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The clinical course of a woman with metastatic reticulum cell sarcoma and intractable lactic acidosis is described. Although her illness was dominated by a myelopathy, she developed severe lactic acidosis which could not be related to decreased tissue oxygen delivery. Necropsy showed extensive hepatic replacement with tumor and widespread disease. This and other possible pathogenetic factors causing lactic acidosis are discussed.

A patient with idiopathic thrombocytopenic purpura, known for at least 30 years, developed a sclerosing reticulum cell sarcoma following 7 years of immunosuppressive treatment with azathioprine without steroids.

A case of macroglobulinemia Waldenstrom with a very protracted course—in all 17 years, with seven after chlorambucil treatment was started—is presented. The postmortem examination showed changes both of reticulum cell sarcoma and amyloidosis. A review of the literature on macroglobulinemia and reticulum cell sarcoma is given.

10 patients in whom pruritus was a very prominent symptom were treated with levomepromazine in daily doses of 25–50 mg. 7 of these patients suffered from Hodgkin's disease and 3 from reticulum cell sarcoma. In a number of patients levomepromazine controlled pruritus effectively without significant side-effects. Though all the patients had other simultaneous treatments, e.g. radiation treatment or chemotherapy, the treatment with levomepromazine is considered to be the cause of relief of the pruritus in most of the patients.

134 patients with malignant lymphoma (follicular lymphoma, 56 patients; lymphosarcoma, 50 patients; reticulum cell sarcoma, 28 patients) have been typed for eight well-defined antigens of the HL—A system, the major histocompatibility system in man. A significant association exists between HL—A12 and this disease group. This is most marked for the patients with follicular lymphoma. The significance of this finding is discussed.

The disease we now call diffuse large B-cell lymphoma has gone by many names in the past. These have included reticulum cell sarcoma,[1][1] diffuse histiocytic lymphoma,[2][2] and, more recently, diffuse mixed lymphoma, diffuse large cell lymphoma, or immunoblastic lymphoma—terms from the Working

Because of the personal experience in 12 patients with the diagnosis of reticulum cell sarcoma of the retina, we believe that this entity is not an uncommon cause for a 'pseudouveitis'. A primary reticulum cell sarcoma of the retina must be considered in the differential diagnosis of uveitis or panuveitis if there is: (1) progression in spite of unusual antiinflammatory therapy; (2) if the initial infiltrations are seen in the deeper layers of the sensory retina and beneath the retinal pigment epithelium, and (3) if neurologic symptoms are present in patients more than age of 40. If the patients refuses methods for histologic and cytologic confirmation, the diagnoses can be made clinically.

Infectious mononucleosis was diagnosed in a 50-year-old woman who within one year developed reticulum cell sarcoma. This observation is all the more interesting since an association between infectious mononucleosis and another malignant lymphoma (Hodgkin's disease) has recently been suggested.

A case of polycythaemia vera, known for 4 years and treated with 32P is reported because of the rapidly fatal transition into myelofibrosis and then reticulum cell sarcoma.

IN THIS ISSUE of theArchives, Friedmann et al 1 describe 11 patients with a primary cutaneous pleomorphic small T-cell lymphoma and suggest that this represents a new and distinct type of cutaneous T-cell lymphoma (CTCL). 1 These primary cutaneous pleomorphic small T-cell lymphomas represent only one of the many new types of cutaneous lymphomas that have been published over the last decade in the dermatologic literature. For many decades, mycosis fungoides (MF), Sezary syndrome, and related disorders such as pagetoid reticulosis and lymphomatoid papulosis (LyP) were the only types of cutaneous lymphoma that had been rather well defined. Reports on cutaneous lymphomas other than MF and/or Sezary syndrome were few. These lymphomas, commonly designated as malignant reticulosis or reticulum cell sarcoma, were generally regarded as manifestations of systemic lymphoma, and their prognosis was considered poor. 2-4 With the introduction of immunohistochemical studies in the diagnosis and classification of cutaneous

Lymphoreticular neoplasm of the reticulo-endothelial system is a well-known entity in which the tumor arises from lymphoid precursor cells. The disorders included in this group are NHL and HD, with a changing terminology. The old classification of primary NHL included lymphosarcoma and reticulum cell sarcoma. The cells of malignant lymphomas may exhibit various degrees of differentiation, which may be shown with immunohistochemistry (Resnick and Haghighi 1996; National Cancer Institute 1982).

