Search PubMed⌕ Search

Biomedical subjects

M T Mazur

Publications and source records attributed to M T Mazur.

54 records · Page 3Linked to original sources
PubMed1982

Fatal gestational choriocarcinoma. Clinicopathologic study of patients treated at a trophoblastic disease center.

We studied 31 autopsied cases of gestational choriocarcinoma encountered at the Northwestern University Trophoblastic Disease Center in the past two decades to learn if the clinical and morphologic aspects of these cases have been altered by therapy. These cases were analyzed for cause of death, distribution of tumor and histologic patterns in relation to the amount of chemotherapy. Tumor hemorrhage and/or pulmonary insufficiency were the most common causes of death, irrespective of the amount of therapy although other factors including drug toxicity, sepsis, and uremia led to death in six cases. The amount of chemotherapy generally did not affect the number or distribution of metastases. Histologically, nine cases showed extensive or complete necrosis. Eighteen of the remaining tumors had typical biphasic patterns, but four patients who received multiple courses of chemotherapy had atypical patterns with a marked predominance of cytotrophoblast and infiltrative growth. These atypical patterns do not appear to be a direct result of chemotherapy but may represent a more aggressive form of this tumor. This study shows that fatal gestational choriocarcinoma can have a variety of clinicopathologic features which reflect not only the biologic capabilities of the neoplasm but also the effects of chemotherapy and prolonged disease.

Adolescent↗
PubMed1982

Fatal gestational trophoblastic disease: an analysis of treatment failures.

Forty-eight of 399 patients referred to the John I. Brewer Trophoblastic Disease Center of Northwestern University Medical School from 1962 to 1979 for treatment of gestational trophoblastic disease (invasive mole or choriocarcinoma) died. All patients who died had histologically documented metastatic choriocarcinoma. The time from pregnancy event to treatment was greater than 4 months and/or the pretreatment human chorionic gonadotropin titer was greater than 100,000 IU/L in 64% of these patients. Seventy-one percent of fatal cases developed in association with term pregnancies, abortions, or ectopic pregnancies rather than hydatidiform moles. Fifty percent of patients who died had metastases to the liver, brain, and/or peritoneal cavity when they first presented for treatment. The most common causes of death were hemorrhage from one or more metastatic sites (42%) and pulmonary insufficiency (31%). Factors primarily responsible for the treatment failures in these patients were: (1) presence of extensive disease at the time of initial treatment; (2) inadequate initial treatment; and (3) failure or presently used chemotherapy protocols in advanced disease. Secondary chemotherapy, radiation therapy to sites other than the brain, and adjuvant surgical procedures failed to improve survival in these high-risk patients.

Adolescent↗
PubMed1982

Atypical endometrioid cystadenofibroma with Meigs' syndrome: ultrastructure and S-phase fraction.

A case of an ovarian endometrioid cystadenofibroma with epithelial atypia and Meigs' syndrome is described. The patient had a large pleural effusion that resolved rapidly after extirpation of the tumor. The S-phase fraction, measured by in vitro incorporation of tritiated thymidine, was extremely low, suggesting that this unusual tumor has a limited growth potential despite its atypical features. Ultrastructurally, the epithelial component has few features described in other ovarian endometrioid tumors. The cells have deeply clefted nuclei and numerous secondary cytolysosomes, features more commonly seen in Brenner tumors; the morphologic similarities may reflect a low epithelial turnover rate. Despite a review of the literature and an analysis of the case, the authors were unable to determine the pathogenetic mechanism of Meigs' syndrome.

Adenofibroma↗
PubMed1982

Clear cell adenocarcinoma of the female urethra: clinical and ultrastructural study suggesting a unique neoplasm.

A case of clear cell adenocarcinoma arising in the female urethra is described. The tumor had a tubulocystic pattern and intracytoplasmic glycogen, resembling clear cell carcinomas that occur in the vagina and upper female genital tract. Ultrastructural study, however, showed abundant and elongated microvilli on the tumor cells, a feature not seen in clear cell carcinomas or other common forms of carcinoma arising in the female genital tract. Six other cases of similar tumors of the female urethra were found in medical literature, yet there was no example of this tumor in the bladder or male urethra. Clinical and ultrastructural observations suggest that clear cell carcinoma of the female urethra is a distinctive neoplasm. Abundant microvilli provide morphologic evidence supporting the possibility of origin from the mesonephros. Radical extirpative surgery with urinary diversion appears to be the treatment of choice.

