Patterns of pulmonary fibrosis.
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Cell Division↗
Biomedical subjects
T V Colby
Publications and source records attributed to T V Colby.
Pulmonary histiocytosis X. Immunoperoxidase staining for HLA-DR antigen and S100 protein.
Immunoperoxidase staining for S100 protein and HLA-DR antigen was used to identify histiocytosis X (HX) cells in 23 cases of pulmonary histiocytosis X (PHX), three cases of idiopathic pulmonary fibrosis, and one case of hypersensitivity pneumonitis. S100 protein was present in HX cells in 22 of the PHX cases; HLA-DR antigen was present in HX cells from 16 cases. Varying numbers of peribronchiolar and interstitial cells were positive for either S100 or HLA-DR in two of the three cases of idiopathic pulmonary fibrosis, and in the case of hypersensitivity pneumonitis. Immunoperoxidase staining for chromogranin showed isolated neuroendocrine cells within the mucosa and wall or airways, sites in which HX cells were occasionally found. As other types of dendritic cells, as well as some neuroendocrine cells, may contain S100 protein, positive staining for S100 is not specific for HX cells.
Chromogranins↗
Cell kill and tumor control after heat treatment with and without vascular occlusion in RIF-1 tumors.
RIF-1 tumors (100-300 mg) were exposed in vivo to heat treatment (41-48 degrees C) for 30 min and then assayed for either cell survival or tumor control. The tumors were heated either with normal perfusion or with temporary vascular occlusion (clamped for 30 min prior to and during the 30-min treatment). The physical technique of water bath heating ensured temperature uniformity in both the perfused and vascularly occluded tumors. Survival curves for tumor cells heated under both conditions had a shoulder and exponential regions. While the T0's were not statistically different in the two cases, cells from the tumors whose blood flow had been occluded showed an enhanced sensitivity to heat as evidenced by a reduction of the shoulder by 2.5 degrees C. A similar increase in sensitivity was measured with the tumor cure assay with the TCT50 decreasing from 47 degrees C for unclamped tumors to 45 degrees C for clamped tumors. The two assays are therefore in excellent agreement in assessing the effectiveness of heat treatment and the influence of vascular occlusion on the heat sensitivity of this tumor. Since the clonogenic assay was performed immediately after treatment, this agreement between assays indicates that direct cell kill by heat is the major factor in determining cure in this tumor.
Animals↗
Pulmonary Kaposi's sarcoma. Premortem histologic diagnosis.
Nine open lung biopsies and nine transbronchial biopsies from 10 patients with pulmonary Kaposi's sarcoma were reviewed to define the pattern of involvement in the lung by Kaposi's sarcoma and to determine the usefulness of transbronchial biopsy in making the diagnosis. There were nine patients with acquired immune deficiency syndrome (AIDS) and one patient with sporadic pulmonary Kaposi's sarcoma. A lymphatic distribution was seen in all cases. A spectrum ranging from distinctive polymorphous cellular infiltrates ultimately interpreted as Kaposi's sarcoma to "classic" Kaposi's sarcoma was found. Recognition of the former enabled retrospective recognition of Kaposi's sarcoma in four of eight transbronchial bronchial biopsies. The diagnosis of pulmonary Kaposi's sarcoma in one other patient was made solely on the basis of transbronchial biopsy. Eight patients died from pulmonary Kaposi's sarcoma; two patients are alive with extensive pulmonary Kaposi's at last follow-up. We believe that transbronchial biopsy may be useful in establishing a diagnosis of pulmonary Kaposi's sarcoma in many more patients than is generally appreciated.
Acquired Immunodeficiency Syndrome↗
Reliability of urinary cytodiagnosis in urothelial neoplasms.
A retrospective study was done to explore the reliability of urinary cytologic examination of 117 cases of transitional cell carcinoma seen at this institution for the period 1980 to 1984. A specificity of 99%, sensitivity of 85%, false-positive rate of 11%, and false-negative rate of 10% were obtained. A single blind review of cytologic and histologic material from 66 of the cases was also performed for evaluation of the cytologic criteria employed for the grading of tumors. Cytohistologic correlation of grade I lesions was poor, whereas correlation of grades II and III was reasonably good. Carcinoma in situ was cytologically recognized in all instances but was difficult to distinguish from grade III carcinoma.
Carcinoma in Situ↗
Malignant epithelioid schwannoma arising in a benign schwannoma. A case report.
A case of malignant epithelioid schwannoma arising in a benign schwannoma is described. The findings were supported by morphologic criteria as well as by a clinical history of recent growth of a long-standing mass adherent to the sciatic nerve, accompanied by evidence of metastatic spread. The light microscopic, ultrastructural, and immunohistochemical features are described, and the three previous cases of malignant change in benign neurilemmomas reviewed.
Adult↗
Bronchiolitis obliterans organizing pneumonia.
