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T A Bonfiglio

Publications and source records attributed to T A Bonfiglio.

At least 37 records · Page 2Linked to original sources
PubMed1987

Granulomatous pseudotumors in total joint replacement.

Fourteen patients (15 joints) developed a foreign body reaction to methylmethacrylate, polyethylene, or metal adjacent to a total joint implant, a condition we would like to term granulomatous pseudotumors. There were eight male and six female patients. Their average age was 61 years. The hip was involved in 14 joints (femoral component 11 times, acetabulum 7, and greater trochanter once). One patient presented with granulomatous pseudotumors of the knee. The principal findings included increasing pain and radiographic evidence of loosening occurring on average 2.7 years following the implant. This was followed by a characteristic and gradually developing radiographic pattern of discrete rounded lucencies. These developed into large ovoid lytic areas, destroying both methylmethacrylate and bone. Histologically, the appearances were characterized by histiocytic infiltration and the presence of multiple foreign body giant cells. Foreign material was identified in 9 of 11 cases. The pathogenesis is unknown but appears related to micromovement or loosening of the implant.

Female↗
PubMed1986

The pathology of vulvar squamous cell carcinoma and verrucous carcinoma.

Squamous cell carcinoma is far more common than verrucous carcinoma in the vulva. The clinical and morphologic distinctions between these neoplasms are important to understand because of their contrasting biologic behavior and treatment. Both cancers present with symptoms of pruritus and a noticeable mass. On examination, both tumors commonly occur on the labia and are exophytic. If infection occurs in association with verrucous carcinoma, the resulting induration of the surrounding tissue as well as reactive regional lymph node enlargement may fool the clinician into making an erroneous diagnosis of advanced squamous cell carcinoma. In the 33 percent of cases in which a squamous cell carcinoma is flat and ulcerated, the gross distinction from verrucous carcinoma is easy to perceive. The microscopic analysis of squamous cell carcinomas should specify the neoplastic thickness, depth of stromal invasion, and presence or absence of lymphatic invasion since these parameters are important in predicting the probability of lymph node metastases in superficially invasive cancers. Verrucous carcinomas are thick neoplasms which may invade and compress the underlying stroma with "pushing" margins. It is therefore crucial to recognize the microscopic features of this well-differentiated squamous neoplasm in order not to mistake it for a squamous cell carcinoma which has the capacity to metastasize to inguinal lymph nodes. Human papilloma virus has been implicated in the development of both of these tumors. The treatment for verrucous carcinoma is wide local excision. Because recurrence may occur if the surgical resection margins are involved by the neoplasm, the pathologist must carefully evaluate these margins. It is important to note that recurrence of verrucous carcinoma connotes a poor prognosis. The treatment of a squamous cell carcinoma which is thicker than 2 mm or has a stromal invasion depth of more than 1 mm is vulvectomy and bilateral lymph node dissection. If the neoplasm is less than 2 mm in thickness, regional lymph node metastases have not been reported and lymph node dissection may not be necessary. The best treatment option is wide local excision and close follow-up. As our understanding of superficially invasive vulvar squamous cell carcinoma continues to evolve, however, these recommendations may change.

Carcinoma, Papillary↗
PubMed1984

Selectivity for ovarian cancer of an improved serum radioimmunoassay for human ovarian tumor-associated antigen NB/70K.

An improved NB/70K assay which can be used to reproducibly and accurately measure the NB/70K content of unextracted serum samples has been developed. Analysis of pretreatment serum samples has indicated that the NB/70K assay shows selectivity for ovarian cancer with respect to nonmalignant ovarian cysts and tumors as well as controls; if one considers 10 units of NB/70K as a significant level of antigen, then there are no false positives in the benign and control groups, while 10 of 21 in the ovarian cancer group have significant NB/70K levels. When NB/70K levels of ovarian cancer patients are compared to those of patients with non-ovarian malignant disease, only 4 of 23 patients with non-ovarian cancers had significantly elevated NB/70K levels. However, none of these 4 false positives had levels greater than 20 units.

