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Biomedical subjects

E B Helwig

Publications and source records attributed to E B Helwig.

At least 37 records · Page 2Linked to original sources
PubMed1986

Atypical fibroxanthoma of the skin with metastasis.

Cutaneous atypical fibroxanthoma (AFX) occurs in elderly persons as a small nodule or ulcernodule in actinically damaged skin of the head and neck area. The vast majority of AFX behave in a benign manner, and metastasis is rare. Eight examples of metastasizing AFX are reported. Factors that portend aggressive behavior and metastasis are vascular invasion, recurrence, deep tissue invasion, tumor necrosis and, possibly, defective or depressed host resistance. The metastasizing primary AFX were located on the head, and the metastasis involved the structures in the region of the parotid gland.

Adult↗
PubMed1986

Paget's disease of the ectopic breast with an underlying intraductal carcinoma: report of a case.

Paget's disease may occur at mammary and extramammary sites. Mammary Paget's disease typically involves the nipple and adjacent skin. Almost all such cases are associated with an underlying ductal carcinoma of the breast. A case of Paget's disease occurring at the site of an ectopic breast adjacent to a supernumerary nipple and associated with an underlying intraductal carcinoma is described. A search of the literature revealed no previous report of such cases. Detailed clinical history and histopathologic, histochemical, and follow-up information on this case are presented. The literature on mammary and extramammary Paget's disease is reviewed.

Biopsy↗
PubMed1985

Angiolymphoid hyperplasia with eosinophilia. A clinicopathologic study of 116 patients.

The clinicopathologic spectrum of angiolymphoid hyperplasia with eosinophilia (ALHE) is reported through a study of 116 cases (67 male and 49 female) submitted to the Armed Forces Institute of Pathology. The lesions are most common in the head-neck region and are characterized by single or multiple smooth-top papules or plaques of varying color. Microscopically, ALHE consists of anomalous vascular proliferations and varying degrees of nodular and diffuse lymphocytic infiltrates with eosinophils at all levels of the corium and subcutaneous tissue. In fifty-three cases an arterial structure, confirmed by the presence of an internal elastic lamina, was observed in close association with venular structures or was the site of endothelial cell proliferation. ALHE comprises a spectrum of unusual vascular proliferation with inflammation, encompassing such entities as inflammatory angiomatous nodules, pseudo or atypical pyogenic granuloma, histiocytoid hemangioma, epithelioid hemangioma, and Kimura's disease. The existence of arterial structures among venules and endothelial cell proliferations suggests the presence of arteriovenous (AV) shunts, which may help explain the pathogenesis and biologic behavior of this condition.

Adolescent↗
PubMed1985

Cutaneous mercury granuloma. A clinicopathologic study and review of the literature.

Cutaneous mercury granulomas are rarely encountered. Clinically they pose difficulty in diagnosis when there is no clear history of penetrating injury by objects containing metallic mercury. Histologic, chemical, and scanning electron microscopic studies of such cutaneous lesions were performed on four cases from the Armed Forces Institute of Pathology files. Reported cases from the literature were reviewed. Metallic mercury in tissue sections appears as dark, opaque globules, usually spherical in shape and of varying sizes and numbers. A zone of collagen necrosis often surrounds the mercury globules. A granulomatous foreign body-giant cell reaction and a mixed inflammatory cellular infiltrate composed of neutrophils, lymphocytes, histiocytes, plasma cells, and occasional eosinophils are usually present. Epidermal and dermal necrosis, with or without ulceration or pseudoepitheliomatous hyperplasia, is also a common finding. The gold lysis test and energy-dispersive x-ray analysis confirmed the presence of metallic mercury in the tissue. Following cutaneous injury from mercury, systemic toxicity may develop and death may even occur. An approach to clinical management is discussed.

Adolescent↗
PubMed1984

Subcutaneous sacrococcygeal myxopapillary ependymoma. A clinicopathologic study of 32 cases.

A clinicopathologic investigation was performed on 32 cases of myxopapillary ependymoma occurring as a primary tumor of the skin and subcutaneous tissue of the sacrococcygeal area. The tumor usually presented as an asymptomatic mass at the base of the spine in young individuals. Pilonidal cyst was the most frequent clinical diagnosis. The excised tumors often "shelled out" easily and none was adherent to the vertebral column or spinal cord structures. The tumors were circumscribed and located in the subcutaneous tissue and deep dermis. Microscopically, ultramicroscopically, histochemically, and immunohistochemically, the cutaneous myxopapillary ependymomas showed distinct changes. Follow-up data were available for 23 patients with a median follow-up interval of 7 years. Six patients were followed for 15 years or longer. Metastases occurred in four patients, an incidence of 17%.

