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Biomedical subjects

D J Grignon

Publications and source records attributed to D J Grignon.

At least 127 records · Page 7Linked to original sources
PubMed1990

Merkel cell carcinoma metastatic to the testis.

Tumor metastases to the testes are rare and are usually found incidentally at autopsy or after orchiectomy for prostatic carcinoma. It is even more unusual for testicular metastases to be clinically detected or symptomatic. The authors report two cases of clinically detected testicular metastases from Merkel cell carcinoma of the skin. Merkel cell carcinoma metastatic to the testes has not been reported previously. The two tumors, to some degree, resembled testicular lymphomas and the interstitial type of seminoma.

Aged↗
PubMed1990

Adult Wilms' tumor: a clinicopathologic study of 11 cases.

Wilms' tumor, one of the most common solid tumors in children, may also arise in the kidney of adults. We report here eleven cases seen in patients greater than 18 yr of age at The University of Texas M. D. Anderson Cancer Center, Houston. There were eight males and three females with ages ranging from 21 to 67 yr with a mean of 32 yr. Gross hematuria and/or an abdominal mass were the most common clinical presentations. The patients presented at a later stage than is typical of children (45% with stages III and IV disease), and eight of ten patients (80%) with adequate follow-up died of disease between 12 and 69 mo (mean, 30 mo; median, 25 mo), despite combined treatment with surgery, chemotherapy, and/or irradiation. Pathologically, a classic triphasic pattern was seen in seven cases and a biphasic pattern in four. None of the tumors showed features of anaplasia. Large tumor size and a high mitotic rate were associated with a poor prognosis. In contrast to cases in children, persistent renal blastema was not found in any of our cases, suggesting that the purported histogenesis of these tumors in childhood may not hold true in adults.

Adult↗
PubMed1990

Angiomyolipoma of kidney with lymph node involvement. DNA flow cytometric analysis.

We performed DNA flow-cytometric analysis in three cases of angiomyolipoma of the kidney with lymph node involvement. The primary tumors of the kidneys and tumors in the lymph nodes of all patients contained diploid DNA. All three patients have been monitored for longer than 1 year and have no evidence of recurrence or metastasis. The lack of aneuploidy in both the kidney and the lymph nodes in our patients, although not excluding malignant neoplasia, supports the benign and multifocal nature of this lesion. Larger studies with long-term follow-up are reported to confirm this conclusion.

DNA, Neoplasm↗
PubMed1990

Histologic parameters and DNA ploidy as predictors of survival in stage B adenocarcinoma of colon and rectum.

Stage B adenocarcinomas of colon (61 carcinomas) and rectum (44 carcinomas) were retrospectively reviewed in order to define prognostic indicators and to determine if they are different for tumors arising at the two sites. Parameters evaluated included the substage of the tumor, histologic grade, presence of vascular/lymphatic invasion, residual adenoma or extracellular mucin, and tumor cell DNA content as determined by flow cytometry of paraffin-embedded tissues. Five-year survival was 81.0% for patients with colonic and 87.5% for those with rectal tumors. DNA ploidy was a significant predictor of overall and disease-free survival in patients with rectal adenocarcinomas (improved survival for those with diploid tumors) but not in those with colonic tumors and not in the two groups combined. The degree of differentiation of the tumor was prognostically significant in the colonic group and for the groups combined but not in the rectal group. There was a trend toward better survival in substage B1 tumors, as compared with substages B2 and B3, particularly in rectal neoplasms. Other histologic parameters did not predict survival. We conclude that the prognostic indicators in colonic adenocarcinoma seem to differ from those of adenocarcinoma arising in the rectum and that DNA ploidy has a significant impact upon outcome in stage B rectal adenocarcinomas.

Adenocarcinoma↗
PubMed1989

Renal cell carcinoma. A clinicopathologic and DNA flow cytometric analysis of 103 cases.

