Search PubMed⌕ Search

Biomedical subjects

B M Wenig

Publications and source records attributed to B M Wenig.

71 records · Page 4Linked to original sources
PubMed1994

Epithelioid angiosarcoma of the adrenal glands. A clinicopathologic study of nine cases with a discussion of the implications of finding "epithelial-specific" markers.

Adrenal epithelioid angiosarcomas (AEA) are rare neoplasms. We report the clinicopathologic features of nine cases of AEA. AEA occurred most frequently in the sixth and seventh decades of life (age range, 45-85 years; median, 60); five cases occurred in men and four in women. Presenting symptoms included abdominal mass with or without pain, weight loss, fever, and weakness. Two cases were asymptomatic; one was discovered during evaluation for other disease(s) and the other at autopsy. All neoplasms were nonfunctioning. Radiographic evaluation demonstrated suprarenal or retroperitoneal neoplasms ranging in size from 6 to 10 cm in greatest dimension. Histologically, the neoplasms were invasive, predominantly arranged in solid sheets or nests, and composed of epithelioid cells. Endothelial cell differentiation was suggested by the transition areas between dilated anastomotic vascular spaces and the sheet-like growth, the cytomorphologic similarity between the endothelial cells lining the discernible vascular spaces and those seen in the solid foci, and the presence of intracytoplasmic vacuolization occasionally containing red blood cells. Endothelial derivation was confirmed by immunohistochemistry including Factor VIII-related antigen (FVIII), CD-34 (hematopoetic progenitor cell antigen), and/or Ulex europaeus agglutinin-1 lectin immunoreactivity (UEA-1) and by ultrastructural findings, including rod-shaped microtubulated bodies and intracytoplasmic lumen formation. In addition, cytokeratin reactivity was seen in seven cases, and B72.3 (tumor-associated glycoprotein-72) reactivity was seen in six. Surgical resection was the treatment of choice, occasionally supplemented by chemotherapy. Three patients are presently alive, free of disease, at 13, 11, and 6 years following diagnosis. Three died with metastatic AEA of the lung, and three died of unrelated causes.

Adrenal Gland Neoplasms↗
PubMed1993

Effects of plume produced by the Nd:YAG laser and electrocautery on the respiratory system.

Sprague-Dawley rats were exposed to Nd:YAG laser exhaust (contact and noncontact) as well as to electrocautery exhaust passed through smoke evacuation filters. Exposure periods for each group were equal and increasing in time. Histologic analysis revealed alveolar congestion and emphysematous changes in all modes. Controls exhibited similar change but to a milder degree. It appears that any plume produced by lasers or electrosurgical devices produces pathologic change in rat lungs and that effective smoke evacuation will help control these effects.

Aluminum Silicates↗
PubMed1993

Extranodal sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) of the head and neck.

We report 14 cases of extranodal sinus histiocytosis with massive lymphadenopathy involving a variety of head and neck sites. The patients ranged in age from 3 to 70 years (median, 43 years). Nine cases occurred in women and five occurred in men. The clinical presentation varied depending on the site of occurrence and included nasal obstruction, stridor, proptosis, ptosis, decreased visual acuity, facial pain or tenderness, cranial nerve deficits, mandibular tenderness, and mass lesions. Head and neck sites involved by disease included the nasal cavity, paranasal sinuses, nasopharynx, parotid gland, submandibular gland, larynx, temporal bone, infratemporal fossa, pterygoid fossa, meninges, and orbital region. The majority of patients presented with involvement of more than one site. Nodal involvement was identified in four patients. Special stains for microorganisms were negative. The sinus histiocytosis with massive lymphadenopathy cells demonstrated an immunophenotypic profile supporting derivation from macrophage/histiocytic lineage. Treatment varied and included surgical excision with or without adjuvant therapy (chemotherapy, radiotherapy) or steroids. Several patients required more extensive surgery as a result of extension of their disease to adjacent structures or due to recurrent disease. Twelve patients are alive and either free of disease or have persistent disease. Two patients died, one as a result of complications of disease.

Adolescent↗
PubMed1992

Mycosis fungoides of the larynx. Report of two cases and review of the literature.

