The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform
Guillermo A. Herrera - One of the best experts on this subject based on the ideXlab platform.
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ultrastructural immunolabeling in the diagnosis of monoclonal light and heavy chain related renal diseases
Ultrastructural Pathology, 2010Co-Authors: Guillermo A. Herrera, Elba A TurbatherreraAbstract:Renal dysfunction is often seen in patients with plasma cell Dyscrasias. The abnormal light and heavy chains that are produced by the neoplastic plasma cells in these patients are responsible for the renal abnormalities that occur. The renal manifestations are heterogeneous and include alterations in all three renal compartments; sometimes more than one compartment is affected in a given case. It must be demonstrated that the renal abnormalities are directly related to the underlying plasma cell Dyscrasia to make a definitive diagnosis of an associated lesion. Therefore, it becomes crucial to link the renal findings with the circulating nephrotoxic light or heavy chains. Immunofluorescence is very helpful and diagnostic in the majority of the cases, as it can localize the light or heavy chains to the various renal compartments showing alterations, and frequently confirm monoclonality. However, the antibodies that are used routinely do not necessarily label the abnormal light and heavy chains; the corollary of this is that a negative immunofluorescence workup does not rule out a light- or heavy-chain-related renal disorder. Electron microscopy is also important as it can depict crucial morphologic correlates to provide unique evidence or to simply confirm and clarify diagnostic findings. Ultrastructural immunolabeling combines the information obtained from immunofluorescence and electron microscopy by highlighting specific structures associated with the deposition of the pathogenic monotypical light and heavy chains.
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light chain mediated acute tubular interstitial nephritis a poorly recognized pattern of renal disease in patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Xin Gu, Guillermo A. HerreraAbstract:Abstract Context.—Acute renal failure may be the first clinical presentation in patients with plasma cell Dyscrasia. Recognition of the unusual interstitial inflammatory lesion associated with monoclonal light chains and renal failure described herein is important to guide clinicians in requesting appropriate tests to confirm plasma cell Dyscrasia and providing adequate treatment. Objective.—To describe an unusual pattern of tubular interstitial nephritis in patients with underlying plasma cell Dyscrasia characterized by an interstitial inflammatory reaction associated with deposition of light chains along tubular basement membranes. Design.—Eight cases of light-chain–mediated acute tubular interstitial nephritis were identified from the archives of 4296 kidney biopsy specimens. In all cases, routine light microscopic examination, direct immunofluorescence, and electron microscopic examination were performed. Ultrastructural immunogold labeling was performed in specimens with inconclusive findings and in ...
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light chain mediated acute tubular interstitial nephritis a poorly recognized pattern of renal disease in patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Xin Gu, Guillermo A. HerreraAbstract:Abstract Context.—Acute renal failure may be the first clinical presentation in patients with plasma cell Dyscrasia. Recognition of the unusual interstitial inflammatory lesion associated with monoclonal light chains and renal failure described herein is important to guide clinicians in requesting appropriate tests to confirm plasma cell Dyscrasia and providing adequate treatment. Objective.—To describe an unusual pattern of tubular interstitial nephritis in patients with underlying plasma cell Dyscrasia characterized by an interstitial inflammatory reaction associated with deposition of light chains along tubular basement membranes. Design.—Eight cases of light-chain–mediated acute tubular interstitial nephritis were identified from the archives of 4296 kidney biopsy specimens. In all cases, routine light microscopic examination, direct immunofluorescence, and electron microscopic examination were performed. Ultrastructural immunogold labeling was performed in specimens with inconclusive findings and in ...
