Patients with chronic viral hepatitis and cirrhosis often have elevated serum (X-fetoprotein (AFP) values, the causes of which are unclear. We studied 81 patients with chronic hepatitis C and the relationships of serum AFP and alanine aminotransferase (ALT) values
Materials and MethodsTwo hundred consecutively evaluated patients with chronic hepatitis C who underwent liver needle biopsy at the time of initial examination and whose serum AFP levels were measured at the time of biopsy were identified by the William
We describe 2 male patients in whom hepatosplenic gamma/delta T-cell lymphoma (HSTL) developed 6 and 10 years after renal transplantation. The onset was abrupt with systemic symptoms, cytopenia, and hepatosplenomegaly. The histologic examination of the spleen (case 1), liver, and bone marrow revealed sinusoidal infiltrates of markedly abnormal lymphocytes. The neoplastic cells in these cases were CD2+, CD3+, CD4-, CD5-, CD7+, CD8+, CD16+, CD56+, beta F1-negative, and TIA-1-negative. Both cases displayed clonal rearrangement of the T-cell receptor (TCR) delta gene and the TCR beta gene. The spleen in case 1 was positive for Epstein-Barr virus genome and showed TCR-gamma gene rearrangement by polymerase chain reaction. Isochromosome 7 [i(7)(q10)] was found in each case. Both patients died within 4 months of diagnosis. HSTL has been reported in only 5 renal transplant recipients. HSTL may be relatively more frequent in immunocompromised patients compared with the general population.
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Some believe endocervical glandular atypia (EGA), purportedly composed of cells that are less atypical than cells of adenocarcinoma in situ (AIS),The topic of endocervical glandular lesions with less atypia than adenocarcinoma in situ (AIS) is extremely controversial. Some authors believe there are recognizable and reproducible glandular lesions of increasing atypia that are preneoplastic and culminate in AIS. Others believe that little evidence supports the existence of EGA, and still others remain undecided. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] There is no universally adopted nomenclature for these lesions. Various terms have been proposed, including endocervical glandular dysplasia, cervical intraepithelial glandular neoplasia, cervical glandular atypia, endocervical columnar cell intraepithelial neoplasia, and atypical endocervical hyperplasia. 2 ' 7,10,11,14,16 We prefer the term endocervical glandular atypia (EGA) as a term for a potential lesion with less atypia than AIS because its status as dysplastic has yet to be determined.One of the major problems associated with this topic is the lack of uniform criteria for AIS and, therefore, for EGA. Most authors agree that at one end of the spectrum is AIS, which is composed of indisputably malignant, noninvasive, glandular cells. However, the minimum degree of atypia that is sufficient to warrant the diagnosis of AIS is not established. The confusion this has created can easily be appreciated by studying the different cutoff points for AIS used by different authors. 26 At the other end of the spectrum is the lack of consensus for criteria that distinguish benign cellular changes from low-grade EGA. The lack of standardized minimum criteria for AIS and benign atypia has fueled the controversy over the existence of and histologic criteria of EGA. Some have chosen to split moderately atypical and markedly atypical noninvasive endocervical gland lesions into high-grade EGA (dysplasia) and AIS, while others have chosen to group them together as AIS. The latter group does not recognize the existence of high-grade dysplasia, while the former uses the morphologic spectrum as evidence to support its existence. The semantic 2 0 0
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