Biomedical subjects
Publications and source records attributed to M T Vidal.
A case of nephrogenic metaplasia of the left ureter occurring in a 7-year-old male child, associated with recurrent urinary infection and previous surgical intervention, is described. This is to our knowledge the third reported case of this entity. Nephrogenic metaplasia involves the transitional epithelium of the urinary tract and results in the formation of structures histologically similar to renal tubules.
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Alveolar leukocyte population was studied by means of image analysis techniques in 110 autopsies of infants who died of congenital pneumonia. Considering the short span-life of polymorphonuclear leukocytes and their morphological regressive changes, the working hypothesis established was that an alveolar leukocyte population constituted of immature or young forms would probably correspond to leukocyte exudated in situ rather than emigrated from the chorioamnional blood vessels towards the amniotic fluid and ultimately inspirated into the lung. For the group 0-6 hours of age two completely separated populations of cases were found, 85% of them probably corresponding to true intrauterine pneumonias and the remaining 15% to cases of inspiration of polluted amniotic fluid. In the 6-12 hour period, intermediate cases appeared and a depopulation of the initial clustering of active cases was evident. In the infants who died between 12 and 24 hours a new clustering of active cases appeared suggesting an infection acquired during the process of birth or immediately after.
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Necrotizing angiitis or vasculitis exhibits a wide clinical spectrum characterized by many different cutaneous manifestations. Diagnosis must be confirmed by histopathology. We studied in retrospect 25 patients whose conditions had been diagnosed by skin biopsy. Histologic examination revealed infiltration by polynuclear cells and fibrinoid necrosis of the walls of the blood vessels in the skin. The great variety of clinical manifestations and etiologies stands out in a review of the records of these patients. Necrotizing angiitis has been found associated with mixed cryoglobulinemia; administration of drugs, milliary tuberculosis, bacterial meningitis, rickettsiosis, staphylococcal sepsis, pharyngotonsillitis, and rheumatoid arthritis. Necrotizing angiitis is a group of diseases with a great variety of clinical manifestations, ranging from benign to fatal. The various entities described to date have been more like different clinical forms of the same disease that distinct conditions. In cases of necrotizing angiitis caused by basically immunological mechanisms, the walls of the blood vessels may be impaired in varying diffuse degrees. The prognosis of the disease depends on the intensity of the inflammation and its repercussions on the parenchymas of different organs. The kidney is the most susceptible organ in this case. Treatment should be directed toward the avoidance of predisposing and etiologic factors, detection of the immunological reaction, requiring careful and individual attention in every case.
The case of a 50-year-old woman with a retroperitoneal paraganglioma and nephrotic syndrome is presented. After the tumor was removed deposits of amyloid material were observed in the paraganglioma, kidneys, and liver. There was no thrombosis of the renal vein. The clinical picture (fever and nephrotic syndrome) was similar to that of patients with amyloidosis associated with neoplasms. The nephrotic syndrome disappeared 8 months after the operation. The patient has not had fever or nephrotic manifestations over the past 4 years and is asymptomatic at the present time. We believe this to be the first reported case of paraganglioma associated with amyloidosis. Nor have we found any references to clinical and biological remission of the nephrotic syndrome following surgical removal of the concomitant neoplasm.
Finding a lymphangioma in the upper digestive tract is a rather infrequent event. A case of a 64-year-old man is reported. Diagnosis was made in the course of an endoscopic oesophagogastroduodenal examination and tumor excision with a diathermy snare at the same time. Two years after resection there was no sign of recidivation of the tumor.
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Two patients are presented with lymphadenopathy, hepatosplenomegaly and infiltration of the bone marrow with plasmocytoid cells in whom an important heterogeneous hyperimmunoglobulinemia was detected (3.18 and 5.85 g/100/ml). Autopsy showed widespread poorly differentiated lymphocytic lymphoma with plasmocytoid differentiation in the first case and a well differentiated lymphocytic lymphoma with plasmocytoid differentiation involving lymph nodes, marrow, spleen, liver and kidney in the second case. High concentrations of IgM and IgG were detected in lymph node and spleen homogenates from this case. After splenectomy and cyclophosphamide the immunoglobulins decreased. It is suggested that both cases had a malignant lymphoma with plasmocytoid differentiation and polyclonal gammopathy.