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Biomedical subjects

A N Walker

Publications and source records attributed to A N Walker.

At least 37 records · Page 2Linked to original sources
PubMed1986

Acral mucinous syringometaplasia. A benign cutaneous lesion associated with verrucous hyperplasia.

We describe herein a case of acral mucinous syringometaplasia that presented clinically as a verruca plantaris. Microscopically, verrucous hyperplasia of the epidermis and central, dilated eccrine ducts lined by a mixture of squamous and goblet cells were present. Mucinous syringometaplasia is a benign entity that should be distinguished from other mucin-containing cutaneous lesions.

Adult↗
PubMed1985

Discrepant fibrinogen values during thrombolytic therapy. Comparison of aca and Data-Fi results using immunofixation. Electrophoresis as a reference.

The authors compared aca and Data-Fi fibrinogen values and used a combination of plasma protein electrophoresis and immunofixation with anti-fibrinogen anti-serum to observe changes in fibrinogen from four patients receiving streptokinase (STK) therapy. For three patients, aca and Data-Fi values pre-STK and greater than or equal to 24 hours post-STK correlated well (r = 0.96, slope = 0.92, y-intercept = 2.3; n = 13 pairs); aca and Data-Fi values during STK therapy correlated poorly (r = 0.67, slope = 0.36, y-intercept = 4.1; n = 20 pairs), with aca values up to sixfold higher than Data-Fi. Protein electrophoresis and immunofixation showed loss of the discrete fibrinogen band during STK therapy; instead there was a diffuse electrophoretic zone of anti-fibrinogen reactive material having a slightly different mobility than intact fibrinogen; aca fibrinogen values were inconsistent with fibrinogen band absence. The remaining patient showed no change in the fibrinogen band. Clinically he showed no response to STK therapy. In nonresistant patients, STK results in the degradation of fibrinogen into a mixture of products (FDP), all sharing antigenic determinants with fibrinogen and at least one being still clottable. Our results exemplify loss of intact fibrinogen with persisting anti-fibrinogen reactive FDP during STK therapy. Discrepancies in aca versus Data-Fi results may be due to ways in which FDP interact with different methods--fibrometer versus turbidimetric.

Adult↗
PubMed1984

Glandular inclusions in inguinal hernial sacs and spermatic cords. Müllerian-like remnants confused with functional reproductive structures.

Small, glandular inclusions are present in approximately 6% of hernial sacs from prepubertal males. Identical structures may be present in the spermatic cord. Histologically, these are composed of ciliated, low columnar epithelium with eosinophilic cytoplasm and basal nuclei. A mantle of fibrous tissue surrounds each gland-like structure. These epithelial inclusions may be confused with reproductive ducts of functional importance; however, specific histologic features allow ready distinction. The origin of these structures is uncertain, but it is most probable that they are remnants of Müllerian ducts.

Adolescent↗
PubMed1984

Retrorectal cystic hamartoma. Report of three cases, including one with a perirenal component.

Retrorectal cystic hamartomas (RCHs) are uncommon lesions of controversial pathogenesis that arise in the presacrococcygeal space. We describe the clinicopathologic features of RCHs from three adult patients. Two were asymptomatic women; the third was a man who had a pelvic abscess. All three specimens were multiloculated cysts lined by squamous, transitional, and glandular epithelium. Poorly organized collections of smooth muscle were present in the surrounding connective tissue, but no well-formed smooth-muscle coat was seen. Although RCHs possess elements of three germ-cell layers, their histologic features are similar to those of the embryonic tailgut. The male patient also had a perirenal mass that was grossly and histologically identical to the RCH. The associated kidney was malrotated. A portion of the embryonic tailgut may have been pulled cephalad by the developing kidney, inhibiting its rotation. Clinicopathologic features distinguish RCH from other retrorectal cystic lesions, including teratoma, dermoid, epidermal cyst, rectal duplication, anal duplication, and anal gland cyst.

Adolescent↗
PubMed1983

Ascending myeloencephalopathy due to intrathecal vincristine sulfate. A fatal chemotherapeutic error.

