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M R Wick

Publications and source records attributed to M R Wick.

At least 109 records · Page 6Linked to original sources
PubMed1994

Paraffin section immunohistochemistry as an adjunct to morphologic analysis in the diagnosis of cutaneous lymphoid infiltrates.

In the skin, separation of selected lymphomas from lymphoid hyperplasia can be challenging. The authors examined 45 cutaneous lymphomas, excluding mycosis fungoides (26 small lymphocytic or mixed tumors; 19 large cell lymphomas), 10 "atypical" lesions, and 40 lesions of presumed lymphoid hyperplasia, comparing morphologic attributes of such proliferations with their immunophenotypes in paraffin sections. The object of this study was to determine whether immunologic data obtained from routinely-processed specimens could be used to further objectify morphologic interpretations. Features favoring lymphoma included a lesional epicenter in the lower dermis or subcutis; poor circumscription of lymphoid aggregates; and dissection of lymphoid cells between collagen bundles. Immunostains included antibodies to CD20, CD43, CD45, CD45RO, CD45RA, CD68, proliferating cell nuclear antigen (PCNA), and MB2. Eleven of 26 small lymphocytic or mixed-cell lymphomas and 3 of 10 "atypical" cases demonstrated an abnormal immunophenotype, including co-expression of CD43 and CD20 or non-physiological CD45RA distribution. In contrast, none of 40 cases with benign features manifested aberrant antigen expression. Thirty-one of 37 cases in which > or = 75% of the cells typed as B lymphocytes showed malignant morphologic features, 5 were "atypical" and possibly lymphomatous, and only one had benign features. PCNA stains showed greater positivity of the lymphoid nuclei in lymphomas, and a labeling index of > 30% was correlated with malignancy in this context. These observations indicate that immunostaining may provide useful adjunctive information in distinguishing benign from malignant cutaneous lymphoid proliferations in paraffin sections.

Adolescent↗
PubMed1994

Distribution of surgical pathology reports by a computer-driven telephone facsimile (FAX) device.

The current environment of medical economics increasingly mandates that written reports on surgical pathology specimens be distributed as soon as they are verified by responsible staff members and that they find their way infallibly to clinical physicians attending the patients in question. This brief overview describes the institutional experiences of the authors in managing this aspect of data delivery at large teaching hospitals. A system for FAX-transmittal of surgical pathology reports is described, used in conjunction with a commercial computer software package that was designed explicitly for anatomic pathology.

Hospitals, University↗
PubMed1994

Use of immunostains to ABH blood group antigens to resolve problems in identity of tissue specimens.

Identification of contaminating tissue fragments as "floaters" is a common problem in surgical pathology. They may be introduced at several steps in the processing of specimens, and they are capable of causing interpretative consternation. Using immunohistochemistry with monoclonal antibodies to blood group isoantigens A, B, and H, we studied nine cases in which floaters were present. In five of the study cases, discordant blood group immunostains allowed identification of the artifactual tissue fragments. By chance, the other four specimens contained probable floaters from patients whose blood groups were concordant with those from whom the "native" tissue had been obtained. These results indicate that in some instances, blood group immunostains may resolve interpretative difficulties surrounding floaters. It is likely that application of immunostains, directed at additional blood group antigens, will extend the utility of this procedure.

ABO Blood-Group System↗
PubMed1993

Primary mucoepidermoid carcinoma of the thyroid: diagnosis by fine-needle aspiration biopsy.

Fine-needle aspiration biopsy (FNAB) has been recognized as a safe and reliable procedure in the evaluation of thyroid nodules. We herein report a case of a low-grade mucoepidermoid carcinoma of the thyroid that was diagnosed with this technique. Examination of an intra-operative FNAB showed cohesive clusters of polygonal squamoid cells with distinct cellular borders, uniform round nuclei, distinct nucleoli, and homogeneous amphophilic to cyanophilic cytoplasm. Focal keratin "pearl" formation was apparent, along with extracellular, lightly basophilic mucin deposits mantled by squamoid cells. These cytologic features are characteristic of low-grade mucoepidermoid carcinoma, as seen in other anatomic sites. This impression was confirmed by examination of paraffin sections. Previous reports have indicated that mucoepidermoid thyroid carcinoma is an indolent, locally recurring lesion. However, in spite of low-grade histology in our case, the neoplasm presented with distant metastases to bones, pleura, and lung.

