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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An unusual case of bilateral malignant Brenner tumor with liver and omental metastases is reported. The tumor was histologically a transitional cell carcinoma comparable to a grade III bladder carcinoma. A benign component was not identified, but there were a few nests of malignant epithelial cells distributed in a dense stroma, a pattern identical to that seen in a benign Brenner tumor. ⋯ Nevertheless it is suggested that the current histologic criteria for malignant Brenner tumor be modified to exclude the requirement of an intimately associated benign Brenner tumor. Ultrastructurally the malignant Brenner tumor has many features of the benign Brenner tumor. Some features, notably the basal lamina, micropinocytotic vesicles, nd intracytoplasmic microfibrils, are herein described for the first time in a malignant Brenner tumor.