Biomedical subjects
Publications and source records attributed to P C Beohar.
A young male aged 20 years had resection of the upper lobe of right lung for plasma cell granuloma. Five years later he developed three lesions in the brain, one of which was resected. Brain lesion showed similar histopathological picture. A unique case of plasma cell granuloma involving more than one organ is reported.
Cutaneous tuberculosis incidence was recorded as 0.15%. Of the 42 patients, 23 had scrofuloderma, 17 lupus vulgaris, and 2 tuberculosis verrucosa cutis. Both men and women were affected by the disease in the second and third decades. Its duration was variable. An affirmative family history was elicited in five scrofuloderma patients. The clinical expression largely conformed to the ritual text. Variation in Mantoux test positivity was unremarkable. The disparity in the demonstration of bacilli in the smear and tissue sections was, however, quite apparent in scrofuloderma. The correlation of different parameters indicates a continuous spectrum, formed at one end by lupus vulgaris, and at another by scrofuloderma. A moderate to strongly positive Mantoux text, enormous lymphocytes in the granuloma, absence of tubercle bacilli, negative culture, and an apparently normal immunoprofile were features of lupus vulgaris; whereas scrofuloderma had a moderately positive Mantoux test, lesser number of lymphocytes in the granuloma, large number of bacilli in tissue smear and/or tissue section, raised levels of immunoglobulins, and a grossly lowered C3 levels. The other variants probably occupy a position in between.
Autopsy study of 60 cases of rheumatic heart disease is presented, demonstrating an increased incidence of panvalvulitis in our series. The presence of Aschoff bodies is correlated with the clinical and laboratory parameters of activity and their significance is discussed.
Histo-morphological changes of the coronary vessels in cases of rheumatic heart disease (RHD) have been studied in 60 cases. Involvement of intramyocardial branches of coronary vessels in the form of active rheumatic vasculitis or inactive lesions characterized by medial hypertrophy and replacement fibrosis was seen in 15 of 60 cases. These lesions may affect myocardial function. Atherosclerosis of the pulmonary trunk and its branches was frequently seen in these hearts, indicating that this may be an important index of pulmonary hypertension. An unusual association of bicuspid aortic stenosis and RHD was seen in one case. Another case showed acute myocardial infarction due to coronary embolism from bacterial vegetation of bacterial endocarditis.
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Histological appearances of the tissue fragments obtained by cavitron ultrasonic surgical aspirator (CUSA) were studied in 25 cases to determine whether the aspirated tissue could be used for diagnosis. It was found that a definite diagnosis could be made on the tissue removed by this method.
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The role of histopathology in the diagnosis of donovanosis was assessed in 42 patients. There was heavy infiltration of the dermis with plasma and mononuclear cells but with few lymphocytes and neutrophils. The epidermis contained focal collections of polymorphoneuclear leucocytes. Endothelial proliferation and dilation of dermal blood vessels was striking. Intracellular and extracellular Donovan bodies were shown in Giemsa stained sections from 40 patients. Pseudoepitheliomatous hyperplasia was found in biopsy specimens from a few patients.
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The authors emphasize the meticulous search for microangioma under magnification in cases of spontaneous haematoma. Two cases of low flow (cryptic) arteriovenous malformations are described. The CT scan and angiography are non-contributory in detecting such lesions. These small-sized angiomas are buried in the wall of the haematoma cavity. Histologically there is evidence of thrombosis in arteriovenous malformation.
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