2071/3657. Perspectives in adolescent tuberculosis: three decades of experience. Three hundred seventy-one adolescents and young adults, 10 to 20 years of age, were treated for tuberculosis during a 29-year period. There were 258 patients tuberculin positive without disease, 37 with calcifications on chest roentgenographs, and 76 with active tuberculous disease. All patients received chemotherapy. Active tuberculosis was more common in the 10- to 12-year-old patients. The greater number of tuberculin reactors in this age group suggests that endocrine factors related to the onset of puberty may play a role in conversion. No significant sex difference was apparent. Drug toxicity was rarely a problem. pregnancy subsequent to therapy was not associated with progression or reactivation of disease. Two (possibly three) patients who were properly treated and compliant with the drug regimen had reactivation disease 4 to 14 years later. Cavitary pulmonary disease occurred in the two compliant patients. meningitis, believed to be tuberculous, occurred in the suspected case. Two of these received isoniazid prophylaxis for skin test conversion only. In one patient, treated with two drugs for primary tuberculosis in the past, tuberculous pneumonia developed later. All three recovered. Although reactivation does occur, it is rare. Because most tuberculin reactors were discovered in the 10- to 12-year age group when screened routinely in high school, this procedure should not be abandoned. ( info) |
2072/3657. Extraovarian pelvic serous tumor with marked calcification. We report two cases of low-grade extraovarian pelvic serous tumor. Each contained large numbers of psammoma bodies. The tumors belong to the small group of serous carcinomas that arise from the peritoneum. In both cases the tumor permeated the myometrial lymphatic vessels extensively. One patient is well eight years after surgery. ( info) |
2073/3657. Soft tissue calcification: a complication of vitamin e injection. Two cases of gross soft tissue calcification following intramuscular administration of vitamin e in two premature babies are described. The drug was administered for prevention of retinopathy of prematurity. The relation between this complication and both the dosage used and the duration of the treatment is discussed. In spite of the extent of the calcifications, a benign course was observed. Other reports about this complication are reviewed. ( info) |
2074/3657. Lethal post-transplantation calcinosis. The case studies of four patients with post-transplantation calcinosis are presented. Three of the four patients died of inanition and sepsis secondary to infection of extensive soft tissue ulcers and diffuse cutaneous vascular calcification with gangrene. The fourth patient survived following removal of all four parathyroid glands and autografting of approximately one-half of one gland. Common to the patients was secondary hyperparathyroidism, elevated mean serum calcium levels after transplantation, and radiographic evidence of small and medium vessel calcification. No other differences could be found between these patients and other patients with post-transplantation hyperparathyroidism without calcinosis. In the face of apparently minor complaints of lower extremity discomfort, elevated parathyroid hormone levels (PTH) and positive xerography may indicate subtotal parathyroidectomy regardless of the serum calcium level. ( info) |
2075/3657. Oncocytic adenoma of the parotid gland with psammoma bodies. An unusual slow-growing tumor was found in the superficial lobe of the right parotid gland. It was multilobulated and encapsulated and consisted of sheets of epithelial oncocytes and minor foci of myoepithelium and ducts. Psammoma bodies were abundant. An antibody directed against keratin protein was localized in all tumor cells and in ductal but not acinar elements of adjacent parotid tissue. Ultrastructurally, the neoplastic cells proved to be ductal epithelial and myoepithelial oncocytes. ( info) |
2076/3657. Calcifications of the benign endometrium. A 28-year-old woman underwent a dilatation and curettage procedure in the course of an infertility evaluation, with the finding of multiple psammoma bodies in the tissue from the lower uterine segment. A repeated dilatation and curettage procedure performed five months later again revealed psammoma bodies in the lower endometrium and normal fundal endometrium. The patient previously had been treated with clomiphene. Psammoma bodies in the gynecologic tract most often have been associated with malignant neoplasms; however, a few cases of psammoma body formation or dystrophic calcification of the endometrium in benign conditions have been reported. ( info) |
2077/3657. A syndrome with intracranial calcification and microcephaly in two sibs, resembling intrauterine infection. We report two children, the products of a consanguineous union, who died in infancy. Both children had severe microcephaly intracranial calcification, lissencephaly and polymicrogyria. ( info) |
2078/3657. Subperiosteal osteoid osteoma of the talus. We report three patients with subperiosteal osteoid osteoma of the talus. All showed an erosion of the dorsal surface of the talus with medullary bone sclerosis. Adjacent paraosseous soft tissue calcification was seen in two lesions. Computed tomography demonstrated the nidus of the osteoid osteoma in two cases. ( info) |
2079/3657. Scleroderma after cosmetic surgery: four cases of human adjuvant disease. In 9 cases of human adjuvant disease, 4 cases of scleroderma (3 progressive systemic sclerosis and 1 localized morphea) were observed. Seven to 19 years after injection of foreign substances into the breasts or nose for cosmetic purposes, some patients developed human adjuvant disease. In one case the foreign substances were removed by bilateral mastectomy with no discernible effects on the patient's clinical course. Histopathologic findings of the removed breasts demonstrated foreign body granulomas with calcification. The injected substance was identified as a mixture of liquid and solid paraffin. Human adjuvant disease might be caused by prolonged hypersensitization activated by the injected foreign materials which act as an adjuvant. ( info) |
2080/3657. Crystallographic identification of a calcium deposit in calcified pericarditis associated with articular chondrocalcinosis. In a case of CPPD crystal deposition disease of the pseudorheumatoid type and of long duration, calcified constrictive pericarditis developed and was surgically treated. Analysis of the calcium deposit in the pericardium was carefully made by infrared absorption, x-ray diffraction, and thermogravimetry. It revealed that the deposit was composed of B-type carbonated apatite. Previously, both calcium pyrophosphate dihydrate (CPPD) and apatite crystals, either in the same place or in different tissues, have been reported in the same patient. These observations raise the possibility that the same metabolic error might lead to both types of crystal deposition. ( info) |