RESUMEN
PURPOSE: To compare the progression-free and overall survival in small-volume residual ovarian cancer after treatment with intravenous (IV) cisplatin and paclitaxel or an experimental regimen of IV carboplatin followed by IV paclitaxel and intraperitoneal cisplatin. PATIENTS AND METHODS: Patients were randomized to receive either IV paclitaxel 135 mg/m(2) over 24 hours followed by IV cisplatin 75 mg/m(2) every 3 weeks for six courses or IV carboplatin (area under curve 9) every 28 days for two courses, then IV paclitaxel 135 mg/m(2) over 24 hours followed by intraperitoneal (IP) cisplatin 100 mg/m(2) every 3 weeks for six courses. RESULTS: Of the 523 patients who entered this trial, 462 were determined to be assessable, with prognostic factors well balanced between the treatments. Neutropenia, thrombocytopenia, and gastrointestinal and metabolic toxicities were greater in the experimental arm. As a result, 18% of the patients received < or = two courses of IP therapy. Progression-free survival was superior for patients randomized to the experimental treatment arm (median, 28 v 22 months; relative risk, 0.78; log-rank P =.01, one-tail). There was a borderline improvement in overall survival associated with this regimen (median, 63 v 52 months; relative risk, 0.81; P =.05, one-tail). CONCLUSION: An experimental regimen including moderately high-dose IV carboplatin followed by IP paclitaxel and IV cisplatin yielded a significant improvement in progression-free survival when compared with a standard regimen of IV cisplatin and paclitaxel. Because the improvement in overall survival was of borderline statistical significance and toxicity was greater, the experimental arm is not recommended for routine use. However, the results provide direction for further clinical investigation in small-volume ovarian cancer.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Ováricas/tratamiento farmacológico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carboplatino/administración & dosificación , Cisplatino/administración & dosificación , Supervivencia sin Enfermedad , Esquema de Medicación , Femenino , Humanos , Inyecciones Intraperitoneales , Inyecciones Intravenosas , Persona de Mediana Edad , Neoplasia Residual/tratamiento farmacológico , Neoplasias Ováricas/mortalidad , Paclitaxel/administración & dosificaciónRESUMEN
Surface sediments and mussel samples were collected at six selected locations in the lower-most Tennessee River and Kentucky Lake, U.S.A. and analyzed for butyltin (BT) derivatives. In sediments, total BT concentrations ranged from 6.8 to 356 ng g-1 dry wt. A wide range of concentrations in sediments suggested the presence of localized area of contamination. In mussel tissues, total BT concentrations varied between 26-107 ng g-1 dry wt. BT levels were comparable to the levels reported in mussels from some coastal sites as well as a few freshwater ecosystems. Leaching of tributyltin-containing anti-fouling paints in the ocean-going ships is a source of tributyltin, and discharge of municipal sewage and industrial waste waters in to this watershed may account for the presence of the monobutyltin and dibutyltin derivatives detected in the samples. To our knowledge, this is the first report on the butyltin concentrations in sediment and mussel tissues from the lower-most Tennessee River and Kentucky Lake.
Asunto(s)
Bivalvos/fisiología , Compuestos Orgánicos de Estaño/análisis , Contaminantes Químicos del Agua/análisis , Animales , Monitoreo del Ambiente , Kentucky , Distribución TisularRESUMEN
PURPOSE: CD30-positive anaplastic large cell lymphoma (ALCL) has been described in adults with HIV-1 infection but is extremely rare in HIV-1-infected infants and children. PATIENT AND METHODS: A 14-month-old girl with congenitally acquired HIV-1 infection presented with fever and a tender, erythematous, cystic mass on the right labium majorum. The mass was biopsied. Histologic examination and immunohistochemistry were performed. RESULTS: Histologic examination showed Touton-like giant cells resembling histiocytes and focally abundant neutrophils obscuring the lymphoid infiltrate. Immunocytochemistry revealed a CD30-positive ALCL of T-cell lineage. CONCLUSION: Although non-Hodgkin's lymphoma is known to be associated with HIV-1 infection in children, large cell lymphomas of T-cell lineage are extremely rare in this population. Early diagnosis should be aggressively pursued in an HIV-1-infected child who presents with a fever and cutaneous mass.
