Cat-scratch disease in a patient with AIDS.

A case of cat-scratch disease (CSD) in a patient with acquired immunodeficiency syndrome (AIDS) is reported. The lymph node pathologic characteristics were altered from those usually seen with CSD, showing clusters of vacuolated macrophages admixed with pycnotic nuclear debris instead of the usual suppurative granulomas. Evidence for the diagnosis was provided by Warthin-Starry stain and electron microscopic demonstration of the presumed CSD bacillus. Empiric treatment with antibiotics brought about clinical improvement. This case demonstrates the altered lymph node pathologic characteristics with CSD that may occur in a patient with AIDS.

Jaffe-Campanacci syndrome.

The case of a 15-year-old white boy with a clinical diagnosis of von Recklinghausen neurofibromatosis and a history of multiple fractures of long bones is presented. Radiographic studies and tissue biopsy revealed the presence of multiple nonossifying fibromas of bone. Review of the clinical features and correlation with the pathologic data support a diagnosis of Jaffe-Campanacci syndrome, a malformation syndrome different from but possibly related to von Recklinghausen neurofibromatosis.

Small-cell pediatric tumors: histology, immunohistochemistry, and electron microscopy.

Histology, immunohistochemistry, and electron microscopy give an account on what is known of the correlation between histologic appearance and prognosis in this important group of tumors. Ultrastructural and immunohistochemical findings are presented that frequently are useful in establishing a diagnosis, but also serve to elucidate the histogenesis of some tumors, especially those that lack characteristic features.

Accurate prediction of experimental cancer chemosensitivity using the subrenal capsule xenograft assay.

The chemosensitivity of a murine lung carcinoma grown as a xenograft under the kidney capsule of a rat was compared to the chemosensitivity of this tumor grown as a spontaneous metastasis in its syngeneic host. The chemosensitivity of the tumor to intravenously or subcutaneously administered drugs determined in the short-term xenograft assay accurately predicted the chemosensitivity of this tumor when it was growing as a spontaneous micrometastasis in its syngeneic host, indicating that in both situations the pharmacological determinants of tumor response to anticancer drugs were similar. These results suggest that tumors growing as xenografts under the kidney capsule accurately reflect the responsiveness of these tumors to chemotherapy and support further investigation of the xenograft subrenal capsule assay as a model that may be useful in predicting effective chemotherapy for human tumors.

Lung abscess due to Corynebacterium equi. Report of the first case in a patient with acquired immune deficiency syndrome.

A lung abscess and persistent bacteremia due to Corynebacterium equi are described in a bisexual man with the acquired immune deficiency syndrome (AIDS). Eleven of the 12 previously reported cases have occurred in immunocompromised humans. The occurrence of this infection in a patient with AIDS has not been previously described. Development of resistance to beta-lactam antibiotics was noted following initial therapy. Because this organism resembles nonpathogenic organisms, it may easily be overlooked despite its ability to cause serious infection and persist even with aggressive antimicrobial and surgical therapy.

Malignant osteoclast-like giant cell tumor associated with a uterine leiomyosarcoma.

An unusual case of osteoclast-like giant cell tumor associated with a leiomyosarcoma of the uterus is described. The mononuclear cell component of the giant cell tumor was cytologically malignant and the giant cell tumor was present in a biopsy of vaginal recurrence. The patient expired 17 months after diagnosis with extensive tumor despite surgical and radiation treatment. This is the first report of malignant osteoclast-like giant cell tumor associated with a uterine leiomyosarcoma and only the third report of osteoclast-like giant cell tumor in the uterus.

Evaluation of cyclosporine-treated mice as hosts for growing and testing the chemosensitivity of first-transplant-generation human tumor xenografts implanted under the kidney capsule.

Freshly resected human tumors were grown as xenografts under the kidney capsules of conventional mice immunosuppressed by daily treatment with cyclosporine A (CsA; 60 mg/kg/day, sc). Tumor persistence and growth in CsA-treated mice were comparable to those found in nude mice. Lower doses or less aggressive schedules of CsA resulted in xenograft rejection. CsA (60 mg/kg/day, sc) treatment of mice was toxic but not lethal. It resulted in a 20% decrease in water consumption, a 10% loss in body weight, and significant reductions in thymus, kidney, and liver weights. Therapeutic doses of cancer chemotherapeutic agents were tolerated by CsA-treated mice, but 10% lethal doses were lethal in 100% of the mice. These results indicate that CsA-treated mice would be an economic alternative to nude mice for growing human tumor xenografts and for testing their chemosensitivity, with the caveat that the dose-limiting toxicity of cancer chemotherapeutic agents will be reached at lower doses in CsA-treated mice.

