Intracardiac ectopic thyroid.
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Biomedical subjects
Publications and source records attributed to L Pollice.
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Lymphoadenopathic Syndrome (LAS), diagnosed also with histologycal studies, is described in a polytransfused 11-year old boy affected by beta-thalassemia major. After three days of the admission he suffered a serious acute diarrhea by Aeromonas hydrophila, an opportunistic enteric bacteria demonstrated, up to date, in immunocompromised patients and never in AIDS patients. It is important to remark that beta-thalassemic patients are at high risk from HIV infections, either for the chronic need of transfusions and for the impairment of the immunological functions.
Cells with argyrophil granules were searched for in 131 consecutive specimens obtained from endometrial curettage. Particular care was taken with the fixation methods to avoid a false positivity to the silver impregnation according to Grimelius. We did not consider the grossly argyrophilic positivity on the cellular apex or of the whole cytoplasm, which was partially reduced by diastase digestion and probably due to the presence of glycogen and secretory mucoproteins. Cells with thin argyrophilic granules similar to those observed in endocrine APUD cells were present among glandular cells and/or among stromal cells in 15 of 131 examined specimens. They concerned 5 cases of proliferative endometrium, 3 of secretive endometrium, 5 of hyperplasia, and 2 of carcinoma. In 8 of the 15 cases with argyrophilic cells, immunohistochemical studies with the PAP method showed cells with the presence of FSH, S-100 protein, somatostatin, vasoactive intestinal peptide (VIP), gastrin, and neuron-specific enolase (NSE). The significance and origin of these cells in normal and neoplastic endometrium are discussed.
Intracardiac thyroid goiter (struma cordis) is an exceptionally rare finding. To our knowledge, only two cases have been reported in the literature to date. A middle-aged woman was the subject of our case, in which an intracardiac tumor was clinically diagnosed and surgically resected. The mass, adhesive to the ventricular septum and obstructing the right ventricular outlow tract, histologically was formed by thyroid tissue, separated from the myocardium by fibrous tissue. The woman died of renal failure two weeks after the operation, and at autopsy the thyroid gland showed strumous changes. The similarity to previously reported cases suggests a dysembryologic origin of this ectopia.
In a mediastinal teratoma containing pancreatic tissue rich in islet cells, immunofluorescence studies showed a high degree of differentiation of the endocrine tissue. Insulin-, glucagon-, somatostatin-, and pancreatic polypeptide(PP)-containing cells were all consistently represented. They showed the same precise topographic distribution that is seen in normal islets (i.e., a central core of insulin-containing cells with the other cell types in a peripheral position) and that is thought to be important for the integrated function of the islets. This may explain the absence of clinical symptoms of hypoglycemia. In addition, a nonrandom distribution of endocrine cell types, with PP-rich and PP-poor areas, similar to that found in pancreatic regions embryologically derived from the ventral and dorsal anlagen, respectively, was observed. This finding suggests that the unknown mechanisms responsible for the dissimilar endocrine cell contents in pancreatic regions of different embryologic origins were operating in the teratoma.
A case of inflammatory fibroid polyp of the rectum in an 8 years old boy is reported. This lesion is not infrequently found in the gastro-intestinal tract, is very rare in childhood and has never been reported in the rectum. The pathogenetical hypothesis that fibroid represents a dynamic response to recurrent small injuries with possible different histological patterns is prospected.
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