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F K Mostofi

Publications and source records attributed to F K Mostofi.

At least 55 records · Page 3Linked to original sources
PubMed1995

Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men.

OBJECTIVE: To determine if African-American men with newly diagnosed prostate cancer (PC) have higher pretreatment serum prostate-specific antigen (PSA) values after adjustment for clinical stage, age, and tumor grade, and to determine if any difference detected is related to tumor volume difference. DESIGN: Consecutive case series of newly diagnosed PC patients between January 1990 and September 1994 and cohort analytic study of PC patients treated by radical prostatectomy (RP) and who had whole-mount pathologic tumor volume assessment between May 1993 December 1994. SETTING: Tertiary care military medical center. PATIENTS: A total of 541 evaluable newly diagnosed PC patients (408 white and 133 black) having pretreatment PSA assessment at one laboratory; 91 patients undergoing RP had whole-mount tumor volume analysis. INTERVENTIONS: Medical record review for pretreatment PSA value, race, tumor grade, clinical stage, and age, as well as whole-mount pathologic assessment of RP specimen and measurement of tumor volume. MAIN OUTCOME MEASURES: The PSA differences between black and white PC patients with adjustments for age, biopsy tumor grade (Gleason score), and clinical stage (TNM stage); PSA differences between black and white PC patients undergoing RP with adjustment for age, RP grade, clinical stage, and tumor volume. RESULTS: The mean (geometric) PSA value for 133 black men was 14.00 ng/mL compared with 8.29 ng/mL for 408 white men (P < .001). The black patients had higher PSA values across all stage, grade, and age categories. The racial difference in PSA levels remained statistically significant when stage, grade, and age were simultaneously controlled for (P < .001). Multivariable odds ratio testing revealed that even after adjustment for stage, grade, and age, black patients were 2.2 times as likely as white patients to have a PSA value greater than 10.0 ng/mL (95% confidence interval, 1.3 to 3.6). Tumor volume (geometric mean) was 5.42 cm3 and 2.10 cm3 for black and white RP patients, respectively (P = .002). Across all clinical stages (T1a to T3), black men had tumor volumes 1.3 to 2.5 times greater than those of white men. Multivariable analysis of covariance revealed that tumor volume and stage of disease were important predictors of PSA level, but race, grade, and age were not. (The percentage of white and black patients whose cancer was detected by screening [75.4% vs 70.4%] or who had symptoms [37.7% vs 29.6%] was not significantly different.) CONCLUSIONS: As a group, African-American men with newly diagnosed PC have higher PSA values at initial diagnosis than white men. This PSA difference appears to be due to larger tumor volumes within clinical (TNM) stage categories among black patients. Elevated PSA value was a surrogate for larger tumor volume in this cohort of black men. This stage-for-stage tumor volume disparity even in an equal-access health care environment should prompt further study of screening behavior and/or biological differences of PC in the black population.

Age Distribution↗
PubMed1995

Pathology review in an early prostate cancer detection program: results from the American Cancer Society-National Prostate Cancer Detection Project.

Biopsy materials obtained in the American Cancer Society National Prostate Cancer Detection Project were reviewed at the Central Pathology Laboratory at the Armed Forces Institute of Pathology. Of 265 cases submitted, 177 were diagnosed as prostatic carcinoma, 7 as prostatic intraepithelial neoplasia (PIN), 13 as atypical glands or atypical hyperplasia, and the remaining 68 were benign hyperplasias. Irrespective of the means of detectin or the grading system used (Gleason or WHO-Mostofi), a large majority of the cancers were detected as low-grade tumors. Of 27 cases of PIN reported, 20 were associated with cancer, leaving 7 cases with the sole diagnosis of PIN. These data may indicate the increased use of prostate-specific antigen (PSA), digital rectal examination (DRE), and transrectal ultrasound (TRUS) in the United States is shifting the spectrum of prostate cancer pathology toward early low-grade tumors.

Biopsy↗
PubMed1995

Renal medullary carcinoma. The seventh sickle cell nephropathy.

