Biomedical subjects

F Linell

Publications and source records attributed to F Linell.

At least 19 recordsLinked to original sources

PubMed1992

Histopathologic classification of breast cancer in Sweden and Italy: a comparison between two pathologists.

Two large series of breast cancers (BC), identified in the Pathology Departments of Malmö (Sweden) and Florence (Italy), were independently reviewed by two experienced pathologists, one from each department. Overall, comparison of diagnoses of 372 BCs according to a simplified WHO histologic classification system (in four combined categories) revealed agreement for 74% of the cases. Concordance, as measured by the kappa statistic, was relatively good (0.53 overall). Kappa values for specific categories were also acceptable, being highest for "invasive lobular" BC (0.63) and lowest for "other types" (0.45). The kappa value for "noninvasive" versus all other categories of invasive BC was 0.53. Some BCs were systematically classified as "noninvasive" by one pathologist and as "invasive ductal with a predominant intraductal component" by the other. Invasive lobular BCs were also diagnosed more frequently by one pathologist. These findings suggest that when planning geographical or temporal comparisons of distribution for BC histologic categories, standardization of classification and a centralized review may play an important role.

Aged↗

PubMed1992

Interval carcinomas in the Malmö Mammographic Screening Trial: radiographic appearance and prognostic considerations.

OBJECTIVE: Interval carcinoma is the term used to describe malignant breast tumors that are detected in the intervals between mammographic screenings. These tumors are important because they contribute significantly to breast cancer mortality in the screened population. MATERIALS AND METHODS: Two radiologists retrospectively reviewed the mammograms of the 96 interval carcinomas (17% of all malignant neoplasms in the screened group) that were detected during the 10-year Malmö Mammographic Screening Trial in Malmö, Sweden (average time between screenings, 21 months), including one sarcoma, 75 invasive carcinomas, and 20 noninvasive carcinomas. We recorded the interval between screening and detection, and noted the tumor's appearance on the prior screening mammogram and at the time of diagnosis; these data were correlated with histologic tumor type and the patients' mortality. The doubling time for tumor volume of the invasive carcinomas was estimated. RESULTS: Excluding the sarcoma, 72 carcinomas (75%) were detected within 18 months of screening. Retrospective review of the available preceding screening mammograms (94 cases) indicated that 10 tumors were missed (observer's error), 63 studies showed no tumor (true interval carcinomas), and 21 studies showed subtle signs of malignancy, mostly nonspecific densities or asymmetries (unrecognized sign). Of 66 invasive carcinomas in which doubling times for tumor volume could be calculated, 27 (41%) had doubling times of less than 100 days. At the end of the study, 20 of the 96 patients had died of breast cancer. CONCLUSION: Interval carcinomas in this series were dominated by comedo, medullary, and mucinous carcinomas that often had a nonspecific appearance (when present) on prior screening mammograms. The interval carcinomas also contained a subset of rapidly growing tumors with a grave prognosis.

Aged↗

PubMed1992

Relation between lightscanning and the histologic and mammographic appearance of malignant breast tumors.

The relation between real-time transillumination (lightscanning) and the histologic appearance of 243 breast carcinomas was evaluated. Lightscanning mainly failed in identifying ductal and lobular carcinomas in situ. The result of lightscanning was also poor regarding small, invasive carcinomas. The absorption patterns in elastosis and scar tissue associated with carcinoma played no important role in the ability of lightscanning to identify a cancer. The relation between the lightscanning and mammographic appearance of 85 breast cancers from the same material was also evaluated. Lightscanning performed poorly in identifying tumors characterized by classifications as compared to tumors with other mammographic appearances. However, the difference was not significant.

Adolescent↗

PubMed1991

Breast carcinoma in situ in 167 women--incidence, mode of presentation, therapy and follow-up.

