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Biomedical subjects

E F Scanlon

Publications and source records attributed to E F Scanlon.

At least 91 records · Page 5Linked to original sources

Identical cancers in husband and wife.

Eleven married couples having histologically identical malignant tumors have been encountered: two couples with melanoma; three with carcinoma of the breast; two with carcinoma of the kidney, and one couple each with fibrosarcoma; carcinoma of the floor of the mouth; carcinoma of the colon and rectum, and carcinoma of the nasopharynx. The interval until the spouse of the patient with cancer was diagnosed to have cancer was within five years in all but three instances. The clinical course of the disease tended to be similar in both husband and wife. Generally, the longer the couple had been married, the more successful was their treatment. Those tumors described, as well as those identical cancers of husband and wife previously reported, have been suggested either experimentally or indirectly to have viral relationships.

Adenocarcinoma↗

Delayed-type skin hypersensitivity reaction (DTH) to Thomsen-Friedenreich (T) antigen as diagnostic test for human breast adenocarcinoma.

One intradermal (i.d.) injection of human erythrocyte T antigen in the upper outer arm contralateral to any breast lesion elicits a delayed tuberculin-type hypersensitivity reaction (DTH) in breast carcinoma patients. It is necessary to inject simultaneously but separately the same quantity of MN antigen (about 6--8 cm apart), from which the T Antigen has been prepared, since particularly patients with Stage I breast carcinoma (Internatl. nomenclature) and those with benign breast disease may significantly react to it. The extent of reaction to MN antigen must be subtracted from the reaction to T antigen before interpreting results. DTH response to T antigen was 85% accurate among 67 patients with ductal breast carcinoma of all Stages (including non-invasive), 95% accurate (5% so far falsely positive) among 95 patients with benign breast disease and it was 100% accurate (no false positives) among 36 "healthy" persons tested. Among 18 patients with the comparatively rare and less ominous lobular and tubular breast carcinomata, the DTH reaction was positive in 8 of 16 (50%) patients with lobular, and in none of 2 patients with tubular breast carcinoma.

Adolescent↗

Thyroid carcinoma. Immunology, irradiation, and lymphocytic infiltration.

Patients undergoing thyroidectomies at Evanston (III) Hospital, during a six-month period had immunological studies performed preoperatively. No differential could be found between those with carcinoma or benign pathologic findings. T- and B-cell distribution and lymphocytic response to mitogens varied widely. Quantitative immunoglobulins showed slightly increased levels of IgG in patients with carcinoma and thyroiditis in comparison with those patients with adenomas. Antithyroglobulin antibodies were negative in all patients. Pathology slides from 107 patients with thyroid carcinoma between 1972 and 1978 at Evanston Hospital were reviewed for the presence of thyroiditis, either focal or diffuse. It was found that 50% of all carcinomas had either diffuse or focal thyroiditis. Diffuse thyroiditis was more common in patients with no history of irradiation and papillary carcinoma, and in younger age groups.

Adenoma↗

Parathyroid adenomas following irradiation.

Parathyroid adenomas have been demonstrated to occur following external head and neck irradiation. The median latency interval is 30 years. In a series of 74 consecutive patients with histologically diagnosed parathyroid adenomas, 25% gave a history of prior radiation exposure. When compared to a matched control incidence of 7.9%, statistical significance is reached at p less than 0.01. Thyroid abnormalities were present in 68% of the irradiated patients, and 30% of these were malignant. Tumor of skin, breast, and parotid gland also occurrred more frequently than expected. Forty-seven percent of the irradiated group had malignant neoplasms within the radiation field. The histopathology of the radiation-associated parathyroid adenomas is similar to that seen experimentally.

Acne Vulgaris↗

Symptomatology as an indicator of recurrent or metastatic breast cancer.

Eighty-seven patients with recurrent breast cancer after mastectomy were analyzed for patterns of recurrence and methods of detection. After an average disease-free interval of 30 months, 38% developed osseous metastases, 16% recurred locally, 10% had local plus systemic disease, 10% showed pulmonary metastases and the remainder were distributed among liver, brain, and remaining breast disease. In 79 patients recurrence was heralded by symptoms. Physical examination in five asymptomatic patients revealed local or supraclavicular recurrence. In only three asymptomatic patients was recurrence documented by "routine" chest x-rays (in two), or liver enzymes/liver scan (in one). No asymptomatic disease was found by bone scan. It is concluded that periodic history, physical examination, and chest x-rays are the most important components in the follow-up of breast cancer patients. Radioisotope scans and other radiographs are valuable in confirming symptomatic disease and detecting additional diseases, but cannot be recommended routinely in the asymptomatic patient because of low yield and cost.

Bone Neoplasms↗

Human carcinoma-associated precursor antigens of the NM blood group system.

Blood group NM specificities occur in healthy, benign and carcinomatous breast glands and those of the gastrointestinal (G.I.) tract, but the precursors in their biosynthesis, T (Thomsen-Friedenreich) and Tn, are found in adenocarcinomata and not in benign or healthy tissues. T- and Tn-antigenic specificities are thus human carcinoma-associated. All humans possess anti-T and anti-Tn antibodies. Patients with breast or G.I. tract carcinoma show statistically significant alteration of anti-T titer levels when compared to patients with benign disease and to healthy controls. Breast carcinoma patients but not healthy people showed cellular immunity to T antigen in vitro and in vivo. Most striking was the delayed-type hypersensitivity reaction, which was positive in over 90% of ductal breast carcinoma patients tested and negative in all presumably healthy individuals. T antigen is readily prepared from healthy human red blood cells in uncontaminated form, and free of HL-A and Au antigens. T antigen and anti-T antibodies may be useful in combating some human adenocarcinomata.

