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Biomedical subjects

S F Cramer

Publications and source records attributed to S F Cramer.

At least 73 records · Page 4Linked to original sources
PubMed1982

Sequential histologic study of evolving lentigo maligna melanoma.

Malignant melanoma has been thought to evolve from junctional proliferation of atypical melanocytes, through a stage characterized by large junctional nests, into an invasive an ultimately metastasizing neoplasm. Sequential histologic study of a case of lentigo maligna melanoma suggested that the tumor progressed by development of more aggressive lesions in adjacent skin, rather than by evolution of preexisting lower-grade lesions. The higher grade of the later-developing lesions may result from greater exposure to carcinogens, perhaps by virtue of greater solar exposure prior to onset. Neural factors may be responsible for the progressive development of multi-centric lesions within a restricted region of skin (field effect). We recommend investigation of neurogenic influences in human melanoma, particularly with regard to the role of nerve growth factor.

Female↗
PubMed1981

The cellular basis of metastatic bone disease in patients with lung cancer.

Histologic patterns of tumor-bone interaction were systematically evaluated in 80 cases of metastatic lung cancer involving bone. Patterns of tumor-bone interaction varied with the histologic type of lung cancer, reflecting the biochemical and biologic differences among the different types of lung cancer. Evidence presented here suggests that destruction of bone by metastatic lung cancer is mediated neither by direct contact of tumor cells with bone matrix nor by release of diffusible substances that lyse bone matrix. Among indirect mechanisms, the most prevalent and important was the activation of bone-lining cells by metastatic tumor. Epidermoid carcinomas in particular were associated with histologic patterns of classical bone remodelling, including osteoblastic, osteoclastic, and osteocytic activity. Adenocarcinomas showed a particularly high association with microfractures and manifested a stromal pattern consistent with release of prostaglandins. Ischemic necrosis of bone due to compression of vessels by expanding tumor mass is also a common and important mechanism. Correlation of histologic patterns with reported data on the frequency of metastases and syndromes of ectopic hormone production provides insight into the mechanism(s) of paraneoplastic hypercalcemia in patients with lung cancer.

Adenocarcinoma↗
PubMed1981

Fibrodysplasia ossificans progressiva: a distinctive bone-forming lesion of the soft tissue.

A 3-month-old white female presented with a bone-forming lesion of the soft tissue of the left cheek. Skeletal survey revealed numerous associated radiographic abnormalities, predominantly involving the phalanges. Mineral metabolism and endocrine function were within normal limits. Multiple operations were performed over a 17-year period for palliation of sequelae arising from inability to open the mouth due to ankylosis of the temporomandibular joint by the progressively ossifying lesion. Histologically, the pathologic material had features resembling those of periosteal grafts, with all stages of membranous bone formation and a tendency for more mature lesions later in the course. .The clinico-pathologic features are those of fibrodysplasia ossificans progressiva (FOP). The differential diagnosis of this rare condition from other bone-forming lesions of the soft tissue such as myositis ossificans, extra-skeletal osteosarcoma and osseous metaplasia is discussed.

Bone Neoplasms↗
PubMed1981

Invasive carcinoma of the renal pelvis following cyclophosphamide therapy for nonmalignant disease.

A 47-year-old woman with right hydroureteronephrosis due to ureterovesical junction obstruction had gross hematuria after being treated for five years wtih cyclophosphamide for cerebral vasculitis. A right nephroureterectomy was required for control of bleeding. The pathology specimen contained clinically occult invasive carcinoma of the renal pelvis. Although the ability of cyclophosphamide to cause hemorrhagic cystitis and urine cytologic abnormalities indistinguishable from high grade carcinoma is well known, it is less widely appreciated that it is also associated with carcinoma of the urinary tract. Twenty carcinomas of the urinary bladder and one carcinoma of the prostate have been reported in association with its use. The present case is the first carcinoma of the renal pelvis reported in association with cyclophosphamide treatment. It is the third urinary tract cancer reported in association with cyclophosphamide treatment for nonmalignant disease. The association of the tumor with preexisting hydroureteronephrosis suggests that stasis prolonged and intensified exposure of upper urinary tract epithelium to cyclophosphamide. Patients who are candidates for long-term cyclophosphamide treatment should be routinely evaluated for obstructive uropathy.

Cyclophosphamide↗
PubMed1981

Neurosecretory granules in small cell invasive carcinoma of the urinary bladder.

A 69-year-old man showed symptoms of urinary bladder irritability and hematuria. Cystoscopy and radiographic studies revealed a tumor within a bladder diverticulum. The tumor shared histologic and ultrastructural features with oat cell carcinoma of the lung, including the presence of small numbers of neurosecretory type granules. In spite of conservative surgical treatment, there has been no evidence of recurrent or metastatic tumor over 14 months of follow-up. Hypophosphatemia was present preoperatively, but resolved spontaneously after tumor resection. In regard to histogenesis, a metaplastic origin is favored. This appears to be the first reported case of a neoplasm of Kultschitzky-type cells arising in the urinary bladder.

Aged↗
PubMed1981

Eosinophilic fasciitis: clinical, laboratory, and microscopic considerations.