Over the last 22 years, we have encountered 34 examples of a highly aggressive neoplasm with a microscopic morphology that is highly predictive of finding sickled erythrocytes in the tissue. With the exception of one patient, all are believed to have had sickle cell trait or, in one case, hemoglobin SC disease. These 33 patients are the subject of this report and, where their race was known, they were all blacks between the ages of 11 and 39 years. Between the ages of 11 and 24 years, males predominated by 3 to 1. Beyond age 24, however, the tumors occurred equally in men and women. The dominant tumor mass was in the medulla and ranged from 4 to 12 cm in diameter. Mean size was 7 cm; median, 6 cm. Peripheral satellites in the renal cortex and pelvic soft tissues, as well as venous and lymphatic invasion, were usually present. The lesions exhibited a reticular, yolk sac-like, or adenoid cystic appearance, often with poorly differentiated areas in a highly desmoplastic stroma admixed with neutrophils and usually marginated by lymphocytes. The tumors had usually metastasized when first discovered, and none was confined to the kidney at the time of nephrectomy. The mean duration of life after surgery was 15 weeks. These tumors probably arise in the calyceal epithelium in or near the renal papillae, the same site that produces the more familiar picture of unilateral hematuria in patients with sickle cell trait. We have concluded that renal medullary carcinoma represents another example of renal disease associated with sickle cell disorders. The other six are unilateral hematuria, papillary necrosis, nephrotic syndrome, renal infarction, inability to concentrate urine, and pyelonephritis.

Adolescent↗
PubMed1995

Metanephric adenoma. Clinicopathological study of fifty patients.

We report 50 examples of an uncommon type of renal adenoma from the files of the Armed Forces Institute of Pathology. They appear to be benign tumors with no malignant potential, and their chief importance is related to the fact that they are most often misinterpreted as renal cell carcinoma or epithelial Wilms' tumor. They predominated in females by well over 2:1. The mean age of the patients was 41 years, with a range of 5 to 83 years, and the mean size was 5.5 cm, with a range of 0.3 to 15.0 cm. Presenting signs and symptoms included pain in 11, hematuria in five, and palpable mass in five. In 20 patients the tumors were found incidentally during evaluation for other problems, and in six the other problem was polycythemia. This finding establishes a higher incidence of polycythemia in renal adenoma than in other previously reported renal diseases. Also of preoperative importance is the fact that these tumors are more commonly calcified than other renal neoplasms. Microscopically, these tumors consist of very small epithelial cells that form very small acini in an acellular stroma. Less often, they form tubular, glomeruloid, or polypoid and papillary formations. Most also show evidence of regression in the form of scarring and calcification. These lesions seem histogenetically related to epithelial Wilms' tumor, and, in fact, the two may occur together. They are histologically very similar to the metanephric hamartomatous element of nephroblastomatosis.

Adenoma↗
PubMed1994

Relative sensitivity and specificity of serum prostate specific antigen (PSA) level compared with age-referenced PSA, PSA density, and PSA change. Data from the American Cancer Society National Prostate Cancer Detection Project.

BACKGROUND: Different indexes that may enhance the early detection capability of prostate specific antigen (PSA) have been proposed. In addition to the indexes relating to the normal PSA level, there are data suggesting the usefulness of the PSA level relative to prostate gland volume (PSA density), age-referenced PSA level, and PSA change. Little research comparing the sensitivity and specificity of these measures in the same population has been reported. METHODS: All subjects were participants in the American Cancer Society National Prostate Cancer Detection Project. Specificity was studied in 2011 men without prostate cancer, and sensitivity was determined for 171 men with prostate cancer. RESULTS: Prostate specific antigen change showed the highest specificity (96.4%), and PSA density the lowest (85.3%). The most sensitive index was PSA density, which was positive for 74.7% of the 171 cases of known cancer. A PSA change of more than 0.75 ng/ml per year was the least sensitive index (54.8%). Sensitivity and specificity varied in a narrow range. Improved performance in specificity was achieved only with the loss of sensitivity. CONCLUSIONS: None of the alternative indexes commonly used in general early detection practice demonstrated particular advantage when compared with the normal PSA concentration, defined as no more than 4.0 ng/ml.

Adult↗
PubMed1994

Characteristics of prostate cancer detected in the American Cancer Society-National Prostate Cancer Detection Project.

The American Cancer Society-National Prostate Cancer Detection Project is a prospective, comparative study of a cohort of 2,999 men 55 to 70 years old not suspected on entry of having prostate cancer. A total of 164 prostate cancers is available from this project for analysis. A small proportion of tumors detected were advanced in terms of the clinical stage at diagnosis. Cancer detected by digital rectal examination tended to be more advanced than that found on the basis of only transrectal ultrasound or prostate specific antigen (PSA). A large proportion of patients received curative therapy involving radical prostatectomy in 67.1% and radiotherapy in 18.3%. Of 103 men presumed to have organ confined disease and treated by prostatectomy 64 (37.9%) actually had locally extensive cancer pathologically. PSA level and PSA density were associated with the detection of organ confined cancer but several advanced tumors had PSA levels in the normal range. Age referenced PSA, compared to conventional standards, demonstrated lower sensitivity to cancer with little improvement in specificity. The disease resulting from this multimodality detection effort represented a spectrum of pathological conditions. Further followup and evaluation are needed to determine whether these benefits are reflected in long-term mortality and survival experience.

