18TH Alabama Imaging and Microscopy Society, Birmingham, Alabama, April 29-30, 1999

✍ Scribed by Vanderwinden, Jean-Marie; Rumessen, J�ri J.

• Book ID: 101224974
• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 58 KB
• Volume: 47
• Category: Article
• ISSN: 1059-910X
• DOI: 10.1002/(sici)1097-0029(19991201)47:5<361::aid-jemt7>3.0.co;2-w

✦ Synopsis

pyrophosphate). Joint or tissue destruction occurs as a result of the reactive inflammatory response to the presence of the crystals. Pseudogout can be very destructive, and unfortunately, for symptomatic patients, no treatment significantly reduces crystal formation. Gout, however, does have specific therapies. In addition to crystal deposition, necrotic tissue and old hematomas can undergo calcium phosphate deposition (dystrophic calcification), a clinically insignificant occurrence. Therefore, laboratory analysis of mineralization can be clinically important. Our surgical pathology department received two pieces of firm white-tan material identified as "pocket of pacemaker" in fixative and in the fresh state. The specimens were obtained from the tissue surrounding an old malfunctioning pacemaker from a seventy-four year old female with gout. Due to her history of gout, and the firm nature of the material surrounding her old pacemaker, special processing with alcohol and stains to preserve and identify crystals were performed. No polarizable crystals typical of sodium urate or calcium pyrophosphate were identified, and special stains for urate were negative. A portion of the specimen was selected for examination with the scanning electron microscope. The tissue was attached to an aluminum stub using double stick carbon tabs. The specimen was coated with carbon using a Denton vacuum carbon evaporator (Denton Vacuum Inc., Moorestown, NJ). The specimen was examined and photographed using a Philips XL2O scanning electron microscope (FET Company, Hillsboro, OR). Microanalysis using the EDAX Falcon system (EDAX Inc., Mahwah, NJ) revealed calcium and phosphate. The findings indicate that dystrophic calcification occurred around the pacemaker rather than crystal deposition, hence the mineralization warranted no further therapy.