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Biomedical subjects

J H Beckstead

Publications and source records attributed to J H Beckstead.

At least 73 records · Page 4Linked to original sources
PubMed1985

Malignant neuroendocrine tumor of the jejunum with osteoclast-like giant cells. Enzyme histochemistry distinguishes tumor cells from giant cells.

We report a case of a neuroendocrine tumor of the jejunum metastatic to the liver in a 26-year-old woman. Light and electron microscopy of this tumor revealed a poorly differentiated neoplasm composed of clusters of round to polygonal cells compatible with a diagnosis of neuroendocrine tumor. In the absence of identifiable silver-staining granules or immunocytochemical demonstration of a specific hormone product in tumor cells, this tumor cannot be further classified among the various neuroendocrine tumors that may arise in this location. However, interspersed among tumor cells was a distinct population of multinucleate giant cells having an appearance similar to benign osteoclasts. Enzyme histochemistry for 5'-nucleotidase, acid phosphatase, and nonspecific esterase each showed a dichotomous staining pattern for the small tumor cells and giant cells and suggest that the giant cells are not tumor derived, but represent a second, presumably reactive, cell population.

5'-Nucleotidase↗
PubMed1985

Optimal antigen localization in human tissues using aldehyde-fixed plastic-embedded sections.

Although the utility of antigen labeling techniques in frozen tissues is well known, it is generally acknowledged that an improvement in morphologic preservation is desirable. Conventionally processed paraffin-embedded tissues are limited in the range of antigens that can be detected and newer plastic embedding techniques have been even more restricted. By using cold (4 degrees C) processing and limited fixation a wide range of antigens (including T and B markers) has been demonstrated in 2 mu plastic sections. The morphologic preservation and antigen localization are superior to other techniques. The combination of precise antigen localization and excellent morphologic preservation should expand the diagnostic and investigative uses of immunohistology.

Aldehydes↗
PubMed1985

Pathogenesis of orally induced flare-up reactions at old patch sites in nickel allergy.

The flare-up reaction of old patch test sites following oral intake of antigen have been shown to be site and antigen specific reactions. Using enzyme and immunohistochemistry, the morphology of 6- to 8-week-old patch test sites, before and after oral challenge with nickel, was investigated. Before oral challenge, small scattered perivascular cell infiltrates consisting of macrophages, mast cells, T-lymphocytes, and OKT6+ dendritic cells were found in old patch test sites. In early and strong flare-up reactions combined with systemic toxicoderma-like reactions, polymorphonuclear leukocytes and lysed granular fragments from these cells were prominent. In slower flare-up reactions with little systemic involvement, T-lymphocytes predominated. We conclude that cells, probably macrophages, which are able to secrete inflammatory mediators promoting chemotaxis for polymorphonuclear leukocytes and/or T-lymphocyte proliferation, may play an important role in initiation of the flare-up reaction.

Administration, Oral↗
PubMed1985

Evidence for the origin of Kaposi's sarcoma from lymphatic endothelium.

Previous studies utilizing enzyme histochemistry, electron microscopy, and immunohistochemistry have failed to establish the cell of origin in Kaposi's sarcoma. The authors have rigorously tested the prevailing hypothesis that the lesion defined as Kaposi's sarcoma is derived from vascular endothelial cells. They use seven markers to characterize endothelial cells: three antigens (Factor VIII-related antigen, HLA-DR/Ia, macrophage/endothelial antigens), three enzymes (5'-nucleotidase, ATPase, alkaline phosphatase), and lectin binding (Ulex europaeus I). They applied the markers first to normal skin and lymph node, and then to biopsy specimens from 40 patients with Kaposi's sarcoma. Normal blood vessel endothelium was positive for all seven markers, but normal lymphatic endothelium was negative for all of the markers except 5'-nucleotidase and Ulex europaeus lectin. The neoplastic cells in 40 cases of Kaposi's sarcoma closely resembled those of normal lymphatic endothelium but not those of blood vessel endothelium. This suggests that Kaposi's sarcoma may originate in lymphatic endothelium.