Animals↗
PubMed1984

Effect of estrogen and progesterone on the development of endometrial hyperplasia in the Fischer rat.

The effect of changing endocrine status on the uterine endometrium of the female Fischer rat was observed in vivo after neonatal androgenization, after aging, after estrogen (E) implant in ovariectomized (OVX) rats, and in vitro after progesterone (P) addition to monolayer cultures of uterine tumor cells. Neonatal androgenization produced cystic ovarian follicles and persistent vaginal cornification for 10-14 mo, indicative of an anovulatory, persistent E status. The constant estrous (CE) state, induced by androgenization, uniformly produced focal glandular hyperplasia of the endometrium at 9 mo of age. Focal glandular hyperplasia, which was absent in the cycling 6-mo-old estrous endometrium, was also apparent in the 12-mo-old rats which had ceased cycling and entered natural CE. Subcutaneous estradiol-17 beta (E2) implants in 12-mo-old OVX rats induced early cystic and adenomatous changes in the foci of hyperplasia. Acyclic control rats, 21 mo old, in persistent diestrus (PD) exhibited a 3-fold elevation of serum P associated with glandular atrophy of the endometrium. Ten nM P also inhibited proliferation of endometrial cells in cultures prepared from tumors of 21-mo-old rats. On the other hand, adenomatous hyperplasia was observed in 29-mo-old PD rats, despite the presence of low serum E and elevated serum P. These results indicate that either induced or natural constant E status leads to focal glandular hyperplasia in the Fischer rat. E2 implants in the 12-mo-old OVX Fischer rat induced early cystic and adenomatous changes in the focal hyperplasia. Inhibition of these focal hyperplasias was associated with elevated serum P at 21 mo. The development of adenomatous hyperplasia in the aged endometrium, on the other hand, occurred despite elevated serum P at 29 mo.

Aging↗
PubMed1984

Follicular phase treatment of luteal phase defect with follicle-stimulating hormone in infertile women.

Fifteen infertile women diagnosed by endometrial dating to have a luteal phase defect were treated with human pituitary follicle-stimulating hormone (hFSH) for 45 cycles. Human follicle-stimulating hormone was administered intramuscularly in a dose of 50 IU/day (group 1) for 35 cycles and 100 IU/day (group 2) for ten cycles from either the third or fifth day of the cycle for five days. Plasma estrogen was measured daily during drug injection. Plasma progesterone was measured on the fourth, seventh, and tenth days after ovulation by basal body temperature during 11 pretreatment control cycles and 39 treatment cycles. Endometrial biopsies were performed on the seventh day after ovulation. The daily estrogen levels increased gradually during hFSH treatment. There was no significant difference between the two dosage groups. The mean progesterone levels were: 1) significantly (P less than .02) greater in the treatment cycles than in the control cycles, 2) significantly (P less than .05) greater in the pregnancy cycles than in the nonpregnancy cycles, 3) significantly (P less than .01) greater in the cycles with normal endometrial dating than in the cycles with abnormal endometrial dating after treatment, and 4) significantly (P less than .05) greater in group 1 than in group 2. After treatment, the endometrial biopsy specimens were improved to normal in 20 of 38 cycles. Five patients became pregnant during the treatment. The authors have concluded that hFSH may be useful in treatment of luteal phase defect.

Adult↗
PubMed1984

The pathology of superficially invasive, thin vulvar squamous cell carcinoma.

