Aims: To examine the light and electron microscopic features of appendices removed at the time of surgical reduction of intussusception in children; and to confirm that the viral inclusions seen in some of them are due to adenovirus. Methods: A series of 39 appendices from cases of intussusception and 15 control appendices were reviewed. Light microscopic examination of haematoxylin and eosin stained sections was performed on all of them and one appendix with large numbers of inclusions was examined by electron microscopy. Non-isotopic in situ hybridisation using a biotinylated DNA probe was carried out on sections of appendix from 30 of the cases of intussusception and from the 15 controls. Results: Light microscopic examination showed viral inclusions in 19 of the appendices from the cases of intussusception and in none of the controls. Electron microscopic examination showed virus particles with the typical features of adenovirus. Most of the appendices with viral inclusions in the haematoxylin and eosin stained sections also contained adenovirus DNA as shown by in situ hybridisation. Conclusions: Viral inclusions seen in appendices from cases of intussusception are caused by adenovirus. Adenovirus DNA was not demonstrable in appendices from cases of intussusception without viral inclusions and the aetiological factors involved in intussusception in these children remain unknown. (7 Clin Pathol 1993;46:154-158) Intussusception of the bowel may occur at any age but is particularly common in babies and young children under the age of 2 years. Any part of the intestine may be affected but ileocolic intussusceptions are the most common. In adults usually a lesion such as a polyp or tumour acts as a lead point, but in children only rarely is such an abnormality found.' It has therefore been suggested that hyperplasia of the lymphoid tissue around the terminal ileum is the cause of the intussusception. The association between intussusception and adenovirus infection was first suggested by Strang,2 and following this three different studies showed that adenovirus could be recovered from 50% or more of children with intussusception, significantly more than in controls.-5 More recently a study by Nicolas et al compared the incidence of adenovirus and rotavirus in 64 children with surgically confirmed intussusception.6 Adenovirus was found in 25 of the 64 cases (39%). Serotypes 1 and 2 were most common (10 cases each), followed by type 5 (three cases) and types 3 and 4 (one case each).Yunis et al performed a histological and ultrastructural study of 682 appendices of which 30 were from cases of ileocolic intussusception.7 These 30 cases were examined electron miroscopically. They described two types of intranuclear changes seen on light microscopy as presumptive evidence of adenovirus infection, namely eosinophilic nuclear inclusion bodies and "smudge cells", in which the nucleus is slightly enlarged, homogeneous, and basophilic. Electron microscopic examination showed clusters of replicating viral particles...
Localized giant pseudopolyposis of the colon is a rare complication of both ulcerative colitis and Crohn's disease. It is not regarded as being premalignant, but it may masquerade clinically as a malignancy. This report presents a case and reviews others reported in the literature.
Spinal epidural haemorrhage is a rare entity that occurs uncommonly in adults and rarely in children. It has a typical clinical presentation, although to date, the cause for the majority of cases remains unknown. We present a series of cases where epidural haemorrhage was identified at post-mortem, principly to the cervical cord, in cases outside the age range usually reported for clinical epidural haemorrhage, and with no underlying pathology to account for the finding. We present a hypothesis for a post-mortem cause for this finding and consider that, in the absence of any other identifiable causation, then this is a post-mortem occurrence similar to that of the Prinsloo-Gordon artefact of the soft tissues of the neck. This finding must be interpreted with care so as not to make the mistaken diagnosis of a nonaccidental head injury based on its finding, especially in the absence of intracranial, cranial nerve, optic nerve or eye pathologies.
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