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S Suster

Publications and source records attributed to S Suster.

At least 163 records · Page 9Linked to original sources
PubMed1991

Multilocular thymic cyst: an acquired reactive process. Study of 18 cases.

The clinical and pathologic features in 18 cases of multilocular thymic cyst (MTC) of the anterior mediastinum unassociated with Hodgkin's disease or seminoma were studied. The majority of cases were asymptomatic and discovered incidentally on routine chest x-ray. Several patients presented with acute symptoms of chest pain or discomfort, sometimes associated with dyspnea. Two cases had an incidental thymoma, and two had an incidental thymic carcinoma. The main histologic features of MTC included the following: multiple cystic cavities partially lined by squamous, columnar, or cuboidal epithelium (some having features of Hassall's corpuscles); scattered nests and islands of non-neoplastic thymic tissue within the cyst walls, often continuous with the cyst lining; severe acute and chronic inflammation accompanied by fibrovascular proliferation, necrosis, hemorrhage, and cholesterol granuloma formation; and reactive lymphoid hyperplasia with prominent germinal centers. These features suggest that MTC most likely results from the cystic transformation of medullary duct epithelium-derived structures (including Hassall's corpuscles) induced by an acquired inflammatory process. The changes are similar to those sometimes seen in association with thymic Hodgkin's disease and thymic seminoma, which are also probably due to the inflammation that accompanies these tumors rather than to the tumors themselves. We believe that MTC is pathogenetically analogous to a variety of cystic conditions of the head and neck region, for which the common denominator seems to be the induction of cystic transformation in ductular epithelial formations of branchial pouch or related derivation by an acquired inflammatory process.

Adolescent↗
PubMed1990

Hamartoma of the scalp with ectopic meningothelial elements. A distinctive benign soft tissue lesion that may simulate angiosarcoma.

Five cases of a distinctive benign soft tissue lesion of the scalp in patients ranging from 4 months to 40 years of age are described. Clinically, the lesions appeared as solitary, subcutaneous nodules suggestive of a cystic vascular malformation or other benign condition. Histologically, however, the lesions were characterized by a monotonous, pseudoinfiltrative proliferation of cuboidal epithelioid cells arranged in clusters within the dermis and subcutaneous tissue in intimate association with vessels, adipose tissue, and other connective tissue elements. A prominent feature in all cases was the presence of areas simulating freely anastomosing vascular channels lined by round to spindle-shaped, slightly hyperchromatic epithelioid cells reminiscent of angiosarcoma. Immunohistochemically, these cells were negative for factor VIII-related antigen and Ulex europaeus lectin but were strongly positive with vimentin and epithelial membrane antigen antibodies, this latter being in keeping with the immunohistochemical profile of meningothelial cells. The meningothelial nature of these cells was supported by the electron microscopic demonstration in one case of cells with complex, interdigitating cytoplasmic processes that were joined by scattered cell junctions and contained abundant intracytoplasmic intermediate filaments. The intimate admixture of meningothelial elements with haphazardly arranged connective tissue elements sets these lesions apart from cutaneous meningiomas and warrants their designation as hamartomas with an ectopic meningothelial component.

Adult↗
PubMed1990

Histology of the normal thymus.

We present a review of the normal histology of the thymus, with special emphasis on the developmental, morphologic, and immunohistochemical aspects pertinent to the interpretation of thymic lesions in surgical pathology. Attention is drawn to normal variations in histology, embryonal vestiges and developmental defects, involutional and hyperplastic changes, tissue reactions to injury, and biopsy artifacts that may constitute a source of diagnostic problems.

Epithelium↗
PubMed1990

Benign mixed tumors (pleomorphic adenomas) of the breast.

Six cases of benign mixed tumors of the female breast are described. The tumors were found in three settings: (a) as a de-novo lesion arising from breast parenchyma, (b) as single or multiple nodules arising in a background of benign proliferative epithelial elements, and (c) in association with breast carcinoma. The tumors ranged from 1 to 4 cm in diameter, and were histologically characterized by the admixture in various proportions of benign glandular epithelial and myoepithelial elements and cartilaginous or myxoid components. Immunohistochemical staining supported this interpretation. One of the cases was remarkable for the presence of abundant tyrosine-like crystals, a feature described in benign mixed tumors of salivary glands. None of the tumors has recurred during a follow-up period of 1-7 years. Mixed tumors of the breast are considered to be similar to their dermal and salivary gland counterparts.

