Endocardial fibroelastosis and myocardial calcification secondary to an anomalous right coronary artery arising from the pulmonary trunk.

The case of an infant with endocardial fibroelastosis and a coexistent anomalous right coronary artery that originated from the pulmonary trunk is presented. The causal relation between the two conditions is discussed.

Prostatic mucinous adenocarcinoma.

Primary mucinous adenocarcinoma of the prostate is rare. It is necessary to exclude extraprostatic primary sources, particularly from the gastrointestinal tract and the urinary bladder. Immunoperoxidase stain can serve the purpose of differential diagnosis. Usually, the presence of mucin in prostatic carcinoma is associated with a less aggressive tumor.

Primary mediastinal choriocarcinoma in a man with an abnormal chromosome.

We have described a case of primary choriocarcinoma of the mediastinum and reported the results of electron microscopic and immunohistochemical studies. In the past, the prognosis of this tumor was poor, despite aggressive chemotherapy. Results of the recently developed protocol using intensive therapy with cisplatin-containing agents are promising.

Creatine kinase activity and isoenzyme pattern in various normal tissues and neoplasms.

I measured total creatine kinase (CK; EC 2.7.3.2) activity and isoenzyme pattern in normal and neoplastic tissues. CK activity was detected in all of them examined. In various tumors it was greater than, less than, or the same as that in normal tissue, no clear correlation being seen between total activity and growth rate or degree of differentiation. In several cases, there was a greater proportion of the CK-MM isoenzyme, and 15 of 53 cases showed an atypical CK-MM band. The atypical CK-MM band, also reported by others, might be an insensitive and nonspecific tumor marker. The CK-BB isoenzyme, ubiquitous in neoplastic tissues, might accordingly be a nonspecific marker. Total CK activity was very low in most tumor tissues. Presumably a bulky tumor or an advanced stage of malignancy is a requisite to release of routinely detectable CK-BB into the circulation.

Stone-like calcification of hypernephroma.

A case of stone-like calcification of renal cell carcinoma is presented. The pattern of calcification in relation to prognosis of renal cell carcinoma is discussed.

Malignant fibrous histiocytoma of the ileum.

Malignant fibrous histiocytoma occurs most commonly in the extremities and trunk, but rarely in visceral organs. This report documents a case of malignant fibrous histiocytoma arising in the terminal ileum. Following surgical resection, there is no evidence of recurrence or metastasis in this patient after one-year follow-up studies.

Rectal malacoplakia in a patient with Hodgkin's disease. Report of a case and review of the literature.

A 37-year-old man was found to have classic malacoplakia of the rectum after three courses of chemotherapy for stage IV Hodgkin's disease. Sigmoidoscopy with excisional biopsy was performed because of rectal bleeding. The biopsy specimen of the rectal lesion showed focal extensive granulomatous changes with large macrophages containing round, dense Michaelis-Gutmann bodies. Electromicroscopy demonstrated calcifying spheres with laminated concertric structures (Michaelis-Gutmann bodies) and coliform bacillus in the cytoplasm of macrophages (Von Hansemann bodies). Review of the literature revealed that association of malacoplakia with Hodgkin's disease has never been documented, although it has been reported to be associated with conditions such as malignancy, organ transplantation, collagen disease, and leukemia. The possible role of immune disturbance as an underlying cause of malacoplakia is discussed.

Urinary sediment cytology: potential diagnostic tool for malakoplakia.

The urinary sediment cytology is described in a case of malakoplakia involving the urinary bladder and the renal pelvis. The cytologic alterations are unique and can replace the invasive procedure such as biopsy.

CK-MB isoenzyme in patients with polymyositis.

Total serum creatine kinase and isoenzyme levels were studied in five patients with polymyositis. In all five patients, CK-MB isoenzyme was demonstrated by the column chromatography and electrophoretic method, although there was no evidence of myocardial infarction. The persistent elevation of CK-MB in patients with polymyositis is in contrast to the usual transient increase in myocardial infarction. Serial CK-MB isoenzyme quantitation can be used to distinguish myocardial infarction from polymyositis. CK-MB is a more sensitive indicator than AST and LDH as a monitoring device, but offers no advantage over total CK activity.

Sudden death in young athletes.

The sudden, unexpected death of four young athletes and the findings in their hearts at the time of necropsy were studied. Two athletes had anomalous left coronary origin from the anterior valsalva's sinus. In these cases, the sharp left-ward passage of the coronary artery along the aortic wall may cause the entrance into the left coronary system to be slit-like. There may be an increased expansion of the pulmonary artery and aorta with increased cardiac activity during exercise. Consequently, the left coronary artery may stretch and form a flap-like closure of the orifice of the left coronary, with sudden, fatal myocardial ischemia. The third young athlete had hypertrophic cardiomyopathy that could account for his sudden death; however, the cause of sudden death of the fourth could not be explained despite careful studies.

Case report. Pulmonary dirofilariasis in man.

A case of pulmonary dirofilariasis in a 69-year-old woman is presented. A review of the literature revealed 56 documented cases. As in most cases of pulmonary dirofilariasis, our patient presented roentgenologically a single noncalcified coin lesion and required thoracotomy for diagnosis. The gross and histologic characteristics of the lesion, the life cycle of the parasite, the subcutaneous form of human dirofilariasis, and the possible role of the immunologic tests in establishing the diagnosis are briefly discussed. The incidence of pulmonary dirofilariasis appears to be increasing. Awareness that such entity exists is important since correct preoperative diagnosis can alleviate unnecessary surgical intervention.

Circulating CK-MB and CK-BB isoenzyme after gastrointestinal surgery.

The effect of gastrointestinal surgery on serum creatine kinase activity was studied in 30 patients. The MB isoenzyme was demonstrated in sera of 30% of the patients and BB isoenzyme in 23%. MB content varied from 0.8 to 10.3% of the total creatine kinase activity, and the BB content from 0.6 to 18.4%. The CK-BB was probably of gastrointestinal origin, since gastrointestinal tract contains high CK activity with BB isoenzyme predominating. A cardiac origin for the observed serum CK-MB isoenzyme increase would seem the most likely, although no patients showed evidence of electrocardiographic changes. Increased CK-MB activity has been observed in myocardial ischaemia without infarction.

Total CK activity and isoenzyme patterns in normal and neoplastic tissue of gastrointestinal tract.

Total creatine kinase (CK) activity and isoenzyme distribution were determined in normal and tumour of gastrointestinal (GI) tract. Total CK activity per gram wet tissue appeared to be markedly reduced in malignant tumour tissue, yet it was raised in benign tumour tissue. CK-BB was the predominant isoenzyme in both normal and tumour tissue of GI tract. Alteration of isoenzyme pattern was noted between the normal and tumour tissue. In one patient, macro-CK was found in tissue homogenate.