Histopathology of the thymus of patients with acute lymphoblastic leukemia and lymphoblastic lymphoma in complete clinical remission

The histologic features of thymuses from three patients who underwent thymectomy for acute lymphoblastic leukemia or lymphoblastic lymphoma in complete clinical remission are described. The thymuses from all three patients were fibrotic with a variability in the appearance of the lobules. Some of the lobules consisted predominantly of epithelial cells with small numbers of mature appearing lymphocytes, while other lobules were expanded and composed predominantly of cells having morphological features of immature lymphoid cells consistent with residual or recurrent disease.     

p27 Protein and cancers of the gastrointestinal tract and liver: an overview

GOALS: The purpose of this review is to look at the evidence presented in the literature on the immunoexpression of p27 in cancers of the gastrointestinal tract and liver. BACKGROUND: Cell cycle proteins have been shown to play an important role in the oncogenesis of many tumors. Several of these proteins have been examined in concert and in isolation, and some have been put forward as putative tumor markers. p27, which is an important inhibitory protein in the cell cycle and belonging to a group of cyclin-dependent kinase inhibitors, has also been studied in several malignancies, most notably breast, lung, bladder, and prostate cancers. Considerable work has also been done on the expression of this protein in cancers occurring within the gastrointestinal tract. RESULTS: Cancers occurring in the major sites of the gastrointestinal tract (esophagus, stomach, and colorectum) and liver show a similar pattern with regard to p27 protein levels. p27 emerges as a statistically significant predictor of survival and tumor behavior. It has been suggested that p27 loss occurs early in the carcinogenesis process, with dysplastic epithelium having decreased expression. The more aggressive, metastasizing cancers tend to lack p27 expression as well. Some studies have also invoked the subcellular localization of p27 (cytoplasmic versus nuclear) as also being of prognostic value. CONCLUSION: Therefore, in gastrointestinal and hepatic cancers, low p27 expression is regarded as an important adverse prognostic factor.     

Recurrent pulmonary embolism after Greenfield filter placement

Three patients with documented recurrent pulmonary embolism with an inferior vena cava (IVC) Greenfield filter in place were examined with contrast-material-enhanced cavography. Mechanisms for recurrent pulmonary embolism were found to be propagation of thrombus through the filter struts, occlusion of the IVC at the level of the filter, and loss of contact of the filter hooks with a portion of the caval wall.     

Percutaneous biliary drainage: complications of 118 consecutive catheterizations

We have reviewed our experience with 118 biliary catheterization procedures in 109 patients from 1979 to 1984. Major complications (septic shock, hemorrhage, subphrenic abscess, and formation of an arteriovenous fistula) occurred in five patients (4.2%), three of whom died (2.5%). Minor complications occurred in 41 patients. Our success rate using the procedure was 97%. The complications that occurred are described.