clinico pathologic and immunohistochemical study of dedifferentiated liposarcoma

Twelve cases of dedifferentiated liposarcoma with neural like or meningeal-like whorling pattern, metaplastic bone formation, fibrosarcoma or hemangiopericytoma like area were studied. Most of the tumors were huge masses [ranging from 2.5-60 cm]. Histologically, the tumors revealed in addition to areas of well differentiated liposarcoma discrete nodules consisting of hypercellular and spindle to ovoid cellular proliferation arranged in tight concentric whorls resembling neural tumors of meningiomas. Metaplastic ossification was present in eight of 12 tumors and consisted of variable amounts of osteoblast rimmed bone trabeculae situated at the periphery of the whorled areas or intimately mixed with the whorled cellular component. Immunohistochemical studies were inconclusive in determining the nature of the dedifferentiated whorled element and others

Incidental appendectomy with cholecystectomy

Opinions vary considerably among surgeons as to the advisability of incidental removal of the appendix during laparotomy for some other indications including cholecystectomy [Zbar et al., 1993], jejunoileal bypass for morbid obesity [Kelly, 1902], right inguinal herniorrhaphy [Ring-Morzik et al., 1993], cesarean section, hystrectomy, post partum tubal ligation [Wilson et al., 1973] and exploratory laparotomy. The frequent notation of abnormal pathologic findings in an apparently normal appendix support its elective removal [Lowery and Lenhardt, 1962]. 30% of these appendices had significant histopathological changes. The incidental removal of the appendix cause no increase in the incidence of wound infections in patients who underwent cholecystectomies [Arango et al., 1994]. If the patient in good general condition with an average surgeon, incidental appendectomy when tempered carefully appears to be innocuous favorable cases seems to be indicated

Chilblains: Some clinicopathological and therapeutic aspects

A total of 29 patients with chilblains were included in this study. Chilblains were found to affect women more than men. In a decreasing order, the following symptoms and signs constituted the clinical picture: erythema, itching, swelling, pain and nodules. The condition worsened at night in 58.6% of cases and almost exclusively affected hands and feet. Histopathologically, there was lymphohistiocytic vasculitis with no fibrin deposition. Marked improvement was obtained in 64.7% of patients using nifedipine [Epilat] 20 mg per day while only 16.7% of patients were markedly improved on piribedil [Trivastal] 60 mg per day. Side effects of both drugs [mainly hot flushes and headaches] were infrequent and mild. The use of nifedipine is recommend in the treatment of chilblains

Nevus depigmentosus: a clinical study and immunohistochemical differentiation from vitiligo

A clinical study was out 23 cases of nevus depigmentosus. This condition appears to be commoner in females and 65% of patients are born with it. Nevus depigmentosus commonly has a diameter of 5-10cm with a serrated edge. Stroking with a blunt object produced erythema in over 82% of cases and diascopy of the edge produced equality in color between affected and unaffected skin only 8% of cases. Perfect differentiation between nevus depigmentosus and vitiligo was obtained on using peroxidase-antiperoxidase staining for S-100 positive cells [most probably Langerhans cells] were found in vitiligo while this reaction was completely negative in nevus depigmentosus lesions