Adenocarcinoma↗
PubMed1982

Adenoid cystic carcinoma: a comparative pathologic study of tumors in salivary gland, breast, lung, and cervix.

Histologic, histochemical, and ultrastructural features of eight adenoid cystic carcinomas arising at diverse sites were compared in order to determine diagnostic values and to investigate histogenetic mechanisms. These tumors originated in the salivary glands, breast, uterine cervix, and tracheobronchial tree. By light microscopy each tumor was seen to have morphologic features of adenoid cystic carcinoma, yet only five of the eight cases showed differential staining for the two mucin types, stromal and epithelial, which are reportedly present in these tumors. In contrast, every case showed a set of fine structural features which, in aggregate, are specific for adenoid cystic carcinoma. These features include pseudocysts, intercellular spaces, basal lamina, and true glandular lumens. The most prominent feature is the pseudocyst, which mimics a glandular lumen by light microscopy but is actually a rounded extracellular space containing basal lamina. Ultrastructurally, the variation in composition of the extracellular compartments, including pseudocysts and true lumens, appears to explain the lack of uniformity in the histochemical staining. The tumors also contained cytoplasmic microfilaments in parallel bundles, consistent with myofilaments. The presence of these filaments combined with basal lamina suggests myoepithelial differentiation, yet it is not known whether these tumors truly originate from myoepithelium or show differentiation toward myoepithelium as a part of the neoplastic process. Regardless of their histogenesis, this study shows that true adenoid cystic carcinomas do arise in different organs. Knowledge of the specific ultrastructural features of adenoid cystic carcinomas can be useful in classifying these tumors in some cases.

Adult↗
PubMed1982

Adenoid cystic carcinoma of the uterine cervix: ultrastructure, immunofluorescence, and criteria for diagnosis.

An example of adenoid cystic carcinoma of the cervix was recently encountered in our laboratory and studied by histochemistry, electron microscopy, and immunofluorescence in order to compare the neoplasm with adenoid cystic tumors at other sites and to establish criteria for diagnosis. Histochemically, cervical adenoid cystic carcinoma showed the two types of mucin, epithelial and stromal, as expected in adenoid cystic carcinomas of other organs. Ultrastructurally, this tumor was characterized by redundant basal lamina forming pseudocysts, intercellular spaces, and occasional true lumens with microvilli. Immunofluorescence studies showed that the cells contain at least two antigenically different types of filaments, actin and keratin, and that the cells produce true basement membrane (collagen IV). The presence of actin suggests myoepithelial differentiation even though the tumor probably originated from the cervical reserve cells, and myoepithelium is not a known component of normal cervix. This study shows that cervical adenoid cystic carcinoma is a distinct entity which can be identified and separated from other types of cervical adenocarcinomas.

Actins↗
PubMed1981

Gestational choriocarcinoma. Its origin in the placenta during seemingly normal pregnancy.

Four new cases of primary choriocarcinoma arising in the placenta during a seemingly normal gestation were studied at the Trophoblastic Disease Center of Northwestern University. In each case the patient presented with disseminated metastases while carrying an intrauterine gestation with a normally developing fetus. All four placental primaries were small; three of the tumors were microscopic and found only after extensive sectioning. Histologically, these tumors all appeared to arise from the cytotrophoblastic cells covering the stromal portion of villi, and in some areas the involved villi retained a portion of normal investing trophoblast. This study shows that gestational choriocarcinoma unassociated with hydatidiform mole can have an early stage in which chorionic villi are present. The consistently small size of the lesions studied suggests that primary placental choriocarcinoma may frequently be overlooked or missed, and that choriocarcinoma possibly has its origin in the placenta more often than in retained or persistent trophoblast following pregnancy.

Adult↗
PubMed1981

Atypical polypoid adenomyomas of the endometrium.

