Biomedical subjects
Publications and source records attributed to H Turani.
A case of a rare primary urethral carcinoma is presented. The histochemical characteristics of this tumor are identical to those of colon tumors. The patient was treated with segmental urethrectomy.
Cystic changes of gastric mucosal glands have been described mainly after gastric operations, and like intestinal metaplasia and dysplasia, they may represent a premalignant condition. Their association with gastritis raises the possibility of their being secondary to the inflammatory process. Enterogastric reflux of duodenal contents, local chronic ischemia, and inflammatory reaction as a result of gastric surgery and suture at gastroenterostomy have been considered responsible for this lesion. In 18 of 157 consecutive patients (11.5%) who underwent endoscopic gastric biopsy within a year we found cystic changes of gastric mucosal glands. Cystic changes were present in 43% of 30 patients after gastric operation for duodenal ulcer disease, within an average of 8.4 years in contrast to only 4% of patients with an intact stomach. This change is statistically significant (Z = 1.97, (p less than 0.05) and suggests that there is a cause-and-effect link between the operation and the development of cystic lesions. In three patients we traced the original operative specimen, and in none did we find cystic changes. All the cases were associated with chronic gastritis; mild dysplasia was found in four (22%). The cystic glands were shown (by alcian blue-periodic acid-schiff staining) to secrete neutral mucin like normal gastric glands, and unlike dysplastic glands or intestinal metaplasia where acid mucin is characteristic. Thus, our findings suggest an inflammatory cause for the cystic glandular change (reactive, hyperplastic change of glands), and suggest that it is probably not a preneoplastic state.
We describe a patient with chronic renal failure and transitional cell carcinoma, in whom a nephrogenic adenoma of the bladder was diagnosed after a course of intravesical thiotepa treatment.
We report a case of benign giant cell tumor of the bladder associated with transitional cell carcinoma. This giant cell granuloma represents a reactive reaction that must be distinguished from the giant cell malignant tumor. The morphological, histochemical and immunohistochemical criteria that can aid in the differential diagnosis are discussed.
Behçet's disease is very difficult to diagnose because its clinical signs overlap with those of other systemic diseases. Thus there is a clear need for nonclinical diagnostic criteria for Behçet's disease. The nonspecific cutaneous hyperreactivity response, pathergy, may serve as an important diagnostic indicator. A test for pathergy may also clarify the role of an immune complex mechanism in the pathogenesis of Behçet's disease. In our study of 11 patients with Behçet's disease, deposition of immunoglobulins or complement was not found 4 hours after histamine or saline injection. In contrast, 24 hours after histamine or saline injection, 10 of 11 patients responded positively both clinically and histologically during the active stage of their disease. Vasculitis was noted in only two patients. Thus in most patients no evidence of an immune complex mechanism was observed. We conclude that any nonspecific intracutaneous injection is a good clinical tool for the diagnosis of Behçet's disease.
A combined histopathologic, histochemical, and immunohistochemical study of benign colorectal adenomas is presented. Specimens of 39 adenomas were studied by hematoxylin and eosin (HE) stain, alcian blue-periodic acid Schiff (AB-PAS), and high-iron-diamine-alcian blue (HID-AB). Carcinoembryonic antigen (CEA) was demonstrated by peroxidase-antiperoxidase (PAP) technique. Variable amounts of neutral mucin and decreased sulfated acid mucin content, as well as increased CEA content, were found in the dysplastic epithelium of benign colonic adenomas. These changes were not seen in normal colonic mucosa. It is suggested that the above-mentioned methods may represent an aid in the evaluation of malignant potential of benign polyps.
A 43-year-old woman developed recurrent attacks of intermittent obstructive jaundice 5 years after cholecystectomy. After 6 years of recurrent attacks, an obstructive lesion was finally demonstrated, and was diagnosed at surgery as an amputation (traumatic) neuroma of the midcommon bile duct (CBD). Symptoms disappeared following surgical removal of the lesion. We review the clinical picture of this relatively rare problem, along with its diagnosis, pathogenesis, and treatment.
Inflammatory lesions in the liver simulating tumor formation are rare. Eleven cases have so far been reported in the literature, most of them in recent years. We present an additional case of an "inflammatory pseudotumor" in a 17-year-old male. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying lesions.
Kikuchi's disease is characterized by lymphadenopathy in young patients and may be mistaken for malignant disease both clinically and histologically. We report the case of a 26-year-old man with persistent fever for 3 weeks and splenomegaly, in whom pancytopenia developed afterwards. A bone marrow aspiration was normal. Blood, urine, throat, stool and bone marrow cultures were negative as were serological tests for lues, Toxoplasma, Epstein-Barr virus and Widal's test. An abdominal CT scan showed enlarged retroperitoneal lymph nodes and an exploratory laparotomy was performed. Two lymph nodes were excised and a wedge biopsy of the liver was performed. The histological findings in the lymph nodes were compatible with the diagnosis of Kikuchi's disease. The patient became afebrile on the 2nd postoperative day without any treatment. He has been well for 4 months after discharge.
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Specimens of fifteen surgically resected stomachs with early gastric cancer were histologically and histochemically examined using Alcian blue-periodic acid-Schiff and high iron diamine--Alcian blue stains. Samples were taken from the tumor, from the gastric mucosa 3 cm from the edge, and from the resected margins. In all 15 stomachs colonic intestinal metaplastic changes were present in the tumor tissue, as well as in the adjacent 3 cm mucosa and in the distant resected margins. In all cases neutral mucin content was reduced, whereas acid nonsulfated mucin was increased as demonstrated by Alcian blue-periodic-acid Schiff staining. Furthermore, acid sulfated mucin was demonstrated by high iron diamine-Alcian blue staining in the superficial layer of the metaplastic mucosa adjacent to the cancerous lesion and in the tumor itself. Sparse foci were also found in the surgical margins. We suggest that the increased content of acid sulfated mucin and its distribution might serve as an early indicator of malignant potential of the metaplastic gastric mucosa.
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A case is presented of sudden onset dysphonia in a 59-year-old man caused by acute vocal cord paralysis due to bleeding within a hyperplastic lower right parathyroid gland. There were no laboratory findings of hyperparathyroidism nor coagulation disorder. Acute onset of vocal cord paralysis is rarely associated with benign processes; the current case is the first associated with parathyroid hyperplasia.