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Biomedical subjects

L E Wold

Publications and source records attributed to L E Wold.

At least 109 records · Page 6Linked to original sources
PubMed1985

Bone tumors: magnetic resonance imaging versus computed tomography.

The magnetic resonance (MR) imaging characteristics of bone tumors are described and the clinical utility of MR imaging in patient evaluation is reported. Fifty-two patients with skeletal lesions were examined with a Picker MR imager (0.15-T resistive magnet). Twenty-five patients had primary malignancies, seven had benign bone neoplasms, 15 had skeletal metastases, and five had neoplasm simulators. Forty-five patients had CT scans available for comparison. For demonstrating the extent of tumor in marrow, MR was superior to CT in 33% of cases, about equal to CT in 64%, and inferior to CT in 2%. For delineating the extent of tumor in soft tissue, MR was superior to CT in 38% of cases and about equal to CT in 62%. CT was superior in all cases for demonstrating calcific deposits and pathologic fractures. In four patients with metal prostheses or surgical clips, MR was superior to CT in documenting recurrent tumor because of artifactual degradation of the CT image. Direct sagittal and coronal images from MR permit accurate assessment of the relationship of tumor to adjacent normal structures, including the physis, joints, and neurovascular structures. MR is useful in the evaluation of bone tumors: it is of greatest value in evaluations of the peripheral skeleton, the medullary canal, soft tissues, and postoperative tumor recurrence. With a 0.15-T magnet, MR is less useful in the evaluation of the axial skeleton and cortical bone.

Aged↗
PubMed1985

Testicular neoplasms: 29 tumors studied by high-resolution US.

High-resolution (10-MHz) ultrasonography produces extremely detailed anatomic images of the testis. The sonographic features most helpful in detecting tumors are mass, bright echogenic foci, and diffuse parenchymal texture change. Of 29 patients with testicular neoplasms, 21 (72%) had one or more masses, 19 (66%) had one or more echogenic foci, and nine (31%) had a diffuse parenchymal texture change. Bright echogenic foci were present in six (86%) of seven testes that had a regressed germ-cell tumor. In an attempt to define the histologic features of bright echogenic foci, we performed needle localization under real-time guidance on four operative specimens. We observed immature bone and cartilage, calcification, tubular atrophy and fibrosis, and focal noncalcific scarring. Discovery of occult testicular neoplasms was common (9/29); four patients were thought to have had "extragonadal" germ-cell tumors before abnormalities were found on the sonograms.

Adolescent↗
PubMed1984

Surgical management of hyperinsulinemic hypoglycemia in children.

Nineteen children underwent subtotal pancreatectomy for hyperinsulinemic hypoglycemia. Of the four who were older than 10 years of age at onset of symptoms, three had islet adenomas, and one had endocrine cell dysplasia (ECD). The two patients with multiple adenomas had a family history of multiple endocrine neoplasia, type 1 (MEN 1). Of the 15 who were younger than 1 year of age at onset of symptoms, 12 had ECD alone, and three had ECD with adenomatosis. Four children required a second surgical procedure and near-total pancreatectomy because of persistent hypoglycemia. All 19 patients' conditions improved, with no postsurgical complications. After near-total pancreatectomy, all four patients were treated for fat malabsorption, but only two required insulin because of secondary diabetes mellitus. We concluded that subtotal pancreatectomy is a safe, effective adjunct to the treatment of children with hyperinsulinemic hypoglycemia.

Adenoma↗
PubMed1984

Cancer-to-cancer metastasis.

The development of another separate primary cancer in a patient with 1 malignant tumor is not uncommon but metastasis of a malignant donor tumor to a different host tumor is extremely rare. Most recipient tumors have been primary renal cell carcinomas. We report a case of metastasis of a malignant melanoma to a renal cell carcinoma.

Adenocarcinoma↗
PubMed1984

Yolk sac carcinoma: an immunohistochemical and clinicopathologic review.

The records of 14 children with yolk sac carcinoma were reviewed to determine if the production of specific proteins by the tumor could be used to predict the biologic potential of the neoplasm. Several marker proteins were identified by immunohistochemical staining of tissue specimens. The presence or absence of these proteins (periodic acid, Schiff-positive and diastase-resistant globules, alpha-1-antitrypsin, alpha-fetoprotein, beta-subunit of human chorionic gonadotropin and albumin) was of no prognostic significance when survivals free of disease were compared. Six patients underwent retroperitoneal node dissection as part of initial staging (group A), 1 (17 per cent) of whom had retroperitoneal lymphatic metastasis. Eight patients were not subjected to lymphadenectomy initially (group B). Retroperitoneal node dissection did not produce an increase in survival free of disease. Our findings suggest that retroperitoneal node dissection should not be used routinely in all children with yolk sac tumors. Adjunctive chemotherapy has proved extremely effective in salvaging patients in whom metastatic disease develops.

