Prominent intrasinusoidal infiltration of the bone marrow by mantle cell lymphoma

Intrasinusoidal infiltration of bone marrow (BM) may accompany several malignant lymphoproliferative disorders. In small B-cell lymphomas, this pattern is considered specific for splenic marginal zone lymphoma (SMZL) when exclusive or prominent, although it may occur in other subtypes of non-Hodgkin's lymphomas (NHLs) as a minor feature. Here we report 2 cases of mantle cell lymphoma (MCL) with a prominent intrasinusoidal BM infiltration pattern. Both patients presented with massive splenomegaly and peripheral blood involvement characterized by markedly atypical lymphocytes, but no lymphadenopathy. The cytological features and the phenotype of the lymphoma cells were diagnostic of MCL. The malignant B cells showed coexpression of B-cell markers (CD20+ and CD79a+), CD5 antigen, and cyclin D1 by immunohistochemistry. We discuss the specificity of an intrasinusoidal growth pattern in the bone marrow, emphasizing the importance of using a broader immunohistochemical panel in the differential diagnosis of intrasinusoidal BM infiltration by NHL.     

Effects of two antiandrogen treatments on hirsutism and insulin sensitivity in women with polycystic ovary syndrome

Thirty-two women with polycystic ovary syndrome (PCOS) wereallocated to two antiandrogen treatment regimens; 28 women completedthe trial. Twenty women were treated with ethinyloestradioland cyproterone acetate (EO-CA) cyclically for 6 months andeight women were treated with the gonadotrophin releasing hormone(GnRH) analogue, goserelin for 6 months. Effects on hirsutism,insulin sensitivity (estimated by glucose clamp technique),blood lipids and hormones were measured. Women treated withEO-CA showed a reduction in hirsutism (P <0.05), and decreasedserum androgen concentrations (P <0.001) as well as reducedinsulin sensitivity (P <0.05). In women treated with goserelin,serum androgen concentrations also decreased (P <0.001),but there was no significant reduction of hirsutism. This group,however, showed an improved insulin sensitivity (P <0.05)despite an unchanged body mass index. Bone mineral density wasunaltered in both treatment groups. The reduction in androgenconcentrations caused by EO-CA was not paralleled by increasedinsulin sensitivity, most probably due to the effect of ethinyloestradiolper se. In contrast, the reduction in androgen concentrationsby goserelin was accompanied by an improved insulin sensitivity.     

Visceral leishmaniasis in the acquired immunodeficiency syndrome: Report of two cases

Core biopsies of the bone marrow are indispensable in the evaluation of fever of unknown etiology in human immunodeficiency virus-positive patients. We report two patients in whom visceral leishmaniasis was diagnosed based on the typical morphology, staining characteristics, and ultrastructure of the organisms.     

Chondromyxoid fibroma resembles in vitro chondrogenesis, but differs in expression of signalling molecules

Chondromyxoid fibroma is a rare benign cartilaginous bone tumour characterized by morphological features that resemble different steps of chondrogenesis in terms of both cellular morphology, ranging from spindled to rounded cells, and the extracellular matrix formed, which ranges from fibrous to cartilaginous. The presence in chondromyxoid fibroma of signalling molecules that regulate the spatial expression of proteins involved in normal cartilage proliferation and differentiation was investigated in samples from 20 patients and compared with articular chondrocytes from 11 normal donors cultivated in 3D pellet culture. Sections were stained with safranin-O and H&E, and immunohistochemistry was performed for p16, cyclin D1, FGFR3, BCL2, p21, PTHLH, PTHR1 and N-cadherin. Expression patterns were analysed using hierarchical clustering. In chondromyxoid fibroma, specific morphological features correlated with a distinct pattern of expression. Comparison with normal chondrocytes in pellet culture showed a striking morphological resemblance, but with an unmistakably different pattern of expression. N-cadherin, PTHLH, and PTHR1 were expressed to a significantly higher level (p < 0.01) in articular chondrocyte pellets but, conversely, there was significantly lower expression of cyclin D1, p16 and BCL2 (p < 0.05) in these cells. Morphological similarities reflect common steps in cartilage differentiation, albeit driven by different molecular mechanisms. The proteins we have found to be differentially expressed seem crucial for neoplastic chondrogenesis.     

