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Biomedical subjects

A Chalvardjian

Publications and source records attributed to A Chalvardjian.

At least 19 recordsLinked to original sources
PubMed1998

Cutaneous malakoplakia in a patient with acquired immunodeficiency syndrome (AIDS).

Malakoplakia is an uncommon granulomatous lesion that afflicts predominantly immunocompromised individuals but is extremely rare in acquired immunodeficiency syndrome (AIDS). We report a case of cutaneous malakoplakia in an AIDS patient that presented as a banal right axillary abscess which resolved after excision and drainage. The rarity of malakoplakia in AIDS may be due to a relative or selective preservation of antimicrobial function of monocytes. Malakoplakia is distinguished from other inflammatory or neoplastic lesions by the presence of Michaelis-Gutmann bodies. A correct diagnosis is usually made only after biopsy and is an indication to use antimicrobial agents with adequate cellular penetration and concentration.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Primary renal artery dissection.

A typical case of primary renal artery dissection, an unusual entity causing renal infarction, is described. This abnormality, masquerading as renal colic, affects otherwise-healthy middle-aged men. Angiography, which will confirm the diagnosis, should precede nephrectomy, because vascular repair may be feasible.

Adult↗
PubMed1994

Intrathyroidal lymphoepithelial cysts of probable branchial origin.

Lymphoepithelial cysts with histological features characteristic of branchial cleft cysts have been reported to occur rarely in the thyroid gland. To our knowledge only six cases of this lesion have been reported. Since these reports brought this entity to our attention, we have noted that intrathyroidal lymphoepithelial cysts are not rare lesions. We report six further cases; four were incidental histological findings, and two lesions were clinically detected masses. Each of the cysts had a squamous epithelial lining with abundant underlying lymphoid tissue, including lymphoid aggregates with large reactive germinal centers. All cases were associated with chronic lymphocytic thyroiditis. Because of the histological resemblance to branchial cleft cysts, it is postulated that these lymphoepithelial cysts are branchial in origin. The histogenesis of branchial cleft cysts is unknown; however, the ultimobranchial body, originating from branchial pouches four and/or five, contributes to the embryological development of the thyroid. Branchial cleft derivatives, such as thymus and parathyroid, develop in close association with the thyroid and may be found within the thyroid gland. These branchial cleft-like cysts also may arise from branchial cleft derivatives, and their enlargement may be related to the immunological mechanisms associated with autoimmune thyroiditis.

Adult↗
PubMed1994

Iatrogenic endometrial megapolyps in women with breast carcinoma.

BACKGROUND: Tamoxifen, a widely used drug in adjuvant therapy of breast carcinoma, is now being tested for its effectiveness in chemoprevention. Although its side effects are few, tamoxifen increases the incidence of proliferative lesions of the endometrium, which theoretically should be preventable with progestational agents. CASES: Two postmenopausal women treated with tamoxifen and progestational agents for breast carcinoma developed uterine enlargement and intermittent spotting. Hysterectomy revealed benign endometrial megapolyps with marked stromal decidualization and edema. CONCLUSIONS: The value of multihormonal therapy in breast carcinoma is not established, and the addition of progestogens to tamoxifen may not reduce of developing endometrial lesions, including carcinoma. In both our cases, such a regimen did not prevent the occurrence of endometrial polyps which, although histologically benign, were usually large and thought clinically to be malignant. Periodic gynecologic assessment should be part of the follow-up of all women on long-term tamoxifen therapy.

Aged↗
PubMed1991

Improved endocervical sampling with the Cytobrush.

