PubMed Health⌕ Search

Biomedical subjects

A B Akosa

Publications and source records attributed to A B Akosa.

At least 19 recordsLinked to original sources
PubMed1995

Toxic epidermal necrolysis. A study of the sweat glands.

Toxic epidermal necrolysis (TEN) is a rare dermatological emergency which is caused by drugs and results in a high morbidity and a mortality rate of 20-30%. Ten confirmed cases of TEN were retrieved and the sweat glands were examined. Abnormalities of the sweat duct were found in all the cases and included basal vaculopathy, increased lymphocytic infiltration, basal apoptosis, basal cell hyperplasia and necrosis of the duct. Destruction and loss of the distal duct was present in 40% of the cases and was accompanied by dilatation of the proximal duct. In all cases, the proximal duct was involved to a lesser degree and in continuity with the distal duct, supporting the possibility of cytokine action. The secretory gland was normal. The presence of a significant reduction of sweat ducts in a disease process that involves 30-100% of the total body surface area is of clinical importance.

Adult↗
PubMed1994

Merkel cell carcinoma: a clinico-pathological report of 3 cases.

Merkel cell carcinomas are rare. The head and neck are the commonest sites of presentation. They are slightly more common in females and are frequently misdiagnosed. This tumour has had little coverage in the surgical journals which accounts for the low index of suspicion. Three cases, which were successfully treated surgically, are presented in order to increase awareness. It is a diagnosis that one should have in mind when examining an atypical skin lesion.

Aged↗
PubMed1994

Aspiration cytodiagnosis of pancreatic endocrine tumours.

We have reviewed fine needle aspirates from 11 patients with pancreatic endocrine tumours and evaluated the diagnostic criteria as well as those proposed in the literature in an attempt to formulate reliable criteria for the cytological diagnosis of these tumours. As expected, no single criterion was reliable for diagnosis: however, cells with rounded or polygonal rather than a columnar shape, cytoplasmic granularity, and eccentricity of round or oval nuclei with a finely stippled, evenly distributed chromatin pattern were features which, taken together, usually enabled one to make a reliable diagnosis. A striking feature of the smears was the cellular monotony and absence of pleomorphism of the tumour cells. Immunocytochemistry and electron microscopy identified tumour products and confirmed the diagnosis.

Adenoma, Islet Cell↗
PubMed1993

Necrotising granulomas of the uterine corpus.

Necrotising granulomatous inflammation of the uterine corpus associated with transcervical laser ablation of the endometrium occurred in four patients. The abnormalities seen, including extensive necrosis and hyalinisation with foreign body giant cells containing black foreign material, and eosinophilic homogenisation around blood vessels, were due to the effects of tissue fulguration. The presence of black foreign material in loosely organised histiocytes should alert the pathologist even in the absence of clinical information; stains for organisms are negative.

Adult↗
PubMed1992

Salivary terminal duct carcinoma.

We report two cases of terminal duct carcinoma of the minor salivary glands. The histological features, biological behaviour, treatment and the long-term management are described.

Adenocarcinoma↗
PubMed1991

Sweat gland abnormalities in lichenoid dermatosis.

Lichenoid dermatosis is a pattern description of a variety of cutaneous lesions which primarily affect the dermoepidermal junction. Involvement of skin appendages has been restricted to hair follicles in lichen planopilaris and discoid lupus erythematosus. Sweat gland involvement has not been described in the four common members of this group, namely, lichen planus, discoid lupus erythematosus, fixed drug eruptions and erythema multiforme, although structural abnormalities have been reported in graft-versus-host disease. In a detailed morphological study of 59 cases, including lichen planus (12), discoid lupus erythematosus (18), fixed drug eruption (14) and erythema multiforme (15), 78% (47/59) showed sweat, gland abnormalities. The abnormalities included vacuolation of cell cytoplasm, with and without lymphocytic infiltration, apoptosis of basal cells and basal cell hyperplasia of the excretory ducts which predominantly affected the portion of the duct adjoining the acrosyringium. The portion of the duct close to the secretory gland was only involved in continuity and the secretory glands were unaffected. These abnormalities of the sweat gland mostly constitute primary involvement by the disease process in contrast to structural abnormalities secondary to fibrosis.

Drug Eruptions↗
PubMed1991

The sweat gland in cutaneous vasculitis.

Cutaneous vasculitis commonly presents as palpable purpura, and the late stages may become nodular, bullous, infarcted and ulcerated. Involvement of sweat glands in vasculitic lesions has not been previously described. In a detailed study of 48 cases of non-infarcted cutaneous vasculitis, 18 (36%) revealed morphologically abnormal sweat glands. Basal cell degeneration, necrosis, regeneration and basal cell hyperplasia were found in the excretory ducts. Necrosis of the secretory gland was seen either as apoptosis involving the clear cells or as a whole gland necrosis involving both cell types. This unusual feature has only been described in association with coma, commonly due to barbiturate and carbon monoxide poisoning. Its presence in non-infarcted vasculitis adds support to the hypoxia/ischaemia hypothesis. The functional impact of such lesions in widespread cutaneous vasculitides requires further study.

