[Splenic morphology in angiographic investigations (author's transl)].
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Differences noted in enzyme II directed RNA synthesis under varying salt conditions in nuclei isolated from uninfected and Friend virus (FV)-infected spleen cells, have been attributed to chromosomal modifications (Babcock and Rich 1973). This investigation was undertaken to determine if compositional changes occur in the chromatin of FV-infected spleens, which correlate with an altered rate of synthesis by enzyme II. A quantitative study of the chromatin constituents at various times after infection indicated that they vary in the same temporal manner as the rate of RNA synthesis in isolated nuclei. Relative to DNA, RNA, histone, and nonhistone protein reached a maximum at 14 days postinfection. This was followed by a gradual decrease during the remainder of the infection. Chromatin endogenous DNA-dependent RNA polymerase activity varied in the same manner, suggesting that RNA synthesis directed by enzyme II is modulated by chromosomal proteins.
A 39 year-old man presented for surgery with epigastric pain, tachycardia, hypotension and a progressive decrease of hemoglobin due to blood loss. Immediate abdominal ultrasonography followed by prompt paracentesis revealed massive intraperitoneal hemorrhage. During emergency laparotomy, a linear, actively bleeding rupture of an enlarged spleen was found and splenectomy was performed. The patient survived and the post-operative course was uneventful. Histopathology of the spleen as well as bone marrow biopsy confirmed the diagnosis of T-Cell lymphoma. Chemotherapy was initiated 3 weeks after surgery. To the best of our knowledge, this is the first reported case of previously undiagnosed T-Cell lymphoma presenting as pathologic rupture of the spleen.
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A 20-yr-old female Père David's deer (Elaphurus davidianus) died following a 3-wk history of depression, anorexia, and progressive respiratory distress. At necropsy, numerous soft to firm, tan or blood-filled nodular structures, 1-6 cm in diameter, were noted in the lung and the visceral and parietal pleura and within the mediastinum. Similar nodules were also found in the liver, spleen, kidney, and lymph nodes. Histologically, the nodules were diagnosed as hemangiosarcoma. A benign teratoma was present in the left ovary.
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Although its role and importance is debated, Immunoscintigraphy (IS) remains a popular technique in Malignant Melanoma (MM) follow-up for postoperative assessment. Between April 1990 and December 1996, 287 consecutive patients underwent 650 IS examinations at our Department. Only data on 114 patients, operated up to December 1993, with a follow-up of at least 7 years are given here. IS results were compared to physical examination, to other imaging modalities and, where available, to histology. IS specificity and sensivity, concerning detection of melanoma metastases in lymph nodes, skin, brain, lung, visceral sites and bone, ranged from 37.5% and 22% to 100%. Our results indicate a high diagnostic accuracy of IS only for lymph node examination, but not for other possible locations of melanoma metastases. In our experience IS cannot be recommended for staging of melanoma patients, and should only be used in association with other imaging modalities.
The relationship of age, sex, clinical findings and prognosis was studied among 30 children with malignant reticuloendotheliosis. A male predominance was found, but it was not possible to make any prognostic correlation regarding this parameter. A definitive worse prognosis was found in the early ages, thus 88% of less than 12 months-old children died. Although the visceral involvement degree signifies a poor prognosis, it was found that nevertheless, a solitary osteolytic lesion is in the accordance with good prognosis; all patients who did not have bone lesions died in less than three years. It is the first part of our purpose to enact the usefulness of the clinical findings toward a more precise prognosis in the malignant reticuloengotheliosis. Later on, we will report the possibility to obtain a numerical data from the clinical findings in order to establish an accurate prognosis.
Primary angiosarcoma of the spleen is very rare and only 143 cases have previously been reported. The pathogenesis is unknown. The clinical aspects are variable, but loss of weight, anaemia, splenomegaly and liver metastases are frequently present. The age range is generally 18 to 93 years; only four of the reported patients were under 20 (Chen KTK). The prognosis is very poor in any case and survival isn't more than two years: wherever the spleen undergoes spontaneous rupture the survival should be less than six months. Patients with or without metastatic disease may be treated by chemotherapy but with poor results. Radiotherapy is used for the pain from bone metastasis. We report the clinical case concerning a 79-years-old man with liver metastases and a 5-cm lesion in the spleen, where a subcapsular rupture was suspected.
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A 72-year-old man had undergone surgical castration for metastatic prostate cancer (stage D2, the PSA value was 4,300 ng/ml) in September, 1997. He was well clinically for 16 months with undetected level of PSA. However, he presented with general malaise and gross hematuria in May, 1999. After admission to our hospital his condition rapidly deteriorated and he died one week later with respiratory failure. Autopsy revealed extensive involvement of the prostate and bladder by solid tumor with multiple metastases in lungs, liver, spleen, kidneys and bone. Histological examination revealed pure small cell carcinoma of the prostate.
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Various clinical and pathological features of Hodgkin's disease and its related disorders are discussed: a rare, benign form of Hodgkin's disease with skin loci only; unusual primary sites (bone, spleen, lungs and intestine---including alphs-chain disease): various paraneplastic syndromes caused by hyperparathyroidism and hypercorticism; idiopathic nephrotic syndromes of immunological origin. Reference is also made to possible relationships between lymphoma and leukaemia.
When calcified lesions in the liver or spleen are found during follow-up of patients who have undergone debulking surgery and chemotherapy for advanced ovarian carcinoma, it is very difficult to differentiate recurrent cancer from secondary change after chemotherapy. We present here a patient in whom calcified lesions in the liver and spleen were diagnosed as malignancy on the basis of a preoperative PET study. Malignancy was confirmed by histologic examination after surgery.
Ultrasonography is a harmless reproducibel technique with its own specific indications, an established part of clinical diagnosis in obstetrics, gynecology, ophthalmology, neurology and cardiology. Investigations on the organs of the upper abdomen have greatly extended the indications. Interpreting the sonograms requires experience in providing and evaluating the picture. In part I of this paper normal ultrasonic findings on liver, pancreas, spleen and kidneys are shown and explained on thebasis of the physical characteristics of ultrasound techniques and the various ultrasoundtopographic data. This echographic normal anatomy of the organs mentioned enables us to understand pathologic changes shown in part II. An attempt is also made to allocate and evaluate ultrasonography among other diagnostic techniques.
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The splenic angioma is a rare tumour. Its aspects MRI are still badly known. The authors show that in the 2 brought back cases, there is a hypersignal on the 3 echoes of T2 with a catch of contrast slow and centripetal after Gadolinium injection. The hemorrhagic risk in connection with a spontaneous or traumatic rupture imposes the identification of this lesion.