Renal cell carcinoma is unpredictable in outcome, although the best predictor is tumor stage, followed by histologic grade. The authors retrospectively assessed the clinicopathologic features and DNA ploidy of 103 cases of renal cell carcinoma, the latter determined by flow cytometry of formalin-fixed, paraffin-embedded tissue. The study group comprised 63 men and 40 women (age, 28-80 years; mean, 57 years). Robson stage at diagnosis was Stage I in 52 patients, Stage II in 21, and Stage III in 30. Statistically significant variables in predicting outcome were Robson stage (P less than 0.0001), DNA ploidy (P = 0.0008), mitotic rate (MR, P less than 0.0001), worst nuclear grade (WNG, P = 0.00009), predominant nuclear grade (P = 0.019), and sex (P = 0.044). Tumor size, cell type, and architectural pattern were also assessed but did not prove to be significant. Statistically significant associations occurred between DNA ploidy and WNG (P less than 0.0001), stage (P = 0.0037), and MR (P = 0.015); between WNG and MR (P less than 0.0001) and stage (P = 0.0007); and between stage and MR (P = 0.002). Cox proportional hazards regression analysis of all significant variables showed Robson stage, tumor ploidy, and MR to be independent, significant predictors of outcome. If ploidy data had not been available, WNG would have been independently significant. The authors conclude that DNA ploidy analysis provides significant predictive information on renal cell carcinoma.

Adult↗
PubMed1989

DNA flow cytometry as a predictor of outcome of stage I renal cell carcinoma.

The features most frequently used in predicting the outcome of renal cell carcinoma are stage at presentation and nuclear grade. Recently DNA ploidy pattern, as detected by DNA flow cytometry has also been shown to be predictive. In this study DNA flow cytometry was performed on formalin-fixed paraffin-embedded tissue from 50 patients with Stage I renal cell carcinoma for whom long-term follow-up data were available. Two were eliminated for technical reasons. Of the 48 evaluable tumors, 25 (52%) were diploid, 19 (40%) were nondiploid, and in four, (8%) the ploidy was uncertain. The ploidy pattern was statistically significantly associated with nuclear grade (P less than 0.02), and primary tumor size (P less than 0.05) but did not correlate with cell type, microscopic growth pattern, or the presence or absence of mitotic activity. In the group as a whole, ten patients (21%) died of renal cell carcinoma, seven of 19 (37%) with nondiploid tumor patterns, and two of 25 (8%) with a diploid pattern (P less than 0.03). One of four patients (25%) with tumors of uncertain ploidy also died. However, only two factors, nuclear grade and primary tumor size, were independent predictors of outcome. For Stage I renal cell carcinoma, ploidy can significantly predict patient outcome and correlates with nuclear grade and tumor size, but is not an independent predictive variable.

Carcinoma, Renal Cell↗
PubMed1989

Malignant melanoma with metastasis to adenocarcinoma of the prostate.

Tumor-to-tumor metastases are uncommon despite the fact that the presence of two or more malignancies in a single patient is not a rare occurrence. The most frequent donor tumors are the lung, prostate, and thyroid gland, whereas renal cell carcinoma is by far the most common recipient. In this report we describe a patient dying of metastatic malignant melanoma and locally advanced prostate cancer in which the melanoma metastasized to the prostatic adenocarcinoma. The prostatic primary was well differentiated and stained positively with prostate-specific antigen and prostatic acid phosphatase, whereas the melanoma contained abundant melanin pigment and stained positively for S-100 protein. This is the second reported instance of prostatic carcinoma as the recipient in a case of tumor-to-tumor metastases and the first in the English language literature.

Adenocarcinoma↗
PubMed1989

Role of nuclear grading in stage I renal cell carcinoma.

Through a retrospective histologic analysis of 55 cases of Stage I renal cell carcinoma, we evaluated the usefulness of the nuclear grading system (Fuhrman, Lasky, Limas) in identifying those tumors that will eventually metastasize and kill the patient. The difference in five-year survival rates between patients with combined nuclear grade 1-3 tumors (n = 50, 91%) and grade 4 tumors (n = 5, 9%) was significant (P less than 0.0046). Other predictors of death due to renal cell carcinoma included: tumor size greater than 8 cm (P less than 0.001) and mitoses greater than one per 10 high-power field (P less than 0.01). Within Stage I tumors, therefore, nuclear grade is an important morphologic variable for predicting long-term survival. Identification of nuclear grade 4 neoplasms may become prognostically indispensable to determine the metastatic potential of early-stage tumors and thereby to institute appropriate systemic therapy.

