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J B Taxy

Publications and source records attributed to J B Taxy.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1986

Occult medullary thyroid carcinoma. Unusual histologic variant presenting with metastatic disease.

A 66-year-old man presented with an enlarged cervical lymph node, interpreted on fine-needle aspiration as squamous cell carcinoma. Histologic assessment of the excised mass demonstrated a mucin-positive glandular neoplasm that, by immunohistochemistry, was positive for carcinoembryonic antigen, calcitonin, and neuron-specific enolase. A subsequent total thyroidectomy revealed a grossly normal organ with a 2-mm microscopic focus of medullary carcinoma and foci of C-cell hyperplasia in the immediate vicinity of the tumor. No amyloid could be demonstrated in either lesion. The diagnostic difficulty encountered in this case is related to the presence of a rare morphologic variant (devoid of amyloid and forming mucin-positive glands) occurring as an occult primary but presenting as a metastasis. Although an occult primary in medullary carcinoma is recognized in familial cases, such a phenomenon is rare in sporadic cases.

Aged↗
PubMed1986

The spectrum of olfactory neural tumors. A light-microscopic immunohistochemical and ultrastructural analysis.

Twenty-eight malignant olfactory neural tumors representative of the histologic spectrum commonly designated as olfactory neuroblastoma were subdivided into two groups: Group I closely resembling classical neuroblastoma (20 cases), and Group II exhibiting neuroendocrine features (eight cases). Immunohistochemically, the tumors were analyzed by using antibodies to keratin, neurofilament protein, S-100, and neuron specific enolase. Neuron specific enolase was the most consistently positive in both groups. Single S-100 positive cells, within or at the edges of tumor nests, often corresponded ultrastructurally to Schwann cells at the tumor-stroma interface. Keratin and neurofilament proteins were expressed singly or together by a small number of cases in both groups. All 11 tumors examined ultrastructurally exhibited neuronal processes containing dense-core granules. The results indicate the following: (a) the reliable diagnostic utility of electron microscopy; (b) the frequent occurrence of Schwann cells in these tumors despite their inconspicuousness by light microscopy; and (c) the unexpected expression of keratin by tumors in both groups. The single or coexpression of keratin-neurofilament protein may define a subset of these tumors for which the clinical significance is presently unclear.

Cranial Nerve Neoplasms↗
PubMed1986

Sinonasal undifferentiated carcinoma. An aggressive neoplasm derived from schneiderian epithelium and distinct from olfactory neuroblastoma.

Eight cases of a highly aggressive undifferentiated carcinoma of the nasal cavity and paranasal sinuses are described. The patients, who ranged in age from 30-77 years, had multiple sinonasal symptoms, and each had involvement of the nasal cavity, maxillary antrum, and ethmoid sinus. Six tumors extended into the orbital bones, and five penetrated the cranial cavity. Five patients died of disease from 1 to 41 months after diagnosis (median: 4 months), and three are alive with tumor less than 1 year following diagnosis. Microscopically, the neoplasms formed nests, trabeculae, and sheets containing medium-sized cells with small to moderate amounts of eosinophilic cytoplasm. A high mitotic rate, tumor necrosis, and prominent vascular permeation were characteristic. Seven neoplasms were immunoreactive for cytokeratin, five for epithelial membrane antigen, and four for neuron-specific enolase. Ultrastructurally, occasional small desmosomes and rare membrane-bound, dense-core granules were observed. Sinonasal undifferentiated carcinoma is a distinctive clinicopathologic entity that must be distinguished from other, less aggressive sinonasal neoplasms.

Adult↗
PubMed1986

Rhabdomyosarcoma of the common bile duct in an adult.

Rhabdomyosarcoma (RMS) of the hepatobiliary system is extremely rare in adults. To our knowledge only three cases have been reported in the literature, all involving the gallbladder. The present case concerns a 40-year-old woman who presented with epigastric pain and obstructive jaundice and was found to have a fusiform, submucosal neoplasm in the common bile duct. Histologically, the tumor presented a diagnostic problem due to a predominant sclerotic growth pattern suggesting an epithelial tumor. Extensive sampling revealed a focal alveolar growth pattern with rhabdomyoblasts, although cross striations were not seen. Electron microscopy failed to demonstrate the characteristic thick myofilaments and/or Z-band material. The diagnosis was supported by strongly positive immunohistochemical staining for myoglobin and desmin; the keratin stain was negative. A subsequent supraclavicular metastasis showed the typical histology of an alveolar RMS. The histologic features of the primary tumor suggest that RMS in this location may be underrecognized due to regional similarities to either primary or metastatic infiltrating carcinomas.

