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Biomedical subjects

L Hochholzer

Publications and source records attributed to L Hochholzer.

At least 37 records · Page 2Linked to original sources
PubMed1987

Mucoepidermoid tumors of the lung.

Mucoepidermoid tumors of lung (MET) are rare tumors derived from the minor salivary gland tissue of the proximal tracheobronchial tree. The authors studied 58 cases of MET confined to the lung and used criteria derived from similar tumors of the salivary glands to separate them into low-grade and high-grade variants. The overwhelming majority of low-grade tumors behaved in a benign fashion, whereas 23% of high-grade tumors resulted in patient death. Prognostic factors which appeared to predict future aggressive behavior included high-grade classification, advanced stage at presentation, and perhaps lymph node metastases.

Adenoma, Pleomorphic↗
PubMed1987

Primary pulmonary hemangiopericytoma.

Eighteen cases of primary pulmonary hemangiopericytoma are reported. These pulmonary sarcomas tend to occur in older individuals, frequently as asymptomatic, non-calcified solitary masses on chest radiographs. Morphologically, they have a histology similar to their soft tissue counterparts. No single clinical or histologic feature allowed prediction of biologic aggressiveness in these rare pulmonary sarcomas and the authors recommend that all hemangiopericytomas of lung be considered as potentially malignant.

Adult↗
PubMed1987

Mediastinal hemangiomas.

Hemangiomas of the mediastinum are rare tumors. Fewer than 100 have been reported. This study reviews the cases of 15 patients with mediastinal hemangiomas confirmed pathologically. We analyzed and evaluated the presentation, evaluation, and treatment. Follow-up is available for 14 of the 15 patients and ranges from 15 months to 15 years. Eight of the 15 patients were seen with signs and symptoms related to the tumor. This presentation correlated with invasion of contiguous mediastinal structures by the tumor. Six patients underwent total excision and 6, subtotal excision. During follow-up, residual tumor did not spread, become symptomatic, or show evidence of malignant degeneration. Based on this analysis, we believe that in patients in whom total excision of this tumor can be accomplished only by hazardous resection, a subtotal resection should be performed.

Adolescent↗
PubMed1987

Pulmonary hyalinizing granuloma.

Pulmonary hyalinizing granulomas are distinct fibrosing lesions of lung, having central whorled deposits of lamellar collagen. Twenty-four cases of this unusual pulmonary lesion are reported herein. Hyalinizing granulomas occur in middle-aged persons and are frequently mistaken for metastatic carcinoma radiographically. More than half of the patients had autoimmune phenomena or previous exposures to mycobacterial or fungal antigens. Four patients had sclerosing mediastinitis develop. A progressive debilitating clinical course was related to increasing dyspnea and bilateral disease on chest radiographs. A discussion of the histogenesis and histologic differential diagnosis is presented.

Adult↗
PubMed1987

Lymphoid interstitial pneumonia: clinicopathological and immunopathological findings in 18 cases.

Eighteen patients with lymphoid interstitial pneumonia (LIP) were studied. The diagnosis was established by the microscopic finding of interstitial infiltrates of lymphocytes and plasma cells. Forty-seven% of patients also had germinal centres, while 72% showed interstitial giant cells. Cases studied by the immunoperoxidase technique showed the interstitial plasma cells to be polytypic. The median age of patients was 56 years; most had cough, dyspnea, or chest pain. Chest X-rays showed either patchy interstitial infiltrates (usually bilateral) or poorly defined nodules. Ten patients had hypergammaglobulinemia; one had hypogammaglobulinemia. Two patients had Sjögren's syndrome, two had biopsy-proven chronic active hepatitis, and two had a clinical diagnosis of primary biliary cirrhosis. Follow-up examination of 14 patients showed clearing of symptoms, X-ray infiltrates or stable infiltrates in 4 cases each. Five patients died (mean survival, 41 months), one of whom succumbed to disseminated lymphoma and a second to respiratory failure. Our results support the hypothesis that LIP is a non-neoplastic cellular proliferation in which lymphoma may supervene. The high incidence (22%) of chronic liver disease has not previously been noted.

