Cutaneous malakoplakia in a patient with acquired immunodeficiency syndrome (AIDS).

Malakoplakia is an uncommon granulomatous lesion that afflicts predominantly immunocompromised individuals but is extremely rare in acquired immunodeficiency syndrome (AIDS). We report a case of cutaneous malakoplakia in an AIDS patient that presented as a banal right axillary abscess which resolved after excision and drainage. The rarity of malakoplakia in AIDS may be due to a relative or selective preservation of antimicrobial function of monocytes.

Adrenal pheochromocytoma mimicking small cell carcinoma on fine needle aspiration biopsy. A case report.

Background: Fine needle aspiration biopsy (FNAB) is a sensitive and specific technique in the diagnosis of adrenal tumors. However, in rare cases the cytomorphologic features may mimic small cell neoplasms.

Case: A 54-year-old male presented with a history of hypertension and left flank pain of recent onset.

Primary renal artery dissection.

A typical case of primary renal artery dissection, an unusual entity causing renal infarction, is described. This abnormality, masquerading as renal colic, affects otherwise-healthy middle-aged men. Angiography, which will confirm the diagnosis, should precede nephrectomy, because vascular repair may be feasible.

Intrathyroidal lymphoepithelial cysts of probable branchial origin.

Lymphoepithelial cysts with histological features characteristic of branchial cleft cysts have been reported to occur rarely in the thyroid gland. To our knowledge only six cases of this lesion have been reported. Since these reports brought this entity to our attention, we have noted that intrathyroidal lymphoepithelial cysts are not rare lesions.

Iatrogenic endometrial megapolyps in women with breast carcinoma.

Background: Tamoxifen, a widely used drug in adjuvant therapy of breast carcinoma, is now being tested for its effectiveness in chemoprevention. Although its side effects are few, tamoxifen increases the incidence of proliferative lesions of the endometrium, which theoretically should be preventable with progestational agents.

Cases: Two postmenopausal women treated with tamoxifen and progestational agents for breast carcinoma developed uterine enlargement and intermittent spotting.

Adenohypophyseal tissue in an immature teratoma of the human ovary.

An immature ovarian teratoma containing adenohypophyseal tissue with a central arteriole and interpositioned in mature neural tissue is reported in an asymptomatic 31 -year-old woman. The tumor was a grade 2 immature teratoma according to the modified ThurlbeckScully histological grading system. Immunocytochemistry showed positive staining for growth hormone, prolactin, adrenocorticotropin, and alpha-subunit human chorionic gonodotropin and negative staining for thyroid-stimulating, follicle-stimulating, and luteinizing hormones in the adenohypophysis.

Improved endocervical sampling with the Cytobrush.

Objective: To evaluate the effectiveness of the Ayre wooden spatula, the cotton-tipped swab and the Zelsmyr Cytobrush in obtaining endocervical cells.

Design: Cross-sectional comparison study.

Setting: Family practice unit.

Hormone-producing tumors of the ovary.

The ovary is an endocrine organ that gives rise to a wide variety of neoplastic and tumorlike nonneoplastic conditions, some of which are associated with endocrine activity. The hormones produced may be steroidal or nonsteroidal. The ovary is unique among endocrine organs in reacting to the presence of nonendocrine tumors within it by abnormal or inappropriate production of sex steroidal hormones.

Cytologic diagnosis of extravesical malacoplakia.

Malacoplakia, a rare form of chronic granulomatous inflammation, most frequently involves the urinary tract of middle-aged women. The disease represents an unusual inflammatory response to bacteria, most commonly Escherichia coli, and probably reflects some dysfunction in the immune system of the host. We describe two cases of malacoplakia involving in one patient the vagina and in the other the perianal subcutaneous tissue and lung.

Histiocytosis X in two adults. Treatment with topical mechlorethamine.

Two adult patients with skin lesions typical of histiocytosis X were treated topically with mechlorethamine hydrochloride. In the patient whose disease was limited to the skin, a sustained remission was induced, but in the patient with extensive systemic disease, cutaneous remission lasted only six weeks.

Cutaneous granulomatous vasculitis associated with Crohn's disease.