5'-Nucleotidase↗
PubMed1984

Autopsy findings in the acquired immune deficiency syndrome.

The medical records, premortem biopsy specimens, and autopsy materials from 36 patients with acquired immune deficiency syndrome (AIDS) were reviewed. The majority of the patients were homosexual men. Widely metastatic Kaposi's sarcoma was seen in eight patients, while tumor was confined to the skin in an additional ten. Four patients had high-grade lymphomas. Thirty-five of the 36 patients had at least one opportunistic infection at some point in the course of their illness. Many patients had multiple infectious agents. The most consistent and striking autopsy finding was a severe depletion of lymphoid tissues. Death in the majority (83%) of the patients was attributable to opportunistic infections affecting most commonly the respiratory tract (64%) and meninges (11%). Three patients (9%) died with widely metastatic Kaposi's sarcoma and secondary hemorrhage.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Malignant histiocytosis X. Report of a rapidly fatal case in an elderly man.

A 71-year-old white man developed an increasing number of 1-to-10 mm, erythematous nodules, many with central ulceration, most prominent on the head and trunk. Biopsy of a nodule showed infiltration of the dermis and epidermis by large cells with multilobulated nuclei and numerous mitoses. Electron microscopy showed that most tumor cells contained Langerhans' cell granules. Immunohistochemical studies demonstrated a pattern of antigen expression similar to that of Langerhans' cells including Ia and Leu-6 (T6) antigens. Chest x-ray showed diffuse pulmonary infiltration and similar tumor cells were present in the sputum and urine. He developed increasing dyspnea and jaundice despite chemotherapy, and died 6 months after the onset of the disease. Autopsy showed massive tumor infiltration of the lungs, liver, spleen, and lymph nodes, and focal involvement of the myocardium, skin and bladder. Clinical and cytologic features indicated this case to be a rare example of highly malignant histiocytosis X in an elderly man.

Aged↗
PubMed1984

Malignant fibrous histiocytoma, myelomonocytic leukemia, and Hodgkin's disease arising in an elderly man.

A 74-year-old man developed a locally invasive malignant fibrous histiocytoma of the scalp with multiple facial recurrences and concomitant hematopoietic dysplasia occurring over a 2-year period. One month prior to his death, his hematologic profile evolved into myelomonocytic leukemia. Mixed cellularity Hodgkin's disease involving mediastinal and periportal lymph nodes, which was not suspected antemortem, was discovered at autopsy. In the experience of the authors, this association of neoplasms is unique and raises the possibility in this case of an unidentified stimulus to neoplastic transformation of cells of histiocyte/monocyte origin.

Aged↗
PubMed1984

Histopathologic spectrum of oral Kaposi's sarcoma.

There has been a striking increase in the incidence of oral Kaposi's sarcoma in association with acquired immunodeficiency syndrome (AIDS). Oral lesions are seen in approximately 50% of AIDS patients with Kaposi's sarcoma. Lesions may appear as a flat or raised pigmented area, often resembling a benign vascular lesion, and are commonly found on the palate. Useful histopathologic criteria for the recognition and diagnosis of oral Kaposi's sarcoma include (1) atypical vascular channels (especially in early lesions), (2) a prominent spindle cell component in later lesions, (3) extravasated red blood cells, (4) hemosiderin, (5) the presence of eosinophilic bodies, (6) chronic inflammatory cells in early lesions, and (7) mitotic figures in tumor-stage lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Histiocytosis X cells and Langerhans cells: enzyme histochemical and immunologic similarities.