In1975, we reported the remarkable case of a 42-year-old man with histologically proven widely disseminated reticulum cell sarcoma who, in a remarkably short time, appeared to enjoy not one, but two

Primary lymphomas of the CNS (PCNSL) are tumors whose nosography has only been worked out in relatively recent times, but not all the problems have been resolved

Aged SJL mice spontaneously develop a B-cell malignancy, which has been compared with human follicular center cell lymphoma, an inevitably fatal disease despite conventional therapy (1–4). SJL lymphomas provide a model for development of a new treatment for this disease by revealing the existence of a novel target for therapy, nonmalignant lymphocytes upon which the tumor cells are dependent for growth (5).

The nature of Hodgkin’s disease (HD) and the origin of its characteristic cells, the Reed-Sternberg (RS) cells, are still obscure in spite of the abundant literature on this disorder. In recent years, the concept that HD is a malignant lymphoma has become widely accepted among pathologists, clinicians, and medical researchers working on this disease. However, the evidence accumulated so far with regard to the standard parameters defining neoplastic proliferation, such as clonality, chromosomal abnormality, and transplantability, is still controversial. A further enigma concerning HD as a neoplastic lymphoproliferative disease is the extremely low percentage of putative neoplastic cells (RS cells and their variants) occurring in the polymorphic histopathological setting that characterizes the disease. In contrast, well-recognized neoplastic lymphoproliferative diseases, the so-called non-Hodgkin’s lymphomas (NHLs), usually show monomorphic histological patterns and are constituted predominantly of monoclonal or, more rarely, oligoclonal cell populations.

C57BL/6 murine reticulum cell sarcoma M5076 was injected into the left footpad to induce spontaneous metastasis in the liver and other organs. The preventive effect of OK-432 was assessed with this spontaneous metastasis model. Hepatic colony incidence and number were reduced in OK-432-treated mice compared with untreated. In LATA, spleen cells obtained from treated mice showed significantly higher antitumor effects than those from untreated. The survival time of treated mice was significantly longer than that of untreated. These findings suggested that the treatment by intrasplenic administration with OK-432 had cytotoxicity against metastatic tumor cells in the liver.

Tumors secreting large quantities of immunoglobulins have always focused the attention of scientists as their secreted products are a convenient source of reagents and an indicator of the vitality of the tumoral cells.

By malignant lymphomas we mean a group of systemic neoplasms of the lymphoblastic tissue, and particularly two, involving skeletal pathology: Hodgkin’s disease, and non-Hodgkin lymphomas

The gross appearance of histiocytic sarcoma has not been well characterized since it is usually diagnosed only upon microscopic examination. The sites most frequently affected macroscopically are the liver, lungs, subcutis, lymph nodes, and spleen. The tumors appear as irregular, pale, tan masses or organ infiltrates.

The subject of lymphomas is discussed and five cases seen in our Oral Surgery Department are presented. Histiocytic lymphoma, especially of the oral regions, can present with a variety of clinical manifestations. The signs and symptoms, diagnostic modalities, and treatment are discussed and the most recent classification is included.

It is not rare for spinal cord compression to be seen in malignant lymphoma. By Moshe Friedman's report, it is seen at the rate of 6%. We experienced 4 cases of paraplegia caused by malignant lymphoma. They are three Reticulum cell sarcoma cases and a case of Hodgkin's disease which is the only survival case. First case of Reticulum cell sarcoma died without being rightly diagnosed. Second case died a year and a half later in spite of the good response to chemotherapy (VEMP) and radiation therapy. Third case resulted in neuralgic deficit and was dead without becoming better. The autopsy clarified that there had been metastatic changes in spinal cord, duramater, and brain, . These cases were treated mainly through VEMP method and radiation therapy.

A case of ruptured anterior communicating aneurysm with association of reticulum cell sarcoma and arteriovenous malformation is reported. Sequential CT documented the evolution of a cerebral reticulum cell sarcoma, which added complexity to the clinical course. Cranial CT, cerebral angiograms, and postmortem examination are presented.

A rare and instructive case of cardiac involvement by reticulum cell sarcoma in a 72-year-old woman was presented. In this case acute myocardial infarction was suspected on an electrocardiogram but was proved absent, and only scattered tumor infiltration was demonstrated at autopsy.

