Biomedical subjects
Publications and source records attributed to F A Langley.
Foetal remnants were found in uterine curettings obtained from three women complaining of irregular vaginal bleeding. These findings are discussed in relation to other cases in the literature in which heterotopic tissues have been found in curettings and also for the light they throw on the origin of the so-called uterine teratomas.
Sections of tissue from 256 patients on which a histological diagnosis of hydatidiform mole had been made were reviewed by a visiting pathologist. There was agreement between the reporting pathologists and the visiting pathologist in only 55.1 per cent of cases, a less severe diagnosis was made by the visiting pathologist in 42.2 per cent of cases. The disagreement was as high as 66.6 per cent with pathologists who rarely worked in the gynaecological field. This study casts serious doubt on the consistency of the histological diagnosis of hydatidiform mole made in any one laboratory and between different laboratories. It is suggested that in epidemiological studies the diagnosis should be made by a panel of pathologists using strict histological criteria and in an individual laboratory diagnosis should be made or confirmed by a pathologist experienced in gynaecological pathology.
The need for quality control in diagnostic histopathology and cytology is analysed together with a discussion of previously reported experience in this field. The philosophical and mathematical inferences of this type of exercise are debated also in relationship to personally observed experiences in respect of uterine cervical cytology and histology. The desirability of methods of monitoring of diagnostic quality and of obtaining quality improvement are emphasized and suggestions made regarding the techniques most suited to these objectives.
Eight histological features were measured quantitatively in a group of 77 ovarian mucinous carcinomas and a group of 28 benign mucinous cystomas. These were compared with the duration of survival of the patients and the clinical staging of the tumours. Using the method of discriminant function analysis it was possible to identify a group of tumours of 'borderline malignancy'. Although single histological features were inadequate indicators of prognosis a combination of three features proved fairly accurate.
The clinico-pathological features of 12 patients with a gonadoblastoma are analyzed.
A case of idiopathic arterial calcification is described in a dysmature infant dying of massive pulmonary haemorrhage on the fourth day after a gestation of 36 weeks. The mother had disseminated lupus erythematosis and lupus nephritis treated with large amounts of prednisolone. Unlike most of the previously recorded cases of idiopathic arterial calcification of infancy subintimal proliferation of fibrous tissue and involvement of the coronary arteries did not occur. It is suggested that this non-occlusive form of arterial calcification may be a distinct entity.
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Ninety-two cases of granulosa cell tumor of the ovary have been studied. The clinical and pathologic data from this group were similar to that obtained in previous series. Because of the long natural history of many granulosa cell tumors, crude death rates over a relatively short period give little indication of the true malignant potential of these neoplasms and hence corrected survival rates were calculated; these show that, if no patient died from any other disease, approximately half of the women with this neoplasm would die, as a result of the tumor, within 20 years. Factors indicating a relatively poor survival rate were: age over 40 at the time of diagnosis, a presentation with abdominal symptoms, a palpable mass, a solid large tumor, bilateral tumors, extraovarian spread, and numerous mitotic figures in the tumor. It is suggested that all granulosa cell tumors should be considered as malignant and that the factors pointing to a poor prognosis are those indicating that a particular tumor has been diagnosed at a late stage in its natural history, either because it has been present for a long time or because it is highly malignant. There are no definite criteria for defining the prognosis in a case in which the tumor has been removed at any early stage in its natural life history.
A long-term review of 108 women suffering from various forms of vulval dermatosis is described and a detailed analysis of those with chronic hypertrophic vulvitis, lichen sclerosus et atrophicus, and neurodermatitis is made. One case of neurodermatitis and two cases of lichen sclerosus progressed to carcinoma but no case of chronic hypertrophic vulvitis became malignant. It is possible that vulval dermatoses occur more commonly in the nulliparous than in the parous women and there is a slight preponderance of women who are blood group A. It is suggested that the term "leukoplakia" should be abandoned and that vulval lesions should be described in precise and meaningful histological terms.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.