Supratentorial ependymoma: CT appearance

The computed tomographic appearances of 22 biopsy-proved supratentorial ependymomas were analyzed. Supratentorial ependymomas were usually intraparenchymal, larger than 4 cm, and cystic. Contrast enhancement was moderate to intense, with homogeneous or ring-enhancement patterns commonly seen. Intratumoral calcification was present in one-third of the cases, while hydrocephalus and peritumoral edema were seen in 50%. Intratumoral hemorrhage was not a characteristic of the lesion. In contrast to cellular ependymomas, malignant ependymomas and ependymoblastomas demonstrate higher attenuation prior to administration of contrast material, more intense enhancement, lower frequency of calcification within the tumor, and less distinct margination.     

AL kappa amyloid in a solitary extradural lymphoma.

A 68 year old man with a 10 year history of apparently benign IgM kappa paraproteinaemia presented with dysarthria, left hemiparesis, and a sensory peripheral neuropathy. A calcified right temporoparietal extradural mass was shown by scintigraphy with 123I-serum amyloid P component to contain amyloid. There were no extracranial amyloid deposits. Clinical improvement followed craniotomy and partial resection of tissue which consisted of amyloid and a mixed mononuclear cell infiltrate. The amyloid fibrils consisted of the framework 1 region of the variable domain of monoclonal kappa IV immunoglobulin light chains. There was a prominent B-cell clonal immunoglobulin gene rearrangement in the tumour tissue, supporting a diagnosis of lymphoplasmacytic lymphoma, but no sign of systemic lymphoma. Neurological state, tumour volume, and quantity of amyloid have remained static for two years after treatment with chlorambucil.     

Magnetic resonance imaging of peripheral nerve sheath tumors. Assessment by numerical visual fuzzy cluster analysis

A retrospective, nonblinded review of ten nerve sheath tumors (four malignant) selected for pathologic proof and complete magnetic resonance (MR) evaluation was performed to assess the primary tumor location, signal pattern, and extent of reactive zone. A modification of visual fuzzy cluster analysis (VFCA) that emphasized the number of visual fuzzy clusters in each mass was developed to assess the neural tumors. The MR findings were correlated with the findings at surgery and histopathology. There were six men and four women, aged 19 to 62 years (mean, 43). Nine tumors involved the lower extremity. In all tumors, MRI correctly identified the nerve trunk of origin. Tumor dimensions were generally overestimated by MRI. Three internal signal patterns were observed: homogeneous (1/1 benign), finitely inhomogeneous (5/5 benign), and hectically inhomogeneous (4/4 malignant). The number of visual fuzzy clusters (VFCRs) for each sequence did not allow reliable separation of benign and malignant entities, but when considered in aggregate, benign and malignant lesions segregated in different clusters. This implies that the likelihood of malignancy increases as the number of MR-identifiable tissue types per lesion increase. Three types of reaction (edema) were observed best on long repetition time/echo time (TR/TE) sequences, confined to immediate peritumoral region, intracompartmental, and extracompartmental. The first two patterns correlated well with clinicopathologic findings; however, the third pattern did not. Separation of indolent (benign) cellular masses from aggressive (malignant) ones by MR characteristics is difficult but VFCA shows promise for aiding this differentiation and deserves further investigation in larger study populations.     

塞来昔布治疗骨关节炎的随机对照试验

目的：比较塞来昔布、萘普生以及安慰剂在治疗膝关节骨关节炎时的疗效、安全性、方法：１００３名有症状的膝关节骨关节炎患者随机接受塞米昔布５０,１００,２００ｍｇ,ｂｉｄ;萘普生５００ｍｇ,ｂｉｄ或安慰剂１２周。患者在停用既往ＮＳＡＩＤ药或止痛治疗后２－７ｄ以及服用受试药物治疗后２,６,１２周,根据标准疗效判定方法进行评估。结果：塞来昔布在改善骨关节炎的症状和体征上有显著效果。在治疗后的２ｄ内疼痛明显缓     

