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At least 1,081 records · Page 60Linked to original sources
PubMed2004

Gamna-Gandy bodies in surgical neuropathology specimens: observations and a historical note.

Gamna-Gandy (G-G) bodies are classically defined as spheroidal yellow-brown foci consisting of dense fibrous tissue and collagenous fibers encrusted with iron pigments and calcium salts. These siderotic nodules were first described in the spleen early in the twentieth century and for a short time were considered to be caused by fungal infection due to the presence of unusual "bamboo-like and articulated" fibers in the lesions that vaguely mimicked mycelia forms. This notion was proven to be incorrect in the 1930s and G-G bodies are now considered to result from organization of small hemorrhages. Although originally reported in splenomegaly, G-G bodies are well-recognized findings in atrial myxomas where they form linear arrays of mineral-encrusted fibers, often at the edge of resolving hemorrhages. They rarely have been reported in lymph nodes, thymoma, thyroid adenoma, and renal cell carcinoma. Curiously, published examples of G-G bodies in central nervous system (CNS) neoplasms or vascular malformations have not appeared, despite the known tendency for bleeding, even recurrent episodes of bleeding, in several types of these lesions. Since 1999 I have accrued all the examples of G-G bodies that I have observed in my practice of surgical neuropathology. These cases are presented here and the historical aspects of the entity are reviewed.

Calcinosis↗
PubMed2002

Pulmonary siderophages and unexpected infant death.

It has been proposed that the presence of siderophages in the lungs of infants who die unexpectedly should be considered a marker of a previous hypoxic event, which may preclude a diagnosis of sudden infant death syndrome. The authors retrospectively reviewed all infant deaths (<1 year old) going to autopsy at the Denver Office of the Medical Examiner from January 1999 to January 2001. Lung sections were stained with Prussian blue, and siderophages were counted in 20 high-power fields per lobe sampled. Cell counts were performed by two independent pathologists who were blinded to history and cause of death, with good reproducibility. Iron stain results were then categorized by average number of siderophages per 20 high-power field (category 1 = <5, category 2 = 5-100, category 3A = 100-500, category 3B = >100 in a single lobe, category 4 = >500). The results were subsequently correlated to case history, autopsy findings, and cause/manner of death. Forty-three cases were reviewed. The causes of death included sudden infant death syndrome (16), asphyxia (5), undetermined (6), and other (16). Those deaths were categorized by the above criteria as follows: category 1. (32), category 2. (6), category 3. (4), and category 4. (1). All sudden infant death syndrome deaths were in category 1. Categories 1 and 2 also included deaths in which hypoxia might have been present before death because of such factors as pneumonia and congenital heart disease. Categories 3 and 4 included a known homicidal asphyxia in which repeated episodes of intentional smothering were documented, 2 probable asphyxias, 1 nonaccidental trauma, and 1 undetermined. All 5 cases had questionable circumstances surrounding the death of the infant. Pulmonary siderophages were described in only 1 of the 43 autopsy reports. It was concluded that pulmonary siderophages can be markedly increased in cases of repeated asphyxia. Siderophages may also be increased in cases where hypoxia may have been present for another reason, but not to the same degree. Siderophages are not increased in sudden infant death syndrome. Because iron-laden macrophages often are not recognized on routine examination with hematoxylin and eosin staining, iron stains may be helpful in the evaluation of infant deaths. If siderophages are present in increased amounts without an obvious explanation, further investigation is warranted.

Biomarkers↗
PubMed1999

Erosive injury to the upper gastrointestinal tract in patients receiving iron medication: an underrecognized entity.

Severe gastrointestinal necrosis and strictures after an iron overdose are well described. However, mucosal injury in patients receiving therapeutic iron has received only scant recognition despite its wide use. We studied the clinical and histologic features of 36 upper gastrointestinal tract biopsies from 33 patients (24 gastric, 9 esophageal, 1 gastroesophageal junction, and 2 duodenal) containing characteristic brown crystalline iron material, and evaluated the amount and tissue distribution of the iron. In addition, we investigated the prevalence of iron-associated mucosal injury in upper gastrointestinal endoscopic examinations. The majority of the biopsies (32 of 36, 89%) contained luminal crystalline iron adjacent to the surface epithelium or admixed with luminal fibrinoinflammatory exudate. Thirty biopsies (83%) showed crystalline iron deposition in the lamina propria, either covered by an intact epithelium, subjacent to small superficial erosions, or admixed with granulation tissue. Three biopsies (8%) demonstrated iron-containing thrombi in mucosal blood vessels. Erosive or ulcerative mucosal injury was present in 30 of 36 biopsies (83%). The amount of iron accumulation in cases with mucosal injury was greater than in cases without mucosal injury (mean grades, 2.4+ vs. 1.3+ on a 1+ to 3+ scale; p = 0.002). Iron medication was confirmed in 25 of 33 patients (76%) 22 patients were receiving ferrous sulfate. Approximately half of the patients (17 of 33, 51%) also had underlying infectious, mechanical, toxic, or systemic medical conditions that could have initiated or exacerbated tissue injury. Crystalline iron deposition was found in 0.9% of upper gastrointestinal endoscopic examinations (12 of 1,300), and iron medication-associated erosive mucosal injury was present in 0.7% (9 of 1,300). These results indicate that crystalline iron deposition in the upper gastrointestinal tract is not uncommon. It can induce or exacerbate a distinctive histologic pattern of erosive mucosal injury, especially in patients with associated upper gastrointestinal disorders. Recognition of this pattern by pathologists and its communication to clinicians may aid in optimizing therapy.