Adult↗
PubMed1987

Malignant mesotheliomas with osseous and cartilaginous differentiation.

This report describes ten examples of diffuse pleural tumors felt to represent malignant mesotheliomas with osseous and cartilaginous differentiation. Typically, the patients involved were elderly whites who presented with chest pain, bloody pleural effusions, and diffuse and nodular pleural disease on chest roentgenograms. An asbestos-exposure history was indicated in six of the ten patients. Seven cases were malignant fibrous mesotheliomas, and three were biphasic mesotheliomas. Results of immunoperoxidase studies for cytoplasmic keratin were positive in three of six cases of malignant fibrous mesothelioma.

Aged↗
PubMed1987

Unusual thoracic manifestations of epithelioid hemangioendothelioma.

Intravascular bronchioloalveolar tumors are now recognized as the pulmonary analogue of epithelioid hemangioendotheliomas of the somatic soft tissues. These low-grade endothelial sarcomas have a typical histologic appearance and usually present as bilateral pulmonary nodules in young women. The present report describes four unusual clinical manifestations of the epithelioid hemangioendothelioma: as an anterior mediastinal mass, as diffuse pleural thickening resembling malignant mesothelioma, as a metastatic carcinoma with cancerization of the lymphatics (lymphagitic carcinoma), and as a solitary peripheral calcified nodule. These anomalous clinical presentations correspond to unusual histologic appearances of the tumor at open-lung biopsy, and need to be recognized by both the clinician and the pathologist.

Adult↗
PubMed1987

Sporothrix infection of the lung without cutaneous disease. Primary pulmonary sporotrichosis.

The clinical spectrum of sporotrichosis is expanding and now includes pulmonary infection in absence of skin lesions. Lung involvement, albeit unusual, is a granulomatous pneumonitis which may progress to bilateral, apical, fibrotic, and contracted infiltrates or cavities, thereby mimicking tuberculosis or histoplasmosis. The patients are most often middle-aged men with alcoholism and chronic obstructive pulmonary disease. Our case report is yet another variant of primary pulmonary sporotrichosis that presented as diffuse, bilateral granulomatous pneumonitis without cavitation or predilection for upper lobes.

Dermatomycoses↗
PubMed1986

Alveolar adenoma.

This report describes six cases of an unusual pulmonary neoplasm, the alveolar adenoma, that consists of a benign proliferation of alveolar epithelium and septal mesenchyme. The neoplasm presents as a solitary peripheral lesion on chest radiographs, particularly in older patients. It has unique histologic features, which should be distinguished from those of sclerosing hemangioma, lymphangioma, and bronchioloalveolar carcinoma.

Adenoma↗
PubMed1986

Lymphomatoid granulomatosis: a clinicopathologic study of 42 patients.

We studied the histological and clinicopathological findings in 42 patients who had lymphomatoid granulomatosis (LYG). In addition to small round lymphocytes, small to intermediate lymphocytes with serpentine nuclei, large immature mononuclear lymphoid cells, abundant histiocytes, and vascular invasion by the cell infiltrate were observed in all cases. Fifty percent of lesions had occasional "atypical" cells with multi-lobed nuclei. Three of four follow-up autopsies showed large cell lymphoma, while one other autopsy and the single repeat biopsy showed increased numbers of large immature mononuclear lymphoid cells. Patients were most frequently men 40-60 yr old who had a history of pulmonary symptoms, such as cough or chest pain, and who showed multiple bilateral lung nodules without hilar adenopathy in the chest x-ray. Thirteen patients (38%) died of disease, 11 of them within 12 mth of initial diagnosis. The presence of neurological signs and symptoms, increased mitoses, or increased numbers of atypical multi-nucleated cells in the initial biopsy were not statistically significant predictors of survival.

Adrenal Cortex Hormones↗
PubMed1986

Amyloidosis presenting in the lower respiratory tract. Clinicopathologic, radiologic, immunohistochemical, and histochemical studies on 48 cases.