Two patients with clinical and pathologic features of eosinophilic fasciitis manifested serologic and systemic abnormalities that raised the question of the fundamental nature and relationship of eosinophilic fasciitis to scleroderma. In addition to the characteristic features of eosinophilic fasciitis, both patients exhibited arthritis, a predominantly mononuclear cell infiltration of muscles with normal serum muscle enzyme levels, weakly positive serum antinuclear factor, IgA deficiency, and abnormalities of pulmonary function. In addition, one patient had wide-mouthed colonic diverticulae and synovial deposits consistent with amyloid; the second patient had bone marrow hypoplasia. Although corticosteroid therapy was of benefit, hydroxychloroquine and potassium para-aminobenzoate were of further help in controlling the disorder. Biopsies from the two patients revealed inflammatory lesions to be heaviest deep in the skeletal muscle; fascia was only minimally inflamed with mild fibrosis. The findings suggest that striking fibroinflammatory lesions noted in the fascia in some patients with eosinophilic fasciitis may derive largely from spillover of lesions in neighboring skeletal muscle.

Adult↗
PubMed1981

Subungual keratoacanthoma. A benign bone-eroding neoplasm of the distal phalanx.

Subungual keratoacanthoma is a benign tumor of the fingers and toes that can simulate malignancy and present significant diagnostic problems for both the clinician and the pathologist. It is a rapidly growing nail-eroding tumor that may cause pain, swelling, and inflammation. Radiographs consistently demonstrate a lytic cup-shaped lesion of the tip of the distal phalanx, raising the question of malignancy. Because the lesion lacks the clinical appearance of keratoacanthoma of follicular origin, the diagnosis of keratoacanthoma may not be given clinical consideration. However, the histologic appearance of a central cavity filled with keratinous debris and lined by intensely keratinized, well-differentiated neoplastic squamous epithelium mimics the appearance of keratoacanthoma of follicular origin. The subungual location of the tumor, rapid growth with pressure erosion of the tip of the distal phalanx, and typical histologic features define this keratoacanthoma of nail matrix origin as a distinct entity. Recognition of the entity is crucial if the diagnosis of squamous cell carcinoma, which would lead to an unnecessary amputation, is to be avoided. Ultrastructurally, the keratinization process resembles that of normal nail matrix.

Fingers↗
PubMed1981

Benign glandular inclusion in prostatic nerve.

A benign prostate gland containing corpora amylacea within its lumen was observed within a prostatic nerve in the subcapsular region of a radical prostatectomy specimen. It was cytohistologically distinct from the focal high-grade periurethral prostate cancer, from which it was separated by a distance of 2 cm. Perineural invasion represents an intimate neural-epithelial interaction, and evidence is presented to support the notion that nerves may play an active role in the development of such relationships. Nerve growth factors produced by neoplastic tissue may mediate this phenomenon.

Adenocarcinoma↗
PubMed1981

Squamous cell carcinoma arising in a linear epidermal nevus.

An isolated, pruritic lesion developed in the right breast of a 17-year-old girl during a period of four months. The lesion was well circumscribed, erythematous, indurated, and markedly hyperkeratotic in the center. The histologic diagnosis was well-differentiated squamous cell carcinoma arising in a linear epidermal nevus. The development of squamous cell carcinoma in a linear epidermal nevus is a rare event, previously reported only in long-standing, extensive lesions of middle-aged to elderly patients. This case seems to be unique in regard to the patient's young age, the short duration of the nevus, and the lack of identifiable predisposing factors.

Adolescent↗
PubMed1980

Squamous cell carcinoma arising in pemphigus vulgaris during immunosuppressive therapy.

A rapidly growing squamous cell carcinoma developed in an area of active pemphigus vulgaris on the cheek of a 45-year-old woman during treatment with prednisone and cyclophosphamide. This is the first reported case of this phenomenon. The roles of solar and drug carcinogenesis, autoimmunity, and immunosuppression in the pathogenesis of this tumor are discussed.

Adult↗
PubMed1980

Sebaceous differentiation in adenoid cystic carcinoma of the parotid gland.

The first reported case of sebaceous differentiation in adenoid cystic carcinoma is presented. The tumor arose in the superficial lobe of the left parotid gland of a 48-year-old white man, had a predominantly solid histologic pattern, and manifested focal sebaceous differentiation in each of three recurrences over a two-year period. Review of the medical literature suggests that sebaceous differentiation is a normal property of some salivary ducts and may be found in any type of salivary gland neoplasm which has a ductal component. The differential diagnosis of sebaceous and clear cell lesions of salivary glands is discussed.

Ameloblastoma↗
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↗
PubMed1979

Amylase-producing ovarian neoplasm with pseudo-Meigs' syndrome and elevated pleural fluid amylase: case report and ultrastructure.

Elevated amylase activity was noted in the pleural effusion of a patient who was later found to have a stage I low-grade serous papillary ovarian neoplasm. The effusion resolved spontaneously after resection of the ovarian tumor, which contained large amounts of amylase activity. The ultrastructure of the tumor epithelium resembled that of normal salpinx. Secretory-type cells were present with apical, variably electron-dense secretory granules and cytoplasmic glycogen deposits. Amylase activity in the ovarian neoplasm probably resulted from the presence of functioning endosalpingeal-type epithelium in the tumor. In cases of effusion with unexplained amylase elevations, the possibility of serous ovarian neoplasia should be considered, even in the absence of demonstrable extra-ovarian dissemination.

Amylases↗
PubMed1979

Nerve growth factor in medullary carcinoma of the thyroid.

In a case of medullary carcinoma of the thyroid gland assay was performed for nerve growth factor bioactivity. The tumor extract showed significant amounts of nerve growth factor bioactivity, but extracts of normal thyroid and other types of thyroid neoplasms showed no such bioactivity. Nerve growth factor may be useful as a tumor marker in the diagnosis and management of medullary carcinoma of the thyroid. It may play a role in the development of associated tumors of neural crest origin and may contribute to the development of cachexia in patients with medullary carcinoma of the thyroid.

Adult↗