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Biomedical subjects

T V Colby

Publications and source records attributed to T V Colby.

At least 181 records · Page 10Linked to original sources
PubMed1988

Malignant mesothelioma of the pleura.

Malignant mesothelioma of the pleura most commonly occurs in persons with a heavy occupational exposure to asbestos. Some patients, however, have no such history of exposure. Clinical features include initial complaints of nonpleuritic chest pain and dyspnea. The most frequent roentgenographic finding is a unilateral pleural effusion. Thrombocytosis and elevated erythrocyte sedimentation rates are common. Pleural effusions are typically exudates, are often hemorrhagic, and are usually insufficient for diagnosing mesothelioma based on cytology alone. Even pleural biopsy may not produce enough tissue to enable the pathologist to make a firm diagnosis. Thoracotomy and open biopsy will confirm the diagnosis in most cases. Pathologic distinction from metastatic adenocarcinoma may be difficult even after the use of special stains and electron microscopy. Clinical deterioration is primarily attributable to local spread of tumor. Several factors seem to predict prolonged survival: (1) epithelial histologic subtype, (2) performance score, (3) age of the patient at the time of diagnosis, and (4) absence of chest pain. Surgical treatment, chemotherapy, and irradiation, alone or in combination, have been used for malignant mesothelioma. Except for the palliative effect of irradiation, most treatment protocols have not altered the dismal median survival of approximately 11 months seen in untreated patients with malignant mesothelioma.

Adenocarcinoma↗
PubMed1988

Pulmonary histology for the surgical pathologist.

This is a review of the variety of pulmonary histologic artifacts and incidental findings that may come to the attention of the surgical pathologist. In some cases, these may lead to an erroneous diagnosis; in others, they may obscure the diagnosis. The following groups of lesions are discussed: artifacts seen in biopsy and resection material, site-specific changes commonly encountered, incidental findings and structures seen in biopsy and resection material, and age-related changes. A short review of normal histology is included for perspective and a discussion of the abnormal biopsy that appears normal on first review is presented.

Aging↗
PubMed1988

Histologic diagnosis of extrinsic allergic alveolitis.

Twenty-seven patients with open-lung biopsy findings consistent with extrinsic allergic alveolitis (hypersensitivity pneumonitis) were studied. In only one case had the diagnosis been considered prior to the biopsy. Among the 27 patients, a causative exposure was subsequently identified in 10, and no apparent cause could be found in the remaining 17. The prognosis for the entire group was good; all 10 patients in whom an exposure was found and 13 of 17 without causative exposure are alive without progressive lung disease.

Alveolitis, Extrinsic Allergic↗
PubMed1988

Pulmonary veno-occlusive disease associated with severe reduction of single-breath carbon monoxide diffusing capacity.

A 49-year-old woman presented with pulmonary hypertension, profound arterial hypoxemia, and a single-breath carbon monoxide diffusing capacity (DLCO) which was 17% of predicted. History, physical examination, and chest roentgenograms did not suggest the presence of parenchymal pulmonary disease. Spirometry and lung volume measurements were within normal limits. Pulmonary veno-occlusive disease was diagnosed by lung biopsy. This case illustrates the severe reduction of DLCO which can be associated with pulmonary veno-occlusive disease.

Carbon Monoxide↗
PubMed1988

Lung biopsy in chronic lymphocytic leukemia.

Nine patients with chronic lymphocytic leukemia (CLL), with pulmonary involvement confirmed by biopsy, presented with progressive cough and/or shortness of breath and had interstitial infiltrates on chest radiographs. Biopsies showed a dense lymphocytic infiltrate that followed bronchovascular bundles. We considered CLL the predominant finding, and the cause of the patient's pulmonary disease, in eight cases; in one, a histologically nonspecific organizing pneumonia was the main lesion and CLL was an incidental finding. Culture results were available in six cases and were negative except in one case with presumed contaminants. A granulomatous reaction was present in five cases and was necrotizing in two, although culture results were negative. The only case with a recognizable organism had noninvasive fungal hyphae growing in many of the small airways. All of the patients' respiratory symptoms improved after chemotherapy and/or steroid therapy, and the chest radiographs also showed clearing.

