Biomedical subjects

J G Guccion

Publications and source records attributed to J G Guccion.

41 records · Page 3Linked to original sources

PubMedDate not supplied

Trichomoniasis complicating esophageal intramural pseudodiverticulosis: diagnosis by transmission electron microscopy.

A 58-year-old African-American man presented with a progressive esophageal stricture of unknown etiology complicated by esophageal candidiasis, broncho-esophageal fistula, four episodes of aspiration pneumonia, and a 40-lb weight loss. He ultimately required an esophagectomy. Pathologic examination showed marked thickening of the esophageal wall by submucosal pseudodiverticula typical of esophageal intramural pseudodiverticulosis (EIPD) and extensive mucosal and submucosal chronic inflammation and fibrosis. Small, oval cells with ill-defined nuclei were present in lumens of some pseudodiverticula, light microscopically. Their exact nature could not be determined by light microscopy. The diagnosis of trichomoniasis became apparent only after transmission electron microscopic study of these cells demonstrated characteristic features of trichomonad protozoa. These included four anteriorly placed flagella with kinetosomes, a recurrent flagellum associated with an undulating membrane, a costa, a peltar-axostylar complex, and a small Golgi body with parabasal filaments. This case of EIPD is unusual in that the associated broncho-esophageal fistula and trichomoniasis have not been previously reported as complications of EIPD.

Animals↗

PubMedDate not supplied

Cat scratch disease and acquired immunodeficiency disease: diagnosis by transmission electron microscopy.

A 33-year-old, homosexual, cat-owning, African-American man with human immunodeficiency virus infection by positive serologic tests and acquired immunodeficiency syndrome by CD4 lymphocyte count alone (39 cells/mL) presented with a one-year history of intermittent fever, weight loss, and generalized lymphadenopathy. A malignant lymphoma was suspected clinically. Light microscopic study of a left inguinal lymph node biopsy specimen revealed effacement of the lymph node architecture by a diffuse infiltrate of large, atypical reticulum cells, loose, patchy granulomatous inflammation, diffuse hyaline fibrosis, diffusely proliferated blood vessels, and multifocal degeneration and necrosis. Lymph follicles were absent and lymphocytes were moderately depleted. Microorganisms were not seen in lymph node sections stained with special histochemical stains (including the Warthin-Starry stain). These light microscopic changes were considered suggestive of a malignant lymphoma, especially Hodgkin's disease. The diagnosis of cat scratch disease (CSD) became apparent only after transmission electron microscopic study of the lymph node revealed clusters of small, pleomorphic bacteria in degenerated collagenous tissue and in blood vessel walls. This case illustrates the value of transmission electron microscopy in making the diagnosis of CSD, especially when light microscopic changes are superimposed on those of late human immunodeficiency virus infection of the lymph node.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Disseminated blastomycosis and acquired immunodeficiency syndrome: a case report and ultrastructural study.

A 42-year-old, African-American man presented with a 2-month history of weight loss and fever for 2 weeks. Presumptive diagnoses of human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome were made on the basis of a CD4 lymphocyte count of 23 lymphocytes/mL. Chest x-ray revealed right paratracheal adenopathy and a miliary pattern. The etiology of the patient's pulmonary infection was not known, but tuberculosis was an important consideration. Over 5 days, the pulmonary infection progressed and was complicated by acute respiratory distress syndrome (ARDS), septic shock, and death, despite vigorous antibiotic and supportive therapy. Serologic tests for HIV infection were reported as positive after the patient's demise. The etiology of the patient's pulmonary infection, ARDS, and sepsis was not known until autopsy study revealed enumerable yeast-like cells of Blastomyces dermatitidis in the extensively consolidated lungs and in disseminated foci of infection in most other major organs. Diffuse alveolar damage was closely associated with the pulmonary blastomycosis. Electron microscopic study of the yeast-like cells of B. dermatitidis in the autopsy lung obtained and fixed 5 days after the patient's death revealed excellent preservation of viable organisms.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Giant lamellar bodies in a pulmonary MALT lymphoma: a case report with ultrastructural and immunohistochemical studies.

A 35-year-old, African-American man presented with a 7-year history of a persistent, enlarging pulmonary infiltrate in the right middle lobe associated with three episodes of right-sided pneumonia, recent 12-lb weight loss, and progressive shortness of breath. The nature of the right middle lobe infiltrate was unclear, but recurrent aspiration pneumonia and carcinoma of lung were important considerations. Exploratory thoracotomy with partial lobectomies revealed a low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). Clusters of giant lamellar bodies were a unique finding in this lymphoma. Results of ultrastructural and immunohistochemical studies gave support to the views that these inclusions were derived from both products of cellular degeneration and surfactant. The pulmonary lymphoma subsequently spread to the gastric mucosa. The patient is alive with lymphoma 5 years after the initial diagnosis was made.

Adult↗

PubMedDate not supplied

Papillary eccrine adenoma: an ultrastructural and immunohistochemical study.

A 45-year-old African American man presented with a small, solitary, nonulcerated cutaneous lesion of the right thigh of many years duration, which was excised. Light microscopically, the lesion consisted of an oval, well-circumscribed, intradermal proliferation of tubules, which were often dilated and lined by a double layer of tumor cells with conspicuous intraluminal papillations. Ultrastructurally, there was evidence of both intradermal eccrine duct and eccrine secretory coil differentiation. Although the majority of tumor cells resembled cells of the intradermal eccrine duct, occasional myoepithelial tumor cells and rare tumor cells having secretory granules and resembling dark mucous cells were indicative of eccrine secretory coil differentiation. The positive immunohistochemical staining for S-100 protein, CEA, EMA, and vimentin supported these ultrastructural findings.

Adenoma↗