ABSTRACT
A 35-year-old man who had been occupationally exposed to aerosolized kaolin for 17 years in a Georgia processing plant had diffuse reticulonodular pulmonary infiltrates and an upper lobe mass. Exploratory thoracotomy, performed to evaluate the nature of the mass, revealed an 8 X 12 X 10-cm conglomerate pneumoconiotic lesion containing large amounts of kaolinite. Coincident deposition of silica in the tissue was not demonstrable by either analytic scanning electron microscopy or x-ray diffraction. The case illustrates the effect of chronic kaolin exposure on the human lung and emphasizes the need for periodic evaluation of exposed workers.
Subject(s)
Air Pollutants, Occupational/adverse effects , Kaolin/adverse effects , Pneumoconiosis/etiology , Adult , Environmental Exposure , Humans , Industry , Male , Pneumoconiosis/pathology , Pneumoconiosis/surgery , Pulmonary Fibrosis/etiology , Pulmonary Fibrosis/pathologyABSTRACT
Light-chain glomerulopathy occurred in a middle-aged woman with adult-onset diabetes mellitus and IgG-kappa light-chain multiple myeloma. Unusual features of the glomerulopathy included the presence of numerous epithelial crescents and rapid progression to chronic renal failure. The aggressiveness of her disease may be related to her underlying diabetes mellitus and associated abnormalities in glomerular clearance of macromolecules, including immunoglobulin light chains.
Subject(s)
Immunoglobulin Light Chains/immunology , Kidney Glomerulus , Female , Fluorescent Antibody Technique , Humans , Kidney Diseases/immunology , Kidney Diseases/pathology , Kidney Glomerulus/ultrastructure , Microscopy, Electron , Microscopy, Fluorescence , Middle AgedABSTRACT
A 14-year-old girl with juvenile rheumatoid arthritis developed severe renal amyloidosis and presented with nephrosis and renal failure. Renal function returned to normal in a year and over 23 years, serial biopsies showed remarkable, biopsy-proven regression of amyloid deposits. Amyloid was not found in skin, gum or rectal biopsies. This case demonstrates an improved prognosis and apparent reversibility.
Subject(s)
Amyloidosis/physiopathology , Arthritis, Juvenile/complications , Kidney Diseases/physiopathology , Adolescent , Amyloidosis/complications , Amyloidosis/pathology , Biopsy , Female , Humans , Kidney/pathology , Kidney Diseases/complications , Kidney Diseases/pathology , Time FactorsABSTRACT
This report demonstrates the value of analytical scanning electron microscopy (SEM) in the evaluation of patients with fibrosing pulmonary disease. We describe the findings in six illustrative cases in which prebiopsy or premortem clinical and epidemiologic information did not suggest an etiologic association with exposure to fibrogenic dusts. Exogenous materials were inconstantly recognized by polarized light microscopy, but examination by SEM resulted in localization of significant inorganic deposits in the biopsy and autopsy tissues studied. Talc, mica, graphite, and mixed inorganic dusts were found in these six cases. Characterization of this material by SEM morphology and x-ray energy spectrometry provided the basis for re-appraisal of the exposure history and its potential pathogenetic importance. The technics described utilize routinely processed, paraffin-embedded tissue, and are readily applicable to problems encountered in the hospital setting.
