Edgar Duque

IgA heavy chain disease. A case detected in the western hemisphere.

IgA heavy chain disease (alpha chain disease) was detected in a 46 year old South American (Colombian) of mixed Spanish and Indian (Mestizo) descent. The clinical course was characterized by severe malabsorption, initially thought to be a variant of tropical sprue. Jejunal mucosal biopsy revealed marked villous atrophy with heavy infiltration of the lamina propria by a single monotonous cell type which, by light microscopy, had the appearance of either a large, abnormal plasma cell or a small histiocyte. Electron microscopy of the biopsy specimen demonstrated the presence of abnormal plasma cells, lymphatic distention and abnormalities of surface epithelial cells. At autopsy a 6 by 3 cm mass was found in the right para-aortic area along with many firm 2 cm mesenteric and para-aortic lymph nodes. Histologic examination revealed the presence of a monotonous cell type similar to that found in the jejunal mucosal biopsy specimen.

The Cancer Registry of Cali Colombia — Epidemiologic Studies of Gastric Cancer

Cancer registration in developing countries offers special research opportunities and presents special problems. Findings in these registries not only provide information about the local situation but may also help in the study of trends observed in other countries. Cancer incidence in wealthy western communities tends to show similarities, and often contrasts with patterns common in developing communities. As an example, high rates for colonic and pulmonary cancer and declining rates for gastric and cervical cancer are as characteristic of wealthy communities as they are uncharacteristic of developing communities. These are good reasons for the encouragement of cancer registration in developing countries. We started our work in Colombia as a cancer survey, which was planned to last approximately 3 years. After the planned survey was accomplished, it became clear that its continuation would be highly beneficial and also quite simple because the personnel had already been trained and their experience could be used to great advantage. This explains why our registry uses a combination of the registry and survey techniques: we gather data for all periods of time, but most intensely during the summer months, when we employ medical students for a survey-type activity.