Biopsy, Needle↗
PubMed1993

Eosinophilic ulcer of the oral mucosa. Report of 38 new cases with immunohistochemical observations.

Eosinophilic ulcer of the oral mucosa (traumatic eosinophilic granuloma) mimics oral cancer clinically and is occasionally misdiagnosed as lymphoma on microscopic examination. Trauma is believed to play a role in its development, but its exact pathogenesis is not known. The demographic, clinical, and histologic features of 38 previously unreported cases of eosinophilic ulcer of the oral mucosa are reviewed. Nine representative cases were studied immunohistochemically. Microscopically, the lesions contained a polymorphic inflammatory infiltrate extending deep into the submucosa, underlying muscle, and salivary glands. Numerous eosinophils and large mononuclear cells with pale nuclei and frequent mitoses were seen in all lesions. Lymphocytes, histiocytes, plasma cells, granulocytes, and mast cells were also present. Immunohistochemical stains showed that the lymphocytic infiltrate was composed predominantly of T cells. T-cell-specific antigen-presenting cells were more numerous than the non-antigen-presenting cell type. The large cells with pale nuclei stained positively only for vimentin; the possible myofibroblastic nature of these cells is discussed. Although trauma might have an etiologic role, the pathogenesis of eosinophilic ulcer of the oral mucosa is probably T cell mediated.

Adolescent↗
PubMed1993

Laparoscopic partial nephrectomy in the pig model.

In an effort to further evaluate the potential application of laparoscopy to urologic surgery, we explored the feasibility of using this minimally invasive approach for performing a partial nephrectomy. Nine female pigs underwent laparoscopic partial nephrectomy (LPN) utilizing a plastic cable tie (15 mm. x 4 mm. x 1 mm.) to achieve renal ischemia and an Argon Beam Coagulator probe (ABC) (Birtcher Medical Systems) to fulgurate the transected surface. Six weeks after LPN, 6 pigs underwent creatinine clearance, renin level, arteriography, BP samples and were then killed. The renal remnants were weighed and sectioned for histological studies. These studies revealed excellent function of the renal remnant, no AV fistula, and no evidence of renovascular hypertension. LPN is a feasible, repeatable procedure in the pig. Control of the renal hilum, transient parenchymal compression with a plastic cable, and use of the argon beam coagulator are key elements in performing this procedure.

Animals↗
PubMed1993

Adenocarcinoma in the lung in patients with breast cancer. A prospective analysis of the discriminatory value of immunohistology.

In some patients with a history of breast cancer who also have masses in the lung, making a clinical distinction between primary pulmonary neoplasia and pulmonary metastasis of mammary carcinoma may be impossible. To ascertain whether immunohistologic studies could contribute to resolving this problem, the authors undertook a prospective study of 30 cases showing synchronous or metachronous adenocarcinomas in these two sites. A predefined panel of antibodies--as derived from published antigenic catalogs for breast and lung cancer--was applied to each case. Tumors were interpreted as metastases if they were positive for gross cystic disease fluid protein-15, estrogen receptor protein, or S-100 protein. Conversely, primary adenocarcinomas of the lung were defined by their expression of carcinoembryonic antigen and a lack of the other three determinants. Using these criteria, 15 lesions were classified as metastatic; 11 were categorized as primary pulmonary adenocarcinomas; and 4 cases were indeterminate in origin. Responses to corresponding therapeutic protocols generally supported the validity of the immunohistologic diagnoses; 8 of 15 patients treated for metastatic breast cancer were well at least contact, as were 5 of 11 patients who received therapy for primary carcinoma of the lung. These data suggest that immunohistology plays a useful role in distinguishing mammary from pulmonary adenocarcinomas.

