Biomedical subjects
Publications and source records attributed to E Jacot-des-Combes.
Localized primary extranodal Hodgkin's disease is rare, especially in the digestive tract. A case is reported in which primary Hodgkin's disease presented as an ulcerated tumour of the sigmoid colon. The prognosis and management of such localized extranodal Hodgkin's lesions are discussed.
Primary pulmonary Hodgkin's disease is rare. We report the case of a previously healthy 23-year-old woman who presented with isolated involvement of the right upper pulmonary lobe. Nodular sclerosing Hodgkin's disease was diagnosed after curative surgery. The clinical stage is felt to be IEBL+. The reasons for this staging, as opposed to a stage IV, are discussed. Adjuvant radiotherapy was given, delivering 39.6 grays in 22 courses of 1.8 grays. Three years after diagnosis, the patient is well and free of disease. A review of the literature indicates that the majority of primary pulmonary Hodgkin's disease present as a single mass amenable to curative surgery and radiation therapy. Chemotherapy can be reserved for the rare diffuse presentation.
The case is reported of a 19-year-old patient with gastric carcinoma, in which clinical presentation (intermittent fever, myalgia, proximal muscle weakness and diffuse nodular-trabeculated infiltration of both lungs) was very unusual. The patient developed further complications (microangiopathic hemolytic anemia with disseminated intravascular coagulation) and died of subdural hematoma. Bone-marrow biopsy showed metastatic mucin-producing adenocarcinoma, but the gastric primary site of the tumor could only be demonstrated at autopsy.
An unusual case of primary aldosteronism with bilateral single adenomas is reported. The two tumors were revealed by computerized axial tomography and subsequently confirmed by surgical exploration. Spironolactone therapy prior to the operation induced the formation of spironolactone bodies in only one of the two adenomas. As it has been postulated that these cytoplasmic inclusions may reflect the activity of the adenomatous cells, the presence of the bodies in a single adenoma would indicate a unilateral source of the hyperaldosteronism. Thus, the existence of spironolactone bodies could corroborate the data of functional localizing tests more closely than the morphological findings of computerized tomography.
Examples are reported of lymph node lesions simulating histologically and/or clinically malignant lymphomas. Two main categories of alterations have been distinguished: A. hyperplastic lymph node alterations associated with systemic disease and/or viral or drug-induced lymphadenitis; B. anatomo-clinical entities such as giant lymph node hyperplasia, massive lymphadenopathy with sinus histiocytosis, and angio-immunoblastic lymphadenopathy. It is suggested that in some situations such as angio-immunoblastic lymphadenopathy the borderline between reactive and enoplastic alterations is not clear cut. To evaluate such changes, close collaboration between the clinician, the hematologist and the patholigist is necessary.
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