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Biomedical subjects

A R Solomon

Publications and source records attributed to A R Solomon.

At least 19 recordsLinked to original sources

Angiomatosis with luminal cryoprotein deposition.

BACKGROUND: Angioendotheliomatosis has recently been separated into two types. Malignant angioendotheliomatosis is a lymphoma in which the neoplastic cells accumulate in vascular lumens. Reactive angioendotheliomatosis is a proliferation of capillaries that is less well characterized. OBJECTIVE: Our purpose was to describe the clinical and histopathologic features of three cases of reactive angiomatosis in patients with cryoproteinemia. METHODS: Clinical and histologic data were correlated. Immunoperoxidase staining and electron microscopy were used in the histologic evaluation. RESULTS: All three cases showed tufts of capillaries with luminal deposits of cryoproteins. Immunohistochemical studies showed that the cellularity of the tufts was primarily caused by a proliferation of pericytes. CONCLUSION: Cryoproteinemia can cause angiomatosis that simulates a vascular neoplasm.

Aged

DNA ploidy and cell cycle analysis in ear malignant melanoma by flow and image cytometry.

Sixteen ear malignant melanomas (MM) were studied for ploidy and cell cycle analysis by flow and image cytometry. The results were compared with clinical (age, sex, stage), histologic (depth of invasion, level, type) and prognostic (recurrence, death) parameters. Single nuclear suspensions were obtained from fixed, paraffin-embedded tumor and adjacent normal tissue processed separately according to Hedley's technique. These, a "spiked" specimen of normal tissue and tumor, and a spleen diploid control were analyzed on a FACScan flow cytometer (Becton Dickinson, Mountain View, California, U.S.A.). Feulgen-stained Cytocentrifuge preparations of nuclear suspensions of normal, MM and diploid spleen were analyzed with the CAS 200 Image Analyzer (Cell Analysis Systems, Inc., Elmhurst, Illinois, U.S.A.) against commercial calibration rat hepatocytes defined as diploid. Six (37.5%) MM were diploid, and 10 (62.5%) were aneuploid; 8 (90%) were hypodiploid, for a high frequency. There were no statistically significant correlations between clinical, pathologic, prognostic or cell cycle analysis parameters and ploidy, although poor prognostic features tended to be in aneuploid lesions.

Cell Cycle

Thrombotic vasculopathy associated with cryofibrinogenemia.

Cryofibrinogenemia refers to the presence of cold-precipitable plasma proteins associated with a variety of disorders, including malignancies, inflammatory processes, and thrombohemorrhagic phenomena. Few cases of essential or primary cryofibrinogenemia are reported. We report a case in a 48-year-old man of essential cryofibrinogenemia and hemorrhagic necrosis of the ears and of the upper and lower extremities. Histopathologic studies demonstrated extensive eosinophilic thrombi in the dermal vasculature, with minimal inflammation and no vasculitis. Cryofibrinogenemia should be considered in the investigation of patients with otherwise unexplained cold intolerance and dermal thrombosis associated with minimal or no inflammation.

Arterioles

Cutaneous and cardiac myxomas: an important association.

Carny and others have described the association of cutaneous myxomas and various nevomelanocytic neoplasms with cardiac myxomas and endocrine neoplasms. The association between cutaneous and cardiac myxomas is especially important in view of the potentially serious, even fatal, embolic sequelae of the latter neoplasm.

Heart Neoplasms

Sclerosing panniculitis. A clinicopathologic assessment.

Six patients with well-circumscribed, indurated, inflammatory plaques of the lower extremity are described. Incisional biopsy specimens in each patient revealed fat necrosis, sclerosis, and a lobular panniculitis. These patients are similar to those described under the designations hypodermitis sclerodermaformis or lipodermatosclerosis. The name sclerosing panniculitis is proposed to unify these conditions. The pathogenesis is unknown, although a role for venous stasis or previous thrombophlebitis has been proposed. Systemic or local anti-inflammatory therapies have not been clinically effective.

Adult

Malignant dermal cylindroma in a patient with multiple dermal cylindromas, trichoepitheliomas, and bilateral dermal analogue tumors of the parotid gland.

