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Biomedical subjects

F B Askin

Publications and source records attributed to F B Askin.

At least 73 records · Page 4Linked to original sources
PubMed1987

Primary Ewing's sarcoma involving the bones of the head and neck.

Ewing's sarcoma is a rare tumor of the bone. In the Intergroup Ewing's Sarcoma Study (IESS) approximately 4% of the primary bone tumors arose in the bones of the head and neck. The mean age of patients was 10.9 years; boys slightly dominated the group. Signs and symptoms were local in distribution, with a mass or swelling most frequent. As in other sites, we categorized the dominant histologic pattern as diffuse or filigree, the latter carrying a more unfavorable prognosis. The radiographic appearance may be atypical as compared to Ewing's sarcoma at other sites. Prognosis of head and neck Ewing's is significantly better than Ewing's sarcoma overall. The gnathic bones were commonly affected, yet there was no associated mortality. No patient with primary disease in the bones of the head and neck who survived for 5 years on any of the IESS protocols has subsequently died.

Adolescent↗
PubMed1987

Bizarre (pseudomalignant) granulation-tissue reactions following ionizing-radiation exposure. A microscopic, immunohistochemical, and flow-cytometric study.

Two patients developed extremely bizarre (pseudomalignant) granulation-tissue reactions in the larynx and facial sinuses, following radiation therapy for carcinoma. Containing pleomorphic spindle cells and numerous (sometimes atypical) mitotic figures, both tumefactive lesions simulated high grade malignancies. While the pleomorphic cells contained vimentin immunoreactivity, they were nonreactive for low or high molecular weight keratin. Flowcytometric study of paraffin-embedded tissues revealed DNA indexes of 0.75 and 1.0. Neither recurred locally nor spread distantly after therapy. Their granulation-tissue growth pattern, and the presence of stromal and endothelial cells showing similar degrees of cytologic atypia were central to their recognition as benign. These findings show that severely atypical, sometimes aneuploid, granulation-tissue reactions can occur following radiation exposure. Care should be taken not to misinterpret these lesions as malignant.

Aged↗
PubMed1987

Nuclear roundness factor: a quantitative approach to grading in prostatic carcinoma, reliability of needle biopsy tissue, and the effect of tumor stage on usefulness.

Morphometric analysis and histologic grading were performed on case material from 26 patients. Relative nuclear roundness factor (RNRF) was calculated and correlated with clinical course in 14 patients undergoing prostatectomy for stage A or B prostatic carcinoma. The only patients with progression of disease were two with RNRF of 1.10. RNRF in cases without progression ranged from 0.98 to 1.07. Histologic grading by the methods of Gleason or the M.D. Anderson system failed to discriminate between the progressing and nonprogressing groups. However, when RNRF was measured in tumors initially diagnosed as stage C or D, four of eight were below 1.10, within the range of the nonprogressing low-stage cases. Thus, the usefulness of morphometry and RNRF may be limited to low-stage disease. It was additionally found that RNRF could not be reliably measured in needle biopsy specimens.

Biopsy, Needle↗
PubMed1987

Angiosarcoma of the uterus: a light microscopic, immunohistochemical, and ultrastructural study.

A 71-year-old woman who presented with severe vaginal bleeding was found to have a uterine angiosarcoma after total abdominal hysterectomy and bilateral salpingo-oophorectomy. The diagnosis was confirmed by immunohistochemical studies that showed positive staining of tumor cells for factor VIII-related antigen and by ultrastructural studies revealing vasoformative structures surrounded by a thin basal lamina. Primary vascular tumors of the uterus are rare. The existence of malignant vascular neoplasms of the uterus has been questioned, and at most nine previously reported cases have been generally accepted as valid examples of uterine angiosarcoma. Based on those cases, the prognosis of uterine angiosarcoma is poor. Our studies demonstrate that angiosarcoma does occur in the uterus. Our patient is presently alive with recurrent disease.

Aged↗
PubMed1987

"Recurrence" of a plasma cell granuloma 11 years after initial resection.

Plasma cell granulomas of the lung are usually benign tumors found incidentally on chest x-ray film, though some have been found to be locally invasive. Our report of a plasma cell granuloma recurring 11 years after the initial resection emphasizes that complete surgical resection should be done whenever possible.

Adult↗
PubMed1987

Wilms tumor occurring as a botryoid renal pelvicalyceal mass.

Wilms tumor usually occurs as an abdominal mass arising from the renal parenchyma. A case was encountered in which the neoplasm filled the pelvicalyceal system of an 8-year-old boy as a botryoid mass, with minimal parenchymal involvement. The radiologic manifestations, pathologic features, and surgical implications are discussed.