Thirty-six cases of vulvar squamous cell carcinoma 5 mm or less in thickness were studied, and potential predictors of lymph node metastases were evaluated. Tumor thickness and depth of stromal invasion were measured. Inguinal lymph node metastases were present in six (17%) cases, all of which had primary neoplasms more than 3 mm thick. The most superficial lesion to have lymph node metastasis was 3.2 mm thick and had 1.6 mm of stromal invasion. Nonetheless, depth of stromal invasion of less than 3 mm was associated with statistically fewer lymph node metastases (7%) than that of neoplasms with 3 mm or more of stromal invasion (50%). Although lymphatic or blood capillary invasion was present in four (11%) cases, this feature had no statistically significant association with lymph node metastasis. There was no relationship between clinical stage, surface diameter, or histological grade of the lesion and lymph node metastasis. A significant percentage of cases had either carcinoma in situ (31%) or atypical hypertrophic dystrophy (19%) in the epithelium adjacent to the infiltrating carcinoma. Koilocytotic atypia suggestive of human papilloma virus infection was present in the adjacent epithelium in 47% of the cases. This study suggests that thickness of the neoplasm is a valid predictor for the presence or absence of lymph node metastasis in vulvar squamous cell carcinoma; it may be more useful than neoplastic depth of invasion in this regard.

Carcinoma in Situ↗
PubMed1983

Cervical conization: when is uterine dilatation and curettage also indicated?

Although the primary goal of cervical cone biopsy is treatment of cervical intraepithelial neoplasia, conization plus uterine dilatation and curettage is usually considered as a single, standard procedure. We reviewed 128 cone biopsies (114 of these procedures included dilatation and curettage) over a 3-year period to see whether dilatation and curettage was necessary as an accompaniment to conization. The mean age for all patients was 32.8 years, and 6.25% (eight patients) had a history of abnormal uterine bleeding. There was no evidence of endometrial abnormality in any of the 114 dilatation and curettage specimens. These findings suggest that dilatation and curettage is not warranted as a routine adjunct to cone biopsy. We believe more precise criteria for combining dilatation and curettage with conization are required, and these include: patients in the peri- or postmenopausal period, suspected intrauterine abnormalities, and the presence of abnormal glandular cells in a cytologic sample. With the use of these guidelines, only 18 patients (14%) would have required dilatation and curettage.

Adolescent↗
PubMed1983

An atypical subcutaneous infection associated with acquired immune deficiency syndrome.

Cases of acquired immune deficiency syndrome (AIDS) continue to be reported at an alarming rate. As the numbers of cases increase, so too does the list of unusual manifestations associated with this syndrome. We report here a patient with AIDS who, during his clinical course, had a previously undescribed, histologically atypical, subcutaneous infection develop. Light microscopic, electron microscopic, and microbiologic data are presented. The cause and pathogenesis of this lesion are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Fine needle aspiration cytopathology of bronchial carcinoid tumors: an analytical study of the cells.

While frequently considered to originate in a common stem-cell of neuroendocrine origin, bronchial carcinoid tumors and small-cell anaplastic carcinomas differ significantly in their biologic potential and treatment. Patient management is often dependent on the diagnostic specificity of a pulmonary fine needle aspiration specimen. This study evaluated the cellular features in fine needle aspiration samples from seven bronchial carcinoid tumors and four small-cell anaplastic carcinomas of the "intermediate" type. Planimetric measurements were performed on tracings of 1,100 cells. An analysis of specific cytoplasmic and nuclear features was also obtained on 2,200 cells. Significant quantitative and qualitative differences in the cytomorphology of the cells derived from bronchial carcinoid and small-cell anaplastic neoplasms were obtained, clearly demonstrating that differentiation of these neoplasms is possible on a cytopathologic basis in fine needle aspiration samples.

Biopsy, Needle↗
PubMed1981

Fine needle aspiration biopsy of the lung.

Fine needle biopsy provides a highly accurate diagnostic method which can be performed rapidly with minimal risk. It provides a definitive diagnosis in most patients at low cost with minimal trauma. Patients at poor surgical risk are saved a thoracotomy in many instances. Patients who are clinically inoperable can receive appropriate chemotherapy and radiotherapy without major surgery done solely for diagnostic purposes. In comparative studies, this technique has generally been reported to be superior to bronchoscopic biopsy and sputum cytology in the diagnosis of radiologically evident lung lesions. In screening patients, sputum cytology remains the method of choice and is essentially the only method of diagnosing early lesions not seen radiologically. Bronchial brush biopsy, another technique of great value, is particularly useful in the diagnosis of central bronchial lesions. Appropriate utilization of these three cytologic sampling procedures provides for the highest degree of accuracy in the diagnosis of pulmonary disease with minimum risk to the patient.

