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Biomedical subjects

A Talerman

Publications and source records attributed to A Talerman.

At least 55 records · Page 3Linked to original sources
PubMed1987

Alpha-lactalbumin in "common" epithelial tumors of the ovary. An immunohistochemical study.

Alpha-lactalbumin (AL) has been widely used as an immunohistochemical marker for mammary carcinoma. The authors have investigated the AL reactivity of 36 unselected ovarian epithelial neoplasms using the avidin-biotin-peroxidase immunoperoxidase technic. In eight serous cystadenocarcinomas, both the primary neoplasm and its metastases were examined. Of the 36 tumors, 7 (19.4%) showed positive staining for AL and 5 were of the serous type. The serous tumors showed moderate to strong staining reaction. Three serous cystadenocarcinomas were AL positive in both primary and metastatic sites, while the remaining five were negative in all sites. One mucinous cystadenoma and one clear cell carcinoma showed weak to moderately positive AL reactivity. There was no good correlation between AL positivity and the presence of malignancy or between AL positivity and tumor grade. In view of the relatively high AL reactivity in ovarian neoplasms, it is advisable to exercise caution in interpreting the presence of AL positivity as specific marker for mammary carcinoma.

Carcinoma↗
PubMed1987

Gonadal endodermal sinus (yolk sac) tumor with pure intestinal differentiation: a new histologic type.

We studied 3 cases of a variant of endodermal sinus tumor (EST) or yolk sac tumor (YST). Two tumors originated in the ovary and one in the testis. The patients had very high levels of serum alpha-fetoprotein (AFP). All three tumors had a characteristic histologic appearance and were composed of acinar structures lined by columnar epithelium with large, immature nuclei. Immunohistochemistry and electron microscopy, including freeze-fracture studies, confirmed that this unusual tumor is one with exclusive intestinal differentiation. We feel that this unique tumor is a pure EST (YST) with exclusive intestinal differentiation.

Adult↗
PubMed1987

Testicular tumors other than germ cell tumors.

A heterogeneous group of neoplasms other than those of germ cell type may involve the testis. These tumors vary greatly in their histologic appearances and biologic behavior, and accurate pathologic interpretation is essential to patient care. This review of these various neoplasms emphasizes pathologic aspects, particularly problems in differential diagnosis that may arise.

Cysts↗
PubMed1987

Lipid cell tumor of the ovary in reference to adult-onset congenital adrenal hyperplasia and polycystic ovary syndrome. A case report.

A 30-year-old woman with a virilizing lipid tumor was initially suspected of having adult-onset congenital adrenal hyperplasia (CAH) when her plasma 17-hydroxyprogesterone (17OHP) concentration was found to be very high (298-3,170 ng/dL), to drop in response to an overnight dexamethasone (dex) suppression test (79 ng/dL) and to rise briskly 15 minutes after ACTH administration (751 ng/dL). However, the effect of dex was not sustained or complete: the pregnanetriol excretion dropped only from 5.5 to 4.4 mg daily. Furthermore, the plasma testosterone was inappropriately high (235-537 ng/dL) for adult-onset CAH and was more responsive to endogenous and exogenous gonadotropin stimulation than to ACTH. In addition, there was no evidence of 11 beta-hydroxylation of 21-deoxycorticoids, as would be expected in CAH. Removal of the tumor completely reversed the virilization and the abnormal responses to ACTH and human chorionic gonadotropin. The contralateral ovary bore lipid-laden stromal cells in the deep paracortex that bore a striking resemblance to the tumor cells, and a cyst in that ovary had fluid with a steroid pattern virtually identical to that of the tumor, with an androstenedione: 17OHP ratio of 5:1. There was not evidence of polycystic ovary disease. The clinical picture of type II polycystic ovary syndrome (PCOS) gradually evolved over a one-year period postoperatively: plasma-free testosterone became mildly elevated and was not dex suppressible. The 17OHP response to ACTH became slightly excessive. However, there was no evidence of tumor on computed tomography.(ABSTRACT TRUNCATED AT 250 WORDS)

17-alpha-Hydroxyprogesterone↗
PubMed1987

Pseudosarcoma botyroides in pregnancy: report of a case with ultrastructural observations.

A case of pseudosarcoma botryoides of the vagina diagnosed in advanced pregnancy is described. The cellular characteristics (atypical cells and abnormal mitoses) suggested malignancy, but ultrastructural studies demonstrated the fibroblastic nature of the cells, thus confirming the diagnosis of pseudosarcoma. Local excision and subsequent cesarean section was the method of treatment. Three years later, another pregnancy was terminated by repeat cesarean section and uncontrollable hemorrhage requiring emergency hysterectomy. The histologic study of the bleeding area revealed very edematous areas and lacunaelike endothelium-lined vessels. No cellular abnormalities were observed.

