Experimental endogenous lipid pneumonia and silicosis.
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Biomedical subjects
Publications and source records attributed to B Corrin.
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A 23-year-old woman presented with intractable iron-deficiency anaemia. A barium meal showed widespread mucosal abnormalities in the stomach and massive mucosal hypertrophy was found at laparotomy. Repeated tests for occult blood were negative but gastrointestinal haemorrhage was confirmed by isotopic blood labelling. In the face of persistent anaemia and radiological progression, total gastrectomy was performed, since when a normal blood picture has been maintained. The excised stomach showed hyperplasia of all the mucosal elements, minimal inflammation, and no obvious bleeding point. Blood loss was attributed to diapedesis from a greatly increased capillary network.
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Pleural biopsy in a 45-year-old woman with a haemorrhagic pleural effusion showed malignant cells. Stains for mucin and carcinoembryonic antigen were positive and adenocarcinoma was diagnosed. Some ultrastructural features were more typical of mesothelioma.
Light and electron microscopic features of an epithelioid hemangioendothelioma of the lung in a 43-year-old woman are reported. The tumor cells stained for factor VIII-related antigen. A mass excised from the thigh 10 years earlier showed identical appearances.
The histopathology and ultrastructure of idiopathic interstitial pulmonary fibrosis is described and illustrated. There is evidence that proliferating type II pneumocytes in regenerating alveolar epithelium are implicated in the pathogenesis of this disorder.
Electron microscopy confirms the unity of Histiocytosis X (HX) by identifying a common marker organelle in all three forms of the disease (acute disseminated HX or Letterer-Siwe disease; chronic disseminated HX or Hand-Schuller-Christian disease; localized HX or eosinophilic granuloma). The marker organelle of HX is also found in normal Langerhans' cells: these mononuclear cells are distinct from macrophages but are similarly concerned in antigen transport. HX may therefore be considered to represent a pathological proliferation of Langerhans' cells. The natural history and the clinical, radiological and pathological features of primary pulmonary HX (eosinophilic granuloma of the lungs) are described, together with the differential diagnoses which must be considered by the histopathologist.
The structure of bronchial carcinoids, oat cell carcinomas and pulmonary 'tumourlets' is described and evidence presented that they are related histogenetically, all being derived from certain specialized cells of endocrine or chemoreceptor nature found within the lining epithelium of the airways. Chemoreceptors related to pulmonary blood vessels have also been identified and two different types of pulmonary tumour have both been termed chemodectoma in the belief that they arise from such structures: these are the so-called multiple minute chemodectoma and the larger solitary variety but the exact histogenesis of both these tumours must remain conjectural at present.
Two further cases of the so-called intravascular bronchioloalveolar tumour of lung are reported. Electron microscopic demonstration of Weibel-Palade bodies and immunocytochemical demonstration of factor VIII in the cytoplasm of the tumour cells indicate the vascular nature of these lesions. One patient presented with an enlarged liver and the tumour was found to be involving the liver and parietal pleura as well as the lung. The characteristic micropolypoid structure was not seen in the pleural or hepatic deposits and it is evident that this feature is a consequence of the alveolar architecture of the lung and is not an inherent property of the tumour.