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Biomedical subjects

G Mendelsohn

Publications and source records attributed to G Mendelsohn.

At least 55 records · Page 3Linked to original sources
PubMed1983

Polypoid squamous carcinoma of the esophagus. A case report with immunostaining for keratin.

Polypoid carcinoma of the esophagus is a rare variant of squamous carcinoma, which occurs typically in elderly patients who present with symptoms of dysphagia. This tumor has been given a variety of names, including spindle cell carcinoma, carcinosarcoma, and pseudosarcoma. These designations reflect the controversy surrounding the nature of the spindle cell component of this lesion. We have studied a case of polypoid carcinoma of the esophagus with immunoperoxidase staining for keratin which has been shown to be specific for epithelial cells. Positive staining for keratin was demonstrated in both the carcinomatous and spindle cell "sarcomatous" appearing components of the tumor, supporting the contention that this tumor is of entirely epithelial origin.

Aged↗
PubMed1983

Solid and papillary neoplasm of the pancreas. A potentially curable surgical lesion.

Two patients with a recently recognized pancreatic neoplasm are reported. In both cases the tumors occurred in young women (21 and 24 years) who presented with an abdominal mass. Both tumors were large (approximately 12 x 12 cm), one requiring a distal 85% pancreatectomy and the other a total pancreatectomy. Gross pathologic examination revealed apparent encapsulation, cystic degeneration, and hemorrhagic necrosis. Microscopically, the tumors were characterized by distinctive solid and papillary patterns. Such lesions have been reported recently in the pathology literature as "solid and papillary" or "papillary-cystic" neoplasms of the pancreas. Approximately 60 such cases have been reported to date. The histogenesis of these lesions is debatable. They may be diagnosed incorrectly as adenocarcinomas, islet cell tumors, cystadenomas, or cystadenocarcinomas. Assessing the degree of malignancy can be difficult since this tumor is capable of local invasion but usually does not metastasize. There is only one report of a patient dying from distant metastases. Both patients presented here are alive and well seven and 24 months post-surgery. It would appear that despite their large size these pancreatic tumors are potentially curable by surgical resection.

Adult↗
PubMed1982

Angioimmunoblastic lymphadenopathy progressing to immunoblastic lymphoma with prominent gastric involvement.

Two unusual cases of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), with progression to immunoblastic lymphoma (IL) and prominent gastric involvement are presented, and detailed immunohistologic studies described. In one case, Bence Jones proteinuria of the kappa type was observed during the course of AILD and was identified immunohistochemically in lymph node biopsy specimens and at autopsy. The potential significance of an M component and the importance of recognizing gastric involvement by AILD are discussed.

Bence Jones Protein↗
PubMed1982

Immunoperoxidase detection of carcinoembryonic antigen and blood group substances in papillary transitional cell carcinoma of the bladder.

Immunoperoxidase localization of A and B blood group substances and carcinoembryonic antigen in papillary transitional cell carcinoma of the bladder demonstrated blood group substances in 22 of 48 carcinomas and trace amounts of carcinoembryonic antigen in 26. All 22 cases of transitional cell carcinoma positive for blood group substances were stage O (noninvasive) and 21 were grade I or II (well differentiated). Of 26 tumors negative for blood group substances 14 were grade III (poorly differentiated). Of 17 patients who had tumors positive for blood group substances at any time no positive tumor was followed by invasive carcinoma. In contrast, of 17 patients who had tumors negative for blood group substances 15 either had invasive carcinoma at the time of diagnosis or later. Carcinoembryonic antigen positivity did not correlate with pathologic stage, histologic grade or clinical course.

ABO Blood-Group System↗
PubMed1982

Thyroid venous catheterization in the early diagnosis of familial medullary thyroid carcinoma.