乌鲁木齐市维吾尔族长寿家族成员第二掌骨骨皮质的X线形态学测量分析

用Ｘ线形态学测量方法，对乌鲁木齐部分维吾尔族长寿老人及其家族成员的第二掌骨骨皮质进行了测量。结果表明１０￣３９岁组骨皮质厚度，皮质厚度指数，皮质面积随年龄增长而增大，３０￣３９岁组达到峰值，其中骨皮质厚度、皮质面积的数值男性〉女性，３０￣３９岁组差别有显著性。４０岁以后各组数值开始下降，其下降速度女性快于男性，９０岁以上组最为明显，有显著性差异。     

Metachronous and multiple aneurysmal bone cysts: a rare variant of primary aneurysmal bone cysts

In 1942, Jaffe and Lichtenstein introduced the term aneurysmal bone cyst (ABC). Primary ABC is characterized by the presence of spongy or multi-cameral cystic tissue filled with blood. The process is benign, but it is locally destructive and has a high propensity for recurrence. In this paper, we present the third case of multiple metachronous primary ABCs as a rare variant of ABC. We describe the 10-year history of a 12-year-old boy with metachronous multiple primary ABCs at five different sites (right proximal humerus, right ulna, bilateral distal radius and right lateral clavicle). Furthermore, our patient suffered from vascular malformations, such as aortic isthmus stenosis, hypoplastic thoraco-abdominal aorta and bilateral renal artery stenosis. To date, in contrast to solitary ABC, the multiple lesions have been found more frequently in male individuals. Using interphase cytogenetics, we analyzed three of five of the patients ABCs and one of these was also analyzed by GTG-banding. No chromosomal abnormalities were found. Significantly, we excluded the missense mutation of codon 201 in guanine nucleotide-binding protein 1 gene consistently found in McCune-Albright syndrome (MAS) and in non-MAS cases of polyostotic fibrous dysplasia of bone with or without secondary ABC.     

Case of postradiation osteosarcoma with a short latency period of 3 years

Osteosarcoma is one of the neoplasms that may occur following exposure to radiation. A case of osteosarcoma arising in the craniofacial bone with a short latency period of 3 years after radiotherapy for maxillary squamous cell carcinoma is described. A 64-year-old-man underwent right partial maxillectomy and chemoradiotherapy due to squamous cell carcinoma of his right maxillary sinus. Histologically, the tumor was composed of moderately differentiated squamous cell carcinoma with a component of spindle cell carcinoma. Three years later, osteosarcoma developed in the craniofacial bone within the irradiation field of the first tumor. Detailed histological examination demonstrated that there was no component of osteosarcoma in the first tumor or squamous cell carcinoma in the second tumor. Radiation-induced osteosarcoma usually occurs after a long latency period of more than 10 years after the radiotherapy. In this case, osteosarcoma was possibly a radiation-induced osteosarcoma with a short latency period of 3 years.     

Anatomosurgical study of the superficial and deep circumflex iliac arteries

Summary An anatomical study of the superficial and deep circumflex iliac arteries in 43 formalin-fixed cadavers is presented. The origin, calibre, course, branches, symmetry and variations of the vessels are pointed out as well as their special features related to surgical applications.

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Etude anatomochirurgicale des artères circonflexes iliaques superficielle et profonde: bases anatomiques de la confection du lambeau libre iliaque composé cutanéo-osseux

Résumé Une étude anatomique des artères circonflexes iliaque superficielle et profonde est effectuée sur 43 cadavres formulés. L'origine, le calibre, le trajet, les branches, la symétrie et les variations des vaisseaux sont mis en évidence ainsi que leurs caractères particuliers en vue d'une application chirurgicale.

     

低强度脉冲电磁场对大鼠骨质疏松的影响

目的：观察低强度脉冲电磁场（pulsed electromagnetic fields，PEMFs）对去卵巢诱导骨质疏松症的大鼠生化指标和骨应力的影响。方法：雌性SD大鼠30只，随机等分为3组（n=10），分别为假手术组（Sham）、骨质疏松模型组（Model）、脉冲电磁场照射组（PEMFs）。经适应4wk后，在25mg·Kg^-1戊巴比妥钠腹腔麻醉下，Model组和PEMFs组摘除双侧卵巢．Sham组找到但不切除卵巢。各实验组均在相同环境下饲养，模型制备4wk后开始治疗，由GZY型低强度低频率脉冲电磁场发生仪产生低频脉冲磁场，根据实验要求，我们使用亥姆霍兹线圈形成均匀磁场，PEMFs组经照射刺激治疗，频率14．3Hz，场强2Gs．日照8h。Model组和Sham组正常饲养。治疗8wk后，对各组大鼠血清、尿液中ALP和Ca以及骨应力进行检测。结果：（1）ALP、Ca检测结果：与Model组相比，PEMFs组ALP值、Ca值差异均有统计学意义（P〈0．05）。其中，血清中ALP值，Model组为（275．16±228，57），PEMFs组为（179．30±87．68）；Ca值，Model组为（2，66±0，13），PEMFs组为（2．52±0．05）。（2）骨应力检测结果：Model组为（923．60±34．15Pa），PEMFs组为（1152．85±118，20Pa），组间差异有统计学意义（P〈0．05）。结论：研究发现，PEMFs对于促进骨重建、提高Ca吸收和骨应力恢复具有积极作用。