Intermediate lymphocytic lymphoma: immunophenotypic and cytogenetic findings

A detailed immunohistologic and cytogenetic analysis of 12 cases of intermediate lymphocytic lymphoma was performed. The characteristic immunophenotype of intermediate lymphocytic lymphoma was: surface IgM and IgD+, BA1+, B1+, BA2-, B2-, B4+, Leu 14+, Leu 1+, HLA-DR+, and common acute lymphocytic leukemia associated (CALLA) antigen negative. Clonal chromosome abnormalities were identified in ten cases, with structural or numerical abnormalities of chromosomes 11 or 12 in nine cases. Five cases had structural abnormalities involving the long arm of chromosome 11; three of these had translocations with chromosome 14 at band q32. Three cases had trisomy 12, and one case had a translocation involving the long arm of chromosome 12. The tenth case had a translocation involving the long arms of chromosomes 7 and 9. These characteristic immunophenotypic and cytogenetic findings suggest a close lineage relationship between intermediate lymphocytic lymphoma and small lymphocytic (well differentiated) lymphoma/chronic lymphocytic leukemia. Their differing clinical, cytologic, and architectural features suggest, however, that intermediate lymphocytic lymphoma should be considered a separate category of lymphocytic lymphoma in the International Working Formulation.     

Plasma cytokine levels and monocyte activation in patients with obstructive jaundice

Some monocytic cytokines are important immune regulators. We have investigated cytokine production by monocytes and the blood levels of IL-1β, IL-6, TNFα, and TGFβ, in patients with obstructive jaundice. The supernatant from LPS stimulated monocytes from jaundiced patients released significantly increased quantities of TNFα by both bioassay and radioimmunoassay (RIA) (12.4 ± 2.5 fmol/mL and 32.6 ± 8.3 fmol/mL, respectively, for jaundice, compared with 1.6 ± 0.3 fmol/mL and 2.4 ± 0.5 fmol/mL respectively for controls, and also of IL-6 (54.8 ± 5.0 fmol/mL in jaundice compared with 35.6 ± 5.0 fmol/mL for controls). The production of IL-1β and TGFβ by stimulated monocytes was unchanged. Jaundiced patients had significantly higher plasma TGFβ, but TNFα and IL-1β were below the limits of detection. The highest monocyte TNFα and IL-6 levels were seen in malignant disease patients, especially those with a poor immediate prognosis. We conclude that the production of some cytokines by monocytes is up-regulated in patients with obstructive jaundice.     

Chromosomal abnormalities in untreated patients with non-Hodgkin's lymphoma: associations with histology, clinical characteristics, and treatment outcome. The Nebraska Lymphoma Study Group

We describe the chromosomal abnormalities found in 104 previously untreated patients with non-Hodgkin's lymphoma (NHL) and the correlations of these abnormalities with disease characteristics. The cytogenetic method used was a 24- to 48-hour culture, followed by G- banding. Several significant associations were discovered. A trisomy 3 was correlated with high-grade NHL. In the patients with an immunoblastic NHL, an abnormal chromosome no. 3 or 6 was found significantly more frequently. As previously described, a t(14;18) was significantly correlated with a follicular growth pattern. Abnormalities on chromosome no. 17 were correlated with a diffuse histology and a shorter survival. A shorter survival was also correlated with a +5, +6, +18, all abnormalities on chromosome no. 5, or involvement of breakpoint 14q11-12. In a multivariate analysis, these chromosomal abnormalities appeared to be independent prognostic factors and correlated with survival more strongly than any traditional prognostic variable. Patients with a t(11;14)(q13;q32) had an elevated lactate dehydrogenase (LDH). Skin infiltration was correlated with abnormalities on 2p. Abnormalities involving breakpoints 6q11-16 were correlated with B symptoms. Patients with abnormalities involving breakpoints 3q21-25 and 13q21-24 had more frequent bulky disease. The correlations of certain clinical findings with specific chromosomal abnormalities might help unveil the pathogenetic mechanisms of NHL and tailor treatment regimens.