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Biomedical subjects

J F Greene

Publications and source records attributed to J F Greene.

11 recordsLinked to original sources

Minimal deviation spindle cell melanoma: unusual histologic pattern in an 11-year-old black girl.

An 11-year-old black girl presented with a nodule at the tip of the left thumb that eroded the underlying tip of the distal phalanx. The tumor was composed of junctional nests and uniform atypical spindle melanocytes that formed broad fascicles and diffusely permeated the dermis. Scattered collections of Kamino bodies were present. A single enlarged left axillary lymph node was noted 9 months after the initial presentation. The lymph node measured 7 x 4.5 x 2.5. cm and was replaced by metastatic tumor composed of fascicles of spindle melanocytes. Immunohistochemical examination demonstrated immunoreactivity for S100, HMB45, and Leu 7, and ultrastructural examination revealed the presence of premelanosomes in the primary and metastatic tumor. Now, more than 10 years since her initial presentation, the patient is well with no further manifestation of the disease.

Child

Bile duct abnormalities in the acquired immune deficiency syndrome.

Pathological changes in the liver have been described in patients with acquired immune deficiency syndrome; however, lesions of the bile ducts have not been noted. We report 2 patients with intrahepatic bile duct abnormalities, one having sclerosing cholangitis of the large ducts. We discuss the possibility that these changes are secondary to opportunistic infection or are induced more directly by immunologic mechanisms.

Acquired Immunodeficiency Syndrome

Erythromycin ethylsuccinate-induced cholestasis.

A 52-year-old Caucasian female developed abdominal pain, fever, and jaundice after erythromycin ethylsuccinate administration. Similar symptoms followed the administration of the same drug 5 mo earlier. It is believed that this is the first published case of erythromycin ethylsuccinate-induced cholestasis.

Cholestasis

Transient subcutaneous granulomatosis of the upper extremities in Crohn's disease.

Skin lesions occur fairly commonly in patients with Crohn's disease of the colon (14%). Erythema nodosum and pyoderma gangrenosum are the most frequently recognized. Granulomatosis of the skin, continuous with bowel involvement, has been reported. Involvement of the subcutaneous tissue, discontinuous with intestinal disease, is unusual and we wish to report a case of Crohn's disease of the colon complicated by infraepidermal perivascular granulomas of the forearms. The lesions disappeared spontaneously.

Adult

FDA section.

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Humans

Disseminated herpesvirus infection. Association with primary genital herpes in pregnancy.

A patient with primary herpes simplex virus (HSV) type 2 genital infection had dissemination in the 37th week of her first pregnancy. This was manifested by severe hepatitis, pancreatitis, and genital lesions. Temporary improvement followed the delivery of a healthy infant by cesarean section. Encephalitis became evident on the third postpartum day, and recovery was complicated by profound bradycardia, possibly due to viral myocarditis. Vidarabine was administered for seven days, and the patient survived with only mild neurologic sequellae. To our knowledge, this the fourth reported case of disseminated herpesvirus infection in pregnancy and the first due to HSV type 2. Pregnancy must be considered as a possible predisposing factor in dissemination of primary HSV infection.

Adult

Small cell nonkeratinizing carcinoma of the cervix associated with ACTH production.

The case of a 40-year-old woman with primary small cell carcinoma of the cervix is reported. She developed widespread metastates and florid Cushing's syndrome. Serum ACTH levels were greatly elevated and no site of production other than the tumor could be demonstrated at autopsy. The tumor cells demonstrated features characteristic of cells of the APUD series. Such cells have been demonstrated in normal cervical epithelium; it is likely that they may become malignant, giving rise to tumors with a potential to secrete polypeptide hormones. This case suggests that endocrine active "Apudomas" may arise from the uterine cervix. Certainly, patients with small cell carcinoma of the cervix should be investigated with appropriate serum assays for polypeptide hormones.

Adrenocorticotropic Hormone

Septic endocarditis and indwelling pulmonary artery catheters.

A pulmonary artery catheter removed from a man with idiopathic cardiomyopathy yielded Staphylococcus aureus in culture, as did blood and sputum. Septic endocarditis of the right side of the heart was found at autopsy. A review of 438 autopsy reports in which an indwelling pulmonary catheter had been used and of another 493 reports preceding its use at our medical center suggests no association between the use of indwelling catheters in the right side of the heart and endocarditis in the left, although there is a risk of thrombotic endocardial vegetation formation in the right side of the heart, with possible infection or embolization.

Adult

Coccidioides immitis. A rare cause of pulmonary mycetoma.

Coccidioides immitis occurring as a fungus ball within a chronic pulmonary cavity has previously been reported twice and must be rare. We report a mycetoma composed of both spherule and mycelial forms of Coccidioides immitis, proved by culture and histologic sections. Fungus ball due to Coccidioides immitis is a logical progression from mycelia seen in the cavity wall in the active pulmonary coccidioidal lung cavity.

Coccidioides