Focal nodular hyperplasia and liver cell adenoma: radiologic and pathologic differentiation.
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Adolescent↗
Biomedical subjects
M Wolff
Publications and source records attributed to M Wolff.
[Criteria of identification of schistosomiasis caused by Schistosoma hamatobium and S. mansoni (486 patients: 275 case of schistosomiasis)].
Out of a total of 486 patients who originated from French Equatorial Africa, from the West Indies or from the Indian Ocean, the authors identified 275 cases of schistosomiasis of which 230 were due to S. Hematobium and 45 to S. Mansoni. The diagnostic methods were biopsy of the rectal mucosa, immunofluorescence, in the West Indians, examination of the stools, in the Africans examination of the urine, intravenous urography and less often cystoscopy. The value of these investigations was studied in each case, then by comparison with one another and with data in the literature. The most valuable investigation was biopsy of the rectum, better in Africans than examination of the urine, immunofluorescence and better than cystoscopy when this was possible.
Adolescent↗
Mutagenic studies with acrylonitrile.
The mutagenicity of acrylonitrile (vinyl cyanide, propenenitrile) has been demonstrated in the Ames Salmonella typhimurium/liver microsome assay system. Acrylonitrile, in the presence of a mouse liver homogenate produced mutations in the TA 1535, TA 1538 and TA 1978 strains. Exposure of the bacteria was achieved by spotting the acrylonitrile on a "lawn" of salmonella, by shaking a reaction mixture consisting of bacteria, liver homogenate and acrylonitrile, and by exposing the homogenate and bacteria to an atmosphere containing the acrylonitrile. Mutagenesis by this latter method was observed at exposures as low as 57 ppm, less than three times the TLV of 20 ppm that is designated in the United States.
Acrylonitrile↗
Mesotheliomas and secondary tumors of the pleura.
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Adenocarcinoma↗
A rational approach to total thymectomy in the treatment of myasthenia gravis.
Thymectomy is important in the treatment of myasthenia gravis. Total removal of the gland is considered indicated. Although median sternotomy has been the accepted surgical procedure, the transcervical approach has been advocated as a safer method of achieving total thymectomy. A surgical-anatomical study of the thymus was made in 22 patients. A high incidence of surgically important variations in thymic anatomy was found in the neck and in the mediastinum. We believe wide exposure by way of median sternotomy with direct vision is required to remove all of the extracapsular mediastinal thymus in many patients, and good cervical exposure is required to remove the anomalous tissue in the neck. If a total thymectomy is to be achieved, we recommend a median sternotomy and a cervical incision, using the meticulous dissection described.
Adolescent↗
Aggressive histological features of keratoacanthoma.
Thirty-nine keratoacanthomas from 35 patients have been studied, six of which showed perineural, and one vascular, invasion. Thus far, their aggressive histological behavior has not been paralleled by a similar clinical course. However, continued close follow-up is essential.
Aged↗
[Teaching of periodontal surgery].
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Education, Dental↗
[Congenital cystic dilatation of biliary tract (author's transl)].
The congenital cystic dilatation of biliary tract is un frequent affection and there are many types described (classification of Alonso Lej). The authors present the observation of a little girl of 12 years who presented a complete cystic dilatation ob biliary tract, diagnosed before the operation by intravenous biligraphy. This association of intra and extra hepatic cystic dilatation has been described in 1964 by Arthur and Stuart, and the diagnosis is to be done by intraveinous biligraphy in 30% of cases.
Bile Ducts↗
Pentazocine ulcers.
Four cases of skin ulceration in pentazocine addicts are presented. Appearing in broad areas of a peculiar wood induration and often massive in size, these ulcers can be clinically distinguished from comparable skin manifestations in other types of drug abuse. The histological finding of an obliterative vasculitis of the small vessels helps to explain the non-healing nature of these lesions. It also offers a rationale for the surgical therapy of wide excision, prior to skin grafting.
Adult↗
Epithelial neoplasms of the vermiform appendix (exclusive of carcinoid). I. Adenocarcinoma of the appendix.
