Multiple endocrine neoplasia IIA found at autopsy.

A case is presented of a 32-year-old black female who died from adult respiratory distress syndrome with disseminated intravascular coagulopathy. At autopsy she was found to have typical multiple endocrine neoplasia IIA, a combination of medullary carcinoma of the thyroid, bilateral adrenal pheochromocytoma and nodular hyperplasia of the parathyroid.

[Clinician-oriented and cytology-oriented autopsy. III. The pancreas].

The autopsy is performed with multiple purposes such as medical education, searching direct cause of the death and researches. The first purpose of the autopsy is, however, a service for clinicians. The dissection technic should be determined to present the best clinical-pathological correlation of the lesions. In addition to the careful evaluation of the gross lesions of the pancreas, Smears (Imprints) of the lesions are most useful to make initial pathological diagnoses during autopsy examination. Multiple photographs illustrate both the gross pathological lesions and cytological data of the pancreas.

[Clinician-oriented and cytology-oriented autopsy. Part II. Hepato-biliary system].

The autopsy is performed with multiple purposes. The first purpose of the autopsy is a service for clinicians. The dissection technic should be determined to present the best clinical-pathological correlation of the lesions. Imprint (touch preparation) from the organ is most useful to make initial pathological diagnoses during autopsy examination. This preparation provides not only oncologic data (tumor identification), but also the presence of infections. Numerous photographs illustrate both the gross pathological lesions and infections of the hepato-biliary system.

[Clinician-oriented and cytology-oriented autopsy, Part I. Respiratory system].

The autopsy is performed with multiple purposes. It is felt that the first purpose of the autopsy is a service for clinicians. Dissection technic should be determined to present the best clinical pathological correlation of the lesions. Touch preparation (imprint) from the organs is most useful to establish initial pathological diagnoses during autopsy examination. This provides not only oncologic data (identification of tumors), but also the presence of infectious complications such as opportunistic organisms. Multiple photographs illustrate both the gross pathological lesions and infections, demonstrated by the imprints of the respiratory system.

Entheses and enthesopathy. Anatomical, pathological, and radiological correlation.

Entheses are sites of tendon and ligament attachment to bone, and enthesopathy is a disease process occurring at these sites. It may be inflammatory, degenerative, endocrine, metabolic, or traumatic in nature. Common sites of involvement include the pelvis, femoral trochanter, humeral tuberosity, patella, olecranon, and calcaneus as well as portions of the vertebral column. Specific radiographic features, including bone erosion, hyperostosis, fragmentation, and crystal deposition, may allow a precise diagnosis.

Spinal vacuum phenomena: anatomical study and review.

"Vacuum" phenomena relate to the accumulation of gas, principally nitrogen, in crevices within the intervertebral disk or vertebra. Their appearance does not uniformly indicate "degenerative" disk disease (primary intervertebral osteochondrosis), as gaseous collections may accompany other processes (vertebral osteomyelitis, Schmorl node formation, spondylosis deformans, vertebral collapse with osteonecrosis) affecting the disk and adjacent vertebral bodies. The location and appearance of the "vacuum" phenomena are helpful indicators as to the precise nature of the spinal disorder.

Safety of percutaneous fine-needle pancreatic biopsy: a porcine model.

Percutaneous fine-needle aspiration biopsy was performed on pigs with no complications. Pancreatic cells were retrieved in 73% of the biopsies. Thus, percutaneous biopsy with cytologic examination for pancreatic carcinoma can be performed in order to plan for appropriate therapy.

Proximal tibiofibular joint: anatomic-pathologic-radiographic correlation.

An anatomic-pathologic-radiographic study of the proximal tibiofibular joint was undertaken. This synovial articulation between the proximal tibia and fibula may communicate with the knee joint in 10% of adults. Radiography of the normal proximal tibiofibular articulation outlines a consistent relationship between the proximal portions of the tibia and fibula. Disruption of this normal relationship is indicative of anterolateral or posteromedial subluxation or dislocation. Articular disorders of this joint include reheumatoid arthritis and septic arthritis. In the latter, initial alterations of the knee joint may subsequently extend to involve the proximal tibiofibular joint, illustrating the potential communication between these two articulations.

The adult hip: an anatomic study. Part I: the bony landmarks.

