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Biomedical subjects

H J Norris

Publications and source records attributed to H J Norris.

At least 73 records · Page 4Linked to original sources
PubMed1983

Minimal deviation carcinoma (adenoma malignum) of the cervix.

Minimal deviation carcinoma of the cervix is very rare, representing about 1% of adenocarcinomas of the cervix and less than one-sixth of well-differentiated cervical carcinomas. Composed of distorted glands having an irregular outline and deeply positioned in the cervix, minimal deviation carcinoma often requires hysterectomy to produce a sufficiently deep margin to permit identification of invasion. The gross appearance of the cervix may be normal in early lesions. Minimal deviation carcinoma often grows slowly. The two patients who died of cervical adenocarcinoma did so 6 and 14 years after initial diagnosis and treatment. The 13 cases in this report differ from those previously reported in that the cell types were more varied (most cases in the literature are of a mucinous cell type), the carcinomas were identified at early stages, and the survival of patients was much better than in earlier reports. An association with independent ovarian neoplasms was found.

Adenocarcinoma↗
PubMed1983

Microglandular adenosis of the breast. A clinicopathologic study of 11 cases with ultrastructural observations.

The clinical and pathologic features of 11 examples of microglandular adenosis of the breast are presented. Microglandular adenosis is a rare, benign lesion that is easily confused with carcinoma. It is characterized by a concentrated proliferation of round glands with open lumens in a densely homogeneous stroma that clearly delineates microglandular adenosis from the adjacent uninvolved breast. The glands are lined by a single layer of cells with distinctly vacuolated or granular cytoplasm. Ultrastructurally, the single layer of epithelial cells lacks cytoplasmic protrusions and is surrounded by a thick multilayered basement membrane. Light- and electron-microscopic features that help distinguish microglandular adenosis from well-differentiated (tubular) carcinoma and sclerosing adenosis, entities with which it is easily confused, are discussed.

Adenocarcinoma↗
PubMed1982

Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma.

Endometrial curettings from 204 patients containing severe forms of atypical hyperplasia, carcinoma in situ, and well-differentiated carcinoma were compared with subsequent hysterectomy specimens to evaluate and identify the most useful histologic criteria for predicting the presence of invasive carcinoma. Endometrial stromal invasion, increased degrees of nuclear atypism, mitotic activity, cellular stratification, and epithelial necrosis in curettings were associated with a greater likelihood of carcinoma in the uterus. Of these, stromal invasion was the most significant feature. When stromal invasion was absent, carcinoma was present in the uterus in only 17%, and the carcinomas were well differentiated and confined to the endometrium or only superficially invasive. When stromal invasion was present in curettings, residual carcinoma was present in the uterus in half, and of these, one third were moderately or poorly undifferentiated and a quarter invaded deeply into the myometrium. The criteria for invasion are 1) an irregular infiltration of glands associated with an altered fibroblastic stroma or desmoplastic response; 2) a confluent glandular pattern in which individual glands are uninterrupted by stroma and merge to form a cribriform pattern of stromal replacement; 3) an extensive papillary pattern; and 4) replacement of stroma by masses of squamous epithelium. To qualify as invasion, 2, 3, and 4 must occupy at least one half (2.1 mm) of low power field 4.2 mm in diameter. Because of the important role of stromal invasion in predicting prognosis, future classifications of endometrial neoplasia should utilize this feature in distinguishing atypical hyperplasia from well differentiated adenocarcinoma.

Adenocarcinoma↗
PubMed1982

Well-differentiated (tubular) carcinoma of the breast. A clinicopathologic study of 145 pure and mixed cases.

