Document 5b40KM9wpkpwBVGv4JGjNz4Ne

FILE NAME Talc TALC DATE 1974 DOC TALC041 DOCUMENT DESCRIPTION Autopsy Report M 227 @ ROSWELL PARK MEMORIAL INSTITUTE AUTOPSY REPORT : Date and Time of Death Date and Time of Autopsy 6/29/74 @ 5:30 P.M. 6/30/74 @ 9:30 A.M. Autopsy Number 11354 ProsectoYr. Satchidanand MICROSCOPIC DESCRIPTION CARDIOVASCULAR SYSTEM Section of the heart shows mild focal fibrosis . RESPIRATORY SYSTEM The lungs show thickening and edema of the pleura There is infiltration by malignant lymphoma composed of differentiated small lymphocytes These cells are diffusely infiltrating the lung parenchyma The adjacent lung shows thickening and fibrosis of the alveolar walls The alveolar septae show large atypical cells Several of the alveoli have asteroid bodies and ferunginous bodies Elsewhere the alveoli are filled with dense proteinaceous material In addition large areas of emphysema are noted Considerable thickening of the smaller arterioles is seen Large emphysematous areas are seen The main bronchus shows ulceration and infiltration by malignant lymphoma DIGESTIVE SYSTEM Section of the esophagus shows mild dysplasia There is submucosal edema and squamous metaplasia of the ducts There are a few dilated vessels These probably represant radiation changes The stomach has a preserved mucosa There is no lymphomatous infiltration The small intestine is unremarkable The liver shows mild metamorphosis and mild lymphocytic infiltration of the portal areas There is moderate degree of autolysis of pancreas ENDOTHELIAL SYSTEM The section of the spleen shows A single small lymph node shows chronic passive congestion : infiltration by poorly differentiated lymphocytic lymphosarcoma The vertebral marrow shows focal hypocellularity and multifocal infiltration by malignant lymphoma The femoral marrow is hypercellular and shows erythroid hyperplasia Mild degree of megakaryocytic hyperplasia is seen ENDOCRINE SYSTEM The pituitary gland is unremarkable The thyroid gland is composed of follicles filled with colloid The parathyroid gland is unremarkable The adrenal glands have well preserved cortex and medulla small and large URINARY SYSTEM . Section of the right kidney shows metastatic malignant parenchyma The glomeruli are fairly well preserved changes lymphoma infiltrating the The tubules show autolytic REPRODUCTIVE SYSTEM . The testicles have atrophis The section of the prostate seminiferous tubules gland shows extensive and a few are autolysis hyalinized CENTRAL NERVOUS SYSTEM Sections of the hippocampus and cerebellum are unremarkable Date~ RALPH J. BROWN 6/29/74 @ 5:30 P.M. 6/30/74 @ 9:30 A.M. Chart Number | 11354 131343 Y. Satchidanand M. D. FINAL SUMMARY At autopsy the lungs were found to be very heavy right lung 1400 gms and lt lung 1100 gms Microscopic examination revealed very interesting features Extensive fibrosis was noted This could be attributed to the radiation this patient received for the malignant lymphoma However this patient is said to have worked for many years in a talc factory This explains the ferunginous bodies and the asteroid bodies seen in large numbers in the lungs The ferunginous body also known as the asbestos body is not specific for asbestosis It is formed by a deposition of salts and protein on particles of asbestos However similar deposition is seen in cosmetic talc aluminum silicate and glass fibers Animal experiments have confirmed the above finding Therefore the fibrosis can be attributed to both radiation and lung exposure to talc A fibrogenic impurity