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Biomedical subjects

J E Wheeler

Publications and source records attributed to J E Wheeler.

50 records · Page 3Linked to original sources
PubMed1978

Extraovarian teratoma with peritoneal gliomatosis.

A 25 year old woman underwent removal of a large, incidentally discovered cul de sac teratoma. It was solid but histologically mature and had given rise to multiple peritoneal implants of mature glial tissue. She was alive without evidence of disease 57 months later. This tumor appears to represent the extraovarian counterpart of previously reported ovarian teratomas with peritoneal gliomatosis.

Adult↗
PubMed1977

Intralymphatic BCG in the treatment of gynecologic malignancies: a phase I study.

Thirteen patients with a variety of advanced gynecologic malignancies were administered BCG via the dorsal lymphatics of the lower extremity in addition to standard accepted forms of therapy. Prolonged febrile courses, lymphangitis and suppurative adenitis were observed along the lymphatic pathway of the injected lower limbs. There was no correlation between reaction to a standard anergy panel and survival. There was also no correlation between reaction to a standard anergy panel and the inflammatory response to intralymphatic BCG (ILP-BCG). There was, however, a positive correlation between the inflammatory response to ILP-BCG and survival. Intralymphatic administration of immunostimulants may conceivably be of value as ancillary therapy for use in gynecologic malignancy. However, complications of this approach to immunotherapy are significant and the method should not be used until complications are decreased.

Adult↗
PubMed1977

Malignancy arising in extragonadal endometriosis: a case report and summary of the world literature.

A case of clear cell carcinoma arising in endometriosis of the retroperitoneum is presented. It occurred 5 years after supracervical hysterectomy and bilateral salpingo-oophorectomy and following 4 years of estrogen therapy. The literature concerning malignancy developing in extragonadal endometriosis has been reviewed and is summarized as follows: 1) 45 cases have been compiled, of which 32 were carcinomas and 13 sarcomas; 2) adenocarcinoma was the most common histologic type, although virtually every tumor of müllerian derivation has been described; 3) the typical patient was nulliparous and perimenopausal; 4) the rectovaginal septum was the most common site, and in general the frequency of malignancy in a given site parallels the frequency of endometriosis in that location; 5) simultaneous tumors of the uterus or ovary were present in seven cases (15%); 6) prognosis appeared affected by site and histologic type; 7) a history of prior pelvic irradiation to effect castration was present in three (9%) of the patients with adenocarcinoma; and 8) four (12%) of the patients with adenocarcinoma were subjected to exogenous estrogens or estrogen-secreting ovarian tumors.

Adenocarcinoma, Papillary↗
PubMed1977

Granulomatous salpingitis secondary to Crohn's disease.

A 30-year-old woman with longstanding Crohn's disease underwent resection of bowel and adherent adnexa. Granulomatous enterocolitis and granulomatous salpingitis and oophoritis were present histologically. Unusual features accompanying this tubal process included formation of an adnexal mass and florid atypical proliferation of the tubal epithelium. This proliferation is similar to that epithelial change described in tuberculous salpingitis and should not be confused with carcinoma in situ.

Adult↗
PubMed1976

Androgenic function of a granulosa cell tumor.

Virilizing granulosa cell tumors are uncommon and have not been well studied hormonally. A hirsute woman with a cystic granulosa cell tumor of the ovary is presented. Plasma hormone levles obtained before and after surgery indicate testosterone production by the tumor with LH and FSH suppression. Plasma testosterone (T) and T-index returned to normal after tumor removal, and ovulation resumed.

Adult↗
PubMed1976

Lobular carcinoma of the breast in situ and infiltrating.

Lobular carcinoma in situ, while histologically delineated almost 35 years ago, is still being diagnosed and reported with differing qualitative and quantitative criteria. It is important to recognize this lesion because of its frequent bilaterality and risk of developing infiltrating carcinoma in the affected breast. Because of the apparent morphologic identity of the cell of ALH and the cell of LCIS, because both are associated with some increased risk of developing carcinoma, and because both have an increased propensity to be found simultaneously with carcinoma--especially lobular carcinoma--we believe these lesions should be looked upon as basically identical. Beginning with Ewing's astute intuition nearly 60 years ago18 and culminating with the 1967 report of McDivitt and others,50 pathologists and surgeons have gradually become aware of the long-term risk associated with this nonobligatorily, premalignant lesion (LCIS). As further studies have become available, it is clear that a large majority of women with lobular carcinoma in situ or atypical lobular hyperplasia retaining the involved breast will not develop infiltrating carcinoma. However, there is an increased risk of roughly 1 percent per year. Because of the increased risk, we believe that a meticulous long-term followup is mandatory, and suggest a physical examination every two to three months for the first few years supplemented with yearly mammography (as is now being done at Memorial Hospital for patients with atypical breast lesions6). With such a followup, we believe the mortality should fall well below 5 percent in a 20-year followup, and believe this is a risk that may be acceptable to the patient and her surgeon. The boundaries of the morphologic changes acceptable as ILC have been difficult for many pathologists (including ourselves) to delineate. This is borne out by widely varying incidence figures and is due, at least in part, to the frequent admixture of ILC with poorly differentiated duct carcinoma as well as problems in deciding how large and pleomorphic the cell nuclei may be, and still be designated as lobular in origin. We believe that about 4 to 6 percent of all breast carcinomas are infiltrating lobular, and incidence rates widely divergent from this should be scrutinized carefully. Prognostically, ILC behaves similarly to poorly differentiated duct carcinomas except for some increased risk of subsequent contralateral carcinoma. Future study of lobular disease should be directed toward its histogenesis, long-term risk, and the relative success of different treatment modalities. Hormonal studies and cell culture with chromosomal analysis might shed some light on the mechanism of what may be postmenopausal regression of LCIS.

Adenofibroma↗
PubMed1975

Epitheloid sarcoma masquerading as Peyronie's disease.

A 23-year-old man presented witha firm plague-like penile mass with pain and deviationon erection, suggesting Peyronie's disease. Biopsy was erroneously interpreted asconformatory. Irradiation was the one mode of therapy which gave temporary subjective relief. Extension of the mass and focal gangrene led to rebiopsy 6 years later. Epithelioid sarcoma was present microscopically, and was also found on re-examination of theoriginal biopsy. Partial penectomy was performed, but pulmonary metastasis had alreadyoccurred. He was treated with chemotherapy and radiotherapy and is now alive with disease 2 years later. The diagnosis of possible penile sarcoma, although rare, must be considered in patients with symptons suggesting Peyronie's disease, especially if the lesion continues to enlarge.

Biopsy↗
PubMed1975

Intralymphatic injection of BCG into rhesus monkeys.

Since the route of administration of BCG may have an important function in immunotherapy, we investigated intralymphatic administration to direct BCG to the lymph nodes. Multiple injections of high doses of BCG were administered to 6 rhesus monkeys via the dorsal lymphatics of the lower limb. A suppurative lymphadenitis was observed along the lower limb and in the inguinal area in 5 of the 6 monkeys. However, many of the complications reported with other routes of administration were not observed. Granulomatous reactions and histiocytic responses developed in lymph nodes on the injected sides of the pelvis and distant nodes as well as in the liver. The intralymphatic route is the method by which high doses of nonspecific immunostimulants were delivered to regional lymph nodes. The efficacy of this approach remains to be established in tumor-bearing animals and humans.

Animals↗