The proliferating cell in histiocytosis X has been thought to be an abnormal Langerhans cell since the identification in 1965 of the characteristic X-bodies morphologically identical to the Birbeck granules of epidermal Langerhans cells. This conclusion is based primarily on this finding and on morphologic similarities at the light microscopic level. Enzyme histochemical data have been somewhat conflicting and have not provided strong support for this conclusion. Recently, immunohistochemical studies have shown data consistent with a Langerhans cell origin for histiocytosis X cells. This study documents the presence of nonspecific esterase, acid phosphatase, and adenosine triphosphatase in both Langerhans cells and histiocytosis X cells. Both types of cells also react with antibodies directed against widely distributed leukocyte antigens (HLA-A,B,C; Ia; L3B12); Langerhans cell/thymocyte antigen [Leu 6(T6)]; histiocyte antigen (Leu-M3); helper T-cell/histiocyte antigen [Leu-3(T4)]; and S-100 protein. These results complement earlier immunologic studies and add enzyme histochemical data that strongly support the concept of histiocytosis X as a proliferative disorder of cells of Langerhans lineage.

Adult↗
PubMed1984

Enzyme histochemistry of normal and neoplastic transitional epithelium.

The authors utilized the technic of plastic embedding with enzyme histochemistry for the evaluation of enzymatic expression by epithelium of the lower urinary tract in humans. Alpha-naphthyl acetate esterase and acid phosphatase generally were expressed by normal and neoplastic urothelium. Expression of 5'-nucleotidase and ATPase was more restricted. Alkaline phosphatase, prominent in the transitional cells of lower mammalian species, generally was not present in human urothelium. Enzyme histochemistry has not been applied generally to the study of disease of the lower urinary tract, but this study suggests it may be of value in understanding the biology of this tissue and be of potential use in histopathologic diagnosis of diseases of this region.

5'-Nucleotidase↗
PubMed1984

Enzyme histochemical characterization of chordomas.

The differential diagnosis of chordoma includes chondrosarcoma and ependymoma. We describe four cases of chordoma characterized by enzyme histochemistry in plastic-embedded sections. All the chordomas exhibited strong 5'-nucleotidase positivity localized on the plasma membrane. None of the fetal notochord remnants, chondrosarcomas, ependymomas, or chondroid chordomas tested showed such a reaction. The lack of similarity in enzyme staining between fetal notochord and chordomas is unexpected since notochord has been traditionally regarded as the source of chordomas. This staining pattern provides a marker that can be useful in differentiating chordoma from other neoplasms which have a similar appearance by light microscopy.

5'-Nucleotidase↗
PubMed1984

Persistent diffuse lymphadenopathy in homosexual men: endpoint or prodrome?

Seventy homosexual men with unexplained persistent diffuse lymphadenopathy enrolled in a prospective natural history study from November 1981 to November 1982. These men had demographic, clinical, and laboratory findings similar to those of homosexual patients with the acquired immunodeficiency syndrome. Pathologic examination of lymph node biopsies from 35 patients showed florid follicular hyperplasia. Despite benign reactive pathologic findings, most patients had constitutional symptoms and recurrent non-life-threatening infections. All had evidence of immune dysfunction with B-lymphocyte activation and inversion of the T-lymphocyte helper: suppressor ratio. To date, none of our patients has developed the more malignant manifestations of the acquired immunodeficiency syndrome. The lymphadenopathy syndrome may be an alternative phenotypic response to the "acquired immunodeficiency syndrome agent."

Adult↗
PubMed1984

Histiocytic malignancies. Morphologic, immunologic, and enzymatic heterogeneity.

We have studied 14 hematopoietic malignancies with histologic features of histiocytic differentiation, using frozen section immunologic stains, plastic section enzyme histochemistry, and paraffin section immunocytochemistry. There was morphologic, immunologic, and enzymatic heterogeneity, including findings in seven cases that suggested differentiation toward specialized subsets of histiocytes. Four cases expressed a mature monocyte/macrophage phenotype by frozen section monoclonal antibody staining and three of these had histologic patterns diagnostic of malignant histiocytosis; two other cases had ATPase and S100 protein reactivity and morphologic features consistent with interdigitating (reticulum) cell proliferations; and one case was alkaline phosphatase positive, suggestive of differentiation toward fibroblastic reticulum cells. Four cases had histologic findings consistent with malignant histiocytosis, but weak or unreactive staining patterns and were considered poorly differentiated histiocytic or primitive hematopoietic malignancies. Three other cases, also morphologically consistent with malignant histiocytosis, were identified as probably T-cell lymphomas. The morphologic and phenotypic characteristics of non-neoplastic histiocytes and dendritic cell types and their related neoplasms are discussed. Histiocytic malignancies comprise a diverse group that can be identified and subclassified by immunologic and enzymatic techniques.

