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Biomedical subjects

G F Gray

Publications and source records attributed to G F Gray.

At least 37 records · Page 2Linked to original sources
PubMed1985

Thymic epithelial neoplasms.

We studied 57 tumors of the thymus seen at Vanderbilt University Medical Center between 1957 and 1982. By applying current diagnostic criteria, the classification of 13 tumors was changed. There were 45 epithelial tumors of thymus, including 32 thymomas, two thymic carcinomas, eight carcinoids, and three germinomas. The gross and microscopic features of these neoplasms overlap each other and several other tumors, but with knowledge of the variations it was usually possible to establish a diagnosis with light microscopy. In more difficult cases, electron microscopy was the most useful diagnostic method. New developments in immunologic staining were also of value. The diagnosis of thymoma was used for circumscribed and invasive neoplasms of thymic epithelium without anaplasia. Cytologically malignant thymic epithelial tumors were classified as thymic carcinoma. Thymic carcinomas were more aggressive than thymomas and were not associated with syndromes such as myasthenia gravis or anemia. Thymic carcinoids were frequently aggressive, and several of them produced corticotrophin or calcitonin. Thymic germinomas were histologically identical to testicular seminoma, but may be confused with thymoma because of their lymphocytic infiltrate. Invasive germinomas were radiosensitive.

Adolescent↗
PubMed1985

Malignant melanoma of the tongue following low-dose radiation.

A 47-year-old man had a spindly malignant melanoma of the tongue many years after low-dose radiation therapy for lichen planus. To our knowledge, only 12 melanomas of the tongue have been reported previously, and in none of these was radiation documented.

Dose-Response Relationship, Radiation↗
PubMed1985

Cardiac sarcomas presenting as metastatic disease.

We describe two patients with primary sarcoma of the heart in whom metastatic lesions were the first evidence of disease. One patient had a fibrosarcoma of the tricuspid valve with only pulmonary metastases. The second had a pleomorphic sarcoma of the mitral valve with renal and bony metastases. The possibility of a primary cardiac tumor should be considered in patients with occult metastatic sarcoma.

Adolescent↗
PubMed1985

Cutaneous chromomycosis in renal transplant recipients. Successful management in two cases.

Cutaneous chromomycosis occurred in two renal transplant recipients from the south central United States. Both patients have been managed successfully with surgical excision of isolated lesions, and the condition of one of these has been improved but not cured with low-dose ketoconazole therapy. Even in the immunocompromised host, localized cutaneous chromomycosis may not require more aggressive systemic antifungal chemotherapy.

Abscess↗
PubMed1984

Carcinosarcoma of ileum in regional enteritis.

A biphasic malignant neoplasm, carcinosarcoma, arose in a segment of ileum involved with regional enteritis. The tumor spread throughout the abdomen, and the patient died nine months after diagnosis. The spectrum of intraepithelial dysplasia, carcinoma with varying degrees of differentiation, and sarcomatous-appearing elements suggests that the histogenesis of this tumor is epithelial. This report provides further documentation of the relationship between regional enteritis and unusual neoplasms of the intestine.

Carcinosarcoma↗
PubMed1984

Tumors of the appendix: I. Neoplastic and nonneoplastic mucoceles.

We reviewed the clinical data and pathologic material on 46 patients with lesions originally interpreted as appendiceal mucocele or mucinous adenocarcinoma from two medical centers. The mucoceles, characterized by accumulation of mucus in a dilated lumen, could be divided into three distinct entities: nonneoplastic retention mucoceles (eight cases), cystadenomas (26 cases), and cystadenocarcinomas (eight cases). There were four mucinous adenocarcinomas. Retention mucoceles are associated with little morbidity and are cured by appendectomy. Cystadenomas and cystadenocarcinomas mimic the behavior of ovarian neoplasms of borderline malignant potential. Some of these lesions were associated with pseudomyxoma peritonei, but did not have systemic metastases. Mucinous adenocarcinomas without mucocele mimic the behavior of ordinary large bowel carcinoma.

Adenocarcinoma, Mucinous↗
PubMed1984

Mucoepidermoid carcinoma of salivary glands.

We reviewed the pathologic slides and clinical data of 44 patients with mucoepidermoid carcinomas of major and minor salivary glands. There were 14 well-differentiated, 20 intermediate, and ten poorly differentiated tumors. Two tumors appeared to have only expansive growth. All of the others were invasive, and we identified two patterns of invasion: broad pushing borders and infiltrative permeation. Infiltrative permeation was seen in 13 of 34 well-differentiated and intermediate tumors of which four (31%) metastasized, and in eight of ten poorly differentiated tumors of which five (63%) metastasized. Six of the nine patients with metastases died of carcinoma. Three patients who died with well-differentiated or intermediate tumors survived 10.5 years after diagnosis. Three patients died of poorly differentiated carcinoma less than one year after diagnosis. No patient died of local disease only, and no tumor with a broad pushing border metastasized. Size of tumor, site of origin, tumor cell mitotic rate, and age and sex of the patient had little, if any, effect on prognosis. A combination of tumor differentiation and pattern of invasion were the most useful factors in predicting carcinoma behavior.

