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Biomedical subjects

E B Helwig

Publications and source records attributed to E B Helwig.

At least 55 records · Page 3Linked to original sources
PubMed1980

Neurothekeoma--a benign cutaneous tumor of neural origin.

Fifty-three examples of a benign tumor of nerve sheath origin occurring in the dermis are described. Tumors were usually initially noticed by patients in the first or second decade of life. The tumors tended to occur in the central area of the face, arms, and shoulders. There was a 4.3/1 female to male predominance among affected patients. Histologically, these lesions contained nests and cords of large cells in a variably mucinous matrix. In a number of instances, a close histologic relationship existed between tumor cells and small nerves. Despite nuclear atypia and a variable number of mitotic figures, the tumors have behaved in a benign fashion. To our knowledge only two recurred, and inadequate excision was the apparent cause. We propose the name "neurothekeoma" for these tumors (Gr. Oeke, "sheath").

Adolescent↗
PubMed1980

Perineural invasion by keratoacanthoma.

In 18 examples of keratoacanthoma, the proliferating squamous epithelium histologically invaded the perineural space. The invasion did not adversely affect the biologic behavior and the prognosis.

Adult↗
PubMed1979

Malignant neoplasms associated with nevus sebaceus of Jadassohn.

Nine patients with nevus sebaceus of Jadassohn (NSJ) developed associated morphologically aggressive neoplasms. Four of the tumors were apocrine carcinomas, two of which metastasized to regional lymph nodes, and in one of the two generalized metastases developed. Three tumors were adnexal carcinomas with probable pilar differentiation, but none showed progression of the disease after wide surgical excision. One patient has squamous cell carcinoma and died with generalized metastasis, and one patient had a complex adnexal and squamous cell carcinoma with a large area of anaplastic carcinoma that recurred and invaded the skull.

Adenocarcinoma↗
PubMed1979

Intravenous pyogenic granuloma. A study of 18 cases.

A series of 18 intravenous pyogenic granulomas (IVPG) was studied. The lesions were limited to the neck and upper extremity and appeared as nonspecific tumors. Most had a clinical duration of 2 months or less. Treatment was by excision and there were no recurrences. IVPG consists of an intraluminal polyp attached to the wall of the vein by a fibrovascular stalk. The characteristic appearance is of lobules of capillaries separated by a fibromyxoid stroma. The organization and histologic detail are similar to those of pyogenic granulomas that are uncomplicated by the changes of inflammation. Our observations suggest that IVPG develops in or adjacent to the wall of the involved vein. It probably receives its blood supply from a small artery that enters the lesion in the region of the stalk.

Adolescent↗
PubMed1978

Adenocarcinoid, a mucin-producing carcinoid tumor of the appendix: a study of 39 cases.

Adenocarcinoid is a form of appendiceal carcinoid possessing features of both carcinoid and adenocarcinoma. There are two histologic types. Thirty patients had the goblet cell type, characterized by nests of large mucin-distended cells. Nine patients had the tubular type, characterized by small glandular structures lined by uniform cells. Despite abundant mucin and a goblet cell or acinar-like arrangement, a closer relationship to carcinoid than to adenocarcinoma is suggested by a concentration of tumor elements below the crypts of Lieberkuhn, a lack of evidence of neoplastic transformation of the appendiceal mucosa, and the demonstration of argentaffin or argyrophil granules in 88% of the lesions. Six tumors, all of the goblet cell type, metastasized and resulted in the death of the patients. One of the tumours that metastasized had a prominent tubular component. Most adenocarcinoids can be adequately treated by appendectomy, but hemicolectomy is recommended for those tumors showing atypical foci, a high mitotic count, or spread beyond the appendix.

Adenocarcinoma↗
PubMed1978

Radiologic-pathologic correlation from the Armed Forces Institute of Pathology. Inflammatory fibroid polyp.

The inflammatory fibroid polyp of the stomach, sometimes called eosinophilic granuloma, is a relatively uncommon lesion usually presenting a solitary, benign-appearing filling defect. The differential diagnoses include polypoid adenocarcinoma, hyperplastic mucosal polyp, adenoma, leiomyoma, epitheliod leiomyoma and leiomyosarcoma, and aberrant pancreas. Although difficult to distinguish by gross morphologic features, the inflammatory fibroid polyp shows a distinctive inflammatory response of the mucosal stroma in which eosinophils may be prominent. It is unrelated to the eosinophilic granuloma of lung or bone.

Adenocarcinoma↗
PubMed1978

Cutaneous ciliated cysts.

