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J E Oertel

Publications and source records attributed to J E Oertel.

At least 19 recordsLinked to original sources
PubMed2000

Thyroid cytology and histology.

Fine needle aspiration (FNA) is an economical procedure that allows prompt evaluation of a thyroidal mass. Careful attention to each step of the aspiration will allow good specimens to be obtained. The cytopathologist should obtain the aspirates or else should accompany the clinician performing the aspirations. Unsatisfactory specimens should constitute less than 5% of the total. Reliable diagnoses can be made of papillary carcinoma, medullary carcinoma, anaplastic carcinoma, chronic lymphocytic thyroiditis, benign cystic lesions and the usual colloid-rich adenomatoid nodules. The diagnosis of follicular neoplasms and some cellular adenomatoid nodules remains problematical. Therefore, some thyroid operations inevitably yield benign follicular lesions.

Adenocarcinoma, Follicular↗
PubMed1998

Diagnosis of benign thyroid lesions: fine-needle aspiration and histopathologic correlation.

Fine-needle aspiration is now accepted as the initial procedure for diagnosing a thyroid nodule. General pathologists inevitably will be asked to interpret aspirates as this diagnostic tool continues to be more widely used. This procedure is relatively inexpensive, is safe, and nearly always provides information useful in deciding how to manage the patient. We emphasize the importance of obtaining a representative sample of good quality. This often occurs when the "interventional pathologist" performs the aspirations, but there is no reason that another practitioner cannot become expert. Both histologic and cytologic features are reviewed from normal thyroid tissue, autoimmune thyroiditis, adenomatoid nodules, and follicular neoplasms. We encourage the use of clear, simple, and uniform terminology to facilitate communication.

Adenoma↗
PubMed1998

Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopathologic correlation.

Fine needle aspiration is a diagnostic tool useful as a guide to patient management. We believe that its role in solving the diagnostic dilemmas presented by thyroid nodules is still underappreciated. Current fiscal constraints in health care might bring about a wider use of this simple technique to select patients for surgery. Care in sampling a mass is essential to obtain aspirates that are representative of the lesion and adequate in quantity for interpretation. Several aspirates are needed from all but the smallest masses. Most thyroid carcinomas are well-differentiated with a low grade of malignancy. The majority of these are papillary carcinomas, which are easily diagnosed in good cytologic smears. With fine needle aspirates the goal is to diagnose a follicular neoplasm and to separate it from the adenomatoid nodule. The follicular neoplasm then can be classified as adenoma or carcinoma with the histologic sections. The minimally invasive carcinoma still can be challenging to recognize. We hope that the cytologic criteria and histopathologic correlations presented here will help general pathologists who interpret aspirates. We believe that in the near future additional immunohistochemical methods and genetic markers will be used increasingly to discriminate among the neoplasms and to provide prognostic information.

Adenocarcinoma, Follicular↗
PubMed1997

Follicular variant of papillary carcinoma of the thyroid: fine-needle aspirates with histologic correlation.

Crile and Hazard reported in 1953 a follicular pattern of papillary thyroid carcinoma. Little has been said about this pattern in the cytologic literature. From more than 8,000 thyroid aspirates in our files, we reviewed all those diagnosed as "follicular variant of papillary carcinoma," "suspect follicular variant of papillary carcinoma," and "follicular neoplasm vs. follicular variant of papillary carcinoma." Also, we reviewed all aspirates in which a diagnosis of follicular variant of papillary carcinoma had been made on surgically excised glands, regardless of the cytologic diagnosis; 63 aspirates from 45 patients were collected. All smears were air-dried and stained with Diff-Quik. Most smears were very cellular ("tumor cellularity"), and the neoplastic follicular cells formed empty follicles, rosettes, tubules, and papillary structures. Nuclei were twice the size of red blood cells, had smooth contours, were hyperchromatic, and varied in shape but not much in size. Nuclear overlapping was common. Some nuclei had one small and almost pointed end, thereby resembling arrowheads. Intranuclear inclusions, multinucleated histiocytes, and psammoma bodies were uncommon. Pink-stained colloid was frequent.

Adult↗
PubMed1996

Thyroglossal duct cysts: diagnostic criteria by fine-needle aspiration.