Child↗
PubMed1987

DNA flow cytometry as a prognostic indicator in head and neck cancer.

The prognostic significance of deoxyribonucleic acid (DNA) flow cytometry has been investigated for many solid tumors, but few data have been accumulated for squamous cell carcinomas of the head and neck. To our knowledge, we report the largest number of patients (69) with head and neck primary carcinomas to be studied by DNA flow cytometry. In the first part of this study, we reviewed 109 consecutive patients with laryngeal or hypopharyngeal primary carcinomas which were treated at North Carolina Memorial Hospital during the period of 1981 to 1984. The final analysis comprised 139 DNA histograms (mean coefficient of variation: 8.02) on paraffin-embedded specimens from 48 patients. Of the 48 patients with primary carcinomas, 24 had glottic, 18 had supraglottic, and 6 had carcinomas from the piriform sinus. Patients had follow-up for a minimum of 12 months, with a mean follow-up period of 23 months. Twenty-three of the 48 primary carcinomas (48%) were clearly aneuploid, and the remaining 52% were tetraploid (22%) or diploid (30%). We have concluded that patients with clearly aneuploid primary carcinomas had significantly better prognoses than those with diploid tumors (p = 0.008). High DNA amounts (greater than 40% of cells beyond the diploid peak, DNA G1G0) also correlated with a favorable prognosis when compared with low DNA amounts (p less than 0.01), and this remained significant when the clinical outcome was adjusted for staging of the primary site (T), nodal status, and stage of disease. Ploidy was the most significant prognostic variable for the laryngeal group of patients. In the second part of the study, twenty-one patients with oral cavity squamous cell carcinomas were studied in a similar fashion as the group with laryngeal carcinomas. In this group, a low DNA amount, with 40% as the cutoff point, was associated with a favorable prognosis (p = 0.024), and this remained significant while controlling for T, nodal status, and stage of disease. Numbers were too small to permit evaluation of the impact of ploidy in this group, but there was a slight trend toward aneuploidy and tetraploidy, correlating with a poor treatment outcome (p = 0.228). DNA amount was the most significant prognostic variable for the group of patients with oral cavity carcinomas.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

The prognostic significance of stromal eosinophilia in head and neck cancer.

The pathologies of 82 head and neck tumors were examined for histologic features suggestive of poor prognoses. Twelve descriptive histopathologic variables, including two grading scales for malignant tumors, were correlated with DNA flow cytometric data and clinical outcome. We found no correlation between the grading scales and DNA flow cytometric data or clinical outcome. Only one of the histopathologic variables--stromal eosinophilia--was found to significantly correlate with favorable outcome (p = .018). Stromal eosinophilia may be an important new prognostic indicator for head and neck cancer.

Adult↗
PubMed1987

Cartilaginous variant of congenital adenomatoid malformation of the lung.

We report the occurrence of an unusual variant of congenital adenomatoid malformation (CAM) of the lung in a 16-year-old male. Abundant cartilage in the walls of malformed bronchioles, an extremely rare finding in CAM, distinguishes this lesion from the usual forms. We present the roentgenographic, computed tomographic, and pathologic features of this lesion as well as its embryologic implications. In addition, two similar cases are reviewed, one of which has been briefly discussed in a previous publication. Cartilaginous CAM should be distinguished from another lesion with abundant cartilage, the so-called pulmonary hamartoma.

Adolescent↗
PubMed1986

Mesothelial cysts of the round ligament simulating inguinal hernia. Report of four cases and a review of the literature.

Cysts of the mesothelial investment of the round ligament are rare and occur in women in their late third or fourth decades. They are relatively painless, mobile, may be perceived to be reducible, and should be included in the differential diagnosis of groin masses in women. Differentiation of these cysts from a small indirect inguinal hernia, with which they are frequently associated, is difficult and may be made only at the time of operation. They are likely to be less symptomatic than inguinal hernias. Cysts should not change in size with the Valsalva maneuver, although they may become more conspicuous with coughing. The clinical manifestations of cysts of the round ligament in four patients are described, along with a discussion of their embryologic and pathologic characteristics and a summary of the world literature. An embryologic mechanism of cyst formation is proposed and diagnostic criteria are presented. Symptomatic cysts of the inguinal ligament should be excised and the inguinal canal should be explored for possible associated indirect inguinal hernias. In the absence of symptoms or of a progressive increase in size, surgical removal of a cyst of the round ligament is not mandatory.