Adolescent↗
PubMed1991

Cytodiagnosis in the management of extrahepatic biliary stricture.

A total of 117 patients presenting with extrahepatic biliary strictures between 1981 and 1989 had 206 cytological examinations of the bile duct or bile (153 non-operative, 53 intraoperative) to establish the presence of malignancy. A final diagnosis of cholangiocarcinoma was made in 88 patients, with 29 patients having benign biliary strictures. The cytological techniques used were fine needle aspiration (n = 102) or brushing (n = 24) of the bile duct, or exfoliative cytology of bile (n = 80). Forty one patients with malignancy had two or more examinations with differing results between samples in 20 cases. The overall sensitivity was 72%. There was only one false positive result, giving a patient predictive value of positive cytology of 98%. Intraoperative cytology was more sensitive than non-operative examination (80% v 42%). Overall, the sensitivity of fine needle aspiration (67%) was greater than that of brush cytology (40%) or exfoliative cytology (30%). No complications were encountered. Cytodiagnosis of extrahepatic biliary strictures is a safe procedure which is not technically demanding, and as it has a high sensitivity and predictive value for positive cytology, cytological confirmation of malignancy should be sought in all clinically and radiologically suspicious cases.

Adenoma, Bile Duct↗
PubMed1991

'Solitary' necrotic nodules of the liver: an aetiology reaffirmed.

Morphological features of lesions conforming to the description of solitary necrotic nodules of the liver were compared with liver haemangiomata and necrotic tumour metastases in the liver. An origin in haemangiomata is confirmed for most of the lesions studied, although the necrotic nodule may represent the end stage of a variety of lesions. These lesions are usually benign, although necrotic nodules are often mistaken for liver metastases. A reticulin stain is useful in assessing the lesions.

Adult↗
PubMed1991

Immunoglobulin heavy chain patterns in reactive lymphadenopathy.

Thirty one lymph nodes taken from 24 benign reactive cases, three cases of angiolymphoid hyperplasia with eosinophilia, one case of Kimura's disease and three cases of Hodgkin's disease, were stained for immunoglobulin heavy chains IgG, IgM, IgA and IgE using the peroxidase-antiperoxidase method. Reticular staining of germinal centres and cells containing immunoglobulin in germinal centres and extrafollicular regions were features of all groups. No staining pattern was diagnostic for any of these conditions and in particular, the reticular staining pattern of IgE in the germinal centres that is frequently reported in Kimura's disease and in angiolymphoid hyperplasia with eosinophilia was non-specific.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed1991

Kimura's disease and membranous nephropathy.

An interesting association of Kimura's disease and membranous nephropathy is reported in a 71-year-old Chinese patient, 40 years after emigrating to the UK from Hong Kong. Significant blood eosinophilia and a very high serum IgE level were detected, the latter with a moderate level of specificity to Candida albicans. Light microscopy of renal biopsy was unremarkable despite a proteinuria of nephrotic proportions; diffuse subepithelial dense deposits compatible with membranous nephropathy were identified on electron microscopy. The atopic nature of Kimura's disease is confirmed and C. albicans is suggested as a possible causative agent.

Aged↗
PubMed1990

The sweat gland in graft versus host disease.

Sweat gland abnormalities occur much more frequently than hitherto described in cutaneous graft versus host disease (GVHD). Two patterns of abnormalities were identified in 80 per cent of cases of acute GVHD: a cytopathic pattern consisting of a combination of basal vacuolopathy with or without lymphocytic infiltration and basal cell degeneration, and a proliferative pattern consisting of basal cell hyperplasia. In chronic GVHD, complete sweat gland destruction with fibrosis was commonly observed. Squamous metaplasia and dilation of the sweat glands were less frequently identified. Ki67 immunostaining confirmed proliferative activity in the basal cells of the distal duct. HLA-DR antigens were expressed on the basal cells of the duct and secretory glands in acute GVHD but not in normal skin. Langerhans cells were absent in both normal and abnormal sweat glands. The role of HLA-DR or Langerhans cells in the initiation of GVHD is questioned in the light of the new data and the primary involvement of proliferating cells is confirmed.

Acute Disease↗
PubMed1990

Angiolymphoid hyperplasia with eosinophilia associated with tetanus toxoid vaccination.

Three cases of angiolymphoid hyperplasia with eosinophilia are reported at the site of tetanus toxoid vaccination. All presented as nodules on the upper arm, a known adverse effect of the vaccine following superficial inoculation. Histologically the nodules showed numerous small and medium sized vessels, some lined by hyperplastic endothelial cells with perivascular lymphocytic cuffing and an inflammatory infiltrate of plasma cells, eosinophils and scattered mast cells. Lymphoid follicles replete with germinal centres were identified in the dermis and subcutaneous tissue. Immunostaining revealed a polytypic lymphoplasmacytic infiltrate and a curious IgE reticulated pattern within the germinal centres, a feature described in both Kimura's disease and angiolymphoid hyperplasia. The present study suggests that atopic reaction to tetanus toxoid may be an aetiological factor in some cases of angiolymphoid hyperplasia.

Adult↗