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Biomedical subjects

L R Matz

Publications and source records attributed to L R Matz.

At least 37 records · Page 2Linked to original sources

The complex of myxomas, spotty pigmentation and endocrine overactivity.

We describe a 40-year-old male with acromegaly, multiple and recurrent cutaneous myxomas, spotty cutaneous pigmentation, a mammary myxoma, a large-cell calcifying Sertoli cell tumour of the testis, and an unusual calcifying pigmented neuroectodermal tumour. He presented a combination of clinical and histological features not previously documented within the complex of myxomas, spotty pigmentation and endocrine overactivity, and therefore the findings broaden the spectrum of the syndrome.

Acromegaly↗

Asbestos related interstitial pneumonitis associated with glomerulonephritis and lymphomatoid granulomatosis.

We report a case of pulmonary asbestosis in a patient who also developed glomerulonephritis and lymphomatoid granulomatosis. The pulmonary reaction was unusual, characterized clinically by an acute onset of symptoms after a prolonged latent period and morphologically by an interstitial pneumonitis with prominent desquamative features and a paucity of fibrosis. The association of pulmonary asbestosis with glomerulonephritis and lymphomatoid granulomatosis has been hitherto unreported.

Asbestosis↗

Renal failure and upper urinary tract obstruction after retrograde pyelography with potassium bromide solution.

Two iodine-sensitive women in whom potassium bromide solution was used as a radiocontrast agent for retrograde pyelography developed similar clinical conditions culminating in renal failure. Renal failure was due to upper urinary tract obstruction from fibrosis and fat necrosis in each case. Similar histological findings have been described in rabbit bladder exposed to sodium bromide solution. Different patterns of exposure corresponded with different sites of major damage in the two cases. One patient, who had repeated studies of the pelvicalyceal system with potassium bromide developed papillary necrosis. Systemic exposure to bromide-releasing compounds (in animals) and to bromides (in humans) has also been associated with papillary necrosis.

Adult↗

Endoscopic, histological and ultrastructural correlations in the diagnosis of colitis.

The accuracy of the endoscopic diagnosis, found at fiberoptic distal-colonoscopy, was assessed by correlation with the histological findings of multiple colo-rectal biopsies. Of 25 subjects with normal colon at endoscopy, 18 (72%) had normal histology, while 7 (28%) had histological evidence of mild non-specific colitis (6 cases) or Crohn's colitis (one case). Of 15 cases with endoscopic appearance of mild colitis, histological sections showed mild non-specific colitis in 12 (80%), idiopathic ulcerative colitis in one and Crohn's colitis in another. In 12 patients with an endoscopic diagnosis of moderate-severe colitis, histology confirmed moderate to severe idiopathic ulcerative colitis in 9 (75%) and severe Crohn's colitis in 2. Pseudomembranous colitis was confirmed by histology in 2 out of 3 cases detected by endoscopy. Electron-microscopy, although amplifying the histological findings, did not provide any specific diagnostic information. It is concluded that histological studies of multiple colo-rectal biopsies can significantly improve the diagnostic accuracy of distal-colonoscopy. Biopsies should therefore be obtained routinely in colonoscopy even if the appearances look normal.

Adult↗

Inter-observer variation between pathologists in the classification of cutaneous malignant melanoma in western Australia.

Inter-observer variation between six pathologists in their application of histological classifications during a survey of cutaneous malignant melanoma was analysed using kappa statistics. The highest levels of adjusted agreement were attained for tumour thickness and the presence of ulceration; intermediate levels were achieved on cross-sectional profile, level of invasion, histogenetic type, solar elastosis and the presence of an associated benign melanocytic lesion; agreement on other histological features of melanoma tended to be relatively poor. The problems experienced in the interpretation of these classifications are discussed and suggestions for their improvement are offered.

Australia↗

Inter-observer variation in the histopathological reporting of Hodgkin's disease: an analysis of diagnostic subcomponents using kappa statistics.

Levels of agreement between nine pathologists on the Rye classification of Hodgkin's disease and on diagnostic subcomponents used in applying the classification, were analysed by kappa statistics. Pathologists experienced comparatively little difficulty in agreeing on the presence of nodules and lacunar cells and hence best agreement was achieved on the nodular sclerosis category. Poorer agreement levels on the lymphocytic predominance, mixed cellularity and lymphocytic depletion categories were explained mainly by problems in the assessment of numbers of lymphocytes and abnormal reticulum cells other than Reed-Sternberg cells. Identification of the Reed-Sternberg cell, although of paramount importance to a diagnosis of Hodgkin's disease, appeared to have no great practical relevance to use of the Rye classification in this series of cases.

Cell Count↗

An improved method of analysis of observer variation between pathologists.

An improved method of analysing interobserver variation in histopathological studies is described and illustrated, by use of data from a congruence survey of malignant melanoma. The method provides, between any number of pathologists, an assessment of overall agreement and of agreement on each individual category of a classification system. Adjustment for differences in chance agreement due to varying numbers of categories or an altered composition of cases is included in the analysis. A generalization of the procedure designed to measure the strength of associations between different categories is formulated and explained with the use of an example.

Humans↗

Ischaemic cholecystitis and infarction of the gallbladder.