Adenoma↗
PubMed1990

Deciduosis of the appendix.

A clinicopathologic and immunohistochemical study of six cases of deciduosis of the appendix is presented. The patients were pregnant women aged 18-40 years. In four cases, the patients presented with signs and symptoms of acute appendicitis during their 26th to 31st week of pregnancy; in the other two, the lesions were discovered incidentally in appendectomy specimens obtained during cesarean section and tubal ligation at term. Histologically, the lesions were characterized by the presence of multiple, irregularly distributed submesothelial deposits of decidualized cells in the serosa of the appendix, without any associated evidence of endometriosis. By immunohistochemistry, the decidualized cells strongly labelled with vimentin antibodies, consistent with their stromal origin. In two cases, coexpression of vimentin and desmin intermediate filaments was observed, suggestive of myoid differentiation. The possible relationship of the lesions with the development of symptoms of peritoneal irritation in these patients is discussed along with a review of the literature on the abdominal complications of ectopic decidua.

Adolescent↗
PubMed1990

Morphometric analysis of germinal centers in nonthymomatous patients with myasthenia gravis.

A morphometric analysis of germinal centers (GCs) in the thymus of nonthymomatous patients with myasthenia gravis was performed in 26 patients, including 14 women and 12 men. The GCs were evaluated for number, diameter, perimeter, and cross-sectional area using a computerized interactive morphometric analysis. The GCs ranged from 2 to 19 per case, with an average diameter of 0.02 to 0.43 mm, a perimeter of 0.38 to 1.35 mm, and a cross-sectional area of 0.01 to 0.14 mm2. In thymic sections with fewer than five GCs, the GCs had a mean area of 0.05 mm2, a perimeter of 0.84 mm, and a diameter of 0.24 mm. In thymic sections containing five or more GCs, the GCs had a mean area of 0.04 mm2, a perimeter of 0.62 mm, and a diameter of 0.19 mm. The clinical improvement in these patients inversely correlated with the above parameters, with improvement being observed in patients whose GCs had a mean area of 0.02 mm2, a perimeter of 0.58 mm, and a diameter of 0.17 mm. No correlation was observed between the number of GCs and clinical improvement. The results of our study appear to indicate that computerized interactive morphometric analysis may represent a potentially useful method for the evaluation of the morphometric features of thymic GCs and their correlation with clinical outcome in patients with myasthenia gravis.

Adolescent↗
PubMed1989

Malignant fibrous histiocytoma (giant cell type) of the pancreas. A distinctive variant of osteoclast-type giant cell tumor of the pancreas.

Malignant giant cell tumors of the pancreas are rare neoplasms which have been generally thought to represent epithelial malignancies of either acinar or ductal epithelium. The authors have studied a tumor of the pancreas that was characterized histologically by a proliferation of benign-appearing osteoclast-type giant cells in association with atypical, often bizarre mononuclear cells. Immunohistochemical studies demonstrated negative staining of the tumor cells with epithelial markers, including low-molecular weight keratins, carcinoembryonic antigen and epithelial membrane antigen, and positive staining with vimentin antibodies, supporting a fibroblastic line of differentiation. Electron microscopic examination also showed absence of ultrastructural features of epithelial differentiation such as microvilli, intercellular junctions, or desmosomes. The authors believe the current case represents a true sarcoma of the pancreas, currently best classified as a malignant fibrous histiocytoma, giant cell type. This tumor should be distinguished from the epithelial type of osteoclastic giant cell tumor of the pancreas.

Aged↗
PubMed1989

Nongranulomatous involvement of the bone marrow in lepromatous leprosy.

Bone marrow involvement in lepromatous leprosy has been characterized histologically by a proliferation of foamy histiocytes containing lepra bacilli, the so-called Virchow cells. The authors have studied three patients with biopsy-proven lepromatous leprosy in whom Fite stain, performed on histologic sections of bone marrow aspirates, demonstrated numerous bacilli lying free in the interstitium in the absence of Virchow cells or focal collections of foamy macrophages. Two of the patients had a recent diagnosis of lepromatous leprosy by skin biopsy; the third patient had a 33-year history of lepromatous leprosy that had been treated. Bone marrow aspirates were performed in all three patients for evaluation of anemia. The findings indicate that the bone marrow may act as a reservoir for viable organisms in the absence of a host response in treated and untreated patients with lepromatous leprosy. The persistence of viable organisms in the bone marrow in patients with lepromatous leprosy may account for the high rate of relapse and/or recrudescence of the disease following cessation of specific therapy. Bone marrow examination with the Fite modification of the acid-fast stain is therefore indicated in such patients to evaluate bone marrow involvement and the efficacy of treatment.