In this study, 145 well-differentiated (tubular) carcinomas were divided into two groups: 90 pure tubular carcinomas and 55 which were mixtures in that they contained a component of infiltrating duct carcinoma occupying less than half the tumor. Axillary lymph node metastases developed in 29% of women in the mixed group, but occurred in only 6% of the pure group. The prognosis was good in both groups, with five-year-actuarial survival rates in the pure and mixed groups of 100% and 93%, respectively. Residual carcinoma was present in the mastectomy specimen in 28% of the pure group, and in 40% of the mixed carcinomas. In addition, there was a recurrence rate of 50% in patients with pure tubular carcinoma treated by excisional biopsy. These features indicate simple excision of tubular carcinoma is likely to be inadequate therapy and that a mastectomy is warranted. Axillary node dissections should be done when there is a component of infiltrating duct carcinoma because of the increased risk of axillary lymph node metastasis.

Actuarial Analysis↗
PubMed1982

Granulosa tumors of the ovary in children: a clinical and pathologic study of 32 cases.

Granulosa tumors in children differ histologically from those occurring in adults. Of 32 neoplasms occurring in girls 16 years of age or younger, 26 were juvenile granulosa tumors and three were cystic granulosa tumors; only three neoplasms resembled typical adult granulosa tumors. The juvenile granulosa tumor differs from the typical adult form in that it is composed of larger cells and has luteinization of its cellular components. Two-thirds of the patients had endocrine abnormalities. Fifteen of 20 premenarcheal patients had isosexual precocious pseudopuberty. Of the 12 postmenarcheal girls, seven had menstrual abnormalities and two of the seven were virilized. All 32 patients had Stage Ia tumors. The clinical outcome was generally favorable since only two of 26 patients with follow-up developed a recurrence. Unilateral salpingo-oophorectomy is appropriate treatment for girls with Stage Ia granulosa tumors; 23 of 25 patients treated by unilateral salpingo-oophorectomy were well without recurrence at last contact.

Adolescent↗
PubMed1982

Glassy cell carcinoma of the cervix.

Of the 389 cases of primary adenocarcinoma of the cervix in the Armed Forces Institute of Pathology files, only 9 (2%) demonstrated features of glassy cell carcinoma in one third or more of the tumor. Histologically, glassy cell carcinomas were associated with admixed areas of mucinous adenocarcinoma in 5 instances, and 4 of the 9 neoplasms contained glandular differentiation by glassy cells. Squamous differentiation occurred in 4 of the 9 cases, and intracellular mucin was present in 7 of the 8 glassy cell carcinomas stained for it. Even in the single example without demonstrable mucin production gland formation by the tumor cells was evident. Although the cells have a characteristic appearance, it is unclear if glassy cell carcinoma is a meaningful entity. The need for its separate designation in the classification of cervical carcinoma is questionable. If glassy cell carcinoma exists, examples probably will be found within categories of nonkeratinizing large cell carcinoma and undifferentiated carcinoma.

Adenocarcinoma↗
PubMed1982

Peritoneal leiomyomatosis (leiomyomatosis peritonealis disseminata): a clinicopathologic study of 20 cases with ultrastructural observations.

Peritoneal leiomyomatosis (PL) occurs in women of reproductive age. Of 20 women with PL in this study, 10 were pregnant or immediately postpartum, and 7 were taking oral contraceptive steroids. Only three of the 20 women were not pregnant or taking exogenous hormones. All PL nodules were composed mainly of spindle cells, but decidual cells were admixed with the spindle cells in some of the nodules in six of the 10 pregnant and postpartum women. Electron microscopy was applied to the nodules from six women representing the three different hormonal backgrounds. All contained smooth muscle cells. One was composed exclusively of smooth muscle cells, while four of the six contained smooth muscle cells predominantly but were admixed with myofibroblasts or altered smooth muscle cells and fibroblasts. Decidual cells were conspicuous in the nodules examined ultrastructurally from a pregnant woman. Despite incomplete excisions, none of the 14 women with follow-up had progressive disease. Complete or partial regression of PL was verified by "second-look" laparotomy in four women, but a repeat cesarian section in a fifth woman revealed persistence (or recurrence) of PL 1.5 years after the initial diagnosis. PL probably results from an unusual predisposition, or selective sensitivity, of subperitoneal mesenchymal stem cells in some women to undergo metaplasia and differentiation to smooth muscle, fibroblasts, myofibroblasts, and decidual cells. In the majority of women, hormonal stimulation is an initiator or promoter of the process.

