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Biomedical subjects

M Akerman

Publications and source records attributed to M Akerman.

At least 109 records · Page 6Linked to original sources
PubMed1987

Aspiration cytology of lipomatous tumors: a 10-year experience at an orthopedic oncology center.

The cytodiagnoses of preoperative fine-needle aspirate smears from 72 histologically proven lipomatous tumors (52 lipomas and 20 liposarcomas of varying type) collected during the 10-yr period 1972-1981 were correlated to the corresponding histopathologic diagnoses. Three out of 52 lipomas were erroneously diagnosed as low-grade malignant liposarcomas, and one out of 20 liposarcomas was falsely diagnosed as a benign soft-tissue tumor. Of the 20 liposarcomas, 15 were cytologically diagnosed as such, and the majority of the myxoid and the pleomorphic liposarcomas were correctly diagnosed as to type. Important differential diagnostic problems were, on one hand, the separation of lipoma with regressive changes and histiocytic reaction and lipoma with chondroid metaplasia from low-grade malignant liposarcoma and, on the other hand, liposarcoma from intramuscular myxoma, myxofibrosarcoma, and malignant fibrous histiocytoma. The differential diagnosis of liposarcoma as opposed to other soft-tissue sarcomas is discussed, and it is concluded that preoperative fine-needle aspiration of lipomatous tumors is of value in the management of these tumors.

Biopsy, Needle↗
PubMed1987

Prognostic implication of cytogenetic findings in 106 patients with non-Hodgkin lymphoma.

The cytogenetic findings in samples from 106 patients with non-Hodgkin lymphomas (NHL), histopathologically classified according to the Kiel classification, have been correlated with survival time. Clonal chromosomal abnormalities were found in 60 patients, and only normal karyotypes in ten. The chromosome analysis of the remaining samples failed. The failures did not differ in survival compared with the cytogenetically successful cases, indicating that this group is not a prognostic entity within NHL. The cytogenetic findings were classified in six ways in order to evaluate the prognostic value of the cytogenetic pattern. Multivariate analysis demonstrated that presence of clonal chromosome abnormalities and the number of aberrations both were important prognostic factors independent of histopathology, whereas, the modal chromosome number, presence of translocations, or unidentified marker chromosomes were not. Some characteristic chromosome abnormalities were correlated with survival time: Patients with a 1p+ marker or +7 had a significantly shorter survival time than patients with normal karyotypes only (NN). Patients with +3, +12, 6q-, i(17q), and t(14;18)(q32;q21) did not differ significantly from the NN group.

Chromosome Aberrations↗
PubMed1987

Mitotic activity in non-Hodgkin's lymphoma. Relation to the Kiel classification and to prognosis.

At histopathological diagnosis of non-Hodgkin's lymphoma (NHL) the mean number of mitoses in 10 high power fields (X 40) was determined in thin sections (2 micron) and designated 'mitotic index' (MI). In 38 patients the thymidine labelling index (LI) of the lymphoma cells was also determined. There was a close correlation between MIs and LIs (r = 0.81, P less than 0.001) indicating that MI reflects the proliferative activity in NHL. Among 101 patients with NHL classified according to the Kiel nomenclature MIs were generally lower in lymphomas of low grade malignant type than in the high grade malignant lymphomas. The variation of MIs within morphological subgroups was especially pronounced in high grade lymphomas. Only 18 of 49 patients (37%) with MI greater than or equal to 2 have survived for 2 years in contrast to 37 of 52 patients (77%) with MI less than 2 (P = 0.001). For patients with histologically low grade lymphomas and MI greater than or equal to 2.0 the median survival was 23 months and for those with MI less than 2.0 58 months (P = 0.09). Patients with high grade lymphomas and MI greater than or equal to 2.0 had a median survival of 15 months compared to 57 months for those with MI less than 2.0 (P = 0.04). In a multivariate analysis of 50 patients with centroblastic-centrocytic (CB-CC) or centroblastic (CB) lymphomas the importance of different prognostic factors was analysed. Among the variables age, MI, growth pattern (follicular vs. diffuse), cell type (CB-CC vs. CB), clinical stage (I vs. II-IV), initial chemotherapy (active vs. less active) only age and MI gave significant prognostic information. It is concluded that the assessment of mitoses in NHL gives prognostic information in addition to histopathologic classification. The method is simple and the proliferative activity and histopathological diagnosis can be ascertained routinely on the same occasion.

Adult↗
PubMed1987

Flow cytometric detection of B-clonal excess in fine needle aspirates for enhanced diagnostic accuracy in non-Hodgkin's lymphoma in adults.