A case of fatal myeloencephalopathy secondary to accidental intrathecal administration of vincristine is reported in a 16-year-old boy. He underwent a progressive ascending chemical meningoencephalitis leading to coma, and died 36 days after the injection. Multiple samples of cerebrospinal fluid (CSF) and serum were assayed for vincristine sulfate. CSF levels of vincristine were consistently much higher than serum levels. At autopsy, all regions of the brain that had been in direct contact with the CSF were necrotic. The spinal cord was likewise necrotic throughout its length. Microscopically there was total neuronal loss with tissue destruction in the affected regions. The presence of numerous gemistocytic astrocytes, some in arrested mitosis, was a conspicuous feature in these areas. Three previous reports of intrathecal vincristine instillation are reviewed. No treatment for this devastating iatrogenic error exists, underscoring the importance of preventive measures in chemotherapy administration.

Adolescent↗
PubMed1983

Epithelial polyps of the prostatic urethra. A light-microscopic and immunohistochemical study.

Epithelial polyps of the prostatic urethra are an uncommon and histologically heterogeneous group of lesions. We review the clinical and histologic features of a series of seven such polyps. Six were composed of prostatic-type epithelium. In five instances the epithelium was entirely histologically identical to that of normal prostate. One case contained foci of stratified, mitotically active cells, suggesting adenomatous transformation. All six stained intensely for both prostatic acid phosphatase and prostatic specific antigen. The seventh polyp was cytologically different. It was composed of flattened to cuboidal cells that did not stain for either antigen. All patients were treated by transurethral excision, and none of the six with follow-up developed a recurrence.

Acid Phosphatase↗
PubMed1983

Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients.

A computerised, retrospective study of 818 patients with sarcoidosis was analysed to study the prognosis of each individual manifestation of the disease. The good prognosis of erythema nodosum, acute arthritis and bilateral hilar lymphadenopathy was confirmed, though 16 per cent of patients presenting with erythema nodosum pursued a chronic course. Cor pulmonale and nephrocalcinosis reflected the poorest prognosis while lupus pernio and sarcoidosis of the mucosa of the upper respiratory tract rarely resolved. Bone sarcoidosis also implied chronicity but in four of 31 patients there was no clinical evidence of disease activity two years after the initial diagnosis, although naturally the bone radiograph was still abnormal. Hepatomegaly carried a worse prognosis than splenomegaly, or indeed, than the finding of pulmonary mottling without hilar glands--a stage three chest radiograph.

Adult↗
PubMed1982

Atypical carcinoid tumor of the lung. A clinicopathologic study of 17 cases.

We describe 17 atypical carcinoid tumors of the lung that are histologically intermediate between small-cell undifferentiated carcinoma and typical carcinoid tumor. Atypical carcinoid tumors have a distinctive microscopic pattern of nests, trabeculae, and ribbons of intermediate-sized, moderately pleomorphic cells that lack the nuclear molding and dense hyperchromasia of small-cell undifferentiated carcinoma. Mucin was present in 15 cases and nine contained argyrophilic granules. The three primary tumors and one metastasis studied ultrastructurally contained dense-core granules and variable degrees of squamous and glandular differentiation. Eleven patients were men; six were women. Their mean age was 58 years. Sixteen patients were known smokers. Twelve tumors involved the upper lobes and three were located in the right middle lobe. Mean tumor size was 4.9 cm (median 4; range 2.5--20). Four of 13 patients having potentially curative resection died of tumor. The other nine patients were disease free with a mean follow-up of 20 months. Four additional patients treated palliatively died.

Adult↗
PubMed1982

'Endometrial' adenocarcinoma of the prostatic urethra arising in a villous polyp. A light microscopic and immunoperoxidase study.

A 77-year-old man had a papillary neoplasm of the prostatic urethra removed by transurethral resection. Light microscopically, much of the tissue consisted of a benign villous polyp lined by prostatic epithelium. An adenocarcinoma with cells that resembled those of uterine endometrial carcinoma was also present within the villous polyp. Using immunoperoxidase techniques, prostatic acid phosphatase and prostatic-specific antigen were localized in the epithelial cells of both the villous polyp and the adenocarcinoma. To our knowledge, this is the first reported case of adenocarcinoma arising in a urethral polyp. The immunohistochemical findings and the close association of the adenocarcinoma with the prostatic epithelium of the villous polyp provided evidence that so-called endometrial carcinoma of the prostatic utricle is of prostatic epithelial origin rather than müllerian derivation.

Acid Phosphatase↗