Adult↗
PubMed1989

Malignant epithelioid schwannoma of the skin. A low-grade neurotropic malignant melanoma?

We studied a polypoid cutaneous neoplasm excised from the left arm of a 23-year-old man by light microscopy, immunohistochemistry, and electron microscopy. Histologically, the tumor was composed of a proliferation of round to oval epithelioid cells that were arranged in fascicles and showed a prominent perineural distribution. Immunohistochemistry revealed the presence of S-100 protein and vimentin within tumor cells. Electron microscopy demonstrated reduplication of basal lamina and abundant long-spacing collagen in intercellular spaces. The findings are consistent with a primary malignant epithelioid schwannoma of the skin. We discuss the relationship of this lesion with other neoplasms in the spectrum of tumors showing schwannian and melanocytic lines of differentiation.

Adult↗
PubMed1989

Spindle cell carcinoma of the renal pelvis. Immunohistochemical and ultrastructural study of a case demonstrating coexpression of keratin and vimentin intermediate filaments.

A carcinoma of the renal pelvis characterized histologically by a spindle cell sarcomatoid morphological growth pattern was studied by electron microscopy and immunohistochemical techniques. Ultrastructural examination revealed abundant perinuclear cytoplasmic tonofilament bundles in association with prominent rough endoplasmic reticulum. Immunohistochemical study demonstrated coexpression of keratin and vimentin, two intermediate filaments thought to be specific for epithelial and nonepithelial cells, respectively. It is proposed that the spindle transformation of the epithelial cells in such cases may be explained on the basis of the development by the tumor cells of nonepithelial characteristics, such as the expression of vimentin intermediate filaments, that may be responsible for the adoption of the morphological growth pattern characteristic of neoplasms following mesenchyme-derived lines of differentiation.

Aged↗
PubMed1989

Giant-cell neoplasm of the sphenoid sinus.

A rapidly growing giant-cell neoplasm arising in the sphenoid sinus of a 26-year-old man is reported. The patient's only initial symptoms were severe headaches and left sixth-nerve palsy. Computerized tomography of the brain showed extensive tumor infiltration of the bony structures and soft tissues of the base of the skull. A transsphenoidal surgical procedure proved unsuccessful in removing the tumor. Histologic examination revealed a proliferation of osteoclast-type giant cells against a background of highly atypical mononuclear cells, raising the question of malignancy. The differential diagnosis and problems in nomenclature of this lesion are discussed.

Adult↗
PubMed1989

Intranodal hemorrhagic spindle-cell tumor with "amianthoid" fibers. Report of six cases of a distinctive mesenchymal neoplasm of the inguinal region that simulates Kaposi's sarcoma.

We describe six cases of a distinctive spindle-cell neoplasm apparently arising from inguinal lymph nodes in adult patients. The lesions were characterized histologically by highly vascularized, interlacing fascicles of spindle cells circumscribed by an irregular band of sclerosis and hemorrhage, and surrounded by a compressed rim of lymph node remnant. A striking feature observed in all cases was the presence of stellate-shaped areas containing thick collagen fibers (so-called amianthoid fibers). Immunohistochemically, the tumor cells were positive for actin, muscle myosin, and vimentin. Electron-microscopic examination demonstrated features indicative of myofibroblastic and smooth-muscle differentiation. Follow-up has shown no evidence of recurrence or metastases. The lesions appear to represent an intranodal neoplastic proliferation of mesenchymal cells exhibiting benign biologic behavior. The inguinal location, presence of amianthoid fibers, and the striking rim of hemorrhage surrounding the spindle-cell proliferation set this tumor apart from other lesions. It is important to distinguish this entity from nodal involvement by Kaposi's sarcoma, a lesion it may closely resemble.

Adult↗
PubMed1988

Histiocytic lymphophagocytic panniculitis. An unusual extranodal presentation of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease).