Adult↗
PubMed1985

Nasopharyngeal carcinoma: antikeratin immunohistochemistry and electron microscopy.

Eighteen examples of nasopharyngeal carcinoma (NPC), a tumor with potential diagnostic difficulty, were studied retrospectively. Using the WHO classification, 16 cases were undifferentiated carcinoma (UC). Immunohistochemistry for each tumor was performed on paraffin sections using two commercially available polyclonal antisera and a monoclonal antibody, AE-1. Method 1 used trypsinization, overnight incubation with the primary antibody and the avidin-biotin complex (ABC) technic. Method 2 used a 20-minute incubation with the primary antibody without trypsinization and employed the peroxidase-antiperoxidase (PAP) technic. Method 2 is the one most frequently employed by pathologists who use immunohistochemistry as a diagnostic aid. Method 1 gave clear positive results in each case with antibody AE-1 and, in most cases, with the polyclonal antisera. Electron microscopy in 10 cases demonstrated desmosomes in each case and easily demonstrable tonofilaments in five. The results of this study indicate that in the diagnosis of UC, the most common variant of NPC, squamous differentiation can be documented readily by electron microscopy and immunohistochemistry for keratin proteins. With the latter, optimization of technic is essential for reliable results.

Adult↗
PubMed1985

Herpes simplex lymphadenitis. An unusual presentation with necrosis and viral particles.

An inguinal lymph node was excised from a 23-year-old woman. Histologic examination revealed necrotic foci with cytologic changes indicative of herpes simplex virus; immunohistochemistry and electron microscopy confirmed the presence of virus. Typical cutaneous lesions appeared on the vulva three days after surgery. Focally necrotizing lymphadenitis and cytologic changes of viral transformation are unusual in herpes group infections.

Adult↗
PubMed1984

Adenocarcinoma of the hepatic duct junction. A reappraisal of the histologic criteria of malignancy.

The morphologic distinction between benign and malignant sclerotic processes involving the hepatic duct junction may be difficult. To determine reliable histologic criteria of malignancy, the authors reviewed 18 cases of clinically suspected adenocarcinoma of the hepatic duct junction (Klatskin tumor) retrieved from our autopsy and surgical pathology files over the last decade. The lesions were compared histologically to a variety of benign sclerotic biliary duct lesions, including four cases of primary sclerosing cholangitis (PSC) treated surgically over the same time period. A diagnosis of malignancy was confirmed histologically in 16 suspected Klatskin tumors, based on the presence of severe cytologic atypia (13) and/or perineural invasion (15). The tumor patients averaged 59 years of age with a male to female ratio of 2:1. Patients with segmental tumor resection and postoperative radiotherapy have survived as a group 6 months longer (average, 15.7 months) than those treated with drainage procedures alone (average, 9.5 months) (P less than 0.005), but have had extensive postoperative morbidity. In all the surgical specimens, tumor was present at one or more margins of resection. Primary sclerosing cholangitis patients were younger (average, 31 years of age) with a similar male predominance, but with a strong history of inflammatory bowel disease. All are alive up to 6.5 years since disease onset, with comparatively little postoperative morbidity. Two clinically diagnosed Klatskin tumors were not confirmed on histologic review. Both patients are alive at 1 and 3.5 years following onset of disease, having experienced little postoperative morbidity. Data indicate that Klatskin tumors are relatively aggressive malignancies, distinct from more indolent benign sclerotic disease, but occasionally mimicked by it clinically. Malignancy can be diagnosed histologically with adequate tissue sampling, thereby facilitating clinical decisions regarding radiotherapy or other palliative surgical procedures.

Adenocarcinoma↗
PubMed1984

Laryngeal cysts in adults: a clinicopathologic study of 20 cases.