In the city of Malmö, in southern Sweden, 1693 women were diagnosed as having breast carcinoma during 1976 through 1984. Of these, 167 women had pure in situ breast carcinoma (9.9%). One hundred and thirty-two had ductal carcinoma in situ (DCIS) alone or in combination with lobular carcinoma in situ (LCIS), intracystic carcinoma and/or Paget's disease of the nipple. Thirty-three had pure LCIS and two had pure intracystic carcinomas. The incidence of breast carcinoma in situ (CIS) in women 20 years of age or older was 18.7 per 10(5) woman years with high rates of DCIS for all ages above 40, whereas a decline in incidence rate was seen for LCIS in the postmenopausal age groups. The ratio of DCIS to LCIS was 4:1. Of the 132 patients with DCIS, 46% were asymptomatic and were diagnosed by mammography, 35% presented with clinical symptoms, and 19% of the cases were incidental findings in breasts operated on for benign lesions. Mammography had been performed on all patients with DCIS and contributed to diagnosis in 75%. Sixty-one per cent of all DCIS lesions had microcalcifications suspicious for carcinoma. Eighty-nine of 132 patients with DCIS underwent fine-needle aspiration biopsy (FNAB) before surgical biopsy. FNAB was suspicious or diagnostic for carcinoma in 57/89 (64%). Of 33 cases with LCIS all but one were incidental findings. In one of 28 cases with LCIS examined by mammography there was suspicion of carcinoma. Sixteen per cent of the patients with DCIS were treated by a breast-conserving operation (BCO), the remaining patients by mastectomy (ME) (52%) or subcutaneous mastectomy (SCM) (33%) with immediate reconstruction. Thirty-three per cent of the patients with LCIS were treated by BCO, the remaining patients by ME (18%) or SCM (49%) with immediate reconstruction. Only one patient had radiotherapy postoperatively. In 60% of all CIS cases where an excisional biopsy had been performed there were further foci of CIS in the final ME/SCM specimen. After a median follow-up of 7 years for the DCIS group, three patients out of 21 treated by BCO had invasive carcinoma appearing ipsilaterally. They were alive and without symptoms of recurrent disease 2.5 to 6 years following further surgery. One patient treated by SCM died from generalized ductal breast carcinoma. In the LCIS group (median follow-up 8 years) one patient out of 11 had an invasive tubular carcinoma diagnosed 4 years after BCO. Eight years later she was alive and well after bilateral SCM.

Adult↗

PubMed1991

Bilateral and multifocal breast carcinoma. A clinical and autopsy study with special emphasis on carcinoma in situ.

Bilateral clinical breast carcinoma has been reported to appear in up to approximately 10% of patients with breast carcinoma. Increasing diagnostic activity has raised figures of bilaterality, mainly due to detection of lesions of the in situ type. Knowledge of the natural history of carcinoma in situ is incomplete and clinical implications are uncertain. In the present study bilateral lesions were analysed by extensive histological examination in the following groups of patients: (1) Forty-six women (median age 44 years) with clinical and mammographical unilateral invasive breast carcinoma, where the contralateral breast was removed at subcutaneous mastectomy (SCM) during the course of breast reconstruction, 24/46 (52%) had bilateral malignant lesions, four invasive carcinomas and 20 in situ carcinomas (two ductal carcinomas in situ /DCIS/, 15 lobular carcinomas in situ (LCIS), three both DCIS and LCIS). (2) Fifty-two women (median age 50 years) with a unilateral diagnosis of in situ carcinoma (32 DCIS, 16 LCIS, four both DCIS and LCIS), in whom both breasts were removed at SCM. 25/52 (48%) had bilateral malignant lesions, one invasive carcinoma, 24 in situ carcinomas (three DCIS, 18 LCIS, three both DCIS and LCIS). Twelve of 20 cases with LCIS (60%) were bilateral. Of 36 cases with DCIS, seven (19%) were bilateral. (3) The contralateral breast was removed at autopsy in 64 women previously unilaterally mastectomized (at median age 65) for invasive breast carcinoma. Fifteen of 64 (23%) had contralateral primary carcinoma at autopsy, four invasive carcinomas, 11 in situ carcinomas (six DCIS, five LCIS) and 8/64 (13%) had metastases in the breast. Multifocal malignant findings were also analysed in 47 SCM specimens after excisional biopsy for in situ carcinoma. In 35/47 (75%) further malignant lesions were present in spite of normal mammographic and clinical findings. Four were invasive and 31 had in situ lesions (16 DCIS, 10 LCIS, five both DCIS and LCIS): These findings may favour the hypothesis that some carcinomas in situ may remain silent or even regress. It is thus important to embark upon randomized trials to clarify the natural history of breast carcinoma in situ. Such a trial has been started in the southern region of Sweden.

Adenocarcinoma↗

PubMed1979

Breast hamartomas. An important entity in mammary pathology.

1. Fifteen cases of a rather distinct entity of tumour-like lesion in the breast are presented. 2. They have a distinct mammographic appearance and can be easily shelled out at surgery, leaving symmetrical breasts. 3. They are well-circumscribed lumps of varying size with a smooth surface. 4. Microscopically they show normal or dysplastic glandular structures of lobules and ducts, without neoplastic features, within a prominent fibrous stroma. The lesions appear to be closely related to adenolipomas.

