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Biomedical subjects

J B Stern

Publications and source records attributed to J B Stern.

At least 37 records · Page 2Linked to original sources
PubMed1996

Oncocytic nodular hidradenoma.

Oncocytic neoplasms are most commonly of salivary, thyroid, parathyroid, and renal origin. Ocular adnexal tumors with oncocytosis have been reported. We report an unusual example of a skin adnexal tumor from the back. A tumor of uncertain duration was excised from a 54-year-old man. Light microscopy of hematoxylin and eosin-stained sections showed a large, fairly well-defined cystic nodular hidradenoma with areas infiltrated by numerous closely arranged, large, uniform, oval and polygonal cells with abundant intensely eosinophilic cytoplasm and small central, dark, round nuclei. No significant cellular atypia or mitotic figures were observed. The cytoplasm of these cells showed markedly positive immunostaining with monoclonal antimitochondrial antibodies. Electron microscopy demonstrated cytoplasm packed with mitochondria. Pure oncocytic tumors usually follow a benign clinical course. The focal presence of oncocytes in an otherwise histologically recognizable tumor apparently does not affect the prognosis, which in this case is the favorable outcome expected for a nodular hidradenoma.

Adenoma, Oxyphilic↗
PubMed1995

Pagetoid melanocytosis. Histologic features in benign and malignant lesions.

Pagetoid melanocytosis (PM), the upward discontinuous extension of melanocytes into the superficial epidermis, although generally considered a histologic feature of malignancy, may be seen in certain benign melanocytic lesions. To formulate the histologic criteria for distinction between benign and malignant PM, we examined 218 melanocytic tumors, including melanomas, Spitz nevi, nevi of palms and soles, pigmented spindle cell nevi, recurrent nevi, vulvar nevi, nevi of infancy and early childhood, and ordinary acquired nevi. We found PM to be present in 96% of melanomas, 38% of Spitz nevi, 61% of nevi of palms and soles, 20% of pigmented spindle cell nevi, 60% of recurrent nevi, 80% of vulvar nevi, and none of the ordinary acquired nevi. All the nevi of infancy and early childhood showed PM, but they had been selected for that feature. In melanomas, PM showed significant cellular atypia (81%), which was extensive and diffuse, and in 13% it extended laterally beyond the underlying junctional component. In the benign lesions, cellular atypia was generally absent, nor was lateral extension present, and PM was usually focal or multifocal rather than diffuse and not extensive. Although PM should be considered a tocsin for malignant melanoma, it may also occur in certain benign melanocytic lesions. Accurate interpretation depends on evaluation of all of the pertinent histologic and clinical findings.

Adolescent↗
PubMed1995

Basal cell carcinoma of the sole.

Basal cell carcinoma (BCC) of the plantar surface of the foot is rare, with only 22 previously reported cases. This clinicopathologic study is based on 20 cases of BCC of the plantar surface and plantar-like surfaces from adjacent lower lateral and medial aspects of the foot, submitted to a large podiatric laboratory from 1986 through June 1992 (total specimens for this period = 518,624; total BCC of lower extremities, below knee = 53). There were 15 women and 5 men. The average patient age was 73 years, with a range from 52 to 92 years. The duration of the lesion before diagnosis was 2 months to 12 years, with an average of 2 years. Three patients had a history of trauma. Podiatric clinical diagnoses included BCC (4), SCC (3), soft tissue tumor (2), nevus (1), granuloma (1), keratosis (2), verucca (1), and psoriasis (1). Follow-up information was available on 10 patients; all were free of disease up to 64 months, with an average follow-up of 15.7 months. Three of 20 BCC showed predominant histologic patterns characteristic of fibroepithelioma of Pinkus (FEP). An additional three BCC showed focal or suggestive patterns of FEP. Fourteen tumors showed ordinary BCC histologic patterns. No multicentric-superficial or morphea like BCC were observed. The relatively high incidence of FEP in BCC of the sole correlates with abundant sweat glands and lack of hair follicles on the plantar surface, in accordance with the recent proposal that FEP derives its histologic pattern from the spread of BCC down eccrine ducts, eventually replacing them with solid strands of tumor.

Aged↗
PubMed1995

Proliferative activity in metastatic malignant melanoma: comparison of pre-treatment and post-treatment metastases.

In this study, the proliferative activity of malignant melanoma metastases was assessed before and after isolated limb perfusion chemotherapy by quantitating AgNORs, mitoses and PCNA activity. No significant difference in either AgNOR count, mitotic activity or PCNA index was observed. We conclude that AgNOR count, mitotic activity and PCNA index were not significantly effected by isolated limb perfusion chemotherapy.

Antineoplastic Agents↗
PubMed1995

Argyrophilic nucleolar organizer regions and proliferating cell nuclear antigen/cyclin in Kaposi's sarcoma. Comparison with morphology and with immunoperoxidase staining for factor VIII-related antigen.

