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Biomedical subjects

J B Taxy

Publications and source records attributed to J B Taxy.

At least 19 recordsLinked to original sources
PubMed1996

Neoadjuvant chemotherapy in uterine papillary serous carcinoma.

Uterine papillary serous carcinoma (UPSC) is an aggressive variant of endometrial cancer that frequently imitates serous carcinoma of the ovary in its clinical presentation and histologic appearance. Unlike the ovarian lesion, however, it is known to be particularly resistant to chemotherapy. A patient with a putative diagnosis of unresectable Stage IV ovarian cancer was treated with three cycles of neoadjuvant chemotherapy containing paclitaxel and carboplatin. After a remarkable response, interval cytoreductive surgery was performed. A primary endometrial tumor with the pathologic features of UPSC was found. To our knowledge, the use of paclitaxel-containing chemotherapy in UPSC has not been reported. We suggest that this therapy might be useful in the treatment of patients with advanced uterine papillary serous carcinoma, as well as in an adjuvant setting.

Aged↗
PubMed1994

Breast cancer metastatic to the uterus. Clinical manifestations of a rare event.

Adenocarcinoma of the breast rarely metastasizes to the mucosal surfaces of the uterus. We present two patients with endometrial involvement, in one of whom it was the initial manifestation of her breast cancer. Two additional patients with cervical involvement had abnormal Papanicolaou smears and grossly normal cervices. One of these patients underwent a biopsy, the results of which confirmed metastatic adenocarcinoma. Three of the four patients had previously well-established metastatic disease. The presence of genital, especially mucosal, metastases is indicative of widespread disease and imminent demise. This occurred in one of the patients described here; however, another patient survived 30 months. Breast cancer is a chronic disease for which the metastatic behavior is exceptionally unconventional. Tissue acquired by endometrial curettage or colposcopy may require an awareness on the part of the pathologist to such a clinical circumstance.

Adenocarcinoma↗
PubMed1992

Necrotizing squamous/mucinous metaplasia in oncocytic salivary gland tumors. A potential diagnostic problem.

Tumor necrosis and squamous and/or mucinous metaplasia was found in 4 of 26 oncocytic salivary gland tumors (24 Warthin's tumors and 2 oncocytomas). The necrosis was extensive in two cases, producing architectural and cytologic atypia sufficient to simulate a squamous carcinoma. In a third tumor, necrotic and inflammatory debris occurred within dilated tumor spaces exhibiting squamous and mucinous foci, suggesting low-grade mucoepidermoid carcinoma. Adequate sampling revealed Warthin's tumors in all four cases. An additional 13 tumors showed incidental foci of squamous metaplasia, often accompanied by stromal scarring but without necrosis. Four of these tumors also had focal mucinous metaplasia. In the adjacent non-neoplastic salivary gland, oncocytic metaplasia of ducts was seen in 22 glands; there were 7 oncocytic cysts and 3 oncocytic nodules. The tumor necrosis and metaplasia are reminiscent of necrotizing sialometaplasia of the minor salivary gland, thought to be ischemic in origin. The etiology of necrotizing squamous/mucinous metaplasia described here and the extent to which oncocytosis contributes to these changes is unknown. Possibly the extravasation of oncocytic and/or mucinous secretions or cyst contents may result in the reactive changes observed. Necrotizing sialometaplasia and squamous/mucinous metaplasia of oncocytic tumors appear to be related only morphologically, but the shared histologic features may be useful in excluding the diagnosis of salivary gland carcinoma.

Adenolymphoma↗
PubMed1990

Meningioma of the paranasal sinuses. A report of two cases.

Two patients presented with primary meningiomas arising in the paranasal sinuses. Despite nonspecific symptoms, both patients had extensive local clinical disease. One patient had a lateral rhinotomy with total removal of tumor; he has remained well for 3 years. The second patient, who was not a surgical candidate because of her cerebrovascular disease, was identified retrospectively. Her tumor was not originally studied using current day morphologic methods. She was irradiated following a diagnosis of malignant tumor. The histologic features of nasal meningioma are similar to those of conventional intracranial lesions, including nuclear pseudoinclusions. Although the unusual location may suggest carcinoma, melanoma, or olfactory neuroblastoma, adjunctive use of electron microscopy and immunohistochemistry can be combined to arrive at the correct diagnosis.

Aged↗
PubMed1989

Anal cancer. Microscopic condyloma and tissue demonstration of human papillomavirus capsid antigen and viral DNA.

Sixteen cases of squamous cell carcinoma of the anus, including 4 incidentally discovered in situ lesions, and 3 anal condylomas, were examined for the presence of human papillomavirus (HPV). All in situ tumors and 6 of the invasive tumors were associated with histologic changes typical of condyloma, despite the absence of clinical anogenital warts. Immunohistochemical studies for viral capsid antigen gave positive reactions in two anal warts and in the condylomatous area associated with one invasive tumor. In situ hybridization was accomplished using isotopic DNA probes for HPV 6/11, 16, 18, and 31. Human papillomavirus 6/11 was expressed in the corresponding capsid-positive regions in the two warts and the wart-associated invasive carcinoma. Both HPV 6/11 and HPV 16 were associated with one carcinoma in situ, and HPV 16 was also found within two invasive anal carcinomas, one of which was associated with an extensive vulvar cancer. While these observations do not resolve the "passenger" or direct oncogenic role for HPV in anal carcinoma, the circumstantial evidence is that the oncogenic influence is similar to that accepted for female genital tract cancer.

