Fine-needle aspiration cytology of metastatic malignancies involving unusual sites.
Explore the source record for details and available documents.
Biopsy, Needle↗
Biomedical subjects
A J Herzberg
Publications and source records attributed to A J Herzberg.
Detection of Trichomonas vaginalis in endocervical and ectocervical smears.
The objective of this study was to determine the relative sensitivity of detecting Trichomonas vaginalis in endocervical as compared to ectocervical Papanicolaou-stained smears. The average number of organisms in 10 (200x) high-power fields (hpf) per smear was used for comparing the presence of trichomonads in the two smear types. In every pair of ectocervical-endocervical smears, there were always more trichomonads in the ectocervical smear. Fifty percent of cases showed at least 25 more trichomonads per 200x hpf in the ectocervical smear than in the endocervical smear. In 20 of 50 cases (40%), trichomonads were present only in the ectocervical smear. The organisms were found only in the endocervical smears of women with a heavier ectocervical trichomonad burden. In conclusion, trichomonads are detected in the Papanicolaou-stained ectocervical smear more often than in the endocervical smear; therefore, examination of an adequate ectocervical smear has greater utility than the endocervical smear for the diagnosis of trichomoniasis.
Animals↗
Autoimmune progesterone dermatitis.
Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions during the luteal phase of the menstrual cycle. We describe a woman with postpartum onset of a papulovesicular eruption. The possibility of autoimmune progesterone dermatitis was raised because of the cyclic nature of the outbreak. A reactive intradermal progesterone test confirmed the diagnosis. A review of individual case reports is also presented.
Adult↗
Pleomorphic basal cell carcinoma.
BACKGROUND: A variant of basal cell carcinoma (BCC) with scattered large, pleomorphic cells has previously been reported as "basal cell epithelioma with giant tumor cells" and "basal cell carcinoma with monster cells." OBJECTIVE: Our purpose was to describe the clinical, histologic, and DNA ploidy findings in BCCs with these cytologic features. METHODS: Nineteen pleomorphic BCCs from 15 patients were prospectively collected, and other BCCs in these patients were retrospectively reviewed by light microscopy. One lesion was recurrent. Seven of the pleomorphic BCCs and one nonpleomorphic BCC were studied by image analysis. RESULTS: These pleomorphic BCCs ranged from 2.8 to 12.5 mm in greatest diameter and were most commonly located on the head and neck. Five BCCs were present on the face and scalp of a patient with basal cell nevus syndrome. There have been no subsequent recurrences of the pleomorphic BCCs (follow-up from 3 to 32 months; median, 20 months). All 19 pleomorphic BCCs displayed characteristic features of BCC: peripheral palisading, stromal retraction, mucin production, and apoptosis. All 19 also showed huge pleomorphic mononucleated and multinucleated giant tumor cells. The nuclei of these large cells were often hyperchromatic with prominent nucleoli and abundant cytoplasm, and occasionally with intranuclear cytoplasmic protrusions. In addition, there were frequent and atypical mitoses in 47% of the cases. All pleomorphic BCCs studied by cell image analysis of formalin-fixed, paraffin-embedded tissue were aneuploid. The DNA content of the giant tumor cells was not a multiple of a single DNA value. CONCLUSION: Pleomorphic BCCs clinically present as typical BCCs. Despite their striking focal cellular atypia, these lesions seem to behave as ordinary BCCs.
Adult↗
Subcutaneous dirofilariasis in Collier County, Florida, USA.
A 10-year review of the surgical pathology files of the Department of Pathology at Naples Community Hospital (Naples, FL, U.S.A.) revealed 10 cases of Dirofilaria tenuis and one of Dirofilaria ursi infection. The review consisted of only those lesions for which the pathologists had recorded the presence of a worm in the lesion. Therefore, an unknown number of subcutaneous lesions without parasites were not reviewed. Nine of the 11 cases of Dirofilaria were diagnosed as Dirofilaria or Dirofilaria tenuis originally. An additional case, previously diagnosed as Dirofilaria, was found to be a sparganum larva on review. This finding indicates that, because of the unfamiliarity of pathologists with the diagnostic characteristics of these nematode parasites, infections with Dirofilaria are underdiagnosed or misdiagnosed. If pathologists were more familiar with these parasites, their prevalence and the medical cost of this zoonosis in the southeastern United States could be determined more accurately.
Adult↗
Acquired port-wine stains.
BACKGROUND: An acquired port-wine stain is a rarely reported vascular lesion that mimics a congenital port-wine stain clinically, but is acquired after birth. METHODS: Clinical and histologic information concerning ten patients with acquired port-wine stains was recorded. Stains of seven of these patients were treated with either the copper vapor or pulsed dye laser. RESULTS: Collected information suggests that many acquired port-wine stains are idiopathic in nature. Light microscopic examination of tissue showed vascular dilation identical to that seen in congenital port-wine stains. Results of laser treatment were excellent in four patients, good in one patient, and poor in two patients. CONCLUSIONS: Although some differences exist, acquired port-wine stains are similar to congenital port-wine stains in their clinical morphology, histologic findings, and response to laser treatment.
