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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Observation of a unique population of cells on a Wright-stained blood smear of a patient with metastatic breast carcinoma prompted a study to determine their origin. The primary carcinoma contained a marker, the presence of "signet cells." These were demonstrated in direct peripheral smears and buffy coat preparation of peripheral blood and confirmed histochemically by showing positive periodic acid-Schiff, alpha-napthol and beta-glucuronidase reactions. "Carcinocythemia" is suggested as a name for this unusual process observed over a six month period. Studies of the patient's immunocompetence, of circulating cell surface immunoglobulins and karyotype analysis were made. Postmortem examination revealed retroperitoneal fibrosis, splenic atrophy and extensive metastatic carcinoma but no evidence of leukemia. The cells will be contrasted to those seen in a second patient who appeared to have acute myelocytic leukemia complicating extensive cancer involving the bone marrow. The observations suggest that a leukemia-like blood picture due to circulating cancer cells may occur during the course of metastatic breast carcinoma.
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PMID:Carcinocythemia (carcinoma cell leukemia). An acute leukemia-like picture due to metastatic carcinoma cells. 106 63

The use of Wright-Giemsa-stained smears alone for the classification of acute leukemias often proves unsatisfactory. Some cases of M1, M5a, M7, and L2 are morphologically similar. In such cases, cytochemical stains can provide an inexpensive and available diagnostic tool. M1 is positive for SBB and MPO. M5a is usually NSE positive, whereas SBB and MPO are negative. M7 usually is ANA esterase, PAS, and AP reactive, and do not stain with SBB, MPO, and ANB esterases. The megakaryocytic lineage usually is confirmed by ultrastructural cytochemistry for PPO or immunocytochemistry for platelet glycoproteins and von Willebrand factor. PAS block positivity and AP dotlike reactivity are suggestive of lymphoid lineage. NSE stains are useful in differentiating M2 from M4. Morphologic and cytochemical techniques also can suggest the presence of certain chromosomal abnormalities such as t(8;21) and inv(16), which may have an influence on prognosis. Because not all cases of acute leukemia are easily subtyped by morphology and cytochemistry, immunophenotyping, karyotyping, and molecular analysis of DNA and RNA of leukemia cells also may be required to define cell lineage.
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PMID:The use of cytochemical procedures in the diagnosis and management of acute and chronic myeloid leukemia. 170 64

Immature hematopoietic elements have been identified in eight Wright-stained cytocentrifuge preparations of lumbar puncture-derived cerebrospinal fluid (CSF) from infants and children. These immature hematopoietic elements probably represent contamination from vertebral bone marrow. Recognition that the nucleated cells in the CSF are a contaminant and not indicative of infection or leukemia is important to the immediate care of the child. The only adverse clinical sequela of this contamination identified has been a transient headache. Bone marrow contaminants are one of several abnormalities of CSF found in childhood diseases and may or may not elevate the CSF white blood cell count. This supports the need for pathologist review of all CSF cytocentrifuge preparations from children.
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PMID:Hematopoietic elements in cerebrospinal fluid in children. 201 79

Three cases of spontaneous olfactory neuroblastoma (ONB) in domestic cats were morphologically and immunocytochemically characterized. Diagnostic light microscopic features included Flexner and Homer-Wright rosettes, while ultrastructurally the cells had neuritic processes, intracellular intermediate filaments, and intercellular junctions. Immunocytochemically, the tumors stained positively for neuron-specific enolase, cytokeratins, and S-100 protein antigens. In each case, a key finding was the identification of numerous mature type C retroviral particles within the tumors. In one case, budding of viral particles from the plasmalemma of tumor cells suggested the source of mature particles. This cat and one other were tested, and both were serologically positive for feline leukemia virus (FeLV). The virus in the tumors was identified as FeLV by polymerase chain reaction and immunocytochemistry. No other neoplasms were found in any of the cats, nor was there similar evidence of active viral infection in other non-tumor tissues, including the brain. Although the relationship between FeLV infection and ONB is uncertain, our findings indicate that FeLV should be investigated as an etiologic agent of ONB.
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PMID:Type C retroviral expression in spontaneous feline olfactory neuroblastomas. 217 30

