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Background and Objectives: Granuloma Inguinale (GI) is an endemic sexually transmitted disease (STD) in India. With increasing prevalence of human immunodeficiency virus (HIV) among patients with STD at a clinic in Mumbai, a study was conducted to determine clinico-epidemiologic features of GI and HIV. Goal: To determine possible interaction between GI and HIV. Study Design: Prospective follow-up of 21 consecutive cases (GI in HIV-seropositive individuals) and 29 controls (GI in HIV-seronegative individuals) to determine time to heal. All cases and controls received a standard treatment regimen of erythromycin, 2 g po daily, under supervision until healing occurred. Results: Although GI ulcers at recruitment were not significantly larger among HIV-seropositive individuals as compared with those seen among HIV-seronegative individuals (mean size 4.4 [cm.sup.2] vs. 3.6 [sq.sup.2]; odds ratio [OR] 1.22, confidence interval [CI] .95, 0.63, 2.40; p = 0.52), the former took longer time to heal completely (mean 25.7 days vs. 16.8 days; OR 1.82, CI .95, 0.99, 3.36; p = 0.03) and tended to produce greater tissue destruction (as included in results). Conclusion: These findings are important because slow-healing GI ulcers with underlying HIV infection, which may be caused by their interaction, will lead to increased transmission of both the infections., HIV-infected patients may have a more serious case of granuloma inguinale (GI), which could increase their risk of transmitting HIV. GI is a sexually transmitted disease in India that causes ulcers on the genitals. Researchers examined 21 HIV-positive GI patients and 29 HIV-negative GI patients. All patients were treated with erythromycin. GI ulcers in HIV-positive patients took longer to heal than in HIV-negative patients and also produced greater tissue damage. This could facilitate the transmission of HIV.

Background: Granulomatous lesions are occasionally found in the lymphoid or solid organs of patients with common variable immunodeficiency. Objective: To examine the clinical and immunologic conditions in patients with common variable immunodeficiency who have granulomas. Design: Case series. Setting: Large tertiary care medical center. Patients: 17 hypogammaglobulinemic patients with common variable immunodeficiency whose organ or tissue biopsy samples contained noncaseating granulomas. Measurements: Results of lymphocyte function tests. Results: Eight of 17 patients had granulomas at some point before hypogammaglobulinemia was diagnosed. Sixteen of the 17 had deficient T-cell proliferation to mitogens. Although 14 patients received standard treatment with intravenous immunoglobulin, they have had substantial illness, including frequent autoimmune disease. Conclusions: Dysregulated T-cell function or macrophage activation may have been involved in formation of granulomas and increased illness in hypogammaglobulinemic patients with common variable immunodeficiency. Delay in recognition of antibody deficiency may have contributed to the severity of illness in these patients., Patients with an impaired immune system may be at greater risk of developing nodular growths called granulomas. Blood samples from 17 patients with granulomas and an impaired immune system related to low gammaglobulin levels were tested for lymphocyte reactions. Nearly all of the samples produced low T-cell levels in response to immune stimulation. Many of the patients had identifiable granulomas before being identified as having hypogammaglobulinemia.

Background. Polymorphic reticulosis, a type of lethal midline granuloma (LMG), has been referred to as nasal T-cell lymphoma (NTL) because of its proliferating cells' positive reactivity to anti-T-lymphocyte antibodies. Recently, several studies have suggested that proliferating cells in NTL may be natural killer (NK) in nature. NK cells and human nonmajor histocompatibility-restricted cytotoxic T-lymphocytes have the morphology of large granular lymphocytes (LGL) (i.e., a high cytoplasmic: nuclear ratio and cytoplasmic granules). Whether NTL-LMG possesses an LGL morphology is examined in this study.Methods. Two lymph node smears, peripheral blood showing a leukemic picture, and an electron microscope (EM) examination of a cutaneous lesion, respectively, were obtained from four patients with NTL-LMG. Immunohistochemical examination of the proliferating cells and of the Epstein-Barr virus (EBV) genome by both polymerase chain reaction and in situ hybridization also were performed.Results. All patients presented with necrotic and granulomatous lesions in the upper respiratory tract. Histology showed polymorphous cellular infiltrates containing large atypical cells with positive reaction to CD3 (three patients), CD43 (two patients), CD45RO (two patients), and OPD4 (one patient). Imprint smears revealed azurophilic large membrane-delimited granules in an ample cytoplasm, which was confirmed by EM. The presence of the EBV genome in the tumor cells was observed in one patient.Conclusion. The current findings showed that NTL-LMG or polymorphic reticulosis is a proliferation of LGL with a CD3+ phenotype. Cancer 1995; 75:894-901.

