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Biomedical subjects

J Prat

Publications and source records attributed to J Prat.

At least 163 records · Page 9Linked to original sources
PubMed1982

Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation): a light microscopic, ultrastructural and immunohistochemical study of seven cases.

Seven cases of ovarian yolk sac tumor (endodermal sinus tumor) with patterns resembling those of hepatocellular carcinoma were encountered in patients 7-43 years of age. Two of the patients had gonadal dysgenesis with a 46XY karyotype. At operation three tumors were confined to the ovary and four were associated with intra-abdominal metastases. Two of the Stage I tumors recurred within one year. The hepatoid pattern was a prominent feature of all the tumors and was exclusive in four of them. In one specimen it merged almost imperceptibly with a polyvesicular vitelline pattern. The hepatoid component of the tumors was characterized by discrete masses, nests and/or broad bands of large polyhedral cells with central nuclei and prominent nucleoli; gland-like spaces, some of which contained mucin, were occasionally evident. Each tumor contained numerous PAS-positive, diastase-resistant intracytoplasmic and extracytoplasmic hyaline bodies. Alpha-fetoprotein and alpha-1-antitrypsin were identified by immunoperoxidase and immunofluorescence techniques in four tumors and albumin in two. Immunoperoxidase stains for chorionic gonadotropin were negative in four cases. Ultrastructural analysis of two specimens disclosed features similar to those of hepatocellular carcinoma.

Adolescent↗
PubMed1982

Ovarian Sertoli-Leydig cell tumors with heterologous elements. I. Gastrointestinal epithelium and carcinoid: a clinicopathologic analysis of thirty-six cases.

Thirty-six ovarian Sertoli-Leydig cell tumors containing heterologous elements in the form of gastrointestinal-type epithelium are described. Eight of the cases contained microscopic foci of insular carcinoid; in two of these cases of foci of goblet cell carcinoid were also present. The patients' ages ranged from 4-67 years (average, 23 years). The presenting manifestations were androgenic changes (18 cases), abdominal swelling (15 cases), acute abdominal symptoms (one case), menstrual irregularities (one case), and postmenopausal bleeding (two cases). All of the tumors were unilateral. The surface of the tumor was intact in 32 cases, ruptured in three, and adherent to the diaphragm in one. The tumors usually had both cystic and solid components and averaged 15.0 cm in diameter; mucinous fluid was noted on gross examination in 12 cases. On microscopic examination, the gastrointestinal epithelium contained mucinous cells, columnar cells and argentaffin cells; rarely Paneth cells were seen. It was cytologically benign in 29 cases, of borderline malignancy in five and malignant in two. Follow-up information, available for 31 patients, revealed that 29 were alive without evidence of disease from 1-17 years (average, six years) postoperatively. One patient, who had a poorly differentiated tumor, died of recurrent disease six years after the initial operation.

Adolescent↗
PubMed1982

Ovarian Sertoli-Leydig cell tumors with heterologous elements. II. Cartilage and skeletal muscle: a clinicopathologic analysis of twelve cases.

Twelve ovarian Sertoli-Leydig cell tumors that contained heterologous elements in the form of skeletal muscle (nine cases), cartilage (seven cases) and neuroblastoma (one case) in either the primary of recurrent specimens are reported. Four of the primary tumors also contained foci of gastrointestinal type epithelium with argentaffin cells identifiable in two of them. The age of the patients ranged from 11-48 years (average, 24 years). Ten patients presented with an abdominal mass, one with abdominal pain and one with acute abdominal symptoms. Five of the patients, two of whom were virilized and one of whom was hirsute, had evidence establishing or suggesting androgen overproduction. All the tumors were unilateral. Four had ruptured preoperatively and two ruptured during the operation. The tumors averaged 18.5 cm in greatest diameter and had extensive areas of hemorrhage and necrosis in half the cases. On microscopic examination the Sertoli-Leydig cell component was poorly differentiated in 11 cases and of intermediate differentiation in one case. In two cases the primary tumor was a poorly differentiated Sertoli-Leydig cell tumor and heterologous elements were identified only in a recurrent mass. Follow-up of ten patients revealed that eight of them had died of tumor from five months to seven years postoperatively.

