Demonstration of Cryptococcus neoformans in a stained bone marrow specimen

1977 ◽  
Vol 137 (5) ◽  
pp. 688-690 ◽  
Author(s):  
F. Robert
Keyword(s):  
Bone Marrow ◽  
Cryptococcus Neoformans ◽  
Bone Marrow Specimen

scholarly journals TAFRO syndrome with skin manifestations treated with bortezomib and tocilizumab; a case report

2019 ◽  
Vol 6 (1) ◽  
pp. e01-e01
Author(s):  
Seyedeh Tahereh Mohaddes ◽  
Zahra Rezaei Borojerdi ◽  
Maryam Miri ◽  
Mohammad Moeini Nodeh ◽  
Alireza Rezaei ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Renal Failure ◽  
Case Reports ◽  
Abdominal Distension ◽  
Skin Lesions ◽  
Castleman Disease ◽  
Tafro Syndrome ◽  
Multicentric Castleman Disease ◽  
Bone Marrow Specimen ◽  
Mesangioproliferative Glomerulonephritis

TAFRO syndrome is a new presentation of idiopathic multicentric Castleman disease which is termed as thrombocytopenia, anasarca, myelofibrosis, renal failure and organomegaly (TAFRO). The exact pathophysiology of TAFRO syndrome is unclear and management is mostly based on case reports and expert opinion. In this report, a 37 years old male patient with TAFRO syndrome is discussed. The patient was referred with fever, sweating, anorexia, abdominal distension and generalized edema which has been hospitalized multiple times for such complaints. The patient also developed skin lesions dispersed in red nodules, which was reported as "granuloid hemangioma". Renal biopsy suggested mesangioproliferative glomerulonephritis and bone marrow specimen showed hypercellular active marrow with reticulin fibrosis. The lymph node biopsies were reported as Castleman disease. This report demonstrates that different manifestations of TAFRO syndrome may overlap with other syndromes and can be managed by Bortezomib and Tocilizumab.

scholarly journals Invasive fungal infection by Cryptococcus neoformans var. grubii with bone marrow and meningeal involvement in a HIV-infected patient: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hareton Teixeira Vechi ◽  
Raquel Cordeiro Theodoro ◽  
Andrea Lima de Oliveira ◽  
Ronald Muryellison Oliveira da Silv Gomes ◽  
Rodolfo Daniel de Almeida Soares ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Fungal Infection ◽  
Cryptococcus Neoformans ◽  
Invasive Fungal Infection ◽  
Infected Patient ◽  
Meningeal Involvement

An auxotrophic pigmented Cryptococcus neoformans strain causing infection of the bone marrow

2002 ◽  
Vol 40 (1) ◽  
pp. 1-5 ◽  
Author(s):  
D. Schiappa ◽  
A. Gueyikian ◽  
S. Kakar ◽  
J. A. Alspaugh ◽  
J. R. Perfect ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cryptococcus Neoformans

scholarly journals A follow-up audit of the completion of bone marrow specimen request forms at an academic laboratory

2020 ◽  
pp. 96-99
Author(s):  
L Budding ◽  
M Coetzee ◽  
G Joubert
Keyword(s):  
Bone Marrow ◽  
Clinical Examination ◽  
Blood Count ◽  
Clinical Information ◽  
Full Blood Count ◽  
Hiv Status ◽  
Medication History ◽  
Bone Marrow Specimen ◽  
Transfusion History

Background: In order to ensure that patients receive individualised treatment following bone marrow biopsy, it is necessary for clinicians to provide complete clinical information on bone marrow request forms (BMRFs). An audit of BMRFs six years previously showed poor completion, especially with regard to filling in full blood count results, transfusion history, medication history, information about the clinical examination and HIV status. This lead the laboratory to design a new bone marrow specimen request form. We did a follow-up audit to see if the new form had helped to improve the completion rates. Methods: We compared 400 forms to the 357 that were audited in 2013. The following details were recorded: date and time of collection, patient demographics, requesting doctor’s details, clinical information, current medication, transfusion history and HIV status, and details of the procedure completed by technologists, registrars and pathologists. Results: The 2019 follow-up audit showed significant improvements in the completion of the transfusion history, as well as the clinical examination and HIV status. Registrars and pathologists signed off forms regularly. The completion of patient demographic details, and requesting doctors’ names and telephone numbers worsened. Discussion and conclusion: We recommend that the form be simplified so the requesting doctors only need to tick yes or no, in a tick-box format, if a full blood count has been done in the preceding 24 hours. There needs to be a dedicated space for the hospital and laboratory stickers. Only the name and telephone number of one doctor should be requested. This doctor should preferably be the most senior doctor involved with patient care. All referring laboratories and hospitals will be consulted before updating the form. Unfortunately, it seems that the only way to force the completion of request forms is to introduce an electronic order entry system that does not accept incomplete forms.

