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Percutaneous needle evaluation of intradural extramedullary lesions of the lumbar spine.

A total of eight patients in whom five intradural extramedullary lesions and three epidural lesions were present were evaluated by percutaneous needle biopsy. In four patients the level of aspiration biopsy was determined using the initial myelogram and in those patients fluoroscopic guided percutaneous needle biopsies were performed. Three of these patients had large intradural extramedullary masses (above 1 cm); one patient had an epidural lesion. Diagnostic material was obtained in all cases (medulloblastoma, astrocytoma, small cell carcinoma, adenocarcinoma). Immediate post procedure CT and clinical followup showed no complications. In three patients with small lesions (below 1 cm), post myelographic CT was used to determine the level of aspiration. Post myelographic CT showed an intradural extramedullary mass in one patient and epidural lesions in two cases. Plain CT showed a high attenuation lesion in one patient. CT guided percutaneous needle biopsies in these four patients yielded diagnostic specimens (neurofibroma, uroepithelial carcinoma, hematoma, Thorotrast deposit). Clinical follow up showed no complications. Our experience indicates that percutaneous needle biopsy of intradural extramedullary and epidural lesions of the lumbar spine is safe and efficacious. Depending upon the size of the lesions, myelography or CT can be utilized to determine the level of aspiration.

Adult↗

The growth of two murine hemangioendotheliomas intracranially, subcutaneously, and in culture, and their comparison with human cerebellar hemangioblastomas: morphological and immunohistochemical studies.

Two thorium dioxide-induced murine hemangioendotheliomas, 42021 TCT and 44347 TST, were grown subcutaneously (for up to 22 and 15 passages respectively) or intracranially (single passage) and were adapted to culture as a monolayer and, in a limited fashion, in an organ culture system or in rotary suspension. They remained viable and malignant following 20-21 years of storage in liquid nitrogen, and had ultrastructural similarities to human hemangioblastomas. The murine tumors were positive for Griffonia (Bandeiraea) simplicifolia isolectin B4 binding, establishing their endothelial nature; however, unlike human hemangioblastic tumors, they did not cross-react with antisera to human factor VIII or fibronectin and they did not demonstrate Ulex europaeus type I lectin (UEA I) binding (as is also the case for non-neoplastic murine vascular endothelial cells). A variety of morphological cell types in cultures derived from the tumors were also positive for Griffonia (Bandeiraea) simplicifolia isolectin B4 binding. Both murine hemangioendotheliomas, when implanted in the cerebrum, were potent inducers of reactive gliosis, but there was no evidence of uptake of glial fibrillary acidic protein. Unlike the human cerebellar hemangioblastomas, murine tumors were malignant and invasive and did not contain stromal cells, nor did they demonstrate Weibel-Palade bodies or extensive pinocytotic activity. Thus, the murine tumors appear to more closely resemble angiosarcomas or epitheloid hemangioblastomas than the cerebellar hemangioblastomas.

Animals↗

Investigations into human thorotrastosis. Tissue concentrations of 232-Th and late effects in 13 autopsy cases.

The subjects of investigation were 13 dead thorotrast patients, 10 male, 3 female, with ages ranging from 45 to 79 years. Two thousand organ and tissue specimens were investigated by means of autopsy and by both microscopic-autoradiographic and neutron activation analysis in order to detect late effects and to determine on approximate mean concentration of 232Th (mg per g of tissue). A comparison between late effects and concentrations of the dye medium led to the following conclusions: 1. 232Th is, after intravascular injection, deposited in all organs and tissues of the human body. 2. The highest mean concentrations are shown in the spleen, liver, bone marrow, and lymph nodes. 3. The distribution of 232Th is inhomogeneous in all organs and tissues. The variations of maximum and minimum concentration lie around factor 2.2 X 10(0)-2.4 X 10(5). 4. Late effects occur only in spleen, liver, lymph nodes, and bone marrow, but not in organs and tissues that show a mean concentration of 232Th under 10(-1) mg per g tissue. 5. It is highly probable that tumors of thorotrast patients in organs other than spleen, liver lymph nodes, and bone marrow are not caused by deposition of 232Th or ThO2.

Aged↗

Veno-occlusive disease and peliosis of the liver after thorotrast administration.

A case of veno-occlusive disease and peliosis of the liver without coexisting liver malignancy 35 years after thorotrast administration is presented. In the liver four main widely distributed lesions were found: Veno-occlusive disease (VOD), peliosis, fibrosis and thorotrast deposits. Whether the VOD and the peliotic lesions are pathogenetically related or totally independent cannot be determined in the present case. However, the VOD and the peliosis are possibly related to the protracted alpha-emitting effect of thorotrast deposited in the liver parenchyma.

Alpha Particles↗

Double tumours of the liver following intravenous thorotrast injection. Patho-anatomical report on two cases.

Observations on the contrast between the livers of two patients who underwent an arteriogram with thorotrast in 1941 have been made. The first case produced a cholangicellular carcinoma (CCC) in addition to atypical proliferations of sinusoidal lining cells. The second case produced a very rare tumour combination of a CCC with a haemangioendothelial sarcoma (Haem-SA the problem of double tumours of the liver following thorotrast injection is discussed in the light of these cases. In addition the discussion includes various opinions on Kupffer cells.

Adenoma, Bile Duct↗