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Síndrome de Inmunodeficiencia Adquirida/congénito , Antígeno Ki-1/análisis , Linfoma Relacionado con SIDA/diagnóstico , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Cutáneo de Células T/diagnóstico , Femenino , VIH-1 , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa , Linfoma Relacionado con SIDA/patología , Linfoma Anaplásico de Células Grandes/patología , Linfoma Cutáneo de Células T/patologíaRESUMEN
AIMS AND BACKGROUND: Littoral cell angioma (LCA) is an uncommon vascular tumor of the spleen recently described and interpreted as the tumoral counterpart of the normally present littoral cells lining the splenic sinus channels of red pulp. The diagnosis of LCA is suggested by a quite characteristic morphology and confirmed by the demonstration of a hybrid endothelial/histiocytic phenotype. METHODS: Four original and previously unreported cases of LCA are presented. All four splenic vascular tumors were investigated by light microscopy and immunohistochemistry for endothelial and histiocytic markers. RESULTS: All four cases were associated with visceral epithelial malignancies (colorectal adenocarcinoma in two cases, renal and pancreatic adenocarcinoma in one case each). One case was also associated with an intracranial tentorial meningioma. CONCLUSIONS: We consider our findings as a novelty and signal the possible existence of a clinical syndrome. Five of a total of 21 previously reported cases in the literature were also described as being associated with other cancers (non-Hodgkin's lymphoma in two cases, two not further specified tumors of the liver and brain, an epithelial ovarian cancer, and a non-small cell lung cancer in one case each). Close follow-up and careful investigation in search of a second visceral neoplasm are strongly recommended in cases of LCA, but further clinical observations and more in-depth genetic and molecular studies are needed before any valid conclusions can be drawn.
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Hemangioma/patología , Neoplasias Primarias Múltiples/patología , Neoplasias del Bazo/patología , Anciano , Neoplasias Encefálicas/patología , Neoplasias del Colon/patología , Femenino , Hemangioma/cirugía , Humanos , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/patología , Neoplasias Pancreáticas/patología , Neoplasias del Recto/patología , Neoplasias del Bazo/cirugíaRESUMEN
Juvenile xanthogranuloma (JXG) is a rare lesion of the skin and deep tissues whose cytologic features have not previously been published. We report on 2 cases of JXG in patients aged 5 days and 5 yr who presented with an axillary mass and enlarged supraclavicular lymph node, respectively. Fine-needle aspiration and touch imprints made from the surgical biopsies yielded cellular specimens composed of histiocytes, multinucleated Touton-type giant cells, and variable admixtures of lymphocytes and eosinophils. One lesion was composed primarily of benign-appearing histiocytes with admixed multinucleated giant cells and a few lymphocytes. The second lesion consisted of a few histiocytes, occasional Touton giant cells, many lymphocytes, and scattered fibroblasts. The histiocytes were CD68-positive and S100-negative. Histologic follow-up confirmed the diagnosis of juvenile xanthogranuloma. One patient was lost to follow-up; the other is alive without evidence of recurrence 1 yr after surgery. We conclude that deep JXG has characteristic and diagnostic cytologic features.