Clinically significant cysts in the region of the larynx are uncommon. In this study, 20 cases were recovered for the period 1969-1983. There were eight males and 12 females whose ages ranged from 28-76 years and whose most common symptom combinations were hoarseness (9), local foreign body sensation (5), and pain (4). Laryngoscopic examination revealed cystic lesions 0.5-3.0 cm. in diameter, all localized to the supraglottis with half in the vallecula . Histologically, 17 cysts were closely associated with tonsillar lymphoid tissue. Nine cysts, having squamous lined crypt-like structures and abundant follicular lymphoid tissue, were designated "tonsillar cysts." Eight cysts had a prominent epithelial component and focal follicular lymphoid aggregates. Three cysts were unassociated with lymphoid tissue. Two of these, located in the ventricles of elderly patients, were oncocytic cysts. Both showed oncocytic changes on the surface mucosa and in adjacent salivary gland tissue. In one case, a biopsy of the contralateral ventricle demonstrated oncocytic metaplasia. Treatment in all cases was by surgical excision. Follow-up on 13 patients ranging from three months to 9 years revealed one recurrence of an oncocytic cyst one year after initial removal. We conclude that follicular lymphoid tissue is present in most laryngeal cysts and may play some pathogenetic role in their formation. Furthermore, oncocytic cysts are different from other laryngeal cysts, having a characteristic location, age group, field effect, and recurrence rate.

Adult↗
PubMed1984

Systemic rhabdomyosarcoma with diffuse bone marrow involvement. Case report of an unusual presentation.

Rhabdomyosarcoma presenting as a systemic disease is rare. This report concerns a 12-year-old girl who came to medical attention for what was thought to be a hematologic malignancy. Diffuse lytic bone lesions and large primitive cells in the bone marrow exhibiting erythrophagocytosis supported this diagnosis. During the course of the disease, a soft tissue mass in the region of the left ankle was removed and was a typical alveolar rhabdomyosarcoma. Retrospective review of the marrow, including electron microscopy, demonstrated that the primitive marrow cells were probably rhabdomyoblasts as well. The clinical course was a rapid downhill one in which lytic bone lesions and hypercalcemia were prominent. Although rhabdomyosarcoma eventually may disseminate, initial widespread disease without a clinically apparent primary can be a diagnostic dilemma. This clinical presentation, in combination with the recognized aggressiveness of the alveolar histologic subtype, identifies a rare subgroup of patients with rapidly fatal disease.

Ankle↗
PubMed1984

"Anemone" cell (villiform) tumors: electron microscopy and immunohistochemistry of five cases.

Five large cell malignant neoplasms were studied by immunohistochemistry and electron microscopy. Ultrastructural examination demonstrated numerous circumferential microvilli in 3 cases and a more polarized distribution in 2 cases. The tumor cells in 2 cases demonstrated the surface glycoprotein T29/33, indicative of a hematopoietic neoplasm. Two cases (including one positive for T29/33) contained intracytoplasmic IgG-kappa. Anti-keratin staining using both polyclonal and monoclonal antibodies was negative. Two patients are alive and in remission after treatment for lymphoma. One died with tumor following a progressive course, and one has been lost to follow-up. A fifth patient died of tumor and at autopsy was found to have a disseminated pancreatic tumor. Microvilli around large malignant cells have been commonly associated with epithelial tumors; however, our findings indicate that, in the absence of intercellular junctions and tonofilaments, the possibility of malignant lymphoma should be considered and pursued immunohistochemistry.

Aged↗
PubMed1983

Malignant mesothelioma of the pleura with extensive cardiac invasion and tricuspid orifice occlusion.

Malignant mesotheliomas of the pleura generally cause death by progressive encasement of the lung, but characteristically do not form large tumor masses or deeply invade the lung. Symptoms of pericardial involvement may be present in about 9% of patients at presentation, but at autopsy up to 67% are alleged to extension of the tumor to the pericardium. Infiltration of the myocardium occurs less frequently, but the exact frequency is unknown, and the extent of invasion and clinical effects are poorly documented. The authors report a case of a malignant mesothelioma of the pleura, which extended to involve the pericardium, necessitating pericardiectomy. Subsequently, the patient died as a result of tumor growth through the right atrial wall forming a large intraatrial mass that occluded the tricuspid orifice.

Aged↗
PubMed1983

Paraganglioma of the cauda equina. Report of a rare tumor.

The rare occurrence of a paraganglioma of the cauda equina is described. The correct diagnosis was made only retrospectively after examination of a recurrence nine years after initial surgery. Paragangliomas have not been mentioned in large tabulations of spinal cord tumors, perhaps reflecting the fact that it is only within the last decade that such tumors have been recognized in this unusual location. A literature review has revealed six cases of paraganglioma of the cauda equina reported since 1970. An awareness of the possibility of a paraganglioma intimately associated with the spinal cord as well as the histopathologic appearance are the bases of a correct diagnosis. These tumors are histopathologically similar to paragangliomas in conventional locations, exhibit ultrastructural granules and may, as in the current case, also demonstrate argyrophilic granules.

Cauda Equina↗