Aspergillus↗
PubMed1987

Bladder outlet obstruction by so-called lymphomatoid granulomatosis (angiocentric lymphoma).

Lymphomatoid granulomatosis is an angiocentric, lymphoproliferative disease of the lung, which frequently involves extrapulmonary sites. Controversy persists over whether this process represents malignant lymphoma from its inception. Historically, the disease generally carries a poor prognosis but aggressive chemotherapy has resulted in improved survival. We describe a patient who presented with bladder outlet obstruction resulting from prostatic infiltration by this angiocentric lymphoproliferative disease. The clinical manifestations, pathological appearance and therapeutic options are reviewed.

Aged↗
PubMed1987

Current concepts in the surgical pathology of pulmonary infections.

Among patients with pulmonary infections, those who are immunosuppressed and have pulmonary infiltrates continue to be the most numerous coming to biopsy and present the greatest diagnostic challenge to the surgical pathologist. These are the cases in which immunodiagnostic methods and DNA probes are immediately beneficial. Enthusiasm for application of these new methods for the recognition of infectious agents must be tempered by careful clinicopathologic correlation, since more sensitive methods are likely to pick up more bystander organisms and polymicrobial processes. Nevertheless, the development of organism-specific visualization reagents remains one of the most exciting areas in pathology.

Antibodies, Monoclonal↗
PubMed1987

Simultaneous cytomegalovirus and herpes simplex virus pneumonia.

A 35-year-old patient who underwent renal transplant developed persistent fever, hypoxemia, and diffuse interstitial pulmonary infiltrates one month after allograft implantation. An open lung biopsy specimen demonstrated simultaneous infection with cytomegalovirus and herpes simplex virus type 1. This initially was unsuspected on routine histology, but was confirmed by the demonstration of both viruses with immunofluorescence, as well as the timely recovery in culture of both. The clinical and pathologic implications of an accurate diagnosis of such a simultaneous infection are discussed.

Adult↗
PubMed1987

Pulmonary histiocytosis X and carcinoma.

Four patients who developed both pulmonary histiocytosis X and carcinoma of the lung are described. Some authors have hypothesized that patients with pulmonary histiocytosis X-associated scarring are also at increased risk of developing lung carcinoma. However, case reports of this phenomenon are rare. The cases presently reported may support this hypothesis, although additional factors, such as cigarette smoking, may better explain the association.

Adenocarcinoma↗
PubMed1987

Progressive systemic sclerosis associated with exposure to trichloroethylene.

Trichloroethylene (CHCL = CCL2) is a colorless aliphatic organic solvent with both historical use in medicine as an anesthetic agent and current use in industry as a degreasing agent. Although neither the etiology nor pathogenesis of progressive systemic sclerosis (scleroderma) has been established, this disease has been associated with a wide variety of seemingly unrelated compounds, including exposure to organic solvents. The authors describe a 47-year-old woman with previous excellent health who developed fatal progressive systemic sclerosis after a single 2.5-hour predominantly dermal exposure to trichloroethylene. During a period of 10 months the patient developed proximal scleroderma, reflux esophagitis, microangiopathic hemolytic anemia, restrictive pulmonary disease, pericarditis with effusion, and renal insufficiency with severe hypertension. Renal and skin biopsies were consistent with progressive systemic sclerosis.

Female↗
PubMed1986

Bronchiolocentric chronic lymphocytic leukemia.

Three patients presented with symptoms of severe dyspnea, radiologic evidence of bilateral pulmonary infiltrates, and one had diffuse wheezing on auscultation. Open-lung biopsies revealed a neoplastic lymphocytic infiltrate in an exquisitely bronchiolocentric distribution with relative sparing of the rest of the lung parenchyma. Two patients had a history of chronic lymphocytic leukemia (CLL), whereas pulmonary disease was the initial manifestation of the lymphoproliferative disorder in the third. Clinical and pathologic features of the three cases are discussed.

