ABSTRACT
The synovial membrane in the carpal tunnel of twenty-nine patients suffering from the typical clinical picture of carpal tunnel syndrome was examined microscopically over an eighteen month period with a follow-up of six months to two years. Unusual causes such as tendon sheath tumours and post-Colles fractures were excluded. Three micropathological pictures emerged. Oedema was found in twenty-four patients, chronic perivascular inflammation in three and fibrinous synovitis in two. No difference was detected in the clinical presentation in the three pathological appearances. The authors believe that oedema is the typical picture and the other two appearances could indicate irritation of the synovial membrane as a result of finger activity.
Subject(s)
Carpal Tunnel Syndrome/pathology , Synovial Membrane/pathology , Carpal Tunnel Syndrome/complications , Edema/etiology , Female , Follow-Up Studies , Humans , Male , Synovitis/etiology , Vasculitis/etiologyABSTRACT
Autopsies were performed on 2 patients with aplastic anaemia and 7 with acute leukaemia dying after bone marrow transplantation. Neutropenic enterocolitis was found in 2 of the 3 early deaths occurring before marrow engraftment and was related to radiation or cytotoxic drug damage to the bowel mucosa in the presence of profound neutropenia, allowing infection by bowel organisms. Cytomegaloviral infection was universal in engrafted patients. One had cytomegaloviral (CMV) pneumonia, one CMV hepatitis and enteritis and one CMV enteritis. Three patients had occasional CMV inclusions in various organs without obvious harmful effects. One nonengrafted patient also had CMV pneumonia. Graft versus host disease (GVHD) was a significant finding in 4 engrafted patients. This was difficult to separate histologically from the effects of CMV in the bowel, but easier in liver and skin. The skin changes of GVHD were the most easily interpretable. Interstitial pneumonia was due to CMV in one nonengrafted and one engrafted patients and had no obvious infective cause in 2 engrafted patients. The presence of bizarre epithelial cells in the lungs of these patients suggested an aetiological role for radiation or cytotoxic drugs. Modification of the conditioning regimen may reduce tissue damage and lessen many of these side-effects.
Subject(s)
Anemia, Aplastic/therapy , Bone Marrow Transplantation , Enterocolitis, Pseudomembranous/pathology , Leukemia/therapy , Transplantation, Homologous/adverse effects , Adult , Antineoplastic Agents/adverse effects , Child , Colon/pathology , Cytomegalovirus Infections/etiology , Enterocolitis, Pseudomembranous/etiology , Female , Graft vs Host Disease/etiology , Humans , Male , Neutropenia/complications , Neutropenia/etiology , Pulmonary Fibrosis/pathology , Radiotherapy/adverse effects , Virus Diseases/complicationsABSTRACT
A woman with giant lymph node hyperplasia of the mediastinum and systemic symptoms was treated with radiotherapy. Following a short partial remission, symptoms have persisted for 15 years. Surgical excision remains the treatment of choice, although the failure of radiotherapy may be due to inadequate dosage. If symptoms persist after treatment, a diagnosis of multicentric disease should be excluded. Review of histologic material may be helpful in puzzling clinical cases, as shown by the establishment of the diagnosis in this patient 13 years after the onset of symptoms.
Subject(s)
Hyperplasia/radiotherapy , Lymph Nodes/pathology , Adult , Female , Follow-Up Studies , Humans , Immunoenzyme Techniques , Lymph Nodes/radiation effects , Mediastinum/pathology , Mediastinum/radiation effects , Plasma Cells/immunology , Plasma Cells/pathologySubject(s)
Immunoblastic Lymphadenopathy/pathology , Lymph Nodes/pathology , Adult , Diagnosis, Differential , Humans , Hyperplasia , Middle AgedABSTRACT
A case of signet ring cell lymphoma is presented. This is a rare variant of follicular lymphoma, in which cytoplasmic inclusions of immunoglobulin create the light microscopic appearance of signet ring cells. Although few cases have been reported, the clinical features appear to be identical to those of follicular lymphomas without immunoglobulin inclusions.
Subject(s)
Lymphoma/pathology , Female , Humans , Lymphocytes/pathology , Lymphoma/ultrastructure , Middle AgedABSTRACT
A case of thanatophoric dwarfism living for 10 weeks with minimal supportive care is presented. Although early death is usual, survival for months is compatible with the diagnosis.
Subject(s)
Dwarfism/diagnostic imaging , Dwarfism/congenital , Female , Humans , Infant, Newborn , Radiography , Time FactorsABSTRACT
In 50 necropsies on leukaemic children, the major cause of death was infection. In patients dying during therapy for induction or reinduction of remission, the most frequent infection was a distinctive neutropenic enterocolitis or typhlitis. This was seen in 46% of the whole series and was a major factor in the death in 38%. Other infections were predominantly bacterial pneumonia in patients in relapse, and viral disease, e.g. measles pneumonia, in those in remission. One patient treated for meningeal leukaemia showed an unusual linear calcification of the cortical grey matter.
