Subject(s)
Diarrhea/etiology , Intestinal Neoplasms/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, T-Cell/diagnosis , Mediastinal Diseases/diagnosis , Sarcoidosis/diagnosis , Celiac Disease/diagnosis , Celiac Disease/pathology , Chronic Disease , Diagnosis, Differential , Diarrhea/pathology , Humans , Intestinal Mucosa/pathology , Intestinal Neoplasms/pathology , Lymphoma, Non-Hodgkin/pathology , Lymphoma, T-Cell/pathology , Male , Mediastinal Diseases/pathology , Middle Aged , Sarcoidosis/pathologyABSTRACT
A case is reported of a 34 year old woman, who was hospitalized because of cardiopulmonary shock of sudden unsuspected onset. X-ray examination revealed diffuse interstitial pulmonary infiltration. Intra-aortal counter-pulsation did improve the condition only for short time. On autopsy an adenocarcinoma of the stomach was found, as well as diffuse carcinomatous infiltration of pulmonary lymph and arterial vessels. Thus lymphangiosis carcinomatosa has to be taken into consideration in discussing the differential diagnosis of diffuse interstitial pulmonary infiltration in young patients. The presence of microangiopathic hemolytic anemia may help to establish the diagnosis.
Subject(s)
Shock, Cardiogenic/etiology , Stomach Neoplasms/complications , Adenocarcinoma/diagnosis , Adult , Disseminated Intravascular Coagulation/etiology , Female , Humans , Lymphatic MetastasisABSTRACT
Fragmented erythrocytes (schistocytes) were counted in blood subjects and from 50 patients who underwent various surgical procedures. The results showed to be as follows: 1. The average number of schistocytes in healthy controls of both sexes was 1-20/00 (medium in Thoma chamber 1.4%0/00, in blood smears 2.030/00, with a range from 0-50/00 and 0-60/00, respectively). 2. There was an increase in the number of schistocytes two hours after a surgical procedure (average 60/00), the degree of which correlated with the extent of the operation. Higher values of fragmented erythrocytes were counted after intraoperative blood transfusion (average 100/00). In most cases schistocyte values returned to normal at about 24 hours after surgery. 3. The highest schistocyte counts (18-350/00) were observed in two patients undergoing splenectomy with persistence of elevated counts for a longer period. 4. The average schistocyte number in stored blood of various age was 2.50/00. 5. Both counting of schistocytes in Thoma chambers and in blood smears are applicable, though the values obtained with the latter technique are slightly higher. Quantitative estimtion of schistocytes proves a useful method for evaluating disturbances in microcirculation.