Adult↗
PubMed1989

Deoxyribonucleic acid flow cytometry on primary adenocarcinoma of the bladder: an analysis of 36 cases.

Deoxyribonucleic acid flow cytometry was applied retrospectively to 36 primary pure adenocarcinomas of the bladder, stages A through D. Six tumors were enteric, 3 mucinous, 11 signet ring, 3 papillary, 5 unspecified and 8 mixed. Eight tumors were urachal in origin and 28 were nonurachal. The deoxyribonucleic acid pattern was diploid in 12 cases, aneuploid in 19, tetraploid in 3 and uncertain in 2. Nineteen patients died of disease after a mean of 27.4 months, 7 were well at a mean of 73.9 months, 8 had died of an unrelated cause and 1 was alive with metastatic disease. Ploidy pattern did not correlate with tumor stage, histological pattern or type of outcome: 6 of 12 patients with diploid and 12 of 22 with nondiploid tumors died of disease. However, if the tumor was urachal 1 of 4 patients with a diploid pattern died of disease, while 3 of 4 with an aneuploid pattern either died or were alive with disease. Our data suggest that deoxyribonucleic acid ploidy pattern apparently is not a significant predictor of outcome for primary adenocarcinoma of the bladder except possibly when the origin is urachal.

Adenocarcinoma↗
PubMed1989

Regeneration of the canine urinary bladder mucosa after complete surgical denudation.

To study the site of origin of epithelial regeneration in the urinary bladder after surgical denudation, we completely obliterated the bladder mucosa in 17 dogs, using the neodymium: YAG laser. Bladder-mapping studies showed that the regenerating cells arose from the epithelium of the terminal ureters and urethra. Experimental construction of isolated bladder pouches confirmed these findings and demonstrated that urine flow was not essential for reepithelialization. These results are relevant to the treatment of patients with multifocal carcinoma in situ of the bladder. Although the entire bladder can be denuded successfully, the studies demonstrate that the procedure might fail if the sources of epithelial regrowth, the distal ureters and urethra, contain untreated carcinoma in situ.

Animals↗
PubMed1989

Collagenous spherulosis of the breast. Immunohistochemical and ultrastructural studies.

Collagenous spherulosis of the breast is a recently described benign breast lesion that has previously been seen only incidentally. The authors report two cases of this lesion studied by immunohistochemistry and electron microscopy and a third case studied by light microscopy alone. The results demonstrate the participation of two cell types in the process: myoepithelial cells, which stained positively for cytokeratin, S-100 protein, and muscle-specific actin and contained intermediate filaments with dense bodies, pinocytotic vesicles, and formed cell junctions; and epithelial cells, which reacted for cytokeratin but not for S-100 protein or muscle-specific actin and contained intracytoplasmic lumina, formed lumina with microvilli, and desmosomes. Material constituting the spherules stained intensely for type IV collagen, and its ultrastructure was similar to that of basement-membrane material. The authors conclude that collagenous spherulosis results from a proliferation of epithelial and myoepithelial cells, the latter of which produce basement-membrane material.

Actins↗
PubMed1989

Basal cell carcinoma with hyaline inclusions.

A 67-year-old woman had a basal cell carcinoma of the forehead containing numerous hyaline cytoplasmic inclusions. Electron microscopic studies revealed that these inclusions were aggregates of cytoplasmic filaments. Immunohistochemical studies demonstrated reactivity for keratin, vimentin, and smooth-muscle myosin in these structures. Because of potential diagnostic difficulties, the pathologist should be aware of this unusual form of basal cell carcinoma.

Aged↗
PubMed1989

The prostatic capsule: does it exist? Its importance in the staging and treatment of prostatic carcinoma.