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renal pathologic spectrum in an autopsy series of patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Guillermo A. Herrera, Xin Gu, Lija Joseph, Aubrey J Hough, Bart BarlogieAbstract:Abstract Context.—Renal dysfunction in plasma cell Dyscrasias is common. It is the second most common cause of death in patients with myeloma. Objective.—We evaluated 77 sequential autopsies performed on patients dying from complications of plasma cell Dyscrasias during an 11-year period at the University of Arkansas for Medical Sciences. These consisted of 15% of all the autopsies performed during this time. Design.—The kidneys were evaluated by light microscopy using hematoxylin-eosin–stained sections as well as Congo red and thioflavin T stains when amyloidosis was in the differential diagnosis. Immunofluorescence was performed on selected cases. Results.—The most common lesion identified was cast nephropathy (30%). Other findings included acute tubulopathy, AL-amyloidosis, light chain deposition disease, tubulointerstitial nephritis associated with monotypic light chain deposits, thrombotic microangiopathy, renal infarction, fungal infection, and plasma cell tumor nodules. Autolysis, an expected findi...
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Light chain crystal deposition as a manifestation of plasma cell Dyscrasias: the role of immunoelectron microscopy.
Human Pathology, 2003Co-Authors: Xin Gu, Roberto Barrios, Joiner Cartwright, Ramon L. Font, Luan D Truong, Guillermo A. HerreraAbstract:Light chain crystal deposition disease is a rare and poorly characterized entity that can be confused with a number of different conditions, depending on where the disease process is manifested. The present study explored the role of ultrastructural immunogold labeling in the diagnosis of this condition. Seven cases of light chain crystal deposition (kappa light chain-related) are reported. Immunohistochemistry and immunofluorescence techniques play a rather limited role in the evaluation of these cases, as a result of the inability to detect monoclonal kappa light chains in association with the crystalline structures or high background staining. Ultrastructural labeling is the method of choice to fully characterize these cases. However, surgical pathologists must learn to recognize the findings associated with this condition to avoid misdiagnosis. If the diagnosis is at least suspected, then a complete hematologic workup may identify the underlying plasma cell Dyscrasia. It must be emphasized that in some patients the plasma cell Dyscrasia does not become clinically manifested until years after the diagnosis of light chain crystal deposition.
Xin Gu - One of the best experts on this subject based on the ideXlab platform.
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light chain mediated acute tubular interstitial nephritis a poorly recognized pattern of renal disease in patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Xin Gu, Guillermo A. HerreraAbstract:Abstract Context.—Acute renal failure may be the first clinical presentation in patients with plasma cell Dyscrasia. Recognition of the unusual interstitial inflammatory lesion associated with monoclonal light chains and renal failure described herein is important to guide clinicians in requesting appropriate tests to confirm plasma cell Dyscrasia and providing adequate treatment. Objective.—To describe an unusual pattern of tubular interstitial nephritis in patients with underlying plasma cell Dyscrasia characterized by an interstitial inflammatory reaction associated with deposition of light chains along tubular basement membranes. Design.—Eight cases of light-chain–mediated acute tubular interstitial nephritis were identified from the archives of 4296 kidney biopsy specimens. In all cases, routine light microscopic examination, direct immunofluorescence, and electron microscopic examination were performed. Ultrastructural immunogold labeling was performed in specimens with inconclusive findings and in ...
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light chain mediated acute tubular interstitial nephritis a poorly recognized pattern of renal disease in patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Xin Gu, Guillermo A. HerreraAbstract:Abstract Context.—Acute renal failure may be the first clinical presentation in patients with plasma cell Dyscrasia. Recognition of the unusual interstitial inflammatory lesion associated with monoclonal light chains and renal failure described herein is important to guide clinicians in requesting appropriate tests to confirm plasma cell Dyscrasia and providing adequate treatment. Objective.—To describe an unusual pattern of tubular interstitial nephritis in patients with underlying plasma cell Dyscrasia characterized by an interstitial inflammatory reaction associated with deposition of light chains along tubular basement membranes. Design.—Eight cases of light-chain–mediated acute tubular interstitial nephritis were identified from the archives of 4296 kidney biopsy specimens. In all cases, routine light microscopic examination, direct immunofluorescence, and electron microscopic examination were performed. Ultrastructural immunogold labeling was performed in specimens with inconclusive findings and in ...