Asunto(s)
Ganglios Linfáticos/patología , Xantogranuloma Juvenil/diagnóstico , Xantogranuloma Juvenil/patología , Axila , Biopsia con Aguja , Preescolar , Diagnóstico Diferencial , Humanos , Recién NacidoRESUMEN
UNLABELLED: Infiltration of regional lymph nodes by macrophages has been demonstrated after total joint arthroplasty. Although lymph nodes regulate the immune response, neither cytokine production nor the degree of immunological activation of cells within these nodes after total joint arthroplasty has been investigated. Pelvic lymph nodes were obtained from five patients who had had a total of eleven arthroplasties in seven hips three to twenty years before a pelvic staging procedure for adenocarcinoma (of the prostate in four patients and of the endometrium in one). All lymph nodes had polyethylene or metal debris as well as effacement of the normal nodal architecture by a histiocytic infiltrate. These changes were bilateral in the patients who had had an arthroplasty of one hip. Analysis of specimens from pelvic lymph nodes on the side of the involved hip demonstrated intense immunohistochemical staining of histiocytes for the major histocompatibility complex class-II antigen HLA-DR, a marker of histiocyte immune activation. In contrast, staining was absent in specimens from the contralateral lymph nodes as well as in those from seven patients who had had a prostatectomy but not a hip arthroplasty. Immunohistochemical staining for interleukin-1beta, tumor necrosis factor-alpha, and interleukin-6 demonstrated a much greater expression of these cytokines in the involved lymph nodes. CLINICAL RELEVANCE: Additions improvements in total joint replacement will be facilitated by a more thorough understanding of the biological response to the components and materials of implants. While local biological factors leading to failure of prostheses are currently under intense investigation, the mechanisms and importance of regional and systemic immune responses to wear debris require further study.
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Prótesis de Cadera/efectos adversos , Histiocitosis/etiología , Ganglios Linfáticos/patología , Adenocarcinoma/patología , Anciano , Aleaciones , Colorantes , Neoplasias Endometriales/patología , Femenino , Regulación de la Expresión Génica , Antígenos HLA-DR/análisis , Histiocitos/inmunología , Histiocitos/patología , Histiocitosis/inmunología , Humanos , Inmunohistoquímica , Factores Inmunológicos/análisis , Interleucina-1/análisis , Interleucina-1/genética , Interleucina-6/análisis , Interleucina-6/genética , Ganglios Linfáticos/inmunología , Activación de Macrófagos , Macrófagos/inmunología , Macrófagos/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pelvis , Polietilenos , Neoplasias de la Próstata/patología , Falla de Prótesis , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
BACKGROUND: Young women with nondescript abdominal pain can be difficult to diagnose. Although extrapelvic endometriosis is infrequent, we have treated 7 patients over the past 3 years with endometriosis in the abdominal wall, inguinal canal, or surgical incisions as the etiology of their symptoms. PATIENTS AND METHODS: We reviewed the medical records of patients whose final pathology report confirmed a diagnosis of extrapelvic endometriosis. Seven women who were treated at the University of Rochester Strong Memorial Hospital from May 1, 1991 through April 30, 1994 were identified. RESULTS: All patients were premenopausal with no history of pelvic endometriosis. In 4 patients, symptoms were cyclical. Surgical excision was initially curative in 5 patients. Two women required reexcision. The diagnosis of endometriosis was established at exploration by gross appearance and by frozen section. CONCLUSIONS: Endometriosis should be included in the differential diagnosis of a symptomatic mass in a celiotomy scar, the abdominal wall, or the inguinal canal. Principles of management include obtaining an accurate diagnosis and performing an adequate excision to prevent recurrence.
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Endometriosis , Dolor Abdominal/etiología , Adulto , Endometriosis/diagnóstico , Endometriosis/patología , Endometriosis/cirugía , Femenino , Humanos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
We describe 12 cases of primary soft tissue neoplasms that showed the histologic and immunohistochemical features of solitary fibrous tumors of serosal surfaces (solitary fibrous mesothelioma, submesothelial fibroma). Nine patients were women and three were men whose ages ranged from 28 to 83 years. Seven lesions were located in the head and neck region, and the remainder were located in the back, buttock, perineum, and groin. The lesions measured from 1 to 6 cm in greatest diameter and presented grossly as well-circumscribed, unencapsulated, soft to rubbery tissue masses. Histologically they were characterized by a proliferation of spindle cells exhibiting a variety of growth patterns, including storiform, herringbone, neural with wavy nuclei, and hemangiopericytic admixed with areas of sclerosis. In two cases the lesions showed areas of increased cellularity with occasionally scattered mitotic figures. Three cases were located adjacent to a major salivary gland; in one, entrapment of normal salivary gland acini and ducts could be observed at the edges of the lesion. Immunohistochemical studies showed positive staining of the spindle cells with CD34 (anti-HPCA-1) and vimentin antibodies and negative staining with keratin, actin, desmin, S-100 protein, collagen type IV, and factor VIII related antigen. Follow-up from 6 months to 12 years has shown no evidence of recurrence or metastasis in any of our patients. Solitary fibrous tumors appear to represent ubiquitous mesenchymal neoplasms that may not be necessarily restricted to serosal surfaces. Identification of these lesions is of importance to avoid misdiagnosis with other more aggressive conditions in soft tissue locations.
