Postarthroplasty histiocytic lymphadenopathy in gynecologic oncology patients. A benign reactive process that clinically may be mistaken for cancer

BACKGROUND: A distinctive histiocytosis occurs in the regional draining lymph nodes after large joint replacements, resulting in lymphadenopathy that may mimic cancer both grossly and microscopically. Postarthroplasty histiocytic lymphadenopathy has most often been observed in males during surgery for prostate cancer. METHODS: The authors present three examples of postarthroplasty histiocytic lymphadenopathy that occurred in gynecologic oncology patients. We studied the clinical, histologic, and immunohistochemical features of all three cases and the ultrastructure of one of them. RESULTS: Most involved lymph nodes were enlarged, but histiocytosis was also seen in normal sized lymph nodes. Microscopically, histiocytes with abundant granular cytoplasm were present in the lymph node parenchyma, and, to a lesser extent, in the sinuses. Normal lymph node architecture was variably effaced and the histiocytic infiltrate extended focally into the perinodal tissue. Small, black metal particles were present in the histiocytes in every case. Birefringent polyethylene particles were a prominent finding in all three cases as confirmed by positive modified oil red O staining, and, in one case, by electron microscopy. The histiocytes were strongly immunoreactive for CD68, but immunostains for S100 protein, MAC 387, and cytokeratin were negative. CONCLUSIONS: Enlargement of the lymph nodes in cancer patients who have had large joint replacements may be due to a benign histiocytosis rather than to metastatic cancer. The histologic features of the lymphadenopathy are distinctive and recognizable in routine histologic preparations. Polyethylene wear particles shed from joint prostheses are the most common substances in the histiocytes and are the most likely cause of the histiocytosis.     

Effects of sulthiame upon intellectual, neuropsychological, and social functioning abilities among adult epileptics: comparison with diphenylhydantoin

This report presented results of psychological studies done during a double-blind study which compared sulthiame with diphenylhydantoin as primary agents in the treatment of uncontrolled epileptics. Assessments of intellectual, neuropsychological, and social functioning abilities were made with 22 adult epileptic patients. The results showed significantly less impairment with treatment by diphenylhydantoin than by sulthiame, and substantial differences were revealed on intellectual tasks, on tasks calling for sustained concentration and attention, and on psychomotor problem-solving tasks. The results could not be explained on the basis of increased tonic-clonic seizures while on sulthiame. However, an increase in other types of seizures was noted, as was an increase in EEG epileptiform discharges. Possible mechanisms for the decrement in performance were discussed, and the value of an objective assessment of the psychological effects of anticonvulsant agents was noted.     

Cost-effectiveness of detecting breast cancer in lower socioeconomic status African American and Hispanic women through mobile mammography services

A new method based on jackknifing is presented for measuring the difference between two conditions in the onset latencies of the lateralized readiness potential (LRP). The method can be used with both stimulus- and response-locked LRPs, and simulations indicate that it provides accurate estimates of onset latency differences in many common experimental conditions.     

Oral and booklet presentation of MMPI-2

The MMPI-2 was administered twice to college students under two formats: standard booklet administration and oral presentation, with the examiner reading the items to the students and recording their answers. The two types of administration were compared in a series of mixed-factor analyses of variance. No significant differences were found when comparing oral and booklet presentation for either men or women.     

A single protein catalyzes both N-deacetylation and N-sulfation during the biosynthesis of heparan sulfate

Heparan sulfate is a highly sulfated carbohydrate polymer that binds to and modulates the activities of numerous proteins. The formation of these protein-binding domains in heparan sulfate is dependent on a series of biosynthetic reactions that modify the polysaccharide backbone; the initiating and rate-limiting steps of this process are the N-deacetylation and N-sulfation of N-acetylglucosamine residues in the polymer. We now report that in the rat liver, biosynthesis of heparan sulfate utilizes a single protein that possesses both N-deacetylase and N-sulfotransferase activities. This was accomplished by demonstrating that both activities resided in a purified soluble fusion protein containing the Golgi-lumenal portion of the enzyme. We propose that this protein be renamed the rat liver Golgi heparan sulfate N-deacetylase/N-sulfotransferase.