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renal pathologic spectrum in an autopsy series of patients with plasma cell Dyscrasia
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Guillermo A. Herrera, Xin Gu, Lija Joseph, Aubrey J Hough, Bart BarlogieAbstract:Abstract Context.—Renal dysfunction in plasma cell Dyscrasias is common. It is the second most common cause of death in patients with myeloma. Objective.—We evaluated 77 sequential autopsies performed on patients dying from complications of plasma cell Dyscrasias during an 11-year period at the University of Arkansas for Medical Sciences. These consisted of 15% of all the autopsies performed during this time. Design.—The kidneys were evaluated by light microscopy using hematoxylin-eosin–stained sections as well as Congo red and thioflavin T stains when amyloidosis was in the differential diagnosis. Immunofluorescence was performed on selected cases. Results.—The most common lesion identified was cast nephropathy (30%). Other findings included acute tubulopathy, AL-amyloidosis, light chain deposition disease, tubulointerstitial nephritis associated with monotypic light chain deposits, thrombotic microangiopathy, renal infarction, fungal infection, and plasma cell tumor nodules. Autolysis, an expected findi...
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Light chain crystal deposition as a manifestation of plasma cell Dyscrasias: the role of immunoelectron microscopy.
Human Pathology, 2003Co-Authors: Xin Gu, Roberto Barrios, Joiner Cartwright, Ramon L. Font, Luan D Truong, Guillermo A. HerreraAbstract:Light chain crystal deposition disease is a rare and poorly characterized entity that can be confused with a number of different conditions, depending on where the disease process is manifested. The present study explored the role of ultrastructural immunogold labeling in the diagnosis of this condition. Seven cases of light chain crystal deposition (kappa light chain-related) are reported. Immunohistochemistry and immunofluorescence techniques play a rather limited role in the evaluation of these cases, as a result of the inability to detect monoclonal kappa light chains in association with the crystalline structures or high background staining. Ultrastructural labeling is the method of choice to fully characterize these cases. However, surgical pathologists must learn to recognize the findings associated with this condition to avoid misdiagnosis. If the diagnosis is at least suspected, then a complete hematologic workup may identify the underlying plasma cell Dyscrasia. It must be emphasized that in some patients the plasma cell Dyscrasia does not become clinically manifested until years after the diagnosis of light chain crystal deposition.
M A Karam - One of the best experts on this subject based on the ideXlab platform.
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skeletal trauma preceding the development of plasma cell Dyscrasia
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
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skeletal trauma preceding the development of plasma cell Dyscrasia eight case reports and review of the literature
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
Mohamad A. Hussein - One of the best experts on this subject based on the ideXlab platform.
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skeletal trauma preceding the development of plasma cell Dyscrasia
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
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skeletal trauma preceding the development of plasma cell Dyscrasia eight case reports and review of the literature
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
R. George - One of the best experts on this subject based on the ideXlab platform.
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skeletal trauma preceding the development of plasma cell Dyscrasia
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
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skeletal trauma preceding the development of plasma cell Dyscrasia eight case reports and review of the literature
Medical Oncology, 2003Co-Authors: Mohamad A. Hussein, R. George, Lisa Rybicki, M A KaramAbstract:Plasma cell Dyscrasias are clonal proliferations and accumulations of plasma cells. The etiology of monoclonal neoplasms still remains elusive. A direct correlation between a history of trauma and the development of plasma cell Dyscrasias has not been established. Two recent case reports have described plasmacytomas that were diagnosed in patients who suffered injury at the site of plasma cell neoplasms. We report a series of eight patients who stated a history of trauma to the site where plasma cell neoplasms were later diagnosed. The duration from the date of injury to diagnosis ranged from 2 mo to 20 yr. The M:F ratio was 6:2. The median age was 52 (28–75). Multiple myeloma was confirmed in six patients and plasmacytoma without systemic disease in the other two patients. All eight patients had a κ monoclonal plasma cell population, and all but one had a detectable peripheral κ light chain. All patients presented with persistent discomfort at the site where they had experienced trauma. Even though this article does not establish a relationship between trauma, and the development of plasma cell Dyscrasia, persistent discomfort at a previous trauma site warrants a complete evaluation and consideration for possible plasma cell Dyscrasias.