OBJECTIVE: To document the cytologic diagnostic criteria of fine-needle aspirations of thyroglossal cysts. DESIGN: Midline cervical masses were studied by fine-needle aspiration, and those 11 thyroglossal cysts that were resected served as a baseline for the evaluation of aspirates from 33 similar lesions that were not removed. SETTING: Physicians' offices, hospital outpatient clinics, and the aspiration service of a university department of pathology. PATIENTS: Forty-four patients noting a mass in the anterior neck or found by physicians to have such a mass. INTERVENTIONS: Fifty-one aspirations (second aspirates in seven patients); surgical removal of the cysts in 11 patients. MAIN OUTCOME MEASURES: Aspirates were examined for cells, other particulate matter, and any extracellular material in the background. RESULTS: Smears from thyroglossal cysts are low in cellularity, and inflammatory cells are more numerous than epithelial cells. CONCLUSIONS: Fine-needle aspiration contributes to an accurate preoperative diagnosis of thyroglossal cysts, allowing a Sistrunk procedure to be performed in these patients rather than an inappropriate local resection.

Adenoma↗
PubMed1995

Oxyphilic papillary thyroid carcinomas.

Oxyphilic papillary carcinomas of the thyroid have not been extensively studied because they are rare. The morphology and behavior of 34 cases were described. The average age was 44.1 years, the female-to-male ratio was 3.9:1, and the average diameter of the tumors was 2.3 cm. All had papillary structures present. In 31 cases, there was capsular or parenchymal invasion. Six cancers had local lymph node metastases. The average follow-up for 29 patients was 8.1 years. Tumors reappeared in four patients; one patient died from recurrent disease, one patient with disease died due to an unrelated carcinoma, and two patients were treated successfully. Twenty-seven patients at the end of follow-up were alive with no detectable thyroid cancer. The majority of patients remained free of tumor, especially those younger than 50 years.

Adenoma, Oxyphilic↗
PubMed1992

Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases.

We have examined the microscopic appearance, immunohistochemical staining properties, and clinical behavior of 28 cases of acinar cell carcinoma of the pancreas. Two of the tumors occurred in children. The adult patients ranged in age from 40 to 81 years (mean, 62 years). Males greatly outnumbered females, and most of the patients were white. Presenting symptoms were nonspecific, and jaundice was infrequent. The frequently reported complications from increased serum lipase levels (i.e., arthralgias and subcutaneous fat necrosis) were present in only 16% of the patients. Grossly, the tumors were relatively circumscribed and fleshy, averaging 10.8 cm, with occasionally extensive hemorrhage and necrosis. Microscopically, the tumors were very cellular and characteristically lacked a desmoplastic stroma. Acinar, solid, trabecular, and glandular patterns of growth were identified; individual tumors were usually mixed. Nuclei were round to oval, with minimal pleomorphism and single prominent nucleoli. Mitotic activity was variable. In general the cytoplasm was moderately abundant, eosinophilic, and granular, but many of the solid tumors had cells with scanty cytoplasm. Characteristic periodic acid-Schiff-positive, diastase-resistant cytoplasmic granules were demonstrated in greater than 90% of the cases, and the butyrate esterase histochemical stain for lipase activity was positive in 73%. Immunohistochemically, there was positivity for trypsin in 100% of the cases, for lipase in 77%, for chymotrypsin in 38%, and for amylase in 31%. A minor endocrine component was recognized with antibodies against chromogranin or islet cell hormones in 42% of the tumors. Ultrastructurally, exocrine secretory features were present, with polarized cells showing microvillilined lumina, abundant rough endoplasmic reticulum, and 125-1,000-nm zymogen-like granules. In addition, many cases showed pleomorphic electron-dense granules measuring up to 3,500 nm and containing fibrillary internal structures. Follow-up information was available in 88% of the cases. Half of the patients had metastatic disease at presentation and an additional 23% subsequently developed metastases, which were usually restricted to the regional lymph nodes and liver. The mean survival for all cases was 18 months, with 1- and 3-year survivals of 57 and 26%, respectively. Patients presenting before age 60 years survived nearly twice as long as older patients did. Stage also influenced prognosis, whereas the histologic subtype of the tumors and the location within the pancreas correlated only weakly with survival.

Adult↗
PubMed1989

The pancreas. Nonneoplastic alterations.

