A patient with ameloblastoma of the mandible with histologically confirmed pulmonary metastases 9 years after onset of tumor is described. The effectiveness of three chemotherapeutic agents (cyclophosphamide, methotrexate, Adriamycin), each given alone intravenously, were evaluated. Marked symptomatic improvement was noted with Adriamycin therapy. Ten previous cases of metastatic ameloblastoma are reviewed. The incidence of metastases cannot be predicted on the basis of histology. Three commonly discussed modes of metastasis are via hematogenous and lymphatic routes and the unusual mechanism of aspiration of tumor cells.
The authors present a case of primary uterine reticulum cell sarcoma who developed disseminated disease 6 years after undergoing a total abdominal hysterectomy. Review of the literature reveals 27 other patients with uterine lymphomas. Abnormal vaginal bleeding was the presenting complaint in 66% (14/21) of patients. Reticulum cell sarcoma was the most frequent histologic type, 68% (19/28). 28% of patients were alive and well 6–24 years after therapy.
A patient with Ph1 positive chronic myeloid leukemia (CML) developed blastic transformation which by morphologic criteria appeared to be localized to the lymphatic system. Chromosome analysis at this time, however, revealed new chromosomal abnormalities in addition to the existing Ph1 in all tissues studied (lymph node, blood, and bone marrow) consisting primarily of extra chromosome numbers 19 and 9 and a second Ph1. Therapy resulted in clinical remission with significant decrease in the aneuploid cell lines. However, these reappeared with recurrence of the blast crisis. Colony formation in semisolid culture of blood and marrow cells at the time of initial blast crisis yielded growth patterns characteristic of CML. On recurrence of the blast crisis after therapy, growth patterns were characteristic of CML in blast crisis or acute myeloblastic leukemia even though blood and marrow still showed relatively low levels of myeloblasts and promyelocytes. Possible explanations are discussed for the disparity in distribution between morphologic and chromosomal abnormalities in this patient.
These studies were undertaken in an attempt to relate changes in neutrophil adhesion as measured in vitro in whole blood to neutrophil kinetic changes occurring in normal subjects in response to various stimuli. A variety of technics for measuring neutrophil adhesion in vitro were studied. The most reproducible technic proved to be a modification of that originally described by Kvarstein (1969) in which whole blood is pumped at a fixed rate through a fixed weight of glass beads in a column. Using this technic, there was significant variation from one to another subject, but the mean of differences between duplicates from the same subject differed only by a mean of 3-4 %. Further indirect evidence that microtubule function may play a significant role in neutrophil adhesion was obtained. Vincristine, a chemical known to interfere with microtubule function, proved to reduce neutrophil adhesion while heavy water, a substance known to stabilize microtubules, increased neutrophil adherence. In confirmation of the work of others, adrenal glucocorticosteroids were found to have no effect when incubated in vitro with whole blood, but when neutrophils were taken from normal subjects who had been treated with steroids 4 h before, there was a distinct decrease in neutrophil adherence. Bacterial endotoxin incubated with whole blood in vitro had no effect at small doses, but at large in vitro doses produced an increase in adhesion. Conversely, when neutrophils were obtained from normal subjects treated with bacterial endotoxin a decrease in neutrophil adherence was observed. This latter effect, decrease in neutrophil adhesion in subjects treated with bacterial endotoxin, seems unlikely to be associated with any in vivo kinetic changes known to be produced by bacterial endotoxin. Consequently, we would wonder if the decreased neutrophil adhesion observed after both steroids and endotoxin docs not simply reflect a decreased adherence of cells freshly released from the bone marrow to the blood as compared to those which have been in the blood for some time.
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