Hodgkin's Disease Complicated by Cryptococcemia: One Case Report

A case of Hodgkin's disease which was complicated by disseminated cryptococcemia terminally is reported. The patient was a 19 year old girl and complained of high fever with shaking chins and dyspnea. In the past history, antituberculous treatment was given using PAS, INH and streptomycin for 2 months under the diagnosis of tuberculous pleurisy and several antibiotics and steroids were also given. On admission, antituberculous treatment was continued and prednisolone was also prescribed. She was discharged 15 days later but was readmitted because of abdominal pain and uncontrolable fever. On the third hospital day, a leftcervical lymphnode biopsy revealed. Hodgkin's disease, paragranuloma type. Endoxan and cobalt 60 irradiation were given to the abdomen. On the sixtieth hospital day, she became irritable and comatose and expired. At autopsy, disseminated Hodgkin's sarcoma was noted involving multiple lymphnodes, esophagus, small and large intestines, pancreas, liver, spleen, diaphragm, lungs, peritoneum, uterus, left ovary and bone marrow. In addition, evidence of cryptococcemia involving kidneys, lungs, heart, brain, pituitary gland and lymphnodes, was noted. A brief review of the literature was also made.

The Effects of Methontrexate on the Pancreas of Rats: A Histochemical and Ultrastructural Study

Methonexate is one of the well known anti-cancer chemotherapeutic agents and exerts its action by inhibiting mitoses by inhibition of nucleic acid synthesis. Its effect on actively proliferating normal and pathologic tissues have been well documented. However, little information is available on its effect on tissue which shows no active mitoses but does have a very active metabolic process, such as the pancreas. The present study investigated the histochemical and ultrastructural changes which take place within 24 hours after a single intraperitoneal injection of methotrexate. Using a light microscope for observation, no .specific or constant alteration was noted except for a mild acinar cell dissociation 18 hours after the injection. However, electron microscopic observations showed that several organelles of pancreatic acinar cell revealed ultrastructural changes such as vesiculation and dilation of the cisternae of endoplasmic reticulum, and the appearance of autophagic vacuoles which contained cellular organelles, and showed hyperplasia and dilation of Golgi complexes. The nuclei and zymogen granules were not significantly altered. The changes of endoplasmic reticulum were ,distinctly seen from 1 hour after the injection and were most severe at 6 hours. Autophagic vacuoles appeared at 6 hours and had progressively increased in number and size 18 hours after the injection. Similar changes were also reported in experimental animals which were treated with several cytotoxic agents. According to this study, it is evident that a single administration of methotrexate within short time interval induced a series of ultrastructural alterations in several organelles of the pancreatic acinar cells. It is not clear as yet whether or not this is a specific reaction of cells to methotrexate.

Histochemical Studies of Human Endometrium with Special Emphasis on Secretory Activity and Ovulation

Eighty eight cases of the endometrial biopsy comprising 19 cases of proliferative phase, 21 cases of secretory phase, and 23 cases of menstrual phase from non-sterility patients, and 25 cases of the endometrium at the first day of menstruation from primary sterility patients were examined histochemically. Secretory substance in the epithelial cells of the endometrial glands during the secretory phase and menstrual phase was main1y glycogen. Therefore, it is essential to fix the endometrial tissue in a fixative which can preserve glycogen for the detection of secretory activity more accurately. Among 25 cases of primary sterility, 15 cases showed epithelial secretory vacuoles on hematoxylin and eosin stained sections, and no epithelial vacuolization was noted in the remaining 10 cases. However, PAS staining showed presence of PAS positive diastase sensitive substance in the majority of the later 10 cases except one in which no PAS positive substance was found, indicating that PAS staining is superior than routine hematoxylin and eosin staining for the detection of epithelial secretory substance. The absolute lack of secretory activity in the endometrial glands was infrequent, but a relative decrease of progesterone effect was rather common among the patients complaining primary sterility, and the decreased progesterone effect may not necessarily be due to the absence of ovulation.