Adult↗
PubMed1991

Methylmethacrylate implants: a scanning electron microscopic study.

Two methylmethacrylate orbital implants used for 34 and 5 years, respectively, were examined with a scanning electron microscope. One of the implants was a combination of a prosthesis and an implant containing a magnet. The magnetic force had decreased markedly, and rust crystals were apparent. The methylmethacrylate surface was irregular and rough.

Eye Diseases↗
PubMed1999

Corneal iron ring after hyperopic laser-assisted in situ keratomileusis.

PURPOSE: To report a new corneal iron ring after hyperopic laser-assisted in situ keratomileusis (LASIK). METHODS: Three patients underwent hyperopic LASIK for the correction of hyperopia in both eyes. Spherical equivalent refraction of the patients ranged from +3.37 to +6.50 diopters. LASIK procedure was performed using automated corneal shaper and 193-nm argon fluoride excimer laser. RESULTS: Both eyes of the patients were noted to have a corneal iron ring located at the paracentral area at 6-7 months after surgery. The localization of iron ring corresponded with outside border of central steep zone. Twelve-month examination showed there was no change in color, shape, and density of corneal iron ring. CONCLUSIONS: Corneal topographic changes induced by hyperopic LASIK may cause corneal iron ring to develop.

Adult↗
PubMedDate not supplied

CT and MRI of siderotic regenerating nodules in hepatic cirrhosis.

The demonstration by CT of siderotic regenerating liver nodules in cirrhosis was evaluated and compared with that of MR imaging retrospectively in 27 patients with histologically diagnosed hepatic cirrhosis. Only in one of the two patients with marked iron deposits in regenerating nodules did CT demonstrate multiple high density nodules. In the other patient with marked iron deposits and in seven of the nine patients with moderate iron deposits, the liver parenchyma on CT was demonstrated as heterogeneous and of slightly high density without focal nodules. In 8 patients with mild to moderate iron deposits and in the 10 with no iron deposits, the liver parenchyma was homogeneous on CT. Multiple low intensity nodules in the liver were seen on fast low-angle shot (FLASH) MR images in all 17 patients with iron deposits in regenerating nodules. No low intensity nodules were seen on FLASH MR images in the 10 patients with no iron deposits. If there are iron deposits above a certain level, siderotic regenerating nodules may appear as nodules of high density on CT or as heterogeneous regions of high density liver parenchyma. Magnetic resonance is more sensitive than CT in demonstrating siderotic regenerating nodules.

Adult↗
PubMedDate not supplied

Ferumoxide-enhanced MRI of sideronecrosis superimposed on genetic hemochromatosis.

Genetic hemochromatosis is an autosomal recessive disorder characterized by excessive iron absorption from the gut, resulting in increased total body iron stores, multisystem organ dysfunction, and an increased risk of hepatocellular carcinoma. The magnetic susceptibility effects of excess hepatocellular iron generally cause diffuse hepatic signal loss on T2- or T2*-weighted MR images. Although hepatic iron deposition is usually diffuse, focal areas of iron sparing can occur, and, when present, superimposed neoplasm is a consideration. We describe a patient with cirrhosis, hemochromatosis, and multiple small benign relatively hyperintense iron-poor foci consisting of piecemeal sideronecrosis.

Contrast Media↗
PubMedDate not supplied

Siderotic nodules at MR imaging: regenerative or dysplastic?

OBJECTIVE: To determine if iron containing "siderotic" nodules detected at magnetic resonance (MR) imaging are regenerative (RN) or dysplastic (DN) and to attempt to identify features that may distinguish them. MATERIAL AND METHODS: MR imaging (1.5 T) was performed on 77 cirrhotic patients who underwent orthotopic liver transplantation within 0-117 days (mean 30 days) of MR imaging. Two readers retrospectively evaluated breath-hold gradient-echo pulse sequences (echo time > or =9.0 ms, flip angle < or =45 degrees) for the presence of hypointense nodules, which were classified as micronodular (< or =3 mm), macronodular (>3 mm), or mixed. Nodule distribution was classified as focal (<5), scattered (5-20), or diffuse (>20) per slice. Thin section pathologic correlation was available in all cases, and Prussian blue iron stains were performed. RESULTS: Of 35 patients with pathologically proven siderotic nodules, 10 (29%) had at least 2 siderotic DN. MR detected siderotic nodules in 10 of 10 (100%) patients with siderotic DN and RN, and in 18 of 25 patients (72%) with siderotic RN only. CONCLUSION: Siderotic RN cannot be reliably distinguished from siderotic DN with MR imaging, and therefore the widely used term "siderotic regenerative nodule" should be avoided and replaced by "siderotic nodule."