The proposal that Kaposi's sarcoma undergoes cellular transformation from early to late stages was studied with argyrophilic nucleolar organizer regions, proliferating cell nuclear antigen/cyclin, and immunoperoxidase staining for factor VIII-related antigen. Staining of argyrophilic nucleolar organizer regions was significantly increased in the plaque/nodular stage compared to the patch stage. The endothelial-selective marker factor VIII-related antigen stained more intensely in patch stage lesions. This was inversely correlated with staining of argyrophilic nucleolar organizer regions. Proliferating cell nuclear antigen/cyclin staining did not correlate with tumor stage or with factor VIII-related antigen. The changes in argyrophilic nucleolar organizer regions and factor VIII-related antigen staining are evidence for cellular transformation in Kaposi's sarcoma.

Humans↗
PubMed1995

Cutaneous pathology in Wegener's granulomatosis. A clinicopathologic study of 75 biopsies in 46 patients.

While no cutaneous lesion is specific for Wegener's granulomatosis (WG), several histopathologic entities, including leukocytoclastic vasculitis and necrotizing granulomatous inflammation, are characteristic. This report details the histopathologic features of 75 cutaneous biopsies from 46 patients with WG. Biopsies were subdivided into histologic groups that included leukocytoclastic vasculitis (31%), granulomatous inflammation (GI) (19%), nonspecific ulceration (4%), superficial dermal and epidermal necrosis without inflammation (2.7%), erythema nodosum (2.7%), granuloma annulare (1%), chronic inflammation (31%), and acute inflammatory lesions without vasculitis (9%). No convincing example of granulomatous vasculitis was observed. The histopathologic subgroups were correlated with clinical features, and the results were compared with those from a control group of 82 WG patients with no skin involvement. We found that the histopathologic subgroups of leukocytoclastic vasculitis and granulomatous inflammation correlated with different clinical courses. Patients with leukocytoclastic vasculitis developed WG at an earlier age (median age, 30 years) than did the control group (median age, 45 years). Leukocytoclastic vasculitis developed shortly after onset of WG (median, 15 months vs. 35 months for patients with nonspecific chronic inflammation). All lesions occurred during active disease. Active disease with leukocytoclastic vasculitis was associated with a mean erythrocyte sedimentation rate twice that of active disease in the same patient when leukocytoclastic vasculitis was absent. The patients with leukocytoclastic vasculitis had more rapidly progressive and widespread WG than patients with granulomatous skin lesions or patients without skin lesions. A marked excess of joint and musculoskeletal symptoms and renal disease was seen in patients with leukocytoclastic vasculitis. Patients with granulomatous inflammation also developed WG at an early age (median age, 30 years) when compared with the control group. Cutaneous granulomatous lesions also developed shortly after presentation (median, 12 months). Only 64% of granulomatous biopsies were from patients with active disease. These patients frequently had neither renal nor pulmonary manifestations of WG, and their disease progressed at a slower rate than that of the patients with leukocytoclastic vasculitis. These findings suggest that the cutaneous lesions characteristic of WG may correlate with the activity, distribution, and course of the disease.

Adolescent↗
PubMed1994

Intraluminal flame spread in tracheal tubes.

Intraluminal combustion in polyvinyl chloride tracheal tubes was investigated. Two flame types were observed: intraluminal and downstream. The flame-spread velocity, burning rate, and equivalence ratio of the intraluminal flame were determined. The products of the intraluminal flame were analyzed, revealing compounds capable of further combustion. Below a certain oxidant flow rate, the tubes do not ignite. At low flow rates that support a flame, the burning rate is minimal and the equivalence ratio reveals no fuel available for the downstream flame, suggesting that ignition of tracheal tubes is least likely in the absence of intraluminal flow. We conclude that the downstream flame is the flame type that is most dangerous and that the intraluminal flame is the generator of fuel and ignition energy for the downstream flame.

Chromatography, Gas↗
PubMed1994

Fibroepithelioma of Pinkus. Eccrine duct spread of basal cell carcinoma.

The spread of basal cell carcinoma (BCC) directly into the dermis or down the sides of hair follicles is a common-place pathologic observation. BCC spread via eccrine ducts, which has received less recognition, is the subject of this investigation. We specifically address the question of whether eccrine duct spread accounts for the histologic pattern of the fibroepithelioma of Pinkus (feP) type of BCC. Twenty-five BCC, including 12 feP, five superficial BCC, six ordinary BCC, one BCC of the sole of the foot, and one BCC with prominent hair follicle spread were studied with H&E sections; 11 were immunostained for carcinoembryonic antigen. In ordinary BCC, occasional entrapped eccrine ducts were present. One superficial BCC surrounded the proximal portion of an eccrine duct. The BCC from the sole of the foot showed advanced spread down eccrine ducts; focal obliteration of duct epithelium and lumen was seen, as was transition to strands of solid BCC. Nine of the 12 feP showed one or several eccrine duct foci with tumor strands. These findings suggest that eccrine ducts serve as an initial template in feP and subsequently are replaced by the BCC. However, eccrine duct spread of BCC may occur without necessarily imparting an feP histologic pattern.

