[A case of disseminated intravascular coagulation--a paraneoplastic manifestation of a borderline ovarian tumor]. / Consideratii asupra unui caz de coagulare intravasculara diseminata (CID)--manifestare paraneoplazica a unei tumori ovariene de granita.

A 24-year-old-woman was admitted because of disseminated intravascular coagulation (DIC), menometrorrhagia and galactorrhea. The investigations performed showed a right adnexal tumor after the equilibration of DIC with plasma substitution, we performed a right adnexectomy with limited excision of peritoneal. The pathologic examination showed a focus of endometriosis on the right ovary who had a polycystic look and a right adnexal fibromyxoma (premalignant lesion). The post operative evolution was good, with the loss of entire onco-hemato-endocrinologic picture. We describe the interrelation between DIC (paraneoplastic syndrome), menometrorrhagia and galactorrhea, the pathologic hypothesis and the treatment of DIC.

Aspects of ankylosing spondylarthritis immunopathogenesis correlated with some immunoseric- and synovial parameters in the investigation of histopathological and electronmicroscopic alterations of the articular cartilage correlated with some immunoseric and synovial parameters.

Eighteen biopsies of articular cartilage taken intraoperatory from patients with Ankylosing Spondylarthritis (AS) and from others with traumatisms (controls) were investigated using histopathological (HE, VG, PAS-Alcian, Gömöri, Safranin 0), electronmicroscopic and histoenzymamologic techniques. Histopathologically, the synovitis in AS is characterized by abundant synovia lymphoplasmocytic infiltrates associated with aspects of vascular hyperplasia and fibrosis. At the pannus synovia-cartilage junction we found the invasive synovia lymphoplasmocytic infiltrates. The proteoglycan (PG) depletion is confirmed histopathologically by diminishing the Safranin 0 staining, then ultrastructurally by the existence of collagen revealing areas, whereas biochemically, by the presence of glycosaminoglycans (GAG) in serum and synovial fluid (SF). The morphological data were related to some immunological parameters involved in pathogenesis. In this way, we found pathological values of the immune circulating complexes (ICC) (serum, mean = 73.5 U; SF mean = 81.80 U) and of anti Collagen II antibodies (serum mean = 410 U; SF mean = 436 U). The reactive protein C acting in the phase (CRP) showed high pathological values both in serum (mean = 5.01 mg%) and in SF (mean = 3.6 mg%) of the patients with AS, emphasizing the inflammatory characteristics of the rheumatic disease. The presence of ICC, anticollagen II antibodies and GAS as well in synovia suggests that the inflammatory articulation in AS is a local potential antigen of collagen and proteoglycan nature.

Aspects of immunopathogenesis of rheumatoid arthritis correlated with some immunological parameters in histopathological and electronmicroscopical investigations of the articular cartilage.

The histopathological (H. E., V. G., PAS-Alcian, Safranine 0, Gömöri) and electron-microscopical investigations were carried out on twenty samples of articular cartilage taken during operations from patients with Rheumatoid Arthritis (R. A.) and from others with traumatism, as controls. Histopathologically, the rheumatoid synovial membrane is characterized by synovitis with abundant perivascular lymphoplasmocytic infiltrates. At the pannus synovia-cartilage junction we found the invasive and destructive inflammatory infiltrates penetrating and eroding the cartilage. The histopathological characteristics of the rheumatoid articular cartilage lie in alteration of tinctorial activity, affection of reticuline collagen network and the presence of superficial and deep cartilaginous fissures. The histopathological alterations were confirmed ultrastructurally. Immunologically we found pathological serum values regarding the immune circulating complexes (I. C. C.) (mean = 104 +/- 1.04 U), anticollagen II antibodies (mean = 538 +/- 5 U), reactive Protein C (mean = 16.75 +/- 1.95 mg%) and orosomucoid (mean = 151.1 +/- 4.91 mg%), in seropositive R. A. The corroboration of histopathological, electronmicroscopical and immunological data show the inflammatory and autoimmune feature of this rheumatic disease.

Histopathological and ultrastructural modifications of the articular cartilage in ankylosing spondylarthritis.

The present study aims to analyse the articular cartilage in Ankylosing, Spondylarthritis (AS) versus the normal cartilage (18 cases altogether) by histopathological (HE, VG, Pas-Alcian, Gömöri, Safranine O), electronmicroscopic and histoenzymological techniques starting from the finding that the articular exudate in this affection is characterized cytomorphologically by cytosis (6,100/mm3), with polynucleosis (61%) and ragocytosis (25%). Histopathologically, the articular cartilage in AS evinced an alteration of safraninophilic areas and pale zones located in the neighbourhood of synovial lymphoplasmocytic infiltrates, pointing to the depletion of proteoglycans. The cartilage-synovia interference areas are relevant for the invasive nature of the inflammatory infiltrates which erode the cartilage. The histopathological modifications were confirmed ultrastructurally by the existence of some extended areas of revealed collagen, indicative of proteoglycans depletion. Functionally, chondrocytes have a high oxidative potential expressed by the presence of the peroxisomes and the positive reaction of peroxidase (PO), located near the nuclear membrane and the rough endoplasmic reticulum. The corroboration of histopathological, ultrastructural and histoenzymological data shows the alteration of the articular cartilage in AS, expressed morphologically at the level of the chondrocytes and of their synthesis products, collagen and proteoglycans.