Adolescent↗
PubMed1984

Tumors of the appendix: II. The spectrum of carcinoid.

We reviewed the clinical data and pathologic material from 30 patients with appendiceal carcinoids. Most of the tumors were discovered incidentally in appendectomy specimens. Approximately two thirds were tiny lesions identified only by microscopic examination. One tumor metastasized to a regional lymph node. Five histologic patterns were identified. Problems in differential diagnosis may arise in interpreting the variant patterns, but these patterns appear to have no bearing on prognosis. In reviewing the literature we found that appendiceal carcinoids infrequently metastasize widely and only rarely produce the carcinoid syndrome.

Acute Disease↗
PubMed1983

Primary malignant tumors of salivary gland origin. A 52-year review.

Primary carcinoma of salivary glands is uncommon, comprising approximately 30 per cent of salivary gland neoplasms. The natural history of these neoplasms varies greatly, depending largely upon the cell type. Only prolonged follow-up can furnish worthwhile data, and five or even 10 years is inadequate in several cell types. Case records of 202 patients who had major or minor salivary gland carcinomas during the years 1928 through 1979 were reviewed from the files of Vanderbilt University Hospital. We studied these records with regard to site of origin, cell type, lymph node involvement, signs and symptoms, routes of metastatic spread, and survival. Microscopic sections were available for review in 188 patients (93%). Major and minor salivary glands were involved as the primary site in 74 per cent and 26 per cent, respectively. Prognostic factors are discussed, including histologic type and grade, size, lymph node involvement, vascular and perineural invasion, growth pattern (i.e., infiltrating versus pushing margins), and presence or absence of invasion outside the gland. Our 99 per cent follow-up of these patients revealed that the natural course of many of these neoplasms was characterized by long duration, repeated local recurrences, occasional metastases to regional lymph nodes, and frequent metastases to the lungs.

Adenocarcinoma↗
PubMed1983

alpha 1-antitrypsin deficiency presenting with ascites and cirrhosis in the neonatal period.

We report a 2-wk-old baby with alpha 1-antitrypsin deficiency of Pizz phenotype, who presented with massive ascites and hepatomegaly. Liver biopsy disclosed active established cirrhosis. Unlike all other reported newborns with Pizz type, the patient had no evidence of neonatal cholestatic jaundice. The presentation of Pizz with established liver cirrhosis at such an early age not only adds another cause of cryptogenic cirrhosis in the neonatal period, but also points to a liver insult in some patients with Pizz, which is already determined in utero.

Ascites↗
PubMed1982

Systematic mapping of nephroureterectomy specimens removed for urothelial cancer: pathological findings and clinical correlations.

The nature and extent of mucosal alterations in 30 consecutive surgical specimens removed for urothelial neoplasia were evaluated by systematic mapping. The findings correlated with pertinent pathological, cytological and clinical data. Generally, the grade of the principal neoplasm paralleled the degree of epithelial disturbance in the grossly normal urothelium, high grade carcinomas being associated consistently with severe changes and low grade cancers with hyperplasia only. Cytological studies reflected accurately the grade of the principal neoplasm, and the presence of concomitant contiguous and remote mucosal abnormalities.

Adult↗
PubMed1980

Biliary tract obstruction due to tuberculous adenitis.

A 25 year old woman presented with constitutional symptoms and biochemical evidence of biliary tract obstruction. A mass in the region of the head of the pancreas was detected and she underwent laparotomy which revealed isolated tuberculous adenitis of peripancreatic lymph nodes. Complete recovery resulted following the administration of isoniazid and ethambutal.

Adult↗
PubMed1980

Spindle cell cancer of bladder during cyclophosphamide therapy for Wegener's granulomatosis.

A 38-year-old woman with long-standing Wegener's granulomatosis had remission with cyclophosphamide therapy after failure of response to other agents. Severe cystitis with massive blood loss necessitated a cystectomy. The bladder contained an unsuspected neoplasm, histologically resembling leiomyosarcoma, but desmosomes seen on electron-microscopic examination suggested that this was a spindle cell carcinoma. The findings document occurrence of cyclophosphamide related bladder cancer in a patient without a previously diagnosed neoplasm and indicate a need for cytologic monitoring of the bladder in patients requiring therapy with this drug.

Adult↗
PubMed1979

Hemangioendothelial sarcoma of penis.

Hemangioendothelial sarcoma of the penis in a 44-year-old man was treated by preoperative radiation, penectomy, and chemotherapy. The patient was free of evident disease 2 years later. Electronmicroscopy showed differentiated vascular structures at the periphery of the lesion and anaplastic cells throughout the remainder of the tumor.

Adult↗