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Biomedical subjects

A N Walker

Publications and source records attributed to A N Walker.

54 records · Page 3Linked to original sources
PubMed1982

Papillary carcinoma arising from ectopic breast tissue in an axillary lymph node.

A cystic carcinoma was located in an axillary lymph node of a 90-year-old woman. The lymph node also contained cytologically benign mammary ducts and a few small glands that had epithelium cytologically intermediate between the normal epithelium and the neoplastic cells. In a subsequent mastectomy specimen, a small intraductal papillary carcinoma was found, differing cytologically and architectonically from the nodal carcinoma. The nodal carcinoma is considered primary because of its morphologic differences from the mammary lesion, the in situ nature of the mammary tumor, and the transition of benign to atypical epithelium in the nodal inclusions. The occurrence of two tumors is viewed as a field effect.

Aged↗
PubMed1982

A reappraisal of limited-stage undifferentiated carcinoma of the lung. Does stage I small cell undifferentiated carcinoma exist?

Patients with small cell undifferentiated carcinoma of the lung (SCUC) have a poor prognosis. Surgical excision is avoided if the diagnosis can be made with small biopsy specimens or cytologic preparations. We reviewed 323 consecutive patients with pulmonary neoplasms diagnosed as SCUC, oat cel carcinoma, and undifferentiated or poorly differentiated carcinoma. At the time of diagnosis, only 18 patients had neoplasms classified as clinical Stage I, and only one of these had SCUC after histologic review. Fifteen patients had atypical carcinoid, a tumor with features intermediate between ordinary bronchial carcinoid and SCUC. In two instances, there was insufficient tissue for definitive diagnosis. Cumulative survival of the 15 patients with Stage I atypical carcinoid tumor was 80% at 1 year and 60% at most recent follow-up (mean follow-up 20 months). Mean survival for the 305 remaining patients was 7.9 months. Atypical carcinoid may be misdiagnosed as SCUC or poorly differentiated carcinoma, particularly with limited tissue samples or cytologic preparations. Stage I SCUC exists but is exceedingly rare. Many examples of purported Stage I SCUC probably represent atypical carcinoid. Because atypical carcinoid has a far better prognosis than SCUC, precise diagnosis is important and surgical resection should be considered.

Carcinoma, Small Cell↗
PubMed1982

Serous papillary carcinoma of the endometrium. A clinicopathologic study of 11 cases.

We review 11 cases of serous papillary endometrial carcinoma (SPEC) that are histologically identical to serous ovarian carcinoma. Six patients (55%) had extrauterine involvement at the time of presentation; five of these six died secondary to malignancy and one died of other causes. The remaining five patients presented with tumor confined to the uterine corpus and cervix. One of these developed a vaginal recurrence, one died of other causes without evidence of tumor, and three are alive without disease at 15 months, 18 months, and 13 years. SPEC is a biologically aggressive variant of endometrial carcinoma because it often presents at an advanced clinical stage with an associated high mortality rate.

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PubMed1982

Amyloid tumor of the breast.

A 55-year-old woman had a solitary mammary amyloid tumor without evidence of a systemic, amyloid-related illness. The tumor produced a palpable, firm mass suspicious for carcinoma. Microscopically, amyloid was found in a periductal and perivascular location. It was seen in the fat as well. A prominent giant cell reaction and chronic inflammatory infiltrate were present.

Amyloid↗
PubMedDate not supplied

Morphologic and biochemical studies of chitin expression in Pneumocystis carinii.

Tomato lectin, which binds oligosaccharides of N-acetyl-D-glucosamine, and an antiserum against macromolecular chitin were used to probe sections of human and murine lungs infected with Pneumocystis carinii. By light, fluorescence and electron microscopy, lectin and antiserum binding patterns indicated that both human and murine strains of P. carinii express chitin at all identifiable stages of their life cycles. Light microscopic autoradiographs of murine P. carinii cultured in vitro with 3H-glucosamine revealed dense incorporation of the radiolabel into the cell walls in a pattern analogous to those of the antiserum and lectin binding studies. These investigations offer further evidence that chitin is an integral part of the cell wall of P. carinii trophozoites and cysts.

Animals↗
PubMedDate not supplied

Fine needle aspiration of thoracic extramedullary hematopoiesis.

Thoracic manifestations of extramedullary hematopoiesis (EMH) are well known clinically, radiologically and pathologically; it is generally confirmed histologically by open biopsy or postmortem examination. We report a case of EMH diagnosed by percutaneous fine needle aspiration (FNA) in a patient with long-standing, acquired, sideroblastic anemia. The aspirate was very cellular and composed of normal bone marrow elements with an erythroid to myeloid cell ratio of 3 to 1. Megakaryocytes were abundant but constituted less than 1% of the total cell population. This case illustrates that the diagnosis of EMH is possible by FNA and that thoracotomy for diagnostic purposes can be circumvented.

Biopsy, Needle↗
PubMedDate not supplied

Diagnosis of Legionella micdadei pneumonia from cytologic specimens.

Legionella micdadei is a recently described opportunistic pulmonary pathogen that produces an acute, suppurative pneumonia in patients receiving steroid therapy. Most prospective diagnoses have been made by open lung biopsy. We present a case in which the diagnosis was made from cytologic material. The clinicopathologic features of L. micdadei pneumonia are discussed, and criteria for diagnosis from cytologic specimens are presented.

Biopsy↗
PubMedDate not supplied

Fine needle aspiration under percutaneous transhepatic cholangiographic guidance.

Fine needle aspiration (FNA) is a rapid diagnostic technique accompanied by minimal patient morbidity and providing access to deep visceral lesions. We report three cases of obstructive jaundice secondary to malignancy in which FNA was performed at the time of percutaneous transhepatic cholangiogram. After the cholangiogram was performed and the obstructive lesion identified, a drainage catheter was inserted for decompression of the biliary tree. Using the drainage tube as a guide, multiple FNAs of the area of obstruction were done. In case 1 an area adjacent to the common bile duct was aspirated and diagnosed as adenocarcinoma of undetermined origin. FNA of a liver mass in case 2 revealed poorly differentiated squamous carcinoma consistent with a previous uterine cervix biopsy. Both of these patients were discharged for outpatient treatment following the procedure. In case 3 FNA diagnostic of adenocarcinoma was obtained from an intra- and extrahepatic mass. This patient underwent exploratory laparotomy for possible resection; adenocarcinoma of the head of the pancreas was found. For patients with advanced malignancies, minimizing inpatient hospital time is an important goal. In cases of obstructive jaundice secondary to malignancy, the combined techniques of percutaneous cholangiogram, biliary tree compression and FNA provide both diagnosis and palliation, with minimal morbidity and inpatient care.

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