Adenocarcinoma↗
PubMed1993

Quantitative cultures of the cell fraction and supernatant of bronchoalveolar lavage fluid for the diagnosis of cytomegalovirus pneumonitis in lung transplant recipients.

Results of quantitative shell vial cultures of cell and supernatant fractions of bronchoalveolar lavage (BAL) fluid from lung transplant recipients were compared with results of transbronchial lung biopsies. Cytomegalovirus (CMV) was present in both the cell and supernatant fractions, including 28 (80%) and 29 (83%), respectively, of 35 BAL samples with corresponding biopsies that showed evidence of CMV pneumonitis and 34 (15%) and 75 (33%), respectively, of 227 BAL samples with corresponding biopsies that did not. Cultures of unseparated BAL fluid had a similar yield to cultures of supernatant. Virus titers of cell fractions and supernatants from BAL samples with corresponding biopsies that were positive for CMV pneumonitis were higher than those from BALs with negative corresponding biopsies. Culture of the unseparated fluid is recommended for simplicity and to maximize detection of CMV. Quantitative results may help in the identification of CMV pneumonitis, but additional studies are needed before quantitative cultures can be recommended for routine use.

Bronchoalveolar Lavage Fluid↗
PubMed1993

B72.3 and CD34 immunoreactivity in malignant epithelioid soft tissue tumors. Adjuncts in the recognition of endothelial neoplasms.

The accurate immunohistochemical diagnosis of epithelioid angiosarcoma--as distinct from carcinomas and other epithelioid neoplasms--is hindered by the lack of endothelial-selective reagents that are both sensitive and specific. To evaluate the potential utility of an "epithelial-specific" and an "endothelial-selective" monoclonal antibody in this differential diagnosis, B72.3 [anti-TAG 72 (tumor-associated glycoprotein-72)] and My 10 [anti-CD34 (the hematopoietic progenitor cell antigen)] were applied to 14 examples of angiosarcoma (seven with an epithelioid phenotype), nine epithelioid hemangioendotheliomas, and eight capillary hemangiomas, together with antibodies to factor VIII-related antigen (F8rag) and cytokeratin (CK), and the lectin Ulex europaeus I (UEA). The results of these analyses were compared with stains fro B72.3, CD34, and Ck in a variety of other epithelioid soft tissue neoplasms, including four epithelioid sarcomas, three epithelioid malignant peripheral nerve sheath tumors, three alveolar soft part sarcomas, four clear cell sarcomas (malignant melanomas of soft parts), five malignant fibrous histiocytomas, and seven epithelioid leiomyosarcomas. The endothelial phenotype of each vascular tumor was supported by staining for either F8rag or UEA in all examples. Only angiosarcomas were reactive with B72.3, including five of seven epithelioid variants. None was positive for cytokeratin. Four epithelioid angiosarcomas were also reactive for CD34, but so were the majority of epithelioid leiomyosarcomas and at least one example each of all other epithelioid soft tissue tumors, except alveolar soft part sarcoma. In contrast, none of the latter tumor types was reactive with B72.3. These data indicate that anti-CD34 is not specific for endothelial tumors, whereas B72.3 reactivity is selective for epithelioid angiosarcomas. Despite published reports to the contrary, no tumor in this series was reactive for cytokeratin. An immunohistochemical panel that includes antibodies to both cytokeratin and B72.3, in addition to other lineage-selective mesenchymal markers, is useful in the diagnostic recognition of epithelioid soft tissue neoplasms.

Adolescent↗
PubMed1993

Colloid cyst of the third ventricle. A comparative immunohistochemical study of neuraxis cysts and choroid plexus epithelium.

In an effort to shed light upon the nature of the colloid cyst, the immunohistochemical properties of 21 examples of this lesion were compared with those of other neuraxial cysts and choroid plexus epithelium. The neuraxial cysts included the following: eight Rathke's cleft cysts, 25 pituitaries containing follicular cysts of the pars intermedia, and four enterogenous cysts. Fifteen examples of normal choroid plexus and 12 choroid plexus papillomas were studied as well. These lesions were examined for localization of the following antigens: cytokeratins, epithelial membrane antigen, secretory component, carcinoembryonic antigen, prealbumin, vimentin, glial fibrillary acidic protein (GFAP), S-100 protein, neuron-specific enolase, 68-kD neurofilament protein, chromogranin, serotonin, and lysozyme, and with Leu-7 monoclonal antibodies. Five colloid cysts were immunostained with monoclonal antibodies that were specific for Clara-cell antigens and surfactant, respectively. Sugar moieties were localized using Ulex europaeus I, and Ricinus communis agglutinin I lectins. All Rathke's cleft cysts and follicular cysts of the pars intermedia as well as three selected colloid cysts were examined for pituitary hormones. The epithelial cells of colloid and enterogenous cysts, as well as those lining follicular and Rathke's cleft cyst, showed uniformly strong reactivity for cytokeratins, epithelial membrane antigen, secretory component, and vimentin, and bound Ulex europaeus lectin. Occasional cells in colloid cysts were positive for Clara cell-specific antigens. Reaction for carcinoembryonic antigen was present on the apical surface of scattered cells of colloid, follicular, and Rathke's cleft cysts. Many cells of follicles in the pars intermedia as well as individual cells of five Rathke's cleft cysts were also immunoreactive for chromogranin, S-100 protein, GFAP, and pituitary hormones. Colloid and enterogenous cysts were negative for prealbumin, S-100 protein, GFAP, and neuron-specific enolase; in all but a few instances, they failed to bind Ricinus communis agglutinin. In contrast, normal choroid plexus and choroid plexus papillomas were positive for prealbumin, S-100 protein, neuron-specific enolase, cytokeratin, vimentin, and Ricinus communis agglutinin receptors; they lacked Ulex europaeus lectin, 56/66-kD cytokeratins, and epithelial membrane antigen. Unlike normal choroid plexus, choroid plexus papillomas were often GFAP-positive. All tissues studied were nonreactive for lysosome, serotonin, and neurofilament, and with Leu-7 antibodies. This study indicates that the immunophenotype of epithelium lining colloid cysts is similar to that of other cysts showing endodermal or ectodermal differentiation and to respiratory tract mucosa. Epithelium of colloid cysts is immunohistochemically different from that of normal or neoplastic choroid plexus. These findings indicate an endodermal rather than neuroepithelial nature for colloid cysts.

Brain Diseases↗
PubMed1993

An immunohistochemical comparison of chordoma with renal cell carcinoma, colorectal adenocarcinoma, and myxopapillary ependymoma: a potential diagnostic dilemma in the diminutive biopsy.

Chordoma is one of several similar appearing neoplasms in the retroperitoneum, pelvis, and abdomen with a combination of features including clear cells, with or without cytoplasmic vacuoles, papillary profiles, and a myxoid or myxohyaline stroma. The differential diagnosis of a cellular myxoid or mucinous tumor in a small biopsy, when the entire tumor is not available for pathologic examination, includes metastatic mucinous adenocarcinoma of colorectal and other similar-appearing neoplasms, renal cell carcinoma, and myxopapillary ependymoma. We compared immunohistochemical reactivity of 18 chordomas with 20 colonic adenocarcinomas, 20 renal cell carcinomas, and six myxopapillary ependymomas using antibodies to vimentin, cytokeratin, epithelial membrane antigen, S100 protein, Leu 7, glial fibrillary acidic protein, and carcinoembryonic antigen. All chordomas were immunoreactive for vimentin and cytokeratin, 83% for epithelial membrane antigen, and 83% for S100 protein. Myxopapillary ependymomas were distinguished by immunoreactivity for vimentin and glial fibrillary acidic protein in all cases and S100 protein in 50%. All colonic adenocarcinomas were positive for cytokeratin, epithelial membrane antigen, and carcinoembryonic antigen. Renal cell carcinomas were uniformly reactive for epithelial membrane antigen and cytokeratin, nonreactive for carcinoembryonic antigen, and variably reactive for S100 protein (5%) and vimentin (25%). These data indicate that a panel of immunohistochemical markers can be useful in distinguishing chordoma from potential histologic mimics.

Adenocarcinoma↗
PubMed1993

Expression of parathyroidlike protein in normal, proliferative, and neoplastic human breast tissues.

Parathyroidlike peptide (PLP), or parathyroid hormone-related protein, is a protein of uncertain biological function that is structurally homologous to parathyroid hormone. Immunohistochemical studies have identified aminoterminal epitopes of PLP in breast carcinomas, but not in normal breast. In the present studies, immunohistochemistry and in situ hybridization were performed to evaluate further expression of PLP in normal, proliferative, and neoplastic breast tissues. Using a polyclonal antibody that recognizes epitopes within the middle and carboxyl-terminal domains of PLP, immunoreactive protein was detected within the cytoplasm of lobular and ductal epithelial cells in all normal and fibrocystic breast tissues from 74 patients. The intensity of cytoplasmic staining was increased in association with lactation, adenosis, and simple or atypical ductal hyperplasia and decreased in atrophic lobules. Cytoplasmic reactivity was also observed in 69% (56 of 81) of breast adenocarcinomas. Expression of immunoreactive PLP was inversely correlated with tumor stage and extent of nodal involvement at the time of diagnosis. However, there was no significant correlation with tumor grade, patient age, or hormone receptor status. In situ hybridization studies confirmed the epithelial expression of PLP messenger RNA in PLP-positive normal and neoplastic breast tissue. Interestingly, tumor-associated calcifications were identified in 43% of PLP-positive carcinomas, but in only 12% of PLP-negative carcinomas (P < 0.007). Our results suggest that PLP plays some role in the normal differentiated function of mammary epithelial cells and are consistent with the hypothesis that expression of this protein influences local calcium metabolism.

Adolescent↗
PubMed1993

Carcinosarcomas: current perspectives and an historical review of nosological concepts.

The origins of the concepts pertaining to the histogenesis of "carcinosarcomas" (CS) can be traced to theories that were advanced more than 100 years ago. Since that time, debate has continued over the clonality of these neoplasms and their corresponding lineages of differentiation. This article considers the historical aspects of CS and attempts to place these premises in a modern perspective. A review of current ultrastructural, cell-culture, and immunohistological data is used to support a monoclonal nature for carcinosarcoma, and to suggest that "sarcomatoid carcinoma" is a more apt designation for this tumor entity.

Adult↗
PubMed1993

Sarcomatoid neoplasms of the respiratory tract.

Sarcomatoid carcinomas (SCAs) of the respiratory tract are uncommon neoplasms of adults, most of whom are men in late middle-age who have a long history of tobacco usage. These tumors may be observed in the paranasal sinuses, nose, naso-oropharynx, larynx, trachea, central bronchi, or peripheral lung parenchyma. They may assume a polypoid configuration, with projection into luminal spaces, or show an infiltrative growth pattern like that of typical high-grade carcinoma. Histologically, both biphasic and monophasic variants of SCAs are recognized. The former include tumors with foci of overt carcinoma admixed with areas of divergent differentiation into "committed" mesenchymal tissues, such lesions have usually been termed "carcinosarcomas" in the past. On the other hand, monophasic SCAs lack obviously epithelial foci on light microscopy. Ultrastructural and immunohistological studies support the notion that SCA represents a continuum that embraces carcinosarcomas and spindle-cell carcinomas, all of which are basically epithelial neoplasms. Tumor behavior is site-dependent; SCAs of the nose, sinuses, pharynx, and lungs usually pursue an aggressive course, whereas histologically similar lesions in the larynx are usually found at an earlier stage and, therefore, are associated with a better prognosis.

Carcinosarcoma↗
PubMed1993

Chordoma in childhood and adolescence. A clinicopathologic analysis of 12 cases.

