marrow trephine biopsy findings in acute promyelocytic leukemia

American Journal of Hematology — Thu, 14 Jul 2011 04:00:00 +0100

(Source: American Journal of Hematology)