Carcinoembryonic Antigen↗
PubMed1993

Malignant melanoma in xeroderma pigmentosum: search for a precursor lesion.

BACKGROUND: Malignant melanomas occur with increased frequency and at an early age in patients with xeroderma pigmentosum (XP). OBJECTIVE: The purpose of this study was to describe the histologic features of malignant melanomas in patients with XP and to search for a possible precursor lesion. METHODS: Clinical records and hematoxylin-eosin-stained sections of 19 malignant melanomas from seven patients with XP were examined. A search was conducted for malignant melanoma precursor lesions (melanocytic nevi and solar lentigines lateral to and contiguous with the malignant melanomas). Basal cell carcinomas removed from the same patients were used as controls. RESULTS: Malignant melanomas were characteristically found in biopsy specimens of small elevations and/or changed color foci arising in large, flat, darkly pigmented, gradually enlarging macules. Histologically, solar lentigo was lateral to and contiguous with malignant melanoma in 88% of the malignant melanomas. Transitional areas were present. A significantly lower number (22%) of contiguous solar lentigines, without transitional areas, were observed in the basal cell carcinoma controls. Most of the invasive malignant melanomas were spindle cell malignant melanomas. CONCLUSION: We propose that solar lentigo is the most common precursor lesion of malignant melanoma in patients with XP.

Adolescent↗
PubMed1992

Immunohistochemistry in the differential diagnosis of nodular hidradenoma and glomus tumor.

The histologic distinction between nodular hidradenoma and glomus tumor is an occasional difficult diagnostic problem. Both tumors may show circumscribed aggregates of uniform epithelioid cells, a myxoid stroma, and variable numbers of blood vessels. Especially troublesome are solid cellular hidradenomas without duct-like structures and glomus tumors without a vascular pattern. To develop an immunohistochemical profile useful in this differential diagnosis, 25 selected skin tumors and four normal glomus bodies were studied with antibodies against low molecular-weight cytokeratin (CAM 5.2), epithelial membrane antigen (EMA), carcino-embryonic antigen (CEA), S-100, and vimentin (VIM). The tumors included eight unequivocal hidradenomas, seven unequivocal glomus tumors, and 10 histologically equivocal cases, originally diagnosed as glomus tumors. In all unequivocal glomus tumors and glomus bodies, only VIM was positive. Of the eight unequivocal hidradenomas, three were positive for CAM 5.2, EMA, CEA, S-100, and VIM; two for CAM 5.2 only; one for CAM 5.2, EMA, and S-100; one for CAM 5.2, EMA, and CEA; and one for CEA only. In the histologically equivocal cases, eight were positive for VIM only, characteristic of glomus tumor; and two were positive for CAM 5.2, EMA, CEA, S-100, and VIM, and were reclassified as hidradenomas. The study suggests that morphologic criteria may not always accurately differentiate between hidradenoma and glomus tumor and that in equivocal cases immunohistochemistry may be useful in the differential diagnosis.

Adenoma, Sweat Gland↗
PubMed1990

Eosinophilic pustular folliculitis: fungal folliculitis?

Eosinophilic pustular folliculitis is a rare condition with no known cause. However, a fungal cause is suggested by (1) tinea-like annular lesions, (2) initial clinical consideration of fungal folliculitis in many reported cases, (3) an association with the acquired immunodeficiency syndrome, and (4) an association with scaly and vesiculopustular lesions of palms and soles. We report a case histologically identical to eosinophilic pustular folliculitis but in which hyphal fungal organisms were demonstrated in one of the involved hair follicles.

Adult↗
PubMed1990

Reexcision perineural invasion. Not a sign of malignancy.

Perineural invasion has been reported to occur in both benign and malignant neoplasms. We describe two cases in which perineural invasion by epithelial cells was present in reexcision skin specimens removed because of melanocytic lesions in the original biopsy material. Because of the absence of a primary epithelial neoplasm, this phenomenon was interpreted as a reactive or reparative process, most probably resulting from regenerating traumatized sweat gland ducts. On the basis of this study alone, it may not be possible to distinguish between reexcision perineural invasion and perineural invasion from a primary epithelial neoplasm. For such cases, the following histologic features serve as provisional guidelines favoring an interpretation of reexcision perineural invasion: absence of perineural spread beyond the immediate previous biopsy site, benign appearance of the perineural epithelial cells different from the appearance of the original tumor, and absence of residual epithelial tumor in the vicinity of the involved perineurium.

Adult↗