accompanying talc hydrated magnesium silicate is tremolite A mineral form of asbestos Tremolite is known to form asbestos like bodies and induce interstitial fibrosis RALPH J. 6/29/74 6/30/74 BROWN @ 5:30 P.M. @ 9:30 A.M. Chart Number 11354 131343 Y. Satchidanand M. D. FINAL ANATOMICAL DIAGNOSIS 1. Lymphocytic lymphosarcoma involving right lung right hilar lymph nodes and right kidney following lymphosarcoma of left cervical lymph nodes T08 M9623 2. Bilateral pulmonary congestion and extensive radiation fibrosis right lung 1400 gms and left lung 1100 gms T28 E9320 3. Bilateral pulmonary talcosis 4. Focal acute bronchopneumonia T28 M5602 T28 M4101 5. Bilateral pleural effusion 300 cc each side 6. Atherosclerosis of coronary arteries and aorta moderate 7. Arteriolar nephrosclerosis mild 8. Status Post a Radiotherapy 3600 rads to left neck 11/16/71 - 12/22/71 b Chemotherapy - Vincristine and Cytoxan April - September 1971 E8803 E8829 E8813 ) Chemotherapy with BCNU and Prednisone September 1972 ) Chemotherapy with Adriamycin March 1973 E8838 e Chemotherapy - Methotrexate July 1973 Leukovorin Ara Cytoxan and Vincristine E8830 E8822 f Radiation to whole chest 2100 rads February 1974 E8536 MECHANISM OF DEATH RESPIRATORY INSUFFICIENCY DUE TO AND RADIATION FIBROSIS BILATERAL PULMONARY CONGESTION EDEMA YS 4/3/75 JOHN W. PICKREN M. D. Bathind CHIEF OF PER Bathind Bathind Satchidana M. D. J. Gaeta Sat Gaeta Gaeta D. J. F. M. D. ~ ecoevocepuvuev RALPH J. 6/29/74 6/30/74 BROWN @ 5:30 @ 9:30 P.M. A.M. Chart Number 131343 11354 Y. Satchidanand M. D. FINAL ANATOMICAL DIAGNOSIS 1. Lymphocytic lymphosarcoma involving right lung right hilar lymph nodes and right kidney following lymphosarcoma of left cervical lymph nodes TO8 M9623 2. Bilateral pulmonary congestion and extensive radiation fibrosis right lung 1400 gms and left lung 1100 gms T28 E9320 3. Bilateral pulmonary talcosis 4. Focal acute bronchopneumonia T28 M5602 T28 M4101 5. Bilateral pleural effusion 300 cc each side 6. Atherosclerosis of coronary arteries and aorta moderate 7. Arteriolar nephrosclerosis mild 8 Status Post a Radiotherapy 3600 rads to left neck 11/16/71 - 12/22/71 b Chemotherapy - Vincristine and Cytoxan April - September 1971 E8803 E8829 E8813 ) Chemotherapy with BCNU and Prednisone September 1972 d Chemotherapy with Adriamycin March 1973 E8838 e Chemotherapy - Methotrexate July 1973 Leukovorin Ara Cytoxan and Vincristine E8830 E8822 f Radiation to whole chest 2100 rads February 1974 E8536 MECHANISM OF DEATH RESPIRATORY INSUFFICIENCY DUE TO AND RADIATION FIBROSIS BILATERAL PULMONARY CONGESTION EDEMA YS kb 4/3/75 JOHN W. PICKREN M. CHIONF E PATHOLOGY D. PER Satchidanand Satchidanand M. D. Satchidanand J. F. Gaet M. D. oeqgevGpowe- RALPH J. 6/29/74 6/30/74 BROWN @ 5:30 @ 9:30 P.M. A.M. Chart Number 131343 ' 11354 Y. Satchidanand M. D. FINAL SUMMARY At autopsy the lungs were found to be very heavy right lung 1400 gms and 1t lung 1100 gms Microscopic examination revealed very interesting features Extensive fibrosis was noted This could be attributed to the radiation this pati received for the malignant lymphoma However this patient is said to have worked for many years in a talc factory This explains the ferunginous bodies and the asteroid bodies seen in large numbers in the lungs The ferunginous body also known as the asbestos body is not specific for asbestosis It is formed by a deposition of salts and protein on particles of asbestos However similar deposition is seen in cosmetic talc aluminum silicate and glass fibers Animal experiments