Aged↗
PubMed1994

Proliferating cell nuclear antigen expression to predict occult disease in clinical stage I nonseminomatous testicular germ cell tumors.

We analyzed primary tumor tissue from 89 clinical stage I nonseminomatous germ cell testicular tumor patients for proliferating cell nuclear antigen expression and histological features to determine if these elements could distinguish pathological stage I (52 patients) from pathological stage II disease or patients who later had relapse (37). Using a monoclonal antibody (PC10) developed for use in archival tissue, nuclear proliferating cell nuclear antigen expression was immunohistochemically measured for the overall tumor (total proliferating cell nuclear antigen) and for each neoplastic cell type present. In addition, the primary tumor was examined for the presence of vascular invasion and determination of the percentage of tumor composed of embryonal carcinoma. Univariate logistic regression analysis revealed higher total (p = 0.0001) and higher embryonal carcinoma proliferating cell nuclear antigen expression (p = 0.0437) to be statistically significant risk factors for occult disease, correctly predicting its presence 73% and 61.5% of the time, respectively. More importantly, the presence of vascular invasion and a higher percentage embryonal carcinoma were highly significant risk factors for occult disease and were truly predictive in 80.4% and 77.2% of the cases, respectively. Multivariate logistic regression analysis revealed a combination of vascular invasion and percentage embryonal carcinoma to be the best model to predict occult disease correctly (85.9%). The addition of total or embryonal carcinoma proliferating cell nuclear antigen expression did not improve the clinical use of the model containing vascular invasion and percentage embryonal carcinoma. Although proliferating cell nuclear antigen expression mirrors the biological behavior of clinical stage I nonseminomatous germ cell testicular tumor to some degree, assessment of vascular invasion and percentage embryonal carcinoma has greater clinical use.

Antigens, Neoplasm↗
PubMed1994

Clinically detected carcinoma of the prostate treated by radical prostatectomy in a 29-year-old man.

Prostate cancer is rare in young adults and when clinically detected it has been invariably locally or distantly advanced, undifferentiated and exhibiting aggressive behavior. To our knowledge no previous report documents clinically detected and localized disease amenable to curative surgery in a young adult. We report on a 29-year-old man with clinically detected, moderately differentiated adenocarcinoma of the prostate who was treated by nerve sparing radical retropubic prostatectomy. The patient was disease-free and morbidity-free 30 months after treatment.

Adenocarcinoma↗
PubMed1994

Histopathology of localized prostate cancer. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993.

Future handling of patients with localized prostate cancer will undoubtedly depend upon a more sophisticated prognostication than that available today. The basis will continue to be the histopathological evaluation of tumor size, grade, localization and distribution within the gland. The aim of this section is to summarize current concepts of the morphological characteristics of localized prostate cancer and their prognostic implications as well as to give guidelines for standardization of the methods involved in morphological evaluation. First, baseline recommendations for the tissue processing procedures are given: Needle core biopsies, taken in a systematic way, potentially contain the information necessary for estimation of grade, size, distribution and extension to seminal vesicles, and could yield material for DNA-measurements, cytogenetic and genetic information. For TUR specimens it is suggested that at least 10 grams should be embedded or 8 to 10 cassettes employed minimally. The prostatectomy specimens should be carefully examined. Material should be frozen both from tumor tissue and from other areas eg by taking 'mapping' biopsies in a standardized way. After fixation (in 10% buffered formalin for at least 24 hours) and appropriate inking of surgical margins, whole mount sections at 2.5-5 mm intervals should be cut. The extension of the tumor should be outlined and at least the two largest tumors should be graded. Capsule penetration and extension to surgical margins and seminal vesicles should be indicated. Grading of malignancy should always include the Gleason grade and where possible Gleason score (ie the sum of the dominant and the secondary grade or pattern). The WHO and the Boecking systems combine a grading of glandular architecture with a grading of the nuclear atypia. It is stressed that in core biopsies the amount of cancer is sometimes scanty, which limits the possibility to find dominant and secondary patterns. In such cases, a grading of glandular differentiation and of nuclear grade seems rational. Also, for comparison with cytological grading, the WHO system is suitable, since in both cases both tissue differentiation and nuclear atypia are judged. The future need for objective techniques is recognized. Prostatectomy pathology includes important features with high correlation to postoperative prognosis: eg capsular penetration. The extent of capsular penetration and the extent of involvement of the surgical margins is of importance. Only focal penetration or focal involvement of the margin carry a relatively low risk of of progression.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomarkers, Tumor↗
PubMed1993

Characteristics of prostate cancers detected in a multimodality early detection program. The Investigators of the American Cancer Society-National Prostate Cancer Detection Project.

