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Biomedical subjects

F K Mostofi

Publications and source records attributed to F K Mostofi.

At least 109 records · Page 6Linked to original sources
PubMed1985

Grading of prostatic cancer (I): An analysis of the prognostic significance of single characteristics.

This paper contains the first part of an attempt to quantitate the impact on prognosis of various parameters used in grading of prostatic cancer. Out of 346 patients of Elmer Belts series, 113 were identified whose tumors showed homogeneity with respect to single characteristics of a total of 12 parameters applied for grading in Mostofi's system. By this procedure it was possible to eliminate the possible influence on prognosis of the presence of several tumor formations within the same tumor. By using overall and intercurrent death corrected survival as end points, the impact of each of the 12 parameters on prognosis was studied. Only the architecture of the tumor (the parameter "glands"), variation in size and shape of the nucleus (anaplasia), and grade significantly influenced overall survival. In addition, corrected survival was significantly dependent on the amount of tumor seen and on the presence of mitoses. Subsequently, an attempt was made to replace "grade" by single parameters which had been shown previously to be of prognostic significance. It turned out that this was not possible. Grade is largely dependent on architecture and nuclear pleomorphism, but neither one of these parameters alone can reproduce "grade." Multivariate analysis was next used to further determine the prognostic weight of the individual parameter, and, if possible, to construct a new, more efficient grading system. These results will be reported separately [8]. It is unknown at the present time what the impact of several architectural formations within the same tumor on prognosis may be. The number of different formations found ranges from 1 to 4 in this material; 668 different formations belonging to 346 tumors were graded. The results of this analysis will be reported in part two of this series of papers [7].

Cell Nucleolus↗
PubMed1985

Grading of prostatic cancer: II. The prognostic significance of the presence of multiple architectural patterns.

This second report in a series of three deals with the prognostic importance of the presence of multiple, histologically identifiable architectural patterns in prostatic carcinomas. In the previous paper three of 12 parameters studied were identified as being prognostically significant in patients with single architectural patterns (formations) present in their tumors. The three parameters are nuclear anaplasia, architecture ("glands"), and mitoses, if present. The questions of whether "the worst part of a tumor determines prognosis" or "the presence of differentiated formations improves prognosis" are investigated by applying these parameters to patients with multiple tumor formations. Overall and corrected survival served as parameters. It was shown that the parameters shown to be of importance for prognosis in tumors with single formations also have significant influence in patients with multiple formations. The worst formation determines prognosis, but patients with poorly differentiated tumors do significantly worse if their tumor is homogeneous. The presence of better-differentiated formations improves the prognosis of the worst formation. The observations made are discussed in view of the histopathogenesis of prostatic cancer.

Cell Nucleus↗
PubMed1985

Grading of prostatic cancer: III. Multivariate analysis of prognostic parameters.

This work is based on the two previous publications which are concerned with grading prostatic carcinoma. In the present communication the technique of multivariate analysis is applied to quantify the prognostic importance of parameters which were earlier identified as contributing in a significant manner to grading. The results of this analysis are used to construct a scoring system which differentiates five significantly different prognostic groups. When compared to the results of grading, the new system is shown to be superior. The large group of 228 patients with G2 tumors can be split into three groups, each with a significantly different prognosis. The correlation of the scoring system to local tumor extension (pT category) is described. Recommendations for grading of prostatic carcinoma resulting from this work are the following: Only three independent parameters are of significance for grading prostatic cancer: tumor architecture, nuclear anaplasia, and the presence or absence of mitoses. The combination of these parameters in a scoring system identifies five separate prognostically different groups. The separation achieved by this new system is superior to conventional grading and is suggested for grading prostatic cancer.

Humans↗
PubMed1985

Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis.

The anatomical location of the branches of the pelvic plexus that innervate the corpora cavernosa has been identified previously in stillborn male neonates and fetuses. Based upon these observations, the techniques of radical retropubic prostatectomy and cystectomy have been modified to avoid injury to the autonomic innervation of the corpora cavernosa. However, the exact anatomical relationships of these nerves to the prostate, urethra and other pelvic structures in adults are unclear, since the initial anatomical studies of the pelvic plexus were performed in stillborn neonates in whom the accompanying vessels and fascia had been removed. Because these nerves are microscopic in size and can only be identified by their association with other pelvic structures, it was believed that a more refined understanding of the anatomy was necessary. In an effort to identify precisely the relationship of the cavernous branches of the pelvic plexus to the lateral pelvic fascia and the branches of the prostatovesicular arteries and veins, the following study was performed. Shortly after death a 60-year-old man was perfused completely with Bouin's fixative solution. The entire bladder, prostate, urethra, penis, corpora cavernosa, rectum, and pelvic sidewall fascia and musculature were removed en bloc. The specimen was serially sectioned transversely at 10 mu thickness, and every tenth section was stained with hematoxylin and eosin. An anatomical reconstruction in 3 dimensions was performed and illustrated. Thus, the specific location of the nerves that innervate the corpora cavernosa and their important relationships to the urethra, prostatic capsule, Denonvilliers' fascia and pelvic floor vasculature have been identified.

Autonomic Nervous System↗
PubMed1985

Pathology of germ cell tumors of testes.

