Inflammatory pseudotumor of nerve.

Two cases of inflammatory pseudotumor are described. The first patient, a 35-year-old white man, developed a progressive sensorimotor deficit in the right leg associated with a fusiform sciatic nerve mass in the posterior thigh. The lesion, compressive in nature and situated entirely within the epineurium, was totally resected. Histology revealed lymphocytic and plasmacellular inflammation as well as extensive fibrosis and collagen deposition. The patchy infiltrate consisted equally of CD2, CD3, CD5, and CD7 positive T-lymphocytes as well as CD20-and CD22-positive B-lymphocytes expressing both kappa and lambda immunoglobulin light chains. A selective biopsy of the encompassed and compressed nerve fascicles demonstrated both myelin loss and axonal injury. The second case was that of an 18-year-old woman with focal enlargement of a radial nerve by an epineurial infiltrate of multinucleate histiocytes and T as well as occasional B lymphocytes. No etiology was apparent in either case. The differential diagnosis includes non-neoplastic processes (amyloidoma and tuberculoid leprosy) as well as tumors (benign and malignant peripheral nerve sheath tumors, lymphoma). Although rare, inflammatory pseudotumors must be included in the differential diagnosis of tumor-like lesions of peripheral nerve.

Particulate silicone for use in periurethral injections: local tissue effects and search for migration.

We examined the histologic behavior and migratory tendencies of a silicone-based injectable paste (Macroplastique) with potential application in treating urinary incontinence. Thirteen female dogs were studied. Six received 2 periurethral injections of large-particle paste, with a median diameter of 110 microns, and 7 received similar injections with small-particle paste (median diameter, 73 microns). The paste was radiolabeled with cobalt-57. Histologic analysis was performed at 4 or 9 months. The pathologic appearance revealed intact large-particle injection sites. The small-particle sites had dissipated significantly. This was confirmed by nuclear imaging. Large particles produced an encapsulated fibrous sheath without local migration. There was a histiocytic reaction within the injection site but no granuloma formation. Distant migration was observed in 1 dog (short term, large particle), without an inflammatory response. Migration of silicone occurred locally and distantly in animals that received small particles. X-ray microanalysis confirmed the presence of silicone particles.

The significance of atypia and histologic malignancy in pilocytic astrocytoma of the cerebellum: a clinicopathologic and flow cytometric study.

Biologically malignant pilocytic astrocytomas are rare. Precise morphologic criteria permitting their identification and clinically meaningful distinction from more ordinary pilocytic astrocytomas have not been developed. The histologic grading schemes applied to fibrillary astrocytomas--ones based on nuclear atypia, increased cellularity, mitotic activity, endothelial proliferation, and necrosis--are thought not to correlate with prognosis in pilocytic astrocytomas. Nonetheless, these features were systematically sought in 107 cerebellar pilocytic astrocytomas, four of which were histologically malignant. The clinical, morphologic, and flow cytometric features of these cases were studied. The incidence of histologic malignancy occurring spontaneously in otherwise typical pilocytic astrocytomas was 0.9%; that occurring after radiation was 1.8%. The four histologically malignant tumors occurred in two males and two females, ages 6 to 18 years. All showed increased mitotic activity (three to five mitoses per high-power microscopic field [250x]). Endothelial proliferation and necrosis were present in three and two cases each. DNA ploidy analysis showed the spontaneously occurring malignant-appearing tumors to be aneuploid, whereas both previously radiated tumors were tetraploid; 5% to 11% of cells were in S phase. The appearance of histologic malignancy in pilocytic astrocytoma is rare and less reliably correlated with prognosis than in patients with fibrillary astrocytomas. Essential features of such tumors include a high mitotic index and perhaps a high percentage of cells in S phase.

Astrocytomas of the cerebellum. A comparative clinicopathologic study of pilocytic and diffuse astrocytomas.

BACKGROUND: The majority of patients with astrocytomas of the cerebellum have an excellent prognosis; however, a small percentage of patients continue to do poorly. To clarify the clinical, pathologic, and treatment characteristics that determine prognosis and therapeutic recommendations, a large group of patients with astrocytic tumors of the cerebellum was reviewed and analyzed. METHODS: A clinicopathologic analysis was performed of all patients undergoing initial operation for astrocytomas in the cerebellum between 1960 and 1984. Of the 132 patients, 105 patients had pilocytic astrocytomas and 27 had diffuse astrocytomas. RESULTS: Multivariate analysis revealed that the division of pilocytic and diffuse histologic type was the most significant prognostic factor influencing survival. The 5-year, 10-year, and 20-year survival rates were 85%, 81%, and 79%, respectively, for patients with pilocytic astrocytomas and 7%, 7%, and 7%, respectively, for patients with diffuse astrocytomas (P < 0.001). Pilocytic astrocytomas occurred in a younger age group and were more commonly cystic and completely resected. CONCLUSIONS: Astrocytomas of the cerebellum can be divided into two principal groups, the pilocytic and the diffuse astrocytomas, each of which has distinct clinical, pathologic, and prognostic characteristics.

Temporal shaping of third-harmonic pulses on the Nova laser system.

We demonstrate temporal shaping of 0.35-microm-wavelength pulses produced by a third-harmonic conversion of the output from the Nova Nd:phosphate glass-laser amplifier system for use in inertial confinement fusion experiments. We describe the computer models used to calculate the pulse shape that is required as the input to the amplifier system, the experimental apparatus used to produce these pulses, and the high-power 0.35-microm shaped pulses produced in recent experiments.

Power, energy, and temporal performance of the Nova laser facility with recent improvements to the amplifier system.

High-powered glass-laser systems with multiple beams, frequency-conversion capabilities, and pulseshaping flexibility have made numerous contributions to the understanding of inertial confinement fusion and related laser-plasma interactions. The Nova laser at Lawrence Livermore National Laboratory is the largest such laser facility. We have made improvements to the Nova amplifier system that permit increased power and energy output. We summarize the nonlinear effects that now limit Nova's performance and discuss power and energy produced at 1.05-, 0.53-, and 0.35-microm wavelengths, including the results with pulses temporally shaped to improve inertial confinement fusion target performance.

Harmonic conversion of large-aperture 1.05-microm laser beams for inertial-confinement fusion research.

To provide high-energy, high-power beams at short wavelengths for inertial-confinement fusion experiments, we routinely convert the 1.05-microm output of the Nova, Nd:phosphate-glass, laser system to its second- or third-harmonic wavelength. We describe the design and performance of the 3 x 3 arrays of potassium dihydrogen phosphate crystal plates used for type-II-type-II phase-matched harmonic conversion of the Nova 0.74-m diameter beams. We also describe an alternate type-I-type-II phasematching configuration that improves third-harmonic conversion efficiency. These arrays provide conversion of a Nova beam of up to 75% to the second harmonic and of up to 70% to the third harmonic.

Comparison of Dacron-tipped applicator and cytobrush for detection of chlamydial infections.

Endocervical samples were obtained from 435 females for Chlamydia detection by using both a Dacron swab and a cytobrush. Positive results were obtained from 35 swabs and 34 cytobrush specimens. All specimens positive with the cytobrush were detected also with swab samples. The cytobrush and Dacron swab appear to be comparable for the detection of endocervical infections with Chlamydia trachomatis.