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J van de Stadt

Publications and source records attributed to J van de Stadt.

16 recordsLinked to original sources
PubMed2001

Warty carcinoma of the anus: a variant of squamous cell carcinoma associated with anal intraepithelial neoplasia and human papillomavirus infection.

Warty carcinoma (WC) is a rare variant of squamous cell carcinoma primarily described in the vulva in younger women and classically associated with human papillomavirus (HPV) infection. The gross findings are similar to those of verrucous carcinoma with large, exophytic tumors with a papillomatous surface. Microscopically, the tumor is papillated and contains fibrovascular cores covered by hyperkeratotic epithelium showing presence of koilocytes. We report a case of anal squamous cell carcinoma showing similar features, occurring in a young immunosuppressed male patient with a history of multifocal anal intraepithelial neoplasia (AIN). HPV-16 has been demonstrated both in the WC and in adjacent AIN, but the HPV status appears different in the two lesions: integrated in WC and episomal in AIN lesions. We also have demonstrated by immunohistochemistry that both WC and AIN are highly proliferative entities sharing the same MIB-1 pattern, and that WAF1/CIP1 protein expression is common in the two lesions irrespective of p53 protein expression.

Adult↗
PubMed1999

Extended extradural spinal arachnoid cyst: an unusual cause of progressive spastic paraparesis.

A 15-year old girl presented with a slowly progressive spastic paraparesis since the age of 12. Creatine kinase was slightly increased. Muscle biopsy carried out during tendon surgery for severe toe-walking showed 'myopathic' changes. Subsequent neurological evaluation and radiological studies revealed a large extradural arachnoid cyst extending from the 11th thoracic vertebra to the first lumbar vertebra. Her condition improved after operation. The 'myopathic' features turned out to be the result of chronic spinal compression. MRI is the method of choice to examine patients with non-hereditary progressive spastic paraparesis. Muscle biopsy and tendon surgery should not be performed, without careful neurological examination.

Adolescent↗
PubMed1999

Adenoid cystic carcinoma of Bartholin's gland: what is the optimal approach?

AIMS AND METHODS: We report the case of a locally advanced adenoid cystic carcinoma of Bartholin's gland which required posterior pelvic exenteration, radical vulvectomy and ablation of the ischiorectal fossa in order to obtain tumour clearance with negative margins. Including this case, only three pelvectomies have been performed for this disease. This is the first reported case in which a controlateral unsuspected intravulvar metastasis was found on histology. RESULTS AND CONCLUSIONS: No consensus exists on the adequate surgical management of this particular disease. Nevertheless, a review of the literature and this reported case suggest that radical vulvectomy with negative margins should be preferred to wide local excision as the primary surgical procedure. It also suggests that inguinofemoral lymph-node dissection should only be performed when suspect lymph nodes are found at clinical examination.

Bartholin's Glands↗
PubMed1993

[A man with spontaneous regression of non-Hodgkin lymphoma, hypergammaglobulinemia and infection caused by 2 herpesviruses; causality or coincidence?].

A febrile illness with atypical peripheral blood lymphocytosis (polyclonal CD8+ suppressor/cytotoxic phenotype), complement activation and IgA/G class hypergammaglobulinaemia was found in a 76-year old male with clinical stage III follicular non-Hodgkin lymphoma (NHL). There was serological evidence of active cytomegalovirus (CMV) as well as reactivated chronic Epstein-Barr virus (EBV) infection. Spontaneous regression of NHL appeared, the signs of viral infection improved but hypergammaglobulinaemia persisted. In patients with malignant lymphoma, clinical signs and abnormalities of peripheral blood lymphocytes and serum immunoglobulins should not automatically be considered a consequence of the lymphoma.

Aged↗
PubMed1992

A Pugh score of 8 adequately selects patients with parenchymal cirrhosis for liver transplantation.