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Fibroma/patología , Neoplasias de los Tejidos Blandos/patología , Adulto , Anciano , Anciano de 80 o más Años , Dorso/patología , Nalgas/patología , Diagnóstico Diferencial , Femenino , Ingle/patología , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Perineo/patologíaRESUMEN
We have investigated the role of cytokines (IL-2, IL-3, IL-4, IL-6, IFN-gamma, and GM-CSF) in the generation of primary cytotoxic T lymphocytes (CTL), within a single tumor system. The murine carcinoma line 1 was transfected with expression vectors with cDNA for these cytokines. Line 1 expresses low levels of class I MHC molecules, but can be induced with dimethyl sulfoxide or IFN-gamma to express high levels of class I. Class I low line 1 cells are not susceptible to CTL lysis, while class I high line 1 are lysed by CTL, which allows us to assay for CTL activity. To isolate primary CTL, tumor-infiltrating lymphocytes were isolated from cytokine-expressing or control tumors, growing in vivo. Most cytokines stimulated nonspecific killers, but IL-2 and IL-3 stimulated primary CTL. While IFN-gamma alone did not generate primary CTL, coexpression of IFN-gamma with IL-2 resulted in CTL generation. This is the first comparison of the effects of a series of cytokines on primary CTL development, and has important implications for vaccine development and immunotherapy.
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Citocinas/fisiología , Neoplasias Experimentales/inmunología , Linfocitos T Citotóxicos/inmunología , Animales , Antígenos de Neoplasias/inmunología , Eosinófilos/fisiología , Factor Estimulante de Colonias de Granulocitos y Macrófagos/fisiología , Antígenos de Histocompatibilidad Clase I/análisis , Interferón gamma/fisiología , Interleucinas/fisiología , Ratones , Ratones Endogámicos BALB CAsunto(s)
Enfermedad de Castleman/patología , Ganglios Linfáticos/patología , Adulto , Femenino , Humanos , CuelloRESUMEN
Some of the more interesting and controversial issues concerning the pathology of the uterine cervix have been addressed in this article. It is hoped that this brief overview will serve as a stimulus for the reader to delve into some of these topics in greater detail either by critical examination of the literature or reporting one's own experience with these unusual tumors. A heightened awareness of the aforementioned "tumor-like" lesions may avert a misdiagnosis of malignancy with potentially disastrous consequences.
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Cuello del Útero/patología , Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/patología , Adenocarcinoma/patología , Carcinoma in Situ/patología , Carcinoma Adenoide Quístico/patología , Carcinoma de Células Escamosas/patología , Electrocirugia/métodos , Femenino , Humanos , Hiperplasia/patología , Metástasis de la Neoplasia , Tumor Trofoblástico Localizado en la Placenta/patología , Neoplasias del Cuello Uterino/cirugía , Displasia del Cuello del Útero/cirugíaRESUMEN
Management of patients in ARD remains a complex diagnostic and difficult therapeutic problem. Although the authors have focused on several new and exciting management strategies, it is important to recognize that the vast majority of patients with ARDS simply require meticulous general medical care. In this era of invasive monitoring and other care. In this era of invasive monitoring and other complex technologies, there is sometimes a tendency to neglect the basic issues such as judicious use of antibiotics to avoid superinfection with resistant organisms or antibiotic-associated diarrhea; removal of unnecessary intravenous lines to minimize line related infections; and maintenance of adequate nutrition to promote good skin and mucosal integrity as well as preserving important muscle mass all too often receive a low priority. It is anticipated that with meticulous general medical care, as well as selective implementation of the above treatment strategies, improvement in the outcome of patients is an achievable goal.