Adolescent↗
PubMed1984

Magnetic resonance imaging of aneurysmal bone cyst.

A case of aneurysmal bone cyst is presented, and the radiographic, computed tomographic, and magnetic resonance imaging findings are discussed. The potential advantages of magnetic resonance imaging compared with those of computed tomography are explained. The case is presented to illustrate the potential value of magnetic resonance imaging in the evaluation of bone and soft tissue tumors.

Adult↗
PubMed1984

Testicular yolk sac and embryonal carcinomas in pediatric patients: comparative immunohistochemical and clinicopathologic study.

Twelve Mayo Clinic patients less than 17 years of age were identified who had yolk sac tumors of the testis. Seven additional pediatric patients were identified who had embryonal carcinoma of the testis. These 19 patients form the basis for this study correlating histopathology and immunocytochemical patterns with clinical outcome. Immunoperoxidase studies were done with antibodies to alpha-fetoprotein, beta-subunit of human chorionic gonadotropin, alpha-1-antitrypsin, and human albumin. The immunocytochemical staining pattern in these neoplasms did not appear to correlate with prognosis.

Adolescent↗
PubMed1984

High-grade surface osteosarcomas.

Nine patients (seven males and two females) had high-grade, ordinary-type osteosarcomas that were juxtacortically located. The ages of these patients ranged from 9 to 62 years at the time of diagnosis. The roentgenographic appearance of these tumors occasionally is similar to that of periosteal osteosarcomas. Histologically, these tumors were indistinguishable from ordinary high-grade intramedullary osteosarcomas. None of the nine tumors had histologic features of parosteal or periosteal osteosarcomas. All nine patients were treated by ablative surgery. Seven patients died of tumor. Because of its poorer prognosis, this tumor should be differentiated from other juxtacortical osteosarcomas.

Adolescent↗
PubMed1984

Dedifferentiated parosteal osteosarcoma.

Parosteal osteosarcoma is an uncommon malignant tumor of bone, and in a review of Mayo Clinic records we identified eleven cases of so-called dedifferentiated parosteal osteosarcoma. Ten of the eleven patients had had a long history of treatment for multiple recurrences of the tumor as a low-grade parosteal osteosarcoma and then for a definite recurrence as a high-grade undifferentiated osteosarcoma. The prognosis in this group of patients was similar to that in patients with conventional osteosarcoma.

Adolescent↗
PubMed1984

Giant cell tumor of the small bones of the hands and feet.

Giant cell tumor of bone uncommonly occurs in the bones of the hands and feet. Previous reports suggested that the giant cell tumors in these locations occur in younger patients, are more commonly multifocal, and are associated with a higher risk for local recurrence and pulmonary metastasis than those at the ends of the long bones. A review of our experience with 43 patients having giant cell tumors in small bones is presented. Radiologic and histologic comparison is made with aneurysmal bone cyst and giant cell reparative granuloma (giant cell lesion) of the small bones. Followup information indicates that giant cell tumors of the small bones do occur in younger patients and appear to have a greater propensity for local recurrence than those of the long bones. As the lesions may be multifocal, a patient with documented giant cell tumor of the small bones should have a skeletal survey to search for other lesions.

Adolescent↗
PubMed1983

Tumefactive fibro-inflammatory lesions of the head and neck.

Seven patients had tumefactive inflammatory fibrous lesions of the head similar in histologic appearance to Riedel's thyroiditis, sclerosing mediastinitis, and retroperitoneal fibrosis. Five patients were females, and the mean age at presentation was 48 years. Four patients presented clinically with a mass. Histologically, these lesions were characterized by an admixture of mature fibrous tissue and an inflammatory infiltrate of lymphocytes and scattered polymorphonuclear leukocytes. Initially, all patients had been treated surgically. Two patients received radiation therapy when recurrent disease could not be controlled surgically. Five of the six patients on whom follow-up information was available were alive at follow-up that ranged from 14 to 49 months (mean 29). These lesions are distinct histologically from desmoid tumors, fibromatoses, and nodular fasciitis. The spectrum of fibrosclerosing lesions (Riedel's thyroiditis, idiopathic mediastinal fibrosis, retroperitoneal fibrosis, and sclerosing cholangitis) probably includes this group of tumefactive inflammatory fibrous lesions of the head.