The aim of our study was to develop simple and highly effective scores to estimate prognosis at 1 year for patients with parenchymal cirrhosis and to define the optimum time for liver transplantation with the same degree of accuracy as the prognosis estimation for primary biliary cirrhosis. The prognostic value of 19 variables was studied retrospectively in 91 patients with parenchymal cirrhosis using multivariate analysis and logistic regression. The best prognostic index was obtained with two independent variables: ascites and aminopyrine breath test. Although the receiver operating characteristic (ROC) curve for these two variables was better than the ROC curve for Pugh score, the percentage of correct prediction was excellent for both indices: 92% and 87%, respectively. The critical cut-off value of the Pugh score was 8.8. The prognostic value of a Pugh score < or = 8 or > 8 was confirmed in a prospective study of 145 cirrhotic patients with 78% correct prediction. During this period, 21 patients with parenchymal cirrhosis received transplants with a preoperative Pugh score of 9.5 +/- 2.0 (mean +/- SEM) and 60% 1- and 2-year survival. In conclusion in parenchymal cirrhosis, a Pugh score > 8 indicates a poor prognosis at 1 year. This is a simple, easy and highly effective tool to define the optimal time for liver transplantation in this category of patients.

Follow-Up Studies↗
PubMed1992

Kikuchi's lymphadenitis: report of a Yersinia enterocolitica-associated case and an overview of aetiology and clinical outcome.

Kikuchi's lymphadenitis (KL; histiocytic necrotizing lymphadenitis without granulocytic infiltration) is a generally benign, febrile disorder of unknown aetiology with distinct histological features. To date, a minority of cases reported have been associated with infectious agents. A typical pathological case of KL is described where involvement of Yersinia enterocolitica was shown by an indirect immunofluorescent assay applied to lymphatic tissue. The case is discussed with emphasis on recent insight into the course and aetiology of KL.

Adult↗
PubMed1989

The mucosa of the gastric remnant harboring malignancy. Histologic findings in the biopsy specimens of 504 asymptomatic patients 15 to 46 years after partial gastrectomy with emphasis on nonmalignant lesions.

Endoscopic bioptic screening of 504 asymptomatic postgastrectomy patients, 15 to 46 years after initial surgery, revealed ten gastric stump cancers of which six turned out to be early cancers; three of the early carcinomas were found during follow-up after prior severe dysplasia. At first endoscopy mild dysplasia was found in 58, moderate dysplasia in 11, and severe dysplasia in none of the patients. Follow-up biopsies in 177 patients showed mild dysplasia in 30, moderate dysplasia in six, and severe dysplasia in six patients. Regression of severe dysplasia was not observed. Both progression and regression of mild and moderate dysplasia occurred. At the first endoscopy the frequency of atrophy, intestinal metaplasia, cystic dilatation of glands, and foveolar hyperplasia in the stomal biopsy specimens was 45%, 35%, 54%, and 47%, respectively; during follow-up, 47%, 48%, 56%, and 56% respectively. These four lesions were significantly more frequent in the biopsy specimens of patients with gastric carcinoma or dysplasia than in the other patients and they were present in the environment of the tumor in all the surgical specimens of the six early cancers detected by the screening. Preoperatively a combination of these four lesions could be demonstrated in only those early gastric cancer patients, in whom more than eight stomal biopsy specimens were taken. Of 34 patients with severe atrophy in three or more stomal biopsy specimens taken at the same time, two manifested early stump cancer during follow-up. Severe dysplasia is a marker of malignancy and demands close follow-up; the value of mild and moderate dysplasia is less clear. The combination of atrophy, especially severe atrophy, intestinal metaplasia, cystic dilatation, and foveolar hyperplasia in the biopsy specimens of a single patient may also point to increased cancer risk. It is advisable to obtain multiple biopsy specimens of the anastomosis, also because early gastric cancer may occur without a suspect macroscopic appearance.

Adolescent↗
PubMed1988

Mortality caused by stomach cancer after remote partial gastrectomy for benign conditions: 40 years of follow up of an Amsterdam cohort of 2633 postgastrectomy patients.