OBJECTIVE: To evaluate the effectiveness of the Ayre wooden spatula, the cotton-tipped swab and the Zelsmyr Cytobrush in obtaining endocervical cells. DESIGN: Cross-sectional comparison study. SETTING: Family practice unit. PATIENTS: All postpubertal, nonpregnant women who underwent a routine Papanicolaou smear during a 7-month period. INTERVENTIONS: The three devices were used in each patient in a randomized sequence. An experienced cytotechnologist blinded to the device used evaluated the slides for overall epithelial cellularity (graded from 0 [acellular specimen] to 12 [overloaded sample]), density (the number of groups of five or more endocervical cells) and size of cell clusters (5 to 10 cells per cluster [score of 1], 11 to 100 [2] or more than 100 [3]). MAIN RESULTS: Samples from 2 of the 136 women were rejected because of improper labelling of the slides or failure to use all three devices. Seventy-six (57%) of the smears obtained with the spatula and 71 (53%) with the swab had no endocervical cells, as compared with only 14 (10%) obtained with the Cytobrush (p = 0.001). The overall cellularity (and standard deviation [SD]) of the smears obtained with the Cytobrush (5.69 [SD 1.17], p = 0.001) and the spatula (5.70 [SD 1.46], p = 0.001) was significantly greater than the cellularity of those obtained with the swab (4.31 [SD 1.17]). The Cytobrush yielded significantly more groups of endocervical cells (109.84 per slide) than either the spatula (4.17) or the swab (6.25) (p = 0.001). The Cytobrush also produced larger cell clusters (1.56 [SD 0.67], p = 0.001) than either the swab (0.83 [SD 1.70]) or the spatula (0.64 [SD 0.67]). CONCLUSIONS: The Cytobrush and the spatula should be used instead of the spatula alone or the spatula and the swab for collecting endocervical cells.

Adolescent↗
PubMed1983

Histiocytosis X in two adults. Treatment with topical mechlorethamine.

Two adult patients with skin lesions typical of histiocytosis X were treated topically with mechlorethamine hydrochloride. In the patient whose disease was limited to the skin, a sustained remission was induced, but in the patient with extensive systemic disease, cutaneous remission lasted only six weeks.

Administration, Topical↗
PubMed1982

Gynandroblastoma: its ultrastructure.

Gynandroblastoma is a rare, sex-cord stromal tumor of the ovary that shows morphologic evidence of female and male differentiation. Such a tumor produced masculinization in a 24-year-old woman, whose symptoms disappeared following removal of the tumor. By electron microscopy, the granulosa cell nests displayed Call-Exner (CE) bodies of the hyaline type composed of multiple layers of basal lamina resembling CE bodies of the normal graafian follicle. In contrast, CE bodies of a classic granulosa theca cell tumor were of the spongiform type, consisting of a space limited by a single basal lamina containing altered granulosa cells and cell processes. Both types of CE bodies are believed to arise following secretion by and/or degeneration of granulosa cells, the variation in morphology between the two resulting from differences in amounts of basal lamina deposited. The tubular components of the tumor resembled more closely the rete ovarii than did Sertoli cells, and its proposed that such structures be called by the alternate and less specific term "androblastoma." The identity of Leydig cells was established by demonstrated of intracytoplasmic Reinke crystals. Despite a difference in architectural pattern, there was a close ultrastructural resemblance between the different sex-cord components of the gynandroblastoma.

Adult↗
PubMed1982

Cutaneous granulomatous vasculitis associated with Crohn's disease.

A thirty-nine-year-old man with Crohn's disease of fourteen years' duration developed papules and nodules on his lower extremities which, not infrequently, became purpuric or pustular, and healed with pigmented depressed scars. Histologic examination showed fibrinoid necrosis of the superficial dermal vessels associated with an inflammatory infiltrate consisting mainly of epithelioid histiocytes. Activity of the cutaneous lesions was not correlated with activity of the patient's underlying visceral disease. The cutaneous lesions improved with dapsone therapy combined with prednisone and sulfasalazine. The role of circulating immune complexes in the pathogenesis of vasculitis in Crohn's disease is reviewed.

Adult↗
PubMed1981

Crystalline tissue deposits on a case of multiple myeloma.

