The American journal of surgical pathology
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Am. J. Surg. Pathol. · Nov 1987
Case ReportsWegener's granulomatosis presenting with massive pulmonary hemorrhage and capillaritis.
The typical lesions of Wegener's granulomatosis in the lung consist of necrotizing granulomatous inflammation associated with a necrotizing vasculitis. We report an unusual case in which massive pulmonary hemorrhage was the initial manifestation. ⋯ The diagnosis of Wegener's granulomatosis was established only at autopsy, when necrotizing granulomas and vasculitis were found. This case emphasizes that Wegener's granulomatosis should be considered in the differential diagnosis of pulmonary hemorrhage and necrotizing capillaritis.
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Am. J. Surg. Pathol. · Aug 1986
Spindle cell hemangioendothelioma. A low-grade angiosarcoma resembling a cavernous hemangioma and Kaposi's sarcoma.
Twenty-six cases of a newly recognized form of vascular tumor are presented. The tumor may occur at any age, has a male predominance, and develops preferentially in the dermis and subcutaneous tissues of the distal extremities. Histologically it combines the features of both a cavernous hemangioma and Kaposi's sarcoma. ⋯ Follow-up information in 14 cases indicates that nine patients experienced "recurrences." One patient, who also received radiotherapy, developed regional lymph node metastasis 40 years after diagnosis and following 19 recurrences. No patient, however, has died of his disease, despite relatively limited surgical excision. The term "spindle cell hemangioendothelioma" is suggested for this vascular tumor of low-grade malignancy.
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Am. J. Surg. Pathol. · Jan 1985
Fibrolipomatous hamartoma of nerve. A clinicopathologic analysis of 26 cases.
Nineteen cases of fibrolipomatous hamartoma of nerve without macrodactyly and seven cases with macrodactyly are discussed. Twenty-five involved the hand, wrist, palm, and finger, and one case involved the foot. Nineteen patients had isolated fibrofatty enlargement of nerve, while seven had macrodactyly in addition to the peripheral nerve changes. ⋯ Mature fat cells have been described within the normal nerve sheath, and it is thought that proliferation of these cells leads to the fatty enlargement of the nerve and its coverings. The relationship of these neural changes to the development of macrodactyly remains controversial. Follow-up in 18 patients (69%) reveals a benign course following biopsy, limited excision, or division of the flexor retinaculum in the wrist.
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An unusual pattern of focal involvement of lymph nodes by Hodgkin's disease is described which we have named "interfollicular Hodgkin's disease." It is characterized by florid reactive follicular hyperplasia which overshadows involvement of the interfollicular zones by Hodgkin's disease. The pattern can be mistakenly diagnosed as one of the many causes of reactive follicular hyperplasia. The seven cases studied did not appear to differ clinically from other more recognizable forms of Hodgkin's disease. The importance of this pattern of lymph node involvement by Hodgkin's disease rests on its misdiagnosis as a benign lesion and not on any unusual clinical features.
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The nature of the local histopathologic changes secondary to vasectomy is described in tissue excised at vasovasostomy in 37 secondarily infertile patients. Segments of surgically removed vasa were also studied in four patients with primary infertility who underwent scrotal explorations and subsequent vasoepididymostomy. ⋯ These included suture granuloma, sperm granuloma, and vasitis nodosa, the last being a ductular proliferation originating from the central vas lumen and extending into the perivasal soft tissues. Vasitis nodosa occurred in 66% of the patients, and although it was often found with a sperm granuloma, it did occur by itself and is a lesion which should be recognized.