A 72-year-old woman presented with the sudden onset of multiple, large, firm, subcutaneous nodules in her right arm and left thigh. Biopsy of the lesions revealed a septal and lobular panniculitis of unknown cause. The lesions regressed spontaneously without therapy over a period of a few weeks. A follow-up review of the microscopic slides from the biopsy disclosed a lymphohistiocytic and plasma cell proliferation with lymphophagocytosis by histiocytes, the characteristic morphological features of sinus histiocytosis with massive lymphadenopathy. This diagnosis was further supported by the immunocytochemical demonstration of S100 protein reactivity within the histiocytic cells. A seven-year follow-up has failed to reveal any evidence of recurrence or progression of the disease. Sinus histiocytosis with massive lymphadenopathy should be entertained in the differential diagnosis of cutaneous lesions presenting with septal and lobular panniculitis.

Aged↗
PubMed1988

Reactive histiocytic hyperplasia with hemophagocytosis in hematopoietic organs: a reevaluation of the benign hemophagocytic proliferations.

Histiocytic hyperplasia with hemophagocytosis (HHH) is a relatively rare condition that has often been mistaken for a neoplastic disorder, but which most frequently represents a secondary reactive phenomenon whose associated risk factors have not yet been clearly defined. Histologic sections of hematopoietic organs (bone marrow, lymph nodes, and spleen) from 230 consecutive adults autopsies were reviewed to identify cases of HHH and to correlate them with clinical and autopsy findings. Moderate to severe HHH was present in the bone marrow in 102 and 230 cases, in the lymph nodes in 79 of 191 cases, and in the spleens of 16 of 209 cases. Recent blood transfusions, bacterial sepsis, major surgery, underlying disseminated malignancy, Candida sepsis, and viral infection were studied as potential risk factors. Both crude and adjusted analyses indicated a strong association between recent blood transfusions and the development of HHH in the bone marrow (P less than .0001). There was a marked dose-response relationship between number of units and the risk of HHH, with an adjusted risk ratio of 59.9 for five or more units compared with no transfusions. Bacterial sepsis was also associated with a significantly increased risk of HHH in the bone marrow in both the crude and adjusted analyses (adjusted risk ratio, 4.10; P = .0002). Major surgery and viral infection were only marginally associated with an increased risk for HHH (P = .03 and P = 0.06, respectively), and underlying disseminated malignancy and Candida sepsis did not appear to contribute any risk. Analyses for HHH in lymph nodes and spleen were similar to analysis for the bone marrow, but were somewhat less marked. The results of this study suggest that reactive HHH in hematopoietic organs may be far more common than has previously been acknowledged, and is most often multifactorial rather than related to a single underlying condition, with transfusions and bacterial sepsis constituting the most significant risk factors. Therefore, reactive HHH may represent a frequent secondary phenomenon in critically ill patients undergoing transfusions and should not be mistaken for an ominous sign or for the development of a superimposed malignancy.

Aged↗
PubMed1988

Fibrous papules. A light microscopic and immunohistochemical study.

Thirty-six cases of fibrous papules of the face and nose were studied by light microscopy and by immunohistochemistry. Positive staining with antibodies to vimentin and negative staining with antibodies to S-100 protein, alpha 1-antichymotrypsin, and factor VIII-RAG of the spindle, stellate, and multinucleated cells observed in the dermis support a fibroblastic line of differentiation. Fibrous papules of the nose and face are a distinctive clinicopathologic entity that most probably represents an inflammatory rather than a neoplastic process, sharing some histologic features of angiofibromas (angiofibrosis) and perifollicular fibromas (perifollicular fibrosis).

Adult↗
PubMed1988

Granular cell leiomyosarcoma of the skin.

A case is presented of a multifocal malignant neoplasm involving the skin of the upper back in a 10-year-old boy following radiation therapy to the head and neck for a cerebellar medulloblastoma. Histologically, the neoplastic cells were remarkable for the presence of abundant periodic acid-Schiff (PAS)-positive diastase-resistant intracytoplasmic eosinophilic granules. Immunoperoxidase procedures revealed strong positive staining of the tumor cells with desmin, vimentin, and smooth muscle myosin antibodies, and negative staining for myoglobin, S-100 protein and keratin, thus supporting a smooth muscle line of differentiation for this neoplasm. Electronmicroscopy demonstrated numerous intracytoplasmic autophagic vacuoles that corresponded to the granules observed under the light microscope. Leiomyosarcoma should be entertained in the differential diagnosis of poorly differentiated cutaneous neoplasms histologically characterized by a proliferation of cells containing abundant granular eosinophilic cytoplasm.

Child↗