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Biomedical subjects

R M Austin

Publications and source records attributed to R M Austin.

At least 19 recordsLinked to original sources
PubMed1996

Transitional cell carcinoma of the endometrium.

Only one case of endometrial transitional cell carcinoma (TCC) has been previously reported in the literature. We report a second case. In both the previously reported case and in this case there was a separate focus of TCC in the adnexa. Both patients were treated with adjuvant whole pelvic radiation and are alive and without evidence of disease at 5 years and 15 months, respectively. Study of more cases of endometrial TCC is needed to determine whether this type of endometrial carcinoma has a more favorable response to radiation therapy than other types of endometrial carcinoma with extrauterine spread.

Aged↗
PubMed1995

Stereotactic core biopsy of nonpalpable breast lesions.

We report our experience with stereotactic core breast biopsies (SCBB) for mammographically suspicious, nonpalpable breast lesions. Ninety-seven patients, ages 29 to 94 (mean 57.3 years) underwent SCBB with a 14-gauge Biopty gun. A mean of 5.0 cores was taken from each lesion. Lesions were mammographically categorized by suspicion (high, > 60% chance of malignancy; intermediate, 25-60%; low, < 25%) and according to lesion character (well-defined mass, indistinct mass, spiculated mass, asymmetric density, and clustered microcalcifications [CM]). Histologic and radiographic findings were correlated at the time of biopsy and again retrospectively, with 92 percent correlation and eight percent partial or non-correlation. Of the latter, five of eight lesions represented CM not seen in the histologic samples. Of the 97 sampled lesions, 72 (74%) had been radiographically categorized as low suspicion, 10 (10%) as intermediate, and 15 (16%) as high. The procedure saved 74 women (76%) from open biopsy and added a diagnostic procedure for eight women (8%). Fifteen women (15%) went directly to mastectomy; therefore, the SCBB neither added nor saved a procedure for patients with cancer. Of the 72 lesions categorized as low suspicion, 65 (90%) were potentially saved from open biopsy, while nine of 25 lesions (36%) in the intermediate and highly suspicious groups were potentially spared a procedure. There were no false positive or negative cases among those who had an additional procedure or follow-up. The diagnoses made on SCBB included 15 carcinomas, one case each of atypical ductal and atypical lobular hyperplasia, one reactive lymph node, one intraductal papilloma, one collagenous spherulosis, one membranous fat necrosis, and numerous cases of fibrocystic change and fibroadenoma. In conclusion, we believe that this SCBB method can be an accurate and cost-effective tool in the management of these lesions.

Adult↗
PubMed1993

Opportunities for enhanced cervical and breast screening referral in Charleston County.

In order to increase awareness of the need for pap smear and mammographic cancer screening, the Professional Education Committee of the Charleston County Chapter of the American Cancer Society (ACS) separately surveyed Charleston County women and physicians regarding their use of women's cancer screening tests. Seven hundred and thirty-one women responded to a Cancer Screening Survey for Women. Women not complying with ACS guidelines for pap smears and mammography, when compared to women complying with the guidelines, were found to be twice as likely to be non-white, much more frequently lacked a regular physician or a gynecologist, more commonly lacked insurance paying at least in part for the test, and more frequently reported that physicians visited did not suggest pap smear or mammographic screening. Almost one-third of 75 responding physicians acknowledged not discussing pap smear and mammographic screening with their patients, a practice most often attributed to "specialization." Among physicians not referring women for needed mammograms or pap smears, roughly half also cited patient refusal, deferral, and oversight as reasons. The survey data suggest that a simple, practical, method is needed in doctors' offices to remind women of the need for periodic pap smear and mammographic screening, especially whenever women lacking a regular gynecologist seek any type of medical care. The authors recognize that these samples of females and physicians are not necessarily representative of those components of the Charleston area overall.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Fine-needle aspiration cytology of an endometrioid-like variant of yolk sac tumor.

A 36-year-old male with a history of immature teratoma and embryonal carcinoma of the testis was admitted to the hospital for abdominal pain and fever. A CT scan revealed a large right abdominal mass. The patient's serum alpha-fetoprotein (AFP) was 46.8 ng/ml (reference < 25 ng/ml). Fine-needle aspiration (FNA) of the mass revealed malignant glandular cells. Chemotherapy was instituted, followed by resection of the large abdominal mass. The tumor was grossly encapsulated, consisting of large areas of necrotic, hemorrhagic tissue surrounded by smaller, multiloculated cysts. Microscopically, the tumor had a villoglandular pattern and variably stratified tall columnar cells. A prominent feature of the columnar cells was supranuclear and subnuclear vacuolization. Intracytoplasmic PAS-positive, diastase-resistant hyaline globules were occasionally present. AFP by immunoperoxidase was prominent within the tumor. This recurrence of the previously diagnosed testicular teratoma with embryonal carcinoma represents a yolk sac tumor with components strongly resembling endometrioid carcinoma, a variant only recently described in eight cases of ovarian origin (Clement et al.: Am J Surg Pathol 1987; 11(10):767-778). We believe this is the first reported case of an endometrioid-like variant of testicular yolk sac tumor and also the first report of the FNA cytology findings in this variant.

Adenocarcinoma↗
PubMed1990

Multicentric adult secretory breast carcinoma: DNA flow cytometric findings, prognostic features, and review of the world literature.

