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Biomedical subjects

L M Roth

Publications and source records attributed to L M Roth.

At least 109 records · Page 6Linked to original sources
PubMed1982

Ovarian strumal carcinoid. An immunocytochemical and ultrastructural study of two cases.

Examination by immunoperoxidase methods showed that two strumal carcinoids contained thyroxine in the follicular epithelium and colloid. Ultrastructure showed features of thyroid epithelia. Granule-containing cells replaced some follicular epithelial cells at the colloid interface. The morphology of the granules of these cells resembled those of C-cells and foregut-hindgut carcinoids. Transition between thyroid and carcinoid occurred by proliferation of interfollicular cells which subtly formed trabecular structures. Immunoperoxidase for calcitonin was positive both in the interfollicular cells of one tumor and in cells near the transition from thyroid to carcinoid pattern of the other. We conclude that thyroid tissue is a proven component of strumal carcinoid but that follicular epithelial cells may be replaced by granule-containing parafollicular cells. We suggest that the transition from thyroid to carcinoid is accomplished through an intermediate stage of calcitonin-positive cell proliferation. We emphasize, however, that these neoplasms are types of teratomas which may show several forms of differentiation. The tumor of one patient had mid-gut carcinoid elements and represents the first described strumal carcinoid with the carcinoid syndrome.

Aged↗
PubMed1982

Adenosarcoma of the ovary. A light- and electron-microscopic study with review of the literature.

This is a light- and electron-microscopic study of a large ovarian adenosarcoma in a 50-year-old woman as well as a review of the literature. The tumor showed a variety of müllerian type epithelia and a spectrum of stromal patterns including nonspecific fibroblastic, and endometrial type stroma. The latter ranged from normal-appearing to low-grade sarcoma. This study emphasizes the relationship of ovarian adenosarcoma to cystadenofibroma, on the one hand, and to malignant mixed müllerian (mesodermal) tumor, on the other. It appears that the mitotic count which is used as the primary means for the classification of smooth muscle and stromal tumors of the uterus, has less value in the assessment and prognostication of ovarian adenosarcomas.

Adenofibroma↗
PubMed1982

Metastatic carotid body paraganglioma in von Hippel-Lindau disease. An electron microscopic study.

Pulmonary metastases from a carotid body paraganglioma developed in a patient with von Hippel-Lindau disease. On electron microscopic examination, these metastases consisted solely of chief cells that contained membrane-bound, dense-core granules and formed numerous cytoplasmic processes. These data support the hypothesis that the chief cell is the sole neoplastic cell in paragangliomas. Finally, to our knowledge, this clinical association of a malignant carotid body paraganglioma and pheochromocytoma in von Hippel-Lindau disease is unique.

Adolescent↗
PubMed1981

Ovarian endometrioid adenofibromatous and cystadenofibromatous tumors: benign, proliferating, and malignant.

Ovarian endometrioid tumors with an adenofibromatous pattern have been described but the entire spectrum of these tumors has not been analyzed. A series of ten cases was studied and divided into two benign, four proliferating, and four malignant tumors on the basis of their morphologic characteristics. The most useful criterion for distinguishing proliferating from benign adenofibromatous tumors is increased epithelial proliferation, associated with glandular complexity and crowding in the former. Proliferating tumors may represent one form of the endometrioid tumor of borderline malignancy. The presence of a confluent growth pattern with invasion of the stroma distinguishes malignant from proliferating tumors. The various tumors in this group frequently show squamous metaplasia and are often associated with endometriosis. Because of the relatively small series, the biologic behavior of these histologic variants cannot be evaluated at this time.

Adenocarcinoma↗
PubMed1981

Sertoli-Leydig cell tumors: a clinicopathologic study of 34 cases.