Adult↗
PubMed1989

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↗
PubMed1988

Angiosarcoma of the gastrointestinal tract. A report of three cases.

Three cases of angiosarcoma in the stomach, small bowel, and colon, respectively, are reported. The gastric lesion occurred many years after historic evidence of cutaneous Kaposi's sarcoma. Two of the three lesions exhibited multifocality, and all demonstrated aggressive biologic courses. The varied histologic features of angiosarcoma make this diagnosis difficult to establish in an unusual location such as the gastrointestinal tract. The use of immunohistochemistry for a panel of antibodies, particularly the successful reaction with Factor VIII-related antigen, is important in evaluating light microscopically unusual tumors. A delicate framework of collagen type IV was elicited in each case, but ultrastructurally correlated with short segments of basal lamina in one case. This suggests that the absence of the traditional morphologic expression of basal lamina does not preclude its presence and emphasizes the sensitivity of immunohistochemistry. The lack of previously reported cases of gastrointestinal angiosarcoma may be because the tumor is underrecognized or because it is truly a rare occurrence.

Aged↗
PubMed1988

Merkel tumor of the lower lip: a case report and updated review of the literature work performed at the University of Illinois.

An unusual case of Merkel cell carcinoma of the lower lip with metastasis to the submental nodes is presented. Clinical similarities and the histopathologic and prognostic differences between this tumor and basal or squamous cell carcinomas of the head and neck area are discussed and the current thoughts for treatment are presented. The capricious clinical course and the aggressive nature of the Merkel cell tumor is emphasized. A review of the existing literature is also included in an effort to familiarize the head and neck surgeon with this relatively new but potentially lethal pathological cutaneous entity.

Carcinoma↗
PubMed1987

Pregnancy-associated ectopic decidua.

Extrauterine formation of decidua of stromal cells has been well described, particularly in the cervix and ovary. Sporadic reports have documented decidua formation of peritoneal surfaces and lymph nodes as well as ovarian ectopic decidua in pregnant patients. The apparent hormonal mechanism of this phenomenon suggests a relationship to endometriosis. Between 1983 and 1986, tissue from 10 pregnant patients (acquired from nine at cesarean section and from one at appendectomy) demonstrated submesothelial decidua formation in the form of microscopic nodules and diffuse cell arrangements in an edematous stroma. Some cases showed mild chronic inflammation. An intracytoplasmic lipofusin-type pigment was observed in one case. Four cases had diffuse omental involvement: two with small amounts of free peritoneal blood and two with peritoneal adhesions. Three cases were associated with paratubal cysts: two of these occurred in the uterine and appendiceal serosa, respectively, and one case showed involvement of a retroperitoneal lymph node associated with a pheochromocytoma. No specific gross observations were noted at surgery. There was no prior or subsequent evidence of endometriosis. A review of 958 elective tubal ligations performed between 1983 and 1985 demonstrated 52 examples (5.5%) of serosal decidua formation. Ectopic stromal decidua formation in pregnancy is: (a) a physiologic phenomenon related to the possible specialized sensitivity of the superficial coelomic stroma to progesterone; and (b) diffusely distributed in the peritoneum although it is a clinicopathologic process distinct from endometriosis.

Adult↗
PubMed1986

Utility of specimen angiography in angiodysplasia of the colon.

This study reviews the utility of specimen angiography in identifying colonic lesions clinically thought to represent angiodysplasia. Four elderly patients presented with acute rectal bleeding. The diagnosis of angiodysplasia was made preoperatively in 3 patients by colonoscopy or angiography, or both. These specimens were injected with silicon rubber compound, xerographed, cleared with methyl salicylate, and examined with transillumination before histologic sampling. Although this technique was not used in the fourth case, fortuitous random sampling of the ascending colon revealed vascular changes indicative of angiodysplasia that correlated with a preoperative bleeding scan. Associated lesions in 1 patient were carcinoma of the colon and primary amyloidosis, the concurrence of which has not been described previously. With the injection technique the lesions of angiodysplasia appear grossly as spiderlike, dilated blood vessels. Microscopically, dilated veins, venules, and capillaries are found in the submucosa only or in the mucosa and submucosa. The importance of the postoperative injection is that it prevents the collapse of the blood vessels and enables the pathologist to identify the lesions grossly. As these lesions are usually small, this is important for proper sampling and histologic documentation.

Adenocarcinoma↗
PubMed1986

The feasibility of surgical enucleation for renal cell carcinoma.

Although partial nephrectomy for renal cell carcinoma has been recommended for tumors in solitary kidneys, surgical enucleation has been suggested as an alternative form of surgical management in highly selected patients. To verify the efficacy of surgical enucleation the surgical specimens from 16 standard radical nephrectomies were dissected carefully. The tumors were enucleated ex vivo and carefully investigated pathologically. It was possible to enucleate successfully some well circumscribed, low grade tumors but venous invasion, tumor heterogeneity, occult metastatic disease in lymph nodes, satellite tumor nodules in the kidney and extrinsic spread through the renal capsule were features that may not have been appreciated fully in the operating room. Computerized tomography could not always predict which patients were possible enucleation candidates. Partial nephrectomy remains the preferred surgical treatment in a parenchymal-sparing operation rather than simple enucleation.

Carcinoma, Renal Cell↗