Mortality caused by stomach cancer was analysed in a cohort of 2633 postgastrectomy patients who underwent surgery for benign conditions in the academic medical centre of the University of Amsterdam between 1931-1960. In comparison with mortality from gastric cancer in the general Dutch population, the observed versus expected ratio in the postgastrectomy group was significantly increased among women, after a postoperative latency of more than 15 years (O/E: 4.77; p = 0.011) and among men after a postoperative latency of more than 25 years (O/E: 3.13; p = 0.005). The analysis confirms that the discrepancies in risk appraisal which seem to exist between reports published in Europe and the USA may be explained by the differences in length of follow up in these studies.

Adult↗
PubMed1986

Double-blind crossover trial of prostaglandin E2 in postgastrectomy reflux gastritis.

Excessive Enterogastric reflux following partial gastrectomy is believed to be responsible for bilious regurgitation, vomiting, nausea, and epigastric pain. At endoscopy, striking erythema and inflammatory changes of the gastric mucosa may be seen. The nonsurgical treatment for this syndrome is unsatisfactory. Because of the potential pathogenetic role of regurgitating bile acids, lysolecithin, and pancreatic secretions, it seemed relevant to find out whether prostaglandin E2 (PGE2) in a dose of 0.5 mg qid could protect the gastric mucosa from further damage and thereby lead to symptomatic improvement. The results of this controlled doubled-blind crossover trial, comparing PGE2 and placebo, in the treatment of postgastrectomy reflux gastritis reveal no significant differences between PGE2 and placebo with regard to symptoms, endoscopic features, and histologic evidence of inflammatory changes. Thus, prostaglandin E2 in the dose used appears incapable of improving postgastrectomy reflux gastritis in patients with mild to moderate degrees of this entity.

Adult↗
PubMed1985

Cell proliferation kinetics in the gastric remnant.

Biopsy specimens of the gastroenterostomal area in 60 long-standing asymptomatic postgastrectomy patients and of the mid-corpus region in five normal controls were cultured in [3H]-TdR. Using radioautography, thymidine incorporation rate (TIR) and cell position of the labelled cells were scored. In the normal gastric mucosa cell proliferation was limited to the progenitor cell region. TIR of the stomal area was higher compared to the normal mucosa. In addition, an upward shift of the proliferative compartment towards the luminal surface was observed. In severe dysplasia an expanded pool of DNA-synthesizing cells was present in the uppermost layers of the gastric mucosa, but even in the surrounding non-dysplastic mucosa an upward shift of labelled cells could be demonstrated. These proliferative changes are considered to be compatible with increased cancer risk. The sequence of proliferative events suggests that early cancer formation in the gastric remnant takes place in the superficial mucosa and therefore is easily amenable to endoscopic biopsy.

Cell Division↗
PubMed1984

The operated stomach: a premalignant condition? A prospective endoscopic follow-up study.

2633 consecutive patients in whom a gastric operation had been performed between 1931 and 1960 were selected for an ongoing prospective follow-up study. In 741 already deceased patients mortality due to gastric cancer was 5.13%. 504 asymptomatic postgastrectomy patients participated in an endoscopic-bioptic screening program. Up to now, 10 stump cancers have been detected. Seven had a radical curative resection, and all are still alive. In five of them the cancer was limited to the mucosa and not visible at endoscopy. Gastric dysplasia was found in 70 patients. In three patients with severe dysplasia carcinoma was detected during follow-up study. In 22 patients with prior mild or moderate dysplasia no progression could be demonstrated. Cancer in postgastrectomy patients is estimated to be at least twice as high as in an age-matched Dutch control population with intact stomach. The risk depends on the postoperative interval and the age at which the initial operation was performed. In general, patients from the age of 50 onwards or more than 10-15 years after initial surgery are at risk.

Adult↗
PubMed1977

Lymphangiomyoma.

A case report is presented of the incidental finding of a lymphangiomyoma in a 50-year-old woman who underwent total hysterectomy for squamous cell carcinoma of the cervix. The condition seems to occur only in women after puberty and so far, has been mainly reported in association with chylothorax or chylous ascites. There is no evidence of any clinical complication more than 2 years after removal of the lesion. The lesion is most likely a hamartoma although the term lymphangiomyoma is acceptable. The term lymphangiomyomatosis is best reserved for the fully developed clinico-pathological syndrome.

Carcinoma, Squamous Cell↗