A thirty-nine-year-old man with Crohn's disease of fourteen years' duration developed papules and nodules on his lower extremities which, not infrequently, became purpuric or pustular, and healed with pigmented depressed scars. Histologic examination showed fibrinoid necrosis of the superficial dermal vessels associated with an inflammatory infiltrate consisting mainly of epithelioid histiocytes. Activity of the cutaneous lesions was not correlated with activity of the patient's underlying visceral disease.

Gynandroblastoma: its ultrastructure.

Gynandroblastoma is a rare, sex-cord stromal tumor of the ovary that shows morphologic evidence of female and male differentiation. Such a tumor produced masculinization in a 24-year-old woman, whose symptoms disappeared following removal of the tumor. By electron microscopy, the granulosa cell nests displayed Call-Exner (CE) bodies of the hyaline type composed of multiple layers of basal lamina resembling CE bodies of the normal graafian follicle.

Crystalline tissue deposits on a case of multiple myeloma.

Crystalline tissue deposits were found at the time of autopsy in a 52-year-old male subject who had had multiple myeloma for 6 1/2 years and in whom the hyperviscosity syndrome had developed terminally. The tissue deposits were digested by trypsin, but could not be further characterized by immunohistochemical techniques. The crystals varied in size and shape and were located in tissue histiocytes, renal tubular cells, Leydig's cells, and adrenocortical cells.

Malacoplakia of the female genital tract.

Malacoplakia is an uncommon chronic granulomatous inflammation which most frequently involves the urinary bladder of middle-aged women and rarely affects the genital tract. In this paper 10 cases of female genital malacoplakia are reviewed, seven of which have been reported previously in the literature. Genital malacoplakia usually occurs in women 60 years of age or older and most frequently affects the vagina.

Leydig-like cells in the adrenals of a woman with ectopic ACTH syndrome.

A 36 year old woman with hypercorticism and markedly elevated blood ACTH levels underwent pituitary ablation because of suspected hypophysial Cushing's disease. Since no adenoma was detected in the anterior lobe and the hypercorticism persisted, a bilateral adrenalectomy was performed. Four months later lymph node and mediastinal metastases of an anaplastic small cell carcinoma, with the presence of argyrophil granulation, as well as immunoreactive 19-39ACTH, beta-LPH and alpha-endorphin, were found.

Renal artery aneurysm: a complication of Gianturco coil embolization of renal adenocarcinoma.

A complication of Gianturco coil infarction of a massive renal carcinoma with caval obstruction is presented. The immediate response was excellent but at 4 months the patient became hypertensive and potassium-depleted. A large aneurysm of the renal artery had developed at the site of the coils, necessitating nephrectomy.

Renal angiomyolipoma: ultrastructural study.

An angiomyolipoma from a twenty-six-year-old woman was studied by electron microscopy. The tumor was composed of a mixture of mature smooth muscle cells, fat cells, and abnormal blood vessels. MAny of the smooth muscle cells showed excessive intracytoplasmic accumulation of glycogen, while the abnormal blood vessels lacked a normal media.

Sarcoidosis of the female genital tract.

Sarcoidosis, a chronic, multisystemic disease, is characterized histologically by discrete, well-formed granulomas with little central necrosis. It can affect any organ system in the body and rarely involves the female genital tract. This report includes the description of a patient with genital involvement by sarcoid granulomas, who presented with postmenopausal bleeding.

Ultrastructural study of testis in testicular feminization.

Testicular tissue was investigated by electron microscopy in a case of testicular feminization. The seminiferous tubules were lined by spermatogonia and by Sertoli cells. Spermatocytic maturation was not observed.

Compression of the cauda equina due to a necrobiotic granuloma of ligamentum flavum.

A 56 year old woman developed symptoms of lumbar nerve root compression caused by a granuloma arising in the ligamentum flavum. The histological features of the lesion are discussed and the clinical and radiological findings of the patient are described.

Agarose--starch gel electrophoresis of rat serum lipoproteins.

Rat serum lipoproteins were separated into at least four fractions by agarose-starch gel electrophoresis. The system used was discontinuous in that glycine and sodium barbitone buffer was used in the reservoirs and Tris buffer was used for the gels. The four major bands could be related to the pattern obtained by ultracentrifugation.