Haemoptysis in pregnancy caused by a well-differentiated fetal adenocarcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Haemoptysis in pregnancy is frequently assumed to be caused by a pulmonary embolism. However, it can also be an indicator of serious pathology.</p> <p>Case presentation</p> <p>We report the case of a 27-year-old Caucasian woman who presented with haemoptysis in pregnancy that was discovered to be caused by a well-differentiated fetal adenocarcinoma of the lung.</p> <p>Conclusion</p> <p>This case demonstrates the importance of establishing an accurate diagnosis when a pregnant woman presents with haemoptysis and that more serious pathology should be considered if the clinical symptoms persist and/or the presumed diagnosis of pulmonary embolism is not confirmed.</p

Glycosaminoglycan content is increased in dissecting aneurysms of human thoracic aorta

Ten thoracic aortas were obtained from cases of dissecting aneurysms and 10 from agematched controls. Full wall thickness samples (1 cm diameter) were taken at 12 sites for both Content, concentration and ratio to total glycosaminoglycan (GAG) were determined for chondroitin sulphate (CS), hyaluronate (HA), heparan sulphate (HS) and dermatan sulphate (DS). When compared with controls, content of CS and HS increased over the whole length of dissected aortas, whereas increased HA and DS were localised to dissected areas of affected aortas as were increased tissue mass and collagen and elastin content. Changes in concentration and ratios, significant for some GAGs and consequent upon these increases, may help to compromise the mechanical properties of the aortic wall. The localised increases in HA and DS content in areas where collagen and elastin were increased suggests that these GAGs are functionally related to these fibrous proteins in aorta, whereas CS and HS are not. © 1994

Distribution of myocardial macrophages in the normal human heart

Macrophages are important in inflammatory processes in heart disease and in transplantation rejection. A resurgence of interest in the macrophage has emanated from recent evidence implicating it as an effector cell in atherosclerosis and transplantation rejection. The detailed distribution of the macrophage within the normal human heart is unknown. We quantified macrophage numbers in the different chambers of the heart. Large tissue blocks (1.5–2.0 cm(3)) were removed from specific sites in 5 ‘normal’ control hearts (2 males, 3 females, age range 19–46 y). Paraffin-embedded sections were stained with a CD68 pan macrophage marker. Positive cells were enumerated within 20 random fields. Results were analysed using a generalised linear modelling method using the Poisson distribution. Macrophages were identified within septa, and often close to blood vessels, in the myocardium, and in the majority of areas in all hearts. Macrophage numbers varied significantly between areas (range 0–6 cells/high power field; P<0.001), and between the 5 hearts analysed (P<0.001). In general, there were significantly more macrophages in the ventricles (RV P<0.01, LV P<0.05), but these differences were affected by heart differences. This study provides a baseline for the range of macrophage numbers within normal hearts, thus enabling comparisons with macrophage numbers within diseased and transplanted hearts

The detection of Epstein-Barr virus DNA in lung tissue from patients with idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a clinical syndrome in which the precipitating factors are unclear. An association between Epstein-Barr Virus (EBV) and IPF had previously been suggested using serology and immunohistochemistry. This study sought confirmation of the presence of EBV DNA in the lung tissue of patients with IPF. Lung tissue obtained surgically from 27 patients with IPF and 28 control subjects was investigated for the presence of EBV by immunohistochemistry and polymerase chain reaction (PCR) analysis. Immunohistochemistry used antibodies specific for EBV lytic cycle antigens (gp340/220 and VCA). Nested PCR analysis used oligonucleotide primers specific for EBV and was sensitive to one copy of EBV DNA. Twelve of the 27 patients with IPF (44%) and three of the 28 control subjects (10%) were EBV positive by immunohistochemistry (p � 0.005). Thirteen of the patients with IPF (48%) and four of the control subjects (14%) were EBV positive by PCR (p � 0.007). Eleven of the patients with IPF (41%) and none of the control subjects were EBV positive by both immunohistochemistry and PCR (p � � 0.001). These data further suggest an association between EBV and IPF. In addition it defines a novel method for detecting EBV in lung tissue. EBV may be involved in the pathogenesis of the disease; however, further studies are required to establish a causa

Epstein-Barr virus associated graft failure following heart/lung transplantation

A case is described of late pulmonary graft failure in a heart/lung transplant recipient. The major characteristics were alveolar fibrosis and a restrictive physiological deficit. Epstein-Barr virus was implicated as an aetiological agent using immunohistochemical analysis and by a response to treatment with ganciclovir