Finding
Fourteen patients sections is necessary, but the preparation with stage 4 disease were excluded from of these required special techniques and the study and the remainder (34) underskill not always found in the routine went diagnostic laparotomy and splenecthistopathology laboratory.
Paper
Proceedings: Granulomatous orchitis due to histoplasma capsulatum masquerading as sperm granuloma.
Abstract
Viral and Epidemiological Studies loss, sweating, fever, pruritus) advanced stage, only four of 15 without systemic D. R. GAMBLE (Public Health Laboratory, symptoms did so. Clinical assessment of West Park Hospital, Epsom) Epidemispleen size was unreliable and 13 patients ological data suggest that juvenile diabetes who did not have palpable spleens had may occur in genetically predisposed histological evidence of disease. Clinical children but that its onset is associated assessment of liver involvement appeared with, and is probably triggered by, more satisfactory and the only liver environmental factors. The nature of biopsies showing Hodgkin's disease came these factors is at present uncertain but from patients whose livers were clinically there is growing evidence that diabetes enlarged. Lymphangiography proved may follow virus infection in animals and more reliable in assessing intraabdominal it may also do so in man. lymphadenopathy than in many previously The incidence of new cases of juvenile reported series with fewer than 10% of diabetes follows a seasonal pattern with lymphangiograms incompatible with the a peak in cases occurring among children operative findings. False negative findings aged 9 years or over but not in younger were more frequent than false positives, patients. The age incidence increases from but were only seen in patients whose birth to a major peak at 11 years and then disease was confined to coeliac axis or declines; minor peaks occur at 5 years splenic pedicle nodes. No mortality and and at 7 or 8 years. Children who first little significant morbidity resulted from attend school or play groups before the the operation. age of 5 develop diabetes earlier than Laparotomy is recommended for exact those who start school at 5, and in these staging in all patients with Hodgkin's children the peak incidence occurs sooner, disease confined to lymph nodes and is at about 5 or 6 years. Environmental critically important in patients with factors are clearly responsible for these systemic symptoms and disease apparently differing patterns and, apart from virus localized above the diaphragm. infection, such factors as diet, stress, Refer environmental temperature, physical ence activity, social class, and bacterial "Rosenberg, S. A. (1966). Cancer Res., 26, 1310. infections may be involved, either singly or in combination. Data will be presented A Simplified Approach to Metabolic Bone on the effects of season, year, and age, on Disease the incidence of juvenile diabetes, and the relationship of these findings to environR. P. TOWERS (St Vincent's Hospital, mental factors will be discussed. Dublin) Increasing appreciation of the importance and frequency of metabolic Diagnostic Laparotomy and Splenectomy bone disease has led to greater demands in the Staging of Hodgkin's Disease by clinicians for precise information. The deficiencies of radiological and bioJ. A. WHHTAKER (Welsh National School chemical investigation mean that bone ofMedicine, Cardiff) Forty-eight patients biopsy, with particular reference to the seen in a two-year veriod had histologicdemonstration of osteoid seams, is ally proven Hodgkin's disease. All were necessary. As decalcification obscures the assessed clinically and radiologically and distinction between calcified bone and staged according to the recommendations uncalcified bone, the use of undecalcified of the Rye conference'. Fourteen patients sections is necessary, but the preparation with stage 4 disease were excluded from of these required special techniques and the study and the remainder (34) underskill not always found in the routine went diagnostic laparotomy and splenecthistopathology laboratory. omy to determine the extent of Hodgkin's Attention is drawn to the method disease within the abdomen. published by Tripp and Mackay in 1972. The preoperative staging was compared Based upon a technique by Gomori in with the final staging which took account 1933, this procedure involves immersing of operation findings and histological data pieces of alcohol-fixed bone in 2% from spleen sections and from lymph aqueous Ag NO, in the dark for 48 hours, node and liver biopsies. Eighteen patients followed by a reducing process which (53%) changed stage, including 15 leaves a black deposit of silver at the advancing to a later stage. Whereas 10 interface between bone and osteoid. of 11 patients with early clinical disease Routine decalcification and paraffin (stage 1-2) and systemic symptoms (weight embedding permit staining by a variety 929
Authors
M. Monroe
Journal
Journal of Clinical Pathology