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Biomedical subjects

G Mendelsohn

Publications and source records attributed to G Mendelsohn.

At least 19 recordsLinked to original sources

Hysteroscopic dissemination of endometrial carcinoma.

BACKGROUND: In patients with endometrial carcinoma, the use of hysteroscopy may result in malignant peritoneal cytology. The significance of these mechanically disseminated malignant cells is uncertain. CASE: Disseminated endometrial carcinoma occurred in a 39-year-old patient with endometrial carcinoma which had been hysteroscopically resected and treated conservatively. Hysteroscopic dissemination was strongly suggested based on the limited extent of carcinoma in the uterus, the exophytic nature of the pelvic tumor implant, and the lack of associated endometriosis. CONCLUSION: Hysteroscopy should be reserved for patients in whom prior endometrial sampling fails to demonstrate malignancy.

Adult↗

The fate of fresh and preserved, noncrushed and crushed autogenous cartilage in the rabbit model.

This study was conducted to investigate volume retention and chondrocyte survival rate in autogenous fresh noncrushed, fresh crushed, preserved noncrushed, and preserved crushed cartilage grafts in rabbits. During the first phase of this investigation, cartilage was harvested from the right ear of 20 New Zealand white rabbits, then preserved. Four months later during the second phase, two 6-mm discs of previously harvested and preserved cartilage, one crushed and one noncrushed, were applied to the right ear. At the same time, two 6-mm discs of fresh cartilage graft were harvested from the left ear and then placed at a higher level on the same side, one crushed and one noncrushed. Three months after implantation, the rabbits were sacrificed and the grafts were evaluated. The preserved noncrushed cartilage retained 91.34% of the volume (SD = 2.46). Although most of the chondrocytes were nonviable, vascular ingrowth occurred with a significant repopulation of chondrocytes peripherally, in association with vascular endothelial ingrowth. The preserved crushed cartilage retained 74.19% of the volume (SD = 3.06). Most of the original chondrocytes were lost, but vascular ingrowth did occur and some osteoid formation occurred on the crushed cartilages. All chondrocytes on the fresh noncrushed cartilage grafts were viable and the grafts retained 94.54% of the volume (SD = 2.46). Crushed fresh cartilage retained 69.73% of its volume and the amount of viable chondrocytes ranged from 70% to 90% in the specimens evaluated (SD = 5.15). Although there is no question that noncrushed cartilage is superior, crushed cartilage can be used with a fair degree of predictability to attain the aesthetic goal.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Adenoid cystic carcinoma of the breast.

Adenoid cystic carcinoma of the breast is a rare neoplasm, with only 140 cases having been reported to date. Data on 123 of these cases are reviewed herein and another case is presented in detail. Several features distinguish this type of breast cancer from more typical histologic types and suggest that it may have a unique tumor behavior. The prognosis appears to be favorable and the incidence of axillary lymph node involvement is lower. Distant metastases are uncommon, but they tend to occur without prior lymph node involvement. This lack of prognostic significance for negative axillary lymph nodes underscores the need for other prognostic markers in this disease and suggests that axillary dissection can be eliminated in most cases. Similarities to typical breast cancer include the incidence of local recurrence and the lack of effect of surgical treatment on distant metastases and overall survival. These data suggest that breast-conserving treatment may be applicable to adenoid cystic carcinoma.

Breast Neoplasms↗

Somatostatin-producing neuroendocrine tumor of the ampulla (ampullary somatostatinoma). Evidence of prosomatostatin production.

Two cases of somatostatin-producing ampullary neuroendocrine tumors (somatostatinoma) are reported. The authors have characterized their immunoreactivity using antibodies specific for the amino- and carboxyl-terminal portions of prosomatostatin, the precursor of somatostatin in the normal synthetic pathway. Cytoplasmic staining was found using each of these two antibodies in the tumor cells of both ampullary somatostatinomas as well as in the cytoplasm of cells in the hypothalamus, crypt cells of the duodenal mucosa, mucosal cells of the biliary tract, D cells of the pancreatic islets, and parafollicular cells of fetal thyroid. These studies suggest that the synthesis of somatostatin in ampullary somatostatinomas occurs through the normal pathway from the precursor prosomatostatin.

Ampulla of Vater↗

Report of a case of localized Castleman's disease with progression to malignant lymphoma.

Patients with multicentric Castleman's disease have an increased risk of developing non-Hodgkin's lymphoma. However, development of lymphoma in the localized form of Castleman's disease has not been previously reported. This case study describes a patient with localized Castleman's disease, hyaline vascular type, whose course was complicated by follicular non-Hodgkin's lymphoma.

