Essential thrombocythemia (ET) is one of the myeloproliferative disorders characterized by an elevated platelet count, usually greater than 1,000 X 10(9)/L. It may be associated with either hemorrhagic or thrombotic tendencies. Although it usually affects older people, we have recently encountered two young women with ET who had a total of six spontaneous abortions before the end of the first trimester. During her most recent pregnancy, one of the patients underwent plateletpheresis on four separate occasions before the 12th week. She reached 34 weeks but demonstrated evidence of fetal growth retardation and pre-eclampsia. At delivery there were scattered villus infarcts in the placenta. Based on this patient and previous reports in the literature, we postulate that the spontaneous abortions, fetal growth retardation, and pre-eclampsia may be related to the thrombocytosis and suggest that the use of antiplatelet agents throughout pregnancy should be seriously considered in such cases.
The histopathology of rectosigmoid biopsies from 20 patients with bloody diarrhea resulting from verotoxin-producing Escherichia coli infection is reported. The biopsies displayed a range of appearances, from normal to mild, nonspecific inflammation to acute infectious-type colitis. Surface-adherent or invasive bacteria were not identified. The morphologic features of infectious colitis and the absence of bacteria suggest that verotoxin may be responsible for the pathologic changes.
Aims: To determine the prevalence and pathology of intramammary lymph nodes in breast specimens.Methods: AUl breast specimens examined by a single pathologist over 70 months in a large teaching hospital were studied retrospectively. AUl the surgical pathology reports were reviewed. Relevant glass slides from cases in which intramammary lymph nodes were identified were also reexamined. Results: Breast specimens (n = 682) were examined. Seven lymph nodes were found in five patients. The specimens comprised 533 biopsy specimens, 29 segmental resections, 22 reduction mammoplasties, 77 modified radical mastectomies and 20 gynecomastia mastectomies. No clinically relevant microscopical abnormalities were found in four lymph nodes and slight sinus histiocytosis was seen in two nodes. One node contained metastatic adenocarcinoma and benign glandular epithelial inclusions. Conclusion: Although rare, intramammary lymph nodes may be detected by careful gross examination ofbreast specimens even in the absence of clinical identification. They can occur in any quadrant of the breast and can display a variety of pathological conditions. Pathologists should be alert to the existence and potential importance of these lymph nodes. (7 Clin Pathol 1992;45:1023-1026 The occurrence of lymph nodes in the breast has not been extensively reported, even in anatomy textbooks. There is also a dearth of a single source of information on the pathological importance of these lymph nodes. MethodsThe reports on all specimens of the breast in which the author performed a gross examination were reviewed over 70 months.The hospital in which the cases were collected is a fairly large, university affiliated, teaching hospital with close to 1000 beds. The specimens were received mainly from general surgeons, with a smaller number from plastic surgeons, and the rare case from a general practitioner. Most patients had had surgery because of a clinically detected condition, but a smaller number were from patients in whom an abnormality had been detected by mammography.As a component of the gross pathological examination, specimen mammography was performed on all cases in the following categories: (a) lesions detected by screening; (b) biopsy specimens taken after a preoperative mammographic needle localisation; (c) mammoplasty specimens in women aged over 30 years; (d) biopsy specimens measuring more than 3 0 cm in greatest dimensions, in which there was no grossly visible abnormality.Gross examination was done in a routine manner with inspection of the external aspects and subsequent examination of thick slices (3-4 mm) of the entire specimen. Special clearance techniques by fat dissolution were not done. Whenever possible, the examination was done in conjunction with a review of the mammographic films. Selected sections were taken either for frozen sections, using a cryostat, or paraffin wax embedded sections. These were stained with haematoxylin and eosin and an occasional case was stained with special stains such as elastic van Gieson or pe...
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