Biomedical subjects
Publications and source records attributed to J B Viloria.
We report the case of a laboratory worker who received close medical follow-up after accidently inoculating her hand with a needle containing a Humera strain of Leishmania donovani amastigotes. She developed a leishmanoma and histologic evidence of local lymphatic dissemination before being treated. The spectrum of disease caused by L. donovani is discussed.
The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation.
Six cases of undifferentiated carcinoma of the parotid gland with heavy lymphocytic infiltration have been treated at Montreal General Hospital over the past 23 years. A thorough review of the literature revealed another 31 similar cases which are discussed. For unknown reasons, these malignant tumors seem to be more common in North American Inuit. Their relatively better prognosis may be attributed to the protective function of the heavy lymphocytic infiltration. Surgery has been the treatment of choice with postoperative radiotherapy in indicated cases. Longer follow-up is necessary to assess the role of lymphocytic infiltration in improving survival.
Fibrous histiocytomas are soft tissue neoplasms of histiocytic origin showing partial fibroblastic and histiocytic differentiation. The histopathology of these tumors and their nomenclature are discussed. A case of primary intraosseous malignant fibrous histiocytoma of the mandible is presented and added to the previously reported nine cases. One hundred and ten cases of fibrous histiocytoma are reviewed, a rapidly increasing number of reported cases in the deep tissues of the head and neck region. No definite reliable histologic criteria have been found to predict the true malignant lesions. Malignant fibrous histiocytomas show the most aggressive behavior in the head and neck region with a metastatic rate of 30-42%. Aggressive surgery remains the treatment of choice with a five year survival rate of approximately 60%, chemotherapy and radiotherapy being used as adjunctive treatment.
Three cases of adenocarcinoma of the lung manifesting as acute pericardial effusion with tamponade are presented and the medical literature concerning this unusual manifestation of extracardiac malignancy is reviewed. We have found 22 cases of carcinoma and 4 cases of sarcoma. Of the carcinomas, 14 of 19 (74%) with known primary are pulmonary and 13 of 18 (72%) with tissue diagnosis are adenocarcinomas. Daignosis was made by cytologic examination of pericardial fluid in 14 of 16 cases (87%) in which it was performed. The lymphatic drainage of the heart renders some anatomical explanations for the prevalence of carcinoma of the lung as the cause of cardiac tamponade and the discrepancy of finding tumor cells in the pericardial fluid but not in the pericardium. Patients treated with pericardiectomy with or without ancillary radio- or chemotherapy survived longer than those treated with periocardiocentesis or radio- or chemotherapy alone.
Three cases of necrotizing sialometaplasia of minor salivary glands are presented. Clinically and pathologically, this nonneoplastic lesion of the palate can be easily mistaken for carcinoma. The main histologic features are localized infarction of minor salivary glands and extensive squamous metaplasia with retention of the lobular architecture of the involved glands. The possible etiologic factors are discussed.
Sebaceous cell carcinoma of the parotid gland is a rare lesion. A review of the English literature reveals nine previously reported cases. Two cases are presented in which the tumor was originally diagnosed as mucoepidermoid carcinoma. Aggressive treatment of the recurrence, which was subsequently recognized as sebaceous cell carcinoma has resulted in apparent cure. Histologic features and possible histogenesis are discussed.