To evaluate the relative merits and deficiencies of Millipore filter and cytocentrifuge preparations in the detection of central nervous system (CNS) acute leukemia in pediatric patients, 300 cerebrospinal fluid (CSF) specimens from 17 patients were prepared by both methods. The 17 patients studied were all diagnosed and treated for CNS leukemia. Leukemic blast cells were found by at least one method in 91 CSF specimens, and the results of both techniques were positive in 77 (85%) of 91 specimens. Of the 14 specimens in which the results of only one method were positive, seven yielded positive results only by the cytocentrifuge method, and seven yielded positive results only by the Millipore filter method. In 12 of the 14 discrepant specimens, the paired specimen whose results were not interpreted as positive was technically unsatisfactory (nine specimens) or had cells suspicious for blast cells rather than unequivocal blast cells (three specimens). Blast cells were identified in specimens with low nucleated cell counts (less than or equal to 5/mm3) by both methods and usually were immediately preceded or followed by CSF specimens showing florid disease. We conclude that performance of both methods is unnecessary for routine surveillance if processing techniques yield quality preparations. Cytocentrifuge preparations stained by Wright's method allow better morphologic correlation with bone marrow blast cells and allow easier identification of blood or bone marrow contamination.
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PMID:Millipore filter vs cytocentrifuge for detection of childhood central nervous system leukemia. 242 76

Aspirates obtained from bone marrow were prepared for routine Papanicolaou staining and screened by a cytologist. As a preliminary study, 100 consecutive bone marrow aspirations were examined. It was shown that metastatic carcinoma and primary bone marrow disorders (including leukemia, myelodysplastic syndromes, and multiple myeloma) can be recognized on Papanicolaou-stained marrow aspirates using the same cytologic criteria employed in the evaluation of cells from any site. Evaluation of bone marrow aspirates in the cytology laboratory is feasible and can be used to augment parallel services employing air-dried Wright-Giemsa-stained specimens in the hematology laboratory.
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PMID:Cytologic evaluation of Papanicolaou-stained bone marrow aspirates. 248 55

Felty's syndrome (FS) refers to the occurrence of rheumatoid arthritis, splenomegaly, and neutropenia. A subset of these patients has recently been described with a chronic T cell leukemia of large granular lymphocytes (LGCL). To examine the spectrum of lymphocyte abnormalities in FS and LGCL, we examined phenotypic and genotypic properties of lymphocytes from eight FS patients. In two of these FS patients, we observed an elevated proportion of T cells with an unusual phenotype (CD3+/Leu-7+/Leu-8-/CR3+) (46 +/- 5% of mononuclear cells). The FS lymphocytes had large granular morphology on Wright-Giemsa stain and were active in antibody-dependent cellular cytotoxic activity. This phenotype, morphology, and activity was similar to LGCL patients except that the latter T cells additionally expressed the Fc-IgG receptor recognized by monoclonal antibody Leu-11 (CD 15). In the remaining six FS patients, the proportion of CD3+/Leu-7+/CR 3+ T cells was only 10 +/- 8%, which was not significantly different from age-matched normal subjects (6.6 +/- 2.2%). To determine the clonality of T lymphocytes in FS and LGCL, we examined DNA for rearrangements of the T cell antigen receptor beta-chain (Ti beta) and gamma-chain (Ti gamma) genes by using Southern blotting techniques. We found a clonal rearrangement of the Ti beta 1 and Ti gamma genes in both LGCL patients. In contrast, no clonal rearrangements of Ti beta or Ti gamma genes were detected in lymphocytes from the FS patients. These results indicate that FS patients are heterogeneous in their phenotype and that one subset exhibits polyclonal expansion of an unusual lymphocyte subset.
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PMID:Comparison of T cell receptor gene rearrangements in patients with large granular T cell leukemia and Felty's syndrome. 310 95