We studied 48 cases of amyloidosis localized to the lower respiratory tract. Fourteen cases were classified as tracheobronchial amyloidosis. Twenty-eight cases showed solitary or multiple nodules, and six cases had a diffuse interstitial parenchymal pattern. Almost all patients with tracheobronchial and diffuse interstitial amyloidosis had respiratory symptoms (usually dyspnea), whereas most with nodular amyloidosis were asymptomatic. Nodular parenchymal and, less frequently, tracheobronchial amyloidosis had contiguous cellular infiltrates of plasma cells, lymphocytes, and giant cells. Immunohistochemical staining of specimens from 18 cases showed these plasma cells to be polytypic, except for two tracheobronchial lesions that had a disproportionate number of lambda light chain-bearing plasma cells. Permanganate oxidation of specimens from 19 cases showed patterns in keeping with immunoglobulin-derived amyloid in 12. Local deposits of amyloid in lung may arise from deposition of circulating precursor proteins.

Adult↗
PubMed1985

Primary pulmonary sporotrichosis. Report of eight cases with clinicopathologic review.

Pulmonary sporotrichosis in the absence of lymphocutaneous disease is unusual; however, its incidence may be greater than previously recognized. This report describes the AFIP experience in eight cases of primary pulmonary sporotrichosis and reviews an additional 23 cases. The disease is often a bilateral, apical, chronic and cavitary, progressive, destructive, and debilitating infection, most often seen in middle-aged men with a history of alcoholism and chronic obstructive pulmonary disease. In this clinical setting, pulmonary sporotrichosis closely mimics tuberculosis or histoplasmosis. However, this clinical charade can be unmasked by serologic tests, cultures, and identification of the causative agent, Sporothrix schenckii, in sections of paraffin-embedded lung containing necrotizing granulomas and stained with periodic acid-Schiff and Gomori methenamine-silver nitrate. Previously not recognized is the presentation of primary pulmonary sporotrichosis as a solitary, peripheral, necrotizing pulmonary nodule, observed in two patients. Chronic cavitary pulmonary sporotrichosis is usually refractory to drug therapy; however, when combined with surgical resection, cure can be attained.

Adult↗
PubMed1983

Primary non-Hodgkin's lymphoma and pseudolymphoma of lung: a study of 161 patients.

The authors studied 161 cases of primary non-Hodgkin's lymphomas and pseudolymphomas of lung. Small lymphocytic proliferations, which they believe to be lymphomas, constituted 31.6 per cent of cases; plasmacytoid lymphocytic and small cleaved follicular center cell lymphomas (Lukes-Collins system), 22.4 and 11.8 per cent of cases, respectively; and the remaining follicular center cell lymphomas and B-immunoblastic sarcomas, 5.6 per cent of cases. Pseudolymphomas constituted 14 per cent of cases. Most patients were elderly and asymptomatic; in most cases a solitary nodule or infiltrate was observed on a chest radiograph. Radiographic evidence of effusion was found in both lymphomas and pseudolymphomas, but hilar adenopathy was restricted to lymphomas. A few peribronchial reactive germinal centers and intralesional giant cells/granulomas were seen frequently in unequivocal lymphomas, so their presence cannot be used to exclude neoplasia. A generally monomorphic cell population and invasion of bronchial cartilage or visceral pleura are suggestive of malignancy, whereas primitive cytologic appearance and invasion of lymph nodes or parietal pleura are pathognomonic of malignancy. Diffusely admixed mature lymphocytes and plasma cells with numerous reactive follicles suggest pseudolymphomas. Immunologic determination of clonality may be diagnostically definitive. Most localized lesions in lung were treated by surgical resection, whereas in cases of extensive pulmonary disease, biopsies were performed and patients were treated by chemotherapy or irradiation. Both lymphomas and pseudolymphomas recurred, most often within three years. Pseudolymphoma recurred only in lung. When distant spread of lymphoma occurred, it commonly involved extranodal sites. Only 18 of 101 patients with lymphoma died with or of tumor, and no patient with pseudolymphoma died of disease. Neither histologic subtype among the "small cell" lymphoid lymphomas nor the presence of regional node involvement was prognostically significant, but pleural effusion on the initial chest radiograph was a significant predictor of both recurrence and mortality.

