Comparison of various clinical and pathological classifications of tumors of testes.
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Biomedical subjects
Publications and source records attributed to F K Mostofi.
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In summary, it may be said that, to date, among urologic tumors, seminoma is the only one in which lymphocytic and/or plasmacytic infiltration is known to improve the prognosis, and the available information on tumors of bladder, kidney, and prostate do not yet permit any statement relative to prognostic significance of inflammatory cell infiltration. When studying the relationship of lymphocytic and/or plasmacytic infiltration to tumors, it is essential for one to distinguish between cases in which the infiltration is in intimate relationship to the tumor cells and/or where the tumor cells show definite degenerative changes, e.g., seminoma, from those cases in which the inflammation is present at some distance from the tumor, e.g., chronic prostatis, and from those in which the inflammation is preexisting, e.g., schistosomiasis. Claims made about the prognostic significance of such infiltration should have adequate controls.
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The clinical and pathologic findings in 16 cases of carcinoid tumor of the testis are presented: 10 tumors were primary in the testis, 2 were teratomas, 2 were in the spermatic cord and 2 were metastatic. Most of these tumors occurred in middle-aged patients and the symptoms were those of testicular tumor in general, that is swelling, pain and tenderness. In none of the primary case was there evidence of carcinoid syndrome and no determination of serotonin was made before orchiectomy. Followup in 12 cases was from 4 months to 16 years postoperatively. Three patients died 2 to 4 years after orchiectomy: 1 with generalized metastasis and 2 with intercurrent diseases. Two patients were lost to followup and the remaining patients are well. Although ovarian carcinoids usually occur in teratoma and do not metastasize 1 of the primary cases produced generalized metastasis.
This presentation reports the light and electron microscopic findings relating to the vascular and glomerular changes in the kidney in a series of 25 patients having malignant hypertension, the hemolytic-uremic syndrome, scleroderma, or toxemia of pregnancy. The pathologic changes were generally similar in each of the diseases studied, the changes being related more to the severity and duration of injury than to the specific disease. Vascular narrowing was due mainly to intimal thickening, and by light microscopy the lesions were categorized as onionskin, mucinous, or fibrous with or without associated elastosis. Intimal erythrocyte extravasation, fibrinoid necrosis, and luminal thrombosis were also seen. Electron microscopy provided additional morphologic information: Myointimal cells were found to be the cellular component in each type of intimal thickening; it was possible to distinguish collagen from large intimal accumulations of basement membrane material; mucinous intimal material was characterized ultrastructurally; and fibrinoid necrosis was identified as a lesion inconstantly associated with cellular necrosis and consisting mainly of fibrinoid material and small deposits of fibrin. It seems likely that there is a common pathogenesis for intimal thickening in a variety of diseases and that this involves endothelial cell damage and increased permeability, leakage of serum and erythrocytes into the intima, and a healing reaction of the vessel wall was developing from migration of smooth muscle cells into the intima with subsequent myointimal cell proliferation and fibrogenesis. A common glomerular change in all diseases studied was a striking accumulation of electron lucent material between the endothelium and the lamina densa of the basement membrane. This lesion was interpreted as a manifestation of acute ischemia.
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