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Biomedical subjects

R G Freeman

Publications and source records attributed to R G Freeman.

At least 37 records · Page 2Linked to original sources
PubMed1988

Clear cell basal cell epithelioma: light and electron microscopic study of an unusual variant.

We report the light and electron microscopic study of 7 examples of an unusual clear cell variant of basal cell epithelioma (BCE). The clear cells show cytoplasmic vacuoles that contain glycogen but do not stain with mucicarmine or fat stains. By electron microscopy the cytoplasmic vacuoles consist of empty spaces not surrounded by membranes. The clear cell pattern may occupy all or part of a given tumor. Typical nodular BCE was found in all 7 cases, but not in every section. Some nodules were composed of mixed solid and clear cell types. Differentiation of this uncommon variant from other clear cell tumors is important.

Aged↗
PubMed1987

Diagnosis of mastocytosis subsets using a morphometric point counting technique.

Mastocytosis, a disease that varies in its clinical presentation, is usually documented by histologic examination of lesional skin. However, no universally accepted histopathologic criteria exist for establishing the diagnosis of this disease. We have combined the method of morphometric point counting with the mast cell-specific stain, conjugated avidin, to accurately quantify mast cells in cutaneous tissue sections of mastocytosis. Using this histologic approach, we found that macules, papules, and nodules of mast cell disease had from ninefold to nearly a 160-fold greater mast cell content than was observed in normal skin and in several other cutaneous disorders. This technique also permitted the objective histologic stratification of mastocytosis skin lesions according to their mast cell density. Morphometric point counting in conjunction with conjugated avidin offers a simple and accurate method for establishing the diagnosis of mastocytosis.

Avidin↗
PubMed1986

Ataxia-telangiectasia associated with sarcoidosis.

Ataxia-telangiectasia and sarcoidosis are diseases characterized by abnormalities of the immune system. We examined a 13-year-old female with ataxia-telangiectasia who developed atrophic, violaceous plaques of the skin and a destructive, polyarticular arthritis. The histologic features of both skin and synovium were most consistent with a diagnosis of sarcoidosis. Interaction of these two immunologic disorders may have resulted in the unusual features of this patient's disease.

Adolescent↗
PubMed1985

Syringocystadenoma papilliferum. A plasmacytotropic tumor.

Seven cases of syringocystadenoma papilliferum were studied by immunohistochemical methods for the presence of IgG, IgA, IgM, and secretory component in tumor epithelial cells and IgG, IgA, and IgM in plasma cells underlying the tumor epithelium. Six of seven cases showed IgA positivity within epithelial cells, one case showed faint intraepithelial IgG staining, and none stained for IgM. Four of five cases were positive for secretory component. The plasma cells were predominantly of the IgG and IgA class. These findings suggest that the association of plasma cells with this tumor is a consequence of epithelial attraction via a mechanism similar to that utilized by glands of the normal secretory immune system.

Adenoma, Sweat Gland↗
PubMed1984

Prevention of self-inflicted trauma in comatose patients.

A solution to the problem of self-inflicted trauma to the tongue in decerebrate and comatose patients is outlined. The neurophysiology of jaw movement in the comatose patient is the basis of design of an intraoral fixed appliance which prevents discoordinate or neuropathologic mandibular chewing movements and facilitates healing of pre-existing lesions. Described in detail are the fabrication, insertion, and maintenance of this protective prosthesis, with emphasis on the need for joint effort between the neurosurgery and dentistry teams.

Child↗
PubMed1984

Subacute cutaneous lupus erythematosus and discoid lupus erythematosus. Comparative histopathologic findings.

Subacute cutaneous lupus erythematosus (SCLE) is a recently described distinct subset of lupus erythematosus (LE) having characteristic clinical, serologic, and genetic findings. This study describes the histopathologic characteristics of SCLE and determines whether it could be differentiated from discoid lupus erythematosus (DLE) on histopathologic grounds alone. Biopsy specimens from 33 patients having either SCLE or DLE, as defined by strict clinical criteria, were examined without knowledge of the clinical diagnosis. Histologic discrimination between SCLE and DLE was accomplished in 82%. The specimens from DLE lesions had substantially more hyperkeratosis, basement membrane thickening, follicular plugging, and superficial and deep inflammatory cell infiltrate, while SCLE had more epidermal atrophy. The histopathologic differences between SCLE and DLE further support the concept that SCLE is distinct from DLE and should be considered a unique subset of LE.

Acute Disease↗
PubMed1983

Herpes gestationis: clinical and histologic features of twenty-eight cases.

We have studied 28 patients with well-documented herpes gestationis (HG) to determine the frequency of complications and to review the histopathology, immunopathology, and clinical parameters of disease. The frequency of miscarriages and other maternal complications in our series was not extraordinary. Fetal complications were similarly limited. Less than 5% of infants had cutaneous lesions, and no other untoward fetal complications were apparent. Although the clinical features of our patients largely paralleled those typically reported for patients with HG, several variants of disease were noted. We report one woman with immunofluorescence-confirmed HG who had no clinical disease during a subsequent pregnancy. We also identified cases in which the characteristic vesiculobullous lesions of HG never developed. Instead, four women had urticarial papules or plaques throughout their clinical courses. HG was verified in these four women by typical immunofluorescent findings and by recurrent, classical disease during subsequent pregnancies in two. In addition, two women were identified with recurrent HG during pregnancies by different husbands.

Abortion, Spontaneous↗
PubMed1980

Structure and significance of the pits with their tumors in the nevoid basal cell carcinoma syndrome.

Parallel histopathologic, histochemical, scanning, and transmission electron microscopic (EM) observations were made on palmar pits of one patient and on palmar pits, with an unprecedented number of basal cell carcinomas. of another patient. The first scanning view of tumor growing into the lumen of a pit from the genetically defective epidermis below is presented. The anatomy of the pit is demonstrated for the first time by scanning view of a transected pit. Our observations confirmed those of Hashimoto et al on the mechanisms involved in premature desquamation of the stratum corneum and on the true nature of the epithelium at the base of the pit. This epithelium resembled closely basal cell epithelioma and represented carcinoma in situ. The striking demarcation afforded by the axure B stain of normal and abnormal portions of the palmar epidermis with pit and the poor stainability of the pit with tumor was likewise confirmed. The tumors exhibit aggressive behavior infrequently.

Adolescent↗
PubMed1979

The keraton. A biological unit of the epidermis.

The term keraton is proposed to denote that specific subpopulation of epidermal cells that matures to form epidermis and horny layer exclusive of other functional units within the epidermis such as melanocytes, acrosyringium, acrotrichium, Langerhans' cells, and nerves.

Epidermal Cells↗
PubMed1978

Diseases of the oral mucosa.

The dermatologist is often called upon to evaluate diseases of the oral mucosa. He should be prepared to give expert advice based on sound knowledge of oral diseases. This may be aided by biopsy study if the principles and pitfalls of obtaining and interpreting a biopsy specimen are followed. These are discussed and examples are given to illustrate some of the more common and important problems that may be encountered.

Adult↗
PubMed1978

Reticular pigmented anomaly of the flexures.

Reticular pigmented anomaly of the flexures (Dowling-Degos' anomaly) is a rare, benign, new genodermatosis that has recently evolved from independent observations and studies by several dermatologists. Because of its favorable prognosis, differentiation of this benign disorder from acanthosis nigricans, a cutaneous marker of possible or existing internal malignant disease, is highly important. Careful clinical appraisal of the eruption in correlation with the characteristic microscopic features makes the diagnosis simple and straightforward.

Humans↗