have confirmed the above finding Therefore the fibrosis can be attributed to both radiation and lung exposure to talc A fibrogenic impurity accompanying talc hydrated magnesium silicate is tremolite A mineral form of asbestos Tremolite is known to form asbestos like bodies and induce interstitial fibrosis e veo nueov eds M 227 fi Name ~ Date and Time of Death Date and Time of Autopsy ) ROSWELL PARK MEMORIAL INSTITUTE AUTOPSY REPORT RALPH J. BROWN 6/29/74 @ 5:30 P.M. 6/30/74 @ 9:30 A.M. MICROSCOPIC DESCRIPTION ' Chart Number 131343 Autopsy Number 11354 ProsectoYr. Satchidanand e CARDIOVASCULAR SYSTEM _ Section of the heart shows mild focal fibrosis e 98 fi RESPIRATORY SYSTEM The lungs show thickening and edema of the pleura There is infiltration by malignant lymphoma composed of differentiated small lymphocytes These cells are diffusely infiltrating the lung parenchyma The adjacent lung shows thickening and fibrosis of the alveolar walls The alveolar septae show large atypical cells Several of the alveoli have asteroid bodies and ferunginous bodies Elsewhere the alveoli are filled with dense proteinaceous material addition large areas of emphysema are noted Considerable thickening of the smaller arterioles is seen Large emphysematous areas are seen fi The main bronchus shows ulceration and infiltration by malignant lymphoma @ e e @ e fi@ e DIGESTIVE SYSTEM Section of the esophagus shows mild metaplasia of the ducts There are radiation changes The stomach has dysplasia There is submucosal edema and squamous a few dilated vessels These probably represant a preserved mucosa There is no lymphomatous infiltration The small intestine is unremarkable The liver shows mild metamorphosis and mild lymphocytic infiltration of the portal areas There is moderate degree of autolysis of pancreas ENDOTHELIAL SYSTEM The section of the spleen shows chronic passive congestion A single small lymph node shows infiltration by poorly differentiated lymphocytic lymphosarcoma and multifocal infiltration by The vertebral marrow shows focal hypocellularity malignant lymphoma The femoral marrow is hypercellular and shows erythroid hyperplasia Mild degree of megakaryocytic hyperplasia is seen The pituitary gland is unremarkable The thyroid gland is composed of follicles filled with colloid The parathyroid gland is unremarkable The adrenal glands have well preserved cortex and medulla small and large e e @ e Section of the right kidney shows metastatic malignant parenchyma The glomeruli are fairly well preserved changes lymphoma infiltrating the The tubules show autolytic REPRODUCTIVE SYSTEM . The testicles have atrophis seminiferous tubules and a few are hyalinized The section of the prostate gland shows extensive autolysis CENTRAL NERVOUS SYSTEM Sections of the hippocampus and cerebellum are unremarkable e e hp . we M 227 Name Date and Time of Death 6s Date and Time of Autopsy sd ROSWELL PARK MEMORIAL INSTITUTE AUTOPSY REPORT RALPH J. BROWN 6/29/74 @ 5:30 P.M. 6/30/74 @ 9:30 A.M. Chart Number 131343 Autopsy NumberA 11354 Prosector Satchidanand MI BRAIN The dura mater and the leptomeninges are smooth and unremarkable The sagittal sinus and the cerebral arteries are patent Serial coronal sections of the cerebrum show no evidence of softening hemorrhage or any ventricular system is patent dilatation The cerebellum tumor The and shows no pons and medulla are unremarkable Representative sections are taken and the rest is saved YS 7/18/74 JOHN W. PICKREN M.D. P CHIEF OF PATHOLOGY PER Satchidanand M.D. @evwsegqsedw ee