Pathology and immunohistochemistry of papillomavirus-associated cutaneous lesions in Cape mountain zebra, giraffe, sable antelope and African buffalo in South Africa.

Skin lesions associated with papillomaviruses have been reported in many animal species and man. Bovine papillomavirus (BVP) affects mainly the epidermis, but also the dermis in several species including bovine, the best-known example being equine sarcoid, which is associated with BVP types 1 and 2. This publication describes and illustrates the macroscopic and histological appearance of BPV-associated papillomatous, fibropapillomatous or sarcoid-like lesions in Cape mountain zebra (Equus zebra zebra) from the Gariep Dam Nature Reserve, 2 giraffes (Giraffa camelopardalis) from the Kruger National Park, and a sable antelope (Hippotragus niger) from the Kimberley area of South Africa. An African buffalo (Syncerus caffer) cow from Kruger National Park also had papillomatous lesions but molecular characterisation of lesional virus was not done. Immunohistochemical staining using polyclonal rabbit antiserum to chemically disrupted BPV-1, which cross-reacts with the L1 capsid of most known papillomaviruses, was positive in cells of the stratum granulosum of lesions in Giraffe 1, the sable and the buffalo and negative in those of the zebra and Giraffe 2. Fibropapillomatous and sarcoid-like lesions from an adult bovine were used as positive control for the immunohistochemistry and are described and the immunohistochemistry illustrated for comparison. Macroscopically, both adult female giraffe had severely thickened multifocal to coalescing nodular and occasionally ulcerated lesions of the head, neck and trunk with local poorly-circumscribed invasion into the subcutis. Necropsy performed on the 2nd giraffe revealed neither internal metastases nor serious underlying disease. Giraffe 1 had scattered, and Giraffe 2 numerous, large, anaplastic, at times indistinctly multinucleated dermal fibroblasts with bizarre nuclei within the sarcoid-like lesions, which were BPV-1 positive in Giraffe 1 and BPV-1 and -2 positive in Giraffe 2 by RT-PCR. The sable antelope presented with a solitary large lesion just proximal to the right hind hoof, which recurred after excision, and was BPV-1 positive by RT-PCR. Other wart-like growths were present elsewhere on the body. The Cape mountain zebra either succumbed from their massive lesions or were euthanased or removed from the herd because of them. The lesions were BPV-1 and/or -2 positive by RT-PCR. The buffalo lesions were wart-like papillomatous projections in the inguinal and udder region. Stratum granulosum cells that stained immunohistochemically positive in the various species appeared koilocyte-like, as described in human papillomaviral lesions.

Prevalence and body distribution of sarcoids in South African Cape mountain zebra (Equus zebra zebra).

There are no reports in the literature describing any tumours, and specifically sarcoids, in zebras. The equine sarcoid, a locally aggressive, fibroblastic skin tumour, is the most common dermatological neoplasm reported in horses. The Cape mountain zebra (CMZ) has been described as one of the most vulnerable mammals in South Africa with current populations existing in isolated units. All South African CMZ are descendants from no more than 30 individual animals originating from 3 populations, namely the Mountain Zebra National Park, and Kammanassie and Gamka Mountain Nature Reserves near Cradock. The possibility therefore exists that the existing populations arose from a very small gene pool and that they are considerably inbred. A reduction in major histocompatibility complex diversity due to genetic bottlenecks and subsequent inbreeding probably contributed to uniform population sensitivity and the subsequent development of sarcoid in two CMZ populations, namely in the Bontebok National Park and Gariep Nature Reserve. The entire population of CMZ in the Bontebok National Park was observed and sampled during 2002 to document the prevalence and body distribution of sarcoids. During the same year, a comparative study was carried out on an outbred population of Burchell's zebra in the Kruger National Park. The prevalence in CMZ in the Bontebok National Park was 53 %, while the Burchell's zebra in Kruger National Park had a prevalence of 1.9 %. The most common sites for sarcoid in CMZ were the ventral abdomen and limbs. Prevalence of sarcoids in horses recorded in the literature varies between 0.5 % and 2 %. The Gariep Nature Reserve recently reported a prevalence of almost 25 % in CMZ in the reserve.