Adult↗
PubMed1986

Significance of ploidy in laryngeal cancer.

We studied 48 patients with laryngeal or hypopharyngeal primary tumors with DNA flow cytometry. Twenty-four of the tumors were glottic, 18 were supraglottic, and 6 were from the pyriform sinus. Patients were followed for a minimum of 12 months, with a mean follow-up of 23 months. Twenty-three of the 48 primary tumors (48 percent) were clearly aneuploid, 22 percent were tetraploid, and 30 percent were diploid. We concluded that patients with aneuploid primary tumors, high DNA levels, or both have a significantly better prognosis than those with diploid tumors, and this remained statistically significant when clinical outcome was adjusted for tumor status, stage, and nodal status.

DNA, Neoplasm↗
PubMed1986

Glomus tumor of the vulva: a case report.

Glomus tumors are benign neoplasms associated with intense pain localizable to the tumor nodule. A case of a glomus tumor of the vulva is presented. Simple resection is curative.

Adult↗
PubMed1986

Immunohistochemical evidence for the vascular origin of primary adrenal pseudocysts.

Pseudocysts are the most common nonfunctioning cystic adrenal lesions associated with symptoms. We have studied tissue from two patients with large adrenal pseudocysts in whom no antecedent cause could be documented. Immunohistochemical examination of these formaldehyde-fixed paraffin-embedded tissues with antibodies directed against the major proteins of the basement membrane (laminin and type IV collagen) revealed intense linear staining surrounding the cystic spaces and at the compressed adrenal cortical/pseudocyst interface. These findings lead us to conclude that these lesions are vascular in nature and, therefore, closely related to the previously recognized adrenal cysts of endothelial origin.

Adrenal Gland Diseases↗
PubMed1985

Progesterone secreting Sertoli cell tumor of the ovary.

A 33-year-old woman presenting with secondary amenorrhea and galactorrhea was found to have a Sertoli cell tumor of the ovary. The neoplasm also had a sex cord tumor with annular tubules (SCTAT) component. Further investigations revealed that in many respects the patient was endocrinologically pregnant. She had markedly elevated serum estrogen and progesterone levels and the endometrium demonstrated pronounced decidualization, but there was no evidence of actual pregnancy. Estrogen and progesterone were demonstrated by immunohistochemistry to be present in both the Sertoli cell and SCTAT portions of the tumor.

Adult↗
PubMed1985

Esophagitis: a frequent consequence of gastroesophageal reflux in infancy.

A control group of infants was evaluated to determine criteria for the diagnosis of histologic esophagitis. Based on our observations, histologic esophagitis was defined as four or more intraepithelial neutrophils or one eosinophil per high power field or both. Esophageal biopsy specimens from 33 consecutive infants younger than 2 years who had been examined for clinically significant gastroesophageal reflux (GER) were reviewed for histologic esophagitis. Endoscopy had been performed in each patient, and 4.1 +/- 1.1 (mean +/- SD) biopsy specimens had been obtained above the distal 20% of the esophagus. Twenty (61%) infants had histologic esophagitis, including 15 with intraepithelial eosinophils alone, one with intraepithelial neutrophils alone, and four with both. Older infants (7 to 24 months) with histologic esophagitis were more likely to have moderate to severe inflammation than were infants younger than 7 months of age (P = 0.01). Endoscopic evidence for gross esophagitis was found in six (18%) infants; of these, five had abnormal biopsies, including four with moderate to severe inflammation. Among the 27 infants with a grossly normal esophagus, 14 (52%) had histologic esophagitis, including nine (33%) with moderate to severe inflammation. We conclude that in infants with clinically significant GER: (1) esophagitis is common, (2) histologic esophagitis frequently occurs in the absence of gross endoscopic findings, (3) the likelihood of moderate to severe inflammation increases after 6 months of age, and (4) intraepithelial eosinophils are a sensitive marker for acute inflammation in association with GER.

Biopsy↗
PubMed1985

Squamous metaplasia of the breast. An ultrastructural and immunologic evaluation.

Squamous metaplasia in the breast is rare. This case of an intracystic papilloma of the breast with prominent squamous change was found by electron microscopy and immunohistochemistry to contain evidence of squamous differentiation within myoepithelial cells. The findings suggest that squamous metaplasia of the breast may result from myoepithelial cell differentiation in a manner analogous to the development of squamous lesions in the cervix and salivary gland. The possible relationship of this finding to the development of squamous lesions of the breast is discussed.

Adult↗