scholarly journals Evidence of a Role for Monocytes in Dissemination and Brain Invasion by Cryptococcus neoformans

2008 ◽  
Vol 77 (1) ◽  
pp. 120-127 ◽  
Author(s):  
Caroline Charlier ◽  
Kirsten Nielsen ◽  
Samira Daou ◽  
Madly Brigitte ◽  
Fabrice Chretien ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cryptococcus Neoformans ◽  
Trojan Horse ◽  
Brain Invasion ◽  
Fungal Burden ◽  
Trojan Horse Method ◽  
Kinetics Of ◽  
Intravenous Inoculation

ABSTRACT The pathogenesis of cryptococcosis, including the events leading to the production of meningoencephalitis, is still largely unknown. Evidence of a transcellular passage of Cryptococcus neoformans across the blood-brain barrier (BBB) and subsequent BBB disruption exists, but the paracellular passage of free yeasts and the role of monocytes in yeast dissemination and brain invasion (Trojan horse method) remain uncertain. We used our model of disseminated cryptococcosis, in which crossing of the BBB starts 6 h after intravenous inoculation, to study paracellular passage of the BBB. We prepared bone marrow-derived monocytes (BMDM) infected in vitro with C. neoformans (BMDM yeasts) and free yeasts and measured fungal loads in tissues. (i) Spleen and lung CFU were >2-fold higher in mice treated with BMDM yeasts than in those treated with free yeasts for 1 and 24 h (P < 0.05), while brain CFU were increased (3.9 times) only at 24 h (P < 0.05). (ii) By comparing the kinetics of brain invasion in naïve mice and in mice with preestablished cryptococcosis, we found that CFU were lower in the latter case, except at 6 h, when CFU from mice inoculated with BMDM yeasts were comparable to those measured in naïve mice and 2.5-fold higher than those in mice with preestablished cryptococcosis who were inoculated with free yeasts. (iii) Late phagocyte depletion obtained by clodronate injection reduced disease severity and lowered the fungal burden by 40% in all organs studied. These results provide evidence for Trojan horse crossing of the BBB by C. neoformans, together with mechanisms involving free yeasts, and overall for a role of phagocytes in fungal dissemination.

The Reduction of Leukemic Blasts in Bone Marrow Aspirate on Day 6 of Remission Induction Treatment Is Predictive for Complete Remission Rate and Survival in Adult Acute Myeloid Leukemia; the Results of Multicenter, Prospective Polish Adult Leukemia Group Trial.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4375-4375
Author(s):  
Jerzy Holowiecki ◽  
Sebastian Grosicki ◽  
Slawomira Kyrcz-Krzemien ◽  
Kazimierz Kuliczkowski ◽  
Marek Kielbinski ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Overall Survival ◽  
Complete Remission ◽  
Remission Rate ◽  
Prospective Trial ◽  
Complete Remission Rate ◽  
Remission Induction ◽  
Induction Treatment ◽  
Early Evaluation ◽  
Bone Marrow Specimen

Abstract The goal of this study was to prove the significance of an early evaluation of leukemic blast reduction based on cytological examination of bone marrow aspirates obtained on day 6 of remission induction treatment. Patients. 90 adult AML patients aged 18–60 (median 47) registered to the PALG prospective trial evaluating the efficacy of 3 remission induction protocols: DAF: daunorubicine (DNR) 60 mg/m2/d iv, d 1–3; cytarabine (AraC) 200 mg/m2/d ci, d 1–7, and fludarabine 25 mg/m2 2h inf. iv d 1–5), DAC (like DAF but cladribin is used at 5 mg/m2 instead of fludarabine) and the standard DA 3+7 regimen. Bone marrow aspirates were performed before the treatment and on the 6-th day of the first remission induction course, and the MGG stained marrow smears were evaluated at each centre by two experienced hematologists. Results. Based on the proportion of blasts in bone marrow specimen on day 6 patients were arranged into 2 groups: “responders”with ≤5% of blasts (n=59) and “non responders” with >5% of myeloblasts in bone marrow (n=31). The complete remission rate (CR) in the first group equalling 89% (51/59) was significantly higher in comparison to that obtained in the second group 29%(9/31), p=0,008. The probability of overall survival (OS) was also higher in the group of “responders” if compared to “non responders”; 65% versus 45% respectively, p=0,009. In multivariate analysis including bone marrow examination, cytogenetic risk group, age, leukocyte count at diagnosis and the induction arm only the persistence of leukemic blasts >5% in bone marrow specimen on 6-th day of induction was associated with higher risk of not achieving CR (HR = 52,6; p=0,00002), and with shorter OS (HR=3,13; p=0,02). Conclusion. This prospective, multicenter study demonstrates that a simple and commonly accessible evaluation of the leukemic blasts reduction in bone marrow smear on the 6-th day of remission induction treatment is a reliable and independent predictor for achieving CR and for overall survival. This offers a decision point for an early modification of the treatment strategy.

