Lymphomatoid granulomatosis of the skin and lung. An angiocentric T-cell-rich B-cell lymphoproliferative disorder.

Objective: To test the recent hypothesis that lymphomatoid granulomatosis (LYG) is a clonal B-cell proliferative process related to Epstein-Barr virus (EBV).

Background And Design: Historically, LYG has been classified as an angiocentric T-cell lymphoproliferative disorder. To further characterize LYG in the skin, we analyzed for EBV RNA in lymphocytes using in situ hybridization, coupled with colabeling for B-cell and T-cell markers.

Heterotopic bone formation in the gastrointestinal tract.

Heterotopic bone is found rarely in the gastrointestinal tract. Here we report four cases, one of which occurred in Barrett's esophagus in an area of metaplasia of specialized cell type without evidence of neoplasia. In the remaining cases, bone was associated with mucin-producing tumors of the appendix, transverse colon, and rectum.

Colonic mucosal abnormalities associated with oral sodium phosphate solution.

Background: Oral sodium phosphate (NaP) is increasingly used as a colonic cleansing agent for colonoscopy. It has been shown to be efficacious, well-tolerated, and safe. Mucosal abnormalities associated with NaP have recently been described.

Fulminant herpes colitis in a patient with Crohn's disease.

Herpes simplex virus (HSV) is a well-recognized cause of gastrointestinal infection, most commonly in patients with underlying immunodeficiency. The esophagus, perianum, and rectum are the most common sites of involvement; however, extensive colitis is rare. We describe a woman with Crohn's disease who developed pathologically proven HSV colitis.

Squamous cell carcinoma of the lip in a 19-month-old child: a case report.

Squamous cell carcinoma of the lip is rarely seen in children. We present the case of a 19-month-old child, without known risk factors, who developed invasive squamous cell carcinoma involving the skin and underlying muscle of the lip. The histology of the tumor was invasive squamous cell carcinoma of the keratoacanthoma type.

The fate of the skin graft in laryngoplasty.

In laryngoplasty procedures, laryngotracheal soft tissue defects are often repaired using skin grafts. While stenting is necessary to approximate and immobilize the graft, prolonged stenting causes increased bacterial counts, granulation tissue formation, tissue ischemia, and graft failure. Optimal time for stent removal has not been experimentally defined.

The effects of supercooling chemicals on myocardial ultrastructure: a transmission electron microscopy case study.

Extended ischemia results in organ infarction which limits the availability of donor hearts. Hypothermic storage extends heart preservation by effectively stopping cellular metabolism, thereby preventing toxic accumulations of metabolic wastes and depletion of energy stores. However, cell swelling as a result of ion concentration changes and cell laceration due to ice crystal growth are consequences of hypothermic ischemia.

The fate of medialized cartilage in thyroplasty type I.

Thyroplasty type I is rapidly emerging as the preferred means of medializing a paralyzed vocal fold. We discuss our experience with the fate of a medialized cartilage window 9 months after an otherwise successful operation. Cartilage resorption over time resulted in degeneration of voice and in progressive aspiration.

Epstein-Barr virus-infected marmoset cells do not form lymphomas in mice with severe combined immunodeficiency.

EBV has been associated with several malignancies in humans. EBV can also infect marmoset B lymphocytes, which, as opposed to human B cells, are permissive for lytic Epstein-Barr viral replication. Mice with a severe combined immunodeficiency phenotype (SCID mice) are extremely susceptible to EBV-induced lymphomagenesis when inoculated with EBV-infected lymphocytes.

The role of natural-killer-cells in the pathogenesis of epstein-barr virus-associated burkitt-lymphoma in a scid mouse model.

Epstein-Barr virus (EBV) is associated with both benign and malignant lymphoproliferative processes. Recently, mice with severe combined immunodeficiency (SCID) have been described that develop EBV-induced lymphomas when inoculated with peripheral blood lymphocytes from EBV-seropositive individuals. To investigate the pathogenesis of EBV-associated Burkitt lymphomas, we intraperitoneally inoculated SCID mice with cells from EBV-infected Burkitt lymphoma (BL) cell lines.

Cutaneous cryptococcosis in a patient with cutaneous T cell lymphoma receiving therapy with photopheresis and methotrexate.

Photopheresis is being used with increasing frequency as therapy for patients with neoplastic and dermatologic diseases and is being evaluated as therapy for patients with AIDS. We describe a patient with advanced cutaneous T cell lymphoma who developed pulmonary and cutaneous cryptococcosis after receiving therapy with photopheresis and biweekly methotrexate. We consider the potential roles of cutaneous T cell lymphoma, methotrexate, and photopheresis as predisposing factors in the development of serious cryptococcal infections.