Background and Methods. Of the 200 cases of ABC in the Rizzoli Institute files, 15 had solid features on both gross and histologic examination. Inasmuch as fibrous proliferation with giant cell and bone production along with fibromyxoid areas and small aneurysmal spaces were found in the solid parts of the aneurysmal bone cyst, a grossly solid and radiographically osteolytic bone lesion with these microscopic features was called a solid aneurysmal bone cyst. Some authors call the same lesion extragnathic giant cell reparative granuloma. Results. Sixty percent of the patients were female. The metaphysis was the preferred location in the long bones (8/11). Radiographic appearance was not specific, and sometimes a malignant lesion was very difficult to rule out. In seven patients, the lesion was considered radiographically 'aggressive.' Intralesional excision (curettage) in 12 patients and marginal resection in 3 patients with diaphyseal location was effective in controlling the lesion. No recurrence was detected after a mean follow-up of 59 months. Conclusions. High proliferative activity of the benign-appearing proliferative spindle cells, often with fairly abundant mitoses, associated with benign giant cells and immature bone production are the features of this pseudosarcomatous hyperplastic lesion. It is sometimes is mistaken for a malignant tumor. Cancer 1993; 71:729-34.

Cutaneous granulomas are small red spots on the skin that can be swollen, inflamed, or infected. They can appear in association with a variety of different infectious diseases, and they can occur in people who have poor immune function due to immunodeficiency disorders or treatment with immunosuppressive drugs. (The immune system is the body's natural defense system for fighting infection. Patients who have undergone transplant surgery require treatment with drugs that suppress the immune system to prevent rejection of the donated tissue.) Cutaneous granulomas located on the arms, legs and face may be an early warning sign of immunodeficiency. This article describes the case reports of three children who developed cutaneous granulomas on their legs, arms and faces. All three children had severe lung and ear infections during early childhood. Not until after the cutaneous granulomas appeared was it determined that these children had some form of immunodeficiency. None of the children had AIDS or infection with HIV (the virus that causes AIDS). One child required a bone marrow transplant because of chronic anemia (abnormally low numbers of red blood cells). One year after the transplant the child developed cutaneous granulomas. Treatment with prednisone improved the skin lesions in this child. Prednisone improved the skin lesions in the other two children as well, but both of them died from severe immunodeficiency. It is concluded that children who develop cutaneous granulomas should be examined and tested for immunodeficiency. (Consumer Summary produced by Reliance Medical Information, Inc.)

Juvenile xanthogranuloma (JXG) is a benign tumor of the skin that occurs most often on the head and neck of infants and young children. This growth usually goes away without medical intervention. The tumor consists of an accumulation of histiocytes and Touton giant cells in the dermis, or the inner skin layer. Histiocytes are cells that are present in loose connective tissue, and Touton giant cells are large cells with many nuclei, often found in xanthomatosis, a condition characterized by the deposition of fats in tissues. Cases are described of 17 patients with a variant form of JXG. These cases of variant JXG had unusual tissue microscopic features, were difficult to diagnose, and were sometimes confused with malignancies. The clinical characteristics and microscopic features of this variant of JXG are described. A peculiar feature observed was the absence of Touton giant cells and foam cells, which contain a foamy cytoplasm. In addition, the number of dividing cells was large. (Consumer Summary produced by Reliance Medical Information, Inc.)

Libuse Heinz-Momcilovic, MD and P. K. Rohatgi, MD--VA Medical Center & George Washington University, Washington, DC, USA Introduction: There are numerous causes of chronic diffuse pulmonary parenchymal diseases. We report [...]

Retailers need to learn health care for new aquarium fish shipments. Salt and other electrolytes help heal injured fish when used properly. It is also effective to employ water changes and antibiotics.

We describe the first reported case (to our knowledge) of pulmonary granulomatosis caused by aspirated green tea. In this case, we found granulomatous alveolitis with lymph follicles, T lymphocytosis with [...]