Thirty-four cases of Sertoli-Leydig cell tumor were studied. All tumors were limited to the ovary at the time of initial surgery. Eight tumors were well differentiated, 15 were of intermediate differentiation, and 11 were poorly differentiated. Six cases contained heterologous elements. The less differentiated tumors occurred in patients with a lower median age and were more likely to produce androgenic manifestations. Follow-up of one year or longer was obtained in 15 patients, with an average follow-up in these patients of 6.1 years. Only one patient, who had a poorly differentiated tumor, died of the neoplasm in this series. Although follow-up was limited in this study, our findings suggest that the better differentiated tumors have a relatively favorable prognosis. This neoplasm is composed of sex-cord and stromal elements, and its components have the capacity to a greater or lesser extent to recapitulate the cells of the testis at different stages of development.

Adolescent↗
PubMed1980

Intravenous leiomyomatosis of the uterus with extension into the heart.

A 42 year old woman presented with impaired filling of the right atrium and right ventricle two years after removal of uterine leiomyomas. At the time of hysterectomy, intravenous leiomyomatosis was noted, with extension of the tumor into the inferior vena cava. The tumor subsequently extended into the right atrium and coronary sinus, and protruded through the tricuspid orifice. It was successfully removed from the heart, and proved to be histologically benign.

Adult↗
PubMed1979

Juvenile granulosa cell tumor: a clinicopathologic study of three cases with ultrastructural observations.

We have encountered three cases of a recently recognized form of granulosa cell tumor referred to by Scully as the juvenile type, and we have made ultrastructural observations on one case. This variant is encountered almost exclusively in the first two decades, and is characterized at the optical microscopic level by a macrofollicular or a diffuse, sometime disorderly pattern of growth, often with extensive luteinization and hyperchromatic nuclei. One of our patients developed precocious pseudopuberty. Our ultrastructural observations in this case supported the concept that this tumor is a granulosa cell tumor, and the tumor showed some similarities to previously reported granulosa cell tumors. A spectrum of cells was observed ranging from well differentiated granulosa cells to stromal cells with many intermediate forms present. The stromal cells varied from being fibroblast-like to theca-like. Both granulosa and stromal cells sometimes contained abundant lipid. Evidence of luteinization, i.e. abundant smooth endoplasmic reticulum and tubular mitochondrial cristae, was not noted in either the granulosa or stromal cells. Focal areas of smooth endoplasmic reticulum were found, however, in teh cytoplasm of cells intermediate between granulosa and stromal types. These cells may represent the source of steroid hormone secretion.

Child↗
PubMed1979

Massive ovarian edema. A clinicopathologic study of five cases including ultrastructural observations and review of the literature.

Massive ovarian edema is a tumor-like condition occurring in young women considered to be the result of torsion of the ovary to the extent that it interferes with venous and lymphatic drainage, but is insufficient to cause necrosis. Marked enlargement of the ovary occurs, and the patient usually presents with an adnexal mass. If the torsion occurs acutely abdominal pain is prominent. If it occurs gradually, the patient may be virilized and stromal luteinization is often observed microscopically within the involved ovary. Edema fluid accumulates in the stroma but the tunica albuginea and superficial cortical zone are characteristically uninvolved. In one patient, precocious puberty was the presenting finding and this regressed following excision of the mass. This unique finding suggests that the lesion can result in the production of significant quantities of estrogen, and that this is less likely to be recognized after menarche. In the case studied by electron microscopy, the principal finding was the presence of both fibroblasts and myofibroblasts in the edematous stroma. The increased number of myofibroblasts may be a response to the edema.

Adult↗
PubMed1979

Extraskeletal Ewing's sarcoma. Histologic and ultrastructural observations in three cases.

The histologic and ultrastructural morphology of three cases of Ewing's sarcoma of soft tissue are described and the fine structural features of extraskeletal Ewing's sarcoma are compared to those of similar round-cell tumors that are considered in the differential diagnosis. By light microscopy, these tumors are indistinguishable from Ewing's sarcoma of bone. Ultrastructurally, the salient features are also comparable to Ewing's sarcoma of bone and include: 1) absence of surface modifications; 2) cell-contact sites in the form of small thickenings of apposed membranes and large desmosome-like specializations; 3) undifferentiated cytoplasm usually containing abundant glycogen and occasionally nonspecific microfilaments; 4) significant variation in shape and irregularity of nuclear profiles. The ultrastructural features of extraskeletal Ewing's sarcoma are sufficiently distinctive to allow separation from from other small-cell malignant neoplasms in the majority of cases.

