Biomedical subjects

D R Mody

Publications and source records attributed to D R Mody.

25 records · Page 2Linked to original sources

PubMedDate not supplied

Glandular lesions of the cervix. Validity of cytologic criteria used to differentiate reactive changes, glandular intraepithelial lesions and adenocarcinoma.

OBJECTIVE: To determine the validity and reproducibility of various cytologic criteria as discriminators between different glandular lesions of the cervix. STUDY DESIGN: Seventy-three cervicovaginal smears with glandular lesions and a documented histologic and/ or clinical correlation were studied. The lesions included reactive changes, low grade glandular intraepithelial lesion (LGIL) (encompassing endocervical glandular dysplasia), high grade glandular intraepithelial lesion (HGIL) (encompassing adenocarcinoma in situ) and invasive adenocarcinoma (IA). Twenty-three cytologic criteria were used to evaluate the smears, and the results were scored and statistically analyzed. RESULTS: Reactive lesions consistently showed well-defined cell borders, normal nuclear/cytoplasmic (N/C) ratio, minimal or absent nuclear overlapping, round to oval nuclei with fine chromatin and prominent nucleoli. HGIL (adenocarcinoma in situ) showed feathered edges, rosettes, cell strips, increased N/C ratio, elongated nuclei, marked nuclear overlapping and nuclei with hyperchromatic, coarse chromatin. IA shared features with HGIL but had a greater tendency to show a dirty background, single cells, mitotic figures, nuclear pleomorphism and large nucleoli. Logistic regression studies indicated that the presence of mitotic figures, a dirty background and single cells increases the odds ratio for predicting invasion. LGIL showed features similar to those of high grade lesions, but the changes were more subtle. These lesions were also less cellular and less likely to show cell strips, feathered edges and rosettes. Similar to HGIL and IA, LGIL showed nuclear overlapping, increased N/C ratio, oval to elongated nuclei and nuclear hyperchromasia. CONCLUSION: There is overlap between the cytologic criteria for the various glandular lesions of the cervix. However, some of these criteria can consistently distinguish clinically significant lesions from reactive benign changes seen in the glandular epithelium.

Adenocarcinoma↗

PubMedDate not supplied

Ber-EP4 for differentiating adenocarcinoma from reactive and neoplastic mesothelial cells in serous effusions. Comparison with carcinoembryonic antigen, B72.3 and Leu-M1.

OBJECTIVE: To evaluate the efficacy of Ber-EP4 in distinguishing epithelial cells from mesothelial cells in routine cytologic preparations. STUDY DESIGN: Paraffin-embedded cell blocks of serous effusions from 32 patients (11 metastatic adenocarcinomas, 16 reactive mesothelial proliferations and 5 malignant mesotheliomas) were immunostained with Ber-EP4. For comparison, cell block preparations of adenocarcinomas and mesotheliomas were also immunostained with the most commonly applied markers of adenocarcinoma: carcinoembryonic antigen (CEA), B72.3 and Leu-M1. In addition, cytocentrifuge preparations of 14 reactive effusions and 2 metastatic adenocarcinomas were stained prospectively with Ber-EP4. RESULTS: All adenocarcinomas showed intense membrane staining, while all mesothelial proliferations, both benign and malignant, were negative. The Ber-EP4-positive immunostaining was remarkably clean, with very minimal nonspecific staining. CEA stained 11/11 adenocarcinomas, B72.3 stained 10/11, and Leu-M1 stained 8/11; mesotheliomas were negative with all three antibodies. CONCLUSION: Ber-EP4 is at least as useful as CEA, B72.3 and Leu-M1 in the diagnosis of serous effusions. It has the advantage of high sensitivity and ease of interpretation because of the high percentage of tumor cells stained, characteristic membranous staining and lack of cross-reaction with background inflammatory cells.

Adenocarcinoma↗

PubMedDate not supplied

"Osteoclastic" giant cell carcinoma of the pancreas. Report of a case with aspiration cytology.

BACKGROUND: Osteoclastic giant cell carcinoma (OGC) is an uncommon variant of ductal carcinoma of the pancreas. It is important to differentiate this variant from other giant cell pancreatic lesions, particularly the more aggressive pleomorphic giant cell carcinoma. CASE: Aspiration cytology was performed in a case of OGC. Aspirates of OGC demonstrated three populations of discohesive cells: (1) large, bizarre, pleomorphic malignant giant cells with high nuclear/cytoplasmic ratios, irregular nuclear membranes and coarse chromatin; (2) spindle or small mononucleate cells; and (3) bland, osteoclastlike epithelial giant cells with multiple small, round, central nuclei and prominent nucleoli. CONCLUSION: Multinucleate giant cells can be seen in pancreatic abscesses, fat necrosis, pseudocysts, tuberculosis, sarcoidosis and fungal infections. When the cells are associated with malignant epithelial cells, the differential diagnosis includes metastatic carcinoma, malignant melanoma, Hodgkin's disease, large cel anaplastic lymphoma, trophoblastic tumor, epithelioid sarcoma, malignant fibrous histiocytoma, angiosarcoma and rhabdomyosarcoma. Immunohistochemical stains, such as vimentin, S-100, leukocyte common antigen, human chorionic gonadotropin, Factor VII Ag, actin and desmin play an important role in differentiating between these lesions.

