Myocardial lesions following open heart surgery.
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Biomedical subjects
Publications and source records attributed to D E Henson.
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The results of expressing patient outcome are compared using two staging systems: localized, regional, and distant (LRD) and the TNM of the American Joint Committee on Cancer (AJCC). Expressing patient outcome depends on the staging system used. There is overlap between the stage definitions of the LRD and the TNM. A single stage in the LRD may include more than one stage grouping of the TNM and vice versa. For most sites, "localized" provides lower survival rates than stage I of the TNM. The TNM provides more precise information about prognosis because its definitions reflect the latest survival information and diagnostic technology. Time trends can be measured only with the LRD because of its stability over the years. The precision of the TNM has been achieved at the expense of time trend analysis. The LRD is usually not an acceptable end point for the assessment of early cancer detection.
The advantages and disadvantages of the different methods for calculating survival according to the TNM (Topography, Lymph Node, and Metastasis) are described. Methods include the observed, relative, and conditional survival rates. For large cohorts, relative survival calculated by the life table method is most useful. Conditional survival, which requires long-term follow-up, is clinically the most informative. In addition, follow-up methods employed by tumor registries are considered.
A national task force consisting of members from the American College of Radiology, the American College of Surgeons, and the College of American Pathologists examined the issues surrounding stereotactic core-needle biopsy for occult breast lesions. Their report includes indications and contraindications, informed consent, specimen handling, and management of indeterminate, atypical, or discordant lesions.
The clinico-pathologic features of six cases of chronic cholecystitis with focal lymphoid hyperplasia (CCLH) are described and compared with five examples of malignant lymphoma involving the gallbladder. The clinical presentation of CCLH was identical to that of conventional chronic cholecystitis with cholelithiasis. Microscopically there was chronic inflammation and fibrosis in the wall of the gallbladder as well as extensive lymphoid hyperplasia with many lymphoid follicles having germinal centers. The five patients with malignant lymphoma also had chronic cholecystitis; four had a previous diagnosis of lymphoma established by a lymph node biopsy and were also found to have liver involvement during cholecystectomy. The gallbladders with malignant lymphoma showed acute and chronic cholecystitis and a monotonous lymphoid proliferation easily distinguishable from CCLH. We conclude that CCLH displays characteristic pathologic features and should be separated from the chronic and xanthogranulomatous types of cholecystitis.
Bile aspirated from 374 gallbladders immediately after they were excised for cholelithiasis or cholecystitis was examined cytologically. Smears from 250 cases were considered adequate for cytologic analysis, and the findings were correlated with the histologic diagnosis. Poor correlation was obtained with hyperplasia (28%) and dysplasia (25%). In contrast, cytohistologic correlation was good for cases of carcinoma in situ (four of six cases) and invasive carcinoma (seven of seven cases). Several reasons are given for the discordance between cytologic and histologic diagnosis of hyperplasia and dysplasia. The experience gained in this study may serve in the preoperative identification of these cancer precursors in high-risk patients.
Prostate cancer is becoming an increasing health concern world wide, and its significance is also increasing in Hungary, where mortality rates are very similar to those in the United States of America. Mortality from prostate cancer is increasing disproportionately to the aging of Hungarian men or overall population growth, and the explanation for this alarming trend is as yet unexplained. Nevertheless, the data suggest that prostate cancer will continue to assume increasing importance as a medical problem and the need for fundamental epidemiologic investigations is clear.