BACKGROUND, Waldenstrom's macroglobulinemia (WM) is a rare immunoproliferative disorder, the clinical course of which varies. In related B-cell neoplasms, such as multiple myeloma and chronic lymphocytic leukemia, the histologic features of bone marrow are considered to be of prognostic relevance. METHODS. To assess the prognostic features of WM, the authors reviewed the clinical and pathologic features of 22 patients. Bone marrow aspirates and core biopsies were available for each case. Immunostains for a panel of hematopoietic markers as well as p53 and proliferating cell nuclear antigen (PCNA) were performed. RESULTS. There were 14 males and 8 females, with a mean age of 60 years. At presentation, two histologic subtypes, lymphoplasmacytoid (73%) and lymphoplasmacytic (27%), were observed. Four patterns of bone marrow infiltration were delineated: diffuse (45 %), nodular-interstitial (22%), mixed paratrabecular-nodular (20%), and paratrabecular (13%). In 11 patients, the infiltrate occupied greater than 70% of the bone marrow; in 8 patients, 30-70%; and in 3 patients, less than 30%. PCNA reactivity was observed in 58% of cases and p53 reactivity in 21%. Ten patients died of disease with an average survival of 84 months. The remaining 12 patients were alive with disease at last follow-up. The pretreatment parameters that were correlated with shorter survival were hemoglobin, white blood cell count, platelet count, splenomegaly, lymphadenopathy, and serum immunoglobulin M level. CONCLUSIONS, The findings of this study suggest that some pretreatment parameters, such as cytopenia, serum immunoglobulin M level, splenomegaly, and lymphadenopathy, correlate with poor prognosis for patients with WM. In contrast, histologic features and expression of p53 and PCNA did not correlate significantly with survival. (C) 1997 American Cancer Society.

Journal Article The Author's Reply Get access J.D. Cotelingam, M.D. J.D. Cotelingam, M.D. Captain, Medical Corps,U.S. Navy Uniformed Services University of the Health Sciences Bethesda, Maryland Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 96, Issue 1, 1 July 1991, Page 146, https://doi.org/10.1093/ajcp/96.1.146 Published: 01 July 1991

: Infection with the human immunodeficiency virus (HIV) and the subsequent destruction of T4-positive helper cells are associated with the development of infection with opportunistic pathogens and with the development of various malignancies. Patients with acquired immunodeficiency syndrome (AIDS) are also at higher risk for Kaposi's sarcoma and non-Hodgkin's lymphomas. It has been asserted that the increased incidence of these malignancies is associated with alterations in the immune system. If the immune system is truly a factor in protection against malignancy, then HIV-infected patients may be at greater risk for other forms of cancer as well. Liposarcoma is usually a malignancy of later life; it is rarely found as a primary tumor of the thorax. This letter describes the first documented case of a young patient with HIV infection and liposarcoma of the mediastinum. A 27-year old male patient's left mediastinotomy revealed well-differentiated subtype. In light of this tumor's location in a relatively young person, we suggest that there may be an association of liposarcoma with HIV infection. Keywords: Virus diseases, Immunosuppression, Reprints.

We observed an unusual and clinically unsuspected pleomorphic adenoma developing in the anterior midcervical region of a young man. The tumor developed within an ectopic parotid-type salivary gland. Surgical extirpation seems to have been curative. Embryologic concepts explaining the histogenesis of ectopic salivary glands (ESGs) are explored, and the problem of their concurrence with neoplasms is addressed. An additional feature was the presence of well-developed lymph nodes within the glandular complex, a morphologic component of ESGs that has not been previously emphasized.

We describe the clinical and pathologic aspects of an unusual case of pleomorphic adenoma of the epiglottis. A 69-year-old man had impaired speech and a "lumpy sensation" in the throat. Following clinical evaluation and a diagnostic biopsy, the tumor was totally excised with excellent results. Pleomorphic adenoma of the larynx is most uncommon. To our knowledge, no report describing the clinical and pathologic features of this entity in the epiglottis or larynx has been previously reported. This is the only example of an epiglottic pleomorphic adenoma among 391 cases seen at Presbyterian-University Hospital and the Eye and Ear Hospital of Pittsburgh during a 21-year period.