Showing papers by "Dale C. Snover published in 1990"

Graft-versus-host disease of the gastrointestinal tract.

Abstract: Gastrointestinal tract disease (GIT) is relatively common following bone marrow transplantation (BMT). Infections, particularly with viral agents, are similar to those affecting any immunosuppressed transplant recipient. However, two unique aspects of BMT are (a) cytotoxic damage caused by the chemotherapy and irradiation used to eradicate the patient's native marrow and (b) gastrointestinal involvement with graft-versus-host disease (GVHD). GVHD may affect any portion of the GIT; therefore, both upper and lower GIT biopsies may provide diagnostic information not evident in biopsy from a single site. The upper GI tract has a higher yield of positive biopsy specimens, but it is more difficult to biopsy. The basic histopathological feature of acute GIT GVHD, which occurs in the first 100 days posttransplant, is necrosis of individual cells in the regenerating compartment of the mucosa. Severe disease may lead to loss of crypts and eventual sloughing of the mucosa. The histology of acute GVHD may be simulated by cytoreductive agents and viral infections, particularly with cytomegalovirus (CMV). Therefore, an absolute biopsy diagnosis of acute GVHD cannot be made in the first 21 days posttransplant or in any mucosa containing CMV inclusions. The GIT is less often involved in chronic than in acute GVHD. The basic pathology of chronic GIT GVHD is fibrosis of the submucosa and subserosa. Therefore, mucosal biopsy is of limited usefulness in the diagnosis of chronic GVHD.

Primary hepatic lymphoma in an adolescent treated with hepatic lobectomy and chemotherapy.

Abstract: A case of B-cell non-Hodgkin’s lymphoma, confined to the liver, in a 17-year-old boy is reported. The patient was treated with an extended left hepatectomy and combination chemotherapy: Cytoxan (cyclophosphamide), vincristine, prednisone, and methotrexate (COMP). The patient remains disease free at 1 year. Cancer 65:2222-2226.1990, OST CASES of the primary hepatic lymphoma have M been reported in adults. ’ Only two cases have been reported in children.2 Both children received a combination of radiotherapy and chemotherapy, but died of disease within 7 months of diagnosis. We report a case of primary hepatic lymphoma in an adolescent boy that was successfully treated with a combination of partial hepatectomy and chemotherapy.

Cystic central necrosis of transplanted pancreas

Abstract: The computed tomographic (CT) findings in pancreas transplant rejection have been reported to include graft swelling and inhomogeneity. We report a patient with transplant rejection in whom the preoperative CT examination and specimen radiographs revealed large cystic structures within the pancreas. Cystic central necrosis has previously been reported in patients with pancreatitis, but here it is associated with transplant rejection.