Five unusual polypoid lesions of the endometrium which we term atypical polypoid adenomyomas are described; these growths occurred in premenopausal women. Each of the polyps was characterized by irregular atypical glands with squamous metaplasia and a cellular, smooth muscle mesenchyme, having a pattern to be distinguished from infiltrating adenocarcinoma or a malignant mixed müllerian tumor. Electron microscopy in one case confirmed the presence of a well-differentiated smooth muscle component. These lesions were focal and noninvasive. Two of the three patients who had hysterectomies has small residual lesions confined to the endometrium. Follow-up from 4 to 24 months showed no recurrence. One patient had a second D & C reported as normal; she subsequently became pregnant. The benign behavior of these unusual polyps suggests that atypical adenomyomas can be managed conservatively in the premenopausal woman without the necessity of a hysterectomy.

Adult↗
PubMed1980

Metastasizing leiomyoma of the uterus. S-phase fraction, estrogen receptor, and ultrastructure.

A 33-year-old woman had a metastasizing leiomyoma in which mitotic figures could not be found. The tumor was composed of well differentiated smooth muscle indistinguishable from uterine leiomyoma or normal myometrium by light and electron microscopy. The S-phase fraction of the tumor, measured by in vitro tritiated thymidine labeling, was near the upper limit of the range seen in seven ordinary uterine leiomyomas and was distinctly lower than that in a uterine leiomyosarcoma. The content of estrogen receptors in the cytosol was within the range seen in uterine leiomyomas. Metastasizing leiomyoma is an actively proliferating neoplasm of mature smooth muscle that appears to be hormonally responsive. The tumor in our patient showed no clear differences from ordinary leiomyomas in findings relating to the rate of cellular proliferation, morphology, or estrogen receptor content.

Adult↗
PubMed1980

Pulmonary infarct: an unusual manifestation of fibrosing mediastinitis.

We have recently seen lung biopsy specimens showing pulmonary infarcts in two patients with fibrosing mediastinitis. The patients were young, and in each, the infarcts were the first manifestation of the underlying mediastinal fibrosis. The infarcts had several distinctive histologic features and may have been caused by constriction of major pulmonary veins by the fibrosis.

Adult↗
PubMed1980

Histogenesis of morphologic variations in tumors of the uterine wall.

We investigated seven uterine wall lesions, selected because of the presence of unexpected patterns or components, to determine their relationship to normal uterine constituents. These lesions included a bizarre leiomyoma, a palisading leiomyoma which resembled a schwannoma, two myxomas, irradiated myometrium, a plexiform tumor, and a leiomyoma with tubular structures. All of these lesions except for the epithelial component of the plexiform tumor showed ultrastructural characteristics of smooth muscle, demonstrating a common origin from the myometrium. Two tumors, the plexiform tumor and the leiomyoma with tubules, had the pattern of epithelial structures suggesting origin from müllerian mesencyme: the plexiform tumor resembled incompletely differentiated endometrium and the tubular structures in the leiomyoma had features of mesothelium. We conclude that these varied and often confusing morphologic patterns reflect the capacity of uterine smooth muscle and stroma to undergo a wide spectrum of alterations including differentiation toward epithelial structures. Changes of this type occur in benign and malignant uterine stromal neoplasms and do not in themselves have prognostic significance.

Adult↗
PubMed1978

Endolymphatic stromal myosis: unique presentation and ultrastructural study.

We describe a case of endolymphatic stromal myosis (ESM) in which the lesion presented uniquely as recurrent frond-like cervical polyps. The lesion behaved aggressively, spreading to the peritoneum. Ultrastructurally, this tumor closely resembled proliferative phase endometrial stroma, in accord with the theory that ESM is a low-grade stromal sarcoma. The ultrastructural correlations may aid in developing future therapy, including progestagen administration for these unusual tumors.

Diagnosis, Differential↗
PubMed1978

Proliferative serous tumors of the ovary. Histologic features and prognosis.