Adolescent↗
PubMed1984

Inflammatory fibroid polyps of the intestine.

The clinical and pathologic features of 64 inflammatory fibroid polyps of the large and small bowel in 63 patients are reported. Six of the lesions in the small bowel were studied by electron microscopy. Follow-up information was obtained from 39 patients. The lesion was always benign, occurred at all ages, and had a world-wide distribution. The lesions were polypoid, sessile, originated in the submucosa, infiltrated the muscularis propria, and most closely resembled granulation tissue. The principal mesenchymal cell by electron microscopy was the fibroblast. No associated medical conditions were identified and the cause remains unknown.

Adolescent↗
PubMed1984

Eccrine acrospiroma.

Explore the source record for details and available documents.

Adenoma, Sweat Gland↗
PubMed1983

Localized epidermotropic reticulosis (Woringer-Kolopp disease).

In order to clarify the biologic behavior and establish clinical and histologic criteria for the diagnosis of a cutaneous disease originally described by Woringer and Kolopp, we examined fifteen new cases and reviewed thirteen reports. The disease presents as a single, chronic, asymptomatic, circinated, scaly plaque. It preferably involves distal extremities and affects middle-aged individuals, as well as a considerable number of youths. The male to female ratio is 2:1. The treatment of choice is surgical excision or radiotherapy. One lesion resolved with an intralesionally administered steroid. Follow-up data of the twenty-eight cases suggest that this is a benign lesion. Paradoxically, its atypical microscopic features contrast with its benign clinical appearance and biologic behavior. The lower epidermis appears focally infiltrated by large atypical mononuclear cells that spare the dermis. Ultrastructural observations suggest that these are stimulated T lymphocytes, which sometimes are mixed with histiocytes. We propose the term "localized epidermotropic reticulosis" for this distinct clinicopathologic entity, which is different from mycosis fungoides.

Adolescent↗
PubMed1982

Carcinoma cuniculatum (verrucous carcinoma of the skin): a clinicopathologic study of 46 cases with ultrastructural observations.

Forty-six examples of carcinoma cuniculatum, a rare variant of squamous cell carcinoma of the skin, were studied by means of light and electron microscopy and immunoperoxidase techniques. The tumors usually presented as ulcerated, fungating, and polypoid masses with openings of sinus tracts onto the skin surface that exuded foul-smelling greasy material when pressure was applied. On microscopic examination the tumors were seen to be composed mainly of mature squamous keratinocytes with foci of cellular atypia. Electron microscopic studies revealed features of well-differentiated squamous cell carcinoma. The tumor may affect any cutaneous area of the body, and there is a predilection for the feet, particularly the soles. The cause must still be determined, but trauma, chronic irritation, and/or viral infection may play a role. The neoplasm is a low-grade carcinoma capable of local invasion, extension into bone, and rare metastasis to the regional lymph node. Although immunoperoxidase studies revealed no inclusions, infection by human papilloma virus (HPV) remains a possibility.

Adult↗
PubMed1981

Leiomyosarcoma of the skin and subcutaneous tissue.

In a study of 65 primary cutaneous leiomyosarcomas and 15 primary superficial subcutaneous leiomyosarcomas, tumors occurred at any age but were more common in middle age and most common on the extremities. They developed as solitary painful or tender intracutaneous or subcutaneous nodules. Microscopically, the cutaneous leiomyosarcomas consist of a poorly delineated proliferation of spindle-shaped atypical myomatous cells arranged in interlacing fascicles which merge into collagenous stroma. Subcutaneous leiomyosarcomas are more sharply circumscribed and typically include a vascular pattern. About 40% of the cutaneous leiomyosarcomas recurred, but none metastasized despite a high mitotic frequency and marked cytologic atypia. Among the 12 patients with subcutaneous leiomyosarcomas, one-half of the tumors recurred and one-third eventuated in metastasis or tumor-related death. Cutaneous leiomyosarcomas have a relatively benign biologic course and may be excised conservatively, but are less likely to recur if the local excision is wide enough to require a skin graft for closure of the surgical defect. For primary subcutaneous leiomyosarcoma, early wide local excision with adequate clear histologic borders constitutes rational treatment.

Adolescent↗
PubMed1981

Granular cell tumors of the gastrointestinal tract and perianal region: a study of 74 cases.