A case of multicentric secretory breast carcinoma in a 39-year-old white female is described. Mammograms, DNA analysis, touch preparation cytology, and positive estrogen receptors are reported for the first time in this rare favorable mammary carcinoma. A review of the 33 reported cases with follow-up in adult females, including the present case, has revealed lymph node metastases in nine (27%), recurrence in four (12%), and distant metastases leading to death in two cases (6%). In patients treated with less than simple mastectomy there has been local recurrence in 4 (33%) of 12 cases and in three of the four cases (75%) greater than or equal to 2.0 cm. Increased size and lack of gross circumscription of the neoplasm and presentation in the adult age group appear to identify cases with an increased risk of disease progression. In patients over 20 years old, especially with neoplasms greater than 2 cm in diameter, modified radical mastectomy has to date achieved the most favorable outcome. Minimal experience (two cases) is available regarding treatment with limited surgery and radiation therapy, and there is no available data regarding possible benefit from adjuvant chemotherapy.

Adult↗
PubMed1990

Histologic sampling requirements in ovarian carcinoma: a review of 51 tumors.

In a review of 29 serous and 22 mucinous adenocarcinomas of the ovary, we quantitated the various histologic patterns seen in these neoplasms in order to document histologic variability and assess current anecdotal recommendations (one section per 1-2 cm of maximum tumor diameter) for adequate histologic sampling of epithelial ovarian neoplasms. Mucinous carcinomas showed more histologic variation than serous carcinomas, but both showed substantial portions with benign or borderline histology in many neoplasms. One serous and one mucinous carcinoma were likely to have been classified as borderline tumors if only current sampling recommendations had been followed. The remaining adenocarcinomas were adequately sampled by current standard practice. The two tumors in question had unusual clinical and histological features which prompted additional sampling. Caution is particularly warranted when initial frozen section sampling shows features of borderline tumor histology or low grade epithelial atypia, especially in mucinous epithelial neoplasms where histologic variability is greatest.

Adenocarcinoma, Mucinous↗
PubMed1988

Cholecystojejunostomy intussusception.

Intermittent prolapse of a jejunal loop into the gallbladder lumen was observed following cholecystojejunostomy in a patient with advanced carcinoma of the pancreas. This unusual complication was documented by cholangiography and sonography.

Aged↗
PubMed1987

Fibromatosis of the breast. A clinical and pathological study of 28 cases.

The clinical and pathologic findings of 28 examples of fibromatosis of the breast not involving the deep fascia or chest wall are reported. Five of the 20 lesions treated by local excision recurred. Recurrences developed within a 4 to 8 month period following surgery in four of the five instances, and 6 years after surgery in one instance. One lesion recurred five times over a period of 3 years. None of the patients died from their disease, and none developed a metastasis. Those lesions that recurred had been inadequately excised initially, since surgical margins showed fibromatosis. Specific histological features, such as size, cellularity, atypia, and mitotic figures, were not helpful in predicting recurrence. Although local excision appears to have been adequate in the majority (75%) of the patients, the infiltrative nature of fibromatosis necessitates documentation of tissue margins in order to avoid the possibility of recurrence. The differential diagnosis includes benign reactive processes (such as keloid and nodular fasciitis), fibrous histiocytoma, low-grade spindle-cell (metaplastic) carcinoma, and fibrosarcoma.

Adolescent↗
PubMed1987

Malignant Brenner tumor and transitional cell carcinoma of the ovary: a comparison.

The clinical and pathologic features of 16 malignant Brenner tumors (MBT) having an associated benign Brenner component were compared with 29 primary ovarian transitional cell carcinomas (TCC), neoplasms differing from MBT only in that a benign Brenner component was absent. Transitional cell carcinoma represented a more aggressive neoplasm. Twenty of twenty-nine (69%) presented in advanced stages (II-IV) compared with only three of sixteen (19%) MBT. Among stage IA tumors, only three of seven (43%) patients with TCC were well at last contact, compared with nine of eleven (88%) patients with Stage IA MBT. In addition to not having a benign Brenner component, TCC lacked the prominent stromal calcification common in most benign and malignant Brenner tumors. Transitional cell carcinoma is sufficiently different from MBT in that it is reasonable to suppose that ovarian TCC arises directly from pluripotential surface epithelium of the ovary and from cells with urothelial potential, rather than from a benign or proliferative Brenner tumor precursor.

Adult↗
PubMed1986

Liposarcoma of the breast: a clinicopathologic study of 20 cases.

The clinical and pathologic features of 13 patients with pure liposarcomas of the breast and seven patients with liposarcomas that had arisen in cystosarcomas are reviewed. Metastases occurred in three of the 13 patients with pure mammary liposarcomas, and two women died of tumor. One of the patients with a liposarcoma that had arisen in a cystosarcoma had a local recurrence one year after diagnosis but was subsequently lost to follow-up study. Fourteen of the 20 patients for whom follow-up information was available for as long as 14 years had no evidence of recurrence. Features associated with the development of recurrence, based on the cases studied here and previous reports, included the pleomorphic liposarcoma pattern and an infiltrative margin. Features associated with tumor-free survival included the well-differentiated liposarcoma pattern, male gender (two patients), and a circumscribed microscopic tumor margin. There were no axillary lymph node metastases. Follow-up data indicate that complete surgical excision of tumor with tumor-free margins is necessary, but total mastectomy and removal of the axillary tail are not required unless these procedures are needed for complete excision.

Adult↗
PubMed1986

Muscle anatomy of the human esophagus.

We studied the esophageal musculature of 11 cadavers to assess the distribution of striated and smooth muscle. The lower 54-62% of the esophagus was found to be exclusively smooth muscle, the proximal 4.1-5.6% to be exclusively striated, and the remainder to be mixed. The area in which striated and smooth muscle portions were approximately equal, the 50/50 point, was found to be 4.7 +/- 0.6 cm from the proximal portion of the cricopharyngeus muscle. This point corresponds to the previously described physiologic low pressure zone in the proximal esophagus.

Adult↗