Renal failure and severe hypokalemia associated with acute myelomonocytic leukemia.

The leukemias have long been associated, albeit rarely, with the development of renal failure and several metabolic perturbations. While renal insufficiency may result from a variety of mechanisms in the setting of leukemia, severe leukostasis with microvascular insufficiency and renal parenchymal infiltration by blast cells are rare and infrequently described etiologies. In addition, hypokalemia can occur from lysozyme-induced renal tubular injury with inappropriate kaliuresis.

Metastatic dermatofibrosarcoma protuberans with fibrosarcomatous change in the absence of local recurrence. A case report of simultaneous occurrence with a malignant giant cell tumor of soft parts.

An unusual case of a metastasizing dermatofibrosarcoma protuberans with fibrosarcomatous change (DFSP-FS) is reported. The tumor metastasized to unusual sites, including soft tissues of the cheek, forearm, and retroperitoneum 5 years after surgical resection without local recurrence. In addition, the patient had a second, histologically distinct fibrohistiocytic tumor: a malignant giant cell tumor of soft parts.

Improved ultrastructural lung preservation with prostaglandin E1 as donor pretreatment in a primate model of heart-lung transplantation.

Donor pretreatment with prostaglandin E1 as a pulmonary vasodilator has developed as a simple, effective means to provide excellent preservation in heart-lung transplantation. This study was undertaken to investigate the degree of ultrastructural preservation of the lung with prostaglandin E1 and other pulmonary vasodilators in a primate heart-lung transplantation model. Heart-lung transplantation was performed in 14 African green monkeys.

The morphologic features of diversion colitis: studies of a pediatric population with no other disease of the intestinal mucosa.

Studies of diversion colitis have not shown a consistent pattern of histopathologic features, and many descriptions are difficult to interpret because of the presence of underlying intestinal mucosal disease. To define the histologic changes in patients free of other mucosal inflammatory disease, we studied the resected segments of bypassed colorectum from 37 patients with Hirschsprung's disease treated by a two-stage procedure, using rectal biopsy specimens taken for initial diagnosis and trimmings from proximal to the stoma as controls. Biopsy specimens from a further 14 patients of similar age but without colorectal mucosal disease were used as additional controls.

Squamous cell carcinoma arising in a thyroglossal duct cyst.

Carcinoma arising in a thyroglossal duct cyst is a rare event, occurring in less than 1% of abnormalities of the thyroglossal duct. To date, there have been approximately 100 cases reported, with papillary carcinoma accounting for the vast majority. Squamous cell carcinoma, on the other hand, is an even rarer event.

Granular cell tumor of the biliary tree. A report of two cases and a review of the literature.

Granular cell tumors are relatively uncommon soft tissue tumors usually presenting in the skin and subcutaneous tissues or tongue, although many sites have been described. Two cases arising in the extrahepatic biliary tree are described, and the previously reported cases of this rare presentation are reviewed. These tumors may mimic sclerosing cholangitis and cholangiocarcinoma clinically, and occasionally histologically, in this relatively young group of patients.

Periodic acid-Schiff-positive organisms in primary cutaneous Bacillus cereus infection. Case report and an investigation of the periodic acid-Schiff staining properties of bacteria.

Primary cutaneous Bacillus cereus infection frequently presents as a single necrotic bulla on the extremity of an immunocompromised patient. In lesional biopsy specimens and smears, the large gram-positive rods of B cereus may be mistaken for Clostridium species. This is a potentially serious error, as Bacillus species are resistant to penicillin and other beta-lactam antibiotics.

Unilateral cutaneous emboli of Aspergillus.

A 40-year-old white woman with acute nonlymphocytic leukemia, which relapsed despite bone marrow transplantation and various chemotherapeutic regimens, developed fever and neutropenia. Her fever was unresponsive to broad-spectrum antibiotics, and on hospital day 53 she developed purpuric macules with necrotic centers on her left hand and forearm. Frozen sections of lesional skin were stained with Grocott's methenamine-silver and showed hyphae consistent with a species of Aspergillus; culture of the skin biopsy specimen yielded a pure culture of Aspergillus flavus.

Cutaneous metaplastic synovial cyst.

Metaplastic synovial cyst, a recently described entity, is histologically characterized by a cystic cavity lined by metaplastic synovial tissue that is often hyperplastic and protrudes into its lumen as villous structures. Clinically, these lesions resemble suture granuloma and develop at the site of previous surgical trauma. We have studied 4 cases of this unusual entity and have investigated the immunohistochemical profile in an effort to determine the nature and derivation of their lining tissue.