11/1975. Papillary endothelial hyperplasia presenting as a chest wall neoplasm. Soft tissue hematomas generally resolve but may persist and develop into slow-growing, organized masses. These chronic expanding hematomas are characterized by a pseudocapsule and a predominantly necrotic central cavity, with foci of newly formed capillaries. These have been called chronic expanding hematomas or Masson's papillary endothelial hyperplasia. These lesions can mimic vascular neoplasms and must be considered in the evaluation of expanding soft tissue vascular malformations. ( info) |
12/1975. Colonic obstruction due to sigmoid muscular hyperplasia. We report a case of acute colonic obstruction initially presumed to be secondary to acute diverticulitis, necessitating emergent surgical intervention. Pathologic examination failed to reveal evidence of inflammation, fibrosis or neoplasia. Marked hypertrophy of the sigmoid circular muscle layer was documented and thought to be the etiology of the colonic obstruction. ( info) |
13/1975. Parathyroid carcinoma secondary to prolonged hyperplasia in chronic renal failure and in coeliac disease. The presentation of parathyroid carcinoma in patients with chronic renal failure is rare, although with improvements in life expectancy associated with this condition there have now been 12 reported cases, including the first case we report here. It has been proposed that in these cases there has been a malignant transformation of benign parathyroid hyperplastic tissue. We also report the first case of parathyroid carcinoma associated with coeliac disease and suggest that the same mechanism may be responsible. We review the presentation, diagnosis, treatment and natural history of the disease. ( info) |
14/1975. Renal cell carcinoma in children with diffuse cystic hyperplasia of the kidneys. We report the clinical, pathologic, and genetic features of renal malignancy in two children with diffuse cystic hyperplasia. Both presented with massive bilateral nephromegaly. Neither had a family history or clinical findings suggestive of tuberous sclerosis or von hippel-lindau disease. The kidneys of both children were extensively replaced by tubulocystic hyperplasia with large eosinophilic epithelial cells. The masses of hyperplastic tissue were nodular, compressing remnants of uninvolved renal parenchyma. Tubulopapillary carcinoma was present in both children, one of whom had bilateral multicentric carcinoma. No loss of heterozygosity was detected in the tumors at the TSC1, TSC2, or VHL gene regions, and no alterations in the VHL gene were detected using single-strand conformation polymorphism analysis. These cases of bilateral renal enlargement with diffuse cystic hyperplasia appear to represent a new clinical syndrome that may warrant bilateral nephrectomy because of the risk of malignancy. ( info) |
15/1975. Lymphoid lesions of the conjunctiva: relation of histopathology to clinical outcome. A retrospective clinicopathologic study of 40 patients with lymphoid lesions of the conjunctiva demonstrated the validity of current histologic criteria in predicting clinical outcome. overall histologic architecture as well as cytologic detail must be used to differentiate benign reactive lymphoid hyperplasia from lymphoma. Lesions verified clinically as being malignant had obvious malignant cytologic features. Clinical signs of surface follicularity, multifocality, and minimal elevation suggest benignancy. All the benign lesions, on histopathologic examination, were either follicular in architecture or composed of mature lymphocytes, and were generally restricted to the substantia propria. Bilaterality and clinical recurrence do not necessarily imply a malignant disease. ( info) |
16/1975. Nodular regenerative hyperplasia of the liver and antiphospholipid antibodies: report of two cases and review of the literature. Nodular regenerative hyperplasia of the liver (NRHL) is a rare disorder characterized by diffuse micronodular transformation of the hepatic parenchyma without fibrous septa between the nodules. This condition appears to be associated in many occasions with systemic autoimmune diseases. We describe two new patients with NRHL in whom antiphospholipid antibodies (aPL) were detected in their sera and review the few similar cases reported previously. We also discuss the possible relationship between aPL and NRHL and suggest that these antibodies may play a role in the pathogenesis of some cases of NRHL, specially those with an associated antiphospholipid syndrome. ( info) |
| A patient with bilateral fibromuscular hyperplasia in the carotid arteries with development of aneurysms is reported. The patient had no symptoms except for a palpable mass on one side and a bruit on both sides. Surgery was carried out bilaterally, using direct end-to-end suture on one side and a reconstruction with an autologous vein on the other side. It is suggested that fibromuscular hyperplasia may be the cause of some of the internal carotid artery aneurysms reported as congenital or with uncertain etiology. Reconstructive surgery of the carotid artery is recommended due to the obvious hazards of the condition. ( info) |
| PURPOSE: To report an unusual case of familial exudative vitreoretinopathy in an infant. methods: Case report. A 6-day-old girl had unilateral microphthalmia in the right eye, with a retrolental plaque initially diagnosed as persistent hyperplastic primary vitreous. Three months later, peripheral retinal vascular changes and a fibrovascular ridge were noted in the left eye, suggesting familial exudative vitreoretinopathy as the cause in both eyes. RESULTS: The microphthalmic right eye was unsalvageable. The left eye developed an exudative retinal detachment despite photocoagulation of the peripheral avascular retina. Additional cryotherapy resulted in resolution of the detachment and regression of the vascular changes. CONCLUSIONS: With highly asymmetric involvement, neonatal familial exudative vitreoretinopathy can mimic persistent hyperplastic primary vitreous. Fellow eye involvement can progress rapidly. ( info) |
19/1975. A proposal for a staging system for hyperplastic rhinosinusitis based on the presence or absence of intranasal polyposis. This study of 30 patients with hyperplastic rhinosinusitis reveals that the major determinant of the success or failure of conservative therapy is the presence or absence of intranasal polyposis. When polyposis is confirmed both clinically and radiographically, surgical intervention appears to be the rational way to handle most cases. When intranasal polyps are not present, an aggressive medical regimen is called for, one that includes a short-term, low-dose oral corticosteroid and an antibiotic, along with periodic radiographic assessment. Regardless of how much disease is seen on computed tomography, if it does not also detect intranasal polyps or masses, the potential for clearing with conservative therapy is extremely high. ( info) |
20/1975. Familial macroglossia-omphalocele syndrome. A kindred is reported in which 8 infants were affected with the macroglossia-omphalocele syndrome. Their characteristics varied from an almost complete clinical picture to nodular hyperplasia with cytomegaly of the adrenals as the only manifestation of the disease. Chromosome analysis was normal. This syndrome appears to be inherited as an autosomal recessive trait, with a high proportion of incomplete clinical forms. The index patient also has signs of the rubinstein-taybi syndrome. The simultaneous occurrence of these two syndromes is probably a fortuitous event. ( info) |