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Biomedical subjects

A H Dao

Publications and source records attributed to A H Dao.

At least 19 recordsLinked to original sources

Malignant lymphoma of the ovary: report of a case successfully managed with surgery and chemotherapy.

Incidental finding of a primary malignant lymphoma of the ovary in a 20-year-old patient is presented. Two and a half years following ablative surgery and adjuvant chemotherapy, the patient is alive and disease free. Ovarian lymphoma is a disease of reportedly poor prognosis. However, many previously reported cases of ovarian lymphoma actually represented ovarian involvement by a more diffuse lymphomatous process. If stringent criteria are used for case selection, true primary ovarian lymphoma usually carries a favorable prognosis.

Adult↗

Inflammatory pseudotumor of the pelvis: case report with review of recent developments.

A case of a successfully treated inflammatory pseudotumor (IPT) of the pelvis in a 9-year-old male is presented. Review of the literature indicates that IPTs have been reported from a variety of anatomic locations. They form a spectrum of lesions ranging from benign, infection-related lesions to low-grade malignancies, capable of local recurrences and rare distant metastases. The site of involvement seems to have prognostic implication. Pulmonary IPTs are found in older patients and are almost always benign, whereas extrapulmonary IPTs tend to occur in younger patients and are, in general, more aggressive, with a recurrence rate of up to 24 per cent and mortality of up to 7 per cent. The treatment of choice is complete resection of the lesion.

Child↗

Pathology of acute fatal babesiosis in hamsters experimentally infected with the WA-1 strain of Babesia.

A strain of Babesia (strain WA-1), recently isolated from a human in Washington State, was found to be unusually virulent for hamsters; it caused acute infection and death in a large proportion of animals 5 to 7 days after inoculation. To assess the basic pathologic lesions associated with this infection, 30 male Syrian hamsters (Mesocricetus auratus) were inoculated intraperitoneally with the WA-1 strain. Twelve animals (40%) died within 5 to 6 days. The other 18 animals, all infected and clinically ill, were killed on the sixth or seventh day for biochemical study. All 12 animals that died from the infection showed high parasitemia, heavy intravascular hemolysis, and pronounced vascular stasis with red-cell sequestration in the spleen, liver, lungs, kidneys, and brain. Serologic study revealed severe anemia (mean hematocrit, 29) with hemolyzed serum and marked elevation of the serum transaminases. The mechanism of death was thought to be diffuse anoxic tissue damage secondary to vascular stasis, which led to multiorgan failure.

Acute Disease↗

Human papillomavirus in women. A three-year experience in a county hospital colposcopy clinic.

The human papillomavirus (HPV) has been associated with cervical dysplasia and carcinoma. This report summarizes the authors' experience with HPV-related problems over three years, 1987-89, while managing 1,644 women at a county hospital colposcopy clinic. Probes for HPV DNA were not used, and the diagnoses were made with cytologic and histologic criteria alone. The percentage of patients referred to the clinic with HPV found on routine Papanicolaou smears rose significantly, from 3 in 1987 to 18 in 1989. Fifteen percent of those referred because of HPV on a Papanicolaou smear were found to have cervical intraepithelial neoplasia (CIN) grade II or III after they were evaluated at the clinic. Of the 367 cases of biopsy-proven cervical HPV, only 33 (9%) were recorded on Papanicolaou smears performed immediately before the biopsy, and 140 (38%) also had concomitant, biopsy-proven CIN, grade II or III. Of the 195 instances in which the colposcopic impression was simple HPV without CIN, 46 (24%) had high-grade CIN on biopsy. We conclude that the proportion of patients with HPV-associated problems is increasing, that the Papanicolaou smear is not sensitive in detecting cervical HPV infections, that patients with HPV changes found on Papanicolaou smears should be evaluated with colposcopy and that lesions that appear colposcopically to be simple HPV should undergo biopsy to rule out the presence of high-grade CIN.

Biopsy↗

Malignant lymphoma of the breast: a review of 13 cases.

Thirteen cases of primary malignant lymphoma of the breast are reported from a 15-year retrospective review of records. The ages ranged from 19 to 75 years. One patient had nodular sclerosing Hodgkin's disease and 12 had non-Hodgkin's lymphoma. Eleven patients were treated with local excision, followed by radiotherapy, chemotherapy, or both. One patient had mastectomy and chemotherapy, and one had local excision only. Four patients died 6 months to 7 years after initial diagnosis. One patient was alive and with disease 5 years later. The remainder were alive and free of disease 24 months to 9 years after presentation. Prognosis depended on the clinical stage and histologic grade of the lesion. Five-year survival was 72 per cent, which was slightly better than that observed in mammary carcinoma.

Adult↗

A case of opisthorchiasis diagnosed by cholangiography and bile examination.

A case of symptomatic opisthorchiasis in a 66-year-old Laotian immigrant is presented. The diagnosis was made by transhepatic cholangiography and by finding the trematode eggs in bile fluid. The characteristic cholangiographic changes of opisthorchiasis are described, including the intraluminal filling defects, the diffuse irregular dilation of the intrahepatic bile ducts, and the abrupt endings of the terminal branches. The importance of microscopic examination of the bile is stressed especially when stool examination is negative.

Aged↗

Primary malignant melanoma of the adrenal gland. A report of two cases and review of the literature.