In kindreds with familial medullary thyroid carcinoma (MTC), individuals are often detected whose peripheral plasma calcitonin (CT) levels are undetectable in the basal state but increase minimally following provocative testing. The proper management of such patients has been uncertain, but most investigators have advocated repeat testing and evaluation after an interval of several months. The present study was conducted to evaluate the diagnostic implications of these modest increases in plasma calcitonin. In 25 kindred members at direct risk for familial medullary thyroid carcinoma (MTC), basal peripheral plasma calcitonin (CT) levels were less than 240 pg/ml. Following provocative testing with intravenous calcium or pentagastrin or both, calcitonin values remained below 240 pg/ml in eight subjects (Group A), however, they were mildly elevated (260-580 pg/ml) in 12 subjects (Group B) and moderately elevated (700-940 pg/ml) in five subjects (Group C). Following the transfemoral placement of a catheter into the inferior thyroid vein (ITV), provocative testing was repeated, and ITV and peripheral blood samples were collected simultaneously. Basal ITV plasma CT levels were below 240 pg/ml in all patients in Group A, however, they were mildly elevated (500 pg/ml) in one of the 12 patients in Group B and moderately elevated (800 pg/ml, 1400 pg/ml) in two of the five patients in Group C. Following provocation, ITV plasma CT levels became markedly elevated in one patient in Group A and in all of the patients in Groups B(2520+/-635 pg/ml) and C (6322+/-2598 pg/ml). Thyroidectomy was performed in patients whose ITV plasma CT level was elevated following provocative testing. Medullary thyroid carcinoma of C-cell hyperplasia were evident either on microscopic (1/1 patient in Group A;9/12 patients in Group B; and 2/5 patients in Group C), or gross (3/12 patients in Group B;3/5 patients in Group C) examination of thyroidectomy specimens. In only one of 14 patients was metastatic MTC noted on histologic examination of resected cervical lymph nodes. Postoperative peripheral plasma CT levels were unchanged from basal and less than 240 pg/ml following provocative testing in all but one patient. The present study then provides definitive evidence that patients at direct risk for familial MTC who have even minimally abnormal responses in peripheral plasma CT following provocative testing generally harbor some stage of a C-cell proliferative disorder. Identification of such individuals with early disease is important because thyroidectomy offers an extremely high cure rate.

Adolescent↗
PubMed1982

The prognostic and biological significance of cellular heterogeneity in medullary thyroid carcinoma: a study of calcitonin, L-dopa decarboxylase, and histaminase.

We evaluated the cellular distribution of calcitonin (CT), L-dopa decarboxylase (DDC), and histaminase [diamine oxidase (DAO)] in 33 patients with medullary thyroid carcinoma (MTC). CT immunostaining was uniform (greater than 90% of the cells) and intense (4+) in lesions from 7 patients with C-cell hyperplasia and 6 with microscopic MTC: conversely, patchy CT staining (less than 40% of the cells) and diminished intensity (1+) were found in metastases from 8 patients who died of virulent disease. In 17 patients who underwent thyroidectomy for macroscopic cervical MTC with no evidence distant metastases, CT staining was intense (3-4+) and homogeneous (greater than 90%) in 11 subjects who were well 0.5-16 yr postoperatively. Six patients with similar clinical presentations had heterogeneous staining for CT in primary tumor (less than 40% of the cells; 1-2+ intensity); 5 died of disseminated MTC 0.5-5 yr postoperatively (P less than 0.001). Biochemical studies of distant metastases revealed an inverse relationship between the distribution of CT and that of both relationship between the distribution of CT and that of both DDC (r = 0.71; P less than 0.01) and DAO (r = 0.81; P less than 0.001). We conclude that cellular heterogeneity in MTC tissue is associated with a distinct biochemical pattern, and its presence, whether in a primary or metastatic lesion, indicates a virulent neoplasm associated with a grave prognosis.

Adult↗
PubMed1981

Relationship of ectopic ACTH production to tumor differentiation: a morphologic and immunohistochemical study of prostatic carcinoma with Cushing's syndrome.

A case of Cushing's syndrome in a patient with an ACTH-producing prostatic carcinoma is presented. Initial transurethral biopsy showed a moderately well-differentiated adenocarcinoma. The development of Cushing's syndrome was associated with a change in the morphology of the tumor; repeat transurethral prostatic biopsy and autopsy showed an admixture of moderately well-differentiated adenocarcinoma and anaplastic carcinoma. Immunoperoxidase studies revealed ACTH only within the anaplastic component of the tumor, which also showed strong argyrophilia. Electron microscopic studies revealed abundant dense-core granules within the anaplastic portion of the tumor with only very scanty granules in the differentiated portion. This case strongly supports the contention that cells with APUD characteristics can differentiate within epithelial tissues of multiple embryologic origins, and that the possession of APUD features does not necessarily imply origin from any specific neuroendocrine progenitor cell.

Adenocarcinoma↗
PubMed1981

Distribution of blood group substances in normal human colon. Use of the unlabeled antibody (PAP) immunoperoxidase technic to identify A and B blood group substances.

A modification of the unlabeled antibody immunoperoxidase technic, using human antisera to identify blood group substances A and B in normal human colon is described. Overall, staining for the blood group substances is strongest in the cecum and proximal colon; there is a progressive reduction of staining for the blood group substances in the distal colon with almost complete loss in the recto-sigmoid area. The blood group substances are present in epithelial cells and in epithelial mucin, the most intense positive staining often being located in the supranuclear, Golgi region of the cells.

ABO Blood-Group System↗
PubMed1981

Medullary carcinoma of the thyroid in the multiple endocrine neoplasia IIA syndrome.