Aged↗

PubMedDate not supplied

Cytology of gastrointestinal histoplasmosis. A report of two cases with differential diagnosis and diagnostic pitfalls.

BACKGROUND: Gastrointestinal (GI) histoplasmosis is a rare manifestation of Histoplasma capsulatum (HC) infection. There are no reports of its cytologic diagnosis in the literature. CASES: A search of the cytology and surgical pathology files of the Methodist Hospital uncovered two cases of GI histoplasmosis and histiocytes within cytologic specimens. Papanicolaou-stained endoscopic brushings of an obstructing, apple-core, right colonic mass in a 58-year-old, heterosexual male revealed numerous vacuolated single cells interpreted as suspicious for signet ring cell carcinoma. The resected colon showed granulomatous inflammation with numerous histiocytes containing pale, oval yeasts of HC. The patient was subsequently found to be human immunodeficiency (HIV) positive; this was his first manifestation of the acquired immunodeficiency syndrome. The second patient was a 69-year-old, HIV-negative male with a fungating anal mass suspicious for squamous cell carcinoma. Direct smears showed oval histiocytes with intracellular yeasts of HC. CONCLUSION: Accurate diagnosis is crucial to patient management and therapy. Careful attention to the nuclear and cytoplasmic details of histiocytes and histiocytelike cells is important to avoid interpretive errors. Diagnostic pitfalls include signet ring cell adenocarcinoma, lymphoma, melanoma, goblet cell carcinoid, malakoplakia and such infections as mycobacteria, Entamoeba histolytica and Calymmatobacterium granulomatis. Ancillary studies, such as microbiologic cultures and immunohistochemical and histochemical staining, can be performed in the appropriate clinical setting.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Alpha-mannosidosis. Report of a case with morphologic, cytologic and immunohistochemical considerations.

We report the histopathologic features of the knee bone and synovium and the cytologic features of the synovial fluid from a patient with alpha-mannosidosis. The synovium showed marked papillary hyperplasia with infiltration of foamy histiocytes containing periodic acid-Schiff-positive, diastase-resistant material. Severe degenerative changes were seen in the knee bone. The synovial fluid showed increased numbers of macrophages containing periodic acid-Schiff-positive, diastase-resistant material. The differential diagnostic considerations in the synovial fluid are also discussed.

Adult↗

PubMedDate not supplied

Ploidy studies by image analysis on fine needle aspirates of the breast.

Quantitative DNA analysis was performed on preoperative fine needle aspirates of 12 breast cancers and 1 benign lesion using the Cell Analysis Systems (CAS) Model 200 image analysis system. The smears were prepared on CAS slides, routinely processed for Papanicolaou staining, and then destained and restained with Feulgen stain after cytologic evaluation. Four cases were DNA diploid, 3 were tetraploid, 1 was diploid/tetraploid, and 5 were aneuploid. When compared to analysis of samples from the resected tumor, both DNA index and S-phase fraction were constant.

Biopsy, Needle↗

PubMedDate not supplied

GLUT1 expression in human breast carcinoma: correlation with known prognostic markers.

BACKGROUND: Breast cancers have been shown to have increased glucose uptake and utilization, and to express the facilitative glucose transporter Glut1. The aim of this study was to determine the biological significance of Glut1 expression in breast cancer. METHODS: Paraffin sections of 118 breast cancers were immunostained with antibody to Glut1. The percent of Glut1-positive cancer cells in each tumor was correlated with known prognostic markers, and with patient outcome. RESULTS: Glut1 was expressed in 42% of the tumors. Glut1 immunoreactivity correlated positively with the proliferative activity as determined by Ki-67 immunostaining, and with the total histologic score, and showed negative correlation with bcl-2 immunostaining. There was no correlation between the percent of Glut1-immunoreactive cancer cells and estrogen receptor status, tumor size, or lymph node status. CONCLUSIONS: 1) Glut1 expression is increased in breast cancers with higher grade and proliferative activity, and 2) glucose transport in the majority of breast cancers may be mediated by a glucose transporters other than Glut1.

Breast Neoplasms↗