Human pathology
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The clinicopathologic features of nine patients with inflammatory polyps of the anorectal transition zone (inflammatory cloacogenic polyp, ICP) were reviewed. All polyps were characterized histologically by crypt hyperplasia and a thickened muscularis mucosa arising beneath a surface epithelium consisting of variable proportions of squamous, columnar, and often transitional epithelium. Tubulovillous architecture was characteristic. ⋯ Papillomavirus was demonstrated by histochemical and immunohistochemical methods in one case in which multiple foci of dysplasia were also noted. Two patients had Crohn's disease, and the remaining patient had a coexistent adenocarcinoma located several centimeters proximal to his ICP. The pathologist and clinician must be aware that although ICP is often associated with SRUS/mucosal prolapse, it may occur in other clinical settings.
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The authors review the clinical, radiographic, and pathologic features of the benign pulmonary lymphoid disorders. The essential role of immunopathologic techniques in distinguishing pulmonary lymphoid hyperplasias from malignant lymphoma is stressed. A theory regarding the development of pulmonary lymphoid hyperplasia is proposed as a basis for understanding these disorders. The authors suggest that lymphoid hyperplasia is a basic inflammatory response of the lung.
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Artificial substitutes for specific functional portions of blood are being developed. Perfluorocarbons have received the most publicity in recent years, and one, Fluosol-DA, is undergoing clinical trials in the United States. The perfluorocarbon emulsions physically dissolve oxygen, which distinguishes them from the chemical binding that occurs in hemoglobin. ⋯ A large clinical trial from Japan suggests that Fluosol-DA is safe to transfuse, although recent work suggests that Fluosol-DA may produce significant pulmonary reactions that can be prevented by steroid administration. These reactions are probably caused by complement activation by an emulsifying agent in Fluosol-DA. Recent applications of Fluosol-DA include use in a resuscitative fluid, use in occlusive vascular disease, an special applications, such as treatment of carbon monoxide poisoning, which take advantage of the solubility properties of perfluorocarbons.
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Osteomas, although usually found in the frontal and ethmoid sinuses or the mandible, may be located on the inner table of the skull. We report the incidence, distribution, histologic features, and clinical correlates of intracranial osteomas arising in the dura mater and the falx cerebri in 200 consecutive adult autopsies. Ten patients (5 per cent of autopsies) were found to have meningeal osteomas. ⋯ The authors consider these cases of meningeal ossifications and reports of meningeal calcifications to represent osteomas arising from the dura mater and the falx cerebri. Thus, intracranial osteomas may be more common than was previously recognized. In some instances, the abnormal biochemical state accompanying chronic renal failure may stimulate new bone formation in the osteogenic tissue of the dura mater.
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The occurrence and pattern of cytoplasmic muramidase containing histiocytes were studied by the unlabeled antibody peroxidase-antiperoxidase method in biopsy material from patients with Hodgkin's disease, non-Hodgkin's lymphomas, and reactive hyperplasia. The majority of lymph nodes from patients with Hodgkin's disease, nodular lymphoma, and reactive hyperplasia gave positive staining reactions when tested in this manner. Differences in the staining pattern were observed for the different conditions studied. ⋯ Since the mottling pattern appeared to be produced by virtue of a large amount of extracellular muramidase, the elevation of the serum muramidase level in Hodgkin's disease may be related to enzymatically active secretory histiocytes. Moreover, the mottling staining pattern was observed frequently in the lymphocytic predominance and nodular sclerosis type of Hodgkin's disease, but relatively infrequently in the mixed cellularity or lymphocytic depletion types, suggesting that the variation in histiocytic activity may be related to the course of the disease. The decreased staining reaction observed in the latter two categories could not be accounted for by a decrease in the numbers of histiocytic cells in hematoxylin and eosin stained sections, suggesting that release or synthesis may be defective in those unfavorable types of Hodgkin's disease.