Pathologic evaluation of tumor extent in a radical prostatectomy specimen for prostatic adenocarcinoma is extremely important in staging and planning further therapy. We studied whole-organ sections of 50 prostate glands, obtained at either radical prostatectomy for adenocarcinoma or cystoprostatectomy for bladder cancer, to evaluate the so-called capsule of the prostate, the prostatic apex, and the surgical margins. The outer surface of the prostatic portion of the specimen was totally inked with different colors for the anterior, posterior, left, and right areas. Cross sections were processed for histologic examination, and the apex (distal 1.5 cm) was amputated and radially sectioned (like a cervical cone). We found that the "capsule" is made up of a band of concentrically placed fibromuscular tissue that is an inseparable component of the prostatic stroma. The outer surface of this tissue gives rise to a few bundles of fibromuscular stroma that penetrate and disappear into the periprostatic connective tissue stroma. The apex is sparse in glandular elements, particularly in the anterior portion, and the outer fibromuscular layer is no longer present. Thus we conclude that the prostate does not have a true capsule, but only an outer fibromuscular band.

Humans↗
PubMed1989

Extra-adrenal myelolipoma.

Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world literature. We report a series of three cases, all occurring in women in an age range of 68 to 83 years (mean, 77 years). One patient presented with a pelvic mass while the other two cases were incidental findings at autopsy. All lesions were presacral in location, encapsulated, and not attached to adjacent structures. Sizes ranged from 6 to 12 cm in greatest dimension and from 72 to 330 g. Color was a variegated yellow to red-brown. Microscopically, all were composed of mature fat and focal collections of normal hematopoietic elements. The nature of these lesions is not known but most authors favor a choristomatous origin. They must be distinguished from extramedullary hematopoietic tumors seen in patients with severe anemias, myeloproliferative disorders, and skeletal disease.

Aged↗
PubMed1988

Primary rhabdomyosarcoma of the kidney. A light microscopic, immunohistochemical, and electron microscopic study.

Primary rhabdomyosarcoma of the kidney is a rare and highly aggressive tumor in the adult population. A case is reported in a 70-year-old woman with the diagnosis confirmed by immunohistochemistry and electron microscopy. This is the first case studied using the immunoperoxidase technique and the second with electron microscopic examination. To make a diagnosis of primary sarcoma, of the kidney, three criteria must be met: (1) a metastatic sarcoma must be ruled out; (2) the tumor must arise from renal parenchyma; and (3) a sarcomatoid variant of renal cell carcinoma needs to be excluded. The literature is reviewed and available clinical and pathologic details are summarized.

Aged↗
PubMed1988

Intraluminal crystalloids in whole-organ sections of prostate.

Demonstration of intraluminal crystalloids and mucin can aid in the diagnosis of prostatic adenocarcinoma. Crystalloids have been reported in 10% to 23% of prostatic adenocarcinomas. This incidence may not be accurate, however, because previous studies were based on specimens obtained by transurethral resection or transrectal biopsy. This study was based on the examination of 54 prostates (9 obtained from radical prostatectomies for prostate cancer and 45 from cystoprostatectomies for bladder carcinoma) processed by a whole-organ section method. Crystalloids were found in all nine prostatic carcinomas from radical prostatectomy specimens. Thirty-one of 45 specimens from cystoprostatectomies had single or multiple foci of adenocarcinoma; of these, 20 cases (64.5%) had crystalloids. Numbers of crystalloids varied not only from case to case but also from area to area within the same case. Crystalloids were occasionally identified in benign and dysplastic glands that were adjacent to areas of carcinoma. Cases without prostatic carcinoma and benign or dysplastic glands distant from areas of carcinoma did not contain crystalloids. Twenty-four prostatic adenocarcinomas had intraluminal mucin; mucin was not found in benign glands. In conclusion we found the incidence of crystalloids to be higher than that reported in previous studies, a difference we believe is because of sampling. We confirm previous observations that intraluminal crystalloids and mucin are helpful in diagnosing prostate adenocarcinoma.

Adenocarcinoma↗