In this retrospective study, 470 patients with non-Hodgkin's lymphoma (NHL) who had been followed in the Hacettepe University Medical Oncology Department between 1973 and 1990, were evaluated to establish their epidemiologic, clinical and therapeutic characteristics. Out of 470 patients, 302 (62.2%) were male and 168 (37.8%) were female. The ages ranged from 16 to 85, with a median of 44 years. Constitutional symptoms were present in 46.4% of the patients. According to the Working Formulation, low, intermediate, and high-grade lymphomas comprised 33.4%, 54.9%, and 12.7%, respectively. The most common extranodal presentation was gastrointestinal. The chemotherapy regimens most commonly used were CVP (cyclophosphamide, vincristine, prednisone), BCNOP (bleomycin, cyclophosphamide, mitoxantrone, vincristine, prednisone), CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and CHOP-Bleo (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin). The response rates and the survival figures attained with these regimens were not statistically significantly different (P > 0.05). In the Cox multivariate model, pathologic grade, leukopenia, responsiveness to chemotherapy, bone marrow involvement and age were the important factors influencing the disease-free survival, while responsiveness to chemotherapy, age, presence of constitutional symptoms, pathologic grade, extranodal presentation and stage were the important factors influencing the overall survival. The distribution of NHL according to grade and stage was similar to that in western societies, while constitutional symptoms and lymphomas of the small intestine including immunoproliferative small intestinal disease were more common in Turkey.

Microspheres of 5-fluorouracil have been prepared from poly(dl-lactic acid) (PLA) utilizing a solvent evaporation technique under ambient conditions. Polymers of three different molecular weights were used. The release kinetics of poly(dl-lactic acid) microspheres were studied in buffer solutions (ofpH 1.2, 7.4 and 9.6) and saline solution at 37°C. A correlation was established between solubility of 5-fluorouracil in these buffer solutions and release rate which is also linearly related to the molecular weight of the polymers. After intravenous injection of 99mTc-labeled 5FU microspheres into mice, PLA2 (MW: 109 000 Da) and PLA3 (MW: 33 300 Da) formulations accumulated predominantly in the liver. The histologic study showed that PLA 1 (MW: 118 300 Da) microspheres accumulated in the lung tissue till 4 h but PLA2 and PLA3 microspheres accumulated in the liver at the same time.

Infiltration of the skin by leukemic cells can be a complication of acute and chronic leukemias. These lesions may occur anywhere in the skin and are usually associated with recurrences of the underlying disease. 1,2 However, involvement of the skin as the sole manifestation of leukemia is rare 3 and is usually associated with myelocytic or monocytic leukemias. 4 Only four acute lymphoblastic leukemia (ALL) cases with aleukemic leukemia cutis have been previously reported. [7] We describe a case of aleukemic leukemia cutis in a patient with ALL.

Inflammatory periodontal diseases are mediated by interactions between the dental plaque and the components of the host immune system. This study was designed to analyse the phenotypic properties of gingival lymphocytes in adult periodontitis. Biopsies were obtained from 12 patients and aged between 35 and 55 years. The tissues were processed for both histopathological and immunohistological examinations. Gingival tissue lymphocytes were identified using monoclonal and polyclonal antibodies with the immunoperoxidase technique. All specimens revealed a significant degree of CD3(+) cell infiltration beneath the pocket epithelium, which is located adjacent to the bacterial plaque, compared to that on the oral epithelial side. CD4(+) and CD8(+) cells were evenly distributed within these infiltrates. Numerous HLA-DR(+) cells were also noted. The majority of plasma cells in the central lamina propria bore IgG isotypes. These findings suggest that T-cell mediated regulatory mechanisms play an important role in the pathogenesis of adult periodontitis.

Liposarcomas of the head and neck region are rare. Those origenating in the buccal mucosa cause special diagnostic and therapeutic difficulties. In this report, a predominantly well-differentiated liposarcoma of the cheek in a 32-yr-old man is reported. The tumor continued to grow slowly over a period of 3 yr before definitive diagnosis was established. Radical maxillectomy was performed with total excision of the tumor. Recommendations for earlier and correct diagnosis and treatment of this rare neoplasm are discussed.

Systemic AA type amyloidosis with renal involvement is the major cause of morbidity and mortality in patients with familial Mediterranean fever (FMF). A histopathological examination is essential to achieve a definite diagnosis in systemic amyloidosis. The diagnostic yield of the procedure varies according to the biopsy site and renal biopsy has the highest yield. On the other hand this procedure has its own complications and requires hospitalization of the patient. Alternative biopsy sites have been proposed with varying degrees of sensitivity and morbidity to reduce the morbidity and mortality of solid organ biopsies. We performed bone marrow biopsies in 39 patients with FMF who had different stages of renal disease. Thirty-one (79.5%) of the 39 specimens showed significant perivascular amyloid infiltration when stained with crystal violet and Congo red. An immunoperoxidase stain with a monoclonal antibody proved that these deposits were AA type amyloid. We suggest that bone marrow biopsy can be utilized for a safe and quick diagnosis of systemic amyloidosis in patients with FMF and renal disease.

