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Biomedical subjects

M R Wick

Publications and source records attributed to M R Wick.

At least 145 records · Page 8Linked to original sources
PubMed1991

Primitive polypoid granular-cell tumor and other cutaneous granular-cell neoplasms of apparent nonneural origin.

Most cutaneous and noncutaneous granular-cell tumors are currently thought to be of Schwann-cell derivation. We present seven unusual cutaneous granular-cell lesions in which Schwann-cell origin can be excluded or is inapparent. Four of these lesions are of a previously undescribed type, and, unlike conventional granular-cell tumors of the skin, show a polypoid configuration, numerous mitoses, cytologic atypia, and a primitive immunophenotype. We propose the term "primitive polypoid granular-cell tumor" for these lesions. One occurred in a child, and three in adults. There have been no metastases to date, with follow-up periods of 2, 4, 4, and 16 years, respectively, although one tumor recurred locally. Additional cases and longer follow-up may be required to rule out the possibility that primitive polypoid granular-cell tumor is a low-grade malignancy. Two other granular-cell lesions represent variants of leiomyosarcoma, one of which widely metastasized. The last case is a granular-cell form of nodular basal-cell carcinoma. Cutaneous granular-cell neoplasms can show varying differentiation and behavior. Pathologists should not equate the occurrence of cytoplasmic granularity in a cutaneous neoplasm with the diagnosis of granular-cell schwannoma.

Adult↗
PubMed1991

Immunoreactivity for estrogen receptor protein in sweat gland tumors.

The histologic and immunophenotypic similarities between sweat gland carcinoma and breast cancer are well known. Indeed, these likenesses often preclude the diagnostic separation of primary cutaneous glandular neoplasms from metastatic mammary carcinomas, based on light microscopic and immunohistochemical features alone. To assess whether the presence of estrogen receptor protein (ERP) in breast carcinoma might serve as a diagnostic marker in this context, we analyzed 33 eccrine carcinomas, 24 sebaceous carcinomas, 15 intraepidermal apocrine carcinomas (extramammary Paget's disease), and 42 benign sweat gland tumors for ERP content. The monoclonal anti-ERP H222 was used with a modified avidin-biotin-peroxidase complex (ABC) method and paraffin sections. For comparison, eight cutaneous metastases of mammary carcinomas were similarly studied. ERP was identified in six of eight secondary neoplasms. However, this steroid-binding protein also was detected in 10 of 33 eccrine carcinomas. In three of 10 eccrine hidradenomas, each of two examples of hidradenoma papilliferum, and two of three chondroid syringomas, ERP-reactivity was noted as well. The remaining eccrine, apocrine, and sebaceous neoplasms were nonreactive. Among immunoreactive eccrine neoplasms, eight of 10 carcinomas occurred in males, whereas most ERP-positive benign eccrine tumors arose in females. The potential expression of ERP by sudoriferous malignancies reinforces the biologic similarities between mammary and cutaneous adnexal neoplasms. Moreover, ERP reactivity in the latter lesions underscores the inability of immunohistochemistry to distinguish primary and secondary glandular tumors of the skin with certainty.

Breast Neoplasms↗
PubMed1991

Kaposi's sarcoma unrelated to the acquired immunodeficiency syndrome.

Kaposi's sarcoma has achieved considerable notoriety in the past decade because of its association with the acquired immunodeficiency syndrome (AIDS). Nonetheless, this neoplasm continues to affect patients who do not have AIDS, and analysis of such cases may provide information that is useful in understanding the pathogenesis and treatment of Kaposi's sarcoma. Recent data indicate that non-AIDS-related Kaposi's sarcoma shows a predilection for individuals with the HLA-DR5 haplotype and that this genetic locus may affect immune function. In addition, other information suggests that infection with cytomegalovirus may represent the "trigger" for oncogenesis in patients with Kaposi's sarcoma. In view of the latter finding, therapies with such antiviral agents as zidovudine may be indicated in cases of non-AIDS-related Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Lymphoepithelioma-like carcinoma of the skin with adnexal differentiation.

Lymphoepithelioma-like carcinoma of the skin (LELCS) is a recently-described tumor entity with a microscopic resemblance to undifferentiated carcinoma of the nasopharynx. Only five cases of this lesion have been reported heretofore. We document three additional examples of LELCS that were composed of clustered dermal arrays of cytologically malignant, mitotically active polygonal cells, without connections to the overlying epidermis or skin appendages. Chronic inflammatory cells were interspersed throughout each of the tumors. Two of them demonstrated multiple foci of trichilemmal-type keratinization among the neoplastic cells, whereas the other exhibited focal eccrine ductal or glandular differentiation. None of the neoplasms was found to contain nucleic acid of Epstein-Barr virus by in situ hybridization. It is postulated that LELCS represents a primitive cutaneous appendage tumor. Based on the results of a prior publication and those of the current assessment, this neoplasm is thought to have the potential for both sweat glandular and follicular differentiation.