We studied 11 patients with a cutaneous cyst lined by a simple columnar ciliated epithelium. All of the patients were women in the second or third decade of life. Each had only a single lesion, located on the lower extremity. Clinical examination showed a cyst without specific identifying characteristics. The cyst is considered benign, because of the high degree of differentiation and lack of cellular atypia. The origin of the cyst is unknown. We favor the theory of sequestration and migration over that of transplantation or metaplasia.

Adolescent↗
PubMed1978

Apocrine gland adenoma and adenocarcinoma of the axilla.

Apocrine tumors from the axilla of 12 patients were studied clinically and pathologically. Based on histologic features, two tumors were classified as adenomas and ten as adenocarcinomas. All of the neoplasms were characterized by a glandular arrangement of large cells with abundant eosinophillic cytoplasm and evidence of decapitation secretion. The cytoplasm of the tumor cells contained PAS-positive, diastase-resistant granules. Intracytoplasmic particles of iron were demonstrable in three of ten tumors. Follow-up was available for all 12 patients. The two patients with apocrine adenoma are alive and well. Two patients with adenocarcinoma died of unrelated causes shortly after diagnosis. Of the remaining eight patients with adenocarcinoma, three have died of disease, and one is living with skeletal metastasis. A correlation appears to exist between tumor differentiation and prognosis.

Adenocarcinoma↗
PubMed1978

Lichen nitidus. A study of forty-three cases.

Among forty-three cases of lichen nitidus studied, twenty-one patients were Caucasian, twenty-one were Negro, and one was Spanish-American, ranging in age from five to fifty-eight years. The arm, forearm, trunk, and genitalia were sites most commonly involved. Clinically, the eruption usually appeared as tiny papules. Histologically, the papules showed a parakeratotoic "cap," epidermal atrophy, liquefaction degeneration of the basal layer, and a dermal infiltrate of lymphocytes, epithelioid cells, and sometimes giant cells.

Adolescent↗
PubMed1977

Cellular leiomyomas of the stomach in 49 patients.

The cellular leiomyoma of the stomach is composed of tightly packed, generally uniform spindle cells arranged in palisades, whorls, or interdigitations. Although these neoplasms have been variably considered to arise from gastric smooth muscle or Schwann cells, the morphogenesis is incompletely resolved. Perhaps they derive from a multipotential gastric stromal stem cell that is capable of differentiating toward smooth muscle. A cellular gastric tumor composed of fairly uniform, elongated spindle cells is unlikely to be malignant. Of 49 such tumors, only one metastasized. The combination of an increased mitotic rate and large tumor size is possibly indicative of malignant potential.

Adult↗
PubMed1977

Sarcomas of the stomach.

Sarcomas of the gastric wall, other than lymphomas, are a heterogeneous group of stromal malignant neoplasms composed of round and spindle cells. Many are malignant forms of epithelioid leiomyoma. Small cell size, high cellular density, a high rate of mitotic activity, and cellular pleomorphism are helpful clues in distinguishing malignant from benign gastric stromal tumors. Sarcomas of the stomach are aggressive, rapidly growing neoplasms. Among 44 examples metastasis occurred in three-fourths of the patients, usually within the first year after diagnosis.

Adolescent↗
PubMed1977

Cutaneous lymphangioma.

Cutaneous lymphangiomas from 158 patients were studied clinically and pathologically. Lymphangiomas show a predilection for the neck and axilla, breasts and chest, and buttocks and thighs, but may occur on almost any area of skin. They show highest incidence of onset in infancy, the majority are present by age 5 years, but they may appear spontaneously in adolescence or adult life. No correlation among cutaneous lymphangioma, mucous membrane lymphangioma, internal lymphangioma, or lymphangiosarcoma was found. No familial histories of lymphangioma were elicited. Single surgical excision cured 75% of cutaneous lymphangiomas and reexcision cured an additional 12%. The cutaneous lymphangiomas are divided into superficial "lymphangioma circumscriptum" and deep "lymphangioma cavernosum." No specific histologic criteria could be found to differentiate lymphangioma from "bloodless" hemangioma, primary from secondary lymphangioma (lymphangiectasia), or cystic cavernous lymphangoma from cystic hygroma.

Adolescent↗
PubMed1977

The fine structure of granuloma annulare.

The necrobiotic disease granuloma annulare was studied with the electron microscope in an effort to develop a theory for the mechanism of development of necrobiotic connective tissue. That mechanism must provide for the disappearance of nuclei, the tinctorial change in collagen, and the retention of connective tissue outlines characteristic of necrobiosis. Our observations suggest that necrosis of histiocytes and fibroblasts with release of lysosomal enzymes is an important early event in the development of necrobiosis. Increased quantities of extracellular hyaluronic acid are also present in the earliest recognizable lesions. The combination of lysosomal enzymes and abundant hyaluronic acid in the interstitium results in swelling of collagen. Necrotic cellular debris is deposited about many collagen fibrils. This material seems to protect collagen from further destruction and may account for the preservation of connective tissue outlines observed at the light microscopic level. Some collagen fibrils not protected by cellular debris appear to be disrupted into constituent filaments. Crossbanded filamentous aggregates that resemble fibrous long spaced collagen were also observed and may represent an abnormal reassembly of disrupted collagen.

