Biomedical subjects
Publications and source records attributed to J C Vuletin.
A prostatic leiomyoma with nuclear atypia, similar in appearance to atypia sometimes seen in uterine leiomyomas, was an incidental finding in a fifty-three-year-old man who underwent prostatectomy for hyperplasia. The smooth muscle nature of the lesion was confirmed by electron microscopic examination. This is the third lesion of this type to be reported.
A case of low-grade ovarian stromal sarcoma in a postmenopausal woman is described. Although pelvic recurrences of the tumor followed 5 and 7 years after the original surgery, the patient has remained well and without evidence of tumor 3 years since the last operation. Histopathologic, electronmicroscopic, and hormonal studies are described. There was evidence of estrogenic stimulation by the theca elements of the tumor in this patient. Cases previously reported in the world literature as malignant thecoma were analyzed, and most of them were considered inadequately documented; indeed most of them were probably either sarcomatoid granulosa cell tumors, stromal sarcomas, or fibrosarcomas. If a thecoma ever becomes malignant, the tumor cells dedifferentiate so that they cannot be recognized any longer as theca cells; instead, they proliferate as a stromal sarcoma or fibrosarcoma. It is proposed, therefore, that the term "malignant thecoma" not be used. On the other hand, very rare malignant ovarian stromal tumors do exist, consisting of undifferentiated stromal cells, fibroblasts, and theca cells, which can show evidence of hormonal activity.
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Argentaffin cells were searched for in the epithelial nests of 30 Brenner's tumors, with the Fontana-Masson stain for the screening. Although these cells were found in five tumors, ultrastructural examination of one case, in which the argentaffin cells were multiple, identified the cytoplasmic granules as lysosomes and not as amine precursor uptake and decarboxylation (APUD)-type granules. We conclude that the epithelial component of Brenner's tumors consists of urothelium only and does not include the cells containing argentaffin APUD-type granules.
Disseminated histiocytic proliferation and intestinal malakoplakia due to Mycobacterium intracellulare occurred in a 2-year-old white boy. Light and electron microscopic examination of autopsy material disclosed disseminated histiocytosis and malakoplakia of the intestine with numerous intracellular acid-fast bacilli. The isolated organism produced a similar disseminated histiocytosis and finally death when injected into experimental animals. A review of the literature showed only 12 previously reported cases of disseminated histiocytosis due to M intracellulare infection. We were unable to find a previous report of malakoplakia due to nontuberculous mycobacterial infection.
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Serum angiotensin-converting enzyme in a patient with type 2 acute neuronopathic Gaucher's disease (242 nmol/min/ml) was 10.8 times higher than values for eight patients with other hereditary neurologic abnormalities (22.5 +/- 2.0) and 9.4 times higher than those for 12 patients with other diseases (25.7 +/- 2.6) (P less than 0.001). Serum lysozyme was not elevated in the patient with type 2 Gaucher's disease. These results indicate that elevated serum angiotensin-converting enzyme in an infant with neurologic involvement and hepatosplenomegaly is suggestive of the possibility of type 2 Gaucher's disease. Typical Gaucher's cells and fibrosis were observed by light and electron microscopy of the liver. An aspect hitherto unreported in Gaucher's disease or in the liver was that approximately 20% of the collagen fibrils were of the long-spacing type, with periodicity of 1,000 to 1,100 A and diameters of 900 to 1,500 A.
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A tumor mass removed from the subcutaneous tissue of the shoulder of a dog had the light and electron microscopic features of extraneuraxial meningioma. The neoplasm probably arose from arachnoid cap cells displaced during embryogenesis.
Squamous cell carcinoma of the stomach is a rare, unusual lesion which tends to occur at a somewhat earlier age than adenocarcinoma. Grossly and radiologically the tumor is indistinguishable from adenocarcinoma and may involve any portion of the stomach. Although the pathogenesis of this lesion remains unclear, most authors favor the "metaplastic theory" for the development of the tumor. In this case it is felt that the tumor probably arose from gastric squamous mucosa present congenitally in the lesser curvature.
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Jejunal mucosa from 7 patients with amyotrophic lateral sclerosis (A.L.S.), 20 newly reported patients with multiple sclerosis (M.S.), and 35 control patients without either disease was studied by immunofluorescence. An immune reaction was present in all A.L.S. specimens and consisted of altered ratios of immunoglobulin-labelled cells in the lamina propria, complement-labelled cells in the same location, and, in some, immunoglobulin and complement deposits in the epithelial basement membrane. Poliovirus antigen was detected in 4 cases, and in 1 of the these cases measles antigen was also present. A fifth specimen showed large amounts of herpesvirus antigen. In 2 cases studied at necropsy, both viral infection and immunological change was confined to the proximal jejunum. Measles antigen was identified in every case of M.S., and in biopsy specimens from 16 of the 20 M.S. patients immunological reactions similar to those seen in A.L.S. were present. With 2 exceptions, the controls did not show these changes in the jejunal mucosa. The exceptions were a patient with Friedreich's ataxia, who had an increase of IgG-labelled cells and some complement-bearing cells in the lamina propria, and a patient diagnosed as having non-tropical sprue, in whom large quantities of herpes antigen were seen.
This is the eighth case report of an endodermal sinus tumor of the mediastinum (first case studied by electron microscopy). The ultrastructure of the tumor was found to mimic that of the normal yolk sac and was also similar to that of three previously reported cases of endodermal sinus tumor of the ovary, thus confirming the correctness of Teilum's original interpretation of the tumor as arising in germ cells and differentiating towards extraembryonic structures.
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Immunoglobulin deposits and DNA were identified by use of immunofluorescence microscopy within the ciliary process and choroid of a majority of (NZB X W)F1 mice with murine lupus. The number of animals with such deposits increased from 57% at 36 weeks of age to 90% at one year of age. Ultrastructural examination showed electron-dense deposits between the basement laminae of the endothelium and pigmented epithelium of the ciliary process, accompanied by alterations in the epithelial basement membranes. Similar electron-dense deposits were also identified in the vicinity of the lamina choroidocapillaris. The titer of antibody to DNA did not correlate with the presence of ocular deposits, suggesting that time is an important factor in the development of ocular immunopathology in these animals.
A case of diencephalic-midbrain hemorrhage presenting with excessive thirst, coma, and death is discussed. Some diencephalic dysfunction syndromes are reviewed, as well as their physiological basis. Thirst and drinking behavior can provide a valuable localizing symptom and sign in clinical-pathological correlations.
A case of centronuclear or myotubular myopathy in a 13-year-old boy who was admitted with hypotonia and congenital ptosis is reported. Clinical, electromyographic and pathologic studies are discussed. A review of the electron microscopic features and comparison with out findings is included. Review of the literature disclosed near 50 cases of centronuclear myopathy. The diferential diagnosis is discussed.