Female↗
PubMed1978

Magnetite pneumoconiosis.

A subject is described who was exposed to fine particles of magnetite (Fe3O4). His chest radiograph demonstrated the presence of multiple small rounded opacities; however, his lung function remained unaffected.

Adult↗
PubMed2004

Corneal iron ring formation associated with overnight orthokeratology.

PURPOSE: To describe a case of iron deposition in both eyes after overnight orthokeratology. METHODS: This is a case report of a 31-year-old man who underwent overnight orthokeratology. The subject was fitted with rigid gas-permeable contact lenses of reverse-geometry design to correct myopia. RESULTS: The prefitting manifest refraction was -4.75 -0.25 x 175 in the right eye and -4.50 -0.25 x 175 in the left eye. There was no corneal abnormality until 9 months after treatment, but development of corneal arcuate lines in both eyes was observed at the 1-year follow-up visit. Visual acuity was not affected. The deposition pattern corresponded to the outside border of central flatter zone, as shown on the corneal topography map. CONCLUSION: The current findings suggest that tear pooling between the corneal surface and the back surface of the contact lens plays a role in the development of corneal iron ring after orthokeratology with reverse-geometry contact lenses.

Adult↗
PubMed2005

Corneal iron line following LASIK with epithelial ingrowth.

PURPOSE: To report a new corneal iron line following keratorefractive surgery. METHODS: Case report and review of the literature. A 51-year-old man developed epithelial ingrowth after otherwise uneventful LASIK surgery. The patient, satisfied with an uncorrected visual acuity of 20/25 and otherwise asymptomatic, declined to have his flap relifted to treat the ingrowth. RESULTS: Six months postoperatively a corneal iron line was noted at the leading edge of the epithelial ingrowth. Vision remained stable. CONCLUSIONS: : Epithelial iron lines have been reported with a number of conditions, including post-refractive procedures. This is the first report of an iron line associated with epithelial ingrowth following LASIK.

Corneal Diseases↗
PubMed2006

Central corneal iron deposition after myopic laser-assisted in situ keratomileusis.

PURPOSE: To describe central corneal iron deposition after myopic laser-assisted in situ keratomileusis (LASIK). METHODS: Patients visiting our outpatient clinics between February 2003 and January 2004 and displaying post-LASIK corneal iron deposits were retrospectively enrolled in the study. RESULTS: Forty-two eyes of 24 patients developed corneal iron deposition after myopic LASIK surgery. All eyes displayed a small, spotty iron deposit located in the center of the corneal flap. The median interval between LASIK and diagnosis of corneal iron deposition was 22.5 months. The spherical equivalents of achieved correction ranged from 4.00 D to 17.50 D. CONCLUSION: Spotty corneal iron deposition can develop in the center of the corneal flap after myopic LASIK surgery. Because it is asymptomatic, the condition may have been hitherto underestimated in patient populations.

Adult↗
PubMed2006

Rebiopsy in patients with untreated hepatitis C: a useful procedure.

BACKGROUND: The progression of fibrosis in the early stages of chronic hepatitis C virus is variable, and the ideal interval to perform a new biopsy in untreated patients is still unknown. AIMS: We evaluated the histologic progression of patients with untreated hepatitis C virus with two liver biopsies and correlated disease progression with demographic, epidemiologic, biochemical, and histologic variables. PATIENTS AND METHODS: Untreated hepatitis C virus-infected patients with two liver biopsies at a minimum interval of 1 year were studied. Gender, age, parenteral risk factors, duration of infection, alcohol intake, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, and histologic findings were analyzed. RESULTS: Fifty-five patients were included. The first biopsy showed low grades of fibrosis and periportal necroinflammatory activity in 93%. A second biopsy was performed after 39 +/- 14 months; 40% of patients showed a progression of fibrosis and/or periportal necroinflammation. Comparison between groups with and without histologic worsening revealed no differences in demographic, epidemiologic, biochemical, or histologic data. CONCLUSIONS: Histologic worsening occurred in 40% of untreated patients after 3.2 years. No factor could be established at the first biopsy to predict which patients are at risk of progression. Thus, histologic reassessment between 3 and 5 years seems to be the only approach to document disease progression and establish treatment indication.

Adolescent↗
PubMed2005

Welder's lung associated with pneumothorax.

A 23-year-old male working in welding for 8 years was admitted to the hospital with chest pain. A large right pneumothorax with complete lung collapse was seen radiographically and a tube thoracostomy performed. At high-resolution computed tomography, multiple bilateral well-marginated nodules with surrounding ground-glass opacity were seen. Welder's lung was considered in this patient because of his work in welding for 8 years with iron dust exposure, multiple nodules with ground-glass opacity were seen on HRCT, and serum ferritin and ferritin levels in bronchoalveolar lavage fluid were elevated. The granules in alveolar macrophages obtained from parenchymal biopsy and bronchoalveolar lavage stained strongly with iron dyes. Following avoiding exposure to welding fumes, the lung lesions disappeared without additional therapeutic interventions after a 3-week period. Welder's lung with associated lung lesions has been described, although complicating pneumothorax is unique to the case presented herein.

Adult↗