Adolescent↗
PubMed1982

Ovarian mucinous tumors with foci of anaplastic carcinoma.

Four ovarian mucinous cystic tumors that contained solid nodules of anaplastic carcinoma in their walls are described. All the tumors had metastasized at the time of or shortly after operation and two have already proven fatal. The anaplastic nodules may be confused on gross and microscopic examination with sarcomas and sarcoma-like nodules, both of which may also be encountered in the wall of mucinous cystic tumors. Although the distinction of foci of anaplastic carcinoma from foci of sarcoma may not have prognostic significance, both of them should be separated from sarcoma-like nodules because of the favorable prognosis associated with the latter. In favor of a diagnosis of anaplastic carcinoma are poor circumscription of the nodules, vascular invasion and absence of a prominent inflammatory reaction with multinucleated giant cells of the epulis type.

Adolescent↗
PubMed1982

Ovarian endometrioid carcinomas resembling sex cord-stromal tumors. A clinicopathological analysis of 13 cases.

Thirteen endometrioid carcinomas of the ovary with predominant patterns resembling those of sex cord-stromal tumors are reported. Eight of these neoplasms had been misinterpreted by the referring pathologists as sex cord-stromal tumors, almost always of the Sertoli-Leydig cell type. The latter diagnosis was suggested by a predominance of small tubular glands or winding, elongated solid tubular structures. In four cases, the presence of luteinized cells in the tumor stroma contributed to the misinterpretation. Each specimen, however, had one or more features establishing its endometrioid nature, including large tubular glands resembling those of the typical endometrioid adenocarcinoma, foci of squamous differentiation, luminal mucin accumulation, and adenofibromatous components. Two tumors were bilateral. The age range of the patients (from 58 to 86 years) differed markedly from that of patients with Sertoli-Leydig cell tumors, who are generally much younger, as did the associated clinical manifestations, which were those of ovarian cancer in general. No androgenic effects were observed and estrogenic manifestations were evident in only one of the cases.

Adenocarcinoma↗
PubMed1981

Megavoltage irradiation for pure testicular seminoma: results and patterns of failure.

The survival, patterns, and mechanisms of failure in 171 patients with pure testicular seminoma treated with megavoltage irradiation from 1950 to 1976 were analyzed. The survival of the entire group was 93% at five and ten years post-irradiation. Survival at five years was significantly less for Stages III and IV (45%) when compared with Stages I and II (95%, P less than 0.001). Extranodal relapses were more common in early stages, and abdominal recurrences occurred in more advanced stages. Salvage treatment, management of HCG-producing seminomas, and second testicular seminomas are analyzed. The need for aggressive and appropriate radiation technique is emphasized.

Chorionic Gonadotropin↗
PubMed1981

Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project.

This report presents the cytologic findings and the rates of dysplasia for 4,589 young women enrolled in the National Cooperative Diethylstilbestrol-Adenosis (DESAD) Project. Mucinous columnar cells and/or metaplastic squamous cells with or without mucinous droplets were encountered in 22% of vaginal scrape smears from all diethylstilbestrol (DES)-exposed participants identified by review of prenatal records and in 43% of women in whom vaginal epithelial changes (VEC) were observed by colposcopy or by iodine staining. The frequency of cellular findings in the vaginal scrape smears was closely related to the timing of the administration of the DES to the mother. With increasing age of the daughters, the overall frequencies of both the mucinous and metaplastic cells decreased; relative to each other, an increasing proportion was metaplastic squamous cells. These data suggest that, as the women grow older, vaginal adenosis regresses by the process of squamous metaplasia. Endometrial type cells were found in 2% of vaginal scrape smears. Their cyclical occurrence during the menstrual cycle and lack of correlation with the presence of VEC indicated an origin from the uterine corpus rather than the tuboendometrial type of adenosis. Squamous cell dysplasia of the vagina and cervix was detected by biopsy or scrape smear specimens in 1.8% of DES-exposed women in the record review group. The rate of unexposed women was twice as high. In general, the rates of dysplasia were higher in the cervix than vagina, and the more severe degrees of dysplasia were encountered only in those women who were referred to the DESAD Project or who themselves requested entry. Four patients who were referred or who themselves requested entry were found to have clear cell adenocarcinoma of the vagina. The vaginal smear provided the first clue to the presence of an abnormality in three of them.

