Value of the necropsy in perioperative deaths

Article Abstract:

Deaths occurring with the 30 days following any surgical procedure (perioperative deaths) will be the subject of a new audit coordinated by the Royal College of Surgeons and Anesthetists, which will be generally identified as the Confidential Enquiry into Perioperative Deaths (CEPOD). This study reviews, retrospectively, a series of 213 perioperative death necropsies out of a total of 1,451 carried out in three hospitals in Northern Ireland. All clinical and necropsy records of the test group were examined, and comparisons were drawn between the final clinical diagnoses made by the patients' physicians and those confirmed at the necropsy. Discrepancies noted were divided into 4 classes; two major discrepancies - those which affected patient survival and either could (class I) or could not (class II) have been treated - and two minor discrepancies - either not related to causes of death but could have been treated (class III) or incidental diagnosis that could not have been made before death (class IV). Clinical diagnoses not confirmed at necropsy were described as false positive clinical diagnoses. Diagnoses made at necropsy, but not clinically considered in life, were characterized as false negative diagnoses. Class I discrepancies were found in 44 cases, class II in 62 cases, class III in 63 cases and class IV in 101 cases. No discrepancy was noted in 50 cases. The frequency of discrepant diagnoses points out the importance of necropsies in perioperative deaths, as an audit of patient care and as a learning circumstance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Patient outcomes, Mortality, Surgery, Autopsy

---

Monocytoid B cell lymphoma: clinical and prognostic features of 21 patients

Article Abstract:

Monocytoid cells, which resemble monocytes (a white blood cell), were first described in association with lymphadenitis in 1959. They are also referred to as immature sinus histiocytes. In 1984 and 1985, monocytoid cells were identified as B lymphocytes that show positive reactivity with monoclonal B cell antibodies. These cells have also been found in other reactive lymph node lesions, including those associated with AIDS and Hodgkin's disease. The first malignant B cell lymphoma (MBCL) was characterized in 1985; to date 56 cases have been described. Twenty-one cases of lymph node MBCL, drawn from the Kiel Lymph Node Registry, were selected for further study. In seven of the MBCL cases, a concomitant low grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) was found in the stomach, nasopharynx, salivary glands, and thyroid gland. Clinical data, including age, sex, presenting history, pre-existing and co-existing diseases, and staging of the disease are outlined. In addition, detailed histologic and cytologic descriptions of these cases are presented. MBCL primarily affects the elderly, and has high remission, relapse and long-term survival rates. Patients were followed-up for 3 to 83 months. The co-existent or underlying presence of low grade B cell lymphoma of the MALT type should be carefully ruled out in all cases of nodal MBCL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Prognosis, B cells, Cell differentiation

---

Tartrate resistant acid phosphatase positive splenic lymphoma: a relatively benign condition occurring in a time-space cluster?

Article Abstract:

New methods for the identification of lymphomas are available that can be used to separate different diseases that have similar appearances. The authors describe the cases of four elderly female patients with massive spleens and atypical lymphoid cells in the peripheral blood and bone marrow. All the women resided within a short distance of each other, had similar symptoms and clinical characteristics, and came to the same institution within 18 months. The cells were all tartrate-resistant acid phosphatase (TRAP) positive. Microscope analysis and immunocytochemical staining studies were carried out, and the findings were compared with those of other chronic B cell leukemia-lymphoma cases. While resembling other lymphoproliferative disorders in some characteristics, this small group of patients had in common a unique combination of findings, which set them apart. The disease was not aggressive, and each patient responded well after the surgical removal of the spleen. The proximity in both time and space of the occurrence of these four cases suggests the presence of a common causative agent. It is important to be able to characterize the lesion in each case, so that the type and extent of treatment can be properly administered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Demographic aspects

Similar abstracts:

• Abstracts: Renal failure in multiple myeloma: pathogenesis and prognostic implications. Disseminated echovirus infection in a patient with multiple myeloma and a functional defect in complement: treatment with intravenous immunoglobulin
• Abstracts: Mature teratoma of the retroperitoneum: radiologic, pathologic, and clinical correlation. part 2 Cystic teratoma of the ovary: CT detection
• Abstracts: HIV-1 peptides induce a proliferative response in lymphocytes from infected persons. Effect of cytokines on HIV release and IL-2 receptor alpha expression in monocytic cell lines
• Abstracts: Renal failure in multiple myeloma: pathogenesis and prognostic implications. part 2 Plasma cell dyscrasias
• Abstracts: The role of surgery in the multimodal treatment of primary gastric non-Hodgkin's lymphomas: a report of 76 cases and review of the literature

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.