Involvement of the larynx by mycosis fungoides is extremely rare with only three reported clinical cases in the English-language literature. We present two patients with laryngeal mycosis fungoides, one of whom presented with vocal cord paresis (progressing to paralysis) as the initial clinical manifestation of laryngeal involvement. Our clinical findings and the observations from the three previous case reports suggest that laryngeal mycosis fungoides has a predilection for the arytenoids, aryepiglottic folds, and the laryngeal surface of the epiglottis. Laryngeal involvement, like other forms of visceral dissemination, appears to manifest clinically in the terminal stages of the disease. The natural history, clinical features, histopathology, and treatment of mycosis fungoides are reviewed and the etiopathology of the vocal cord paralysis is described.

Aged↗
PubMed1992

Metastasizing mixed tumor of salivary glands. A clinicopathologic and flow cytometric analysis.

Among salivary gland neoplasms are a group of rare tumors that are histologically identical to benign mixed tumors that inexplicably metastasize; they have been called metastasizing mixed tumor (MZMT) of salivary glands. We report the clinicopathologic features and flow cytometric findings for 11 cases of MZMT. At the time of discovery of metastatic disease, the patients, six women and five men, ranged in age from 20 to 83 years. Primary sites of involvement included the parotid gland (eight cases), submandibular gland (two cases), and the nasal septum (one case). With one exception, all the patients had at least a single recurrences of their primary mixed tumor, but two or more recurrences were the norm before development of metastatic foci. The metastases were discovered from six to 52 years following the occurrence of the primary tumor. Metastatic deposits were identified in bone, lung, regional lymph nodes, skin, kidney, retroperitoneum, oral cavity, pharynx, calvarium, and central nervous system. The metastases either occurred simultaneously with an episode of recurrent mixed tumor (n = 5) or from 5 to 29 years after a recurrence (n = 6). The treatment of the primary, recurrent, and metastatic neoplasms was surgical excision. Follow-up, ranging from 8 months to 16 years following the diagnosis of MZMT, revealed seven patients to be alive without disease (64%) and two dead of causes unrelated to metastatic disease (18%). Two patients (18%) died as a direct result of metastatic tumor at 3 and 2 years after metastasis of their mixed tumors. Flow cytometric analysis revealed a diploid DNA cell population in the primary and/or metastatic tumors in nine cases. Aneuploid DNA cell content was identified in two of the cases. DNA ploidy levels and cell proliferation rates were compared with those of conventional benign mixed tumors and also with malignant mixed tumors. Retrospective analysis of histologic parameters (mitotic rate, cellular pleomorphism, infiltrative growth, vascular or lymphatic invasion) and flow cytometric analysis failed to identify criteria to predict the development of metastasis in these neoplasms.

Actins↗
PubMed1991

Primary adenocarcinoma of the nasal cavity and paranasal sinuses.

Eight cases of primary adenocarcinoma of the nasal cavity associated with wood dust exposure are reported. The patients include seven men and one woman between the ages of 31 and 81 years. All the patients had a history of wood dust exposure. Carpentry was the occupation in four patients; inspector for railroad boxcars in one; teacher in a wood-work shop in another and worker in a desk factory in the other. The only female patient was a school teacher whose husband had a wood-work shop at home. Clinically, epistaxis and/or nasal obstruction were the most common symptoms. The histology of the tumors varied and consisted of well differentiated adenocarcinoma, clear cell adenocarcinoma, papillary-mucinous adenocarcinoma, and "colonic-type" adenocarcinoma. Follow-up data showed that three patients were alive of whom two had either recurrent or metastatic disease at one and three years following the initial diagnosis, respectively. The third patient was alive and well four years after initial diagnosis. Three other patients died but a direct cause of death was not identified. The remaining two patients were lost to follow-up.

Adenocarcinoma↗
PubMed1990

Leiomyosarcoma of the sinonasal tract. A clinicopathologic study of nine cases.

The clinicopathologic features of nine cases of sinonasal tract leiomyosarcoma (SNTL) referred to the Armed Forces Institute of Pathology, Washington, DC, during the period from 1970 through 1988 are described. This report represents the largest study to date on SNTL, and our results are compared with the 21 previously reported cases of SNTL. Of the nine cases described, patients ranged in age from 22 to 86 years (mean, 55 years). The most frequent clinical presentation was nasal obstruction unilaterally. The neoplasms were limited solely to the nasal cavity in four cases (44%) and involved both the nasal cavity and paranasal sinuses in the remaining five cases. Light microscopic, immunocytochemical, and ultrastructural features served to characterize these tumors as malignant neoplasms of smooth-muscle origin. In contrast with previous studies, immunocytochemistry was employed to differentiate SNTL from other spindle cell malignancies of the region, using newly available monoclonal antibodies to smooth-muscle antigens. Treatment was surgical. Radiotherapy or chemotherapy did not appear to affect the progression of the disease. Furthermore, no relationship was found between the aggressiveness of SNTL and morphologic parameters (eg, mitotic count and tumor size). Instead, prognosis was dependent on the distribution of disease at presentation. Of all 30 patients with SNTL described to date, 10 had the neoplasm confined solely to the nasal cavity. The 10 neoplasms did not recur. We conclude that SNTL may best be regarded as a locally aggressive neoplasm with only limited metastatic potential and that it could be curable by complete surgical excision.