In reviewing all proliferative serous tumors of the ovary seen at Barnes Hospital from 1950 to 1974, we quantitated histologic characteristics and defined criteria for diagnosis in 55 borderline tumors, 13 well-differentiated cystadenocarcinomas, and 15 cystadenomas with unusual proliferative areas. This last type with focal proliferation behaved in a benign fashion and should be considered a variant of a simple cystadenoma. Stromal invasion was the only histologic feature which consistently distinguished carcinomas from the borderline tumors. The presence in some borderline tumors of severe cellular atypia, marked epithelial disorganization, frequent mitoses, and cribriform glands in the stroma neither signified carcinoma nor indicated poor prognosis. No patient with a Stage I borderline lesion died of tumor. Although the mortality of patients with Stage IIb or Stage III borderline tumors is high, tumor-related deaths rarely occurred before 5 years, and three patients lived more than 10 years. Borderline serous tumors are low-grade malignant neoplasms which differ from overt carcinomas in the excellent prognosis of Stage I lesions and in long survival even with widespread abdominal disease.

Cystadenocarcinoma↗
PubMed1977

Macrophage deformability and phagocytosis.

The influence of several metabolic inhibitors and pharmacologic agents on macrophage deformation (induced by fluid shear stress) was examined in relationship to changes in ATP content and phagocytosis of latex beads. Two relatively specific inhibitors of glycolysis (iodoacetate [IA], and sodium fluoride [NaF]) and a sulfhydryl-binding agent (N-ethylmaleimide [NEM] markedly inhibited phagocytosis and reduced cell deformability. A microtubule-disrupting agent (vinblastine) and a highly specific inhibitor of glycolysis (2-deoxyglucose) markedly inhibited phagocytosis without influencing cell deformability. An organomercurial sulfhydryl binding agent p-chloromercuribenzene (PCMBS) and a microfilament-disrupting agent (cytochalasin B) inhibited phagocytosis and increased cell deformability. The effects of these agents on phagocytosis and cell deformability bore no consistent relationship to alterations in cellular content of ATP. The observation that 2-deoxyglucose, the most specific inhibitor of glycolysis examined, reduced ATP content to levels far lower (15 percent of control values) than those achieved by any other agent examined and inhibited phagocytosis without altering cell deformability, suggests that alterations in cell deformability induced by NaF, IA, NEM, PCMBS, and cytochalasin B are not due to inhibition of glycolysis per se, but instead result from direct or indirect effects of these agents on cell constituents, possibly contractile proteins, which are determinants of cell deformability. The finding that cytochalasin B, NEM, PCMBS, and IA interfere with phagocytosis and alter cell deformability, together with evidence that these agents interact with isolated actin and myosin, suggests that contractile proteins are important both in phagocytosis and as determinants of cell deformability. The observation that vinblastine, colchicines, and heavy water (D(2)O) did not alter cell deformability, even though vinblastine caused formation of intracellular crystals of microtubular protein, indicates that microtubules are not major determinants of cell deformability. The observations that beads adhered normally to surfaces of cytochalasin B- and of PCMBS-treated cells and that shear-stress induced deformation was increased whereas phagocytosis was markedly inhibited, suggest that deformation of cells around beads associated with ingestion depends on some form of cellular (contractile?) activity, whereas deformation of cells by fluid shear stress is a passive phenomenon.

4-Chloromercuribenzenesulfonate↗
PubMedDate not supplied

Metastatic melanoma: the spectrum of ultrastructural morphology.

The fine structure of 26 metastatic melanomas, including 13 pigmented and 13 amelanotic tumors, as studied to define ultrastructural criteria for diagnosis. Several important features in addition to melanosome granules were identified. Dendritic cytoplasmic processes were seen in 25 of the 26 cases, cell clusters formed by concentric aggregates of several cells and their processes were present in 18, and microvilli were found on cell surfaces in all cases. The cytoplasm was complex, containing numerous mitochondria, Golgi systems, endoplasmic reticulum, nonspecific filaments, and microtubules. Nuclear morphology was variable. Basement membranes and cell junctions including desmosomes were often encountered, and some melanomas shared features with Schwann cells, including complex membrane interdigitations. All tumors contained melanosomes, although the classic forms were frequently difficult to identify and abnormal variant forms often predominated. Knowledge of the variant melanosome morphology and an understanding of the other fine structural features of malignant melanocytes can help identify those cases that lack classic premelanosome granules.

Adolescent↗