Javier Arias-Stella

The placenta and the newborn infant at high altitudes

Abstract A comparative study of the placenta and the newborn infant at Rio Pallanga (altitude 15,100 feet) and Lima (500 feet) is presented. Three parameters were analyzed, the weight of the newborn infant, the weight of the placenta, and the ratio of the weight of the placenta to the weight of the newborn infant (placental coefficient). The mean values of these parameters were analyzed according to Fishers t test. The results showed that: (1) at high altitudes, the newborn infants weighed significantly less than those born at sea level; (2) the placentas at high altitude weighed more than the placentas at sea level; (3) the value for the placental coefficient at high altitudes was significantly higher than at sea level; (4) the number of cotyledons in high-altitude placentas was half that of sea level placentas, indicating a lesser degree of septation and probably a greater proportion of functioning parenchyma; and (5) no differences were found in the volumes of the placentas. The physiologic role of the placenta at high altitudes is discussed.

Verruga peruana mimicking malignant neoplasms.

We have shown that in some cases fully developed florid verruga peruana nodules, as well as late-resolving, deeply situated lesions, can histologically suggest a variety of tumors to experienced pathologists. The compact proliferation of endothelial cells characteristic of florid verruga lesions can give rise to two pseudoneoplastic histologic patterns. One consists of sheets or islands of cells arranged in an epithelioid or pseudoepithelioid pattern (cases 1 and 2) in which the following histologic diagnoses were considered: squamous carcinoma, sweat gland carcinoma, epithelioid hemangioendothelioma, epithelioid sarcoma, melanoma and metastatic carcinoma. The other pattern of the florid lesion is characterized by a predominantly spindle cell arrangement (case 3) and in it the following diagnoses were made: Kaposis sarcoma, fibrosarcoma, melanoma and leiomyosarcoma. The dense lymphoplasmacytic and histiocytic infiltrates of the late-resolving, deeply situated nodules (case 4) suggested the following histologic conditions: malignant lymphoma, nodular Hodgkins disease, reticuloendotheliosis, and reticulosarcomatosis. Some histologic features thought to be of value to help in the differential diagnoses are discussed. It is emphasized that only the finding of Rocha-Limas inclusions on light-microscopic studies and/or the demonstration of bartonella organisms in the lesions by electron-microscopic studies can objectively establish a diagnosis in a given lesion. However, knowledge of the epidemiologic data and particularly the presence of other lesions in the patient make it relatively easy to rule out neoplasia.

Pathology of chronic mountain sickness.

Arias-Stella, J., Krüger, H., and Recavarren, S. (1973).Thorax, 28, 701-708. Pathology of chronic mountain sickness. Pathological data on chronic mountain sickness are scarce due to the fact that the disease is ameliorated or cured by descent to a low altitude. In this report we describe a case of chronic mountain sickness occurring in a woman of 48 years at Cerro de Pasco (4,300 m above sea level). The necropsy findings are compared with the limited pathological observations reported by others. It is apparent from our findings that in fatal cases the main changes are located within the pulmonary circulation. So far histological studies have been reported only in cases of the secondary form of chronic mountain sickness. The basic pathology of the primary form (Monges disease) remains to be defined.