Aged↗
PubMed1991

Rudimentary meningocele of the skin. Clinicopathologic features and differential diagnosis.

Although "rudimentary meningocele" (RM) or "meningothelial hamartoma" of the skin is a seemingly recently described entity, it has been included in past reports as a variant of primary cutaneous meningioma. We document our experience with four such lesions and compare the histologic and immunohistochemical features of these cases with those of seven classic meningoceles (CM) and four giant cell fibroblastomas (GCF). Although all of these entities share significant points of microscopic similarity, RM and CM are lesions composed of meningothelial cells, whereas GCF is probably of myofibroblastic origin. Rudimentary and classic meningoceles demonstrate cellular immunoreactivity for vimentin and epithelial membrane antigen, whereas the cells of GCF lack the latter determinant and may express muscle-specific actin. Our observations suggest that RM and CM represent closely related developmental malformations; however, RM becomes clinically apparent in a somewhat older patient population than CM and is not associated with major skeletal anomalies as may be found with CM. The distinction between various cutaneous meningothelial proliferations has prognostic importance, as does their separation from GCF. RM and CM are adequately treated by simple excision, whereas GCF, a probable form of fibromatosis, has the potential for local recurrence.

Child, Preschool↗
PubMed1991

Benign cutaneous adnexal tumors in childhood and young adults, excluding pilomatrixoma: review of 28 cases and literature.

Benign adnexal tumors of the skin, excluding pilomatrixomas, were identified in 28 patients between the ages of 4 and 20 years with a mean age of 15; 23 women and 5 men. Most lesions were described as papules and they occurred on the face, scalp and neck in 75% of cases. Trichoepithelioma and syringoma accounted for 56% of all neoplasms. Only one patient gave a history of familial trichoepitheliomas. The remaining tumors were examples of syringocystadenoma papilliferum, eccrine acrospiroma, and eccrine and apocrine hidrocystomas. Excisional biopsy constituted the treatment in all cases; only one neoplasm, an eccrine acrospiroma, recurred locally.

Adenoma↗
PubMed1991

Neuroendocrine neoplasms of the mediastinum.

Neuroendocrine neoplasma of the mediastinum include thymic carcinoid and small cell carcinoma, parathyroid tumors, and aorticopulmonary or paravertebral paragangliomas. All of these lesions are composed of cells with similar morphological, functional, and biochemical attributes, and may be the sources of eutopic or ectopic hormonogenesis. However, their clinical, immunohistochemical, and ultrastructural features are dissimilar in part, and allow for the effective application of special studies in differential diagnosis. This report presents a review of the above-cited neoplasms, and provides recommendations regarding their pathologic evaluation and treatment.

Adenocarcinoma↗
PubMed1991

Microglandular adenosis of the breast. An immunohistochemical comparison with tubular carcinoma.

Microglandular adenosis (MA) of the breast is a benign, disorganized proliferation of glands lined by a single layer of cells. As such, differential diagnosis between MA and tubular carcinoma may be challenging in selected cases. A panel of antibodies was applied to 10 cases of MA and 10 of tubular carcinoma to investigate the potential benefit of immunohistochemistry in the separation of these lesions and the possible role of myoepithelial cells in MA. The luminal cells in nine cases of MA were surrounded by a cuff of muscle-specific actin-reactive cells, which also coexpressed cytokeratin and vimentin. The immunophenotype of these cells is characteristic of myoepithelial differentiation, which was heretofore thought to be lacking in MA. This finding demonstrates that myoepithelial cells are indeed present in MA subjacent to luminal epithelial cells; moreover, it distinghuishes MA from tubular carcinoma, all examples of which were actin negative in this analysis. In addition, circumferential type IV collagen deposition was observed around constituent glands of MA in nine cases but was lacking in all tubular carcinomas. Other markers included in this evaluation (S100 protein, gross cystic disease fluid protein 15, carcinoembryonic antigen, estrogen receptor protein) were of no differential diagnostic value.

Actins↗
PubMed1991

Estrogen-receptor protein in thyroid neoplasms. An immunohistochemical analysis of papillary carcinoma, follicular carcinoma, and follicular adenoma.

Epidemiologic features of well-differentiated thyroid tumors and experimental evidence suggest that female sex hormones may exert effects on this gland and its neoplasms. This possibility was addressed by investigating the expression of estrogen-receptor protein in 80 thyroid neoplasms. Patients with papillary carcinomas, follicular carcinomas, and follicular adenomas were selected from each of the following groups: (1) postpubertal-premenopausal women (who are associated with the most favorable prognosis and greatest incidence of these neoplasms); (2) postmenopausal women; and (3) men of various ages. Sections from formalin-fixed paraffin-embedded tumors were stained with antiestrophilin antibody (clone H222) and the avidin-biotin-peroxidase complex method. In addition, other markers were included to distinguish thyroidal from other estrogen-receptor protein-reactive neoplasms; an anticytokeratin mixture, antithyroglobulin, and anti-gross cystic disease fluid protein-15 were applied in all cases. The expression of estrogen-receptor protein was detected in eight of 10, six of 10, and nine of 10 papillary carcinomas; four of eight, two of seven, and one of five follicular carcinomas; and none of 10, none of 10, and two of 10 follicular adenomas, in groups 1, 2, and 3, respectively. Nuclear staining was regional or multifocal in distribution. Cytokeratin and thyroglobulin were detected in all tumors. In contrast, none displayed anti-gross cystic disease fluid protein-15 immunoreactivity. These results indicate that the estrogen receptor may be detected immunohistochemically in thyroid neoplasms. However, no differences that could account for possible estrogen-related epidemiologic and prognostic variation in such tumors could be ascertained. Other discriminating immunostains, primarily including anti-gross cystic disease fluid protein-15 and thyroglobulin, are effective in distinguishing between thyroidal and extrathyroidal tumors that may express estrogen-receptor protein.

Adenocarcinoma↗
PubMed1991

Gross cystic disease fluid protein-15 in salivary gland tumors.

Gross cystic disease fluid protein-15 (GCDFP-15) is a 15-kd glycoprotein that is expressed by normal apocrine epithelia and in a majority of breast carcinomas. However, recent studies have demonstrated that this substance is also present in tumors of the salivary glands, sweat glands, and prostate gland. To determine whether the expression of CGDFP-15 might aid in the differential diagnosis of salivary gland lesions, the anti-GCDFP-15 monoclonal antibody D6 was applied to paraffin sections of 133 such neoplasms. Benign tumors (76% reactive) were more often labeled than malignant lesions (28% reactive) by this antibody; overall, 53 (41%) of 133 cases were positive for GCDFP-15. Notably, the tubuloglandular components in 17 (81%) of 21 pleomorphic adenomas were reactive, but no example of either adenoid cystic carcinoma or polymorphous low-grade adenocarcinoma were labeled. In contrast, 24% of adenocarcinomas stained with this antibody. The apparent expression of GCDFP-15 by a spectrum of salivary gland tumors supports their biologic relationship to lesions of the cutaneous apocrine glands and breast. Furthermore, the demonstration of this determinant may be of use in suggesting the salivary gland nature of poorly differentiated carcinomas of the head and neck, and it may facilitate the separation of pleomorphic adenoma from histologically similar malignant neoplasms in the salivary glands themselves.

Apolipoproteins↗
PubMed1991

Tumefactive fibroinflammatory lesion of the extremity. Report of a case and review of the literature.

Tumefactive fibroinflammatory lesion is an idiopathic fibroinflammatory process of the head and neck region. Although benign histopathologically, it is invasive, destructive, and locally recurrent, leading to uncertainty regarding its proper management; as the disease is rare, determining optimal treatment is difficult, given the anecdotal nature of reports. We report the first case of a tumefactive fibroinflammatory lesion occurring outside the head and neck region. Our patient was treated with corticosteroids and had a favorable response, supporting this approach as initial treatment. Immunohistochemical studies performed on a pretreatment specimen were consistent with a secondary inflammatory component because no monoclonal nor aberrant phenotypes were detected. The tumefactive fibroinflammatory lesion appears to be indistinguishable from the other known idiopathic fibroinflammatory processes; patients presenting with any one of these should be evaluated for the others.

Adrenal Cortex Hormones↗
PubMed1990

Small cell carcinoma of the major salivary glands. An immunohistochemical study.

Small cell carcinomas of the major salivary glands are rare tumors, accounting for less than 1% of malignant neoplasms at these sites. To date, approximately 41 such tumors have been described. They recently have been classified into two groups, based on the ultrastructural presence or absence of intracytoplasmic neuroendocrine (NE) granules, "small cell neuroendocrine carcinoma" and "small cell ductal carcinoma". This study concerns 11 primary small cell carcinomas that had been previously studied ultrastructurally; it was undertaken to determine whether these lesions possessed a neuroendocrine phenotype, using a battery of immunohistochemical stains. Antibodies to epithelial membrane antigen (EMA), cytokeratin (CK), Leu 7, vimentin (VIM), synaptophysin (SYN), chromogranin (CHR), and neuron-specific enolase (NSE) were employed, with the avidin-biotin-peroxidase complex technique and paraffin sections. All tumors in this study expressed at least one neuroendocrine marker. In eight tumors EMA was found; CK was present in all 11 cases, seven of which demonstrated focal paranuclear staining. Leu 7 was seen in eight tumors, VIM was expressed in two cases, SYN was found in three tumors, and CHR was detected in three neoplasms. Anti-neuron-specific enolase labeled eight tumors. From the preceding data one may conclude that all small cell salivary gland carcinomas have neuroendocrine characteristics, even though dense core granules cannot be demonstrated in some of them ultrastructurally.

Animals↗
PubMed1990

Microcystic adnexal carcinoma. An immunohistochemical comparison with other cutaneous appendage tumors.

Since its initial description, microcystic adnexal carcinoma (MAC) of the skin has been controversial. In particular, it features keratin production of the type seen in some pilar neoplasms , and has been thought to pursue partial follicular differentiation. Diagnostically, MAC may be difficult to separate from desmoplastic trichoepithelioma (DTE) in superficial biopsy specimens. We studied 12 MACs, 22 malignant eccrine acrospiromas, 7 sudoriferous syringometaplasias, 6 syringomas, 5 DTEs, and 40 other benign pilar neoplasms immunohistochemically. Paraffin sections and antibodies to "hard" (pilar) keratins. epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu-M1, and S100 protein were employed. The MACs exhibited reactivity for hard keratin subclasses AE 13 and AE 14, EMA, CEA, and Leu-M1. Desmoplastic trichoepitheliomas expressed positivity for AE 14, EMA, and Leu-M1 focally, but lacked the other specified markers. Syringomas and malignant acrospiromas displayed EMA, CEA, and AE 14 reactivity, and 5 syringometaplastic lesions were AE 14-reactive. Benign pilar tumors aside from DTEs were reactive only for AE 13, AE 14, or both. These data indicate that MAC exhibits an immunophenotype that is a "hybrid" of those seen in pure sweat glandular and follicular neoplasms, and suggest that it may indeed show combined pilar and sudoriferous differentiation. Based on these results, it also appears that immunohistochemical analysis may be useful in the diagnostic separation of MAC and DTE.

Adenoma, Sweat Gland↗
PubMed1990

Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases.

The distinction between malignant epithelioid pleural mesothelioma (MEPM) and peripheral adenocarcinoma of the lung with pleural invasion (PAL) continues to represent a diagnostic challenge in selected cases. In order to provide comparative data on histologic, histochemical, and immunohistochemical features of these neoplasms, we analyzed 51 ultrastructurally categorized MEPMs and 52 PALs with the periodic acid-Schiff-diastase (PAS-D), mucicarmine, and colloidal iron stains, and a panel of immunohistologic reagents. Antibodies to cytokeratin, vimentin, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu M1, the B72.3 antigen, blood group isoantigens (BGI), placental alkaline phosphatase, amylase, S100 protein, and Clara cell antigen were used, as applied to paraffin sections with the avidin-biotin-peroxidase complex technique. Ultrastructural studies revealed long, branching microvilli in MEPM cells in all cases, with length-to-diameter ratios (LDR) of 10:1 or more. In contrast, PAL manifested short, nonbranching microvilli with LDR of 8:1 or less. Reactivity with PAS-D and mucicarmine stains was strictly confined to PAL, and hyaluronidase-sensitive colloidal iron-positivity was restricted to MEPM. However, only 63% and 41% of these respective neoplasms demonstrated such histochemical reactivity. Immunohistologic results correlated well with electron microscopic classification. All MEPMs and PALs were reactive for cytokeratin; in addition, the majority of tumors in each group expressed EMA, and a minority were reactive for vimentin. In adenocarcinomas of the lung, Leu M1 was observed in all cases, CEA was apparent in 96%, B72.3 labeled 84%, and BGI were present in 67%; all PALs expressed at least two of these determinants, but none was seen in any mesothelioma. The other markers included in this study also were observed in some PAL cases, but not in MEPM. These findings suggest that immunohistology parallels electron microscopy in efficacy in the diagnostic separation of MEPM and PAL. Using antibodies to Leu M1, CEA, and the B72.3 antigen, reactivity for at least two of these three markers appears to exclude a diagnosis of pleural mesothelioma. The other glycoproteinaceous, oncoplacentofetal, and cytoplasmic antigens we studied can be used to reinforce such a determination, since their distribution is confined to adenocarcinomas.

Adenocarcinoma↗