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Biomedical subjects

M Akerman

Publications and source records attributed to M Akerman.

At least 127 records · Page 7Linked to original sources
PubMed1985

Aspiration cytology of soft-tissue tumors. The 10-year experience at an orthopedic oncology center.

Since 1972, we have included fine-needle aspiration cytology in the pre-operative evaluation of soft tissue lesions referred to our Orthopedic Oncology Group. In 365 consecutive patients the cytodiagnosis was correctly malignant in 66/74 tumors and correctly benign in 260/271 lesions; cytology was non-diagnostic in four sarcomas and 16 benign lesions. The final pre-operative diagnosis should be based on all pre-operative data to minimize the effect of any misjudgement as regards cytodiagnosis; only two of the 19 false cytodiagnoses were of consequence for the patient. We conclude that aspiration cytology used in this way is a valuable adjunct to determine the further management of soft tissue tumors.

Biopsy, Needle↗
PubMed1984

Malignant lymphoma of the testis.

Lymphoma presenting in the testis was evaluated in 24 patients. The tumours were classified according to both the Rappaport and the Kiel classification. The Rappaport classification yielded only two tumour types--15 diffuse histiocytic and 9 diffuse mixed histiocytic-lymphocytic, with no pure lymphocytic lymphoma. No difference in survival time was found between these two tumour types. According to the Kiel classification there were four histological tumour types--immunoblastic (11 cases), centroblastic (2), centroblastic/centrocytic (6) and polymorphic immunocytic (5). In comparison with the other tumour types, the centroblastic/centrocytic lymphomas seemed to be advantageous as regards survival. It is concluded that systemic treatment with chemotherapy in accordance with current principles for malignant lymphoma is indicated following orchiectomy in localised testicular lymphoma as well as in disseminated disease. The value of post-operative radiotherapy to regional nodes is questionable.

Adult↗
PubMed1984

Kinetics of 201Tl uptake in adenomas and well-differentiated carcinomas of the thyroid. A double isotope investigation with 99Tcm and 201Tl.

A visually increased uptake of 201Tl chloride corresponding to a 'cold' (131I or 99Tcm ) thyroid nodule is mostly seen in well-differentiated carcinomas but also often in follicular adenomas. Since a visually increased uptake of 201Tl can be due to an increased initial uptake and/or a delayed elimination, an extended dynamic investigation was performed in patients with well-differentiated carcinomas or with follicular adenomas. Data were collected in a dynamic simultaneous double isotope ( 99Tcm + 201Tl) study up to 50 min after intravenous administration. Adenomas could be significantly separated from carcinomas by the elimination (p = 0.0001), but not by the initial uptake.

Adenoma↗
PubMed1983

Preoperative scintigraphy with correlation to cytology and histopathology in carcinoma of the thyroid.

At preoperative scintigraphy of 83 consecutive histopathologically confirmed thyroid carcinomas a solitary reduced uptake was observed in 70 per cent. The minimum detectable size was 10 mm for differential carcinomas showing this image, but in the 'screening group' of hereditary medullary carcinoma several scintigrams were considered normal despite a tumour size of 10 to 15 mm. In the imaging of the undifferentiated carcinoma a solitary reduced uptake with disappearance of the entire affected lobe was often demonstrated. Multifocal areas in the dot scintigram representing tumours were often missed at fine needle aspiration biopsy. Computer-processed scintigrams were superior in showing multifocal lesions.

Adenocarcinoma↗
PubMed1983

Treatment of soft-tissue sarcoma should be centralised.

New concepts regarding surgical margins and new modalities of preoperative examination make centralized care advantageous for patients with soft-tissue sarcomas. This study describes how the organizational level of surgical service and surgical technique have changed with time in southern Sweden. After reviewing all cases of soft-tissue sarcoma in the trunk and extremities registered during 1964-81, 261 patients remained for analysis. The material was divided into patients treated within or outside the Orthopaedic Oncology Group (OOG) for southern Sweden, which started in 1970. Patients treated by the OOG were separated into patients referred before and after surgery. In 1964-69, one-third (25/73) of the patients had a wide or compartmental excision at final surgery of the primary tumour compared with two-thirds (126/188) in 1970/81. Further, four-fifths (111/142) of the patients treated by the OOG finally had wide or compartmental excisions, whereas only one-third (15/46) of the patients treated outside the OOG over the same time period had obtained this type of surgery. When recorded, the tentative pre-operative diagnosis was a benign lesion in more than one-half of the patients treated outside the OOG. In two-thirds of the patients referred before surgery the biopsy and treatment, a wide or compartmental excision, were combined into one surgical procedure. Over the years the number of patients referred increased. During 1980-81, 35 of 38 patients with soft-tissue sarcomas were referred to the OOG: 11 before any biopsy, 14 after a malignant cytodiagnosis and 10 following marginal excisions.

Adolescent↗
PubMed1982

Aspiration cytology of soft tissue tumours. A prospective study of its influence on choice of surgical procedure.

