Thymic carcinoma arising from long standing thymoma and presenting with pituitary metastases

Primary thymic squamous cell carcinoma is uncommon and has only rarely been linked to a pre-existing thymoma. We are reporting a case of primary thymic squamous cell carcinoma with pituitary metastases, in a patient with a long standing thymoma.

Up-regulation of angiotensin II receptors by in vitro differentiation of murine N1E-115 neuroblastoma cells

In vitro differentiation of murine neuroblastoma N1E-115 cells induced by low serum (0.5%) and dimethyl sulfoxide (1.5%) increased the uptake of 45Ca2+ as well as basal and forskolin-stimulated adenylate cyclase activity. Associated with these biochemical indices of differentiation was an increase in the density of binding sites for the angiotensin II (Ang II) receptor agonist 125I-[Sar1]-Ang II and the antagonist 125I-[Sar1,Ile8]-Ang II (125I-SARILE). This up-regulation was apparent within 24 hr and was maximal at 72 hr. Other manipulations that independently increased intracellular cAMP or Ca2+ levels produced a qualitatively similar up-regulation of Ang II receptors. In vitro differentiation did not diminish the specificity of these receptors for Ang-II related peptides. Sarcosine-substituted Ang II receptor antagonists such as [Sar1,Gly8]-Ang II, [Sar1,Thr8]-Ang II, or SARILE itself competed for 125I-SARILE in a monophasic fashion, whereas the competition displayed by the agonists Ang II, angiotensin III, and Crinia-Ang II for 125I-SARILE-labeled sites was biphasic, consisting of distinct high and low affinity components. Moreover, in vitro differentiation predominantly increased the density of high affinity sites for angiotensin III and Crinia-Ang II, but the lower affinity site for Ang II, and in all three cases the majority of this increased binding was insensitive to guanine nucleotides. Collectively, these results demonstrate that the expression of Ang II receptors on neuron-like cells is regulated by the biochemical events accompanying differentiation and suggest that the biphasic nature of the binding of some angiotensin agonists may be indicative of multiple receptor subtypes.

Severe chronic EBV infection associated with specific EBV immunodeficiency and an EBNA+ T-cell lymphoma containing linear, EBV DNA

A patient with severe chronic Epstein-Barr virus (EBV) infection (CEBVI) of 6 years duration developed an EBV+ T-cell lymphoma. To determine whether the development of the T-cell tumor was linked to EBV, we studied this patient's EBV-specific immune response and her T-cell tumor tissue for evidence of EBV infection. Peripheral blood lymphocytes from this patient were systematically studied for immune function and response to EBV. Tumor tissue was examined for EBV genome and for evidence of EBV replication. This patient failed to develop anti-EBV nuclear antigen (EBNA) antibodies and had decreased mitogen responsiveness. Her T-cells showed a broad suppression of both autologous and allogeneic B-cells, which was coincident with clinical hypoimmunoglobulinemia. A selective cytotoxic T-cell defect toward autologous EBV-infected B lymphoblasts, which could not be corrected by the addition of lymphokine-mediated T-cell help, was also documented. A lymph node biopsy taken 5 years after her clinical presentation revealed lymph node architecture completely effaced by a diffuse CD3+, CD4+, Ia+, CR2+ T-cell lymphoma containing EBNA and linear, replicating EBV DNA. Select CEBVI patients with humoral and combined cellular aberrations in the immune response to EBV may be predisposed to the development of EBV+ T-cell tumors.

Granular cell lesions of the jaws and oral cavity: a clinicopathologic, immunohistochemical, and ultrastructural study

A clinicopathological, immunohistochemical, and ultrastructural study of 44 oral granular cell lesions was performed. A total of 35 mucosal granular cell tumors, 4 granular cell ameloblastomas, 1 lichen planus with granular cell change, and 3 congenital epulides of the newborn were studied. Pseudoepitheliomatous hyperplasia was found to occur in only a minority of these cases. Immunohistochemically, the majority of granular cell lesions were uniformly positive for S-100 protein and focally positive for vimentin in one half of the cases, suggestive of origin from a Schwann cell or a precursor mesenchymal cell. Congenital epulis of the newborn and central odontogenic granular cell tumor were negative for S-100 protein, epithelial membrane antigen (EMA), and prekeratin, suggesting a mesenchymal origin for these lesions.

Resolution of intestinal cryptosporidiosis after treatment of AIDS with AZT

Intestinal cryptosporidiosis commonly results in severe protracted diarrhea that contributes significantly toward morbidity and mortality in patients with acquired immunodeficiency syndrome. No satisfactory therapy for cryptosporidiosis currently exists. We describe a patient with severe secretory diarrhea and malabsorption who had clinical, microbiologic, and histologic resolution of cryptosporidiosis after therapy with zidovudine.

Merkel cell carcinoma arising in the oral mucosa

This is the first reported case of a Merkel cell carcinoma arising in the oral mucosa. The tumor occurred in a 53-year-old white man, and it originated in the right mucobuccal fold. The Merkel cell origin was confirmed by electron microscopic and immunohistochemical studies.