Fine needle aspiration (FNA) cytology is a valuable aid to diagnosis and tumour staging in patients with non-Hodgkin's lymphoma. These tumours are often multicentric and involve sites such as the liver or the spleen which are not easily accessible to surgical biopsy. Particularly with splenic involvement, there is a diagnostic problem of morphologically distinguishing the lymphoma cells in an admixture of normal lymphocytes. Since most lymphomas in adults are of B-cell origin, we studied the diagnostic value of adding a surface immunoglobulin (sIg) light chain analysis to the cytological evaluation of FNAs. B-clonal excess was determined by flow cytometric analysis of the sIg light chain distribution and a monoclonal finding was considered diagnostic of lymphoma. In primary diagnostic procedures the light chain analysis established a diagnosis of lymphoma in 5/14 (36%) aspirates from patients with poorly differentiated tumours. Fine needle aspirates performed as part of staging procedures were morphologically normal or inconclusive in 19 cases; in seven of these (37%) lymphoma involvement was diagnosed by the light chain analysis. Diagnostic precision was enhanced by combining morphological and immunological evaluation of fine needles aspirates in patients with established or suspected non-Hodgkin's lymphoma.

B-Lymphocytes↗
PubMed1987

Relationship between cytogenetic findings and histopathology in non-Hodgkin lymphoma.

The cytogenetic findings in 70 patients with non-Hodgkin lymphoma have been correlated with tumor histopathology according to the Kiel classification. Certain chromosome aberrations displayed a nonrandom association with the grade of malignancy: 4 lymphomas out of 6 with 1p+, 5 out of 7 with del(6)(q15), 7 out of 11 with 14q+, and 5 out of 8 with +18 belonged to the high grade malignancy group, whereas 9 lymphomas out of 10 with t(14;18) were low grade malignant. Two aberration types were closely associated with specific histopathologic subtypes: t(14;18) occurred in 7 cases out of 10 in centroblastic/centrocytic (cb/cc) follicular lymphomas, and 5 cases out of 6 with i(17q) were cb or cb/cc. Although less striking, there was a tendency for del(6)(q15) to occur in cb or cb/cc lymphomas (4 cases out of 7), in contrast to only 1 case out of 5 with the more distal deletion del(6)(q21).

Adolescent↗
PubMed1987

Cytogenetic studies in Hodgkin's disease.

Cytogenetic analysis was attempted in 20 patients with Hodgkin's disease. No mitoses were found in 2 cases, normal metaphases in 7, and normal metaphases with nonclonal aberrations in 7. Of the 4 cases with clonal aberrations, one had +16 as the sole change, whereas the remaining tumors had multiple numerical and structural changes.

Adolescent↗
PubMed1987

Aspiration of musculoskeletal tumors for cytodiagnosis and DNA analysis.

Preoperative fine-needle aspirates of 25 soft tissue tumors and four bone tumors were used for cytodiagnosis and flow cytometric DNA ploidy analysis. The results were compared with the histopathologic diagnosis and flow cytometric DNA ploidy analysis on tissue samples after surgery. There was good agreement between the cytodiagnoses and histopathologic diagnoses with regard to benign tumor or sarcoma. There was good agreement between the ploidy determinations in aspirates and tissue samples in 20 out of the 26 tumors that could be analyzed. Aneuploid cell populations were found in 13 tumors cytologically classified as sarcoma and in one tumor classified as unspecified malignant tumor. These 14 tumors also showed aneuploid cell populations in the tissue samples and were histologically diagnosed as high-grade malignant sarcomas. The combined evaluation of preoperative cytodiagnosis and DNA ploidy on aspirates may give valuable prognostic information.

Adult↗
PubMed1987

Primary localized non-Hodgkin's lymphoma of the thyroid: a retrospective clinicopathological review.

Primary localized non-Hodgkin's lymphomas (NHL) of the thyroid are rare. The data presented are derived from 819 consecutive patients with NHL and six patients with anaplastic thyroid carcinomas of small cell type investigated and treated at our department between 1970 and 1981. The present analyses are based on the 19 patients, who were found to have localized primary thyroid lymphomas. Four of these patients were initially considered to have undifferentiated small cell carcinomas of the thyroid but revealed to be lymphomas at re-examination supplemented with immunohistopathologic staining. Prognosis has been evaluated with regard to initial stage, histopathology according to the Kiel classification and therapy. Median follow-up was 5 years. The crude survival was 77% 5 years after diagnosis. This was not significantly less (4.2%) than the overall-survival in an age- and sex-matched population, despite the majority of patients having tumours which were locally advanced, often with spread to regional lymph nodes, and in many cases a histology showing a high-grade malignancy according to Kiel classification. The excellent prognosis in the current study compared to other studies is probably mainly attributed to more extensive staging procedures. The biologic behaviour supports the hypothesis that these lymphomas represent lymphomas of mucosa associated lymphoid tissue (MALT). According to present results anaplastic thyroid carcinoma of small cell type must be extremely rare.

Aged↗
PubMed1986

Is the EORTC prognostic index of thyroid cancer valid in differentiated thyroid carcinoma? Retrospective multivariate analysis of differentiated thyroid carcinoma with long follow-up.