Adolescent↗
PubMed1984

Circulating Sézary cells. A new preparatory method for their identification and enumeration.

Although Sézary cells are not specific for the Sézary syndrome, the enumeration of these circulating abnormal lymphoid cells is important in the evaluation of patients with mycosis fungoides, Sézary syndrome, and benign dermatoses that might be confused with these entities. Various techniques have been developed for this purpose, but none of the techniques have been widely accepted as practical and accurate. We describe a new method of preparing blood specimens for the identification and enumeration of circulating Sézary cells. Peripheral blood was separated on a density gradient and the mononuclear cell fraction was embedded in plastic. Semithin sections were cut, stained for alpha-naphthyl acetate esterase, and examined by light microscopy. We found that the percentage of Sézary cells correlated well with the clinical diagnosis of Sézary syndrome in the subjects who were studied.

Adult↗
PubMed1983

Desmoid tumors: local control and patterns of relapse following radiation therapy.

Desmoid tumors are benign neoplasms, arising from musculoaponeurotic tissues, which tend to be locally infiltrative, resulting in a high rate of local recurrence following surgical resection. Nineteen patients with desmoid tumors underwent radiation therapy at the University of California, San Francisco, between 1970 and 1980. Fifteen patients were referred with local recurrence following one or more surgical resections. Three patients were referred for initial radiation therapy with unresectable tumors, and one patient received planned postoperative irradiation following subtotal tumor resection. At the time of treatment, 8 patients had nonresectable disease measuring greater than 10 cm. Five patients had residual tumor masses measuring 4 to 6 cm, and six had only microscopic disease following resection. The majority of patients were treated to a tumor dose of 50-55 Gy at 1.6 to 1.8 Gy per fraction. With a median follow-up of 8 years, 13 patients remained free of recurrent disease following radiation therapy. The 5 year relapse free survival was 72% with 10 patients continuing to be free of disease 5 to 11 years following therapy. Local control was not related to the amount of disease present at the time of treatment. Of the 6 patients who developed recurrent disease, only 1 patient had a true in-field recurrence. Four patients recurred at the margin of the radiation field 1 to 5 years following therapy. Of these four patients, 3 were successfully salvaged while 1 died as a result of tumor extension into a major vessel. One patient with an extensive mesenteric mass did not respond to therapy and died 1 month post irradiation. The patient with the in-field recurrence and 1 patient with a marginal recurrence were successfully treated with combination chemotherapy. Moderate dose radiation therapy to desmoid tumors can result in lasting local control when surgical resection is not possible. Post operative radiation can improve the rate of local control for patients with a high risk of recurrence. As desmoid tumors tend to be locally infiltrative, fields must be very generous to prevent marginal recurrence. Systemic chemotherapy offers an alternative to ablative surgery in the event of local failure following radiation therapy.

Adolescent↗
PubMed1983

The evaluation of human lymph nodes, using plastic sections and enzyme histochemistry.

The histopathologic evaluation of the human lymph node is frequently difficult. Although immunologic markers have been used recently in such evaluations, enzyme histochemical markers have been used only sporadically since their introduction in the 1930s. One reason that they have been neglected is that they have required the use of frozen sections. This article describes the use of a plastic embedding technic with enzyme histochemistry in a series of more than 300 reactive human lymph nodes. Enzyme histochemical reactions were preserved very well and could be localized extremely well with this technic, which allowed the identification of histologic features not readily apparent by other means. The technic may be valuable in evaluating both reactive and neoplastic lymph nodes.

5'-Nucleotidase↗