RESUMO
A case of asynchronous bilateral breast necrosis in a 40-year-old woman with untreated chronic hypercholesteraemia is described. Mastectomies were performed, and histological examination revealed bilateral breast calciphylaxis characterized by extensive vascular calcification with coagulative necrosis. Breast calciphylaxis is a rare disease clinically characterized by progressive tissular necrosis with secondary cutaneous ulceration and by vascular calcification and thrombosis. However, the nature of the vascular calcification has remained poorly understood up to now, owing to the absence of any precise mineralogical examination. In this case the mineral deposits were analysed for the first time: only hydroxyapatite was found. The etiology is discussed, and the high cholesterol rate of the patient is implicated.
Assuntos
Doenças Mamárias/diagnóstico , Calciofilaxia/diagnóstico , Hipercolesterolemia , Adulto , Doenças Mamárias/patologia , Doenças Mamárias/cirurgia , Calciofilaxia/patologia , Calciofilaxia/cirurgia , Diagnóstico Diferencial , Durapatita/química , Feminino , Humanos , Mastectomia , Necrose , Neovascularização Patológica/diagnóstico , Neovascularização Patológica/patologia , Neovascularização Patológica/cirurgiaRESUMO
This study was undertaken to investigate the mineral phase of spherulitic calcifications discovered in the pulpous mesenchyme of human primary molars by microradiography. Analytical scanning electron microscopy and x-ray diffraction disclosed that well-crystallized brushite is the major compound of the spherulites. The mechanism leading to the crystallization of brushite is far from well understood. Histologically, on decalcified sections, inflammatory cells and capillaries can be seen trapped in the spherulites. In the light of these findings, it could be suggested that metabolic conditions may promote the crystallization of brushite in the pulp of primary molars.
Assuntos
Fosfatos de Cálcio , Calcificações da Polpa Dentária/patologia , Polpa Dentária/ultraestrutura , Dente Molar/ultraestrutura , Dente Decíduo/ultraestrutura , Adolescente , Fosfatos de Cálcio/análise , Criança , Cristalografia , Microanálise por Sonda Eletrônica , Feminino , Humanos , Masculino , Microrradiografia , Difração de Raios XRESUMO
Diagnosis of pneumoconiosis was made in 2 dental technicians presenting with interstitial lung disease. The occupational origin of inhaled dust was confirmed by mineralogic analyses, which disclosed mainly large amounts of chromium-cobalt-molybdenum particles originating from Vitallium prostheses, but also showed abrasives (silica and silicon carbide) and asbestos in 1 patient. The presence of Vitallium and its chemical stability in bronchoalveolar lavage and lung several years after cessation of exposure confirm the resistance of this alloy to corrosion by body fluids. This contrasts with the high solubility of cobalt described in cobalt or hard metal disease. We suggest that dental technician's pneumoconiosis is a complex pneumoconiosis distinct from silicosis, asbestosis, or hard metal disease and that Cr-Co-Mo alloys play a role in its pathogenesis.
Assuntos
Técnicos em Prótese Dentária , Doenças Profissionais , Pneumoconiose/metabolismo , Adulto , Biópsia , Brônquios/metabolismo , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/metabolismo , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Minerais/metabolismo , Pneumoconiose/diagnóstico por imagem , Pneumoconiose/patologia , Alvéolos Pulmonares/metabolismo , Radiografia Torácica , Irrigação TerapêuticaRESUMO
The problems encountered in diagnosing the rare types of pneumoconiosis ( silicatosis other than asbestosis, aluminosis and hard metals fibrosis), result from the difficulties in realising a good occupational anamnese and from the disease pattern by itself. The classical examinations, (X-rays of the thorax and lung function measurements), are not able to detect the cause of these diseases, which are fundamentally characterised by an absence of specificity. These last years, new methods of diagnoses (angiotensin converting enzyme, gallium scan, transbronchial biopsies, mineralogical, cytological and histological examinations of the lung tissues and of the bronchial alveolar lavage) were developed and progressively introduced in the daily practice in pneumology. Only the examination of lung biopsies and of the products of bronchial alveolar lavage, in particular the mineralogical examinations, may usefully orientate the diagnosis. The bronchial alveolar lavage has the advantage of an easy repetition and of a small invasive character. Moreover this technique is of a rather low financial cost. However the results of these examinations must be interpreted with the greatest caution, in function of the complete medical and occupational data. The experience following more than 500 BAL shows that the discovery of talc and kaolin is very significant for an exposition since these minerals were never observed among not exposed subjects. The evidence of these minerals argues also for the diagnosis of talcosis or kaolinosis if there are radiological lesions that are compatible with these diseases. On the other hand a recent study suggests that the identification of multinuclear macrophages and of tungsten and/of tantalum in the bronchial alveolar lavage is pathognomonic of the pathology of the hard metals.