Adolescent↗
PubMed1982

Bronchocentric granulomatosis: roentgenographic manifestations.

The roentgenographic manifestations of bronchocentric granulomatosis were reviewed in 15 patients. Nine patients had mass lesions. Four had alveolar infiltrates and 2 presented with reticulonodular infiltrates . Correlation of these radiographic patterns with the pathologic findings helps explain the varied morphologic appearance of this disease on the chest radiographs. Upper lobe involvement and unilateral disease were predominant. Seven of 15 patients (47%) presented with solitary mass lesions. Pleural reaction was occasionally noted. Hilar adenopathy and cavitation were infrequent. There was little correlation between radiographic pattern and clinical presentation.

Adult↗
PubMed1981

Ganglioneuroblastoma of the posterior mediastinum: a clinicopathologic review of 80 cases.

The pathology and clinical course of 80 cases of ganglioneuroblastoma (GNB) of the posterior mediastinum are presented. Many neoplasms in this series had previously been classified as differentiating neuroblastomas or immature ganglioneuromas. The prognosis for this group is far better than that for either neuroblastomas or intra-abdominal GNBs. Follow-up was obtained for 72 patients, of whom 55 were followed for 2-23 years. The five-year actuarial survival rate was 88%. Prognosis was related to histologic growth pattern, age, and extent of disease at diagnosis. Stage I tumors were curable by simple excision; children with Stage II tumors treated with surgery and radiation responded as favorably as did those who received adjunctive chemotherapy. In contrast to those associated with late recurrences, the only examples of fatal primary tumors, with one exception, were those patients with Stage IV lesions at the time of initial diagnosis. The therapeutic implications and need for uniform terminology in classifying GNBs are discussed.

Adolescent↗
PubMed1981

Bronchocentric granulomatosis.

The clinical and morphologic features in 15 patients with bronchocentric granulomatosis were reviewed. Patients were divided into two groups on the basis of the morphologic findings. Group I consisted of five patients with necrotizing granulomas containing abundant eosinophils in the areas of necrosis. Three of these patients were asthmatic, two had elevated blood eosinophil counts, and in one there were fungal hyphae within necrotizing granulomas. In another case a sputum culture was positive for Aspergillus. The findings in these cases support the contention that some bronchocentric granulomas associated with tissue eosinophilia may represent a hypersensitivity reaction to inhaled Aspergillus. Group II included 10 patients with bronchocentric granulomas showing many polymorphonuclear cells but few eosinophils. One of these 10 had asthma, and blood eosinophilia was found in only one patient. The etiology and pathogenesis of these bronchocentric granulomas in unclear. The differences in morphology and clinical symptomatology between the two groups suggest that these lesions may arise from more than one etiologic agent and pathogenetic mechanism. Follow-up information was available for 11 individuals. Corticosteroids were given to four patients and lesions were resected from five patients. Neither recurrence of bronchocentric granulomas nor death due to them was reported.

Adolescent↗
PubMed1981

Pulmonary blue bodies.

Pulmonary blue bodies are intra-alveolar laminated basophilic concretions of uncertain etiology. Blue bodies were studied in lung biopsy specimens from 10 patients. The patients ranged in age from 47 to 69 years and were predominantly men. Three had a history of overt exposure to environmental dusts such as sawdust and asbestos, and two showed occasional ferruginous bodies in the lung, raising the possibility of pneumoconiosis. In eight cases there was interstitial pneumonitis, which resembled desquamative interstitial pneumonia by light microscopy but which was often seen to be patchy and asymmetrically distributed in the lung by chest x-ray examination. Of two other patients, one had xanthogranulomatous inflammation and the other, necrotizing granulomatous inflammation. Light and electron microscopic, histochemical, microchemical, and x-ray diffraction studies of blue bodies were also performed. Calcium carbonate is a major component of blue bodies and is responsible for their birefringence in unstained sections and ready solubility in acid solutions. Blue bodies also contain a mucopolysaccharide matrix and iron. We offer the hypothesis that blue bodies (calcium carbonate) are a product of histiocytic catabolism.

Aged↗