BACKGROUND: Few data are available to describe the clinical and pathologic characteristics of prostate cancers detected through early detection programs. The American Cancer Society National Prostate Cancer Detection Project (ACS-NPCDP) is a multimodality, multicenter study of the feasibility of early prostate cancer detection using digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostate specific antigen (PSA). One hundred fifty-six prostate cancers are available from this project for analysis. METHODS: The ACS-NPCDP is a prospective, comparative study of a cohort of 2,999 men between 55 and 70 years of age not suspected of having prostate cancer. DRE, TRUS, and PSA are performed for each subject on an annual basis for as long as 5 years. Biopsies are performed on the basis of recommendations from DRE or TRUS results. Although elevated PSA alone was not typically a basis for biopsy, in some instances biopsies were recommended because of the degree of elevation in PSA. Diagnoses are confirmed by participating pathologists and by pathologic analysis. RESULTS: A small proportion of cancers detected were advanced in terms of the clinical stage at time of diagnosis. A total of only six cancers were stage C1 to D1, and five of these were preexisting cancers detected at the first examination. Cancers detected by DRE tended to be more advanced than those found on the basis of only TRUS or PSA. A large proportion of patients received curative therapy, involving radical prostatectomy for 67.9% and radiation therapy for 17.9%. Of 100 men presumed to have organ confined disease and treated by prostatectomy, 64 actually proved to have localized cancer, a rate of upstaging of 36.0%. PSA level and PSA density were associated with the detection of organ confined cancer, but several advanced cancers had PSA levels in the normal range, limiting the usefulness of these measures for staging. CONCLUSIONS: The cancers resulting from this multimodality detection effort represented a spectrum of pathologic findings. These data, however, suggest that early detection interventions in men not suspected to have prostate cancer will yield tumors with a favorable stage distribution that are likely to benefit from treatment. Further follow-up evaluation is needed to determine whether these benefits are reflected in long-term mortality and survival experience.

Aged↗
PubMed1993

A pathologist's view of prostatic carcinoma.

In this article, the pathologic findings of carcinoma of the prostate were reviewed. Criteria were discussed for the pathologic diagnosis of prostatic carcinoma (PC), premalignant lesions, lesions that simulate PC, immunopathologic findings, special types of PC, effects of therapy on the prostate, and recent efforts to improve diagnostic and prognostic capabilities. The possible role of the study of nucleolar organizing regions was reported. A new method for demonstrating chromosomes in formaldehyde-fixed paraffin-embedded tissue was mentioned. The need for research in all aspects of the pathology of prostatic cancer was emphasized.

Acid Phosphatase↗
PubMed1993

Cluster of testicular cancer in police officers exposed to hand-held radar.

Within a cohort of 340 police officers, six incident cases of testicular cancer occurred between 1979 and 1991 (O/E 6.9; p < 0.001, Poisson distribution). Occupational use of hand-held radar was the only shared risk factor among all six officers, and all routinely held the radar gun directly in close proximity to their testicles. Health effects of occupational radar use have not been widely studied, and further research into a possible association with testicular cancer is warranted.

Adult↗
PubMed1993

Staging of early prostate cancer: a proposed tumor volume-based prognostic index.

Current staging of early prostate cancer separates patients into two groups: those with palpable and non-palpable tumors. Such staging relies on digital rectal examination in making this separation, despite the low sensitivity, low specificity, and low positive predictive value of this method. As an alternative, tumor volume may be useful for staging because of its powerful prognostic ability and its potential to be assessed clinically due to recent advances in imaging techniques such as transrectal ultrasound. In this study, we evaluate the utility of tumor volume in predicting progression of early prostate cancer based on the composite published evidence from nine pathologic studies of serially-sectioned prostates. Logistic regression revealed that tumor volume was a good positive predictor of all measures of tumor progression. There was a 10 percent probability of capsular invasion in tumors measuring about 0.5 cm3; 10 percent probability of seminal vesicle invasion in tumors measuring about 4.0 cm3; and 10 percent probability of metastases in tumors measuring about 5.0 cm3. These composite results suggest that tumor volume is a significant predictor of cancer progression. A volume-based prognostic index is proposed as an adjunct to staging for early prostate cancer.

