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Biomedical subjects

M Brandwein

Publications and source records attributed to M Brandwein.

42 records · Page 3Linked to original sources

Bilateral vocal cord paralysis following endotracheal intubation.

Bilateral vocal cord paralysis following endotracheal intubation is an uncommon cause of respiratory obstruction. We report one case, adding to ten previously identified. We dissected eight human cadaver larynges and noted the path of the anterior ramus of the recurrent laryngeal nerve. It appeared to be particularly vulnerable to compression injury as it passed between the arytenoid cartilage and the thyroid lamina. This point was confirmed by histologic sections of intubated larynges.

Aged↗

Sinonasal hemangiopericytomas: a clinicopathologic and immunohistochemical study of seven cases.

BACKGROUND: Sinonasal hemangiopericytoma (SNHPC) is a rare lesion usually of low-grade malignant potential. Aggressive and metastatic cases are uncommon, and experience using adjuvant therapy on these cases has been limited. Tumor-induced osteomalacia has a very rare association with SNHPC. Further, the diagnosis of SNHPC remains one of histologic-pattern recognition. Traditionally, immunohistochemistry has aided in excluding other diagnoses; only vimentin has been consistently expressed by the tumor spindle cells of HPC. Recent studies have shown that Factor XIIIa is also expressed by HPC, (as well as tumors of fibrohistiocytic differentiation) and hence may be yet another helpful positive marker in establishing an immunohistochemical profile. METHODS: We identified 7 patients at this institution with SNHPC from 1990 to 1994. Immunohistochemistry was performed on seven formalin-fixed paraffin-embedded tumors utilizing antibodies to factor XIIIa as well as antibodies to vimentin, factor VIII, muscle-specific antigen, cytokeratin, and S-100. RESULTS: All 7 patients were initially seen with nasal obstruction or epistaxis and underwent surgical resection. The period of follow-up was from 3 months to 14 years (mean 54 months) for 7 patients. Three patients had recurrent disease after 3, 5, and 10 years. The first 2 were known to have been originally treated by polypectomy. One patient required adjuvant radiotherapy for metastatic disease and local extension. One patient was initially seen with tumor-induced osteomalacia which dramatically improved following resection of the lesion. The immunohistochemical profile revealed strong expression of vimentin in 7/7 cases, and of factor XIIIa in 4/7 cases; tumor cells did not express the other markers studied. CONCLUSIONS: Adequate surgical resection with negative margins appears to be the appropriate therapy for SNHPC. Our 1 case associated with tumor-induced osteomalacia was reversible after surgical excision of the tumor. The immunohistochemical results suggest that the pattern of vimentin and factor XIIIa positivity, as well as lack of expression of other markers, is consistent with the diagnosis of HPC, which still remains in the domain of histopathology.

Adult↗

Atypical granular cell tumor of the larynx: an unusually aggressive tumor clinically and microscopically.

A 36-year-old man presented with a recurrent, rapidly enlarging laryngeal tumor causing upper airway obstruction. Microscopic study revealed a granular cell tumor (GCT) with marked atypia, pleomorphism, and pagetoid spread to the overlying epithelium. Histologic pleomorphism occurs rarely and is usually mild in laryngeal GCT. Malignant granular cell tumor (MGCT), a very unusual entity, can be diagnosed with confidence when there is clinical evidence of malignancy (i.e., metastasis). We support the concept of "atypical" GCT when marked pleomorphism is present, yet no metastasis has occurred. This will indicate to the otolaryngologist and pathologist the possibility of greater potential for aggressive clinical behavior.

Adult↗

Histomorphometric analysis of human sphenoid and maxillary mucosa: measurement of relative density of goblet cells and basal cells.

The majority of malignant tumors of the paranasal sinus are squamous cell carcinomas and arise most commonly in the maxillary sinus, and less commonly in the nasal cavity and other sinuses. Glandular tumors (nonsquamous tumors) develop much less commonly and have a different distribution within the paranasal sinuses. The majority of adenomatous tumors arise from the surface mucosa and submucosal seromucinous glands. Attempts to explain tumorigenesis propose that the distribution of these tumors is based on the variance of different cell types among the sinuses. The authors used morphometric analysis to measure the relative density of goblet cells and basal cells from maxillary, and sphenoid sinus specimens. Surgical specimens of normal maxillary and sphenoid mucosa were retrieved from 5 and 10 patients, respectively. All specimens were stained with periodic acid-Schiff stain. The area of goblet and basal cells in five representative areas of each specimen were measured and compared to the total cross-sectional area of the mucosa, giving a relative density of each cell type. The average goblet cell density was 31.19% (SD +/- 10.27%) in maxillary tissue and 33.25% (SD +/- 20.80%) in sphenoid tissue. Student's t-test showed no statistically significant difference in goblet cell density between the two sinuses. The average basal cell density was 9.53% (SD +/- 0.87%) for maxillary tissue and 10.91% (SD +/- 1.91%) for sphenoid tissue. Again, no statistically significant difference between the two sinuses existed. In conclusion, there is no clearly detectable difference in the histologic composition of these two paranasal sinuses to explain the different incidence of glandular tumors, and other etiologic factors must be considered in explaining tumorigenesis at these sites.

Cell Count↗