A case report is presented of an 81-yr old male who developed a reticulum cell sarcoma of the cecum while on immunosuppressive therapy for 13 yr for a primary diagnosis of macroglobulinemia. The considerable overlap between immunoproliferative disorders and the increased incidence of malignancies in patients receiving immunosuppressive therapy are discussed.

A 52-year-old man developed intermittent swelling, pain, and paresthesia during a one-year period prior to the histologic diagnosis of reticulum-cell sarcoma. The clinical profile and radiographic examination suggested either chronic osteomyelitis or malignancy. Treatment was confined to radiation therapy with resolution of the malignancy but a guarded prognosis. Twenty-two previously reported cases of primary reticulum-cell sarcoma of the mandible are reviewed.

Patients with systemic reticulum cell sarcoma often develop evidence of ocular involvement months or several years prior to the onset of neurologic symptoms. This neoplasm appears to have proclivity of arising multicentrically within the subpigment epithelial space, as well as in the vitreous. When this occurs it may produce a peculiar ophthalmoscopic picture of multiple large, solid detachments of the pigment epithelium that is rarely duplicated by any other disease. Three patients illustrating this disease are presented.

A 56-year-old man presented with recalcitrant uveitis with anterior chamber and vitreous cells. He developed small scattered lesions in the macular areas of both eyes, which disappeared in the right eye and evolved to multifocal, discrete, punched-out lesions resembling birdshot retinochoroidopathy in the left eye. Ocular reticulum cell sarcoma (RCS) was suspected but was not confirmed by diagnostic vitrectomy. The patient died 3 years later and was found to have RCS with central nervous system and ocular involvement. The occurrence of tumor cells under the retinal pigment was the apparent cause of the multifocal lesions that disappeared in the right eye and that led to discrete punchedout lesions with no scarring in the left eye.

A 66-year-old white woman with a confusing spectrum of central nervous system signs and symptoms had a diagnostic enucleation of her blind left eye showing retinal infiltration. Histopathologic examination showed reticulum cell sarcoma involving the retina. The patient died one month later and autopsy revealed diffuse central nervous system reticulum cell sarcoma along with right eye and systemic involvement. A review of the literature indicates intraocular reticulum cell sarcoma to be an apparently uncommon occurrence, although ocular examination may be frequently overlooked.

The two cases presented involved a sarcoma which may arise primarily in the gingivae and mandible. These sarcomas were treated with radiation and chemical antitumor agents. The primary lesions showed complete remission, but later there was rapid extension and metastasis to many vital organs. A review of the literature demonstrates the lesion's occurrence in the head and neck region in Japan and other countries.

In 1966-1986, two men and four women (mean age 47.5 years) underwent surgery for primary sternal tumour. Three of the tumours were benign (two condromata, one osteochondroma) and three were malignant (two chrondrosarcomata, one reticulum cell sarcoma). Inflammatory or degenerative lesions impeded differential diagnosis in three additional cases (without tumour). The tumours were treated with radical resection of the affected part of the sternum, including the relevant attached structures. Marlex-mesh reconstruction of the defect was necessary in four cases. There was no operative mortality. One Marlex graft became infected. At follow-up (average 11.1 years, range 9.0-14.7 years), five patients were alive without recurrence of tumour and the sixth had died of unrelated cause.

Extramedullary plasmocytomas of the skin are rare, especially if a participation of the bone marrow is lacking. A 76-year-old patient developed multiple skin tumours within 2 months. In addition he showed an increase of serum immunoglobulin A. Histopathologically the tumours resembled reticulum cell sarcoma with few plasma cells, partly immature.

This paper has reported a case of the so-called early gastric reticulum-cell sarcoma a case in which no malignant tumor was proved by X-ray and endoscope inspections but atypical cells were found by proteolytic lavage cytology and diagnoses were subsequently repeated for two years until finally typical malignant cells were found.The paper has also emphasized the importance of studying the cell morphology of malignant lymphoma and of the follow-up by cytodiagnoses.

The response of a patient with histologically proven reticulum cell sarcoma to no treatment other than large doses of ascorbic acid is described. At the time of first diagnosis, the disease was widely disseminated, and a very dramatic regression of all parameters of disease activity was induced by the continuous administration of large doses of ascorbic acid. Reduction in dosage some months later coincided with reactivation of the disease process. The reinstitution of regular high-dose ascorbic acid therapy induced a second complete remission. The case report is illustrated by serial radiographs. The significance of the therapeutic response is briefly discussed in relation to general schemes of cancer management.