Assuntos
Pneumoconiose/diagnóstico , Adulto , Idoso , Biópsia , Brônquios/patologia , Diagnóstico Diferencial , Feminino , Humanos , Caulim/análise , Masculino , Metais/análise , Pessoa de Meia-Idade , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/diagnóstico , Silicose/diagnóstico , Talco/análise , Irrigação TerapêuticaRESUMO
Asbestos bodies (AB) were counted in bronchoalveolar lavage (BAL) fluid from 62 patients with suspected asbestos related diseases, 2 patients with known exposure to asbestos but without related disease, and 40 control subjects. BAL fluid contained AB in all patients with obvious exposure (28 of 28), including the 2 without related disease, in most patients with suspected exposure (26 of 28), as well as in 5 of 8 patients without known exposure but with suspicion of asbestos related disease (mesothelioma or pleural plaques). Among the 40 control subjects, the results in 5 were positive but to a low degree (less than 1 AB/ml of fluid). Quantitative analysis correlated with the type of disease: AB counts were higher in patients with interstitial lung disease than in those with benign (p less than 0.02) or malignant (p less than 0.01) pleural disease. Only 9 of 13 patients with mesothelioma had a positive lavage. In conclusion, the finding of AB in BAL fluid correlates with the occupational risk and can disclose unknown exposure better than a questionnaire, but a positive lavage is not a proof of disease. Quantitative differences in AB counts suggest a different pathogenesis for pleural and parenchymal disease.
Assuntos
Amianto/isolamento & purificação , Asbestose/diagnóstico , Adulto , Idoso , Brônquios/análise , Brônquios/patologia , Broncoscopia , Tecnologia de Fibra Óptica/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Alvéolos Pulmonares/análise , Alvéolos Pulmonares/patologia , Risco , Irrigação TerapêuticaAssuntos
Amianto/efeitos adversos , Oxalato de Cálcio/fisiologia , Pneumopatias/etiologia , Adulto , Cristalização , Microanálise por Sonda Eletrônica , Exposição Ambiental , Humanos , Pneumopatias/patologia , Masculino , Microscopia Eletrônica de Varredura , Derrame Pleural/análise , Irrigação TerapêuticaRESUMO
A post-mortem histological examination of the eyes of a case of primary hyperoxaluria revealed the presence of crystals in the ciliary processes and at the level of the retinal pigment epithelium. The crystallography study demonstrated that it consisted of wewhellite. The ocular lesions are compared with those found by other authors in primary hyperoxaluria, after prolonged methoxyflurane anaesthesia, after experimental administration of dibutyloxalic acid or naphthalene, and in the human retina in longstanding detachments. Most of the factors which give rise to the presence in the eye of oxalate and its selective precipitation in the midst of certain ocular tissues remain hypothetical. The retinal lesions observed in primary hyperoxaluria appear to be pathognomonic for hyperoxalaemia.
Assuntos
Manifestações Oculares , Olho/ultraestrutura , Erros Inatos do Metabolismo/complicações , Oxalatos/urina , Adulto , Animais , Corpo Ciliar/ultraestrutura , Microanálise por Sonda Eletrônica , Humanos , Corpos de Inclusão/ultraestrutura , Masculino , Erros Inatos do Metabolismo/patologia , Metoxiflurano/efeitos adversos , Microscopia Eletrônica de Varredura , Microscopia de Polarização , Naftalenos/farmacologia , Oxalatos/metabolismo , Epitélio Pigmentado Ocular/ultraestrutura , Coelhos , Descolamento Retiniano/etiologia , Difração de Raios XAssuntos
Placas Ósseas , Úmero , Idoso , Fenômenos Químicos , Físico-Química , Ensaios Clínicos como Assunto , Corrosão , Fixação de Fratura/instrumentação , Humanos , Fraturas do Úmero/cirurgia , Úmero/diagnóstico por imagem , Úmero/cirurgia , Masculino , Metais , Microscopia Eletrônica de Varredura , Radiografia , Propriedades de Superfície , Fatores de Tempo , Difração de Raios XRESUMO
Magnetite crystals larger than 2 micrometers are absent from rocks and fines. Smaller opaque spheres in the fines can tentatively be identified as magnetite. Their concentration is not higher than 1 x 10(-6) particle per particle smaller than 1 millimeter. In the fines from the sampling site, the contribution of material similar to type 1 carbonaceous meteorites is insignificant, either because it never existed, or because it was evaporated or comminuted by impact or was diluted by indigenous material. Other magnetite habits typical of carbonaceous meteorites or possibly of cosmic dust or comets were also sought without success-such as rods, platelets, framboids, spherulites, and idiomorphic crystals.