Aged↗
PubMed1986

Primary pulmonary Hodgkin's disease. A clinicopathologic study of 15 cases.

Fifteen cases of primary pulmonary Hodgkin's disease are reported. This presentation of Hodgkin's disease occurred more frequently in women (2:1) and older individuals, and B symptoms were relatively common (7 of 13). The majority of patients had nodular lesions on chest radiographs. An unfavorable prognosis was linked to B symptoms, older age (greater than 60 years) and multiplicity and bilaterality of lung lesions. The histologic differential diagnosis is discussed, particularly in regard to Wegener's granulomatosis and non-Hodgkin's lymphomas.

Adult↗
PubMed1986

Systemic absorption of gallbladder sclerosing agents in the rabbit. A preliminary study.

The absorbed levels of ethanol or tetracycline, used as gallbladder sclerosing agents, were measured in the systemic blood circulation of 16 rabbits. The maximal systemic level of ethanol was 46 mg/dl and of tetracycline was 4.6 micrograms/ml after 30 minutes of gallbladder exposure. Comparable serum levels would be considered nontoxic in humans. As a gallbladder sclerosing agent, tetracycline (50 mg/cc) was slightly more effective than 95% ethanol exposed for either 15 or 30 minutes.

Animals↗
PubMed1986

New concepts in the non-Hodgkin lymphomas: radiologic implications.

Non-Hodgkin lymphomas are a heterogeneous group of neoplasms believed to be derived in the majority of cases from a common ancestor, the lymphocyte. The clinical and radiologic implications of the newer concepts in the classification, staging, and treatment of these neoplasms form the basis for this review. The disease course, staging requirements, and treatment strategies are determined by histologic classification, prognostic grade of the tumor, disease presentation in a nodal or extranodal site, and clinical stage. The unique and common radiologic features of these neoplasms are reviewed in each of the major anatomic regions of the body.

Abdominal Neoplasms↗
PubMed1986

Pleural lipoma. Diagnosis by computed tomography.

Until recently, a definitive diagnosis of lipoma in the thorax could only be established by thoracotomy. We undertook this study to determine if chest CT could provide such an answer. Among 4,000 chest CT scans, six patients were found to have lipoma according to the following selected criteria: CT features of a pleural mass; a lesion showing completely homogeneous density with CT numbers indicating fat, and exclusion of other fatty lesions. In these six patients, the lipoma was an incidental finding, four were men, the mean age was 64.3 years, one-half were obese, and none had chest pains or dyspnea. Lesions varied in size from 2 to 4 cm and occurred along the chest wall. The CT numbers of the masses ranged from -54 to -129. None developed malignancy. In conclusion, we recommend clinical and chest CT follow-up for the asymptomatic patient who fulfills our CT criteria for lipoma. Biopsy or resection is recommended for lesions that are inhomogeneous.

Aged↗
PubMed1986

Factors predicting survival in adults with stage I and II large-cell lymphoma treated with primary radiation therapy.

The records of 148 consecutive patients with Ann Arbor stage I and II large-cell lymphoma treated with primary radiation therapy with or without adjuvant chemotherapy were analyzed retrospectively for pretreatment prognostic variables and results of treatment. For patients treated with radiation to fields on one side of the diaphragm, the 5 year freedom-from-relapse rate was 25% and the survival rate was 35%, but for those given additional transdiaphragmatic radiation or for those given radiation plus adjuvant chemotherapy, the rates were both approximately 67%. In a multivariate analysis, the only significant pretreatment prognostic variables were the number of sites of involvement and bulk of disease, with relapse as the endpoint. For patients treated with radiation to both sides of the diaphragm or with radiation plus adjuvant chemotherapy, the 5-year freedom-from-relapse rate was 82% for the group with a favorable prognosis (with less than three sites of involvement and a mass size of less than 10 cm) and 55% for those with an unfavorable prognosis.

Actuarial Analysis↗