1/7. Influenza virus-induced encephalopathy: clinicopathologic study of an autopsied case.BACKGROUND: Rapid progressive encephalopathy with a high fever, consciousness loss and recurrent convulsions has been occasionally reported in children during influenza pandemics in japan since 1995. We examined a 2-year old girl with hemorrhagic shock and encephalopathy syndrome associated with acute influenza a virus infection (A/Nagasaki/76/98; H3N2), to answer several questions for which no histologic or virologic data exist. methods: A clinicopathologic study using immunohistochemical staining and viral genome detection by reverse transcriptase polymerase chain reaction (RT-PCR) was performed with this autopsied case. RESULTS: The virus antigen was positive in CD8 T lymphocytes from the lung and spleen. The virus infected a very limited part of the brain, especially Purkinje cells in the cerebellum and many neurons in the pons, without inducing an overt immunologic reaction from the host. The RT-PCR used for detecting the hemagglutinin gene demonstrated positive bands in all frozen tissues and cerebrospinal fluid taken at autopsy and not in samples obtained on admission. CONCLUSIONS: The pathologic change induced by the direct viral invasion cannot be responsible for all of the symptoms, especially for the rapid and severe clinical course of the disease within 24-48 h after the initial respiratory symptoms. Together with the rapid production of several inflammatory cytokines, the breakdown of the blood-brain barrier may induce severe brain edema and can be a major pathologic change for the disease. Any therapeutic strategy to control this multistep progression of the disease could be effective.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
2/7. Hepatosplenic gammadelta-T-cell lymphoma with leukemic course after renal transplantation.Hepatosplenic gammadelta-T-cell lymphoma (HSTCL) is a rare extranodal T-cell non-Hodgkin's lymphoma (T-NHL) with only 46 well-documented cases in medical literature. Notably, a relatively high number of these case reports (15%) describe the occurrence of HSTCL after solid organ transplantation. We describe the case of a 45-year-old man who developed a leukemic HSTCL 5 years after renal transplantation and continous immunosuppression with cyclosporine A and prednisolone. After a rapid clinical course, the patient died and autopsy was performed. The malignant lymphocytes showed a natural killer-like gammadelta-T-cell phenotype (CD2( ), CD3( ), CD7( ), TCR gammadelta( ), CD56( ), TIA-1( ), CD4(-), CD8(-), and TCR alphabeta(-)) and infiltrated the sinusoids of liver and the red pulp of the spleen. Cytogenetically, an isochromosome 7q, trisomy 8, Y-loss, and a translocation t(1;4) was detectable. This case shows the difficulties of recognizing HSTCL early in the clinical course and underlines that all types of T-NHL, nodal as well as extranodal, have to be considered in the differential diagnosis of posttransplantation lymphoproliferative disorders. Moreover, HSTCL seems to occur as a specific late complication of solid organ transplantation.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
3/7. An extremely rare inversion of the preduodenal portal vein and common bile duct associated with multiple malformations. Report of an adult cadaver case with a brief review of the literature.A preduodenal position of the portal vein (PDPV) is a very rare congenital anomaly; even rarer is its association with a preduodenal position of the common bile duct (PDCBD). To the seven cases of PDCBD mentioned in the literature, we add this particularly rare case which is associated with multiple abnormalities such as situs inversus totalis, intestinal malrotation, short pancreas, bilobed spleen, accessory spleen, and abnormal ramification of the celiac axis, superior mesenteric artery and renal arteries. Besides describing and illustrating this case, we also discuss the anatomy and embryology of these structures and briefly review the patterns of previously reported cases that we found. We performed an immunohistochemical examination of the pancreas to demonstrate the ventro-dorsal pancreas in our case. For the explanation of the embryology of the PDCBD, the ventro-dorsal pancreas and PDPV malformation, we emphasized the reverse rotation of the ventral pancreas and duodenum.- - - - - - - - - - ranking = 2keywords = spleen (Clic here for more details about this article) |
4/7. An autopsy case of I-cell disease. Ultrastructural and biochemical analyses.An autopsy case of I-cell disease in a 4-year-old Japanese girl is presented. In this report, the authors analyze the relationship between morphologic (including electron microscopic) and biochemical findings. Lymph node, spleen, and kidney, which were stained with Hale's colloidal iron method, contained large amounts of hexosamine. These substances had accumulated in lymphocytes of B-cell lineage.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
5/7. An unusual form of chronic myeloproliferative disorder. Aleukemic basophilic leukemia.A 52-year-old Japanese man manifested various clinical signs and symptoms such as vomiting, high fever, dyspnea, cough, sweating, palpitation, eosinophilic leukocytosis and hepatosplenomegaly. These histamine-related clinical manifestations showed a dramatic response to steroid therapy. After 10 months of hospitalization, he suddenly succumbed to candidal septicemia at the end of the third cycle of steroid therapy. autopsy revealed neoplastic proliferation of immature basophils in various internal organs without involvement of the skin. The neoplastic cells, positive immunohistochemically for leukocyte common antigen, possessed lobulated nuclei and weakly metachromatic cytoplasmic granules, predominantly of the basophil type, which exhibited weak naphthol ASD-chloroacetate esterase activity. Mast cell-type granules were also observed ultrastructurally. The neoplastic infiltration was associated with fibrosis in the liver, spleen and bone marrow and with extramedullary hematopoiesis in the liver, spleen, lymph nodes and perihypophyseal tissue. The bone marrow showed uneven and multifocal involvement. Despite the lack of leukemic manifestations and the results of chromosomal analysis, the most suitable diagnosis was aleukemic basophilic leukemia within the category of chronic myeloproliferative disorder. Kinship of this neoplasia to systemic mastocytosis is discussed.- - - - - - - - - - ranking = 2keywords = spleen (Clic here for more details about this article) |
6/7. Esophageal cancer complicated by acute myelofibrosis--report of an autopsy case.An autopsy case of esophageal cancer complicated by myelofibrosis was studied. A 62-year-old Japanese patient with esophageal cancer, received surgical treatment and then splenectomy. The resected spleen was normal in appearance. Five months later he received radiation therapy for the cancer. After the therapy, his blood profile revealed thrombocytopenia and leukoerythroblastosis, and the bone marrow punctures were dry tap. He died of disseminated fungal infections at eleven months after the first operation. An autopsy of the patient revealed a striking increase in the megakaryocytes and a moderate increase in the reticulin fibers in the bone marrow. Myeloid metaplasia was noted in the lymph nodes, kidneys, and other organs and tissues, although the lymph nodes were not grossly swollen. These findings suggest esophageal cancer complicated by acute myelofibrosis. This it the first case report on esophageal cancer complicated by acute myelofibrosis.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
7/7. Metastatic malignant melanoma transplanted via a renal homograft: a case report.A case of transplantation of a malignant melanoma via a cadaver renal homograft is presented. The recipient developed a widespread malignancy ninteen months after renal transplantation. At autopsy the tumor was diagnosed as a malignant melanoma. autopsy of the donor had previously revealed a spindle cell malignancy in the spleen. It is postulated that the splenic tumor in the donor represents a spindle cell variant of malignant melanoma, and hence this malignancy was inadvertently transferred to the recipient via the renal homograft.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |