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M R Wick

Publications and source records attributed to M R Wick.

At least 91 records · Page 5Linked to original sources
PubMed1995

Fibroma and giant cell tumor of tendon sheath: a comparative histological and immunohistological study.

Giant cell tumor of tendon sheath (GCTTS; "nodular tenosynovitis") and fibroma of tendon sheath (FTS) have traditionally been considered to be two points in a single neoplastic continuum. However, no systematic studies have addressed this concept directly to date. To more clearly define their relationship to one another, we studied five FTSs and seven typical GCTTSs by light microscopy and paraffin section immunohistochemistry. Tissue samples were stained for vimentin, desmin, smooth muscle actin (SMA), S100 protein, leukocyte common antigen (CD45), CD68 antigen (KP1), HAM56 antigen, alpha-1-antichymotrypsin (AACT), and MAC387 antigen. These reagents were chosen to address proposed "fibrohistiocytic" and myofibroblastic lineages for the two lesions. All tumors had a lobular appearance. GCTTS was more cellular than FTS; it contained conspicuous numbers of osteoclast-like cells, and the stroma was not extensively hyalinized. In contrast, FTS was matrix-rich, often with extensive stromal sclerosis, and contained only rare giant cells. Immunophenotyping of GCTTS showed that both the spindle cell and giant cell components were positive for vimentin, LCA, CD68, HAM56, AACT, and MAC387, suggesting monocyte-macrophage-like features. Limited reactivity for desmin and SMA also implied conjoint myofibroblastic differentiation. On the other hand, FTS showed focal staining with HAM56 (all cases) and for CD68 (one case); staining for vimentin and SMA was uniformly intense and diffuse. Based on these results, we conclude that GCTTS and FTS both exhibit varying degrees of monocyte-macrophage-like and myofibroblastic differentiation. The predominance of macrophage-related determinants in GCTTS and myofibroblastic markers in FTS supports the premise that these lesions represent phenotypic extremes of a single clinicopathologic entity.

Adolescent↗
PubMed1995

Effect of piezoelectric energy on porcine kidneys using the EDAP LT.02.

EDAP International (Cambridge, Massachusetts) has developed a new piezoelectric lithotripter (LT.02) that differs from their earlier model (LT.01) in two important respects: method of stone visualization and available power. The LT.02 provides both in-line fluoroscopy as well as real time ultrasound. The maximum energy is 1400 Bar (compared with 1100 Bar in the LT.01). The purpose of this study was to determine whether treatment with the EDAP LT.02 piezoelectric lithotripter would cause significant renal injury in minipigs. Accordingly, 18 minipigs were divided into 3 groups of 6. Each group received a treatment of 20, 40 or 60 minutes; the power level and shock wave frequency were kept at maximal levels throughout the treatment period. Three pigs from each group were sacrificed at 72 hours (acute). The remaining 9 pigs were sacrificed 1 month following LT.02 treatment (chronic). Histopathologic analysis of the treated kidney revealed that 33% of the 9 acute pigs developed a small capsular hematoma, whereas 66% showed only a small parenchymal contusion ( < or = 1% of total renal volume). Among the chronic pigs, 66% had a small cortical scar, whereas 33% had no macroscopic pathology. Despite the differences in the number of shock waves delivered, these changes were evenly distributed among the 3 groups. Histologic acute changes included circumscribed areas of hemorrhagic infarction, vascular thrombosis with recanalization and focal tubular obstruction and damage. At 30 days, however, these acute injuries had completely resolved in 3 pigs and were only notable as minute areas of focal tubular loss in 6 pigs.

Animals↗
PubMed1995

Hemangiopericytoma: histopathological pattern or clinicopathologic entity?

The tumor designated by Stout and Murray as "hemangiopericytoma" (HPC) more than 50 years ago continues to represent a source of uncertainty and disagreement among pathologists. In particular, questions exist regarding the synonymity of a hemangiopericytomatous growth pattern--defined by a monomorphic population of compact polygonal or bluntly fusiform cells and a branching stromal vascular pattern with a "staghorn" configuration--and the presence of a reproducible biological entity. It has been shown repeatedly that these same histologic features may be observed at least focally in a diversity of neoplasms, including "true" hemangiopericytomas, synovial sarcomas, mesenchymal chondrosarcomas, infantile fibrosarcomas, malignant fibrous histiocytomas, malignant peripheral nerve sheath tumors, leiomyosarcomas, endometrial stromal sarcomas, solitary fibrous tumors, myofibromas, malignant mesotheliomas, thymomas, sarcomatoid carcinomas, malignant melanomas, and "phosphaturic mesenchymal tumors." Despite their potential sharing of the microscopic attributes in question, such neoplasms have individualistic clinical features and can also be distinguished from one another by specialized pathologic analyses. HPC is "defined" in that context by reactivity for vimentin, with or without CD34 and CD57, but it lacks other immunodeterminants of epithelial, neural, and myogenous differentiation. Paradoxically, this phenotype is indeed associated with the presence of myogenous-type cytoplasmic filaments in ultrastructural evaluations of HPC. Other lesions that may resemble "true" HPC--but which possess dissimilar subcellular and clinical characteristics--include solitary fibrous tumors, hemangiopericytomalike tumors of the sinonasal tract, and "infantile (congenital) hemangiopericytomas." Such observations suggest that the hemangiopericytoma is both a pathologic entity and a morphological pattern, and they emphasize the utility of adjuvant pathologic studies in this diagnostic context.

Actins↗
PubMed1995

Malignant rhabdoid tumors: a clinicopathologic review and conceptual discussion.

The malignant rhabdoid tumor (MRT) has been a controversial lesion since its seminal description. There is no consensus as to whether it represents a distinctive clinicopathological entity or, alternatively, a phenotypic pattern that is potentially common to several disparate neoplasms. MRT of the kidney is a childhood tumor that is associated with uniformly aggressive behavior, but it shows a wide spectrum of histologic, immunophenotypic, and cytogenetic findings. Malignant extrarenal rhabdoid tumors (MERTs) have been observed in pure form over a broader range of patient ages and anatomic locations, but they show substantial morphological and biological homology with renal MRT. Lastly, "composite" extrarenal rhabdoid tumors (CERTs)--in which recognizable "parent" neoplasms are admixed with MERTs--also have been recognized in several topographic sites. In aggregate, these observations suggest that "rhabdoid tumors" are a heterogeneous group of lesions with dissimilar lineages of differentiation. Particularly in CERTs, it is likely that the rhabdoid phenotype represents a common end point of clonal evolution in tumors of clearly different origins. Despite these caveats, the authors do support retention of the diagnosis of "rhabdoid tumor," because the affiliated morphological pattern is uniformly attended by aggressive biological behavior despite potential dissimilarities at a subcellular level.

Abdominal Neoplasms↗
PubMed1995

Angiosarcoma-like neoplasms of epithelial organs: true endothelial tumors or variants of carcinoma?

Past experience has shown the existence of tumors in various viscera that assume growth patterns that are usually associated with angiosarcomas of skin and soft tissue. The lineage of differentiation pursued by the former of these proliferations has been the subject of controversy, with some investigators concluding that "angiosarcomatoid" neoplasms of solid organs were, in actuality, variants of high-grade carcinomas. The latter statement does appear to have partial validity, inasmuch as immunohistologic, ultrastructural, and clinical data on "pseudovascular carcinomas" do support their basic identity with high-grade epithelial malignancies of the breasts, skin, and lungs. Those lesions show uniform reactivity for keratin and epithelial membrane antigen, but they fail to express von Willebrand factor, CD31, or CD34, which are regarded as endothelial determinants. On the other hand, however, angiomatoid neoplasms of the thyroid gland are more complex; some represent indisputable carcinomas, others manifest seemingly "pure" mesenchymal phenotypes, and still others display a mixture of epithelial and endothelial phenotypes at ultrastructural and protein-chemical levels of specialized investigation. At present, it must be acknowledged that the distinction between angiomatoid thyroid carcinomas and "true" thyroid angiosarcomas is an academic one, because the prognoses and treatments for these lesions are essentially identical.

Breast Neoplasms↗
PubMed1995

"Pseudoneoplastic" leprosy. Leprosy revisited.

A 70-year-old Italian man with a history of squamous cell carcinoma of the lung presented with a nodular skin eruption. He had traveled extensively in India and Sri Lanka. The nodules were well demarcated and measured up to 3.5 cm in diameter. Histologically, there was a proliferation of spindled and polygonal cells with focal and relatively inconspicuous cytoplasmic vacuolation. A macrophage-monocyte lineage for the cells was confirmed by paraffin section immunohistochemistry, using the monoclonal antibodies anti-CD45, MAC-387, KP-1, UCHL-1, MT-1, L26, and MB2. Infiltrating borders, extension of the lesion into the subcutis, and involvement of small dermal nerves and eccrine glands initially suggested the possibility of a "histiocytic" neoplasm of indeterminate biological potential. However, air-dried and Giemsa-stained material from a fine-needle aspirate of one cutaneous nodule showed needle-shaped intracellular "negative images," and acid-fast stains revealed a large number of intracytoplasmic bacilli in virtually all of the vacuolated lesional cells. Furthermore, a second skin nodule that was excised 3 weeks after initial presentation showed the typical morphology of lepromatous leprosy. The clinicopathologic features of this case demonstrated several similarities with those of so-called "histoid" leprosy. Unusual morphologic variants of leprosy need to be considered in the interpretation of unusual "histiocytic" infiltrates in order to avoid a mistaken diagnosis of neoplasia, regardless of the geographic locale in which the patient is evaluated.

Aged↗
PubMed1995

Solitary syringoma. Report of five cases and clinicopathologic comparison with microcystic adnexal carcinoma of the skin.

Five cases of solitary syringoma (SS) were found by the authors in a search of adnexal neoplasms seen over an 18-year period. These tumors all occurred in adults as mobile, flesh-colored, circumscribed papules of the facial skin, measuring < or = 5 mm in greatest dimension. Each was cured by simple punch or shave biopsy excision. Comparison with nine histologically similar variants of microcystic adnexal carcinoma (MAC) showed that the latter lesions differed from SS in that they showed much deeper invasion, with regular involvement of the underlying subcutis and perineural or vascular-adventitial infiltration. Moreover, SS was wider than it was deep on microscopic examination, whereas the converse pertained to MAC. Knowledge of the typical clinicopathologic attributes of these two tumor types should prevent clinicians and pathologists from confusing them with each other.

Adenocarcinoma↗
PubMed1994

Midkine and pleiotrophin expression in normal and malignant breast tissue.

BACKGROUND: Some growth factors may promote tumor growth by affecting tumor angiogenesis. The angiogenic growth factor, pleiotrophin, was demonstrated previously in human breast carcinoma tissues; however, the pattern of pleiotrophin expression in normal breast tissues has not been established. METHODS: The expression of pleiotrophin and the related growth factor, midkine, was examined by polymerase chain reaction amplification of reverse transcriptase copies of RNA transcripts (RT-PCR) from freshly resected normal and malignant human breast tissues. Northern blot analysis of midkine expression was performed on a limited number of the specimens and on human and canine breast carcinoma cell lines. Clinicopathologic variables from the breast cancer patients were examined in relation to the growth factor expression patterns. RESULTS: The majority of both malignant and normal breast tissues expressed pleiotrophin. In contrast, midkine was expressed frequently in the malignant breast tissues but in only one of the normal specimens. Northern blot analysis of the breast carcinoma cells lines showed that they commonly expressed midkine transcripts. The only correlation of the growth factor expression patterns with the other clinical variables was the finding that the three midkine-negative breast carcinoma specimens also had low estrogen receptor levels. CONCLUSIONS: By this analysis, the expression of pleiotrophin was equivalent in both malignant and normal human breast tissues. Midkine, on the other hand, exhibited increased expression in the breast carcinomas but showed much lower expression in the normal breast tissue. Although the cellular source of the midkine expression was not determined by the RT-PCR assay, the Northern blot analysis showed that isolated populations of breast cancer cells commonly express this growth factor. This is the first example of a tissue simultaneously expressing high amounts of both pleiotrophin and midkine, a finding of unclear pathophysiologic significance.

Adult↗
PubMed1994

Isolated lung transplantation in children: pathological diagnosis and incidence of pulmonary complications.

The pathological findings in the allografts of 14 children who underwent lung transplantation (LT) at St. Louis Children's Hospital, St. Louis, MO, in the period between July 1990 and May 1992 were reviewed. The study is based on histological analysis of 63 transbronchial biopsy (TBB) specimens, eight open lung biopsy specimens, and three pneumonectomy specimens. The mean age at transplantation was 10.5 years (range, 1 to 17 years) and the average follow-up period was 5.7 months. Sufficient tissue for an adequate pathological examination was obtained in 58 (92%) TBB specimens. Each specimen consisted of a mean of 6.12 tissue fragments, but only 4.79 fragments contained actual lung parenchyma for suitable examination. Ten patients (71%) had 23 biopsy-proven episodes of acute rejection with a frequency of 1.64 episodes per patient. The first episode was documented at a mean of 19 days after transplantation. Six patients (42.8%) developed bronchiolitis obliterans (BO). The definitive diagnosis of this condition was made either by open lung biopsy (n = 3) or on allograft pneumonectomy (n = 1), and it was infrequently recognized by TBB. Four of the six patients died less than 9 months after the diagnosis of BO was made, indicating the grave consequences of this complication. Two other deaths were attributed to the development of posttransplantation lymphoproliferative disorders.

Adolescent↗
PubMed1994

Pseudovascular adenoid squamous cell carcinoma of the lung: clinicopathologic study of three cases and comparison with true pleuropulmonary angiosarcoma.

Pseudovascular adenoid squamous cell carcinoma (PASCC) is a variant epithelial neoplasm with the ability to simulate the growth pattern of angiosarcoma. It has been documented in the breast, skin, and, recently, lung. We describe three additional examples of pulmonary PASCC occurring in two men and one woman. The patients' ages ranged from 47 to 54 years at diagnosis, and all patients had radiographically and macroscopically typical squamous carcinomas of the lung. Histologically, the tumors showed the presence of interanastomosing pseudoluminal spaces that were lined by obviously atypical epithelioid cells and focally contained erythrocytes. Overtly carcinomatous growth was apparent only very focally. A comparison case of true pleuropulmonary angiosarcoma in a 57-year-old man showed closely similar microscopic features, but it lacked areas that resembled conventional carcinomas. Immunohistologic studies revealed uniform reactivity for keratin in PASCC of the lung. Two cases also stained positively for epithelial membrane antigen and vimentin, but all of them were negative for von Willebrand factor, CD31, CD34, and binding of Ulex europaeus I lectin. Electron microscopic examination of the three cases showed the presence of intercellular desmosomes and cytoplasmic tonofibrils. The example of true pleuropulmonary angiosarcoma demonstrated an endothelial immunophenotype. Two of three patients with pulmonary PASCC survived for at least 20 months, whereas the individual with true angiosarcoma died within 3 months. Together with prior reports on such lesions, these data suggest that angiosarcoma-like carcinomas of the lung differ pathologically and behaviorally from primary pulmonary endothelial malignancies.

Biomarkers↗
PubMed1994

Angiomatoid carcinoma and 'angiosarcoma' of the thyroid gland. A spectrum of endothelial differentiation.

The existence of angiosarcoma of the thyroid gland and its relation to angiomatoid carcinoma have been debated. The authors reviewed eight angiomatoid thyroid neoplasms. Controls consisted of six sarcomatoid thyroid carcinomas without angiomatoid features and an angiosarcoma metastatic to the thyroid gland. All eight angiomatoid neoplasms consisted of epithelioid cells with prominent eosinophilic cytoplasm lining vascularlike spaces. All eight expressed vimentin. Four tumors were predominantly angiosarcomalike neoplasms, based on staining for factor VIII-related antigen (three of four), CD31 (four of four), CD34 (one of four), and Ulex europaeus I lectin (four of four); they lacked epithelial markers other than cytokeratin (two of four). Four tumors were designated as angiomatoid carcinomas, based on staining for multiple epithelial markers: cytokeratin (four of four), epithelial membrane antigen (three of four), thyroglobulin (three of four). Three angiomatoid carcinomas also expressed or labeled with one or more vascular markers: CD34 (one of four), CD31 (two of four), Ulex europaeus I lectin (one of four), factor VIII-related antigen (one of four). The metastatic angiosarcoma to the thyroid gland labeled for factor VIII-related antigen, vimentin, CD31, and with Ulex europaeus I lectin. It did not express CD34. The six sarcomatoid carcinomas without angiomatoid features stained for cytokeratin (four of six), epithelial membrane antigen (one of six), and vimentin (six of six). None labeled for thyroglobulin, factor VIII-related antigen, CD31, CD34, or with Ulex europaeus I lectin. Angiomatoid carcinomas of the thyroid gland exhibit both epithelial and endothelial features. "Angiosarcoma" may represent the extreme in this spectrum of endothelial differentiation. All tumors behaved in a similar clinical fashion characterized by persistent local disease, widespread metastases and poor prognosis.

Aged↗
PubMed1994

Biphasic and monophasic sarcomatoid carcinomas of the lung. A reappraisal of 'carcinosarcomas' and 'spindle-cell carcinomas'.

To address the premise that pulmonary "carcinosarcomas" and spindle-cell carcinomas are part of a single clinicopathologic continuum, the authors studied 21 examples of such lesions as defined by World Health Organization criteria. Two biphasic tumors demonstrated an admixture of overt carcinoma with other foci showing partial rhabdomyogenic differentiation; 15 others were histologically similar but lacked "heterologous" sarcoma-like elements; and four lesions were monophasic spindle-cell sarcomatoid carcinomas. One of the latter also contained rhabdomyosarcoma-like areas by light microscopy. Sarcomatoid components were reactive for keratin and/or epithelial membrane antigen (EMA) in 18/21 cases. In addition, desmin and muscle-specific actin were co-detected in the same spindle cells that were keratin-positive in 4 tumors, 3 of which were those with partially myogenic histologic features. Vimentin was present in keratin- or EMA-reactive sarcomatoid cells in 12 neoplasms, and all cases were labeled with an antibody to collagen type IV. Survival was poor in this group of patients; only 1 was alive at last contact. These data support the contention that "carcinosarcoma" of the lung is part of a spectrum with "spindle-cell carcinoma." It is proposed that the terms "biphasic sarcomatoid carcinoma" and "monophasic sarcomatoid carcinoma" are more apt descriptors for such tumors.

Adult↗
PubMed1994

Metastatic malignant melanoma with "rhabdoid" features.

The authors propose the addition of malignant melanoma to the list of extrarenal neoplasms that may be predominantly composed of polygonal cells with the cytologic features of "rhabdoid" tumor. A review of 313 metastatic melanomas disclosed 49 examples with rhabdoid features, from which 31 had sufficient material for further pathologic and immunohistologic characterization. A control group of 46 nonrhabdoid metastatic melanomas was examined in parallel fashion. In 39% of cases, rhabdoid melanomas manifested relative deletion of S100 protein compared with the control tumors. However, there were no differences in staining with HMB-45. Vimentin immunoreactivity was concentrated in the paranuclear cytoplasm of rhabdoid melanoma cells. However, ultrastructural studies of these cases failed to show corresponding whorls of intermediate filaments and instead demonstrated paracrystalline paranuclear inclusions in profiles of rough endoplasmic reticulum. It is concluded that metastatic rhabdoid melanoma exhibits significant morphologic similarity to other rhabdoid tumors at a light-microscopic level. However, it usually retains enough melanocytic attributes to allow for accurate diagnostic recognition. Probably because patients with metastatic melanoma have an extremely poor prognosis overall, no worsening of biologic behavior was associated with rhabdoid cytomorphologic findings in this tumor type when compared with the control cases.

Adult↗
PubMed1994

Granulocytic sarcoma: an immunohistologic comparison with peripheral T-cell lymphoma in paraffin sections.

In evaluating histologically malignant infiltrates in the skin, it is often challenging to distinguish granulocytic sarcoma (GS) from selected cases of peripheral T-cell lymphoma (PTCL). These lesions have clinical features in common, in addition to shared histologic attributes. These include similarity in dermal distribution and growth pattern, nuclear characteristics, propensity to recruit other inflammatory cell types, and production of matrical sclerosis. In order to determine if immunohistology could contribute to differential diagnosis in this setting, we analyzed 15 cases of mucocutaneous GS, and compared them with 11 cases of well-documented PTCL. Antibodies in the CD15, CD20, CD34, CD43, CD45, CD45RO, and CD68 groups were used, as well as anti-myeloperoxidase (anti-MPX), anti-lysozyme (anti-LYSO), Mac387, and MB2. Anti-LYSO and anti-MPX were sensitive and specific markers of GS, labeling 93% and 80% of GS cases, respectively, and no cases of PTCL. Anti-CD15 and MB2 were also specific for GS, but each labeled only 60% of GS cases. CD34, CD68, and Mac 387 were specific but insensitive markers of GS. CD43 and CD45 were not particularly useful discriminants, with each being seen in 93% of GS cases, but also 64% and 100% of cases of PTCL, respectively. CD45RO was specific for PTCL; it was present in 82% of PTCL cases and no GS cases. Thus, conjoint reactivity for CD43, CD45, MPX, and LYSO characterizes GS, and differs from the pattern of PTCL, which is characterized by reactivity for CD45 and CD45RO, occasional reactivity for CD43, and lack of other specified markers.

Adolescent↗