Seventy-four patients with 75 examples of granular cell tumors occurring in the gastrointestinal tract and perianal region were studied. Twenty-four were located in the esophagus, eight in the stomach, three in the small bowel, four in the appendix, twenty in the large bowel, and sixteen in the perianal region. Nine cases had multiple tumors either occurring in the same area of the bowel or in other organs, mostly the skin. Approximately 50% of the tumors occurring in the esophagus and perianal region showed varying degrees of acanthosis or pseudoepitheliomatous hyperplasia. In the perianal tumors the pseudoepitheliomatous hyperplasia was much more extensive and could be mistaken for squamous cell carcinoma. The world literature was reviewed and a total of 66 cases of granular cell tumors were reported in the area of study. In neither our 74 nor the other reported cases was there evidence of recurrence or malignant behavior of the tumors, thus confirming their benign biologic behavior.

Adolescent↗
PubMed1981

Melanocytic nevi in neonates.

The histologic features of seven congenital nevi within 3 months of birth were studied, together with the ultrastructural features of one of the lesions examined microscopically within 48 hours of birth. All seven lesions showed melanocytic hyperplasia within the epidermis and within pilosebaceous and eccrine sweat units. Nevus cells within the dermis were located in proximity to the adnexae. Melanocytic hyperplasia within the epidermis showed a variety of patterns, at least one of which simulated the atypical melanocytic hyperplasia seen in the superficial spreading type of melanoma. The fine structure of the melanosomes in one case studied by electron microscopy resembled hair-bulb melanosomes. They were distinctly different from melanosomes characteristic of epidermal melanocytes, nevus cells, or melanoma cells.

Eccrine Glands↗
PubMed1981

Ultrastructure of subcutaneous sacrococcygeal myxopapillary ependymoma.

Electron microscopic examination was performed on three cases of myxopapillary ependymoma that occurred as primary tumors in the skin and subcutaneous tissue of the sacrococcygeal region. Some features found in both normal and neoplastic ependymal cells were observed. These included microvilli, cilia, desmosomal attachments, and cytoplasmic filaments. Other features noted, basement membranes and greatly decreased cilia, are characteristic of myxopapillary ependymomas and normal choroid plexus. In these situations, ependymal cells are apposed to connective tissue. The ependymal nature of this rare tumor is reaffirmed.

Basement Membrane↗
PubMed1980

Subungual malignant melanoma: a clinical-pathologic study.

In a study of 66 cases of subungual malignant melanoma, a clinical misdiagnosis often delayed histologic diagnosis and proper treatment. Most subungual melanomas are deep lesions at the time of histologic examination. Female patients have a relatively good prognosis as opposed to the poor prognosis of male patients. Paradoxically, a few patients with relatively shallow tumors and low mitotic rates died with metastases and a few patients with deep aggressive-appearing melanomas are alive and well more than five years later. Metastases, however, may become evident many years after the primary tumor has been resected. Metastases to the regional lymph nodes may be found at the time of amputation but do not preclude a long survival. No difference in prognosis related to the extent of the amputation could be identified. A variety of histologic patterns may be present and the adjacent epidermis frequently shows changes of precancerous melanosis but the survival is not affected.

Adult↗
PubMed1980

Metastatic basal cell carcinoma: a clinicopathologic study of seventeen cases.

Basal cell carcinoma is a common cutaneous neoplasm that rarely metastasizes. We studied the clinical and pathologic features of 17 patients with metastatic basal cell carcinoma as recorded in the files of the Armed Forces Institute of Pathology (AFIP). Sixteen of the patients were male, and as far as it could be determined, all were white. The most frequent site of metastasis was lung (9 cases), followed by bone (5), lymph nodes (4), liver (3), spleen (1), and adrenal gland (1). Thirteen of the patients had metastatic lesions involving only one organ system. Mean survival time after metastasis was 1.6 years. Features of metatypical (basosquamous) basal cell carcinoma were common in the primary and recurrent tumors, and metastatic lesions generally had a metatypical or adenoid pattern. Two of the five bony metastases demonstrated shadow cells characteristic of pilomatrixoma. The metatypical pattern of a basal cell carcinoma is a feature of an aggressive lesion with the ability to metastasize.

Adrenal Gland Neoplasms↗
PubMed1980

A modified Warthin-Starry procedure at low pH for melanin.

The Warthin-Starry argyrophilic silver stain peformed at pH 3.2 is a highly effective method for the demonstration of melanin in tissue sections. Eighty-five melanocytic tumors were studied using the Warthin-Starry and the Fontana-Masson procedures. The Warthin-Starry technic stained a greater number of cells in 68% of the tumors, with no loss of cellular detail. Twenty-three per cent of the tumors that appeared amelanotic on hematoxylin-and-eosin-stained sections were positive for melanin with the Warthin-Starry stain, but negative with the Fontana-Masson technic. The Warthin-Starry stain is more sensitive and specific for melanin than is the Fontana-Masson procedure.

Humans↗