Clinical, biochemical, and morphologic parameters in 72 patients with familial medullary thyroid carcinoma (MTC) associated with multiple endocrine neoplasia IIA (MEN IIA) were reviewed. Sixty-nine patients had undergone total thyroid resection. In 27 patients (Group I) the thyroid tumors were smaller than 0.7 cm in diameter; five of these patients had C-cell hyperplasia alone. In 19 patients (Group II) tumors ranged from 0.7 to 1.5 cm, and in 26 patients (Group III) they were larger than 1.5 cm. The mean ages at surgery were 19.6 years (Group I), 33.7 years (Group II), and 32.2 years (Group III). Regional lymph node metastases occurred less often in patients of Group I, 4/20 (20%) and Group II, 4/13 (30%) than in those of Group III, 14/17 (82%) [p = 0.0001]. Elevated postoperative plasma calcitonin levels, indicative of residual MTC, were observed less frequently in patients in Group I, 6/27 (22%) and Group II, 6/15 (50%) than in Group III, 11/15 (73%) [p = 0.005]. All of the patients in Group I and Group II are alive (mean follow-up of 3.5 years and 6.0 years following surgery), whereas 6/26 (23%) Group III patients have died of metastatic MTC, three within 2 years of initial diagnosis. Histologic features varied with tumor diameter. All tumors from patients in Group III contained amyloid, while the majority of those from patients in Group I had an infiltrative configuration and 9/22 tumors lacked amyloid. Among neoplasms from patients in Group III, mitotic figures correlated with distant metastases or death from tumor. Only 1/16 patients who died from MTC had a distinctive tumor morphology, namely a prominent component of small cell anaplastic carcinoma. Early detection of minimal MTC in MEN IIA family members offers the best chance of curing patients with this potentially fatal lesion.

Adolescent↗
PubMed1981

Endocrine-related biochemistry in the spectrum of human lung carcinoma.

The association of hormonal syndrome and APUD (amine precursor uptake, decarboxylase) features with small cell carcinoma of the lung (SCC) has suggested that SCC has a separate cell origin from other major forms of lung cancer. Recently, however, both SCC and non-SCC lung cancers have been found to contain small polypeptide hormones and APUD enzymes. The present study quantitates, in 50 samples of human lung cancer tissue, relationships among the 4 major types of lung cancer and endocrine-related properties. Among 4 parameters measured (dopa decarboxylase, histaminase, beta-endorphin, and calcitonin), no single marker clearly separated SCC from non-SCC lung cancer. The high activity of dopa decarboxylase (the "D" in "APUD") best separated SCC from non-SCC, but significant overlap existed even for this critical APUD property. In fact, 2 adenocarcinomas had among the highest concentrations of dopa decarboxylase, histaminase, and calcitonin of any tumor tissue studied. The simultaneous appearance of high levels of 2 or more markers favored SCC. This was quantitated by deriving an index unit based upon the product of the values for the 4 markers in each lesion. This index separated all SCC from all non-SCC lung carcinomas, with the exception of the above 2 adenocarcinomas. Endocrine-related properties thus occur throughout the spectrum of human lung cancer. Biochemical differences between the major histopathological types are quantitative rather than qualitative and probably reflect the fact that the major forms of lung cancer represent a continuum of differentiation within a common cell lineage which includes both SCC and non-SCC lung tumors.

APUD Cells↗
PubMed1981

Distribution of carcinoembryonic antigens and blood group substances in adenocarcinoma of the colon.

Immunoperoxidase techniques were used to localize carcinoembryonic antigens (CEA) and human blood group substances (BGS) in 41 adenocarcinomas of the colon and 15 metastases or recurrences of these tumors. Ten primary tumors (24 per cent) were strongly positive for both antigens, 12 (29 per cent) were positive for BGS only, 11 (27 per cent) were positive for CEA only, and eight (20 per cent) contained only microscopic amounts of either. With few exceptions, individual tumor cells contained either CEA, BGS, or neither, but not both. Cancers of the left colon which were positive for BGS were associated with a lower frequency of metastases than were those without BGS (p less than 0.01); tumors lacking both CEA and BGS metastasized more frequently than those tumors containing either or both antigens (p less than 0.01). In tumors of the right colon, there was no significant correlation between antigen content and frequency of metastases. In three cases, the development of recurrent or metastatic tumor was associated with a loss of BGS positivity. The data suggest that immunohistochemical studies of BGS and CEA may be of value in estimating the clinical behavior of certain colon carcinomas.

Adenocarcinoma↗
PubMed1981

Invasive aspergillosis complicating Cushing's syndrome.

