Cutaneous pleomorphic small T-cell lymphoma is a rare, recently recognized lymphoma, different from mycosis fungoides and Sézary syndrome. Only a few cases have been reported and no treatment ...modalities have been defined. We reviewed the clinical, histologic, immunohistochemical, molecular biologic, and follow-up data of 11 primary cutaneous pleomorphic small T-cell lymphomas.
The lesions presented as red purplish nodules, tumors, or plaques. The infiltrate consisted of small pleomorphic lymphoid cells without epidermotropism in nine patients and with a propensity to infiltrate the dermis and subcutaneous fat. Most cases were CD4+/CD8-. A T-cell clone was detected in the skin lesions of nine patients tested. The mean follow-up was 70.1 months and the median follow-up was 20 months. Ten patients are alive with three having persistent lesions. Interferon alfa-2a induced partial or complete remissions in five patients. Interferon alfa-2a combined with a regimen containing doxorubicin chlorhydrate induced a complete remission in a patient suffering a relapse after cyclophosphamide and interferon alone.
Cutaneous pleomorphic small T-cell lymphoma is a well-defined type of low-grade cutaneous lymphoma with favorable prognosis. Interferon and/or chemotherapy are the treatment of choice in patients with large tumor burden.
Introduction: In 2000, Air France asked the University of Creteil (Paris XII) to design the training program for the 1,000 flight attendants before the widespread deployment of defibrillators (AEDs) ...on commercial aircraft. Methods: Initially, nurses from the airline medical department received legal certification as AED instructors by the emergency teaching center of Creteil. The University of Creteil selected 250 instructors: all emergency field professionals. AEDs training and certification was conducted for crew members between November 2001 and November 2002. By January 2003, all aircraft were fully equipped with AEDs. Since then, all cases of cardiac arrest that occurred were reviewed comprehensively. Comments from the crew were collected. A 2 1/2 hour refresher course was organised every year. Guidelines on all medical emergencies on board and 17 videos were created by the University and tailored to an aircraft environment. They were available to assist flight attendants and pilots for providing relevant interactive medical consultation with a physician of the emergency dispatch center of Paris. Results: Over a 6 year period we assessed the ability of flight attendants to apply protocols to improve in-flight medical care and the effective use of AEDs. The flight attendants appreciated the course with hands on practice with mock scenarios and the strong medical leadership provided by emergency field professionals. Training by professionals gave the flight attendants confidence and allowed for the survival of four passengers treated for a cardiac arrest. One of these passengers not requiring defibrillation had only a short term survival. No complications arose from the use of AEDs. Discussion: This report highlights the ability of flight attendants to give better onboard care for the future. The emergency physician of the dispatch center has the possibility to consult on line a data base that will indicate ground medical facilities before advising diversion.
Mononuclear cells from hairy cell leukemia have been studied in three cases by ultrastructural immunocytochemistry. Cells have fairly detectable surface immunoglobulins, without monoclonal ...distribution however. In addition these cells have a peroxidatic activity which is revealed in the perinuclear space and strands of endoplasmic reticulum.