A study of primary epithelial neoplasms of the appendix (with the exception of classical carcinoids), produced 24 adenocarcinomas and 42 benign lesions from the files of the Laboratory of Surgical Pathology of Columbia University. Invasive adenoarcinomas were often complicated by appendicitis and were then unexpectedly discovered during appendectomy. In one third of the cases the carcinomas were found in juxtaposition to adenomatous lesions of the appendix. Well-differentiated adenocarcinomas of the colonic type generally had a better prognosis than signet-ring cell (or microglandular) tumors. The most reliable criterion for correlating prognosis was the Duke's method of staging. Since invasive adenocarcinomas of the appendix can metastasize to regional lymph nodes, treatment should ideally consist of ileocolectomy.
Adenocarcinoma↗
Epithelial neoplasms of the vermiform appendix (exclusive of carcinoid). II. Cystadenomas, papillary adenomas, and adenomatous polyps of the appendix.
Forty-two cases of benign epithelial neoplasms of the appendix gleaned from the files of the Laboratory of Surgical Pathology, Columbia University, were studied. The majority were associated with dilatation of the appendix, or "mucocele." Conversely only 50% of all cystically dilated appendices examined had definite underlying adenomatous changes. Thus it is important to distinguish between cystic neoplasms (cystadenomas) and non-neoplastic retention cysts of the appendix. The most frequently found benign epithelial neoplasms were papillary adenomas. Even in the presence of atypia we labeled them benign. Appendectomy is usually adequate treatment for all adenomatous lesions occurring in the appendix. Almost a quarter of the cases reviewed were found to have synchronous or metachronous neoplasms elsewhere in the colon, while several patients harbored multiple colonic neoplasms in addition to the appendiceal adenomas. Thus a patient with an adenomatous lesion of the appendix should undergo a systematic search for other colonic lesions.
Adenoma↗
Focal nodular hyperplasia of the liver: a clinicopathologic study and review of the literature.
We received the clinical records and pathologic material of 20 patients with biopsy proven hepatic focal nodular hyperplasia. The majority of the patients were females of child bearing age, five of whom had a history of oral use of contraceptives. In every instance focal nodular hyperplasia was an incidental finding; liver function tests were always normal. Focal nodular hyperplasia is a distinct histopathologic entity, distinguishable from liver cell adenoma. Specifically it consists of nodular aggregates of cytologically normal hepatocytes with foci of intranodular bile duct proliferation. Focal nodular hyperplasia appears to be a benign entity, even in patients in whom the lesion was not excised. The association between focal nodular hyperplasia and oral use of contraceptives may be coincidental, although hormonally related vascular changes may be responsible for rupture of the lesion.
Adolescent↗
Malignant lymphomas of the salivary glands. Review of the literature and report of 33 new cases, including four cases associated with the lymphoepithelial lesion.
Malignant lymphomas involving major salivary glands have been reported to occur in 31 cases. To these, we add 33 cases, 17 of which were studied in detail from the points of view of clinical presentation, classification (Rappaport), staging (Ann Arbor), therapy, and subsequent course. The parotid gland was involved much more frequently than the submandibular gland. No example of sublingual gland involvement was discovered in the present series. Most of the patients were in the sixth and seventh decades of life. Noteworthy is that all sub-types of lymphosarcoma were encountered, with only a single case of Hodgkin's disease present. In four of the patients, the characteristic histologic picture of lymphoepithelial lesion was found in juxtaposition to malignant lymphoma. The majority of patients received one or more courses of postoperative radiotherapy, which offered the best chance for long-term remission. However, only 40% of patients were free of disease after two years.
Diagnosis, Differential↗
Pulmonary metastases from benign-appearing smooth muscle tumors of the uterus.