Patients with Cushing's syndrome are susceptible to opportunistic infections. Invasive fungal infections in patients with Cushing's syndrome caused by endogenous glucocorticoid excess rarely are reported, and aspergillosis occurring in this setting, to our knowledge, has not been described. Two patients with Cushing's syndrome and notably elevated levels of circulating cortisol had invasive aspergillosis develop. A patient with endogenous hypercortisolism caused by adrenal cortical carcinoma suffered a subarachnoid hemorrhage from rupture of an Aspergillus mycotic aneurysm. The other patient, who had an adrenocorticotrophic hormone-producing prostatic carcinoma, had pulmonary and disseminated aspergillosis develop. Exogenous corticosteroids are known clinically and experimentally to facilitate disseminated aspergillosis. Endogenous hypercortisolism also may bae an important factor predisposing to invasive aspergillosis.

Aged↗
PubMed1981

Colonic "precancer" in Crohn's disease.

Two patients with longstanding Crohn's disease, who developed colonic carcinoma and showed associated "precancer" identical to that seen with ulcerative colitis, are reported. The first patient developed rectal adenocarcinoma at age 42 yr, 27 yr after the onset of symptoms while the second patient had a clinically silent small colonic carcinoma at the time of colectomy, 40 yr after the onset of disease. Both patients had characteristic Crohn's disease. In both patients, in addition to the carcinoma, there was multifocal "precancer" characterized by (a) epithelial dysplasia and (b) adenomatous growth pattern and villiform proliferation of the mucosa. These changes were identical to those associated with ulcerative colitis and, in both cases, were present adjacent to and distant from the infiltrating carcinomas. It is important to note that such epithelial changes, termed "precancer" in the setting of longstanding ulcerative colitis, can also occur in association with longstanding Crohn's disease. Further studies are needed to define the incidence of such precancerous changes in Crohn's disease more clearly and to evaluate the relationship between these changes and carcinoma. Careful evaluation of patients with longstanding Crohn's disease and "precancer" is warranted to exclude concomitant carcinoma.

Adenocarcinoma↗
PubMed1980

Tumor cell origin of histaminase activity in ascites fluid from patients with ovarian carcinoma.

We have demonstrated by tissue assay and immunohistochemical techniques that tumor cells appear to be the source of the increased histaminase activity found in 60% of ascitic fluids from patients with ovarian carcinoma. The histaminase activity in 64% of tumor tissues studied was greater than 100 U/g of tissue, a value higher than that for normal tissues other than kidney and intestine. The presence of elevated ascitic fluid histaminase activity (greater than 3.5 U/ml) correlates with the presence of high histaminase activity in tumor tissue. Histaminase activity is higher in ascitic fluid from the patients than it is in their plasma, probably reflecting the direct entry of histaminase into the peritoneal cavity.

Amine Oxidase (Copper-Containing)↗
PubMed1980

Relationship of lysozyme (muramidase) to histiocytic differentiation in malignant histocytosis: an immunohistochemical study.

Malignant histiocytosis (MH) is a rare, usually fatal systemic disease considered to be a neoplasm of true histiocytes. Because MH may be difficult to differentiate from non-Hodgkin's lymphomas or carcinoma, we examined surgical and autopsy material from 10 patients with MH using the immunoperoxidase technique to determine if the presence of intracellular lysozyme is helpful in making this distinction. The cases of MH were divided into three groups based on the degree of cytologic atypia and the amount of phagocytic activity of the neoplastic cells: group I--minimal cytologic atypia and rare erythrophagocytosis; group II--minimal cytologic atypia with extensive erythrophagocytosis: group III--moderate to marked cytologic atypia and rare phagocytosis. Moderate to strong staining for lysozyme was observed in the neoplastic cells of group I, weak or absent staining in group II cells, and no staining in group III cells. These findings suggest the loss of detectable enzyme in poorly differentiated or dedifferentiated neoplastic histiocytes. Consideration must be given to these observations in evaluating the use of lysozyme as a possible serum or tissue aid to the diagnosis of MH.

Adolescent↗
PubMed1980

Relationship of metastatic medullary thyroid carcinoma to calcitonin content of pheochromocytomas: an immunohistochemical study.

Immunoperoxidase studies have been utilized to investigate further the previously reported presence of immunoassayable calcitonin in pheochromocytoma tissue from some patients with MEN II syndromes. We have been able to demonstrate calcitonin in pheochromocytoma tissue only in two patients with MEN II syndromes in whom the pheochromocytomas contained metastatic medullary thyroid carcinoma. In both cases, the calcitonin was present only in the medullary carcinoma. We have not been able to demonstrate immunoreactive calcitonin in normal adrenal glands or in pheochromocytomas of other patients with and without MEN syndromes. Adrenal medullary cells and thyroid C cells are both of neural crest origin and both possess APUD characteristics. The presence of calcitonin in medullary thyroid carcinoma cells and not in pheochromocytes has important implications with regard to cellular differentiation and peptide hormone production.

Adrenal Gland Neoplasms↗