Dilantin-associated lymphadenopathy. Spectrum of histopathologic patterns.

The association of Dilantin (hydantoin) therapy and lymphadenopathy in the form of "pseudolymphoma" or malignant lymphoma has been reported primarily in the clinical literature in single case reports or small series, most of which contain very few pathologic details. We studied a series of 25 lymph node lesions collected at the Armed Forces Institute of Pathology from 1965 to 1991 that were suspected to be related to intake of the antiseizure medication Dilantin. Each case had been coded by the Environmental and Toxicology Department according to the so-called "operational degrees of certainty," which gives the possibility that a pathologic change is the result of a drug.

A morphologic study of Vietnam veterans.

The possibility that service in Vietnam has had an adverse effect on Vietnam veterans and is the cause of some of their current illnesses has been a controversial issue in the post-Vietnam period. Addressing this problem, a pathology study has been carried out at the Armed Forces Institute of Pathology (AFIP). Pathologic diagnoses found in Vietnam veterans have been compared with a control group of contemporary veterans without Vietnam service.

Hemorrhagic cellular leiomyomas ("apoplectic leiomyoma") of the uterus associated with pregnancy and oral contraceptives.

The clinical and pathological findings in 22 women with a distinctive hemorrhagic cellular (HC) leiomyoma of the uterus are described. Characterized by a dense cellularity accompanied by hemorrhage and edema, 17 occurred in women taking oral contraceptives, three occurred in pregnant women, and one was found in a woman 3 days postpartum. One woman, not pregnant or taking steroids, was using hydrochlorothiazide.

The morphologic spectrum of halothane-induced hepatic injury: analysis of 77 cases.

Hepatic histopathology and clinical-pathologic correlations were studied in 77 patients who met clinical criteria for halothane hepatotoxicity. They were divided into groups based on the type of surgery (minor or major) and outcome (nonfatal, biopsy group or fatal, autopsy group). The two nonfatal groups (minor surgery and major surgery) and the two fatal groups (minor surgery and major surgery) were comparable with regard to age, time of onset from exposure, peak aminotransferase values and peak bilirubin determinations.

Oral contraceptives and stroke in young women: a clinicopathologic correlation.

Pathologic studies of women with fatal cerebrovascular disease who have received oral contraceptives are infrequently found in the literature. Three cases of this type are reported here. The pathologic findings included an intrinsic vascular lesion in the form of intimal hyperplasia with and without associated thrombosis, found in arteries supplying the brain.

Myocardial changes in malignant hyperthermia.

Although consideral information is available concerning the structural and biochemical changes in the skeletal muscles of patients with malignant hyperthermia, little is known of the cardiac changes in this disease. However, ventricular fibrillation and cardiac arrest are frequent in these patients. In 3 patients with malignant hyperthermia, contraction bands and foci of myofiberlysis were found in the heart at necropsy.

Morphologic changes in adverse drug reactions in infants and children.

The morphologic findings in 102 validated cases of adverse drug reactions classified in the "causative" and "probable" category are reported. All of them are well documented cases of drug associated reactions. The patterns of tissue reactions in these cases are divided into the following categories: inflammation, degeneration and infiltration, hypoplasia and aplasia, hyperplasia, necrosis, circulatory disturbances and vascular abnormalities, and teratogenesis.

Adverse drug reactions and death. A review of 827 cases.

A study of 827 cases of adverse drug reactions (ADRs) in which autopsies were done was carried out to determine the relative frequency of drugs that caused adverse reactions, their sites of action, and the variety of pathologic processes induced by them. Because a variety of nondrug factors played critical roles in generating many of the ADRs, these 827 cases were divided into seven groups. Only one of these groups (25% of the total) met the criteria of ADRs in the usual definitional sense and were also lethal.

Diagnostic problems in drug-induced diseases.

The evaluation of adverse drug reactions (ADR's) in clinical patients is usually a complex and multifactorial problem. A methodology for this evaluation has been derived from the experience with over 3,000 cases. Illustrative cases are presented to demonstrate in detail a variety of means of linking a drug with an ADR.