We report on a patient who developed a fistula between the primitive left iliac artery and left ureter following combined treatment with systemic chemotherapy, local radiotherapy and surgery with ureteric diversion and ileal bladder. The role of each of the factors involved in this uncommon complication is discussed.

Aged↗

PubMedDate not supplied

[Histopathological features of carcinomas of the bladder treated with radiotherapy. Anatomo-clinical correlation].

We evaluated the effects of radiotherapy (total dose 6,100 rads; 1,500 intraoperative and 4,600 external irradiation) on urothelial carcinomas in 16 patients. Tumor response and the histopathological changes were evaluated. All but one of the patients were men. Mean patient age was 58 years. The urothelial tumors were graded from I-III according to the histological features and degree of invasion. Two were classed as grade I, 6 grade II and 8 grade III. The post-irradiation cystectomy specimens revealed no tumor cells in 9 cases (56%); 2 grade II and 7 grade III tumors. All cystectomy specimens revealed histopathological changes following radiotherapy: edema and congestion (16 cases), squamous metaplasia (11 cases), multinucleated giant cells (7 cases), fibroblast proliferation (6 cases), dystrophic calcification (4 cases), macrophages with lipids (3 cases) and osseous formation (1 case). The mean patient follow-up was 18 months. Four patients died (3 from the tumor). Mean patient survival was 12 months. The foregoing findings indicate that radiotherapy appears to be more effective in destroying the more undifferentiated and deeper urothelial carcinoma.

Adult↗

PubMedDate not supplied

Hepatitis induced by drugs used as alcohol aversion therapy.

We report here on the hepatic lesions produced in 17 alcoholic patients who had received Cyanamide or Disulfiram as aversion therapy. The characteristic lesion consists of cytoplasmic inclusions, similar to Lafora bodies. They are found predominantly in periportal hepatocytes, including those lining the cholangioles. They appear to be persistent but are lost after death of the inclusion-bearing liver-cell when both the inclusion body and the dead hepatocyte are removed by macrophages. As well as the inclusion bodies, portal or periportal inflammation and necrosis of isolated liver-cells are seen. The inflammatory infiltrate is usually denser in the periportal areas and is associated with liver-cell destruction. The inflammation is usually followed by portal fibrosis which can be severe if treatment is prolonged. In one case, in which two biopsies were performed, cirrhosis developed while that patient was on Cyanamide.

Adult↗