Adult↗
PubMed1981

Adenofibroma and adenosarcoma of the uterus: a clinicopathologic study of 35 cases.

The clinical and histopathologic features of ten adenofibromas and 25 adenosarcomas of the uterus were studied. The most useful criterion for distinguishing adenofibroma from adenosarcoma was the frequency of mitotic figures found in the stroma. Adenofibromas had fewer than four mitotic figures per 100 HPF in the most active areas; adenosarcomas had four or more. Myometrial invasion, histologically malignant heterologous mesenchymal elements, and marked atypia of stromal cells were histologic features detected only in adenosarcoma. Of the women with adenosarcoma, ten (40%) had recurrences, with a median interval to recurrence of five years. The only morphologic feature that correlated with aggressive behavior of adenosarcoma was deep myometrial invasion. Adenofibroma and adenosarcoma are in the family of mixed mesodermal tumors, but are distinct clinical and pathologic entities.

Adenofibroma↗
PubMed1981

Dysgerminoma with syncytiotrophoblastic giant cells. A histologically and clinically distinctive subtype of dysgerminoma.

The clinical and pathological features of six dysgerminomas containing syncytiotrophoblastic giant cells were studied; these represented 3% of the dysgerminomas in the AFIP files. Syncytiotrophoblastic giant cells, the distinguishing histological feature, were present either in clusters or were distributed diffusely. Human chorionic gonadotropin was demonstrated immunocytochemically within the cytoplasm of the syncytiotrophoblastic giant cells in both of the two tumors tested for it. Serum or urine gonadotropin titers, measured in four patients, were elevated in three, and two of these were thought to have ectopic pregnancies. All of the dysgerminomas were Stage Ia, and the six patients were well 1-14 years after treatment.

Adnexa Uteri↗
PubMed1981

Mesenchymal tumours of the uterus. VII. A clinicopathological study of 60 endometrial stromal nodules.

Endometrial stromal nodules are well-circumscribed neoplasms composed of cells identical to those in low-grade endometrial stromal sarcoma and proliferative endometrium. The clinical and pathologic features of 60 endometrial stromal nodules were studied to determine their characteristics and behaviour. A follow-up of up to 16 years revealed that none of the 60 patients developed recurrences or died of her disease, indicating that circumscribed endometrial stromal tumours are benign. A number os specific features such as irregularities in the margin, high mitotic counts, and a glandular trend did not seem to alter the benign course of this lesion.

Adult↗
PubMed1980

Sertoli tumors of the ovary. A clinicopathologic study of 28 cases with ultrastructural observations.

The clinical and pathologic features of 28 Sertoli tumors of the ovary are presented. Seventeen of the 18 neoplasms had a functional effect. The effects were hyperestrinism (eight women), isosexual precocious puberty (three girls), virilization (four women), a progestational decidual reaction on the peritoneum (one woman), and a combination of virilizing and estrinizing signs (one woman). There were three histologic patterns: simple tubular, complex tubular, and folliculome lipidique. Two neoplasms recurred, both of which had the distinctive feature of invasion of the supporting stroma by individual and columns of tumor cells in the original tumors. Electron microscopic evaluation of three neoplasms disclosed. Charcot-Böttcher filaments unequivocally identifying the Sertoli differentiation of the predominant cells in the neoplasm. The identification by electron microscopy of a smaller population of cells within the three tumors similar to typical ovarian stromal cells suggests that Sertoli tumors arise from ovarian stromal cells.

Adolescent↗
PubMed1980

The role of adjuvant therapy in Stage I ovarian cancer.