Adult↗
PubMed1990

Teflonomas of the larynx and neck.

Intracordal fluorocarbon (Teflon, Mentor O and O Inc, Norwell, MA) injection has been used for decades to correct paralytic dysphonia, a result of unilateral laryngeal paralysis. Infrequently, the Teflon extravasates and infiltrates into the soft tissues of the neck and larynx producing a mass that clinically simulates a malignant lesion. We report eight cases of so-called "Telonomas" of the larynx and neck that have been identified in the files of the Armed Forces Institute of Pathology Otolaryngic Tumor Registry and from the Cytopathology Service at the George Washington University Medical Center. Patients ranged in age from 31 to 72 years. Vocal cord paralysis, treated by Teflon injection, was caused by primary laryngeal carcinoma or metastatic carcinoma (breast, lung) involving the recurrent laryngeal nerve, surgical trauma to the recurrent laryngeal nerve, or postviral neuritis. Subsequent symptomatology, related to extravasation of the Teflon with a resulting "Teflonoma", included a neck mass or persistent hoarseness. Infrequently, there was associated airway obstruction or voice changes. Diagnosis was made by fine needle aspiration or by excision of the suspicious mass and subsequent identification of a foreign body granulomatous reaction with associated birefringent material. Infrared absorption spectrophotometry identified the foreign material as a fluorocarbon which was further substantiated by scanning electron microscopy and energy dispersive x-ray analysis. Surgical removal of the mass alleviated all symptoms.

Adult↗
PubMed1990

Laryngeal and hypopharyngeal liposarcoma. A clinicopathologic study of 10 cases with a comparison to soft-tissue counterparts.

We report the clinicopathologic findings of 10 cases of primary laryngeal and hypopharyngeal liposarcoma. The tumors occurred in patients ranging in age from 37 to 77 years. They showed a marked male to female predominance of 9 to 1. The tumors, which occurred exclusively in the supraglottic larynx or hypopharynx (pyriform sinus), caused airway obstruction; this was the most common presenting symptom. All of the cases were well-differentiated liposarcomas (grade I). Atypical cells, scattered lipoblasts, and infiltration differentiated malignant laryngeal fatty tumors from benign ones. To date, none of these tumors has metastasized; however, multiple recurrences are common. Surgery is the treatment of choice; radiotherapy should be decided on an individual basis.

Adult↗
PubMed1990

Contact ulcers of the larynx. A reacquaintance with the pathology of an often underdiagnosed entity.

We reviewed the histologic features of 105 cases of contact ulcers of the larynx. Despite its characteristic clinical findings and correlative histopathology, the appropriate diagnosis was suggested in only one case. Instead, a descriptive diagnosis was most often rendered. Lesions for which this entity has been mistaken include pyogenic granuloma, hemangioma, hemangiopericytoma, Kaposi's sarcoma, angiosarcoma, spindle cell carcinoma, and granulomatous infectious diseases. Inappropriate diagnosis or failure to recognize the pathologic features of these lesions as correlating to a specific disease state deprives the patient of curative, well-established therapeutic procedures. We describe the histologic spectrum of contact ulcer of the larynx as well as its clinical findings, thereby familiarizing pathologists to an entity well recognized by otolaryngologists.

Adult↗
PubMed1990

Pathologic manifestations of acquired immunodeficiency syndrome in the head and neck.

Various diseases of the head and neck that appear in association with AIDS have been delineated. These diseases may be the initial manifestations of AIDS or may be part of systemic involvement following HIV infection. Both clinicians and pathologists must be aware of the protean manifestations of AIDS in order to establish an accurate and complete diagnosis. Once the diagnosis is established, therapy, which may potentially enhance the quality of life of the infected individual, can be initiated.

AIDS-Related Complex↗
PubMed1989

Polymorphous low-grade adenocarcinoma of seromucous glands of the nasopharynx. A report of a case and a discussion of the morphologic and immunohistochemical features.