Adolescent↗

PubMed1979

Extreme duct papillomatosis of the juvenile breast.

Three cases of peculiar and very severe ductal papillomatosis of the breast are reported. This ductal papillomatosis was unusual, both in its histological architecture and in occurring in juveniles, viz. girls aged 11, 14, and 17 years. In two of the patients breast cancer was diagnosed 27 and 11 years later. In one of them the ductal papillomatosis must be presumed to have been precancerosis, while in the other patient there was possibly from the outset an unusually papilliferous, intraductal carcinoma of low malignancy.

Adolescent↗

PubMed1979

Breast cancer screening with mammography: a population-based, randomized trial with mammography as the only screening mode.

A population-based, randomized breast cancer screening project was undertaken using mammography alone. Of 17,447 invited women aged 50-69, 12,765 (73%) attended the screening. On the basis of the screening films, malignancy was suspected in 405 women (3.2%) who were recalled for complete mammography. Additional films showed that the suspicion of malignancy was false in 194 women. The remaining 211 women (1.7%) were referred for clinical and cytological examination. Of these, 159 had surgery. Breast cancer was proved in 97 women, corresponding to a prevalence rate of 7.6/1000. Fifty-three (55%) of the carcinomas were either in situ or invasive with a diameter of less than or equal to 1 cm. Axillary metastases were found in 19 patients (19.6%). Cancers detected at screening were significantly less advanced than those in the control group. There was a remarkably high frequency of tubular carcinoma among cancers detected at screening.

Aged↗

PubMed1979

Lesions of the dorsal renal artery in surgery for renal pelvic calculus. A potential cause of renovascular hypertension.

2 cases of lesions of the dorsal renal artery in surgery for renal pelvic calculus are described. In 1 of the cases hypertension developed. Anatomic factors and previous operations predispose to this complication. An arterial complication should be suspected when hypertension develops postoperatively. The blood pressure of patients with known renal vascular complications should be checked repeatedly for several months postoperatively. The diagnosis is radiological, renal angiography being the definite procedure although a reduction of kidney size observed at urography may indicate the vascular lesion.

Adult↗

PubMed1979

Mammary hamartomas.

Five cases of mammary hamartoma are described, with special reference to the radiographic features. Hamartomas are well circumscribed lesions composed of normal or dysplastic mammary tissue. They are probably more common than has been anticipated from the literature and are important because they may be confused with other well circumscribed tumors, such as cystosarcoma phyllodes. The radiographic characteristics of hamartoma allows a tentative diagnosis in most cases.

Adult↗

PubMed1979

Correlations between clinical and postmortem findings in listeriosis.

Clinical data were correlated with postmortem findings in 14 cases of fatal listeriosis in adults and 23 cases of listeriosis during pregnancy and the neonatal period. Most children born with congenital listeriosis showed the typical morphological picture of granulomatosis infantiseptica. Occasionally no pathological changes were demonstrable. In adult patients the morphological lesions were those of non-specific purulent meningoencephalitis or septicemia. Sometimes encephalitis with abscesses in the brain was found.

Abortion, Septic↗

PubMed1979

Mammary hamartoma, a benign breast lesion.

Hamartoma or mastoma is a benign breast lesion which is unfamiliar to most clinicians. Five cases with this lesion are presented. It is a rather soft, sharply delineated lump which may cause a considerably asymmetry of the breasts. Radiologically it appears as a circumscribed tumour with homogenous or varying density and at operation the lump is easily enucleated. Histologically it contains normal or dysplastic mammary tissue. It is unilateral and benign. The lesion is now more frequently diagnosed because of increased use of mammography and can be mistaken for a neoplasm. It is therefore important that clinicians and radiologists are acquainted with it.

Adult↗

PubMed1977

Renal revascularization after splenic artery implantation into the kidney. Studies on angiography ex vivo, microangiography and histology in dogs.

Twenty-eight mongrels were subjected to splenic artery implantation into the left kidney for a period of time varying from 7 days to 32 weeks. In 25 of the kidneys a renal artery stenosis was created. Angiography ex vivo, microangiography and histological examination showed that direct implantation of the splenic artery into the renal parenchyma regularly was followed by an initial thrombus formation in the implanted artery and an early recanalization of this thrombus. Newly formed vessels could be demonstrated in the vicinity of the intrarenal portion of the artery already during the second week after implantation. By way of these newly formed vessels three different types of communications were established between the implanted artery and the original intrarenal arteries.