Humans↗
PubMed1993

A clinicopathologic, histologic, and immunohistochemical study of mixed germ cell-stromal tumors of the testis in 16 dogs.

In a review of 262 neoplasms in 225 dogs, 18 tumors in 16 dogs were mixed germ cell-stromal tumors containing intimately admixed germ cells and Sertoli cells in tubular structures of various sizes. Seven of the 18 neoplasms were predominantly composed of germ cells, and 11 were predominantly composed of Sertoli cells. In 15 neoplasms, the germ cells were more anaplastic than the Sertoli cells, and in three neoplasms, both cell types were anaplastic. Five of the seven mixed-cell tumors with predominantly germ cells had germ cells infiltrating the adjoining tissues. Immunocytochemical studies of all 18 mixed-cell tumors, testes from five clinically normal dogs, six seminomas, and six Sertoli cell tumors revealed that neuron specific enolase (NSE) and vimentin were useful in demonstrating the dual population of the mixed cell tumors by differential staining of the germ cells and Sertoli cells. Half of the tumors stained differentially with desmin. In the normal testes, seminomas, and Sertoli cell tumors, parallel staining of germ cells and Sertoli cells by NSE and vimentin was seen, but only the appropriate tissues stained with desmin. The mixed-cell tumors in this study had morphologic features in common with mixed germ cell-sex cord stromal tumors and gonadoblastomas of human beings; clinically, they had more in common with the former. These mixed cell tumors in dogs should be classified separately.

Animals↗
PubMed1993

[Detection of numerical chromosome aberrations in urologic malignancies using in situ hybridization from formarin-fixed paraffin sections].

It has been shown that molecular cytogenetics in interphase nuclei is applicable to paraffin embedded sections from formarin-fixed materials utilizing in situ hybridization (ISH). This allows precise identification of numerical abnormalities of chromosome in tumor cells without disruption of tumor morphology. Thirteen cases of bladder cancer and twenty six cases of prostate adenocarcinoma were evaluated for numerical aberrations of chromosome 1, 7, 10, 11, 17, 18, X and Y utilizing biotinylated probes specific for the alpha satellite region. In two cases from total prostatectomy, one case from total cystectomy and two cases from TUR-P specimen, hybridized chromosomes could not be detected in individual tumor cells. With respect to the appearance of the ISH signal, optical concentration and time for the digestion enzyme has to be established essentially. This technique can now be applied on the detection of biological activity in various types of urological cancer.

Adenocarcinoma↗
PubMed1993

[Histopathological comparison of prostatic adenocarcinoma in Japan and the United States].

Histopathological comparison of clinical prostatic adenocarcinoma between Japan and the United States (US) has been made with retrospective analyses on 1,037 and 987 cases, respectively. All cases were histologically evaluated by the same pathologist (M.H.) without previous knowledge of clinical information according to application of the Japanese General Rules for Prostatic Cancer (JGRPC) based on the predominant degree of histological differentiation, the nuclear grading by WHO classification and the Gleason grading systems. The age distribution of the patients was slightly different among both groups. However, this difference appeared not to be essential, because there existed difference of the date on diagnosis between two groups. Even though considering this time difference on registration, much more cases from Japan had stage D disease. The observed incidence of the histological differentiation classified by JGRPC among over-all cases did not show significant difference, however, the incidence among the cases with same stage between two groups differed with some statistical significance. Much more cases from the US fell in well differentiated adenocarcinoma and frequency of moderately differentiated adenocarcinoma was higher in the Japanese even in the cases diagnosed at advanced stages. The observed incidence of nuclear grade 3 was also higher in the Japanese. Gleason primary and secondary grade 5 and score 9-10 appeared more frequently in the cases from Japan.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

Pathology of carcinoma of the prostate.

In this presentation the authors review the pathology of prostatic carcinoma (PCa), and discuss criteria for pathologic diagnosis, premalignant lesions, lesions that simulate PCa, immunopathology, special types of PCa, effects of therapy on the prostate, and recent efforts to improve diagnostic and prognostic capabilities. The possible role of study of nucleolar organizing regions is reported. A new method for demonstration of chromosome in formalin-fixed, paraffin-embedded tissue is presented. The need for research in all aspects of pathology is emphasized.

Acid Phosphatase↗