Pathological, immunological, and molecular features of Hodgkin's disease associated with HIV infection. Comparison with ordinary hodgkin's disease.

The aim of the present study was to analyze in a series of 24 HIV-positive Hodgkin's disease (HD) patients the morphological and immunological features, the presence of rearrangements in the immunoglobulin heavy chain (IgH) gene, expression of the Epstein-Barr virus (EBV) latent membrane protein-1 (LMP-1), and the existence of deletions in the intracytoplasmic domain of the LMP-1 gene. The results obtained were compared with those from a parallel series of 56 patients with ordinary HD. Briefly, comparison of the two series showed a predominance of unfavorable histological subtypes in HIV-positive HD patients. The mixed cellularity subtype was more frequent in HIV-positive than in HIV-negative HD patients: the difference in percentage was statistically significant (p = 0.04). Neoplastic cell-rich cases were significantly more frequent (p = 0.40) in HIV patients (59%) than in ordinary HD patients (34%). In 25% of HIV-infected and in 14% of ordinary HD patients, the neoplastic cells were CD20+, a difference that was not statistically representative. Clonal IgH rearrangements were detected in 33% of HIV-infected patients and in 23% of ordinary HD patients, a nonsignificant difference. LMP-1 expression was detected in 100% of HIV-positive patients and in 57% of ordinary HD patients (p = 0.004). A 30-base-pair deletion in the carboxy-terminal domain of the LMP-1 gene was found in 16 of 18 HIV-infected patients (89%), whereas it was identified in only 8 of 25 ordinary HD patients (32%) (p = 0.008). In conclusion, HD in HIV-infected patients as compared with HD in HIV-negative individuals is associated with morphological features of aggressivity, with a higher frequency of neoplastic cells, and with constant LMP-1 expression. The fact that LMP-1 is expressed in all HIV-infected patients suggests that EBV plays an etiological role in the pathogenesis of HIV-associated HD. Furthermore, the presence of EBV strains carrying deletions near the 3' end of the LMP-1 gene in the majority of cases may be related with the morphological and clinical aggressivity of HD in immunocompromised patients.

[Progressive disseminated histoplasmosis in AIDS patients]. / Histoplasmosis diseminada progresiva en pacientes con SIDA.

The clinical histories of 12 AIDS patients whose histoplasmosis diagnosis has been confirmed by histopathological studies were reviewed aimed at knowing the main clinical and microbiological aspects of the disseminated progressive histoplasmosis. In every case it appeared as a febrile and waste disease with an elevated hepatomegaly frequency and generalized adenopathies. More than 50% of the patients had anemia and an accelerated erythrocyte sedimentation. The chest X-ray showed pulmonary lesions in 50% of the patients, whereas, the abdominal ultrasound allowed to observe hepatomegaly and splenomegaly in 58.3 and 41.6% of the patients, respectively. A low sensitivity was found in the culture of different clinical specimens as well as in the antibody detection techniques. It is discussed the need to improve tha laboratory diagnosis methods, particularly those which make possible the antigen detection in a fast and specific way.

Leydig cell tumor of testis with adipose metaplasia.

A Leydig cell tumor of testis was discovered during evaluation of infertility in a 36-year-old white man with azoospermia and high plasma estrogen level. Histological examination revealed multiple foci of calcification and massive adipose metaplasia. This is the first time that adipous metaplasia is observed in association with Leydig cell tumor of testis.

Sebaceous gland hyperplasia of the vulva: a case report.

A unique case of sebaceous gland hyperplasia presenting as polypoid lesions on the vulva of a 32-year-old white woman is reported. Sebaceous hyperplasia is a benign condition most frequently seen on the forehead of elderly patients. The reported case presented with three soft, nontender polypoid lesions located on mons veneris and right labium majus. Histological examination showed hyperplastic sebaceous lobules not associated with hair follicles. The extremely rare site of the lesion, the clinical and histopathological differential diagnosis, and a therapeutical approach are discussed.

[Intoxication by diphenoxylate (author's transl)]. / Intoxicación por difenoxilato

Two cases of intoxication by diphenoxylate, inespecific antidiarrheal, depressor of the intestinal motility, are presented. Diphenoxylate is chemically related with meperidine. One case was caused by hipersensitivity and the other one by overdose. Both had a favourable outcome. Existent bibliography was reviewed and clinical signs of this intoxication pointed-out. It is suggested that diphenoxylate should not be prescribed to children under thirty months.

Exéresis del disco intervertebral por vía anterior / Anterior cervical diskectomy

Se señala que el método de la exéresis del disco por vía anterior sin fusión, se utilizó como proceder quirúrgico en el tratamiento de 32 pacientes que presentaban degeneración del disco cervical con manifestaciones clínicas de cervicobraquialgia. La desaparición a largo plazo del dolor en el 59 porciento de los pacientes, asociado con la mejoría en el orden neurológico en el 60 porciento, permiten considerar dicha intervención no sólo sencilla en la labor quirúrgica, sino también útil como terapéutica (AU)