We have presented a brief discussion of WHO International Histological Classification of Testicular Germ Cell Tumors. This classification divides the tumors into those of one histologic type and those of more than one type. Seven basic histological categories are recognized: seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, polyembryoma, choriocarcinoma and teratoma. Comparison of the WHO classification with the Pugh-Cameron classification reveals that except for seminoma and spermatocytic seminoma comparability between the 2 classifications is impossible. The relationship of various cell types to each other has been discussed. The origin of each cell type from malignant transformation of germ cell has been emphasized. The WHO classification has been demonstrated to correlate well with clinical tumor markers. The Pugh-Cameron classification can not be correlated with markers. More importantly, by specifying the individual components that are present in a tumor, the WHO classification provides exact information as to the possible structure of metastasis so that the urologist is in a much better position to properly manage the patient with a metastatic testicular tumor.

Choriocarcinoma↗
PubMed1984

Pathology of epithelial tumors & carcinoma in situ of bladder.

We have reviewed the World Health Organization International Histological Classification of Tumors of Urinary Bladder. The classification recognizes papilloma as a distinct entity, which, although histologically benign, has a definite increased risk of progression to carcinoma. The classification further characterizes carcinomas of bladder in terms of certain features which have considerable influence on treatment, recurrence and prognosis. These are: the patterns of growth, the histology of the tumor, the grade, the pathological stage, the mode and location of spread, and the status of the remaining mucosa. We have called attention to the need for proper recognition of nonpapillary, noninvasive superficial mucosal lesions which have hitherto been dismissed as atypia and dysplasia. We have demonstrated that these lesions present a high risk for development of invasive carcinoma and recommended that the term "intraepithelial neoplasia" be employed and graded one to three to eliminate the use of terms atypia, dysplasia and CIS. We have emphasized the need for development of technics to demonstrate invasive and metastatic potential of epithelial tumors of bladder.

Adenocarcinoma, Mucinous↗
PubMed1984

Tumor markers and pathology of testicular tumors.

The WHO International Classification of Testes Tumors has been briefly discussed. The classification divides the tumors into those of a single cell type and those of more than 1 cell type. Seven basic histological categories are recognized: seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, polyembryoma and teratoma. The classification correlates well with tumor markers and with clinical behavior.

Choriocarcinoma↗
PubMed1984

Epithelial abnormalities of urinary bladder.

We have called attention to certain epithelial lesions of the bladder characterized as proliferative, metaplastic, and neoplastic. In the first group are included hyperplasia, von Brunn's nests, papillary cystitis, papilloma and inverted papilloma. The second category includes squamous metaplasia, mucous metaplasia, and tubular metaplasia. These two categories, while benign, are indicative of agitated sick mucosa and may progress to neoplasia. The neoplastic changes consist of carcinoma involving the surface epithelium, von Brunn's nests, papillary cystitis, and/or cystitis cystica.

Adenoma↗
PubMed1983

Localization of alpha-fetoprotein and human chorionic gonadotropin to specific histologic types of nonseminomatous testicular cancer.

We used an indirect immunoperoxidase technique to localize alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) to specific histologic types of testicular germ cell cancers. Among 20 nonseminomatous tumors studied, yolk sac tumor reacted for AFP in 13 of 15 cases, teratoma in 3 of 11 cases, and embryonal carcinoma in 3 of 14 cases. Syncytiotrophoblasts alone reacted for HCG in 14 of 15 cases, and syncytiotrophoblasts associated with choriocarcinoma reacted for HCG in 2 of 2 cases. There was a close correlation between the tissue demonstration of AFP and HCG and elevated serum levels of AFP and HCG, respectively. We conclude that in nonseminomatous testicular cancer yolk sac tumor is the primary site of synthesis of AFP, and syncytiotrophoblasts are the only site of synthesis of HCG.

Adult↗
PubMed1982

Transplantation in patients with a history of renal cell carcinoma: long-term results and clinical considerations.

We report four cases of renal transplantation after prior incidental removal of renal cell carcinomas. Follow-up periods ranged from 21 months to 8 years. Our experience provides the first long-term follow-up of such cases and indicates that the overall prognosis is favorable when asymptomatic renal adenocarcinomas are removed prior to renal transplantation. The period between nephrectomy and renal transplantation ranged from 8 hours to 30 months. Three patients had prolonged tumor-free survival, and one died from a widely disseminated second adenocarcinoma 21 months after transplantation.

Adenocarcinoma↗
PubMed1980

Pathology in the Soviet Union.

Five pathologists from the United States visited the Soviet Union for three weeks in April 1978 to learn of the training in and the practice of pathology in that country. The major observations of the Americans were that (1) pathology is a medical specialty in the Soviet Union, with practice limited to anatomic pathology; (2) exfoliative cytology and clinical pathology are not part of pathology; (3) interest, both clinical and experimental, in occupational, environmental, and geographic pathology is conspicuous; (4) an autopsy rate of 90% to 95% is customary; and (5) there is an organized and hierarchical framework for practice, with career patterns established early and change infrequent.

Autopsy↗
PubMed1980

Intraprostatic lymphatics in man: light and ultrastructural observations.

Despite reports that human prostate is without lymphatics, electron microscopic studies of prostatic curettings of human prostate have demonstrated unequivocal evidence that lymphatics exist in prostate proper. Such channels are found in two locations: between the muscle cells and in the fibrous stroma supporting the muscle bundles. The lymphatics between the muscle cells are of smaller caliber and probably represent initial lymphatics. They are intimately connected by anchoring filaments and microfibrils to the smooth muscle cells. The functional relationship between these has been discussed. No lymphatics were seen in subepithelial location. We saw only blood capillaries in that area.

Capillaries↗