Descriptive study of an outbreak of equine sarcoid in a population of Cape mountain zebra (Equus zebra zebra) in the Gariep Nature Reserve.

An outbreak of equine sarcoid occurred in a population of Cape mountain zebra (Equus zebra zebra) at the Gariep Nature Reserve located in the southern Free State Province of South Africa in 1996. The course of the outbreak during 1996 to 2003 is described. During this period the average population size was 69 animals. Initially (1996) all affected animals were removed from the population. New cases continued to manifest and the incidence varied between 4.6% and 17.6%. Prevalence reached 24.7% in 2002. No sexual predilection was noticed in the 39 recorded cases. Of the affected individuals, 64% had a single lesion and no animal had more than 4 lesions. In males, the majority of lesions occurred in the inguinal area (55.17%), whereas in females they mostly occurred on the head and neck (41.38%). Lesions can increase 260% in size annually and may impede movement.

Surgical treatment of metastatic melanoma of the small bowel.

Eighteen of 1420 patients with primary cutaneous melanoma presented with symptomatic small bowel metastases and were reviewed to establish the role and efficacy of surgical intervention. The median interval between treatment of the initial skin lesion and detection of the intestinal metastases was 4.4 years (range, 2 months to 15 years). Most patients presented with either anemia, abdominal pain, bowel obstruction, or intussusception. In six patients, small bowel involvement was the first sign of metastatic disease. Seventeen of the 18 patients underwent laparotomy, and all overt metastases were completely excised in 12. Three patients died postoperatively. Fourteen of the 17 patients had satisfactory palliation with complete symptomatic relief. Median survival after resection was 13 months (range, 2 days to 300 months). Median survival of the 12 patients in whom all macroscopic disease was resected was 44.5 months (range, 2-300 months), whereas the median survival in the four with incompletely resected tumors was 4 weeks (range, 2 days-24 weeks). Five of 12 patients who underwent complete resection of small bowel metastases survived more than 6 years, 3 of whom remain well and free of disease at 6, 14, and 25 years. These results justify active surgical intervention in patients with symptomatic small bowel metastatic melanoma, both for relief of symptoms and prolongation of life.

[The dangers of mammography in diagnosing a palpable lump in the breast]. / Die gevare van mammografie in die diagnose van 'n tasbare knop in die bors.

The success of mammography screening programmes in the detection of unsuspected and impalpable breast cancer has led to reliance on a negative mammographic report as assurance that no malignancy is present even in palpable breast lumps. Pre-operative mammography was performed on 38 patients with palpable lumps who were subsequently proven by histology to have carcinoma of the breast. In 4 patients (10.8%) the mammogram was negative; 3 were also assessed as benign clinically. In 5 cases (13.5%) the report was negative but biopsy was recommended; 3 of the 5 were assessed as benign clinically. Therefore, in 9 of the 38 patients (24%) malignancy was not diagnosed unequivocally on mammography, although 3 of these patients had clinical stigmata of malignancy. Twenty-nine patients (76%) were diagnosed correctly by mammography; 5 of these cases were assessed as benign clinically. Six of the 38 cases (16%) were thought to be benign on both mammography and clinical examination. Thus, even confirmation by mammography that a breast lump without clinical signs of malignancy is indeed benign, does not rule out the possibility of carcinoma.

Successive urinary papillomavirus excretion, condylomata acuminata and urogenital epithelial malignant disease after renal transplantation.

Of 3 renal allograft recipients who were found to excrete papillomavirus in the urine, 1 has since developed a condyloma, 1 a condyloma and a keratinizing squamous carcinoma and 1 a transitional cell carcinoma. Peroxidase-antiperoxidase staining has confirmed the presence of papillomavirus antigen in the condylomas. The significance of these findings is discussed.

Determination of plasma adrenaline and noradrenaline levels with the Cat-a-Kit.

A method for the determination of catecholamines (Cat-a-Kit; Upjohn Diagnostics) is discussed. It depends upon the enzymatic conversion of the catecholamines to their ring o-methylated analogues in the presence of s-adenosyl-L-methionine-methyl-14C and catechol-o-methyltransferase. Values obtained from the blood plasma of 16 tetraplegic and 11 healthy volunteers are reported. The advantages and disadvantages of the Cat-a-Kit are discussed.