Primary lymphoma of the liver treated with hepatic lobectomy and chemotherapy.
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Biomedical subjects
Publications and source records attributed to C Redondo.
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A clinicopathological study of seven cases of intravascular leiomyomatosis (IVL) was performed. The patients' ages ranged from 29 to 80 and all cases were associated with uterine leiomyomas. The intravascular extension involved preferentially uterine vessels, although the adnexa were also affected. Microscopically, the intravascular tumors resembled the primary leiomyomas. Mitotic count was low and never exceeded 3 per 10 high-power fields. Thick venous vessels, sometimes with thrombosis, were a conspicuous marker in intravascular locations. Necrosis and hemorrhage were found in four cases. Epithelioid IVL was found in one instance associated with a lipid cell tumor of the ovary. This series supports, for most cases, the notion of an origin from a preexisting leiomyoma. A review of treatment, prognosis, and histogenesis of IVL is performed.
A case of bilateral breast cancer in a patient with a Klinefelter mosaic syndrome is presented. The tumor in the left breast was an infiltrating lobular carcinoma with characteristic in situ component. To the knowledge of the authors, this is the first case in the English literature of lobular carcinoma of the breast in a phenotypic man. In fact, it was the pathologic diagnosis which led to the study of the chromosomal abnormality.
The prolonged partial thromboplastin time observed in the plasma of a 36 year old asymptomatic man was related to the reduced prekallikrein activities (coagulant; antigenic; and amidolytic) and the absence of coagulant and immunologic activities of high molecular weight kininogen (HMWKg). The patient's plasma also exhibited impaired surface-mediated fibrinolysis and impaired generation of kallikrein. The coagulation defect was identified as the "Fitzgerald trait". The levels of CH50, C2, C4 and C-1 inactivator were normal. Venous occlusion in the patient gave rise to a normal release of extrinsic plasminogen activator from the vascular endothelium. The administration of DDAVP led to a FVIII/VWF response which was similar to that obtained in healthy subjects. No alteration could be observed in the contact phase proteins after DDAVP administration.
A case of an unusual congenital intramedullary tumor of the spinal cord is reported. A paraplegic 11-day-old boy with hypotonia and atrophy of the abdominal and lower-extremity muscles showed a complete myelographic block between T-5 and T-8. Surgical exploration disclosed an elongated tumor mass within the spinal cord, that blended with the surrounding nervous-system tissue. Light and electron microscopy showed that the tumor was composed of intermingled well differentiated astrocytes and fibroblasts. These two cell types often were surrounded by the same basal lamina. There were no intercellular junctions. Gliofibrils were abundant, and the interstitial spaces contained abundant collagen and reticulin fibers. There were no histological signs of malignancy. We conclude that this is a case of prenatally arising gliofibroma.
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The case of a European patient with a malignant lymphoepithelial lesion of epithelial type is presented. This type of tumor has an exceptionally high incidence among Eskimos. To the authors' knowledge this is the first case reported with an ultrastructural study that demonstrates the squamous nature of the tumor cells.
Out of 110 cases of fever of unknown origin (FUO) that met Petersdorf and Beeson's criteria 15 patients were selected because of prolonged FUO with more than six months elapsed between admission and the final diagnosis. In this group of chronic FUO an etiological diagnosis was reached in 11 cases, distributed as follows: four cases with infections (two with toxoplasmosis, one with brucellosis, and another with a brain abscess); one with colon carcinoma; two with collagen-vascular diseases (systemic lupus erythematosus, temporal arteritis); and four with different diseases (two with familial mediterranean fever, one with idiopathic granulomatous disease, and another with factitious fever). In four cases no cause for the FUO could be determined. The procedures used to obtain the diagnosis were non-invasive in five cases (clinical course and serological tests), and invasive in another five (angiography, biopsies, and exploratory laparotomy). In one case the ethology could only be ascertained at autopsy. In the FUO with a prolonged course the peculiar etiological spectrum, the lesser yield of invasive procedures, and a mortality inferior to that of FUO in general all deserve special emphasis.
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A patient is reported with stage IV-B Hodgkin's lymphoma, lymphocyte depletion type, and associated hypouricemia (1,7 mg/dl). In the few cases described of this association hypouricemia was secondary to a high renal clearance of urate, but in no case was the involved tubular level precisely delimited. In the present case the pyrazinamide and the probenecid tests were performed, disclosing the existence of a possible defect in the postsecretory reabsorptive phase which was improved by therapy. The different pathogenetic mechanisms described to explain this transitory tubular defect are reviewed.
Out of 23 cases with a final diagnosis of idiopathic fever, 20 had self-limited fever with complete resolution. Comparing the cases of self-limited fever with other groups of patients with fever of unknown origin, the following differences were apparent: compared with tumoral and collagen diseases, self-limited fever occurred more frequently below age 40, the difference being significant (p less than 0.01). Chills occurred more frequently in self-limited fever than in tumoral and collagen diseases, while the incidence was similar in infectious diseases. Infectious, tumoral and collagen diseases presented with significantly greater weight loss (p less than 0.01) than self-limited fever. A greater incidence of hepatosplenomegaly was noted in self-limited fever than in infectious diseases. Hemoglobin and erythrocyte sedimentation rate (ESR) were significantly higher in self-limited fever than in the other illnesses. The NBT test was positive, with a reduction superior to 30% in the six cases in whom it was performed. In nine cases various invasive procedures were utilized: radiology, biopsy, laparoscopy (two cases), and laparotomy (one case). The data on the present series of self-limited idiopathic fever support an infectious origin of the disease because of the following: absence of an age difference with the group with a demonstrated infectious cause; fever of less than two months duration in most cases; presence of chills and less incidence of weight loss, anemia, and elevated ESR in relation to the other groups of fever of unknown origin; a positive NBT test; and spontaneous evolution to complete resolution of the disease.
A case of an intracerebral "primary" arachnoidal cyst of the left fronto-parietal region is reported. No communication with the ventricular system or with subarachnoidal space was found at the first surgical procedure. It contained genuine choroid plexus and clinically behaved as an expansive intracranial mass.
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