scholarly journals Toll-Like Receptor 9-Dependent Activation of Bone Marrow-Derived Dendritic Cells byURA5DNA from Cryptococcus neoformans

2011 ◽  
Vol 80 (2) ◽  
pp. 778-786 ◽  
Author(s):  
Misuzu Tanaka ◽  
Keiko Ishii ◽  
Yuri Nakamura ◽  
Akiko Miyazato ◽  
Atsuko Maki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Dendritic Cells ◽  
Cryptococcus Neoformans ◽  
Fungal Pathogen ◽  
High Dose ◽  
Apparent Difference ◽  
Dependent Manner ◽  
Toll Like Receptor ◽  
Content Type ◽  
Cpg Motif

ABSTRACTCryptococcus neoformansis an opportunistic fungal pathogen that causes meningoencephalitis in immunocompromised patients. Recently, we reported that Toll-like receptor 9 (TLR9) is involved in host defense againstC. neoformans: specifically, it detects the pathogen's DNA. In the present study, we aimed to elucidate the mechanisms underlying TLR9-mediated activation of innate immune responses by using theURA5gene, which encodes a virulent component of this fungal pathogen. A PCR-amplified 345-bpURA5gene fragment induced interleukin-12 p40 (IL-12p40) production by bone marrow-derived dendritic cells (BM-DCs) in a TLR9-dependent manner. Similar activity was detected in the 5′ 129-bp DNA fragment ofURA5and in a synthesized oligodeoxynucleotide (ODN) with the same sequence. Shorter ODN fragments, which contained GTCGGT or GACGAT but had only 24 or 21 bases, induced IL-12p40 production and CD40 expression by BM-DCs, but this activity vanished when the CG sequence was replaced by GC or when a phosphorothioate modification was introduced. IL-12p40 production caused by active ODN was strikingly enhanced by treatment with DOTAP, a cationic lipid that increases the uptake of DNA by BM-DCs, though DOTAP failed to induce IL-12p40 production by inactive ODN and did not affect the activity of an ODN-containing canonical CpG motif. There was no apparent difference in intracellular trafficking between active and inactive ODNs. Finally, an extremely high dose of inactive ODN suppressed IL-12p40 production by BM-DCs that had been stimulated with active ODN. These results suggest that theC. neoformansURA5gene activates BM-DCs through a TLR9-mediated signaling pathway, using a mechanism possibly independent of the canonical CpG motif.

scholarly journals Minimal Disease Detection and Confirmation in Hematologic Malignancies: Combining Cell Sorting with Clonality Profiling

2006 ◽  
Vol 52 (3) ◽  
pp. 430-437 ◽  
Author(s):  
Barbara K Zehentner ◽  
Wayne Fritschle ◽  
Tess Stelzer ◽  
Keely M Ghirardelli ◽  
Kimberly Hunter ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Tumor Cell ◽  
Cell Sorting ◽  
Cell Fraction ◽  
Patient Specific ◽  
Pcr Analysis ◽  
Diagnostic Certainty ◽  
Bone Marrow Specimen ◽  
Minimal Disease

Abstract Background: In this study we demonstrate the technical application of flow cytometry and cell sorting combined with gene-rearrangement clonality profiling to detect and confirm minimal disease in 2 leukemia and 2 lymphoma cases. Methods: Specimens with low percentages (0.05%–5%) of abnormal lymphoid populations were identified by flow cytometry. The abnormal lymphoid populations were sorted by flow cytometry, and the purified tumor populations along with unsorted fractions were subsequently analyzed for the presence of clonal gene rearrangements by PCR and fluorescence-based capillary electrophoresis fragment analysis. Results: In 3 cases, distinct clonality profiles could be detected in the purified tumor cell fraction, and suspicious amplicons of identical sizes were detected among the polyclonal backgrounds in the unsorted specimens. For 1 patient, a monoclonal signal was detected in the sorted tumor cell fraction but not in the unseparated bone marrow specimen containing 0.05% abnormal lymphoblasts. A subsequent bone marrow specimen containing 4.8% recurring leukemia cells tested positive with a clonality profile that matched the previous profile in the sorted cell population. Conclusions: The described method integrating 2 technologies allows genotypic confirmation of an aberrant population detected by immunophenotype to increase diagnostic certainty. This strategy provides a sensitive tool for disease monitoring without the need for patient-specific primer design and assay optimization required for quantitative PCR analysis.

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