Primary malignant melanoma of the adrenal gland is an established entity despite early doubts. It originates in the adrenal medulla from cells derivative of the neural crest. Because of the high frequency of metastatic involvement of the adrenal by cutaneous and ocular melanomas, rigid diagnostic criteria should be followed. Only four cases of this lesion have been reported since 1946. Review of these four together with the two described in this article shows that primary adrenal melanoma is a highly malignant tumor of middle age that often manifests as a painful flank mass. Distant lymph node metastases can be seen as a presenting sign. Treatment is not effective with a mortality rate approaching 100 per cent within two years. Since the true melanocytic origin of primary adrenal melanoma has not been established and because of the similarity of its pathologic findings with the pheochromocytomas, we believe that adrenal melanoma arises from the pheochromocytes and should be called "melanotic malignant pheochromocytoma."

Adrenal Gland Neoplasms↗

Xanthogranulomatous cholecystitis. A clinical and pathologic study of twelve cases.

Xanthogranulomatous cholecystitis often presents as a severe chronic cholecystitis associated with abdominal pain, fever, and leukocytosis. Gallstones are present in most cases. At operation, there are adhesions to surrounding tissues, and sometimes a mass is found, mimicking tumor of the gallbladder. The gross and microscopic appearances are characteristic with multiple intramural nodules composed of foamy histiocytes and inflammatory cells. Cholesterol contents of these nodules are high. Involvement of the Rokitansky-Aschoff sinuses with liberation of bile lipids into the adjacent tissue is implicated in the pathogenesis of this lesion.

Adult↗

Serum beta-human chorionic gonadotropin levels relate poorly with the size of a tubal pregnancy.

Ectopic implantation usually begins with relatively normal growth of trophoblast and serum beta-hCG progression. However, the trophoblast eventually erodes into vessels and a variable degree of bleeding and hematoma compromises its growth. The serum beta-hCG level then usually begins to demonstrate some degree of abnormal progression. For our patients, the length of the ectopic pregnancy varied widely, depending mainly on when the individual patient chose to seek medical treatment. Infertility patients followed from the moment of conception would thus be expected to show a better correlation between early beta-hCG levels and the size of the tubal pregnancy. Preconditions for the operative laparoscopic management of a tubal pregnancy usually include that the tube be unruptured, less than 3 cm in diameter, and readily accessible via the laparoscopic approach. Ackerman et al. suggested there was a general correlation between the serum beta-hCG level and tubal rupture, and the present data demonstrate an overall positive correlation between the size of the tubal pregnancy and the serum level. However, the range of levels is so broad for any given size of mass or tubal status that this correlation is not meaningful clinically. A reliable method to determine the size and status of a tubal pregnancy before laparoscopy would be valuable. Unfortunately, we did not find the preoperative serum beta-hCG level to be useful for making this prediction.

Chorionic Gonadotropin↗

Granular cell tumors.

A lesion of unknown etiology and histogenesis, the granular cell tumor usually arises in the skin or soft tissue. It has been reported, however, in other sites and can be multifocal. The authors have seen 31 such tumors in 26 patients in their institutions since 1970. Most (21) patients were females, and 12 patients were black. The average age was 41.8 years, excluding two newborns with a congenital granular cell myoblastoma of the gingiva. The most common site of occurrence was the skin; seven tumors originated from the trunk and five from the extremities. Four lesions were found in the breast, three on the vulva, two in the axilla, two in the gum, two in the buccal cavity, two in the esophagus, and one each in the stomach, gluteus muscle, eyelid, and bronchus. Two patients had multiple synchronous lesions. These were bilateral hand lesions in one patient, and lesions of the breast and axilla in the other. A third patient had three separate lesions which arose over the course of 5 years, involving the bronchus, the gluteus muscle, and the buccal mucosa. An additional esophageal lesion was an incidental finding 3 years after excision of a granular cell tumor of the breast. All of the tumors were removed with local, simple excision, except for the 2-cm lesion in the stomach for which a wedge resection of the fundus was necessary and the bronchial lesion for which a wedge resection of the left upper lobe of the lung was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Visceral larva migrans involving the myocardium: report of two cases and review of literature.

Two cases of asymptomatic visceral larva migrans (VLM) involving the myocardium, discovered during open heart surgery, are reported. Only 7 cases of VLM myocarditis were found in recent English publications. All 7 cases involved children, with most of the patients acutely ill. Our 2 asymptomatic cases, coupled with the high rate of positive serologic tests in the general population, stress the widespread nature of Toxocara canis infection in human and the large number of subclinical, undetected cases.

Child, Preschool↗

Evaluation of the new generation of urinary pregnancy tests.

Five new enzyme-linked urinary pregnancy tests were compared with the older hemagglutination assay. Urine came from 60 patients with a simultaneous serum beta-subunit of human chorionic gonadotropin determination. The new enzyme-linked kits have improved sensitivity with fewer false positive results than the older system. Some kits are clearly quicker and simpler to use than others.

Antibodies, Monoclonal↗

Pseudotumor of the lung.

Benign lung tumors in children are rare. An equally uncommon finding is the inflammatory pseudotumor, a lesion that is grossly similar to a tumor and yet cannot be histologically defined as a neoplasm. They have been called xanthomas, histiocytomas, solitary mast cell granulomas, and xanthogranulomas by various authors. There is a tendency to overtreat these lesions as if they were malignant. In previous reports, lobectomy has been the usual treatment for these tumors. If a pseudotumor is suspected at exploratory thoracotomy, a wedge resection and frozen section should be considered. When these benign lesions are easily accessible, they can be enucleated, leaving all of the normal pulmonary tissue intact without compromising cure.

Adolescent↗