Adult↗
PubMed1979

The Sertoli cell in mixed gonadal dysgenesis.

Since 1937, over 100 cases of mixed gonadal dysgenesis have been described. Thus far, no correlation has been made between the light and electron microscopic morphology of the gonad and the appearance of the ipsilateral internal genitalia. In the case presented in this paper the presence or absence of the Sertoli cell in the ipsilateral gonad correlates with the morphology of the internal genitalia on that side.

Female↗
PubMed1978

Androgen, estrogen, and progesterone by a lipid cell tumor of theovary.

In a 64-year-old woman with a virilizing lipid-cell tumor of the left ovary, serum progesterons, androgens, estrogens, and cortisol levels in the peripheral and ovarian veins were measured. Although virilization was the only symptom of hormone production by the tumor in this patient, endocrine studies showed that several steroids were secreted by this neoplasm. Of the steroids measured, androstenedione was the principal secretory product. Pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone, and testosterone were also secreted, but in quantities which were one third to one sixth the amount of androstenedione. The tumor's pattern of hormone secretion was similar to patterns of steroid production by ovarian stromal cells found in previously reported in vitro studies. This case and a review of the literature demonstrate that androstenedione appears to be the predominant secretory product of lipid cell tumors, whereas testosterone is the predominant secretory product of hilus cell tumors.

17-alpha-Hydroxypregnenolone↗
PubMed1977

Extramammary Paget's disease of the vulva. A clinicopathologic study of 13 cases.

The clinicopathologic findings of 13 patients having extramammary Paget's disease of the vulva are discussed with emphasis on its histogenesis and biological behavior. For the purpose of study and assessment of prognosis, these cases were divided into two groups, those with an underlying invasive cutaneous adnexal adenocarcinoma, and those lacking an underlying invasive lesion. Four cases contained invasive cutaneous adnexal adenocarcinoma; in one of these the invasion was superficial. Three of the cases with an invasive lesion and three other cases showed in situ adenocarcinoma of sweat glands. Surgical treatment is mandatory for both groups of patients. The prognosis was excellent for the patients having Paget's disease without an underlying invasive carcinoma. From the literature, the prognosis of those with an underlying invasive carcinoma of the vulva appears to be less favorable. Multiple surgical excisions may be required to control the recurrences and metastases. A frequent association with other internal malignancy was observed. In four cases, second malignancies were found. Of special interest was the demonstration in one case of columns of neoplastic cells extending from involved sweat glands to the surface epithelium via the intradermal sweat duct. Our study leads us to support the concept that the Paget's cells, in a number of cases, are derived from an underlying carcinoma in situ of sweat gland origin.

Adenocarcinoma↗
PubMed1977

Tergal modifications associated with abdominal glandular cells in the Blattaria.

Tergal abdominal modifications of 30 species of Blattaria (Dictyoptera) were studied by means of histological scanning electron microscopy techniques. Despite marked anatomical diversity of the glands, only a few basic types of cells are present. Male tergal glands which are involved in sexual behavior generally have glandular cells filled with electron transparent vacuoles (type 3a) and those with dense myeloid secretion (type 3b); in addition some have large cells without ducts, not in contact with the cuticle and surrounded by other cells (type 2). External setae, usually associated with these structures, are mechano-receptors or mechano-chemoreceptors. Glands not involved in courtship (e.g., defensive glands) usually have large glandular cells with a ductule that reaches the end apparatus secreted by the glandular cell itself (Type 3) but lack types 2, 3a, and 3b. Species which do not have distinctive tergal modifications may have concentrations of microscopic pores or openings associated with glandular cells on certain segments. The chemistry of the secretions produced by tergal glands is unknown for most species. This paper emphasizes the need for behavioral and biochemical studies to elucidate the biological significance of cockroach tergal glands.

