Association of gastric lymphoid follicles and Helicobacter pylori infection.

Lymphoid tissue is normally absent in the gastric mucosa; however, lymphoid follicles are very frequently noted in Helicobacter-associated gastritis. We reviewed 237 cases of chronic gastritis with lymphoid follicles. Out of this 227 cases (95.8%) were found to have H. pylori infection. The significance of this finding and its possible relationship to primary gastric lymphoma are discussed.

Pleuropulmonary blastoma of the lung presenting as posterior mediastinal mass: a case report.

Pulmonary blastoma is a rare primary neoplasm of the lung. A case of a 2 1/2-year-old girl with a rapidly progressing pleuropulmonary blastoma clinically presenting as a posterior mediastinal mass is discussed.

Steroid-responsive Rosai-Dorfman disease.

Nodular skin lesions on the lateral aspects of the legs of a female child were first noticed at the age of 6 days. A biopsy of the lesions was done at the age of 6 months when the child had also developed cervical and inguinal lymphadenopathy and angiomatous lesions on the face. The diagnosis of Rosai-Dorfman disease (RDD; also known as sinus histiocytosis with massive lymphadenopathy, SHML) was made. Increasing respiratory obstruction by lymphoid tissue prompted a 2-week trial with oral prednisolone. A dramatic response occurred, with complete resolution of all clinical findings within 5 days, but with recurrence of lymphadenopathy 6 weeks after stopping with medication. Further observations over the next 3 years established a consistent response to prednisolone and a pattern of steroid dependence.

Intrathoracic extramedullary hematopoietic tumor in hemoglobin C disease.

A case of intrathoracic extramedullary hematopoietic tumor associated with hemoglobin C disease is reported in a 27-year-old Bangladeshi man. The patient's initial complaints were generalized weakness, weight loss, and left upper abdominal pain. Hospital workup revealed a solitary intrathoracic mass in the posterior mediastinum, which was suspected to be a lymphoma based on fine-needle aspiration. The mass was excised and proved to be an extramedullary hematopoietic tumor. The problem of differential diagnosis is discussed.

Basement membrane thickening in the placentae from diabetic women.

A light microscopy study was carried out on 48 placentae. Seventeen placentae were obtained from non-diabetic mothers while the other 31 placentae were from both women with controlled diabetes and women who had an abnormality of the glucose tolerance test. All the women delivered at 38-40 weeks of gestation. Placentae from diabetic patients showed immaturity of the villi, hypertrophy of the capillaries and thickening of the basement membrane of the trophoblastic villi (3.2 +/- 0.35 microns) and the amniotic membrane (1.8 +/- 0.3 microns). Focal fibrinoid necrosis, an increase in the number of Hofbauer cells and dilatation of villi capillaries were also commonly observed in placentae from diabetic mothers, and the normal cuboidal cells lining the amniotic membrane tended to become tall columnar (17.6 +/- 6.3 microns) with distally located nuclei. Similar findings were observed in patients who had a potentially abnormal glucose tolerance test, which suggests the possibility of primary lesion in origin. Therefore, control of hyperglycemia may only partially prevent the development of placental abnormalities.

Unusual bilateral renal histiocytosis. Extranodal variant of Rosai-Dorfman disease.

A 37-year-old Bangladeshi presented with large bilateral masses involving the hilus of the kidneys. No lymphadenopathy was noted. Nephrectomy was performed. Histopathologically, it revealed a lymphohistiocytic and plasma cell inflammatory tumoral proliferation with characteristic lymphophagocytosis by the S100-positive-CD1-negative histiocytes. Extranodal presentation of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) should be entertained in the differential diagnosis of bilateral masses involving the kidneys.

Hepatocellular carcinoma: A clinicopathological analysis of 118 cases from Riyadh Central Hospital.

A review of 118 cases of histologically diagnosed hepatocellular carcinoma in Riyadh Central Hospital over a 15-year period from 1985 to 1989, showed that there were 73 Saudi nationals and 45 other nationalities. The overall sex ratio was 2.5;1, M:F (1.92:1 in Saudis; and 4:1 in other nationalities). The mean age for male Saudis was 61.2 years (range, 34-85) and for females 60.9 years (range, 18-80). Peak incidence occurred at 50 years for males and 60 years for females. Hemoperitoneum from ruptured tumor (7 cases) and 1 case of recurrent hypoglycemia were noted in the series. Tumor grading was Grade I, 10 (11.5%); Grade II, 49 (56.3%); Grade III, 28 (32.2%). Cirrhosis was associated with tumor in 58.0% of cases. Hepatitis B surface antigen was positive in 47.5% of Saudis and 47% in the whole group. Schistosomal serology was available in 21 cases and positive in 85.7%. The importance of hepatitis B virus in etiopathogenesis of hepatocellular carcinoma is reflected in this study.

Pattern of primary gastrointestinal tract malignancy among Saudi nationals: A retrospective study.

This histopathological reports from the central laboratory of Riyadh Central Hospital for between 1404 to 1406H (1984 to 1986) were reviewed retrospectively to determine the pattern of primary cancer of the gastrointestinal tract among Saudi nationals. During the study period, a total of 32,990 histopathological examinations were conducted. Neoplasms were identified in 4683 cases (14.2%); 1772 (37.8%) were malignant and 2911 (62.2%) were benign. The stomach (31%), liver (20%), and esophagus (19%) were the most commonly involved organs. The proportional frequencies of gastrointestinal malignancies differ from those seen in Western countries, although the age and sex distribution are similar. The possible etiological factors are discussed and the need for a cancer registry emphasized.