Adenocarcinoma↗

Preoperative physical assessment of thyroid glands in previously irradiated patients.

The Evanston Hospital maintains an Irradiated Thyroid Evaluation Clinic that has evaluated 695 patients since 1975. One hundred fourteen patients were retrospectively analyzed, and an attempt was made to correlate the preoperative physical examination with the pathologic specimen after thyroidectomy. There was no statistically significant difference between the incidence of carcinoma in glands containing a single nodule (23 per cent) and in multinodular glands. Postirradiation thyroiditis complicated the physical description of glands preoperatively. The categorization of physical findings served only to identify persistent thyroid abnormalities, which must be explored surgically. The overall incidence of carcinoma in the 114 available cases was 34 per cent, with nodal metastases in 18 per cent of the patients with carcinoma.

Female↗

The value of bone scans in the management of patients with carcinoma of the breast.

The bone scan has become a major staging and screening test for patients with carcinoma of the breast. The routine use preoperatively of bone scans to detect occult osseous metastases has been advocated to prevent radical operations on patients with Stage IV disease. Periodic use post-operatively of bone scans has also been advocated to detect metastic disease before the onset of symptoms. In view of the prevalence of this disease, the implications of this approach in terms of cost alone warrant consideration. All bone scans obtained of patients with carcinoma of the breast during a five year period were reviewed and the results correlated with the pathologic stage of the disease, the presence or absence of symptoms and pertinent clinical data. The sensitivity, specificity and predictive value of the bond scan was then analyzed for each group. Recommendations for the use of bone scans in patients with carcinoma of the breast are based upon these data.

Bone Neoplasms↗

Irradiation-induced polyglandular neoplasia of the head and neck.

Eighteen patients are presented with twenty-one tumors of the head and neck, which include ten salivary gland tumors and eight parathyroid adenomas. Eight of the patients also had thyroid neoplasms. All patients had a history of prior irradiation to the head and neck. Seventy per cent of the salivary gland tumors and 37 per cent of the thyroid tumors were malignant. Recommendations are made for detection and treatment.

Acne Vulgaris↗

Aspiration cytology of head and neck masses.

Fine needle aspiration biopsy and cytologic examination of the aspirate were performed on 203 masses involving glandular and nodal structures of the head and neck: thyroid gland (85); salivary glands (31); and lymph nodes (87). Overall cytologic-histologic correlation was 91 per cent, with a 10 per cent false-negative rate. The ease of the procedure coupled with the rapidity of obtaining a pathologic diagnosis allows a more intelligent therapeutic approach.

Adenolymphoma↗

Cytologic findings of aspiration of tumors of the breast.

Fine needle aspiration biopsy for cytologic diagnosis has been shown to be an effective adjunct to the clinical evaluation of masses of the breast by physical examination and mammography. In addition to adequately decompressing cystic masses, the procedure has been beneficial in obtaining a pathologic interpretation of any mass that is to be observed. Preoperative knowledge of the malignant nature of a mass of the breast allows the physician to investigate more selectively the possibility of metastatic disease and to consider more intelligently treatment options. Furthermore, the psychologic agony of the unknown for the patient and her family is avoided. Although histologic confirmation is always recommended before proceeding with mastectomy, a positive cytologic diagnosis can suffice when clinically advanced carcinoma is present or when there are medical contraindications to surgical treatment. Because of the false-negative rate of aspiration cytologic diagnosis, all clinically malignant or suspicious masses should have a biopsy in the face of benign cytology. This point cannot be over emphasized and is particularly pertinent to those patients in whom high risk factors of carcinoma of the breast are present. Inconclusive aspirates should be repeated or a biopsy of the mass should be done.

Adult↗

Thyroid disease following irradiation for benign conditions.

One hundred twenty-five patients with a history of prior irradiation to the head and neck region for benign disease underwent thyroidectomies between 1967 and 1976 at Evanston Hospital. One hundred twenty-four had a palpable abnormality. Forty-two had carcinoma, and nine of these had nodal metastases. Palpation was found to be more accurate than thyroid isotope scan in finding carcinoma within an abnormal gland. Some form of irradiation thyroiditis was found in one half of the resected specimens.

Adolescent↗

Small bowel perforation secondary to metastatic carcinoma of the lung.

This is a report of small bowel perforation secondary to a metastasis from a primary adenocarcinoma of lung in a 62-year-old woman five months after resection of the primary tumor. She had received radiation therapy and corticosteroids after surgery. Features of this and five previously reported cases are discussed. Modern therapy may alter the course of pulmonary cancer resulting in more frequent observation of this rare complication.

Adenocarcinoma↗

Blood group MN precursors as human breast carcinoma-associated antigens and "naturally" occurring human cytotoxins against them.

Blood groups MN active substances were found in benign and malignant human mammary glands. However, the precursor T (Thomsen-Friedenreich) antigen, as determined with human sera, occurred in all cancerous breast tissues tested but not in the benign mammary glands. Anti-T antibody, which is present in all human sera, was severely depressed in 21.16% of 189 breast carcinoma patients, compared with 3.62% of 470 persons of similar age without cancer. Of 720 persons tested approximately 85% of those with severely depressed anti-T had carcinoma; their IgG, IgM and IgA concentrations were of normal range. A greater than 25%-90% increase in anti-T titer score was found in 65.6% of 32 patients bled 1-14 months after mastectomy for carcinoma as compared with 3.1% of 32 patients with breast biopsy who had no carcinoma. All differences in anti-T titer score changes reported are statistically highly significant. Injection of T antigen from human erythrocytes increased anti-T titer scores.

Adolescent↗