Diffuse cystic malformation of stomach.
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Biomedical subjects
Publications and source records attributed to V Tchertkoff.
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Computed tomographic study of six cases with primary cerebral non-Hodgkin lymphoma are reviewed. Three had a history of intravenous drug abuse and were diagnosed as having acquired immunodeficiency syndrome (AIDS). All cases presented with space occupying lesions in the frontal lobe with the exception of Case 4. Computed tomography demonstrated multiple lesions in AIDS cases whereas non-AIDS lesions were invariably single. The AIDS patients died within 1 year despite radiotherapy as compared with the non-AIDS patients.
Toxoplasma gondii is the cause of the most common opportunistic infection of the brain in AIDS but is extremely rare as the cause of a solitary lesion of the spinal cord. Symptoms are weakness of the lower limbs followed closely by paralysis unless diagnosed and treated early. We present such a case in an intravenous drug abuser with AIDS and emphasize that MRI is the diagnostic tool of choice and that the index of suspicion should be high in immunosuppressed patients.
BACKGROUND: Subacute measles encephalitis (SME), or measles inclusion body encephalitis (MIBE), is a rare central nervous system (CNS) complication following infection by the measles (rubeola) virus. It usually occurs in young patients with defective cellular immunity from either congenital or acquired causes. In the United States, with the resurgence of measles infection and the human immunodeficiency virus (HIV) pandemic, subacute measles encephalitis should be added to the differential diagnosis in acquired immune deficiency syndrome (AIDS) patients presenting with unexplained CNS manifestations. CASE: A 2-year-old, HIV-positive, white male was admitted for generalized convulsive seizures. Vaccination was described as "up to date." Despite treatment with anticonvulsive drugs, the child continued to develop frequent partial and generalized seizures. Cephalic computed tomography and magnetic resonance imaging revealed a hypodense area in the right parietotemporal cortex without an associated mass effect. Fine needle aspiration biopsy (FNAB) of the affected area showed neuronal reduction, degeneration with eosinophilic intranuclear inclusions, perivascular lymphoplasmacytic infiltration and gliosis. Electron microscopy of the intranuclear inclusions revealed fine, fibrillar, tubular nucleocapsids, consistent with the measles virus. CONCLUSION: Acute measles encephalitis (AME), subacute sclerosing panencephalitis (SSPE), and SME are the three CNS syndromes associated with measles infection. Serum and cerebrospinal fluid (CSF) antibody titres against measles virus are usually high and helpful in the diagnosis of AME and SSPE. In SME, neither serum nor CSF antibody titres against measles are high. Therefore, FNAB is necessary for a definitive diagnosis.
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is one of the most common opportunistic infections, with a range of 4-7% in acquired immunodeficiency syndrome (AIDS) patients. Clinical diagnosis is often difficult, and the specific pathologic agent requires cytologic and pathologic confirmation. CASE: A 38-year-old, Haitian male was admitted with a new-onset seizure disorder. On computed tomography (CT), there were right frontoparietal cortex, right external capsule and right basal ganglia lucencies. Fine needle aspiration biopsy (FNAB) of the radiolucent area revealed foci of white matter demyelination and a few eosinophilic inclusions in oligodendrocytes plus abnormal giant astrocytes. Ultrastructurally, JC virions were observed in the nuclei and cytoplasm of the oligodendrocytes. CONCLUSION: Diagnostic cranial CT-guided FNAB, with cytologic and histologic studies, is extremely valuable in evaluating the nature of central nervous system demyelinated and space-occupying lesions in AIDS.
BACKGROUND: Malignant rhabdoid tumor of the kidney in children is considered a distinct entity. Malignant tumors with rhabdoid features in adults in extrarenal locations and in children over the age of 5 years are considered phenotypic variants. CASE: In a case of recurrent transitional cell carcinoma with rhabdoid features of the kidney in an adult, confirmed immunohistochemically and ultrastructurally, fine needle aspiration cytology showed discohesive, large- to medium-sized polygonal cells with eccentric nuclei; prominent nucleoli; abundant, pink cytoplasm; and paranuclear, eosinophilic density, corresponding to cytoplasmic eosinophilic globules seen in the histologic sections and cytoplasmic filamentous inclusions seen ultrastructurally. CONCLUSION: The cytologic features of malignant rhabdoid tumors are characteristic.