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Biomedical subjects

M L Goodman

Publications and source records attributed to M L Goodman.

14 recordsLinked to original sources

Benign metastasizing pleomorphic adenoma of salivary gland: diagnosis of bone lesions by fine-needle aspiration biopsy.

Two cases of benign salivary gland pleomorphic adenomas metastatic to bone (benign-metastasizing pleomorphic adenomas) diagnosed by fine-needle aspiration biopsy are presented. Both primary tumors were slightly atypical cytologically but neither case demonstrated features of carcinoma. The metastatic lesions contained benign epithelial, myoepithelial, and stromal components. In both cases the clinical history was either not known by the radiologist or not communicated to the cytopathologist interpreting the case, and a primary tumor of bone was the leading clinical diagnosis. Obtaining pertinent clinical history and comparing the cytomorphology of the bone aspirate with the primary parotid tumor allowed for an accurate diagnosis in both cases. The differential diagnosis with primary bone tumors is discussed and the importance of clinical history is emphasized.

Adenoma, Pleomorphic

Chondroblastoma of the temporal bone. Case report and literature review.

Chondroblastoma is a rare tumor of bone that represents approximately 1% of all primary bone tumors. In the temporal bone, only 33 have been reported. We present a case of chondroblastoma of the temporal bone, followed by a literature review and analysis of reported cases. We conclude that the best chance for a prolonged disease-free interval is total excision using a combined otolaryngologic and neurosurgical approach.

Adolescent

Solitary fibrous tumor of the nasal cavity and paranasal sinuses.

We report two solitary fibrous tumors of the nasal cavity and paranasal sinuses that were histologically and immunohistochemically virtually identical to solitary fibrous tumors (fibrous mesotheliomas) of the pleura. One tumor arose in a 48-year-old woman and the other in a 45-year-old woman. Both patients presented with nasal symptoms, and both patients are alive without evidence of disease 6 months and 1 year after excision. The tumors had a disorganized or "patternless" arrangement of spindle cells in a collagenous background and prominent vascular channels of varying size. Immunoperoxidase stains on paraffin sections showed staining of the cells for vimentin only; there was no staining for keratin, S-100 protein, desmin, and actin. Both cases presented some degree of diagnostic difficulty and had to be distinguished from other spindle cell tumors of the nasal cavity and paranasal sinuses, such as hemangiopericytoma, angiofibroma, and fibrous histiocytoma.

Biopsy

The inflammatory response to endotoxin.

A typical inflammatory response resulted from the intravenous injection of endotoxin (E. coli) into living rabbits. Each rabbit was studied at three levels: the microvasculature and supporting tissue in the ear chamber was observed microscopically (up to X200) before, during, and at regular intervals following the injection of endotoxin; leucocyte and platelet counts were made periodically throughout each experiment; and tissue samples for histological study were obtained from each rabbit prior to death. The animal was anaesthetised before histological samples were secured. Within minutes after the intravenous injection of endotoxin, leucocytes were observed sticking to the endothelial cells lining the venules and the arterioles. Emboli appeared in the microcirculation within 10 min. Swelling of the microvascular endothelial cells was evident at 1 hr; oedema and extravasation of the cellular elements followed. The rectal temperature and leucocyte and platelet counts all fell within 10 min. of endotoxin. Histological examination of tissue from the ear chamber and visceral organs showed inflammatory changes. Congestion of the microvasculature, swelling of the endothelial cells, and margination and migration of neutrophils were common histological features in all organs. The earliest cells affected appeared to be the leukocyte and platelet.

Animals

Guidelines for prognosis in head and neck cancer with nodal metastasis.

Patients with squamous cell carcinoma of the head and neck with cervical node metastasis were studied retrospectively to delineate the prognostic significance of certain clinical and histologic parameters. The patients were divided into radiated and non-radiated groups for analysis purposes. A good prognosis was found in non-radiated patients with an active nodal plasmacytic inflammatory response. No prognostic information was obtainable in observing the inflammatory response of nodes altered by radiation effects. Extranodal spread of the tumor indicated a poor prognosis for radiated and non-radiated patients, being more significant in the non-radiated ones. Patients receiving preoperative radiation must be separated from non-radiated patients in evaluating host response parameters for prognostic purposes.

Adult

Disodium cromoglycate in anaphylaxis and pollinois.

