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Biomedical subjects

L W McDonald

Publications and source records attributed to L W McDonald.

At least 19 recordsLinked to original sources
PubMed1994

Pineal region: rare location of a cavernous haemangioma.

Cavernous haemangiomas are commonly located within the central nervous system. There are only 11 cases of this malformation found in the pineal region reported in the literature, and only four of them have documenting photomicrographs. Very little has been written about diagnostic features of these tumours when they occur in this area. We describe our diagnosis of a cavernous haemangioma in the pineal region with special emphasis on its radiologic and histologic aspects.

Adult↗
PubMed1991

Imprints, smears, and frozen sections of brain tumors.

In this study, we compared the suitability and accuracy of imprints, smears, and frozen sections of suspected brain and spinal cord tumors of 150 patients. Eighty-six percent of the imprints, 91% of the smears, and 99% of the frozen sections were suitable for interpretation. Among the suitable preparations, 82% of the imprints, 92% of the smears, and 99% of the frozen sections agreed with our diagnosis on paraffin sections. Although frozen sections were clearly more accurate than imprints and smears, the latter two provided diagnoses in patients with acquired immunodeficiency syndrome where frozen sections were not done to avoid contaminating our cryostat and in a patient with an epidermoid cyst of the middle fossa that could not be adequately frozen sectioned. Our study shows that imprints and smears complement frozen sections in the intraoperative diagnosis of tumors of the central nervous system.

Biopsy↗
PubMed1985

Embolic stroke complicating systemic lupus erythematosus.

Embolic stroke complicating systemic lupus erythematosus has been infrequently reported. We examined a 25-year-old woman who suddenly became hemiplegic. Two-dimensional echocardiography identified a source of emboli. At cardiac surgery, friable thrombotic vegetations were found adhering to the mitral valve leaflets, left ventricular septal wall, and chordae tendineae. At autopsy several weeks later, careful pathologic examination of the heart failed to reveal evidence of thrombus formation or endocarditis. An embolus identical in appearance to the thrombotic vegetations described at cardiac surgery was found lodged in the left middle cerebral artery underlying the recent brain infarction. To our knowledge, this is the first report of embolic stroke in systemic lupus erythematosus caused by extensive cardiac thrombus formation in the absence of underlying endocarditis.

Adult↗
PubMed1984

Metastatic small cell carcinoma of the lung presenting as pituitary apoplexy and Cushing's syndrome.

We describe a woman with metastatic small cell carcinoma of the lung who presented with pituitary apoplexy and hyperprolactinemia. Within seventeen months she developed florid Cushing's syndrome with anasarca, hyperpigmentation, hypertension with marked hypercortisolemia (not suppressible with 8 mg dexamethasone), elevated serum ACTH, hypokalemic metabolic alkalosis, and multiple hepatic metastases. This picture suggested the presence of ectopic ACTH syndrome. She died 26 months after the episode of pituitary apoplexy. Primary small cell carcinoma of the lung was diagnosed post-mortem. Metastases were present in the left lung, regional lymph nodes, heart, liver, bone marrow, sphenoid bone, anterior pituitary and pituitary capsule. Posterior pituitary was normal. There was no evidence of pituitary hyperplasia, of adenoma or of primary pituitary carcinoma. The results suggest the presence of a primary ACTH-producing small cell carcinoma of the lung that metastasized to the parasellar sphenoid bone and then extended to the anterior pituitary and dura to mimic a primary intrasellar cause of pituitary apoplexy and Cushing's syndrome. The case demonstrates how difficult it may be to diagnose the etiology of Cushing's syndrome and it emphasizes a unique variation in the presentation of small cell carcinoma of the lung.

Adrenocorticotropic Hormone↗
PubMed1980

Arachnoidal cell hyperplasia. Its relationship to aging and chronic renal failure.

The biological implications of human arachnoidal cell hyperplasia are unclear. In a study based on 922 autopsies performed over a four-year period that investigated the conditions associated with arachnoidal cell hyperplasia, hyperplasia was found in 184 cases (study cases). The incidence of arachnoidal cell hyperplasia was found to increase linearly with advancing age. In a case-control design used to ascertain any other clinical associations, 22 of the study cases had comcomitant chronic renal failure, whereas only four in a control group matched for age at time of death had chronic renal failure. No other associations were observed. Arachnoidal cell hyperplasia seems to be an age-related phenomenon and shows a statistically significant association with chronic renal failure.

Adolescent↗
PubMed1979

Association of meningiomas with extraneural primary malignancy.

In an autopsy-based, case-control study of meningiomas over a 20-year period, there were 76 patients with meningiomas, and 20 of them also had an extraneural primary malignancy. In two control populations with autopsy-proved central nervous system (CNS) pathology (group I) and non-CNS pathology (group II), extraneural primary malignancies were seen in two patients in group I and in seven patients in group II. There was a high degree of statistical association between meningioma and extraneural primary malignancy (chi2 = 17.22, p less than 0.005 group I and chi2 = 7.61, p less than 0.01 group II). Screening of patients with meningioma for extraneural primary malignancy, and of patients with extraneural primary malignancy for meningioma are strongly indicated for the benefit of the patients as well as for further elucidation of the etiologic and temporal relationships between the two conditions.

Adolescent↗