Adenocarcinoma↗
PubMed1981

Tubular Krukenberg tumor. A problem in histopathologic diagnosis.

A review of a series of 70 Krukenberg tumors seen in consultation disclosed 13 cases with a predominant tubular pattern. Eleven of them had been diagnosed by the referring pathologist as a tumor in the sex cord-stromal category, usually a Sertoli-Leydig cell tumor; no diagnosis was preferred in the other two cases. Three factors contributed to the erroneous diagnoses: a prominent tubular pattern, luteinization of the stroma of the tumor in five cases, and associated virilization in two cases. Each tumor, however, contained typical signet-ring cells that were readily demonstrable with mucicarmine stains. In six cases the tumors were unilateral and in seven, bilateral. Ten patients died of their cancer from 2 to 21 months after the diagnosis had been made. In one case the ovarian tumors were not discovered until autopsy. Two patients are alive 7 and 9 months postoperatively. A primary tumor was found in the stomach in four cases and in the sigmoid colon and appendix in one each. No primary tumor was found in seven cases but an autopsy had been performed in only one of these. The diagnosis of Krukenberg tumor must always be considered in the differential diagnosis of an ovarian tumor with a tubular pattern even though endocrine manifestations are present.

Adult↗
PubMed1980

Epidermoid cyst of the ovary. A report of three cases with comments on histogenesis.

Three cases of epidermoid cyst of the ovary are presented. In each case small epithelial nests were found in the wall of the cyst, which, on serial section, proved to be focally cystic with mucin and keratin debris in their lumens. A comparative study of these epithelial nests, Walthard nests, and the epithelial components of a Brenner tumor revealed striking morphologic similarities. The findings suggest that epidermoid cysts originate from epithelial cell nests of the type encountered in Brenner tumors.

Adult↗
PubMed1979

Sarcomas in ovarian mucinous tumors: a report of two cases.

Two sarcomas that appeared as distinct solitary nodules in the walls of ovarian mucinous cystic tumors are described. One of the tumors was a fibrosarcoma associated with a mucinous cystadenoma; the other was an undifferentiated sarcoma in a mucinous cystadenocarcinoma. Both patients died within 1 1/2 years of their operations with distant metastasis; one of them had had metastatic sarcoma in the para-aortic lymph nodes at the time of exploration. These two cases are the only well-documented examples of this unusual combination of tumor types.

Cystadenoma↗
PubMed1979

Ovarian mucinous tumors with sarcoma-like mural nodules: a report of seven cases.

Seven cases of mucinous ovarian tumors with sarcoma-like nodules in their walls are reported. The age of the patients ranged from 18--81 years. Each of them had a large abdominal mass which proved on exploration to be a Stage Ia cystic ovarian tumor. All the specimens contained one or more discrete nodules in their walls, most of which were soft, dark brown, and hemorrhagic. On microscopical examination the epithelial component of four of the tumors was of borderline malignancy and of three was well-differentiated carcinoma. Three patterns were encountered in the nodules: pleomorphic and epulis-like in four cases, pleomorphic and spindle-celled in one case, and giant cell-histiocytic in two cases. These patterns simulated those of malignant giant cell tumor of soft parts, spindle cell sarcoma, and well-differentiated rhabdomyosarcoma, respectively. Postoperative follow-up ranging from 1 to 11 1/2 years (average 7 1/2 years) revealed no evidence of recurrence. Reports of seven similar tumors were found in the literature. Although follow-up has been less complete in these cases, none of the tumors is known to have spread beyond the ovary. These data suggest that mural nodules of the types described are not sarcomatous but could represent a reactive process that has no effect on the prognosis of the patient.

Adolescent↗