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Síndrome de Dificultad Respiratoria , Enfermedad Aguda , Corticoesteroides/efectos adversos , Corticoesteroides/uso terapéutico , Terapia Combinada , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/prevención & control , Humanos , Incidencia , Óxido Nítrico/uso terapéutico , Pronóstico , Respiración Artificial , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/patología , Síndrome de Dificultad Respiratoria/terapia , Factores de Riesgo , Tomografía Computarizada por Rayos XRESUMEN
We report a case of hepatic cysticercosis in a 62-year-old man who had been diagnosed with a colonic adenocarcinoma 9 years previously. Additional clinical studies failed to show disease in the soft tissues, brain, orbit and heart. The patient was successfully treated with a course of praziquantel and prednisone and is alive and well 28 months after diagnosis. This is the first reported case of hepatic cysticercosis that has resulted in significant morbidity.
Asunto(s)
Cisticercosis , Parasitosis Hepáticas , Adenocarcinoma/complicaciones , Biopsia , Neoplasias del Colon/complicaciones , Cisticercosis/diagnóstico , Cisticercosis/tratamiento farmacológico , Cisticercosis/epidemiología , Humanos , Hígado/parasitología , Hígado/patología , Parasitosis Hepáticas/diagnóstico , Parasitosis Hepáticas/tratamiento farmacológico , Parasitosis Hepáticas/epidemiología , Masculino , Persona de Mediana Edad , Praziquantel/uso terapéutico , Prednisona/uso terapéuticoRESUMEN
BACKGROUND: Primary lymphoma of bone is a rare, aggressive neoplasm that can present with a large, soft-tissue mass despite minimal evidence of cortical destruction on plain radiographs. METHODS: High resolution magnetic resonance imaging (MRI) examinations of four patients with primary lymphoma of bone were reviewed retrospectively, and in each case intramedullary tumors demonstrated "penetrating channels" extending through the cortex. The MRI studies were correlated with the histopathologic assessment of the tumor for each patient. Immunohistochemistry was performed for immunophenotyping and for cytokine expression by tumor cells. The cytokines that were investigated were interleukin-1, interleukin-6, and tumor necrosis factor-alpha, molecules known to regulate osteoclastic activity. RESULTS: The linear cortical foci noted on MRI correlated with the histopathologic findings of tumor-associated cutting cones, in proximity to osteoclastic bone resorption. Immunohistochemical stains showed a B-cell phenotype for each tumor and positive immunoreactivity in tumor cells for cytokine mediators that stimulate osteoclastic activation. CONCLUSIONS: These findings indicate that the tumor cells in these cases produce soluble cytokine mediators that may regulate extensive osteoclastic activity. In primary lymphoma of bone, tumor activation of osteoclastic resorption, with production of tumor tunnels through the cortex, may represent one of the mechanisms by which lymphoma escapes the intramedullary space and forms large, soft-tissue masses without extensive cortical destruction.
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Neoplasias Óseas/patología , Huesos/patología , Citocinas/metabolismo , Linfoma/patología , Adulto , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/fisiopatología , Humanos , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Linfoma/diagnóstico , Linfoma/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteoclastos/fisiología , Estudios Retrospectivos , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Chronic rejection is a major cause of graft failure in solid organ transplants after the first year. A characteristic lesion in a variety of chronically rejecting organs is a fibrointimal proliferative arteriosclerosis. It has been speculated that approaches to tolerance induction may be effective in obviating not only acute, but also chronic, rejection. A picture of chronic rejection develops naturally in heart grafts transplanted from the Lewis-to-F-344 strain of rat. We examined whether tolerance induction by bone marrow transplantation and development of hematopoietic chimerism or tolerance induction by intrathymic inoculation of alloantigen could effectively prevent chronic rejection in an established model of chronic rejection. Bone marrow chimeras were developed in F-344 hosts by transplantation of T cell-depleted allogeneic marrow (TCD A BMT). Another set of F-344 hosts was inoculated with intrathymic allogeneic bone marrow cells. Heart grafts in these animals demonstrated tolerance for 120 days after transplantation. Control F-344 animals treated with a short course of cyclosporine consistently developed chronic rejection by 120 days following heart transplantation. Strikingly absent from the tolerant animals was any sign of graft arteriosclerosis, which was demonstrated in the vast majority of control animals. Analysis of cytokine mRNA profiles at 30 days following heart transplantation demonstrated differences between control and tolerant animals. These results suggest that tolerance induction can effectively prevent chronic rejection.
