An ultrastructural study of intranuclear rodlets in a malignant extracranial neuroepithelial neoplasms.
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Biomedical subjects
Publications and source records attributed to K W Min.
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The clinicopathologic data of 5 patients who died of nonbacterial thrombotic endocarditis (NBTE) and disseminated thrombosis and multiple infarcts associated with mucin-producing adenocarcinomas were presented. Histochemical studies on the valvular vegetations and thrombi revealed that histochemically stainable mucinous substance was an integral part. In 1 patient, circulating mucinous substance was found prior to the development of NBTE and disseminated thrombosis, and the identical mucinous substance was found in the tumor tissue, indicating a possible pathogenetic role of tumor mucin in NBTE-associated mucin-producing adenocarcinomas. Our observations and reports of others suggest that intravascular mucin may be responsible for the clinical syndromes of mucinous malignancies, venous thrombosis, and NBTE with emboli.
A case of prostatic adenoma believed to originate from the prostatic duct is described. There were morphologic similarities to basal cell adenomas of salivary glands, and it was concluded that the tumor is a benign counterpart of "salivary gland" carcinomas, rarely observed in the prostate.
We describe two adults with fulminant pneumococcemia and disseminated intravascular coagulation aftertraumatic splenectomy. One died in a few days, and the other survived with amputation of gangrenous toes and fingers. Although the relationship between the serious blood-borne bacterial infection with disseminated intravascular coagulation and lack of adequate splenic tissue has been well established, the mechanism is poorly understood and there are no specific therapeutic measures available. We review the literature in regard to the possible prophylactic measures and discuss the benefits of various measures.
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Red cell aplasia and an enlarging anterior mediastinal mass developed in a patient being followed for thyroid carcinoma. Differential diagnosis included thymoma and metastatic thyroid carcinoma. Preoperative scanning demonstrated significant uptake of 75Se-selenomethionine whereas 67Ga-galiium citrate failed to visualize the mass. Subsequent thoracotomy revealed a lymphocytic thymoma which was resected, resulting in reversal of the red cell aplasia. The use of 75Se-selenomethionine scanning maybe a useful adjunct in the preoperative evaluation of suspected thymomas.
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A veterinarian's assistant who sniffed methoxyflurane as a euphoriant developed fulminant hepatitis and died of hepatic failure. The abuse of fluorinated anesthetics has been reported and may be more frequent than is commonly believed. It is suggested that fluorinated anesthetics should be considered as a causative agent in a case of fulminant hepatitis, especially in patients who have easy access to such drugs.
The case of a patient who had palpable purpura on his lower extremities due to Lactobacillus-caused subacute bacterial endocarditis is reported. Histologic examination of the purpuric lesions demonstrated a leukocytoclastic angiitis. It is postulated that purpuric and other cutaneous lesions of subacute bacterial endocarditis are related to circulating immune complexes.
Biopsy specimens of intestinal mucosa from two patients with malabsorption syndrome were examined with routine light and electron microscopy. Both showed intact intestinal mucosa, but by electron microscopy, the presence of Giardia lamblia in the intervillar spaces was identified. Electron microscopy is useful for the identification of this parasite, since the stool examinations in up to 50% may be negative. The parasites appear in light microscopy as cellular debris and can be easily overlooked, while by electron microscopy the typical morphologic features of the parasite are diagnostic.
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An association between viral hepatitis and two rheumatic disease syndromes has been observed. Twenty-nine patients manifested a transient polyarthritis, sometimes associated with a rash (Group I). Ten patients were seen with a multisystem disease (Group II). Histologic evidence of arteritis or glomerulonephritis was present in seven of ten patients with multisystem disease. Liver tissue from 18 patients showed morphologic evidence of hepatitis with viral features in 9 of 10 patients in Group I and in 6 of 8 patients in Group II. Hepatitis B surface antigen (HBsAg) and/or antibody to HBsAg were detected in sera of all 39 patients. Abnormal liver functions were present in 36. Twelve Group I patients and 2 Group II patients became jaundiced. Rheumatoid factor was present in sera of seven patients in each group. The third component of complement (C3) was depressed in 13 patients in Group I and 7 patients in Group II. The fourth component of complement (C4) was decreased in 8 of 21 Group I and 3 of 7 Group II patients. Synovial fluid C3 was decreased in 2 of 11 Group I and 1 of 4 Group II patient's fluids. Articular inflammation in patients with transient polyarthritis responded in three to seven days to aspirin, acetominophen and/or bedrest alone and rashes disappeared spontaneously. Patients with multisystem disease generally had a prolonged illness and responded somewhat unpredictably to prednisone or a combination of prednisone and cyclophosphamide.
Ultrastructural features of neoplastic cells can provide clues for correct diagnosis when light microscopy fails. Secretory granules are characteristic in the following tumors: mucin granules in poorly differentiated adenocarcinomas, zymogen granules in acinic cell carcinomas, lysosomal granules in prostatic carcinomas, melanin granules in malignant melanoma, carcinoid, islet cell tumors, pheochromocytoma, and neuroblastoma granules in the corresponding neoplasms. Among cytoplasmic organelles, rough surfaced endoplasmic reticulum characterizes adrenocortical, ovarian, and hepatocellular carcinomas and plasmacytomas. Tonofibrils are characteristic of squamous cell carcinomas. Glycogen deposits distinguish Ewing's sarcoma from lymphoreticular neoplasms. Intercellular relationships and membrane specialization are important features in the differential diagnosis of various undifferentiated tumors. The frequent resolution of difficult diagnostic problems by electron microscopy outweighs the disadvantages of this technique, such as the expense and time required.
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