Biomedical subjects
Publications and source records attributed to V Zeman.
A dysontogenetic cyst in the edge of the tongue in 1-year old boy was found lined with gastric, duodenal, and intestinal mucosa with its own lamina muscularis mucosae, with a thin layer of submucous connective tissue encircled by bundles of smooths muscle imprecisely separated from the striated lingual muscle.
Foamy cells were found in the stroma of 23 out of a total of 1,073 differentiated carcinomas of the thyroid gland investigated during the 1946--1977 period, i. e. in 2.1% of the cases concerned. Of these, 15 carcinomas with foamy cells showed purely papillary differentiation, while the remaining 8 showed mixed papillofollicular structures. Apart from the papillary structure, the development of foamy cells may have been associated with hypercholesterolaemia due to hypothyroidism.
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A female aged 22 died 13 hours after having given birth to a live mature fetus. On autopsy, bilateral phoechromyocytomas, a mucosal neurofibroma of the tongue and a solid medulary carcinoma of the thyroid with amyloid associated with Hashimoto's lymphocytic thyroiditis were detected. After parturition, there occurred bleeding into the left-side pheochromocytoma followed by a release of phenyl alkylamines into the circulation. This resulted in fatal peripheral circulatory failure.
A collision carcinoma of the thyroid was revealed in a surgically removed thyroid affected with Hashimoto's thyroiditis. A follicular carcinoma composed of rather uniform and spherical cells. The anaplastic carcinoma appeared to collide with structures of a noncornifying squamous cell carcinoma supposed to originate in the isthmic area from a ductus thyreoglossus cyst.
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In patients aged 79, 80 and 81 cardiac malformations were found at autopsy which did not permit to decide with certainty whether they were congenital or acquired. In the first case the lesions appeared as a band-shaped fibromuscular subvalvular aortic stenosis, the second one being an isolated aneurysm of the membranous septum directed to the righ side and combined with a minute diverticulum in the muscular part of the interventricular septum. The apex of the aneurysm faced the septal cusp of the tricuspid valve. From its dorsocranial circumference two tunnel-like formations projected in the dorsocranial direction terminating blindly beneath the atrial septal endocardium. The ventral canal protruded into the right, the dorsal one into the left atrium. Rather marked regressive changes and areas of florid chronic inflammation were found in the terminal parts of these channels. In the third case observed the pathological lesion were aneurysms of the Valsalva sinuses.
In a surgical series of 54 carcinomas of the thyroid in children under 15 years of age (22 males, 32 females), differentiated carcinoma was disclosed in 50 cases. Of these, the pattern was purely papillary in 5, purely follicular in 3 and mixed, i.e. papillary and follicular, in 42 cases. There was an admixture of a solid component in 25 of the mixed cases. In one case the tumour was solid medullary carcinoma with amyloid and 3 cases appeared to be anaplastic carcinomas. In 21 cases the material available for microscopical examination was both that of the primary focus and of a metastasis. In only 2 of such cases the pattern was identical in the primary carcinoma showed a purely follicular pattern in the metastases. In the remaining 18 cases the primary carcinomas appeared as structurally uniform but showed an admixture of the other differentiated component or of a solid one in the metastases. The reverse also occurred in some cases. Therefore it appears to be impossible to assess the pattern of the primary growth from its metastasis. No essential difference was disclosed in the tendency of histologically different neoplasms to metastasize. During orientational histological examination of the removed glands intrathyroidal metastases were revealed in 66%. The discrimination between the two extreme and consequently even the mixed variety of differentiated carcinomas is of no practical significance in childhood because there is no obvious correlation between the histological pattern and formation of metastases, as well as between histology and induction of hormonal function. Age and sex seems to play a more significant role in the biological behaviour in children. The incidence of carcinoma is higher in females, whereas the biological behaviour seems to be worse in males.
The study has been based on an autopsy series of 474 unrecognized valvular defects of the left heart in high age groups beyond 65. The series comprised 186 males and 288 females with an average age of 77. The incidence of valvular defects was 4.02%. There was a significantly higher incidence of mitral valve insufficiency than in lower age groups of clinically recognized valvular defects (10.75%). The ratio of mitral insufficiency to the stenosis of the left venous ostium and combined mitral defect with prevalence of stenosis was 1:4. The prevalence of males in the series of isolated stenosis of the left arterial ostium attained only 1.35:1.
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