Adult↗
PubMed1986

Primary mucinous carcinoid tumor of the ovary.

A case of primary mucinous carcinoid tumor of the ovary occurring in a 37-year-old woman is described. The tumor, which replaced the left ovary, was accompanied by metastases in the contralateral ovary and para-aortic lymph nodes. Careful investigations excluded metastatic origin of the tumor. The tumor was solid, but contained an epidermoid cyst. There were no other teratomatous elements. The patient was treated with combination chemotherapy. A second-look operation 9 months following diagnosis revealed extensive microscopic involvement of the peritoneal cavity. The patient's condition deteriorated and she died 1 year after diagnosis. Detailed autopsy revealed peritoneal, pleural, lymphatic, and bone marrow carcinomatosis, but no evidence of a primary tumor elsewhere. Microscopic, ultrastructural, and immunocytochemical findings are described. It is considered that primary mucinous carcinoid tumor of the ovary represents a specific histopathologic entity. Unlike other types of primary ovarian carcinoid tumors, it behaves as an aggressive malignant neoplasm.

Adult↗
PubMed1986

Morphometric data to FIGO stage and histological type and grade for prognosis of ovarian tumours.

The prognostic value of using histological typing, grading, and morphology, in addition to clinical staging, was assessed in 98 cases of invasive ovarian cancer of the common epithelial types (serous, mucinous, and endometrial). All of these cases had at least five years of follow up. When regression analysis was used, the International Federation of Gynaecology and Obstetrics' (FIGO) staging system was the best indicator for prognosis. Analysis of a combination of morphometric features was the second best indicator, being especially useful for the those patients with stage I disease. Variables that indicated a relatively poor prognostic outcome were mitotic index above 30; volume percentage epithelium above 65%; shortest nuclear axis above a mean of 1 X 1 micrometers. Histological typing of ovarian tumours was of limited value; mucinous tumours have a somewhat better prognosis than serous tumours, but the prognostic value of typing alone was found to be limited. Qualitative histological grading was useful, but the prognostic value of morphometric grading was better. Measurement of morphological features with an interactive computer program is simple and can be done by a pathologist or a technician: in future it is likely that such automated systems of measurement will improve the objectivity of tissue analysis.

Cell Nucleus↗
PubMed1986

Grading ovarian tumors. Evaluation of decision making by different pathologists.

Although grading of ovarian tumors is widely performed, the criteria for each grade are not well defined; as a result, pathologists tend to establish their own criteria without, however, assessing the actual predictive value of the criteria. In order to investigate this relationship, four gynecologic pathologists independently reviewed and carefully graded as benign, borderline or malignant (grade I, II or III) 40 "common" epithelial tumors of the ovary, without reference to clinical, prognostic or other findings. Intermediate grades were allowed. Subsequently, a subjective grading form was completed for each case; the form contained questions regarding the histologic and cytologic features. The sets of features with the biggest correlation with the tumor grades differed among the pathologists. This may indicate that the observers use different features in their grading processes. Moreover, the pathologist with the highest number (five) of significant microscopic features in the multivariate model had the lowest coefficient of correlation between his tumor grade and his feature set. The correlation coefficients for the other pathologists were quite similar, although the features used (no more than two or three) varied. The participants in the study felt that the methodologic approach had an educational value for them. Further investigations are required to evaluate whether the differences in the underlying decision making process also result in frank disagreement in ovarian tumor grading.

Carcinoma↗
PubMed1986

Interpathologist and intrapathologist disagreement in ovarian tumor grading and typing.

In order to evaluate possible differences in the typing and grading of ovarian tumors, four different gynecologic pathologists independently evaluated slides from 198 patients. Histologic typing was done using the WHO recommendations, and the tumors were graded as benign, borderline or malignant (well, moderately or poorly differentiated). All of the slides were assessed twice by each pathologist (with approximately a 12-month time interval) in a "blind" fashion (i.e., without any knowledge about stage, treatment and clinical outcome). In addition to assessing interobserver agreement, the intraobserver consistency was evaluated by comparing the first and second assessments of the same pathologist. Histologic grading showed the best correlation between observers' results; however, the level of agreement was low. Complete agreement was rare, both in the first and second assessments (18.7% and 32.8%, respectively). Complete disagreement was rare, but occurred, both in the first and second assessments. Agreement in histologic typing was rather good after panel discussions; further analysis of the data revealed that the lack of agreement could not be attributed to any one of the pathologists in particular. The intraobserver agreement in grading and typing the same tumor differed. The number of cases with more than one grade difference between the first and second assessments varied from 0.5% to 3.2% between the different pathologists. Complete consistency was also varied: 87%, 78%, 64% and 62%. Histologic typing in general was less consistent, although some pathologists were better than others. The results indicate the need for objective criteria for grading ovarian tumors.