Chordoma is a distinctly uncommon neoplasm in the first two decades of life. To characterize further its clinicopathologic features in this age group, we studied 12 chordomas from six males and six females (age range, 1 month to 20 years at diagnosis), with a mean age of 6 years. Six tumors arose in the clivus, four in the cervical or thoracic vertebrae, and two in the lumbar and sacrococcygeal areas. The clinical presentations reflected the location. Histologically, six cases were classic chordomas; the remaining six had atypical or nonclassic features of a round cell or spindle cell tumor. Immunohistochemical stains for vimentin and cytokeratin were positive in all cases tested, whereas epithelial membrane antigen was detected in 11 examples, and S100 protein reactivity was noted in nine lesions. The tumors were uniformly nonreactive for glial fibrillary acidic protein and carcinoembryonic antigen. Electron microscopy in six cases demonstrated large primitive cells with attenuated cell junctions, whorls of cytoplasmic filaments, vacuoles, and glycogen aggregates. Ten children had died of tumor at intervals of 3 weeks to 4.5 years after diagnosis and treatment. Lung, lymph nodes, and other organs were the distant metastatic sites in seven cases. These findings imply that chordomas in children are more variable histologically and may pursue a more aggressive clinical course than their adult counterpart. Immunohistochemical studies are particularly helpful in the differentiation of atypical chordomas from other round and spindle cell neoplasms.

Adolescent↗
PubMed1993

Cutaneous sarcomas and sarcomatoid neoplasms of the skin.

Cutaneous sarcomas and sarcoma-like lesions pose special problems for pathologists. These lesions manifest a great deal of clinical and histological overlap, and they may be virtually impossible to separate from one another on conventional microscopy. Spindle-cell squamous carcinoma (SCSC), sarcomatoid malignant melanoma (SCMM), and fibrohistiocytic tumors, such as "atypical fibroxanthoma" (AFX) and superficial malignant fibrous histiocytoma (SMFH), comprise the group of neoplasms in this category that pose the greatest diagnostic difficulty. All may or may not show attachments between dermal tumor cells and the overlying epidermis; all may be composed of varying proportions of fusiform and pleomorphic cells; and all may demonstrate the presence of "divergent" differentiation into bone, cartilage, or myogenous tissues. Electron microscopy and immunohistology usually are required to identify these tumors with certainty. The usefulness in doing so is supported by differing biological behaviors in this context. SCMM shows the greatest tendency for recurrence and metastasis, followed in relative order by SMFH, SCSC, and AFX.

Aged↗
PubMed1992

Immunohistochemical identification of P-glycoprotein in previously untreated, diffuse large cell and immunoblastic lymphomas.

Expression of P-glycoprotein has been linked to multidrug resistance in cancer cell lines and human tumors. We investigated the frequency and clinical significance of P-glycoprotein immunoreactivity in 57 previously untreated diffuse large cell and immunoblastic lymphomas. Banked frozen tissue, which had been obtained prior to chemotherapy, was tested for reactivity with 2 monoclonal antibodies (MRK16 and C219) that recognize different domains of P-glycoprotein, using an immunoperoxidase technique. Thirteen of 57 lymphomas (23%) showed strong staining of greater than 50% of neoplastic cells; 15 of 57 (26%) showed labeling of a minority (11-50%) of neoplastic lymphocytes; 14 of 57 (25%) yielded equivocal results (reactivity in less than 10% of cells); and 15 of 57 (26%) were negative for P-glycoprotein. The 2 monoclonal antibodies were comparable in reactivity. Expression of MDR-1 mRNA was determined in 6 cases with sufficient available tissue, and did not correlate well with the percentages of cells reactive for P-glycoprotein by immunohistochemistry. Thirty-nine of our 57 patients completed multiagent chemotherapy. Contrary to our expectations, we found that P-glycoprotein immunoreactivity did not decrease the likelihood of response to induction chemotherapy. Median survival also was not adversely affected.

ABO Blood-Group System↗