Adolescent↗

Intraoperative surgical specimen evaluation: frozen section analysis, cytologic examination, or both? A comparative study of 206 cases.

Having recently become aware of the merits of cytologic preparations, histopathologists are focusing their attention on cytologic examination as a means of intraoperatively evaluating surgical specimens. This study compares the diagnostic accuracy and quality of frozen-section (FS) and cytologic preparations from 206 surgical specimens. The quality of cytologic preparations was significantly superior to that of FSs (P = 0.0001). With the use of a three-level accuracy scale suited to the practical demands of intraoperative evaluation, there was no significant difference between the accuracy of diagnosis by FS analysis compared with that achieved by cytologic examination (P = 0.35). More importantly--except in one case--whenever one technique did not correctly distinguish benign from malignant disease, the other technique yielded an essentially correct diagnosis. With the use of both techniques, 99.5% of cases were interpreted correctly, at least in regard to benign versus malignant diagnoses. Because significant additional time, equipment, stains, laboratory space, or personnel are not needed to implement intraoperative cytologic studies in a routine anatomic pathology laboratory, the authors advocate the simultaneous use of FS and cytologic studies in the specified context.

Diagnostic Errors↗

Role of the transitional mucosa of the colon in differentiating primary adenocarcinoma from carcinomas metastatic to the colon. An immunohistochemical study.

Differentiation between primary colonic adenocarcinoma arising in flat mucosa and carcinoma metastatic to the colon is often difficult. Examination of the mucosa adjacent to the tumor, the so-called transitional mucosa (TM), may be helpful. The morphologic, ultrastructural, and histochemical characteristics of the TM have been reported previously in detail. In this study the morphologic and immunohistochemical characteristics of the TM have been compared in 18 cases of primary colonic adenocarcinoma and 13 cases of metastasis to the colon. Five immunophenotypic markers were used: carcinoembryonic antigen (CEA), Lewis (x) and (y) blood group antigens, ras oncogene p21, and tumor-associated glycoprotein (TAG-72). Neoplastic transformation of colonic epithelium is associated with altered expression of these antigens. The morphologic and immunohistochemical profile of the TM was similar in both primary colonic adenocarcinomas and metastases to the colon. In some cases the TM adjacent to colonic metastases stained with one or more antibodies while the metastatic tumor was negative. Therefore, in cases where differentiation between primary colonic adenocarcinoma arising in flat mucosa and metastasis is difficult, the use of these reagents, particularly CEA, TAG-72, or ras oncogene p21, may be helpful. The similar immunohistochemical staining pattern of the TM in both primary and metastatic colon lesions supports a reactive, non-neoplastic origin of the TM. Furthermore, expression of these antigens is not limited to neoplastic epithelial cells.

Adenocarcinoma↗

Medullary carcinoma of the thyroid gland: an encapsulated variant resembling the hyalinizing trabecular (paraganglioma-like) adenoma of thyroid.

Two encapsulated medullary carcinomas of the thyroid gland exhibiting an organoid and trabecular pattern with hyalinized stroma and composed of polyhedral to spindled tumor cells with hyaline-appearing cytoplasm are described and compared with three histologically indistinguishable adenomas of follicular cell derivation. Positive immunocytochemical staining for calcitonin and negative staining for thyroglobulin confirms the diagnosis of medullary carcinoma in these tumors, while positive staining for thyroglobulin confirms the follicular cell nature of the adenomas. The distinction between these tumor types is a crucial one, given the prognostic and potential genetic implications of medullary carcinoma.

Adenoma↗

The intrathyroidal hyperfunctioning parathyroid gland.

Six cases of primary hyperparathyroidism due to hyperfunctioning intrathyroidal parathyroid glands are reported. In five cases, hyperparathyroidism was due to an intrathyroidal parathyroid adenoma; in the sixth case, hyperparathyroidism resulted from an intrathyroidal parathyroid carcinoma. All five patients with adenoma were female with ages ranging from 40 to 70 yr. The patient with carcinoma was a 55-yr-old male. In all five patients with intrathyroidal parathyroid adenoma, thyroidectomy was performed when an abnormal parathyroid gland could not be located in the neck during surgery for hyperparathyroidism. The patient with intrathyroidal parathyroid carcinoma presented with hypercalcemia and a palpable right thyroid mass. The differential diagnosis of intrathyroidal parathyroid adenoma includes thyroid follicular adenoma. In some cases, the possibility of medullary carcinoma of thyroid might also be considered. Immunocytochemical staining for parathormone (PTH), thyroglobulin, and calcitonin is valuable in establishing the correct diagnosis.

Adenoma↗

Extrapancreatic gastrinoma with pancreatic islet cell hyperplasia.