Adenocarcinoma↗
PubMed1980

The pathology of breast cancer in women irradiated for acute postpartum mastitis.

The gross and microscopic pathology of breast cancers in women irradiated for acute postpartum mastitis was compared to the breast cancers found in the sisters of the irradiated women. Fifty-one cancers in 50 irradiated women and 25 cancers in 24 nonirradiated women were examined. In considering the lesions in the two populations, the size, location, histologic type, histologic grade, inflammatory response, lymphatic and blood vascular invasion, nipple involvement, axillary lymph node metastases, and menopausal status at the time of diagnosis were statistically indistinguishable. The only parameter that was different in the two populations was the desmoplastic response to the malignant lesion (P = 0.04). The control population had more marked fibrosis within the cancers compared with the irradiated women. With the exception of stromal response, this study shows that breast cancer in irradiated women is similar in the parameters evaluated to breast cancer in a control population.

Acute Disease↗
PubMed1979

Technical considerations of interventional radiology. Unit design and coordination of diagnostic pathology services.

With close cooperation between the clinician, radiologist, and pathologist, and with exacting attention to detail, the combined techniques of interventional radiology and diagnostic cytopathology can provide a definitive diagnosis in a large variety of clinical situations. Undoubtedly, the increasing interest in utilization of these methods will expand the number of patients who can benefit from these rapid, safe, relatively inexpensive, and highly accurate diagnostic techniques.

Biopsy, Needle↗
PubMed1978

The management of clinical stage I endometrial carcinoma.

A retrospective analyses of 307 cases with clinical Stage I endometrial carcinoma was done in an attempt to determine the role of radiation therapy in the optimal treatment of this disease. A review of the modern literature with over 9000 cases served as a useful tool to corroborate inferences and conclusions. The present series has 155 patients (51%) treated with preoperative megavoltage external pelvic radiation with a variation in doses of less than 6%. Five-year survival estimates (79%-83%) in clinical Stage I endometrial carcinoma are similar among the several main treatment combination that are employed; they become a useless parameter for any comparison. The pelvic failure rate constitutes a more useful guideline in assessing the most adequate therapy. The pathologic grade of the tumor is the main prognosticator in endometrial carcinoma. Intimately related to the tumor grade is the depth of myometrial invasion of the carcinoma. The size of the uterus and/or its cavity carry less prognostic significance than traditionally thought. For grade I lesions, there is little error in diagnosis, few pelvic failures and excellent survival (96%); they could be approached with initial surgery and postoperative radiation reserved for selected patients. For grade 2 tumors, the error in diagnosis and the failure rate increases with an overall survival of 87%. For grade 3 tumors, the error in diagnosis and failure rates are quite high with a 5 year survival of only 70%. Preoperative radiation, especially external beam therapy, is suggested for grades 2 and 3 Stage I tumors. The use of this treatment modality yields only 3% pelvic failure and an overall 5 year survival of almost 90%.

Carcinoma↗
PubMed1977

Adenosquamous carcinoma of the endometrium. An entity with an inherent poor prognosis?

Mixed adenosquamous carcinoma of the endometrium have been reported in recent years to have a steady increase in incidence, extreme aggressiveness, poor responses to radiation therapy, and a low five-year survival (less than 20%). In the present report, 87 mixed carcinoma (MC) are compared with 260 pure adenocarcinomas (AC) and 29 adenoacanthomas (AA). There were no basic differences in incidence, clinical history, responses to radiation therapy, and prognosis for any of these three entities. Adenocarcinomas of the endometrium with and without squamous elements should be regarded and approached as any pure AC. There is an overall tendency for endometrial carcinomas to be at an early stage at diagnosis and the five-year survival regardless of pathologic type, stage, grade, myometrial invasion, and therapy is 80%.

Adenocarcinoma↗