Oral cavity evaluation. A part of prenatal care.
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Biomedical subjects
Publications and source records attributed to R C Stepto.
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A 60-year-old woman, 20 years post-menopausal, who had deforming rheumatoid arthritis of 7 years' duration and Sjögren's syndrome of 1 year's duration, had had postmenopausal bleeding for a month prior to admission to the hospital. A diagnosis dilatation and curettage was interpreted as showing acute suppurative endometritis. The patient was discharged, only to have recurrent vaginal bleeding. She was readmitted five weeks later, at which time results of another dilatation and curettage were interpreted as showing xanthromatous endometritis. Total hysterectomy with bilateral salpingo-oophorectomy was done. Examination of Epon-embedded endometrium 1 micrometer thick by light microscopy and subsequently by electron microscopy disclosed intracellular bacilliform organisms within phagolysosomes of atypical histiocytes, lamellar bodies, and various developing stages of calcospherites, Michaelis-Gutmann bodies. The curettings were then received and classic Michaelis-Gutmann bodies were identified in periodic acid--Schiff-stained sections.
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Two cases of advanced ovarian carcinoma treated with chlorambucil and terminating in acute leukemia are presented and the literature reviewed. The first patient was diagnosed by laparotomy as having Stage III ovarian carcinoma, and total abdominal hysterectomy and bilateral salpingo-ophorectomy were performed. After 7 years and 2 months of chemotherapy, acute myeloblastic leukemia was diagnosed, and the patient expired 4 months later. At autopsy no residual ovarian tumor was found. The second patient had a right oophorectomy after the diagnosis of Stage III ovarian carcinoma had been made. After 5 years and 9 months of chemotherapy she developed acute myelomonocytic leukemia and expired 2 months later, with residual ovarian tumor present on autopsy. The benefits of surgical reexploration in occasional cases of good clinical remission after chemotherapy are discussed in view of potential carcinogenicity of cytostatic agents.
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