Polymorphous low-grade adenocarcinoma (PLGA) is a minor salivary gland neoplasm that is characterized by morphologic variability, cytologic uniformity, and an infiltrating growth pattern. To date, this entity has been identified either within the confines of the oral cavity or, rarely, in the nasal cavity. The authors report a case of PLGA that arose in the nasopharynx of a 44-year-old female, representing the first documented occurrence of this tumor outside the oral cavity or the sinonasal tract. The histopathologic and immunohistochemical differentiation from pleomorphic adenoma and adenoid cystic carcinoma is discussed.

Adenocarcinoma↗
PubMed1989

The spectrum of neuroendocrine carcinomas of the larynx.

The purpose of this review is to delineate the spectrum of neuroendocrine (NE) carcinomas of the larynx, thereby highlighting the histologic criteria differentiating these lesions. The importance of the histologic type impacts on and correlates with appropriate treatment modalities, and ultimately reflects on prognosis. A morphologically based classification scheme that incorporates both the histology and biology of each subtype is recommended. In this way, a more standardized nomenclature for these NE tumors is suggested, especially for NE carcinomas previously designed as atypical, pleomorphic, or malignant carcinoids. The distinction between laryngeal NE carcinomas (LNEC) and other malignant proliferations may be difficult when based solely on the morphologic appearance. An analysis incorporating clinical, histochemical, immunocytochemical, and ultrastructural parameters of the NE carcinomas as well as similar appearing lesions is detailed.

Adenocarcinoma↗
PubMed1988

Moderately differentiated neuroendocrine carcinoma of the larynx. A clinicopathologic study of 54 cases.

Fifty-four cases of primary laryngeal moderately differentiated neuroendocrine carcinoma from the Armed Forces Institute of Pathology Otolaryngic Tumor Registry (AFIP-OTR) are reported. The tumors most often present in men in their sixth and seventh decades of life and are heralded by an array of symptoms, the most frequent being hoarseness. The primary site was most often the supraglottic larynx. The investigation has included light-microscopic, histochemical, immunocytochemical, and electron microscopic analyses which support expression of both neuroendocrine and epithelial differentiation. Conservative surgery alone can be utilized if early identification of the tumor and complete surgical removal are assured. The follow-up of the patients reveals 62% as remaining tumor-free after surgical extirpation over periods ranging from 1 month to 16 years (median: 3 years, 9 months). Factors adversely affecting prognosis include metastatic disease at initial presentation, incomplete surgical removal, and vascular or lymphatic invasion. There was no correlation between tumor size, morphologic pattern, mitoses or necrosis, and survival. Sixty-eight percent of the patients gave a history of long-term cigarette smoking. The classification and pathogenesis of these neoplasms remains the focus of much speculation. They are suggested as arising from the cells of the dispersed neuroendocrine system (DNES). However, a more uniform and descriptive nomenclature is necessary. This study resolves this and other issues along with a presentation of clinicopathologic data of the tumor entity.

Adult↗
PubMed1988

Nasopharyngeal papillary adenocarcinoma. A clinicopathologic study of a low-grade carcinoma.

We present the clinicopathologic features of nine cases of a primary nasopharyngeal (NP) papillary adenocarcinoma. Patients ranged in age from 11 to 64 years (median, 37). The ratio of male to female patients was 5:4. They most frequently presented with airway obstruction. Histomorphologic evaluation showed an invasive carcinoma with papillary and glandular features. The tumor displayed transition from normal surface epithelium to neoplasm. Cytologically it was composed of moderately pleomorphic, columnar, and pseudostratified cells with eosinophilic cytoplasm. The nuclei were round to oval and had vesicular or optically clear chromatin. Histochemical analysis confirmed production of epithelial mucin. Immunohistochemical study demonstrated diffuse keratin and epithelial membrane antigen reactivity and focal carcinoembryonic antigen reactivity. No immunoreactivity was seen with S-100 protein, glial fibrillary acidic protein, or thyroglobulin. Taken together, these findings indicate derivation from the nasopharyngeal surface epithelium and help to differentiate these tumors from seromucous gland lesions and metastatic papillary thyroid carcinoma. The biologic potential was that of a low-grade malignant tumor. Simple and complete surgical excision was the treatment of choice. All patients are presently alive and well, free of recurrent or metastatic tumor (median follow-up, 6 years, 9 months).

Adenocarcinoma, Papillary↗