New Guinea pathology : a morphological study of human disease in the Territory of Papua and New Guinea

Cooke, Robin A. (Robin Arthur), 1936- (1973). New Guinea pathology : a morphological study of human disease in the Territory of Papua and New Guinea Honours Thesis, School of Medicine, The University of Queensland.

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Author Cooke, Robin A. (Robin Arthur), 1936-
Thesis Title New Guinea pathology : a morphological study of human disease in the Territory of Papua and New Guinea
School, Centre or Institute School of Medicine
Institution The University of Queensland
Publication date 1973
Thesis type Honours Thesis
Open Access Status Other
Total pages 390 (2v)
Language eng
Formatted abstract
      A wide range of topics was investigated. The most important observation was that amyloidosis, especially primary amyloidosis, was more prevalent than in any previously studied population. No genetic or familial factors were recognised, and no specific cause was found to explain the unique prevalence of this condition. It occurred with equal prevalence throughout the country, and resembled the amyloid found in other countries. The majority of the patients presented to hospital with signs and symptoms of renal disease. A number presented with a goitre which was found to be due to amyloid infiltration of the gland. A combination of goitre and renal disease in children appeared to form a unique clinical syndrome.

      Amyloid was found to be the cause of chronic renal disease in the majority of post mortems on such patients. Clinical observations in the Port Moresby General Hospital showed a similar, very high prevalence of amyloidosis, and a normotensive patient with chronic renal disease was likely to be suffering from amyloidosis.

      Oral cancer accounted for 15.8% of the malignant neoplasms. It occurred predominantly in the coastal people, among whom the habit of chewing betel nut was almost universal. 10% of 315 cases of oral cancer studied personally were of the verrucous variety. These tumours occurred particularly on the labial commissures, on the buccal mucosa, or on both. This relatively high prevalence and this particular anatomical distribution were different from that seen in other countries.

      Skin cancers were common. The lower leg was the commonest site for squamous carcinomas. Melanomas occurred particularly on the feet and they appeared to be more prevalent in the Western and Southern Highlands than in any other area of T.P.N.G. An unusual feature was that 121 of 75 cases reviewed presented for treatment because of involvement of a digit, either finger or toe. Basal cell carcinomas were rare.

      A tumour with clinico-pathological features identical to that of Burkitt's Lymphoma was encountered. It was not as prevalent as in central Africa, but T.P.N.G. was the only other country in the world where it occurred with anything like the prevalence seen in Africa.

      Hepatoma and cirrhosis of the liver were common and the features of these two conditions resembled those seen in other countries in which the prevalence was similar. Jaw tumours, particularly ameloblastomas, were quite prevalent as in other tropical countries. Retinoblastomas were relatively common. Carcinoma of the cervix was common, while hydatidiform moles and chorionepitheliomas appeared to be more prevalent than in Australia, but not as prevalent as among the Chinese.

      Infectious diseases were common; and well recognised conditions such as malaria, leprosy, tuberculosis, filariasis, donovanosis, yaws, mycobacterial skin ulceration, rhinoscleroma, scrub typhus and superficial mycoses all occurred, but there were no features specifically related to their occurrence in T.P.N.G. On the other hand, cutaneous amoebiasis affecting the ano-genital region appeared to be more prevalent than in other tropical countries.

      Emphysema appeared to be as prevalent in post mortem lungs as it was in London, but relatively small amounts of carbon were present in the lungs in T.P.N.G. Cor pulmonale was the commonest form of heart disease encountered in clinical practice and this was most commonly a result of chronic lung disease, particularly emphysema. Myocardial infarction and cerebro-vascular accidents were rare.

      A form of arteritis resembling Takayasu's arteritis of the aorta and its major branches, was encountered, and the clinicopathological features of a group of these cases were described. 50% of 76 goitres removed surgically contained discrete, homogeneous, soft, creamy nodules. On histological examination these could easily be confused with malignant goitres, but it was postulated that they represented a response to severe iodine deficiency.

      Various complications of pregnancy were common but it was interesting that four cases of foetus-in-foetu were encountered.

      Anaemia was prevalent. This was most commonly due to iron deficiency. Megaloblastic anaemia due to deficiency of folic acid was relatively common in pregnancy. Thalassaemia and haemolytic anaemia associated with gross splenomegaly were also encountered.

      Miscellaneous conditions encountered included:- unusual inflammatory conditions of the small intestine – acute Enteritis Necroticans (Pig bel), and Phlegmonous Enteritis; a relatively large number of cases of Dub in Johnson Syndrome which came particularly from the Madang area; a group of cases of Tumoral Calcinosis - a condition relatively common in Africans.

      A series of neonatal autopsies was reported. This revealed no features which were peculiar to T.P.N.G.

      A series of forensic autopsies was reported. The causes of these unnatural deaths - accident, suicide and homicide – reflected the social and cultural conditions in T.P.N.G.
Keyword Medicine -- Papua New Guinea.
Tropical medicine.

Document type: Thesis
Collection: UQ Theses (non-RHD) - Open Access
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