A case report of Gaucher's disease associated with chronic lymphocytic leukaemia is described in a patient with gout and carcinoma of the sigmoid colon. This the first reported case of Gaucher's disease associated with chronic lymphocytic leukaemia.
A 60-year-old woman, 20 years post-menopausal, who had deforming rheumatoid arthritis of 7 years' duration and Sjögren's syndrome of 1 year's duration, had had postmenopausal bleeding for a month prior to admission to the hospital. A diagnosis dilatation and curettage was interpreted as showing acute suppurative endometritis. The patient was discharged, only to have recurrent vaginal bleeding. She was readmitted five weeks later, at which time results of another dilatation and curettage were interpreted as showing xanthromatous endometritis. Total hysterectomy with bilateral salpingo-oophorectomy was done. Examination of Epon-embedded endometrium 1 micrometer thick by light microscopy and subsequently by electron microscopy disclosed intracellular bacilliform organisms within phagolysosomes of atypical histiocytes, lamellar bodies, and various developing stages of calcospherites, Michaelis-Gutmann bodies. The curettings were then received and classic Michaelis-Gutmann bodies were identified in periodic acid--Schiff-stained sections.
The blood group antigens A, B and O(H) are present on the cell surface of many tissues, including the urothelium. It has been shown that loss of these antigens from the surface of tumor cells correlated with subsequent development of invasion. Since the specific red cell adherence test demonstrates the presence or absence of these antigens the test may have an important prognostic and screening value. We have examined bladder washing specimens from patients with bladder tumors and normal controls for this phenomenon. The results in patients with bladder tumors were then compared to original biopsy specimens for the presence or absence of cell surface antigens. The study indicates that our technique presents a simple, reliable test that may be significant in screening as well as followup of patients with bladder cancer.
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