American journal of clinical pathology
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Am. J. Clin. Pathol. · Oct 1995
Case ReportsSevere intravascular hemolysis associated with brown recluse spider envenomation. A report of two cases and review of the literature.
Envenomation by the brown recluse spider (loxoscelism) is classically associated with a necrotic ulcer. Systemic manifestations occur in a minority of cases, but are generally mild and self-limited. The hematologic complications of brown recluse spider bite range from mild hemolysis to fulminant intravascular hemolysis with or without evidence of disseminated intravascular coagulation. ⋯ This article presents two cases of severe hemolysis associated with loxoscelism occurring in two young women in Memphis, Tennessee. The second documented death in an adult from severe hemolysis due to a brown recluse spider bite is reported. A review of the literature emphasizing the pathogenic mechanisms of spider bite hemolysis is also included.
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Am. J. Clin. Pathol. · Apr 1995
Case ReportsThe importance of communication between the pathologist and the clinician in caring for patients receiving gynecologic treatment.
These cases clearly illustrate the importance of communication between the pathologist and gynecologist or gynecologic oncologist to deliver optimal patient care. It is not only important for the pathologist and gynecologist to review the pathologic diagnosis before implementing treatment plans, it is also imperative that the gynecologist provide the pathologist with a thorough history. As part of this communication process, the pathologist conveys abnormalities of histology as well as uncertainties, such as that which occurred in the mucinous cystadenocarcinoma case. By maintaining open communication, the patient receiving gynecologic treatment will receive the best possible care.
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Am. J. Clin. Pathol. · Mar 1994
Detection of subgroups of chronic B-cell leukemias by FMC7 monoclonal antibody.
Monoclonal antibody FMC7 detects subgroups of B-cell leukemias that have arisen from cells in late stages of B-cell maturation. FMC7 was studied by flow cytometry on cell samples from 192 patients with a diagnosis of chronic lymphocytic leukemia (CLL) or lymphoma. The leukemic cells from 16 patients were reactive with this antibody. ⋯ Among 10 patients treated with fludarabine, five responded to therapy. Monoclonal antibody FMC7 is useful for identifying a group of atypical variants of CLL, PLL, and other B-cell lymphomas in leukemic phase that can be easily confused with CLL. Careful attention to the cell morphology and histologic features is important for the differential diagnosis of FMC7-positive, B-cell lymphoproliferative diseases.
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Am. J. Clin. Pathol. · Mar 1993
Case ReportsLocalized pleural microdeposition of type A amyloid in a patient with rheumatoid pleuritis. Histologic distinction from pleural involvement in systemic amyloidosis.
Decorticated pleural tissue from a 74-year-old man with rheumatoid arthritis, an exudative pleural effusion, and normal left ventricular function contained microscopic deposits of amyloid A protein, localized to the interface between a deep layer of dense fibrocollagen and a layer of granulation tissue beneath a surface fibrin exudate. Previously reported instances of pleural amyloid deposition have occurred in patients with presumed systemic amyloidosis, and most such effusions are the result of congestive heart failure. This patient had no evidence of systemic amyloidosis, and this case appeared to be an example of an unusual form of localized amyloidosis, so-called periinflammatory amyloidosis A. These observations suggest that amyloid in a pleural biopsy should not be construed per se to be diagnostic of systemic amyloidosis.
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Am. J. Clin. Pathol. · Jan 1993
Case ReportsPostmortem diagnosis of acute anaphylaxis by serum tryptase analysis. A case report.
Systemic anaphylaxis is an acute allergic emergency resulting from generalized mast cell degranulation. In the United States, it is estimated that anaphylaxis accounts for about 500 deaths each year. Hymenoptera-sting hypersensitivity is one of the most common causes of systemic anaphylaxis. ⋯ At autopsy, performed 14 hours after the event, the only pathologic findings were laryngeal edema and congestion of lung. Postmortem tryptase levels in the blood were obtained and were instrumental in confirming a diagnosis of acute anaphylaxis. This case is reported to discuss the difficulties associated with using traditional histamine levels in making a diagnosis of anaphylaxis and to validate the value of using tryptase levels to document acute anaphylaxis as a cause of death, even when serum is not obtained until many hours after death.