PubMed · 5558536
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J Andrew. 1971. Neurigenic intermittent claudication.. https://pubmed.ncbi.nlm.nih.gov/5558536/
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Evaluation in the emergency department of the patient with chest pain remains a common problem. Large numbers of patients are admitted to the hospital because of diagnostic uncertainty. Strategies dealing with this population include risk stratification by clinical presentation, serial cardiac enzyme assays to exclude myocardial infarction, and detection of myocardial ischemia with nuclear scintigraphy or echocardiography. Each of these strategies is rational with specific benefits and weaknesses. Bypassing these steps and performing immediate exercise testing is the newest approach that appears to be safe, timely, and cost-effective.
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A workshop jointly sponsored by the University of Hong Kong and the Society for Hematopathology explored the definition, differential diagnosis, and epidemiology of angiocentric lymphomas presenting in the nose and other extranodal sites. The participants concluded that nasal T/natural killer (NK) cell lymphoma is a distinct clinicopathologic entity highly associated with Epstein-Barr virus (EBV). In situ hybridization for EBV an be very valuable in early diagnosis, especially if tissue is sparse. The cytologic spectrum is broad, ranging from small or medium-sized cells to large transformed cells. Histologic progression often occurs with time. Necrosis is nearly always present, and angioinvasion by tumor cells is seen in most cases. Nasal T/NK cell lymphoma has a characteristic immunophenotype: CD2-positive, CD56-positive, but usually negative for surface CD3. Cytoplasmic CD3 can be detected in paraffin sections. Clonal T-cell receptor gene rearrangement is not found. Tumors with an identical phenotype and genotype occur in other extranodal sites, most commonly in the skin, subcutis, and gastrointestinal tract, and should be referred to as nasal-type T/NK cell lymphomas. The differential diagnosis includes lymphomatoid granulomatosis, blastic or monomorphic NK cell lymphoma/leukemia, CD56-positive peripheral T-cell lymphoma, and enteropathy-associated T-cell lymphoma.