The promyelocytic leukaemia cell line HL-60 differentiates to a macrophage-like cell when exposed to the phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA) and other agents which activate protein kinase C. To investigate this phenomenon we developed an HL-60 variant which does not differentiate when exposed to TPA. HL-60 cells were exposed to the mutagen ethyl methanesulphonate and were cloned in soft agar in the presence of a normally lethal concentration of TPA. One colony of cells that proliferated in TPA was obtained. The cells of this phorbol ester tolerant (PET) line have retained their resistance to TPA for several years without selective pressure. They are somewhat larger than their phorbol ester sensitive (S) parent, but they are otherwise morphologically similar. When PET-cells are exposed to TPA their growth is arrested for approximately 48 h. Thereafter, they resume their original rate of replication at all concentrations of TPA tested. S-cells undergo changes typical of HL-60 when exposed to TPA; they aggregate, stop growing, adhere to the flask and die. The PET-cells appeared to be as sensitive as S-cells to other agents which differentiate HL-60 such as retinoic acid, dimethysulphoxide, and 1,25-dihydroxyvitamin D3, as determined by rate of proliferation in culture, Wright's stain, nitroblue tetrazolium reduction, and induction of the ectoenzyme NAD-glycohydrolase. TPA-induced protein phosphorylation was studied using one- and two-dimensional polyacrylamide gel electrophoresis. Several proteins increased their incorporation of 32P when S- and PET-cells were exposed to TPA, the most prominent of which were the two previously described nuclear matrix proteins of 80 kd and 33 kd. There was no difference in the protein phosphorylation pattern in S- and PET-cells, nor in how this pattern changed on TPA exposure. Fluorescent activated cell sorting and karyotypic analysis revealed PET-cells to be a hypotetraploid variant of S-cells, with approximately 80 chromosomes, including a marker chromosome iso(1p) not found in the S-cells. Identification of the biochemical lesion responsible for this TPA resistance in PET cells will provide clues concerning the mechanism of this important pathway for the induction of cell differentiation.
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PMID:A phorbol ester tolerant (PET) variant of HL-60 promyelocytes. 316 84

Using FAB criteria, we retrospectively classified 195 adult acute leukemia cases seen over a six-year period. Acute lymphoblastic leukemia (ALL) was separated from acute nonlymphoblastic leukemia (ANLL) by negative peroxidase. The dysmyelopoietic syndrome was separated from ANLL when the percentage of immature leukemic cells was less than 30%. The 55 cases of ALL and 140 cases of ANLL thus defined were initially independently subclassified with Wright's stained smears by three observers. Cases were then jointly reviewed by using all available information, and a final consensus diagnosis was reached. For ALL, there was complete agreement (of initial independent observations) about subtype in 32 of 55 (58%); for only one case was there total disagreement. For ANLL there was complete agreement in 89 of 140 (64%) and total disagreement in 5 of 140 (4%). Frequent disagreement of independent observations with the consensus diagnosis were L1 interpreted as 12, M5 interpreted as M4, L3 interpreted as L2, L2 interpreted as L1, M1 interpreted as M2 and M4 interpreted as M5. Although there appears to be variation between observers, all but 6 of 195 cases had at least two observers in agreement. Disagreement appeared to be partly based on varying interpretations of subjective criteria and partly on the variability in determining percentages of cell types present. The use of nonspecific esterase stain or lysozyme appeared to improve diagnostic agreement over that observed using Wright's stained slides alone in approximately 5% of cases of ANLL.
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PMID:Diagnostic concurrence in the subclassification of adult acute leukemia using French-American-British criteria. 617 97

An unusual case of acute myelomonocytic leukemia (AMML) in an 81-year-old man is described. Ultrastructural examination revealed the presence of distinct Auer bodies, which commonly are found in acute promyelocytic leukemia (APL). The Auer bodies had a splinterlike appearance with a distinct tubular substructure. The morphologic appearance of the leukemic cells coupled with the results of cytochemical staining reactions (alpha-naphthyl AS-D chloroacetate esterase, alpha-naphthyl butyrate esterase, Sudan black B, and periodic acid-Schiff reaction) identified this leukemia as myelomonocytic in origin. APL-like Auer rods in AMML now can be included in the spectrum of morphologic forms commonly seen in myelogenous leukemia and lends support to the hypothesis of an aberrant stem cell. In addition to the APL-like Auer rods, the leukemic blasts contained giant pink-staining granules on Wright's stain, some of which had a tubular substructure similar to the Auer rods under the electron microscope. The presence of these megagranules is a morphologic aberration termed "the pseudo-Chediak-Higashi anomaly of acute leukemia," and now has been described for the first time in AMML at the ultrastructural level.
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PMID:A cytochemical and ultrastructural study of acute myelomonocytic leukemia exhibiting the pseudo-Chediak-Higashi anomaly of leukemia and "splinter-type" Auer rods. 619


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