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Biomedical subjects

C E Connolly

Publications and source records attributed to C E Connolly.

At least 55 records · Page 3Linked to original sources

Coeliac proctitis.

An increased association of ulcerative colitis and coeliac disease has been reported, as have the results of several small-bowel biopsy studies in ulcerative colitis. Forty-two patients from a population of 438 patients with coeliac disease had rectal biopsies. Fourteen of these showed inflammation of various degrees of severity, including three compatible with a diagnosis of ulcerative colitis. The presenting complaint in 34 of these patients was diarrhoea or steatorrhoea. Twenty-seven patients had coeliac disease diagnosed at the same time or after their rectal biopsy. The other 15 were previously diagnosed coeliacs. Twelve of the 14 patients with abnormal rectal biopsy specimens were known to have subtotal/total villous atrophy at the time of rectal biopsy. Proctitis as seen in these coeliac patients had no unique features to differentiate it from proctitis caused by other disorders. The diarrhoea/steatorrhoea stopped in all patients on commencement of a gluten-free diet, except in those with ulcerative colitis. Proctitis is common in patients with coeliac disease presenting with diarrhoea/steatorrhoea. This study supports the finding of an increased association of coeliac disease and ulcerative colitis and is, to our knowledge, the first rectal biopsy study of a coeliac population.

Adult↗

Humoral response to wheat protein in patients with coeliac disease and enteropathy associated T cell lymphoma.

Features that might distinguish uncomplicated coeliac disease from enteropathy associated T cell lymphoma were investigated. Of 76 patients with coeliac disease, 71 (93%) had raised levels of alpha gliadin antibody and all responded clinically and histologically to treatment with a gluten free diet. In contrast, none of 16 patients with enteropathy associated T cell lymphoma had raised levels of alpha gliadin antibody, and treatment with a gluten free diet resulted in histological improvement in one and transient clinical improvement in six patients. The ratio of women to men was 2.2:1 in the group with coeliac disease and 1:1.6 in the patients with enteropathy associated T cell lymphoma. Thus patients with enteropathy associated T cell lymphoma do not display a humoral immune response to wheat protein (alpha gliadin), rarely respond to a gluten free diet, and are often men. Patients with uncomplicated coeliac disease usually have raised levels of alpha gliadin antibody, always respond to a gluten free diet, and are frequently women. These findings suggest the presence of two separate forms of enteropathy: one is benign and sensitive to wheat protein whereas the other runs a malignant course.

Adult↗

Breast carcinoma with stromal multinucleated giant cells--a light microscopic, histochemical and ultrastructural study.

A rare form of infiltrating ductal carcinoma of the breast containing numerous benign stromal multinucleated giant cells (MNGC) is described. Giant cell tumours of the breast are usually the result of stromal metaplasia or fusion of malignant cells or occur as extraskeletal giant cell tumours. Benign multinucleated cells in breast carcinoma, however, are a very unusual phenomenon and have been said to arise from the fusion of mononuclear cells, in response to increased vascularity. The present investigation by light and electron microscopy, in part, supports an origin for the multinucleated giant cells from mononuclear cells, but immunohistochemistry surprisingly failed to confirm this observation. Also, the formation of the multinucleated giant cells did not show any direct relationship with tumour vascularity.

Breast Neoplasms↗

Malignant histiocytosis of the intestine: a T-cell lymphoma.

Malignant lymphoma complicating coeliac disease has been characterised on morphological and immunocytochemical grounds as malignant histiocytosis of the intestine (MHI). Fresh tissue from four cases of MHI was studied by means of a panel of monoclonal antibodies; in three cases tumour DNA was studied for immunoglobulin and T-cell receptor (TCR) gene rearrangement. Immunocytochemistry showed a T-cell phenotype in all four cases, confirmed by the demonstration of a rearranged TCR beta-chain gene in the three cases studied. Lymphoma complicating coeliac disease thus appears to be of T-cell, rather than histiocyte, origin.

Adult↗

Renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in same kidney. Subcutaneous abscess of thigh as initial presentation.

A case is reported of the simultaneous occurrence of renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in the same kidney, with subcutaneous abscess of the thigh as the initial presentation. The coexistence of these diseases in the same kidney would seem to be important since they are frequently confused with each other.

Abscess↗

HLA type of patients with coeliac disease and malignancy in the west of Ireland.

HLA, A, B, and DR typing was done on seven of 10 patients with lymphoma, and six patients with carcinoma, all of whom had a flat small intestinal mucosa. Sixty-nine per cent (nine of 13) had HLA B8 and 71% (five of seven) had DR3. The corresponding levels for the local coeliac population are 76% and 84% respectively and the local non-coeliac population 43% and 44%. Two of the patients with lymphoma had a child with coeliac disease. The histological type of the lymphoma was malignant histiocytosis of the intestine in seven, histiocytic lymphoma in two, and was not classifiable in one. The similarity of the HLA type suggests that the flat mucosa in both groups is due to coeliac disease.

Adult↗

'Crystalline' collagen production by an unusual benign soft tissue tumour ('amianthioma').

The morphology of a benign soft tissue tumour producing nodules of collagen in 'crystalline' form is investigated by light and electron microscopy. The distinctive and peculiar arrangement of collagen fibres into bundles of radiating 'crystals' is described. This appearance has not been documented in the literature on soft tissue tumours before, as far as the author bas been able to ascertain.

Adult↗