Animals↗

PubMed1976

Conization as only treatment of carcinoma in situ of the uterine cervix.

Knife conization was performed in 2,099 cases with abnormal vaginal smears. The frequency of complications was low. Carcinoma in situ was diagnosed in 1,500 cases and follow-up showed that conization was curative in 87%. The curative rate was depending on whether the resection margins were free of pathologic epithelium or not. If smears were repeatedly negative the first year after conization a new diagnosis of cancer was made in 0.4%. It was not possible to decide whether these lesions were residual changes or true recurrences. Treatment of carcinoma in situ by conization has so far reduced the frequency of invasive cervical cancer by 60%.

Adolescent↗

PubMed1976

A retrospective study of 304 cases of malignant melanoma in Malmö 1952-71.

In the city of Malmö with about 250 000 inhabitants and only one hospital, all cases of malignant melanoma are referred to the departments of plastic surgery and radiotherapy. Altogether 304 cases were treated between 1952 and 1971 and all patients were accounted for at the follow-up. This figure does not include cases of superficial melanoma, Hutchinsons melanoma or eye melanoma. The incidence of melanoma increased from 3.4 to 8.0 per 100 000 inhabitants during the period. The treatment was the same during the years. The results of the treatment are presented in relation to the stage of disease, surgical procedure used, site of the tumour and sex. The overall 5-year survival rate without recurrence was 62%, while 6% were alive with recurrence. The corresponding figures for stage I cases were 71% and 7%. Total biopsy of the tumour before more radical surgery was not found to have any disadvantage. In view of the good results, we intend to continue the present method of treatment with addition of adjuvant chemotherapy in the "poor risk" groups.

Adult↗

PubMed1976

Bilateral fibromuscular hyperplasia in the internal carotid arteries with aneurysm formation.

A patient with bilateral fibromuscular hyperplasia in the carotid arteries with development of aneurysms is reported. The patient had no symptoms except for a palpable mass on one side and a bruit on both sides. Surgery was carried out bilaterally, using direct end-to-end suture on one side and a reconstruction with an autologous vein on the other side. It is suggested that fibromuscular hyperplasia may be the cause of some of the internal carotid artery aneurysms reported as congenital or with uncertain etiology. Reconstructive surgery of the carotid artery is recommended due to the obvious hazards of the condition.

Aneurysm↗

PubMed1976

Carcinoid tumours. Frequency in a defined population during a 12-year period.

The frequency of carcinoids was studied in a 12-year-period (1958-1969) in Malmö, a town with a population of 220,000 at the beginning of the period and 250,000 at the end of it. Of all persons who had died in Malmö, 46 per cent were necropsied in the first year of the study and 70 per cent in the last (altogether 62.6 per cent). The series was examined in a uniform way at one department of pathology. Carcinoid tumours were found in 1.22 per cent (199 patients) of patients comprised in the entire necropsy series (16,294 autopsies). Bronchial carcinoid accounted for 0.1 percent, the remaining lesions were found in the digestive tract. About 90 per cent of the carcinoids were found incidentally at necropsy. During the same period, 44 carcinoids were diagnosed in surgical specimens examined in Malmö. The average annual frequency of carcinoid in the entire series was about 8.4 per 100,000 inhabitants, which is about 7 times as high as that recorded in the National Cancer Register applying to the whole of Sweden. The value of such country-wide reports is discussed. The carcinoid syndrome is extremely rare and was observed only once during the entire 12-year-period. The localization, frequency of metastases and sex-distribution of carcinoids are described and discussed in detail.

Adolescent↗

PubMed1975

Plasminogen activators in ovarian tumours.

Ovarian tumours obtained at laparotomy were histochemically examined for their local fibrinolytic activity, and simultaneous fibrin/fibrinogen degradation products (FDP) were determined in the serum. The fibrinolytic activity was confined mainly to vessels of both malignant and benign tumours. A very close correlation was demonstrated between the fibrinolytic activity and the vascularity of the sections. FDP were found in the serum in 13 of 14 patients with malignant tumours, but in none with benign tumours. The difference in occurrence of FDP in patients with malignant and benign tumours might be due to the invasive growth of the former with the entrance of thromboplastic substances, fibrinolytic activators or locally formed FDP into the bloodstream.

Biopsy↗