Biomedical subjects
Publications and source records attributed to S Lipper.
A 62-year-old woman developed a recurrent mucinous sweat gland adenocarcinoma of the eyelid. The clinical characteristics of this rare, primary adnexal neoplasm of skin in our patient were, to our knowledge, unique. The tumor mimicked a lacrimal sac tumor and had orbital extension demonstrated preoperatively by computed axial tomography. Orbital extension of the tumor mass was confirmed during a wide, en bloc, excisional biopsy.
A 37-year-old man underwent an enucleation of his left eye because of a lesion that demonstrated the clinical and fluorescein angiographic characteristics of a malignant melanoma. Histologic examination of the eye disclosed a chorioretinal inflammatory mass caused by refractile crystalline material.
Solitary juvenile polyps are common lesions whose pathogenesis is poorly understood. Multiple juvenile polyposis is characterized by large numbers of these lesions either confined to the colon or throughout the gastrointestinal tract. A study of two cases of multiple juvenile polyposis provided fresh insight into the pathogenesis of juvenile polyps and their relationship to colonic adenomas. Mucosal ulceration in very early lesions, together with glandular epithelial calcification, suggested that impaired cell renewal resulting from disturbed regenerative kinetics may predispose to surface epithelial erosion, setting in motion a cycle of ulceration, inflammation, and granulation tissue formation. We postulate that a dyskinetic continuum may link juvenile, "metaplastic," and adenomatous polyps. The finding in our second case of multiple adenomatous lesions, including a villoglandular polyp, emphasizes the neoplastic potential of juvenile polyposis.
A six year old boy with bilateral breast enlargement was found to have a normal endocrine status. Resected tissue revealed the features of pseudogynecomastia due to a proliferation of fibrous tissue traversed by neuroid structures. Multinucleated giant cells were present within the fibrous tissue. Ultrastructural study revealed organized nerve elements in a collagenous stroma. The multinucleated giant cells appeared to be variants of the predominant stromal fibroblasts.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Juvenile polyps are generally considered to have no malignant potential. We report a 16-year old patients with juvenile polyposis coli who presented with diarrhea and hypoproteinemia. Some of her polyps had adenomatous histologic features and a large villoglandular polyp was present in the cecum. The usual nonoperative management of patients with juvenile polyposis may not be appropriate when the polyps show mixed histology. These patients are at risk to develop malignancy although the magnitude of risk is uncertain.
Experience with some of our patients suggests that the diagnosis of subacute sclerosing panencephalitis (SSPE) may be made early and confirmed by the demonstration of high levels of measles complement-fixing antibodies in the cerebrospinal fluid (CSF) and serum, in the absence of classic clinical, electroencephalographic or brain biopsy support for the diagnosis. It is not known when the measles-specific antibodies first appear in the CSF, but these 3 atypical cases suggest that they were present in high titre early in the disease.
A 55-year-old female developed a rapidly fatal, infiltrative, bilateral pulmonary disease. Open lung biopsy and subsequent autopsy revealed diffuse involvement by a malignant lymphoproliferative condition showing a striking angiocentric and angioinvasive pattern. This feature, together with microscopic involvement of hilar lymph nodes, bone marrow, spleen, and other viscera suggested lymphomatous transformation of lymphomatoid granulomatosis (LYG). The paucity of necrosis and of the typical polymorphic infiltrate was at variance with the classical description of that condition; however, the bilaterality of the process and the distinctive angioinvasive growth pattern were unlike the typical primary pulmonary lymphoma. Plasmacytoid cells were observed both by light and electron microscopy. Immunohistochemicl evaluation characterized this disease as a monoclonal lymphoproliferative malignancy.
A 50 year old man presented with lower abdominal pain and hypotension of sudden onset. Emergency laparotomy for a suspected ruptured abdominal aortic aneurysm revealed the source of hemorrhage to be a ruptured vessel in the vascular pedicle of a large, oval tumor. This tumor had a unique appearance, lying virtually free within the abdominal cavity except for a 17 cm long umbilical cord-like vascular attachment to the greater omentum and a single fibrous adhesion to the anterior abdominal wall. Histologic examination disclosed the features of fibrosarcoma with a prominent population of myofibroblasts. Review of the literature yielded no previous examples of a similar pedunculated fibrosarcoma.
A 38-year-old patient with chronic alcoholism was on chemotherapy for acute myelomonocytic leukemia and developed purpuric and erythematous papules. Skin biopsy showed a vasculitis. Subsequent autopsy revealed disseminated tuberculosis with a poor cellular response. This case calls attention to the lack of tuberculoid granulomatous reaction is anergic patients and to the need of pathologists to suspect tuberculosis when necrotizing vasculitis in the skin is encountered in a patient with decreased immunological competence.
The avian sarcoma virus-induced glioma model in rats was used to evaluate radiation dose response (survival curves), giving fractionated treatments to the whole head. Groups of 14 to 20 rats received total doses of 2300, 4600, or 5750 rads over 2, 4, or 5 weeks, respectively. Median group survival times were compared to controls and to each other. All doses of radiation significantly prolonged survival with reference to control. The 4600- and 5750-rad doses were significantly more effective than the 2300-rad dose. In another series of experiments, BCNU chemotherapy (10 mg/kg) was combined with 2300 and 4600 rads radiation therapy. Synergism of therapies was demonstrated. Methylprednisolone acetate (2 mg/kg twice weekly over 4 weeks) alone did not affect survival curves, and its combination with 4600 rads radiation therapy negated the prolongation of survival achieved with 4600 rads alone.
The antidepressant and other behavioral effects of clorgyline, a preferential inhibitor of monoamine oxidase (MAO) type A, were compared with those of pargyline, a preferential inhibitor of MAO type B, in 16 depressed patients. In a subgroup of more severely depressed patients, clorgyline treatment for 4 weeks resulted in significant improvement on both observer-rated and self-rated scales, while minimal changes occurred during pargyline treatment. Similarly, in a crossover study that included 8 patients examined with multiple scales, clorgyline had generally greater antidepressant and antianxiety effects than did pargyline, although pargyline had some activating effects and also tended to produce more side effects. MAO type A inhibition may be more important than MAO type B inhibition for antidepressant efficacy.
During 4 weeks of treatment with clorgyline, a selective MAO-A inhibitor, platelet monoamine oxidase (MAO) activity was unchanged. During a similar 4-week crossover treatment period with pargyline, a selective MAO-B inhibitor, platelet MAO activity was essentially completely inhibited in the same individuals. The differential effects of the two drugs on platelet MAO, which consists exclusively of the MAO-B form, suggests that the in vitro selectivity of clorgyline, and possibly of pargyline, on MAO-A and MAO-B may be maintained in vivo during long-term administration in man. Reductions in blood pressure, heart rate, and plasma amine oxidase activity were generally similar in magnitude during treatment with both drugs, however, suggesting that either these effects are nonspecific consequences of both MAO-A and MAO-B inhibition, or that pargyline also inhibited MAO-A activity.
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