Adolescent↗
PubMed1977

Papillary eccrine adenoma.

We studied in 14 patients a distinctive eccrine sweat gland tumor that we have termed papillary eccrine adenoma. There was a majority of black patients, and the tumors were located most often on the distal extremities. Eleven patients were followed up for an average of 35 months after excision of the tumor. No tumor metastasized but one recurred, and since re-excision the patient has been followed up 30 months further regrowth. Although previously regarded sometimes as malignant, the papillary eccrine adenoma is considered benign on the basis of our experience. Excision, with assurance from pathologic examination that the surgical margins are free of tumor, is the treatment of choice. Recognition of the neoplasm is based on the microscopic appearance of a pattern of structures resembling eccrine ducts, usually dilated, associated with intraluminal papillations.

Adenoma↗
PubMed1976

Gastric epithelioid leiomyoma and leiomyosarcoma (leiomyoblastoma).

A series of 127 surgical specimens of epithelioid leiomyomatous tumors (leiomyoblastomas) of the gastric wall from the files of the Armed Forces Institute of Pathology (AFIP) were studied as to biologic behavior, morphogenesis, and histologic features of value in distinguishing benign and malignant variants. These tumors affect middle-aged men primarily and usually present with upper gastrointestinal bleeding or peptic ulcer-like symptoms. They are composed of a mixture of round epithelioid and spindle cells, many of which have clear cytoplasm. The cells are ensheathed by delicate reticular fibers. The presence of a perithelial or glomoid pattern in some tumors suggests a possible relationship to angiomyoma, glomus tumors, and "pericytoma." The epithelioid leiomyoma, the benign form, often arises in the mid- and distal stomach, especially on the anterior wall. Microscopically, it is recognized by the presence of large epithelioid cells and infrequent mitotic figures. Of 103 epithelioid leiomyomas, only one metastasized and thus was biologically malignant. The epithelioid leiomyosarcoma often arises in the proximal stomach and also distally, especially on the posterior wall. Two histologic types of epithelioid leiomyosarcoma are distinguished from the benign epithelioid leiomyoma by the small size of the cells and occasional higher mitotic counts. One sarcoma variant is a small cell caricature of the leiomyoma. The other is more anaplastic, assoicated with a loss of reticular fibers surrounding the cells and an alveolar arrangement. Epithelioid leiomyosarcomas are the most common type of gastric sarcoma. They are aggressive neoplasms; 63% metastasized, usually within 2 years after diagnosis.

Adolescent↗
PubMed1976

Mucoid cysts of the penile skin.

A study of 28 patients with mucoid cysts of the penile skin is reported. The lesions were seldom diagnosed correctly, either clinically or pathologically. The distinctive histologic features of the cysts include a lining of stratified columnar epithelium, often associated with intra-epithelial mucous cells and/or mucous glands. These cysts most likely arise from ectopic urethral mucosa sequestered in the penile skin during embryologic development.

Adolescent↗
PubMed1975

Relation of lichen sclerosus et atrophicus of the vulva to development of carcinoma.

One hundred and seven patients with lichen sclerosus et atrophicus (LS&A) of the vulva were studies to determine the malignant potential of the LS&A. Five patients had coexisting invasive carcinoma of the vulva or perineum with the LS&A, and 1 patient had coexisting intraepithelial vulvar carcinoma on the clitoris. None of these, however, was known to have LS&A prior to the biopsy for carcinoma of the vulva. The high association of carcinoma and LS*A is probably a result of selection of 2 unusual lesions sent for consultation and evaluation. Squamous hyperplasia in the vulva occurred in association with LS&A in 37 (35%) patients, but only 6 patients had areas of dysplasia coexisting with LS&A. These areas of dysplasia, like the 5 invasive carcinomas, occurred in an area of the vulva where the LS&A was minimal or absent. Follow-up data were obtained on 92 patients with LS&A. Only 1 developed carcinoma of the vulva, which occurred 12 years after identification of the LS&A. When carcinoma arises in the vulva in a patient with vulvar LS&A, it tends to arise in areas of minomal LS&A or isolated areas of relatively normal vulvar skin. This study did not provide evidence of carcinoma arising from LS&A. Five of the 92 patients developed 6 malignant neoplasms in other sites, including carcinoma of the endometrium (3 patients), lung (1 patient), and simultaneous carcinomas of the colon and cervix (1 patient).

Adolescent↗