A case of Zollinger-Ellison syndrome was associated with diffuse islet cell hyperplasia of the pancreas and extrapancreatic gastrinoma. At autopsy, the patient, who had well-documented Zollinger-Ellison syndrome, was found to have gastrinoma in parapancreatic lymph nodes with islet cell hyperplasia but no evidence of pancreatic neoplasm. Possible explanations include the production of a trophic factor by the extrapancreatic gastrinoma, leading to islet cell hyperplasia, or metastasis from a microscopic nodule of gastrin cells that, despite having a "hyperplastic" appearance, exhibited malignant potential.

Adult↗

Osteogenic sarcoma. Malignant fibrous histiocytoma subtype.

A distinctly different entity from the now well-delineated malignant fibrous histiocytoma (MFH) of bone is the MFH histopathologic subtype of osteogenic sarcoma. Although uncommon, recently the authors have encountered six cases of this neoplasm, in each of which the soft tissue component was devoid of bone elements and was microscopically indistinguishable from MFH of bone or soft tissue. Neoplastic osteoid and woven bone were present in the osseous component of each tumor, however. Radiologically, the lesions generally were osteoblastic but focally osteolytic with features typical of osteogenic sarcoma. Pain was the most common presenting symptom. There was no age or sex predilection. Immunocytochemical staining showed strong positivity with alpha-1-antichymotrypsin within malignant bizarre giant cells and occasional neoplastic osteoblasts in five cases. The biological behavior followed a very aggressive course. Four of the six patients developed pulmonary metastases 6 to 12 months after initial surgery; one patient presented initially with pulmonary metastases. Adequate tumor sampling as well as optimal correlation with clinical and radiographic information are required to distinguish the MFH subtype of osteogenic sarcoma from MFH of bone, both being high-grade neoplasms, however.

Adolescent↗

Bronchial carcinoid tumor with amyloid stroma.

The histopathologic, immunohistochemical, and ultrastructural findings of a unique case of an atypical bronchial carcinoid tumor containing abundant stromal amyloid are presented. The differential diagnosis from other neuroendocrine tumors that can produce amyloid is discussed.

Aged↗

Gastric carcinoid tumors, endocrine cell hyperplasia, and associated intestinal metaplasia. Histologic, histochemical, and immunohistochemical findings.

Eleven cases of gastric carcinoid tumor have been studied to review their clinical and pathologic spectrum, to identify any relationship to pernicious anemia, and to evaluate the accompanying gastric mucosal changes, with particular reference to the endocrine cell population. Seven patients were male and four female; ages ranged from 26 to 83 years. Two male patients had documented pernicious anemia and one female patient had unconfirmed pernicious anemia. All patients had marked gastric intestinal metaplasia (atrophic gastritis), which was predominantly fundal (Type A) in three patients with suspected/proven pernicious anemia and antral (Type B) in the other eight. In seven patients, the tumors were typical carcinoids, whereas in 4 patients the carcinoids were "atypical"; one carcinoid was completely polypoid. All cases were argyrophilic, and focal mucin positivity was present in four. Focal somatostatin immunoreactivity was present in four cases, serotonin in three cases, vasoactive intestinal polypeptide (VIP) in two cases, and gastrin (G) in one case. Endocrine cell hyperplasia was identified in the gastric mucosa of eight of 11 patients, including all cases with pernicious anemia; in three of eight cases, G-cell hyperplasia was evident. Numbers of serotonin-positive cells were increased in areas of intestinal metaplasia in all cases. In two patients, there was marked endocrine-cell hyperplasia with multiple small carcinoid tumorlets; the tumorlets stained for G in one. Gastric intestinal metaplasia includes intestinal-like endocrine cells. An association exists between atrophic gastritis and gastric carcinoids, and there is a histogenetic link between atrophic gastritis and some cases of gastric carcinoid tumor.

Adult↗

Angioinvasion in breast carcinoma. An immunohistochemical study of factor VIII-related antigen.

Histologic sections from 63 patients with infiltrating duct carcinoma of the breast were selected for study by immunohistochemical staining with antibody against human Factor VIII-related antigen. Of these 63, 30 had no lymph node metastases at the time of surgery, while 33 had axillary lymph node metastases. A positive correlation exists between the presence of vascular invasion and lymph node metastases. Sixty-nine percent of patients with lymph node metastases had vascular invasion while only 26% of patients without lymph node metastases showed evidence of invasion of blood vessels. The finding of vascular invasion by tumor in patients without axillary lymph node metastases at the time of mastectomy may explain the occurrence of disseminated disease years after treatment.

Breast Neoplasms↗