Women with Stage I epithelial carcinoma of the ovary were initially treated by an extirpative operation and were subsequently randomized to either no further treatment, radiotherapy, or chemotherapy. Only two patients (6%) treated with chemotherapy developed recurrence, compared to five (17%) and seven (30%) patients in the no-treatment and radiotherapy regimens, respectively (P < 0.05). All patients, with the possible exception of those with Stage IA(1)g1, appeared to benefit from adjuvant chemotherapy compared to no treatment or radiotherapy.

Adenocarcinoma↗
PubMed1980

Secretory carcinoma of the breast.

Nineteen examples of a very rare type of carcinoma of the breast have been studied. The carcinoma is unusual in that it has exaggerated secretory features previously reported only (with one exception) in juveniles. But not all the patients in our series were juveniles; they ranged in age from 9 to 69 years (median age, 25 years). Six were 30 years of age or older. Eighteen patients were female and 1 was a 9-year-old boy. Treatment varied from local excision of the tumor to radical mastectomy. Four of the 11 patients who had axillary node dissection had metastatic deposits showing the same secretory features as the primary neoplasm. One of these 4 patients, a 25-year-old woman, died within ten months with disseminated tumor. Because this distinctive pattern of carcinoma is not limited to children and adolescents, we propose that it be called "secretory carcinoma." Since, of the 19 patients, 4 (21%) had axillary node metastases and 1 (5%) died with disseminated tumor, an extended simple mastectomy is recommended as the initial treatment for patients more than 20 years of age.

Adolescent↗
PubMed1980

Coexistence of cervical intraepithelial neoplasia with primary adenocarcinoma of the endocervix.

A review of 389 primary adenocarcinomas of the uterine cervix was conducted at the Armed Forces Institute of Pathology. After histologic classification, each was evaluated for the presence of squamous dysplasia and carcinoma in situ. Squamous epithelium was not present in 159 instances, but 230 cases were eligible for further evaluation. Squamous intraepithelial neoplasia was present in 99 (43%) of these--severe dysplasia and carcinoma in situ comprised over half of the cases. The frequency of squamous intraepithelial neoplasia in the major subtypes of primary adenocarcinoma is discussed. The term cervical (squamous) intraepithelial neoplasia includes all cases of dysplasia (mild, moderate, and severe) and carcinoma in situ.

Adenocarcinoma↗
PubMed1979

Pathologic effects of oral contraceptives.

The pathologic effects of oral contraceptives have been described in this paper and in other reviews [1, 5, 23, 35, 44, 48, 59, 80, 103, 114]. Approximately 10 million women currently use oral contraceptives in the United States. These drugs are beneficial both to the users and for population control. It is their effect on the health status of women who take them that must continue to have well-organized investigation so that more meaningful conclusions concerning their safety will permit continued use. In some instances, the pathologic effects of oral contraceptives make it necessary that new methods of contraception be found. Intensive research in this area is needed and judiciuos use of oral contraceptives must be maintained. A national registry should be formed to record and investigate the cases of women who die or have adverse reactions while taking these agents. A registry might identify associations no previously known to exist in patients taking oral contraceptives. It would serve to concentrate the data in one area so that more material would be available for the study of pathogenetic mechanisms. It would heighten patient and physician awareness of the untoward effects and increase the responsibilities of the women who take them to monitor their own health.

Blood Glucose↗
PubMed1979

Smooth muscle tumors of the vulva.

The clinical and pathologic features of 32 smooth muscle tumors of the vulva were studied to determine the pathologic characteristics that best relate to the clinical behavior and to define criteria for separating leiomyomas from leiomyosarcomas. The length of follow-up ranged from 16 months to 20 years, with a median of 9 years. None of the tumors metastasized. Of the 4 neoplasms that recurred, the 2 with infiltrating margins recurred within 1 year and of these 2, the one with more than 5 mitotic figures in 10 high-power fields (HPF) recurred 5 times within a 2-year period. Neoplasms were discovered during pregnancy in 7 patients; these were characterized by extensive myxoid change, but none of the tumors that occurred during pregnancy showed significant cellular atypism or mitotic activity. Local excision is recommended as initial therapy and also for recurrences.

Adolescent↗