Biomedical subjects
Publications and source records attributed to K J Wajda.
A case of papillary thyroid carcinoma occurring in a 27-year-old man with black thyroid syndrome is reported. The tumor, in contrast to the remaining thyroid, was not pigmented. The significance and potential utility of the differential pigmentation are discussed.
Hyperreactio luteinalis (HL) refers to moderate to marked cystic enlargement of the ovaries due to multiple benign theca lutein cysts and is most often associated with hydatidiform mole or choriocarcinoma. The cause of this condition is unknown, but is believed to be related to elevated levels of, or abnormal ovarian response to, human chorionic and pituitary gonadotropins. Only 47 cases of HL unassociated with trophoblastic disease have been previously reported in the English-language literature, mostly before 1974, and almost exclusively in the gynecologic literature. We present two additional cases of HL unassociated with trophoblastic disease and review the literature. One of our case reports documents the unusual occurrence of unilateral HL. Of the 49 cases described, 11 occurred with fetal hydrops (8 immunologic; 3 non-immunologic), 8 with multiple pregnancies, and 30 in otherwise normal single pregnancies. Hyperreaction luteinalis is most often bilateral and found incidentally at the time of cesarean section. However, HL may present during any trimester as an abdominal mass or acute abdomen. The natural course is postpartum regression. Recognition of HL is important, since misinterpretation at laparotomy or erroneous histologic diagnoses have resulted in unnecessary surgery, often with sterilization in 16 of the cases. A conservative approach is indicated with wedge biopsy and frozen section diagnosis. Oophorectomy is necessary only to remove infarcted tissue or to control hemorrhage.
The phenotypic characteristics of peripheral blood T cell subpopulations regulating human B cell colony growth stimulated by Staph protein A were investigated. Colony growth was facilitated by OKT4 cells, and T cells expressing DR antigens were found to be partially responsible for colony facilitation. A linear increase in the magnitude of colony growth was observed with greater T cell numbers, and maximal colony enhancement occurred when T cells were present during the early stages of colony formation. OKT8 cells did not enhance colony growth and also inhibited the facilitation of colony formation by OKT4 cells. Other experiments showed that the functional activities of OKT4 and OKT8 cells differed in their requirements for DNA synthesis. Although active T cell DNA synthesis was absolutely required for the facilitation of colony growth at all concentrations tested, DNA synthesis was not needed for OKT8 inhibition of OKT4 promotion of colony formation. Thus, distinct T cell subsets whose functional properties differ in their requirements for DNA synthesis regulate human colony growth.
The cytologic presentation of a case of minocycline-associated black thyroid adenoma in a 30-year-old woman is described. A nodule was discovered in the left lobe of the patient's thyroid gland, and fine needle aspiration (FNA) was performed; the nodule and adjacent thyroid were subsequently surgically removed. The cytologic findings included sparse groups of epithelial cells with prominent intracytoplasmic pigment granules. The surgical specimen was interpreted as black thyroid adenoma. This case is unusual in that the pigment had accumulated preferentially in the adenoma. In retrospect, the finding of distinctive pigment in the aspirate of the nodule suggests that the black thyroid syndrome should be considered whenever dark-brown pigment is encountered in FNA cytologic specimens from the thyroid gland.