A malignant dermal cylindroma of the scalp arose from one of multiple long-standing dermal cylindromas in a 76-year-old man with coexisting trichoepitheliomas and bilateral dermal analogue tumors of the parotid gland. The histologic transition from a benign dermal cylindroma to an anaplastic keratinocytic neoplasm was readily apparent. The malignant dermal cylindroma is a rare neoplasm. To our knowledge, the constellation of benign and malignant dermal cylindromas, multiple trichoepitheliomas, and salivary gland neoplasms has not been previously reported.

Adenoma

Eosinophilic panniculitis associated with chronic recurrent parotitis.

A 37-year-old woman presented with recurrent erythema nodosum-like lesions on her arms and legs that were preceded by chronic recurrent parotitis. Microscopic examination revealed a mixed lobular and septal panniculitis with many eosinophils and multiple eosinophilic flame figures similar to those seen in Wells' syndrome. The dermis was not involved. The classification, differential diagnosis, and possible pathomechanisms of eosinophilic panniculitis are discussed.

Adult

Disorders affecting the skin and the heart.

Numerous disorders affect both the skin and the heart. These include inherited and metabolic disorders, rheumatologic diseases, infectious diseases, and a variety of others. In many instances, awareness of this association allows the dermatologist to assist in identifying potentially life-threatening cardiac conditions.

Communicable Diseases

New diagnostic tests for herpes simplex and varicella zoster infections.

Laboratory tests for herpetic infections can be divided into (1) morphologic, (2) immunomorphologic, (3) serologic, and (4) virologic. Tzanck smears are easy to do, inexpensive, and compare favorably with cultures and immunofluorescence tests for specificity and sensitivity, but they require considerable experience to interpret accurately and they cannot differentiate between herpes type 1, herpes type 2, and varicella zoster infections. Biopsies are useful when clues to a diagnosis are being sought. Peroxidase-antiperoxidase and avidin-biotin tests present technical difficulties but interpretational difficulties are low and the results are available in a few hours. They can distinguish between herpes type 1, herpes type 2, and varicella zoster virus, as can immunofluorescence using monoclonal antibodies. Serologic tests are used primarily to distinguish between primary and recurrent herpes simplex infections. Virus isolation in tissue cultures is the gold standard for identifying herpes simplex virus but it is not 100% specific or 100% sensitive. Restriction endonuclease analysis identifies types and strains of virus by their deoxyribonucleic acid composition and it is very useful in epidemiologic studies. Ability to find virus by whatever method is influenced by the stage of the lesion. As lesions age, less infectivity and antigen result in less sensitivity of the tests.

Culture Techniques

Alpha 1-antitrypsin deficiency associated with panniculitis.

Alpha 1-Antitrypsin is the principal serum protease inhibitor. In addition to the well-recognized association with early-onset emphysema and cirrhosis, alpha 1-antitrypsin deficiency may be associated with panniculitis. In this article we describe three patients in whom the recognition of certain clinical and histologic features of panniculitis eventually led to the diagnosis of alpha 1-antitrypsin deficiency. Two of our patients were young adults and one was a child. All three had draining, panniculitis, or cellulitis-like lesions at sites of prior trauma. The histopathologic findings were characterized by liquefactive dermal necrosis and collagenolysis of the fibrous septa of the subcutis. The combination of these clinical and microscopic findings should suggest the diagnosis of alpha 1-antitrypsin deficiency panniculitis. The suspicion can be verified by obtaining quantitative serum levels and enzyme phenotyping. The identification of the alpha 1-antitrypsin deficiency state as the cause of a distinct type of panniculitis adds additional evidence for the elimination of the term Weber-Christian disease.

Adult

Neutrophilic vascular reactions.

Dermatologic diseases are classified most commonly by morphology, by pathogenesis, or by etiology. Nontraditional classifications may be useful in terms of providing a reassessment of traditional views about disease interrelationships. This review of dermatoses characterized by neutrophilic infiltrates and dermal vessel changes reveals evidence suggesting that these dermatoses result from immune complex-mediated, neutrophil-induced dermal vessel damage. Therapeutic approaches to these heretofore unlinked dermatoses are remarkably similar.

Behcet Syndrome

Recurrent subepidermal calcified nodule of the nose.

A form of idiopathic calcinosis cutis, subepidermal calcified nodule (SCN), recurred twice on the nasal ala of a healthy 6-year-old girl whose serum calcium and phosphorus levels were within normal limits. Basophilic granular material and numerous mast cells were present in the superficial dermis. The pathogenesis of SCN is uncertain, but the clinical and histologic features of this lesion are distinctive.

Biopsy