Biomedical subjects

U Khettry

Publications and source records attributed to U Khettry.

58 records · Page 4Linked to original sources

PubMedDate not supplied

Human infection caused by Exophiala pisciphila: case report and review.

One year after receiving a liver transplant and 2 months after treatment with high doses of steroids and monoclonal anti-CD3 for an episode of rejection, a 38-year-old woman developed a skin papule above the left medial malleolus. The papule, which at first had an annular shape, evolved into a pustule, ulcerated, drained, and assumed a crusted verrucous appearance. Multiple satellite papules appeared around the lesion, which was incompletely excised and thought to represent squamous cell carcinoma. Review of the histologic slides revealed pseudoepitheliomatous hyperplasia with multiple epidermal and dermal abscesses, pigmented hyphae, and yeast-like forms. Culture of material obtained at reexcision yielded a dematiaceous fungus that was identified as Exophiala pisciphila. No evidence of dissemination was found. This represents a unique report of human infection with this fungus, a well-recognized pathogen of fish. Except for the absence of sclerotic bodies, the clinicopathologic features resembled those of chromoblastomycosis rather than those of the subcutaneous cystic form of phaeohyphomycosis often associated with species of Exophiala.

Adult↗

PubMedDate not supplied

Immunocytochemical staining of Kupffer and endothelial cells in fine needle aspiration cytology of hepatocellular carcinoma.

OBJECTIVE: To evaluate the significance of the presence of Kupffer and endothelial cells in distinguishing hepatocellular carcinoma (HCC) and adenocarcinoma (AC) on cytologic smears. STUDY DESIGN: Fine needle aspiration biopsies (FNABs) from 43 cases, 21 HCC and 22 AC (8 primary and 14 metastatic), were immunostained for Factor VIII and vimentin as markers for endothelial cells and Kupffer cells, respectively. Cytologic diagnosis was verified by histologic and/or clinical follow-up. RESULTS: Eighteen of the 21 cases (86%) of HCC and 11 (5 primary and 6 metastatic) of 22 cases (50%) of AC showed positive immunostaining for Factor VIII (P = .02). Vimentin immunostaining was positive in 55% of HCCs and 41% of ACs (P = .74). Forty-five percent of cases of HCC showed immunostaining for both Factor VIII and vimentin, while 22% of cases of AC showed immunostaining for both Factor VIII and vimentin (P = .18). CONCLUSION: Immunocytochemical identification of endothelial cells using Factor VIII may have important diagnostic value in separating HCC from adenocarcinomas in liver FNABs. The presence of Kupffer cells labeled with vimentin has no diagnostic significance in FNAB of these tumors.

Adenocarcinoma↗

PubMedDate not supplied

Intracytoplasmic inclusion bodies of erythrocyte origin within hepatocytes in a hepatic allograft.

Intracytoplasmic inclusion bodies with an unusual immunohistochemical profile, histologically similar to alpha 1 antitrypsin globules and megamitochondria, were seen within hepatocytes in a liver allograft biopsy. Electron microscopy revealed that these structures were erythrocytes in various stages of degradation. Their appearance following an episode of Pneumocystis carinii pneumonia suggests a possible relationship between bouts of hypoxia and erythrocyte entry into hepatocytes.

Adult↗

PubMedDate not supplied

Neuropathology of liver transplantation.

We reviewed retrospectively the clinical records, autopsy protocols and central nervous system tissue sections of 50 patients who underwent orthotopic liver transplantation for end-stage liver disease between 12/83 and 8/93. The postoperative survival period ranged from hours (6), weeks (17), months (17), to years (10). All patients received immunosuppressive drugs from the immediate postoperative period to the time of their death (cyclosporine, steroids; occasionally azathioprine, OKT3, FK506). Nineteen patients had neurological manifestations (hepatic encephalopathy) prior to surgery. Post-transplant neurologic signs and symptoms included: hepatic encephalopathy/altered mental status (11), focal or generalized seizures (9) and stroke (2). In the majority of cases (37) the cause of death was septicemia and/or bleeding diathesis. The neuropathologic findings present in 36 patients could be classified into 3 distinct categories: metabolic disorders: hepatic/anoxic encephalopathy, central pontine myelinolysis (15); cerebrovascular disease: subarachnoid and/or intracerebral hemorrhage, bland or hemorrhagic infarction (23); and infection: bacterial meningitis/cerebritis, multifocal fungal microabscesses, presumptive viral meningitis/encephalomyelitis (10). In conclusion, 72% of 50 patients who came to autopsy after liver transplantation were found to have neuropathologic abnormalities; these abnormalities were predominantly infections and vascular diseases.

Adult↗