Rapidly progressive fatal cutaneous T cell lymphoma with a trauma-related presentation.

A case of rapidly progressive cutaneous T cell lymphoma with a trauma-related presentation in a 73-year-old man is reported. Clinically, the patient presented with an ulcerated cutaneous mass at the site of trauma-related hematoma of the leg. The histopathology was that of tumor phase cutaneous T cell lymphoma with involvement of the skin and subcutis. The diagnostic challenge of this clinical presentation and the rapidly progressive course are highlighted.

Leiomyosarcoma of the parotid gland: a case report and review of the literature.

BACKGROUND: A primary leiomyosarcoma of the parotid gland has been reported only three times in the English literature. This type of tumor represents an extremely rare group of salivary gland neoplasm. METHODS: A 44 year old man was initially seen with a 5 cm right parotid mass which was resected with a total parotidectomy, preserving the facial nerve. The patient had no palpable cervical lymph nodes. RESULTS: The majority of the specimen was made up of a relatively well demarcated tumor 5 cm in diameter. The tumor was noted to contain moderate to poorly differentiated primary leiomyosarcoma of the parotid. CONCLUSIONS: A primary leiomyosarcoma of the parotid gland is an extremely rare existing entity. A review of the literature reveals that primary leiomyosarcoma and other sarcomas of the major salivary glands may share similar histogenesis and biologic behavior with their soft tissue counterparts.

Bilateral femoral hypoplasia and maternal diabetes mellitus: case report and review of the literature.

The case of a 21-week fetus with bilateral femoral hypoplasia and bowing related to maternal diabetes mellitus is reported. The femoral middiaphysis (site of hypoplasia and bowing) showed intramembranous ossification instead of the normal endochondral ossification, thus pointing to a transient inhibition of chondrogenesis of the mesenchymal femoral model as the causative mechanism. This finding is correlated with the recent experimental advances in the field of limb development in vertebrates.

Acute leukostasis pulmonary distress syndrome.

A 75-year-old woman in accelerated-phase chronic myeloid leukemia with hyperleukocytosis presented with acute respiratory distress syndrome. Despite early and aggressive pulmonary support and cytoreductive chemotherapy, the patient died. Autopsy confirmed the presence of the leukostasis syndrome. The clinical, radiologic, pathophysiologic, and therapeutic aspects of this entity are reviewed.

Uterine leiomyosarcoma with massive necrosis diagnosed during gonadotropin-releasing hormone analog therapy for presumed uterine fibroid.

Recurrence of heavy vaginal bleeding and massive necrosis of a uterine leiomyosarcoma are reported in a 41-year-old female who was being treated with GnRH-a for a presumed uterine fibroid. The pathogenic mechanisms of such an event are reviewed and discussed in light of the available literature on the subject of GnRH-a and the treatment of uterine smooth muscle neoplasms.

Clear cell carcinoma arising in extraovarian endometriosis: report of three cases and review of the literature.

The literature on malignancy arising in extraovarian endometriosis comprises only three cases of clear cell carcinoma. We wish to report the clinical features and pathologic findings of an additional three cases. The first concerns a 39-year-old oriental pregnant woman who presented with a large intraluminal obstructing lesion of the sigmoid colon, the second case deals with an abdominal wall mass that appeared in a cesarean section scar of a 45-year-old black woman, and the third case describes an ulcerating lesion of the perineum and the buttock in a 43-year-old white woman with a long history of endometriosis in an episiotomy scar. Our observations support the notion that clear cell carcinoma arising in extraovarian endometriosis behaves differently from its counterpart in ovarian endometriosis, but more in line with clear cell carcinoma of the endometrium.

Giant median raphe cyst of the penis with diffuse melanosis of its epithelial lining.

Diffuse melanosis of the epithelial lining of an unusually large median raphe cyst of the penis is reported. Its light microscopic and ultrastructural features are described. The findings are discussed in the context of the published literature of genitourinary melanosis.

Inverted variant of carcinoma cuniculatum of the toe.

An inverted variant of carcinoma cuniculatum of the great toe of a 55-year-old man is reported. Clinically the tumor presented as an inflammatory process of the toe with purulent drainage and bone destruction in the absence of cutaneous ulcer or exophytic growth. It was characterized histologically by endophytic sheets and cords of well-differentiated keratinizing squamous epithelium with minimal cellular atypia and numerous intraepithelial keratin cysts and microabscesses. The diagnostic challenge of the clinical presentation of this variant is emphasized.

Substrate utilization for lactate and energy production by heat-shocked L929 cells.

The hypothesis that heat shock protein (HSP) induction depends on inhibition of respiration was tested by examining the effects of heat shock on tricarboxylic acid (TCA) cycle function. In control L929 cell cultures, glucose and exogenous pyruvate were converted primarily to lactate, and glutamine was extensively oxidized, accounting for more than one-half of the calculated ATP production. During heat shock at 42 degrees C, lactate production from all of the labeled substrates and total unlabeled lactate production increased significantly while oxygen consumption increased slightly. TCA cycle oxidation of pyruvate decreased during this period while that of glutamine increased. Uncoupling of oxidative phosphorylation caused large increases in oxygen consumption at both 37 degrees C and 42 degrees C, indicating that the capacity of the respiratory chain is not exceeded during heat shock. The net effect of these alterations in substrate utilization were decreased ATP generation and increased NADH utilization. Both 14CO2 and lactate production declined during the 24-h period after cultures were returned to 37 degrees C. On the basis of these data, we conclude that while inhibition of respiration plays no apparent role, other metabolic consequences of heat shock related to energy metabolism may be involved in HSP induction.

Hemorrhagic infarction of the kidney. An uncommon presentation of infiltrating urothelial carcinoma of the renal pelvis.

A case of infiltrating urothelial carcinoma of the renal pelvis presenting the pathologic picture of hemorrhagic infarction of the kidney is reported. The physiopathologic mechanisms of this presentation are discussed. It is suggested that urothelial carcinoma be included in the differential diagnosis during the work-up of renal lesions suspected of being papillary necrosis or hemorrhagic infarction.

Necrotizing vasculitis associated with diphenylhydantoin: two fatal cases.

Two fatal cases of widespread necrotizing vasculitis associated with diphenylhydantoin (Dilantin) are presented. Toxic and allergic reactions associated with diphenylhydantoin therapy have been discussed and reviewed in numerous reports since the late 1930s. This vascular complication, however, has previously been reported only twice. In this report, the authors discuss similarities in their two cases and the peculiarities of this entity in the broad spectrum of necrotizing angiitides.

Gas-liquid chromatographic study of monosubstituted benzaldehyde isomers.

Monosubstituted benzaldehyde isomers have been studied quantitatively on nine stationary liquid phases of various physical and chemical characteristics and at different operating temperatures. Apiezon 1 + Bentone 34, dinonyl phthalate and di(2-ethylhexyl)sebacate are found to be selective for quantitative separation of the isomers studied.