Adolescent↗
An unusual case of early malignant transformation in a spiradenoma.
BACKGROUND: Review of the literature reveals that malignant spiradenomas are rare and may be fatal, and typically manifest as rapid enlargement in long-standing spiradenomas. OBJECTIVE: The present tumor was removed 2 months after it was first noted by the patient. A case of what we believe is the earliest stage of malignant transformation within spiradenoma is reported. METHODS: Case report and literature review. RESULTS: The region with malignant transformation was characterized by nuclear pleomorphism, loss of two cell types, and increased mitotic activity with atypical mitoses. Small infiltrating duct-like structures were seen. The large aggregates and sheets of malignant cells described in long-standing tumors were not seen. CONCLUSION: We ascribe the early detection of this tumor to increased public awareness of the importance in seeking early treatment of skin lesions. Histologic examination of this stage may eventually outnumber the now more commonly described latter stages.
Adenoma, Sweat Gland↗
Nail manifestations of systemic diseases.
Changes in the color, shape, or texture of the nails can be indicative of a wide range of disease states. Podiatrists routinely have the opportunity to observe and evaluate this aspect of pedal anatomy. This article provides a review of the relevant anatomy, an approach to the history and examination, and a description of the various nail changes as they relate to specific disease entities.
Disease↗
Differential immunoreactivity of transforming growth factor alpha in benign, dysplastic and malignant prostatic tissues.
Immunohistochemical examination of radical prostatectomy specimens from 57 patients was performed to determine the differential expression of transforming growth factor alpha in the human prostate. In addition, epidermal growth factor receptor (EGFr) immunoreactivity was assessed in each case. Stromal versus epithelial staining was determined for each histological subtype: benign prostatic hypertrophy (BPH), prostatic intra-epithelial neoplasia (PIN), and prostatic cancer (CaP) by a single pathologist reviewer. TGFa staining was predominant in stroma while EGFr was localized to the epithelial basal cell layer. Immunoreactivity of both TGFa (P = 0.002) and EGFr (P < 0.001) revealed a significant reduction in CaP compared to BPH or PIN. Autocrine stimulation of EGFr by TGFa or other unrecognized factors may be present in CaP. Conversely, altered stromal influence of CaP via TGFa may be present. These observations could form the basis for future cancer therapeutic strategies using antagonist factors.
Aged↗
Familial occurrence of multiple cutaneous chondromas.
True cutaneous chondromas are rare lesions with an uncertain pathogenesis. We report an unusual case of a patient with multiple cutaneous chondromas of the face. One of the patient's siblings, a brother, and that brother's son had similar facial lesions. We conclude that this familial pattern suggests an autosomal dominant mode of transmission.
Adult↗
Painful tumors of the skin.
BACKGROUND: Several cutaneous tumors are characteristically associated with considerable and sometimes incapacitating pain. OBJECTIVE: A review of the histologic features of these tumors, subjective characteristics of the pain, hypotheses proposed to explain the mechanism of pain production by the tumor, and treatments that have been effective in abolishing or relieving the patient's perception of the stimulus. METHODS: Review of case reports as well as studies that have proposed mechanisms of pain production based on histologic, electron microscopic, and pharmacologic studies. RESULTS: Several hypotheses may be equally valid in explaining the cause of pain of a single tumor type, while no apparent cause is found in other types of tumors. There is variability in the success of a treatment between patients. CONCLUSION: Our understanding of the mechanism of pain production by cutaneous tumors is limited by the small number of studies (and sample size) addressing the issue as well as by our incomplete general understanding of pain production.
Humans↗
DNA ploidy of basal cell carcinoma determined by image cytometry of fresh smears.
Image analysis of nuclear DNA content (DNA ploidy) was performed on smears of basal cell carcinoma (BCC) obtained during Mohs microscopically-controlled surgery from 51 tumors. DNA ploidy was compared with histologic growth pattern and the contour of the invading edge. There was a statistically significantly increased frequency of DNA aneuploidy in smears from BCC exhibiting partial or total diffuse (infiltrative and superficial multicentric) growth patterns (80%; 32 of 40) as compared to solely circumscribed growth patterns (0%; 0 of 11) (p < 0.001).
Aneuploidy↗
Variability in the Michelin tire syndrome. A child with multiple anomalies, smooth muscle hamartoma, and familial paracentric inversion of chromosome 7q.