The clinicopathological features of forty three patients with gallbladder disease are presented where ischaemia appeared to be the primary aetiological factor. Histopathological changes of severe ischaemia (ischaemic cholecystitis) were present in 16 patients and of infarction of the gallbladder in the remaining 27 patients. All patients with ischaemic cholecystitis and 19 of the patients with infarction of the gallbladder had a thick walled gallbladder due to a serosal reaction, and these 35 gallbladders all contained calculi. The remaining eight patients with infarction of the gallbladder had a thin walled gallbladder without serosal reaction. Only two of these patients had gallbladders that contained calculi. The pathogenesis of thick walled ischaemic cholecystitis or infarction appeared to be related to intramural vascular insufficiency which accompanies calculus disease of the gallbladder. Thin walled infarction of the gallbladder appeared to develop as a result of extramural arterial insufficiency due to arterial disease, thrombosis or trauma. The clinical course of thick walled ischaemic gallbladder disease was not significantly different from severe acute cholecystitis with calculi. However, 75% of the patients with thin walled infarcted gallbladders were severely ill from their associated illness or trauma, and nearly all died.

Adult↗

Angiographic findings in normal and diseased gallbladders including ischaemic cholecystitis and infarction of the gallbladder.

Angiographic studies were performed on 60 normal and diseased gallbladders obtained from cholecystectomy specimens and necropsy examinations. The normal macro and microangiographic pattern was confirmed, as was the reduction in the number of blood vessels in chronic cholecystitis and cholelithiasis. Histological correlation however showed that the degree of arteriographic change paralleled the degree of histological disease. The microvascular pattern was directly related to the degree of mucosal villous atrophy, a change which may be important in the pathogenesis of some types of gallbladder disease. The most severe angiographic changes occurred in the case of ischaemic cholecystitis, and contrasted with the normal blood vessel pattern in a case of thin walled infarction of the gallbladder.

Angiography↗

Reversible renal failure due to renal cholesterol embolism.

A fifty-nine-year-old male developed acute renal failure as a result of renal cholesterol embolism following an arch aortogram. He recovered satisfactory renal function after a period of peritoneal dialysis. The clinical spectrum of renal cholesterol embolism is briefly reviewed.

Acute Kidney Injury↗

Nodular lymphomas with intracellular immunoglobulin inclusions: report of three cases and a review.

Three cases of nodular lymphomas with cytoplasmic inclusions were studied histologically, histochemically and immunocytochemically, and ultrastructurally. One case had Russell body-like inclusions, another had needle-like inclusions not previously reported, while the last showed cells with cytoplasmic vacuoles. Two of the cases were followed to necropsy. New observations are described and the available literature is reviewed.

Aged↗

Collagenous colitis: a case report and review of the literature.

A case of collagenous colitis is reported and the literature reviewed. The disease presents with watery diarrhea and abdominal pain in middle-aged subjects. Women predominate in the small number of reported cases. Colonic and rectal biopsies show excessive collagenization of the so-called collagen table in the superficial lamina propria. There is an associated degeneration and desquamation of the interglandular epithelial lining cells. The cause is not known but the clinical course with symptomatic treatment can wax and wane with corresponding deterioration or improvement in the biopsy features.

Adult↗

The Rye classification of a population based series of Hodgkin's disease patients in Western Australia.

Data are presented on the incidence in Western Australia of subtypes of Hodgkin's disease which were obtained by review of all cases of the disease notified between 1960 and 1974. Observations were also made on within- and between-observer agreement on the use of the Rye classification by a group of 9 surgical pathologists, all in the day-to-day practice of pathology. Although many consensus diagnoses were made only after spirited discussion by the Group, the results suggested that general surgical pathologists can perform nearly as well as lymphoma experts. A comparison of the incidence of Hodgkin's disease and distribution of Rye subtypes in Western Australia with 4 other populations showed a similar overall incidence but appreciable variation in the relative frequency of the subtypes--mainly in the proportions of nodular sclerosing and mixed cellularity.

Adolescent↗

Arthritis associated with a crystallizing cryoprecipitable IgG paraprotein.

A crystallizing IgG-lambda cryoprotein was found in the synovial fluid of a patient with peripheral erosive arthritis and tenosynovitis. The same crystallizing paraprotein could be demonstrated in serum incubated at 4 degrees C, but its formation could be inhibited by the in vitro addition of D-penicillamine. Crystals were present in synovial tissue and appeared to be initiating an inflammatory reaction via complement activation. Slit lamp examination showed crystals in Bowman's membrane. Plasmapheresis led to temporary improvement in the synovitis and tenosynovitis.

Arthritis↗

The origin of multinucleate giant cells in myeloma kidney from mononuclear phagocytes: an ultrastructural study.

Ultrastructural examination of a biopsy of a myeloma kidney has shown structural relationships between the multinucleate giant cells which characterize this condition and macrophage polykarya. On the other hand, no evidence was found of any resemblance to renal tubular cells. Moreover the electron microscopic observations indicate that these multinucleate giant cells, in common with the mononuclear phagocytes, attempt to ingest the cast material which in addition becomes fibrillar in the zones of endocytosis. No such phenomena were observed in the vicinity of tubular cells. In conclusion the ultrastructural evidence suggests that the multinucleate giant cells of myeloma kidney are derived from mononuclear phagocytes.

Female↗