Crystalline tissue deposits were found at the time of autopsy in a 52-year-old male subject who had had multiple myeloma for 6 1/2 years and in whom the hyperviscosity syndrome had developed terminally. The tissue deposits were digested by trypsin, but could not be further characterized by immunohistochemical techniques. The crystals varied in size and shape and were located in tissue histiocytes, renal tubular cells, Leydig's cells, and adrenocortical cells. No crystals were identified within plasma cells. Their presence in the present case may have been related to the relatively long course of the disease, the high levels of serum proteins terminally, and unusual physicochemical structure of the secreted proteins, or possibly to the effects of chemotherapy.

Adipose Tissue↗
PubMed1980

Malacoplakia of the female genital tract.

Malacoplakia is an uncommon chronic granulomatous inflammation which most frequently involves the urinary bladder of middle-aged women and rarely affects the genital tract. In this paper 10 cases of female genital malacoplakia are reviewed, seven of which have been reported previously in the literature. Genital malacoplakia usually occurs in women 60 years of age or older and most frequently affects the vagina. Vaginal bleeding is a common presenting complaint and the lesion may simulate a malignancy. Four of the 10 patients were receiving corticosteroids at the time of diagnosis. Escherichia coli was cultured from urine or from the lesion itself in half of the cases. The disease appears to be an acquired defect in bactericidal function of histiocytes. Antibiotic therapy and surgical excision are effective, although a recurrence developed in one patient and was successfully re-excised.

Aged↗
PubMed1980

Leydig-like cells in the adrenals of a woman with ectopic ACTH syndrome.

A 36 year old woman with hypercorticism and markedly elevated blood ACTH levels underwent pituitary ablation because of suspected hypophysial Cushing's disease. Since no adenoma was detected in the anterior lobe and the hypercorticism persisted, a bilateral adrenalectomy was performed. Four months later lymph node and mediastinal metastases of an anaplastic small cell carcinoma, with the presence of argyrophil granulation, as well as immunoreactive 19-39ACTH, beta-LPH and alpha-endorphin, were found. The primary site of ectopic ACTH production was not revealed. A light and electron microscopic study of the adrenals, in addition to cortical hyperplasia, disclosed numerous small cells associated with nonmyelinated sympathetic nerve fibers and containing cytoplasmic inclusions indistinguishable from Reinke crystals. The Leydig-like cell-nonmyelinated nerve complexes, noted in both the adrenal cortex and medulla, showed perivascular localization, and their morphologic features were similar to those of hilus cells of the ovaries or extraglandular Leydig cells of the testis. The underlying mechanism accounting for the development of Leydig-like cells remained obscure; cytodifferentiation from pluripotent mesenchymal cells, possibly mediated by secretory products of sympathetic nerve fibers, may provide an explanation for their formation.

ACTH Syndrome, Ectopic↗
PubMed1978

Sarcoidosis of the female genital tract.

Sarcoidosis, a chronic, multisystemic disease, is characterized histologically by discrete, well-formed granulomas with little central necrosis. It can affect any organ system in the body and rarely involves the female genital tract. This report includes the description of a patient with genital involvement by sarcoid granulomas, who presented with postmenopausal bleeding.

Endometrium↗
PubMed1978

Renal angiomyolipoma: ultrastructural study.

An angiomyolipoma from a twenty-six-year-old woman was studied by electron microscopy. The tumor was composed of a mixture of mature smooth muscle cells, fat cells, and abnormal blood vessels. MAny of the smooth muscle cells showed excessive intracytoplasmic accumulation of glycogen, while the abnormal blood vessels lacked a normal media.

Adipose Tissue↗
PubMed1976

Ultrastructural study of testis in testicular feminization.

Testicular tissue was investigated by electron microscopy in a case of testicular feminization. The seminiferous tubules were lined by spermatogonia and by Sertoli cells. Spermatocytic maturation was not observed. Leydig cells were numerous and contained well developed, abundant vesicular smooth-surfaced endoplasmic reticulum and large mitochondria with tubulovesicular cristae. Reinke crystalloids were absent. The ultrastructural findings were consistent with the assumption that Leydig cells were under adequate stimulation and were in a stage of active secretion. Hence, the results seem to indicate that testicular endocrine function was maintained in the studied case.

Adult↗