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Arteriosclerosis/prevención & control , Rechazo de Injerto/prevención & control , Quimera por Trasplante/inmunología , Animales , Arteriosclerosis/etiología , Trasplante de Médula Ósea/inmunología , Enfermedad Crónica , Vasos Coronarios/fisiología , Citocinas/genética , Citocinas/metabolismo , Modelos Animales de Enfermedad , Rechazo de Injerto/complicaciones , Rechazo de Injerto/inmunología , Trasplante de Corazón/efectos adversos , Trasplante de Corazón/inmunología , Tolerancia Inmunológica , Isoantígenos/inmunología , Masculino , Miocardio/patología , ARN Mensajero/metabolismo , Ratas , Ratas Endogámicas F344 , Ratas Endogámicas Lew , Ratas Sprague-Dawley , Linfocitos T/inmunologíaAsunto(s)
Aneurisma Infectado/complicaciones , Aneurisma Infectado/microbiología , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/microbiología , Aspergilosis/complicaciones , Hemoptisis/complicaciones , Enfermedades Pulmonares Fúngicas/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Adulto , Humanos , Absceso Pulmonar/complicaciones , Absceso Pulmonar/microbiología , MasculinoRESUMEN
We present an unusual case of extensive placental micrometastases of recurrent breast carcinoma. The discrepancy between the gross and histopathologic findings in this case suggests that in the absence of gross metastases, meticulous microscopic examination may reveal a higher incidence of metastases than has been reported previously.
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Neoplasias Encefálicas/secundario , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/secundario , Enfermedades Placentarias/diagnóstico , Complicaciones Neoplásicas del Embarazo/diagnóstico , Adulto , Neoplasias Encefálicas/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Femenino , Humanos , EmbarazoRESUMEN
A distinctive morphologic alteration originally described as nuclear "clearing" has been observed in endometrial epithelium during pregnancy. Affected nuclei have a clear center and a rim of marginated chromatin, imparting a "glassy" appearance reminiscent of herpesvirus inclusions. We observed this change in gestational endometrium attached to the membranes of an otherwise normal-term placenta. Because of the morphologic suggestion of herpesvirus infection, immunoperoxidase studies using the avidin-biotin method were performed, resulting in intense staining of nuclear inclusions. An identical pattern of nuclear staining was also noted in negative controls. This anomalous staining reaction was replicated with the streptavidin-biotin method but not with the peroxidase-antiperoxidase method. Furthermore, nuclear staining was abolished after sequential preincubation with free avidin (0.05%) and free biotin (0.05%). Using the peroxidase-antiperoxidase method, positive nuclear staining was identified with monoclonal antibodies to biotin. Similar results were obtained in nine additional cases of optically clear nuclei associated with term placentas. We conclude that staining of optically clear nuclei is the result of avidin and streptavidin binding to intranuclear biotin. This anomalous staining pattern could potentially result in the misdiagnosis of herpesvirus infection.
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Artefactos , Núcleo Celular/metabolismo , Núcleo Celular/ultraestructura , Endometrio/metabolismo , Endometrio/ultraestructura , Infecciones por Herpesviridae/diagnóstico , Técnicas para Inmunoenzimas , Complicaciones Infecciosas del Embarazo/diagnóstico , Avidina , Proteínas Bacterianas , Biotina , Diagnóstico Diferencial , Femenino , Humanos , Embarazo , EstreptavidinaRESUMEN
We present an unusual case of in utero adrenal hemorrhage associated with fetal distress. This case was further complicated by transient neonatal hypertension that resolved spontaneously and a nonfunctioning ipsilateral kidney. We discuss the possible underlying pathophysiology.