Evaluation of growth and histology of human tumor xenografts implanted under the renal capsule of immunocompetent and immunodeficient mice.

Fresh surgical explants of human carcinomas were implanted as first transplant generation xenografts under the kidney capsule of mice. Immunocompetent and immune-deficient mice were compared for their ability to support the persistence and growth of these xenografts. Consistent growth of tumor xenografts could not be demonstrated following implantation under the kidney capsule of immunocompetent mice. Immunological infiltration and rejection of the xenografts began 3 days postimplantation, and tumors were largely eliminated from the subcapsular space by 6 days postimplantation. In contrast human tumors consistently grew under the kidney capsule of nude mice. Significant growth became apparent by 9 days postimplantation with most human carcinomas and continued thereafter. Growth was always accompanied by neovascularization of tumor xenografts which was visible by examination of tumor-bearing kidneys under a dissecting microscope (X 6). There was no histological evidence of immunological interference with the persistence and growth of xenografts in nude mice. Thymectomized, irradiated, bone marrow-reconstituted conventional mice, as well as conventional mice, treated daily with 60 mg of cyclosporine A/kg were comparable to nude mice as hosts which supported the long-term persistence and growth of subrenal capsule implants of human tumors. Such mice could provide an alternative to nude mice as hosts in which chemosensitivity assays could be carried out against growing human tumors at a considerable saving in cost and convenience.

Systemic amyloidosis associated with a benign mesenteric lymphoid mass.

This report describes the case of a patient with a mesenteric lymphoid mass with clinical and histologic features suggestive of giant lymph node hyperplasia (GLH) who died as a result of complications related to systemic amyloidosis. To our knowledge, this is only the second case of amyloidosis associated with a benign mesenteric lymphoid mass reported in the literature. The possible relationship of amyloid with GLH will be discussed.

Splenic alterations in hairy-cell leukemia: II. an electron microscopic study.

Spleen from nine patients with hairy-cell leukemia (HCL) were studied for ultrastructural alterations. In all cases, hairy cells with typical ultrastructural characteristics were observed within splenic cords and sinuses. Hairy cells had numerous cytoplasmic processes that interdigitated with cytoplasmic processes of other hairy cells. Hairy cells also adhered to sinus endothelial cells and ring fibers and protruded into spaces between endothelial cells. Some normal sinuses were filled with aggregated hairy cells. Other sinuses appeared dilated. Many sinuses were lined by hairy cells that covered thinned endothelial cells and ring fibers. In these abnormal sinuses, endothelial cells were decreased and many appeared injured. The splenic cords were expanded by an infiltration of hairy cells and by large blood-filled spaces. These findings suggest that hairy cells adhere to many cell surfaces, produce endothelial cell injury and death, and impede the venous flow of blood in the spleen. All of the factors appear to influence the formation of the abnormal splenic sinuses and the blood-filled spaces that characterize HCL.

Splenic alterations in hairy cell leukemia.

Spleens from 12 patients with hairy cell leukemia were studied for morphologic alterations. Paraffin-embedded, plastic-embedded, and fresh-frozen tissue sections were stained for a variety of histochemical reactions. Hairy cells were present in great numbers within the splenic sinuses and cords. Hairy cells adhered to splenic endothelial lining cells, other hairy cells, and erythrocytes. Large clumps of hairy cells filled and partially occluded splenic sinuses. Numerous dilated sinuses, abnormal sinuses, and blood-filled spaces were present in all cases. Ring fibers around abnormal sinuses were fragmented and reduced in amount. Occasionally, the number of reticular fibers appeared increased around abnormal sinuses, but, in general, it was decreased in areas around the blood-filled spaces and in splenic cords markedly infiltrated by hairy cells. The formation of abnormal sinuses and blood-filled spaces probably resulted from the obstruction of venous blood flow and from injury or death of endothelial lining cells.

Day-to-day variation in serum ferritin concentration in healthy subjects.

We report our observations on day-to-day variation in serum ferritin, serum iron, total iron-binding capacity, and percent saturation of binding proteins with iron in 13 ostensibly healthy subjects during five weeks. The average intrasubject coefficients of variation were 14.5, 28.5, 4.8, and 28.0%, respectively. Precision studies on control samples showed greater within-assay and between-assay analytical variation for serum ferritin than for serum iron or total iron-binding capacity. Evidently, serum ferritin varies less in a given individual from day to day than do serum iron and percent iron saturation. Thus, a single measurement of serum ferritin may be a more reliable index of iron stores than an isolated determination of either serum iron or percent iron saturation.