We describe a 2 1/2-year-old boy who has hirsutism and ringed creases of the extremities associated with an underlying smooth muscle hamartoma. Cutaneous findings in this child resemble those in other reports of the "Michelin tire syndrome." Histologic examination showed numerous well-demarcated fascicles of smooth muscle cells randomly distributed at all levels of the reticular dermis with haphazard orientation. These cells were immunoreactive with desmin, which confirmed their smooth muscle nature. In addition to the skin changes, this child has multiple unusual phenotypic anomalies, some of which have not previously been associated with the Michelin tire syndrome. These include distinctive facial dysmorphia, submucous cleft palate, lateral clefting of the mouth, genital, and dental anomalies. He also developed seizures at age 2 1/2 years and has moderate developmental delay. The patient and his mother have apparently identical paracentric inversions of the long arm of chromosome 7 (46,XY,inv(7)(q22q31.3) with no detectable loss or gain of either chromosomal material or DNA markers from the cystic fibrosis (CFTR) region. The relevance, if any, of the karyotypic abnormality to the phenotype in this child is discussed.
Abnormalities, Multiple↗
Generalized papular xanthomatosis in mycosis fungoides.
Xanthomas can occur in association with underlying lymphoproliferative disease, or they can result from lipid deposition in damaged or altered skin. We report a case of generalized papular xanthomas that developed in a patient with Sézary syndrome. The xanthomas were composed of foamy histiocytes that were shown by immunoperoxidase staining to be of the monocyte/macrophage lineage. Electron microscopic studies revealed lipid vacuoles, lysosomes, and myelin figures but no Birbeck granules, features that are consistent with a non-X histiocytosis. Generalized papular xanthomatosis has not been previously described in a patient with cutaneous T-cell lymphoma.
Aged↗
DNA ploidy and proliferation index of soft tissue sarcomas determined by image cytometry of fresh frozen tissue.
The DNA content of Feulgen-stained monolayer imprint preparations from 30 fresh frozen soft tissue and bone sarcomas was analyzed using image cytometry. DNA aneuploidy showed a significant association with increasing tumor grade. Of the grade III tumors, 83.3% (15 of 18) were aneuploid; of the grade I and II sarcomas, 33.3% (4 of 12) were aneuploid (P less than 0.00861). The proliferation index (PI) was determined by the percentage of tumor nuclear area staining with the monoclonal antibody Ki-67. The PI was significantly associated with ploidy and tumor grade. Ki-67 PI was elevated (greater than 2.0%) in 73.7% (14 of 19) of the aneuploid tumors, compared with 30% (3 of 10) of the euploid tumors (P less than 0.04597). Ki-67 PI was greater than 2.0% in 77.8% (14 of 18) of the grade III tumors, compared with 27.2% (3 of 11) of the grade I and II tumors (P less than 0.01773). These findings suggest that DNA ploidy and Ki-67 PI as determined by image analysis may be a useful supplement to tumor grading. The literature examining previous studies of sarcoma DNA ploidy is reviewed.
Adolescent↗
Significance of DNA ploidy in cutaneous lesions.
BACKGROUND: With increasing numbers of studies examining tumor DNA content in many organ systems, accumulating evidence indicates that DNA ploidy analysis may be useful in diagnosis and determination of prognosis. OBSERVATIONS: A review of DNA ploidy studies of cutaneous lesions within the last decade reveals that DNA ploidy may aid in the diagnosis of some lesions. Several studies show an association of DNA ploidy with prognosis. In general, tumors with a diploid DNA content have a less aggressive course than aneuploid tumors. CONCLUSIONS: DNA ploidy cannot yet reliably predict the outcome of an individual patient. This is partially due to differences in methods of specimen preparation, instrumentation, and interpretation of data.
DNA, Neoplasm↗
Adenoid cystic carcinoma of the breast metastatic to the kidney. A clinically symptomatic lesion requiring surgical management.
Adenoid cystic carcinoma (ACC) of the breast is a rare histologic type of breast cancer associated with a good prognosis. A woman who earlier had a pulmonary metastasis surgically resected 6 years postmastectomy developed clinically symptomatic bleeding from a renal metastasis 12 years postmastectomy. An atypical angiographic picture (moderate vascularization) for secondary renal neoplasms was observed. The characteristic histologic features of ACC were present in all specimens; ultrastructural characteristics of ACC were identified in the renal lesion. Successful surgical management of these metachronous solitary metastases demonstrates the therapeutic utility of aggressive management in maintaining disease control of this histologic type of breast cancer.
Breast Neoplasms↗
Extravascular toxicity of two magnetic resonance contrast agents. Preliminary experience in the rat.
We compared the relative toxicities of standard concentrations of two magnetic resonance imaging (MRI) contrast agents, ionic gadolinium diethylenetriaminepentacetic acid (DTPA) and low-osmolar gadolinium-1, 4, 7 tris (carboxymethyl)-10-(2'-hydroxypropyl)-1, 4, 7, 10 tetra-azacyclododecane (HP-DO3A) with that of the conventional radiographic contrast medium meglumine diatrizoate, when extravasated into the deep dermal tissues of laboratory rats. Gadolinium-DTPA caused moderate necrosis, hemorrhage, and edema which was not statistically different than meglumine diatrizoate. In contrast, gadolinium HP-DO3A was significantly less toxic than meglumine diatrizoate. Additional experience will be needed in order to determine whether these laboratory results will be clinically relevant in humans.
Animals↗