The normal development and microanatomy of the pancreas are summarized, and brief comments are made regarding current concepts of the control of exocrine functions. Pathologic alterations of acinar cells (including degranulation, nuclear changes, and cytoplasmic vacuolization) are fairly common, but they are often overlooked. Dilatation of acini, loss of acinar cells, and apparent increases in centroacinar cells and intercalated ductal cells also may occur. Changes in the larger ducts include epithelial atrophy, hyperplasia, and metaplasia; in addition, some relationships to age, ductal obstruction, and ductal carcinoma may exist. However, the majority of the alterations are nonspecific. The major types of chronic pancreatitis are illustrated, especially the irregularity of the pancreatic involvement that is so common. In an attempt to better understand the early stages of acute pancreatitis, foci of acute localized pancreatitis have also been studied.

Acute Disease↗
PubMed1989

Hemoptysis as the presenting manifestation of thyroid carcinoma. A case report.

An unusual case of a 61-year-old man who had hemoptysis as the major presenting manifestation of radiation-induced thyroid carcinoma is reported. The diagnosis was made by bronchoscopic removal of a polypoid lesion that was a direct extension of tumor through the trachea. Bronchoscopy is an effective and reliable means of establishing the diagnosis in this unusual subset of patients with thyroid carcinoma invading the trachea, and should be considered as the first diagnostic procedure in a patient with a thyroid mass and hemoptysis.

Bronchoscopy↗
PubMed1985

Solid and papillary epithelial neoplasm of the pancreas.

Solid and papillary epithelial neoplasm of the pancreas is an uncommon low grade malignant tumor histologically distinct from the usual ductal adenocarcinoma and amenable to cure by surgical excision. It tends to occur in black women in their second or third decade of life and has often been misclassified as nonfunctional islet cell tumor or as cystadenoma or cystadenocarcinoma. Twelve cases were reviewed. Sonography and CT of solid and papillary epithelial neoplasms depict a well-demarcated mass that can be solid, mixed cystic and solid, or largely cystic. The radiologic appearance is dependent on the maintenance of the integrity of the neoplasm versus the extent of retrogressive changes that have occurred.

Adolescent↗
PubMed1980

Malignant lymphoma and other lymphoproliferative disorders of the thyroid gland. A clinicopathologic study of 245 cases.

Two hundred and forty-five cases of malignant lymphoma and other lymphoproliferative disorders involving the thyroid gland have been studied. The patients, predominantly elderly women, usually presented with a rapidly enlarging mass in the neck, often with symptoms of tracheal or laryngeal compression. Radioisotopic scanning of the thyroid usually demonstrated a "cold" or "cool" process, and tracheal deviation (as seen by chest roentgenogram) was common. Lymphoma and related processes were nearly always associated with an underlying lymphocytic thyroiditis. The mean length of follow-up was 45 months, and follow-up was obtained in 96% of the cases. An unfavorable prognosis was related to extension of tumor cells outside the capsule of the gland, necrosis of the tumor, blood vessel wall infiltration, diffuse architectural pattern, and cervical lymph node involvement, with or without disease outside the neck. Tumors composed entirely of plasma cells demonstrated little if any tendency toward systemic extension, and those lymphomas with some plasmacytoid differentiation also displayed a more favorable prognosis.

Adolescent↗
PubMed1978

Microcystic adenomas of the pancreas (glycogen-rich cystadenomas): a clinicopathologic study of 34 cases.

Thirty-four cases of microcystic adenoma of the pancreas were studied. These benign tumors have traditionally been classified as cystadenomas, but have not been clearly distinguished from those cystic neoplasms of the pancreas that have a significant malignant potential. Microcystic adenomas are benign, usually large (mean diameter 10.8 cm), and are composed of many tiny cysts lined by small cuboidal cells containing glycogen but little or no mucin. The tumor may be found incidentally at autopsy or, more commonly, may manifest as an abdominal mass with some associated local pain or discomfort. There is no sex predilection. The patients are usually elderly, both mean and median ages being 68. A microcystic pattern is apparent both grossly and microscopically. Electron microscopy confirms the presence of intracytoplasmic glycogen and the epithelial character of the cells. Follow-up data (mean 6.4 years), available in all cases, indicate that when these tumors occur in the head of the pancreas, fatalities may result either from complications of radical surgery or from gastrointestinal or biliary obstruction. When the tumors occur in the body or tail of the pancreas, biopsy alone may be sufficient.

Adult↗