Adult↗
PubMed1983

Intracavitary cardiac melanoma diagnosed by endomyocardial left ventricular biopsy.

A patient was evaluated for a persistent pericardial effusion and on two-dimensional echocardiography was found to have an intracavitary left ventricular mass. Twenty-two years earlier, a melanoma of the ethmoid sinus had been excised. An electrocardiogram revealed impressive T-wave abnormalities and pathologic Q waves, initially suggestive of "myocardial infarction." However, the coronary arteries were normal at angiography. At catheterization, the left ventricular mass was biopsied, using a transvenous catheter-directed technique, and proved to be a metastatic melanoma. This procedure obviated the need for diagnostic thoracotomy. We believe that this is a unique application of the use of catheter-directed biopsy to make a histologic diagnosis of a left ventricular neoplasm.

Biopsy↗
PubMed1983

Cranial chordomas in children and young adults.

A series of 12 surgically treated and pathologically proven cranial chordomas presenting in children and young adults is reviewed. These rare tumors occur in relation to the path of the primitive notochord; four were parasellar, six were mid-clival, and two were inferior clival in location. Pathological evaluation revealed five of the tumors to have a significant chondroid component. Follow-up studies ranging from 1 month to 21 years revealed that eight patients were alive, all of whom had received radiation therapy following surgery.

Adolescent↗
PubMed1982

Hemangiopericytoma of bone.

Hemangiopericytoma primary in bone is a rare tumor. A review of 15 cases (five from the Mayo Clinic files and 10 from the consultation files) revealed that all tumors were unifocal and that the most common location was the pelvis (three lesions in the sacrum and two in the ischium). The series involved seven male and eight female patients whose ages ranged from 14 to 74 years. Histologically, all of the tumors were composed of cells with round to oval nuclei arranged around vascular spaces. On the basis of cellularity, nuclear atypia, and mitotic activity, four tumors were benign, two intermediate, and nine malignant. Surgery was the primary treatment for the 15 patients. Of the 14 patients with adequate follow-up, eight died of disease, three were alive with recurrent disease, and three were alive and disease-free.

Adolescent↗
PubMed1982

Hemangioendothelial sarcoma of bone.

Hemangioendothelial sarcoma of bone is a rare tumor. A series of 112 cases was studied to define the clinical and pathologic features of this disease. Of the various histologic features evaluated to define the ones most significant prognostically, the histologic grade of the lesions was the single feature that correlated best with disease-free survival. In this series, patients with multi-focal tumors did not have a better prognosis than patients with unicentric disease. Surgery remains the primary treatment for these patients. Radiotherapy may be useful for surgically inaccessible lesions of the axial skeleton. Too few patients have received adjuvant chemotherapy to evaluate its usefulness in this setting.

Adolescent↗
PubMed1982

Patterns for normal colon mucosa and colon adenocarcinoma compared by two-dimensional gel electrophoresis.

A two-dimensional gel "map" of the proteins in normal cells and transformed cells may well help establish the presence of putative tumor-specific protein antigens, which can be isolated and used as antigens. We so examined normal colon mucosa and colon adenocarcinoma, using a sensitive silver stain. Samples were promptly prepared after excision by rapidly trimming the tissue to a small, grossly homogeneous piece, which was frozen on solid CO2. Frozen histological sections and permanent mounts were also prepared for several areas, to document the cellular constitution and to grade the carcinoma. Sample preparation for electrophoresis is described. The DNA was pelleted by centrifugation (108 000 x g x 1.5 h). Little or no pellet was observed, indicating complete solubilization. Many of the tumors contained proteases, liberated during sample preparation, so protease inhibitors were included. A highly reproducible pattern was observed for normal mucosa. Comparison of the gels from paired samples with histological data allows many of the spots to be tentatively assigned to the different cell types present in the mucosa (epithelium, connective tissue, or muscularis mucosa) and, in most tumors analyzed, detection of a series of spots that are not detectable in the pattern for normal tissue. These apparently tumor-associated proteins may be of epithelial cell or stromal origin.

Adenocarcinoma↗