Carcinoma↗
PubMed1985

Anterior mediastinal endodermal sinus (yolk sac) tumor in a female infant.

The first known case of primary anterior mediastinal endodermal sinus (yolk sac) tumor in a female patient, occurring in a 20-month-old infant, is reported. The child presented with cough, fever, and listlessness. Chest x-ray revealed a right anterior mediastinal mass. At thoracotomy a large anterior mediastinal tumor extending from the neck to the diaphragm was found, and was almost totally resected. Microscopically, the tumor displayed many of the histologic patterns observed in EST. Other neoplastic germ cell elements were not identified. The ultrastructural and immunohistochemical findings further confirmed the diagnosis. Serum alpha-fetoprotein (AFP) level, determined during surgery, was elevated to 65,200 ng/ml, whereas serum beta-human chorionic gonadotropin level was normal. Postoperatively, combination chemotherapy consisting of vinblastine, bleomycin, cisplatin, dactinomycin, cyclophosphamide, and doxorubicin was administered with a maintenance program. After 18 weeks on this regimen all the findings were normal, including serum AFP level. The child is well and disease-free 25 months after diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Diffuse malignant peritoneal mesothelioma in a 13-year-old girl. Report of a case and review of the literature.

A case of diffuse malignant peritoneal mesothelioma in a 13-year-old girl is described. The patient had a short history of abdominal pain, distention, and tenderness. At laparotomy she was found to have ascites and numerous nodules and plaques affecting the peritoneal cavity and the omentum. A diagnosis of diffuse pseudotumoral deciduosis was made, which on review was revised to malignant peritoneal mesothelioma. The patient's condition gradually deteriorated and she died 8 months after diagnosis in spite of administration of combination chemotherapy.

Adipose Tissue↗
PubMed1985

Cellular differentiation in ovarian sex-cord-stromal and germ-cell tumors studied with antibodies to intermediate-filament proteins.

Seventy ovarian sex-cord-stromal and germ-cell tumors were immunohistochemically studied for the presence of intermediate-filament proteins of different types used as markers for cellular differentiation. Cells of ovarian granulosa-cell tumors constantly expressed vimentin and appeared to lack cytokeratin. Two tumors previously classified as granulosa-cell tumors were reclassified as poorly differentiated "common" epithelial tumors based on their cytokeratin positivity, vimentin negativity, and morphologic features. Dysgerminomas and Leydig-cell tumors showed only vimentin positivity. Tubular structures in androblastomas, which are considered to represent Sertoli-cell differentiation, were cytokeratin positive, and thus differed from the majority of normal Sertoli cells that are known to express vimentin and not cytokeratin. Embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors showed cytokeratin positivity in the neoplastic cells whereas vimentin was observed in the stromal cells. In immature teratomas, epithelial differentiation was demonstrated with cytokeratin antibodies, and neural and glial differentiation was also frequently demonstrated by immunostaining with antibodies to neurofilaments and glial fibrillary acidic protein. The results show that antibodies to intermediate filaments can be used in the differential diagnosis between ovarian epithelial and nonepithelial tumors, and they provide a very accurate additional method to characterize the cellular differentiation of ovarian neoplasms.

Animals↗
PubMed1985

Ultrastructural features of primary trabecular carcinoid tumor of the ovary.

A case of primary trabecular carcinoid tumor of the ovary in a 48-year-old woman is reported. Histologically the tumor showed typical appearances associated with this neoplasm and was composed of long ramifying and anastomosing cords, ribbons, and trabeculae made up of uniform epithelial cells surrounded by connective tissue stroma. Occasional cells showed orange and red-brown granules in the cytoplasm. A number of cells were argyrophil-positive and occasional cells showed argentaffin positivity. The trabecular carcinoid was associated with mature cystic teratoma (dermoid cyst). Ultrastructurally the trabecular carcinoid was composed of light and dark cells with poorly formed basal lamina. Both types of cell contained membrane-bound neurosecretory granules which were round or oval, varied in size, but uniform in shape. The histological appearances of the tumor and of the neurosecretory granules distinguish trabecular carcinoid from other types of carcinoid tumors of the ovary and other ovarian neoplasms.