Animals↗
PubMed1977

Paget's disease of the vulva. A histogenetic study of five cases including ultrastructural observations and review of the literature.

Five cases of extramammary Paget's disease of the vulva were studied by histologic, ultrastructural, and immunologic methods. In one of these cases, the associated invasive adnexal carcinoma was studied in a similar fashion. In all five cases, carcinoma-in situ of the sweat glands was observed. In two cases, the glands were identified as aporcrine. In the other three it could not be determined whether they were apocrine or eccrine. In one case tumor cells were seen extending from a focus of underlying carcinoma-in-situ of sweat glands through the excretory duct into the surface epithelium. The ultrastructural findings indicated that the Paget's cells as well as the cells of the invasive carcinoma were adenocarcinoma cells, but the findings were not conclusive as to whether the cells were apocrine or eccrine. There was no evidence of origin of the Paget's cells from keratinocytes. We believe that the bulk of evidence favors an extraepidermal origin for extramammary Paget's disease. The tumor is most commonly derived from the secretory portion of sweat glands, probably either of apocrine or eccrine types, or the dermal or poral portion of the sweat duct. Some cases of Paget's disease are derived from other types of glands.

Antigens, Neoplasm↗
PubMed1977

Sebaceous carcinoma of the eyelid with Pagetoid involvement of the bulbar and palpebral conjunctiva.

A case of sebaceous carcinoma with pagetoid involvement of the palpebral and bulbar conjunctival epithelium was studied by light and electron microscopy. Ultrastructurally the neoplastic cells within the conjunctival epithelium were identical to those in the underlying invasive sebaceous carcinoma. Evidence of gradual transformation of conjunctival epithelial cells to the neoplastic sebaceous cells or transitional forms between conjunctival epithelial cells and sebaceous cells was not encountered. The evidence thus supports the theory that the neoplastic cells in the conjunctival epithelium are the result of secondary invasion by the underlying sebaceous carcinoma.

Aged↗
PubMed1977

Mucinous cystadenocarcinoma of the retroperitoneum.

A case of a primary retroperitoneal mucinous cystadenocarcinoma of ovarian type found at laparotomy in the presence of two normal ovaries is described. Careful examination of the tumor showed no evidence of ovarian tissue in the wall. The appearance of this tumor could be traced from areas of benign mucinous cystadenoma, through a mucinous tumor of borderline malignancy to a highly malignant anaplastic tumor containing only occasional mucicarmine positive cells. In areas, the connective tissue of the neoplasm, resembled ovarian stroma in appearance. At autopsy, the retroperitoneum was free of neoplasm, but widespread metastases, consisting of poorly differentiated adenocarcinoma were observed. This neoplasm may have arisen from displaced coelomic epithelium or from a supernumerary ovary.

Cystadenoma↗
PubMed1976

Gonadal and extragonadal yolk sac carcinomas: a clinicopathologic study of 14 cases.

Fourteen cases of yolk sac carcinoma, 10 occurring in gonadal, and four in extragonadal sites, seen at the Indiana University Hospitals from 1949 to 1974, were analyzed with respect to pathologic features, laboratory findings, and clinical course. Their histologic appearance was similar regardless of the site of origin. Two basic histologic types were observed--the more common endodermal sinus pattern and the rare polyvesicular vitelline form. The prognosis is unfavorable, but three of our cases exhibited objective responses to chemotherapy. In our small series, the better prognosis of testicular yolk sac carcinomas in children found by some authors was not evident. Four of the 6 patients with yolk sac carcinoma in which serum alpha-fetoprotein determinations were performed showed positive results. Three of these cases had residual or metastatic disease clinically. The demonstration of alpha-fetoprotein in the serum of patients with yolk sac carcinoma lends further support to the yolk sac origin of these tumors and could also prove to be of prognostic value by indicating the presence of residual or recurrent disease.

Adult↗