A comprehensive anatomic, pathologic and radiographic study of the adult hip was undertaken to define bony landmarks which, when altered, are reliable indicators of disease. Methodology included radiography of cadaveric specimens and analysis of over 300 anteroposterior (AP) radiographs of "normal" adult hips. This information was applied to clinical situations with the following conclusions: (a) The diagnosis of protrusio acetabuli is warranted if the acetabular line projects medial to the ilioischial line by 3 mm or more in men and by 6 mm or more in women. (b) In acetabular trauma, an AP and two oblique radiographs (30 degrees anterior oblique and 30--45 degrees posterior oblique) are required for complete evaluation. (c) Characteristic alterations in the joint space allow accurate diagnosis of disease.

The adult hip: an anatomic study. Part II: the soft-tissue landmarks.

A comprehensive anatomic, pathologic, and radiographic study was undertaken to define reliable soft-tissue landmarks about the hip. Methodology included an analysis of 300 "normal" adult hip radiographs, tissue maceration, cadaveric intra-articular injection studies and review of selected clinical cases. Results, when applied to clinical situations, indicate: (a) The iliopsoas and "capsular" fat planes are poor indicators of small to moderate amounts of intra-articular fluid in the adult. (b) The "capsular" fat plane is not associated with the joint capsule, but in fact is a fat plane between two muscle bundles anterior to the articulation. (c) Distinct soft-tissue planes are available for dissemination of fluid from the hip joint. These include the iliopsoas bursa, which may distend in association with articular disease, and the fat plane of the obturator externus muscle.

Intervertebral disc abnormalities associated with vertebral metastasis: observations in patients and cadavers with prostatic cancer.

Abnormalities of intervertebral discs associated with vertebral metastasis from prostatic carcinoma are described in an investigation utilizing patient and cadaveric material. Radiographic and pathologic findings indicate that discal abnormality in this situation relates to three potential processes: intervertebral disc degeneration (intervertebral osteochondrosis); cartilaginous (Schmorl's) nodes; discal invasion by tumor. In most patients with vertebral metastasis, the adjacent intervertebral disc appears normal, a useful radiographic finding suggesting the presence of tumor rather than infection. Occasional patients with vertebral metastasis demonstrate roentgen abnormalities of the adjacent intervertebral disc indicating the occurrence of one or more of the above processes.

Thorotrast induced adhesive arachnoiditis associated with meningioma and schwannoma.

Adhesive arachnoiditis, a meningioma and a schwannoma were found at autopsy in a 56 year old man who had undergone Thorotrast myelography 33 years previously. Thorotrast was demonstrated in tissue sections by transmission and scanning electron microscopy, radioautography, and x-ray spectrometry.

Intravertebral disk herniations: cartilaginous (Schmorl's) nodes.

Cartilaginous (Schmorl's) nodes are related to prolapses of intervertebral disk material into the vertebral body. These nodes can be produced by any process which weakens either the cartilaginous plate covering the superior and inferior surfaces of the vertebral body or the subchondral trabeculae of the vertebra. Such processes include juvenile kyphosis, trauma, metabolic and neoplastic disorders, and degenerative disk disease. Radiographic abnormalities include indentations of vertebral outline and radiolucencies within the vertebral body with varying degrees of sclerosis. These can be readily differentiated from other vertebral alterations such as "butterfly", "fish", and "H" vertebrae.

Calcaneal abnormalities in articular disorders. Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Reiter syndrome.

The calcaneus of normal control patients, and those with rheumatoid arthritis, ankylosing spondylitis, psoriasis, and Reiter syndrome was studied. Pathological abnormalities of the plantar aponeurosis, Achilles tendon, and retrocalcaneal bursa account for the radiographic alterations. In normal individuals, lateral radiographs show the thickness of the Achilles tendon to be not greater than 8 mm; the retrocalcaneal bursa creates a radiolucency which extends at least 2 mm below the superior surface of the calcaneus. In patients with any of these 4 articular disorders, Achilles tendinitis produces thickening of the tendon, and retrocalcaneal bursitis obliterates the normal radiolucency.

Intra-articular calcification in scleroderma.

Two patients with scleroderma demonstrated intra-articular calcification, which is rarely observed in this disease. The authors suggest that intra-articular calcification and erosion of adjacent cartilage and bone are related.