ABSTRACT
A 49-year-old woman had a mass in the left submaxillary salivary gland that histologic examination showed to be a Warthin's tumor. In addition, there were multiple necrotizing and confluent granulomas that stained positive for histoplasma organisms using the Gomori methenamine silver stain. The histoplasma organisms in the lymphoid tissue with Warthin's tumor is an extrapulmonary manifestation of the disease which probably spread from the lungs via the lymphatics. The coexistence of the Warthin's tumor and the granulomas is a rare incidental finding.
Subject(s)
Granuloma/complications , Histoplasmosis/complications , Submandibular Gland Diseases/complications , Submandibular Gland Neoplasms/complications , Female , Granuloma/pathology , Histoplasmosis/pathology , Humans , Middle Aged , Necrosis , Submandibular Gland Diseases/pathology , Submandibular Gland Neoplasms/pathologyABSTRACT
In 4 out of 202 consecutive electrophoretic patterns for serum alkaline phosphatase isoenzymes, an extra band was observed in the albumin zone. Subsequent heat inactivation tests and comparison studies with an albumin-based bilirubin standard indicated that the band was due to staining of an albumin-bilirubin complex. The band should not be mistaken for an isoenzyme of alkaline phosphatase.
Subject(s)
Alkaline Phosphatase/blood , Bilirubin/blood , Electrophoresis, Cellulose Acetate , Electrophoresis , Isoenzymes/blood , Serum Albumin/analysis , Adult , Alkaline Phosphatase/analysis , Blood Protein Electrophoresis , Cholestasis/blood , Humans , Isoenzymes/analysis , Liver Diseases/blood , Middle AgedABSTRACT
A renal-cell carcinoma was discovered and resected in a 38-year-old female patient who had microcytic normochromic anemia. During treatment with ferrous gluconate, the anemia regressed temporarily but reappeared with the onset of metastases to the abdominal lymph nodes. Heavy deposits of hemosiderin were observed in tumor cells in the resected kidney and lymph nodal metastases. It is postulated that the anemia resulted from metabolic diversion and storage of iron by the tumor cells.
Subject(s)
Adenocarcinoma/metabolism , Anemia/etiology , Hemosiderosis/etiology , Kidney Neoplasms/metabolism , Adenocarcinoma/complications , Adenocarcinoma/pathology , Adult , Anemia/metabolism , Female , Hemosiderosis/complications , Humans , Iron/blood , Kidney/pathology , Kidney Neoplasms/complications , Kidney Neoplasms/pathology , Neoplasm Metastasis/metabolismABSTRACT
A 56-year-old woman had solitary plasma-cell myeloma in the right humerus. Six weeks after local irradiation therapy, she died from pulmonary alveolar hemorrhage and bilateral pleural effusion with malignant plasma-cell infiltration of the right atrium. Ultrastructural studies of the plasma cells from the myocardium demonstrated large bundles of prominent, non-branching, solid cytoplasmic fibrils in many cells. Each fibril had a width of 66--132 A, periodicity of 30--60 A, and a beaded appearance. These features suggest that the fibrils may be protein material, possibly an immunoglobulin.
Subject(s)
Bone Neoplasms/ultrastructure , Cytoplasm/ultrastructure , Cytoskeleton/ultrastructure , Plasma Cells/ultrastructure , Plasmacytoma/ultrastructure , Blood Protein Electrophoresis , Cell Nucleolus/ultrastructure , Cell Nucleus/ultrastructure , Chromatin/ultrastructure , Endoplasmic Reticulum/ultrastructure , Female , Humans , Middle Aged , Mitochondria/ultrastructureABSTRACT
Two patients with IgD myeloma protein and lambda light chains are described. They had marked Bence Jones proteinuria, were treated with melphalan, prednisone, and allopurinol and died in less than one year. At autopsy, there was extensive myelofibrosis associated with neoplastic infiltrates of plasma cells in both cases. On electrophoresis, the serum and urine Bence Jones protein of one patient migrated in the alpha2 region, and the blood vessels of the other patient contained many nodular deposits of amyloid. Because these findings are rare in multiple myeloma, they may be unique to IgD myeloma.
Subject(s)
Amyloidosis/complications , Immunoglobulin D , Multiple Myeloma/blood , Primary Myelofibrosis/complications , Aged , Amyloidosis/pathology , Autopsy , Bone Marrow/pathology , Female , Humans , Immunoglobulin lambda-Chains , Kidney/pathology , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/pathology , Plasma Cells/pathology , Primary Myelofibrosis/pathology , Spleen/pathologyABSTRACT
Autopsy of a patient with well-documented myelofibrosis revealed marked proliferation of mast cells associated with areas of bone-marrow and splenic fibrosis. The findings suggest that the local fibrosis represents the healed phase of an inflammatory reaction mediated by mast cells via the release of histamine into the tissue spaces. Tissue mastocytosis may be the pathogenetic mechanism in some cases of myelofibrosis.
