Biomedical subjects
Publications and source records attributed to M Bray.
A patient with a histologically benign lymphoid pseudotumour of the orbit developed a recurrent mass which proved to be a well differentiated lymphocytic lymphoma. Immunohistological studies showed that a majority of cells in the pseudotumour bore the same immunological markers as the subsequent lymphoma. There were no clinical or radiographic features of the initial lesion which indicated its eventual malignant course.
Vitreous humor chemistry profiles were reviewed on 133 autopsied cases in which death occurred outdoors during a six-year period, to determine whether environmental temperature at the time of death influenced chemistry values obtained at autopsy. The glucose concentration and total carbon dioxide content varied inversely with temperature. Values were significantly higher in the winter than the summer months. The mean glucose level was higher in deaths caused by cold exposure than in other deaths occurring in the cold, but individual cases could not be distinguished on the basis of chemistry values. Potassium levels tended to be slightly lower in winter. It was noted that chemistry studies could be used to help determine whether a body found outdoors in winter actually died in a different, warmer environment.
The effect of chilling at the time of death on the postmortem chemistry of the vitreous humor was studied by using sheep heads obtained immediately following decapitation. One group of heads was kept at room temperature, while the remainder were chilled on ice or in ice water, then refrigerated or frozen. Vitreous humor specimens were taken at intervals over a 48-h period. Chilling inhibited the fall in the glucose concentration and the total carbon dioxide content and lessened the increase in lactic acid, compared to the room temperature group. Rapid glycolysis resumed when the heads rewarmed to room temperature starting at 6-h postmortem, but did not resume at later points. The rate of rise of the potassium and magnesium concentrations was also diminished in the chilled eyes. Freezing and thawing caused an abrupt increase in the potassium and magnesium levels, but other solutes were unaffected.
Immunohistologic methods can be used to help differentiate inflammatory from neoplastic lymphoid proliferations in extranodal sites. The majority of B-lymphocytes in an inflammatory process should show surface or cytoplasmic staining for kappa light chains, reflecting the normal human kappa:lambda ratio of approximately 2:1. If a benign-appearing lesion is found to contain predominantly lambda-positive cells, this may be a sign of an emerging lymphoma. The principle is illustrated by a case report of a lymphoid "pseudotumor" of the orbit that showed a polyclonal staining pattern with a predominance of lambda-positive cells and subsequently developed into a lymphoma-producing IgM lambda.
Vitreous humor chemistry studies were performed on 13 air crash victims who had remained immersed in near-freezing fresh water for seven to eight days. Glucose concentrations were observed to be higher than those in a comparison group of autopsied cases with prolonged postmortem intervals, suggesting that rapid chilling inhibited glycolysis. Evidence of dilution of vitreous humor electrolytes was also noted. After correction for the apparent degree of dilution, the potassium concentrations were found to fall within a narrow range.
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