Because disodium cromoglycate is being used in treating the symptoms of allergic patients and its mode of action remains uncertain, morphological experiments were conducted in an attempt to further elucidate this compound's mode of action. Rabbits with an ear chamber underwent anaphylaxis, lethal or sublethal, with microscopic observations of the microcirculation during anaphylaxis. At death or a chosen interval tissue of the ear chamber was secured for histological examination. The mast cells and the state of their granules were counted for each section. In no instance did disodium cromoglycate have any effect in preventing the gross or microscopic changes and disodium cromoglycate did not protect mast cells in passive anaphylaxis. The nasal mucosa of a subject sensitive to ragweed pollen was exposed to ragweed pollen in a non-pollen season and the gross symptoms of hay fever were noted. When the nasal mucosa was pre-treated with disodium cromoglycate, however, no symptoms were observed and biopsies of nasal mucosa showed more normal mast cells and fewer degranulated mast cells.

Anaphylaxis

Mesenchymal cell atypicality in inflammatory polyps.

Excised nasal polyps should be examined histologically for classification as to aetiological process. Recently a 'pseudosarcomatous' change was reported in nasal polyps. We reviewed one hundred excised polyps for mesenchymal atypicality and found a wide degree of mesenchymal atypicality in the majority of nasal polyps. Nasal and choanal inflammatory polyps are the most frequent nasal masses which the otolaryngologist has to treat. Surgical excision is frequently required to alleviate the nasal symptoms of polyps unresponsive to medical therapy. Excised nasal polyps should be examined histologically for classification as to possible aetiological mechanisms and to rule out neoplastic lesions (Shea, 1947). Smith, Echevarria, and McLelland (Smith, 1974) recently described 'pseudosarcomatous changes' in nasal polyps. This stimulated us to investigate our inflammatory nasal polyps for these histological changes. Causal observations demonstrated an impressive number of inflammatory polyps with varying amounts of atypical mesenchymal stroma cells. To quantitate these alterations, we reviewed the histological slides from one hundred patients with excised inflammatory polyps and the results are the subject of this report.

Humans

Chondrodermatitis helicis: a clinical re-evaluation and pathological review.

Chondrodermatitis helicis, or painful nodule of the ear, is an uncommon benign aural lesion which is seen and treated by dermatologists and otolaryngologists. Because of the sparcity of reports in the recent literature, our experience with 50 patients over a 10-year period is presented. The diagnosis is based on history and physical examination and biopsy need be performed only to confirm the diagnosis in atypical cases. Patients are generally middle-aged or elderly males. There are no associated systemic disorders with this condition. The lesions are discrete, grey to red in color, oval shaped with raised rolled edges, and a central ulcer or depression which often contains a crust or scale. The lesion is typically painful and tender and, for this reason, the patient seeks help shortly after the onset of symptoms. The characteristic histopathologic features are epithelial hyperplasia, collagen degeneration, focal fibrinoid necrosis, and inflammatory components. Clinically, the lesion is misdiagnosed in the majority of instances and is presumably, therefore, treated inappropriately. It should be stressed that this is a benign condition and initial management should be aimed at conservative therapy with local steroid injection or conservative non-deforming surgery. Wide excision, including removal of the underlying cartilage with appropriate reconstrictive closure should be reserved for the conservative treatment failures.

Dermatitis

Follicular carcinoma of Hürthle cell type as cause of hemoptysis.

Summary--A patient with follicular carcinoma, Hürthle cell type, who developed subglottic extension and uncontrollable hemoptysis is presented . In consideration of the patient's age a conservative therapeutic program was instituted with a definite response to I-131 therapy despite poor radioactive iodine (RAI) uptake by the tumor. Laryngectomy and thyroidectomy were eventually required to control hemoptysis; the patient remains socially functional and asymptomatic after a 30-month period. The two-year period of weekly office visits and temporizing treatment as occurred in this patient cannot be recommended. It seems appropriate to advocate surgical treatment including laryngectomy for follicular carcinoma, Hürthle cell type, localized to the laryngotracheal area without regard for the age of the patient.

Adenocarcinoma

Upper airway obstruction associated with regional enteritis.

Two patients are presented with upper airway obstruction associated with regional enteritis (Crohn's disease). Two mechanisms for this obstruction are proposed. The first is involvement of the cricoarytenoid joint with the inflammatory process and the second is extensive edema of the upper airway due to submucosal involvement with the disease process. We were unable to find any previous reports of upper airway obstruction associated with regional enteritis. The data from these patients suggests that Crohn's disease should be included in the differential diagnosis of chronic persistent laryngeal edema.

Adult