Tumour cells may be dispersed into the wound when diagnostic or excisional biopsy is undertaken. This risk is reduced by using fine needle aspiration biopsy. The definitive excision of a soft tissue sarcoma may then be carried out in a more limited manner. In selected cases diagnostic and definitive operation may be combined, accepting the risk of excision of a benign lesion with unnecessarily broad margins. Aspiration cytology could possibly help the surgeon to decide on the extent of the excision. One hundred and nine consecutive patients with soft tissue lesions were referred to the Orthopaedic Oncology Group at Lund in Southern Sweden because of suspected malignancy. Biopsy had not been carried out. Further diagnostic and therapeutic procedures were planned as if aspiration cytology was not going to be used. The procedure was then performed with a fine needle and the cytodiagnosis was used to modify the plan. Sixty-seven tumours were examined histologically. Ten were sarcomas, two metastatic carcinomas and one a malignant lymphoma. The surgical plan was changed after the cytology was known in 33 of the 109 cases. Compartmental or wide excisions which had been planned became unnecessary in 20 patients. No operation was done in 6 patients and in 14 others a more limited excision was carried out. It was possible to avoid planned incisional biopsy in 3 patients with sarcoma.

Adolescent↗
PubMed1981

Surgical treatment of metastatic disease in the thyroid gland.

Metastatic disease in the thyroid gland is uncommon in clinical practice. Preoperative investigation with thyroid scan and fine-needle aspiration biopsy verified or strongly suggested metastatic disease in seven out of nine patients. All patients were treated by thyroid surgery. Three patients died within 4 months in disseminated disease. The remaining seven patients had a survival rate of between 1 and 5 years. Three patients are still alive 12, 29, and 48 months after thyroid surgery. Surgical treatment for metastatic disease in the thyroid, especially due to metastatic renal carcinoma and melanoma, is recommended.

Adenocarcinoma↗
PubMed1981

Scintigraphic evaluation and dynamic studies with thallium-201 in thyroid lesions with suspected cancer.

Scintigraphic studies of the thyroid with thallium-201 chloride were performed in 46 patients in whom the final diagnosis was established by histology. In dynamic studies of 36 patients, sequential imaging was performed the first 40 min after injection. A single exponential, Cexp(-lambda t), was fitted to each of the curves generated from apparently pathological and from normal regions in each patient, as determined by earlier conventional scintigrams. To minimize the effects of normal individual variations, the relation between pathological (p) and normal (n) regions in the same patient was emphasized and quantified by two parameters, namely the extrapolated zero-time intercept (Cp/Cn) and the time development (lambda p-lambda n) of the ratio of counting rates/unit area in the two regions. The turnover appears to be somewhat slower for pathological tissue than for normal tissue. Although this difference was significant on the 5% level for both cancer and adenoma as a group, only the relative disappearance rate (lambda p-lambda n) resolved cancer frm adenoma and from goiter on the same level. All but one of the differentiated cancers had an increased uptake.

Adenocarcinoma↗
PubMed1981

A retrospective clinico-pathologic study of non-Hodgkin's lymphomas classified according to the nomenclatures of Lennert and of Rappaport.

The survival of 88 patients treated for non-Hodgkin's lymphoma 1972-73 have been reviewed. In 49 patients it was possible to do a re-classification of the lymphomas according to Rappaport's and Lennert's classifications. The main obstacle to the classification according to Lennert was inadequacy of the cyto-pathological material. The correlation between survival and pathology was studied and a comparison between the two classifications was made. Lennert's classification was found to have a good reproducibility and to be more accurate than Rappaport's in separating lymphomas with favourable prognosis from those with unfavourable.

Adult↗
PubMed1980

Cytodiagnosis of soft tissue tumors and tumor-like conditions by means of fine needle aspiration biopsy.

In the evaluation of soft tissue tumors primary sarcomas must be differentiated from other malignancies, such as cancer metastases, malignant lymphomas, as well as benign tumors and tumor-like conditions. As far as possible this should be done without open biopsy to avoid local spread. Fine needle aspiration biopsy as opposed to thick needle biopsy utilizes smaller needle diameters up to 0.8 mm with assumed negligible risks of local or distant tumor spread. Such a fine needle aspiration biopsy for cytodiagnosis was supposed to increase the reliability of the preoperative diagnosis. In a consecutive series of 187 patients referred to an orthopedic oncology group because of suspected malignancy fine needle aspiration biopsy was made. In 129 cases with histology and in 49 non-operated cases with at least 2 years of clinical follow-up the reliability of the method is analyzed. In 163 cases the aspirated material was sufficient for a diagnosis and 152 cytological reports were correct regarding the diagnosis of a malignancy contra a benign tumor or tumor-like condition. Thirty-five of 43 malignancies were primary soft tissue sarcomas, 28 of these with a correct cytologic diagnosis of sarcoma. Eight were malignant lymphomas or carcinomas. Fourty-nine patients with 48 benign and one malignant cytological diagnosis were not operated upon. At least 2 years of clinical follow-up confirmed a benign diagnosis in these cases. The total reliability is thus around 85%. Fine needle aspiration biopsy is considered to be a very valuable complement to other investigations in the diagnostic work-up of soft tissue tumors.

Biopsy, Needle↗