A 42-year-old woman was found to have multiple pulmonary nodules 7 years after hysterectomy for leiomyoma. Thoracotomy revealed multiple well differentiated smooth muscle masses containing epithelial inclusions. This patient is similar to others previously reported as examples of "multiple pulmonary fibroleiomyomatous hamartoma" on the basis of slow-growth, benign-appearing histology, and the presence of epithelial elements. Evidence is presented which suggests that these cases represent metastasis from well differentiated leiomyosarcomas. There is a frequent association with uterine smooth-muscle tumor, cases with equally benign-appearing histology have shown lymph node metastasis, the nonmesenchymal elements have been shown to represent engulphed bits of adjacent pulmonary tissue, and the histologic di-ferentiation of benign from malignant mesenchymal tumors is known to be unreliable in some cases. Unlike more anaplastic leiomyosarcomas, this condition may be associated with few symptoms and prolonged survival despite widespread disease.
Adult↗
Effects of pulsatile and nonpulsatile coronary perfusion on performance of the canine left ventricle.
This study compares the effect of pulsatile (Group C, Fib/P) and nonpulsatile (Group B, Fib/NP) coronary perfusion on myocardial performance during 2 hours of normothermic ventricular fibrillation. Group A (BH/NP), used as a base-line observation, consisted of 2 hours of nonpulsatile coronary perfusion in beating hearts. The assessment of ventricular performance included diastolic ventricular compliance, myocardial oxygen consumption and lactate extraction, regional myocardial blood flow, and histology. After 120 minutes of ventricular fibrillation, Group C showed normal ventricular diastolic compliance as compared to a 50 per cent decrease in Group B (p less than 0.01). Myocardial oxygen consumption was not significantly different from that in Group B. Because of a 70 per cent increase in oxygen extraction above Group B (p less than 0.05), total left ventricular myocardial blood flow was reduced (103 +/- 23 versus 260 +/- 36 ml. per 100 Gm. per minute, p less than 0.05) and had near-constant resistance. Lactate extraction was significantly greater and more stable as compared to Group B (9.28 +/- 1.33 versus 1.8 +/- 1.08, p less than 0.05). Left ventricular endocardial/epicardial flow ratio was greater in Group C (1.21 +/- 0.08 versus 1.06 +/- 0.06, p less than 0.05). Minimal subendocardial histologic changes were present as compared to the marked patchy subendocardial ischemic changes seen in Group B. The results demonstrate that the addition of pulsatile flow to coronary perfusion minimized the deleterious effects of prolonged ventricular fibrillation on myocardial performance.
Animals↗
Letter: Hepatic cell adenomas.
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Carcinoma, Hepatocellular↗
Leiomyoma and leiomyosarcoma of the orbit.
Comparison of the clinical and pathologic features of two orbital leiomyomas, two leiomysarcomas, and one embryonal rhabdomyosarcoma showed the leiomyomas occurred in young individuals and the leiomyosarcomas in older patients. The histopathologic diagnosis rested on the intense cytoplasmic eosinophilia and nostriated longitudinal cytoplasmic filaments demonstrated by means of the trichrome stain. The leiomyosarcomas disseminated 15 months and seven years after their orbital presentations. The treatment of both leiomyoma and leiomyosarcoma is surgical. Leiomyomas are encapsulated growths that may have small satellite nodules projecting from the main tumor mass; thus, a margin of normal tissue should also be excised, lest a small lobulation be left behind to serve as the seed for a late recurrence. Once the diagnosis of leiomyosarcoma has been made, and no evidence of metastasis has been found after a thorough systemic evaluation, the orbit should be exenterated, because the tumor is unencapsulated and liable to widespread dissemination. Rhabdomyosarcoma has a much more fulminant course than leiomyosarcoma, and especially more so than that of leiomyoma of childhood. The histopathologic diagnosis of a malignant smooth muscle tumor in a child should always be questioned, since embryonal rhabdomyosarcoma is a much more likely diagnosis.
Adolescent↗
Limited form of Wegener's granulomatosis in ulcerative colitis.
The limited form of Wegener's granulomatosis is described as a complication in 2 cases of chronic ulcerative colitis. The coexistence of ulcerative colitis and the limited form of Wegener's granulomatosis raises the question of a common etiologic basis, possibly an immunologic defect. Awareness of such an association may help shed further light on the etiology of both disorders.
Adult↗