Carcinoid Tumor↗
PubMed1985

Intermediate filament proteins in human testis and testicular germ-cell tumors.

Normal testicular tissue and 76 testicular germ-cell tumors of various types were immunohistochemically evaluated for the expression of intermediate filament proteins of different types. In normal testes, the rete testis epithelium was positive to cytokeratin, and the Sertoli cells, stromal cells, and Leydig cells were positive for vimentin. Cytokeratin-positive cells were also found lining atrophic seminiferous tubules and were occasionally seen within nonatrophic seminiferous tubules. The classical seminomas showed vimentin positivity, but this was usually observed in a small number of tumor cells. In addition, nearly half the seminomas contained single cytokeratin-positive cells, some of which were multinucleated and appeared to represent syncytiotrophoblastic giant cells. The tumor cells in embryonal carcinomas, endodermal sinus tumors, and choriocarcinomas displayed cytokeratin positivity. In some embryonal carcinomas vimentin-positive tumor cells were also found, probably representing attempts at further differentiation of the tumor cells. In immature teratomas, both the immature and the mature epithelial structures showed cytokeratin positivity. The stromal components, including cartilage, contained vimentin, and the smooth-muscle elements, desmin. Neural tissue positive for neurofilaments and glial tissue positive for glial fibrillary acidic protein, were observed in 5 and 3 of 15 cases, respectively. It is considered that antibodies to intermediate filaments are suitable tools to characterize the differentiation patterns of testicular germ-cell tumors and have the potential to aid in the differential diagnosis especially between seminoma and embryonal carcinoma.

Antibodies, Monoclonal↗
PubMed1985

Germ cell tumours.

Germ cell tumours form an important group of gonadal neoplasms and are also found in a number of extragonadal sites like the mediastinum, para-pineal and sacrococcygeal regions and retroperitoneum. Although there are considerable differences between germ cell tumours occurring in different anatomical locations they exhibit a remarkable homology, and are considered as a group. In this review germ cell tumours are discussed as a group emphasizing some of the recent developments in this field. In the testis germ cell tumours form the most common group of neoplasms comprising 90% of all testicular tumours and 99% of them are malignant. In the ovary germ cell tumours comprise approximately 20% of ovarian neoplasms, and more than 90% are mature cystic teratomas and are benign. Malignant testicular neoplasms are 10 times more common than their ovarian and 20 times more common than their extragonadal counterparts. Malignant germ cell tumours have a specific age incidence and occur mainly in children and young adults. Due to this they represent one of the most important groups of neoplasms in this age group. Testicular germ cell tumours show marked racial and geographical differences occurring much more frequently in Western Europe, especially in Scandinavia, as compared with Southern and Eastern Europe. They are rare in Africa and are very uncommon in Blacks as compared to Whites. These remarkable differences are not observed in ovarian or extragonadal germ cell tumours. It is now accepted that histogenetically all the tumours in this group are of germ cell origin, and that germ cell tumours are capable of somatic (embryonal) and extra-embryonal differentiation (fig. 1). The occurrence of extragonadal germ cell tumours in anatomical locations in the midline of the body is explained on the basis of migration of the primitive germ cells during embryonic life from the wall of the yolk sac to the primitive gonad. An all embracing classification of germ cell neoplasms based on the WHO classifications of ovarian and testicular tumours is presented. The importance of careful and thorough examination of germ cell tumours is emphasized, especially in view of the recent advances in the therapy of malignant germ cell neoplasms. The value of tumour markers like alphafoetoprotein (AFP) and human chorionic gonadotropin (HCG) produced by endodermal sinus tumour (EST) and some embryonal carcinomas and choriocarcinoma and syncytiotrophoblastic giant cells respectively in diagnosis, monitoring the progress of the disease, and the efficacy of therapy, as well, as for early detection of metastases and recurrences, is strongly emphasized.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

Pure granulosa cell tumour of the testis. Report of a case and review of the literature.

A case of pure granulosa cell tumour of the testis is described. To the author's knowledge this is the 5th documented case reported in the literature. The patient, a normal 44-year-old male noted a gradual right-sided testicular enlargement for a few months. There was no clinical evidence of gynaecomastia or any endocrinological abnormalities. Orchidectomy was performed and the testis was found to contain a soft yellow, well-circumscribed tumour which microscopically showed the typical appearance of a pure granulosa cell tumour. The patient was well and disease free 3 years after diagnosis. The literature concerning this entity is reviewed and discussed.

Adult↗