Albert J. Behar

Systemic leishmaniasis mimicking malignant histiocytosis

A 22‐year‐old man with fever, hepato‐splenomegaly and severe pancytopenia is described in whom the histologic features of the spleen, liver and lymph nodes were consistent with malignant histiocytosis. Characteristic Leishman‐Donovan bodies were demonstrated on a bone marrow aspirate, and the diagnosis of visceral leishmaniasis was confirmed by culturing the flagellated forms of the pathogen, and by an excellent response to sodium stibogluconate. In view of the similarity in clinical and histologic appearance, visceral leishmaniasis must be considered in the differential diagnosis of malignant histiocytosis in geographic areas where leishmaniasis is still endemic.

Central pontine myelinolysis

SummaryA case of central pontine myelinolysis, the 19th so far published or communicated, is described in a Jewish woman of Yemenite extraction who had suffered for 12 years prior to her death from a mental condition diagnosed as chronic schizophrenia. Anatomo-pathologically the pontine lesion was similar to those described in previous cases, except that in this case there were “pools” of mucoid material present in it. The lesion developed in the absence of alcoholism and in association with a state of general dehydration and electrolyte imbalance in the patient.ZusammenfassungEin Fall von zentraler pontiner Myelinose — der 19. bisher veröffentlichte oder mitgeteilte — wird beschrieben: eine aus dem Yemen stammende Jüdin litt 12 Jahre vor ihrem Tod an einer Nervenkrankheit, die als chronische Schizophrenie diagnostiziert wurde. Anatomisch-pathologisch war die Brückenläsion ähnlich der in den früheren Fällen beschriebenen, mit der Ausnahme, daß Anhäufungen von mucoidem Material vorgefunden wurden. Die Läsion entwickelte sich bei dieser Patientin — ohne Alkoholmißbrauch — in Zusammenhang mit einem Zustand von generellem Flüssigkeitsverlust und Elektrolytgleichgewichtsstörung.

Teratoid Intraocular Medulloepithelioma

The right eye of a 1-year-old black infant with a painful blind eye was studied histologically. It contained a tumor at an advanced stage of growth. The tumor consisted of moderately large, round, and elongated undifferentiated cells and anaplastic cells with mitotic figures combined with multilayered, poorly differentiated epithelial cells that resembled the medullary epithelium of embryonic retina. Strap cells with cross striation typical of striated muscle were also present, together with islands of hyaline cartilage and areas of calcification.

Effect of intrathecal hydrocortisone on advanced adhesive arachnoiditis and cerebrospinal fluid pleocytosis. An experimental study.

FIBROUS ADHESIONS of any etiology in the subarachnoid space are always of serious clinical significance. The study of their pathogenesis and possible treatment in experimental animals is therefore of both practical and theoretic interest. In a previous paper, we demonstrated that the intracisternal injection of talcum in cats caused the progressive development of fibrous pia-arachnoid adhesions. This process, as judged by the progressively increasing intricacy of the reticulin network and the thickening of the reticulin fibrils supporting the adhesions, was seen to begin at the end of the first week and to be well advanced by the end of the third week. The adhesive process was still in progress during the seventh week.’ When cortisone or hydrocortisone were administered intracisternally after the end of the first week, the formation of the pia-arachnoid adhesions was either delayed or prevented.* The primary purpose of the present investigation was to determine whether the intracisternal administration of hydrocortisone arrests the progressive growth of the reticulin network of pia-arachnoid fibrous adhesions after formation has begun. We also examined the variations in the number of inflammatory cells in the cerebrospinal fluid during the course of repeated intracisternal injections of hydrocortisone in the experimental animals. This study was undertaken because the meningeal reaction to intrathecally administered hydrocortisone, as indicated by pleocytosis of the cerebrospinal fluid, is of practical importance because the hormone is administered by this route to patients with inflammatory and degenerative diseases of the central nervous system.”*

Acute Changes in the Central Nervous System of Monkeys Exposed to Protons

Study of the changes occurring in simian brain exposed to protons of varied energy, given in wide dose and dose-rate ranges. Results show that inflammatory reaction and glycogen accumulation in astrocytes occurred practically in all animals. Cerebral cortical necrosis, granule cell pyknosis, and inflammatory reaction occurred at doses far lower than effective for high-energy gamma radiation given other series of monkeys at comparable dose rates. Metallic impregnation, carried out in virtually all the animals tested, revealed a wide variation in glial response even at equal doses and dose rates in the same proton energy series. Proton energy effect, dose effect, dose-time effect, and dose-rate effect were evident in the various morphological categories investigated, but inconsistencies were encountered.