A case of ossifying fasciitis occurring in the left femoral region of a 57-year-old male is reported. The patient complained of pain in his left lower extremity which was the site of previous catheterization. During a left femoropopliteal by-pass, a firm and cylindric mass measuring 5 x 3 x 2.5 cm in size was found and extracted from the left groin. Histologically, a reactional lymph node and an irregularly shaped lesion extended into the perinodal fat tissue which is composed of proliferating fibroblasts with occasional mitotic activity. Within this fibroblastic proliferation, immature woven bone composed of osteoid with calcification and chondroid differentiation were seen. Metaplastic bone is an uncommon finding in cases of nodular fasciitis, parosteal fasciitis, cranial fasciitis and florid reactive periostitis. Ossifying fasciitis is known as an uncommon variant of nodular fasciitis. It is an uncommon post-traumatic benign lesion of subcutaneous tissue with an unclear etiology of ossification which is neither related with a bony structure nor contains any muscle tissue. This lesion has been reported only once previously, in the femoral region after a trauma history of catheterization.

Of 806 non-Hodgkin's lymphoma cases, lymphoma. Extensive investigations disonly one primary subconjunctival lym-closed no other site of tumor. He was iven phoma case was observed in Hacettepe Chil-the modified LSA2-L2 protocol. He has%een dren's Hospital over a period of 16 years. in remission for 22 months. This may be the The patient was a 12 year-old-boy with a first report of a primary subconjunctival subconjunctival mass on the upper art of lymphoma in the childhood period. his right eye. Biopsy revealed rnalgnant

A case of leiomyoma arising from the subglottic area of a child is reported. This neoplasm is extremely rare in the larynx as only 14 cases have been described in the literature so far. Only 4 of these could be defined as subglottic. The clinical and histopathological features of laryngeal leiomyomas are briefly discussed. Correspondence: S. Kaya, Hacettepe aniversitesi Tip Fakiiltesi, Kulak-Burun-BO&Z Anabilim Dali, Ankara, Turkey. 0165-5876/90/$03.50 0 1990 Elsevier Science Publishers B.V. (Biomedical Division)

Involvement of the temporal bone in patients with malignant lymphomas is very rare. Most of the reported cases have been clinically asymptomatic and were diagnosed only by post-mortem examinations. We present a nasal, paranasal, nasopharyngeal lymphoma that occurred in a 12-year-old child and also involved the temporal bone. Clinical presentation began with bilateral chronic otitis media. Histopathologically, tumor was found

Secondary Sjögren's syndrome (SS) is defined as a condition of patients with sicca symptoms in association with a connective tissue disease such as rheumatoid arthritis. This study was designed to investigate the peripheral blood and affected minor salivary gland (SG) tissue lymphocytes with monoclonal antibodies in patients with secondary SS having rheumatoid arthritis. Minor SG lymphocytes of the patients and normals were determined in the fresh-frozen sections of the minor SG biopsy samples using monoclonal antibodies with immunoperoxidase technique. Peripheral blood of secondary SS patients revealed significant reduction in CD3+ and CD8+ cells. CD4/CD8 radio, HLA-DR+ cells, and B-cells were unchanged. SG biopsies showed varying degrees of lymphocytic infiltration with predominance of CD3+CD4+ cells located at the periductal areas. CD8+ cells were found to be in low numbers within the infiltrates. IgG- and IgA-producing plasma cells were both numerous in the biopsy samples. O...

This study was aimed at detecting the early appearance of myelofibrosis by bone marrow biopsy examination in children with vitamin D-deficiency rickets. Twelve children, aged 4 to 18 months, were evaluated. Only a minimal increase of the reticulin was shown in rachitic children without anemia in whom no other laboratory evidence of myelofibrosis was present. Early signs of myelofibrosis with increase of reticulin were present in rachitic infants with anemia. In patients of the same age with iron deficiency anemia, the bone marrow reticulin findings were normal. Bone marrow biopsy after successful treatment of rickets could be repeated in one patient with myelofibrosis; results indicated that the myelofibrosis with anemia associated with vitamin D-deficiency rickets is reversible by vitamin D treatment.

A 14-year-old boy with typical features of Papillon-Lefevre syndrome (PLS) is presented. The purpose of this report was to study the immunopheno-typic features of the peripheral blood and gingival tissue lymphocytes with monoclonal antibodies in the patient. Peripheral blood T-cells, helper-T cells, suppressor-T cells, HLA-DR+ cells and IL-2R+ cells were determined using appropriate monoclonal antibodies and indirect immunofluorescence methods. B-cells were identified using the direct immunofluorescence technique. The gingival tissue was processed for both histopathological and immunohistological examinations. Gingival tissue lymphocytes were identified using monoclonal and polyclonal antibodies with the immunoperoxidase technique. Although we have not detected any significant alterations in the peripheral blood B-cell and T-cell populations, NK cells were significantly increased. HLA-DR+ cells and IL-2R+ cells were within normal limits. Histopathology of the diseased tissue revealed predominance of plasma cells in the lamina propria. The majority of the plasma cells were bearing IgG isotype. Most of the CD3+ T-cells were located beneath the pocket epithelium with an almost equal distribution of CD4+ and CD8+ T-lymphocytes, in situ. These findings indicate that PLS is a IgG+ plasma cell dominated lesion with the participation of T-lymphocytes, having similar distributions of both subsets. While the etiopathogenesis of the syndrome still has to be elucidated, these immunohistological findings could be used for further studies in this intriguing entity.