The European Organization for Research on Treatment of Cancer (EORTC) Thyroid Cancer Cooperative Group presented a prognostic index in 1979 that included all histologic groups of thyroid carcinomas, and was based on a multivariate analysis of 507 patients with a median follow-up of 40 months. The current report not only uses a multivariate analysis to study the clinical validity and reproducibility of this index on case material consisting of 226 differentiated thyroid carcinomas with a considerably long follow-up (11 years), but also it investigates possible prognostic factors, other than those proposed by the EORTC. Three EORTC variables could be reproduced as important: age at diagnosis, locally advanced disease, and distant metastases. Of the additional histopathologic variables tested, microscopic tumor invasion beyond thyroid capsule (pT4) and marked cellular atypia (MCA) proved to be significant. When the effect of the age-correlated tumor factors pT4 and MCA of differentiated thyroid carcinomas were taken into consideration, age alone lost its prognostic importance as a guide for treatment.

Adult↗
PubMed1986

Near-haploidy in a case of plasmocytoma.

Chromosome studies of a solitary plasmocytoma in the femoral bone revealed a near-haploid chromosome number of 31-32 with a loss of one homolog of each chromosome pair except #1, #7, #9, #15, #19-21, and the sex chromosomes (XY). The cytogenetic findings have been compared with 16 cases of near-haploid neoplasms from the literature studied using banding techniques. A common feature present in 13 of the 16 cases reported was found to be disomy 21; the only chromosomes consistently present in one copy in all neoplasms were #2, #3, #4, and #5.

Chromosome Aberrations↗
PubMed1986

Pulmonary manifestations of AIDS: review of 106 episodes.

We reviewed the clinical records and chest radiographs of all patients admitted to our institution between 1982 and 1984 who had pulmonary disease and who were later proved to have acquired immunodeficiency syndrome (AIDS) (95 patients). Diffuse parenchymal lung disease was the most common finding. These infiltrates were usually interstitial and caused by Pneumocystis carinii pneumonia or P. carinii combined with cytomegalovirus infection. Focal, multilobar, interstitial infiltrates were also often seen and usually caused by P. carinii or P. carinii and cytomegalovirus infections. Rarely, well-defined, multiple, interstitial nodules less than 10 mm in diameter were the only or predominant characteristic and were seen only in association with Mycobacterium tuberculosis or Cryptococcus neoformans infections or Kaposi sarcoma. Hilar or mediastinal adenopathy occurred in 17 of the 21 patients with M. tuberculosis or C. neoformans infections. In contrast, only 4% of patients with P. carinii infections presented with these findings. We also found that hilar or mediastinal adenopathy was not significantly associated with peripheral adenopathy. Lung cavitation, pleural effusion, or a normal chest radiograph was uncommon.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Ewing's sarcoma of bone. A correlative cytological and histological study of 14 cases.

A correlative cytological and histological study of 14 cases of Ewing's sarcoma is presented. All smears from the fine needle aspirates were performed during the diagnostic investigation before treatment of the patients. The smears were very cellular with relatively small, round to oval tumour cells which appeared rather uniform. Two cell types could be distinguished, however. There was a predominance of relatively light, so-called principal or chief cells, but smaller and darker cells, so-called dark cells, were also observed. We found that Ewing's sarcoma has a characteristic appearance in smears and that fine needle aspiration cytology can be used in its primary diagnosis. A conclusive diagnosis may be made when the clinical and radiographic findings are also consistent.

Adolescent↗
PubMed1985

Flow cytometric light chain analysis of peripheral blood lymphocytes in patients with non-Hodgkin's lymphoma.

Peripheral blood lymphocytes from 96 patients with non-Hodgkin's lymphoma were studied, either at primary staging, during treatment or in follow up. The amount of surface immunoglobulin light chain per cell was determined by direct immunofluorescence staining analysed by flow cytometry. Discrepancy between kappa and lambda fluorescence profiles in the sample was considered to indicate the presence of monoclonal cells i.e., circulating lymphoma cells. The results were correlated with routine haematological findings, histopathology of the lymphoma and tumour burden. Using routine haematological methods leukaemic spread was evident in 24% of the patients in our study. Using kappa/lambda distribution analysis evidence of circulating lymphoma cells was found in an additional 27%. As expected, the major diagnostic gain was in the low grade malignant group, where 30% of the patients with normal peripheral blood according to standard procedures showed evidence of circulating lymphoma cells in the kappa/lambda distribution analysis. The corresponding gain in the high grade malignant group was 19%. In patients with active disease but without morphological evidence of leukaemia, 37% showed abnormal kappa/lambda distributions. In patients in complete remission the corresponding figure was 18%. The clinical significance of small numbers of circulating lymphoma cells is not yet understood, but a possible outlook is to use kappa/lambda distribution analysis to increase staging precision and in the early detection of relapse.

Flow Cytometry↗