In 50 of 94 patients with bronchiolitis obliterans we found no apparent cause or associated disease, and the bronchiolitis obliterans occurred with patchy organizing pneumonia. Histologic characteristics included polypoid masses of granulation tissue in lumens of small airways, alveolar ducts, and some alveoli. The fibrosis was uniform in age, suggesting that all repair had begun at the same time. The distribution was patchy, with preservation of background architecture. Clinically, there was cough or flu-like illness for 4 to 10 weeks, and crackles were heard in the lungs of 68 per cent of the patients. Radiographs showed an unusual pattern of patchy densities with a "ground glass" appearance in 81 per cent. Physiologically, there was restriction in 72 per cent of the patients, and 86 per cent had impaired diffusing capacity. Obstruction was limited to smokers. The mean follow-up period was four years. With corticosteroids, there was complete clinical and physiologic recovery in 65 per cent of the subjects; two died from progressive disease. This disorder differs from bronchiolitis obliterans with irreversible obstruction. It was confused most often with idiopathic pulmonary fibrosis. In view of the benign course and therapeutic response, a histologic distinction is important.
Adult↗
Follicular bronchitis/bronchiolitis.
Nineteen open lung biopsies demonstrating follicular bronchitis/bronchiolitis were reviewed with special attention to clinical manifestations. Morphologically, follicular bronchitis/bronchiolitis was represented by coalescent reactive germinal centers adjacent to airways in the absence of clinical or pathologic evidence of chronic obstructive pulmonary disease or bronchiectasis. Three clinicopathologic groups were identified: 1) patients with collagen vascular diseases, especially rheumatoid arthritis and Sjögren's syndrome; 2) patients with a familial form of the disease or with immunodeficiency syndromes; and 3) a heterogeneous group of patients with frequent peripheral blood eosinophilia, suggesting a hypersensitivity reaction. Prognosis was related to age at the time of biopsy and, to some extent, to the clinical group. Steroid therapy had inconsistent effects in all groups identified. The differential diagnosis of lymphoid lesions in the lung is also discussed.
Adult↗
Lung biopsy in rheumatoid arthritis.
Forty open lung biopsies from patients with rheumatoid arthritis and possible "rheumatoid lung disease" were reviewed in an attempt to correlate histology with radiologic, physiologic, and prognostic variables. A wide variety of histopathologic features was seen, and primary and secondary patterns of injury were recognized. Five different groups based on histologic patterns were identified: pulmonary rheumatoid nodules, usual interstitial pneumonia (UIP), bronchiolitis obliterans with patchy organizing pneumonia (BOOP), lymphoid hyperplasia, and cellular interstitial infiltrates. The finding of rheumatoid nodules as the primary pattern imparted a uniformly good prognosis, whereas the pattern of UIP indicated a poor one. Patients with BOOP had a more favorable prognosis than did patients with UIP, as did patients with lymphoid hyperplasia and/or nonspecific cellular interstitial infiltrates. Consistent correlations between pulmonary function testing and roentgenographic and histologic findings were not found. The term "rheumatoid lung disease" is of no use as a histologic diagnosis because it encompasses a broad spectrum of morphologic changes that carry significantly different prognoses.
Antibodies, Antinuclear↗
Chemotherapy-induced eosinophilic pneumonia. Relation to bleomycin.
Three cases of eosinophilic pneumonia are associated with bleomycin chemotherapy. As opposed to the more common picture of diffuse alveolar damage, these cases appear to represent a hypersensitivity reaction resembling eosinophilic pneumonia.
Adult↗
Electron microscopy of body fluids.
Transmission electron microscopy and scanning electron microscopy are complementary techniques; the former is useful for examining the fine internal structural detail of tissue and cell surfaces and the latter is useful for studying three-dimensional configurations. The methods and findings of transmission and scanning electron microscopic study of effusions are summarized, and their practical application in routine clinical work is assessed.
Adenocarcinoma↗
Pulmonary lymphoid neoplasms.
The majority of pulmonary lymphomas have a distribution that follows lymphatic routes and a monomorphous (in the case of lymphocytic and large-cell lymphomas) cell population. Mixed-cell lymphomas show a similar distribution and a cytologic composition identical to mixed-cell lesions in lymph nodes. The term homogeneous may be preferable to monomorphous for lymphoplasmacytic lymphomas (such as Waldenström's macroglobulinemia) and mixed cell lymphomas, as their composition is similar from field to field in contrast to inflammatory lesions, which show geographic cellular heterogeneity and variable scarring.
Diagnosis, Differential↗
Well-differentiated lymphocytic lymphoma. A study of 47 patients with primary manifestation in the lung.
Forty-seven cases of primary well-differentiated lymphocytic lymphoma (WDL) of the lung were studied. Diagnosis was based on histologic identification of a lymphangitic pattern of infiltration and monomorphous (homogenous) cytologic composition. Nineteen cases (40%) had ancillary evidence supportive of a diagnosis of lymphoma including simultaneous or subsequent involvement of other organs, monoclonal immunologic markers, or a monoclonal serum gammopathy. The prognosis for the group as a whole was excellent; follow-up (median, 4 years) was available for 33 cases. Only one patient has died of lymphoma. The authors discuss the histologic differential diagnosis of lymphocytic infiltrates in the lung, propose criteria to distinguish reactive from neoplastic lymphocytic lesions, and discuss the significance of monoclonality in the management of these patients.
Adult↗
Hepatic parenchymal lymphoid aggregates in Hodgkin's disease.
One hundred twenty-three liver biopsies performed at staging laparotomy for Hodgkin's disease were reviewed. Discrete parenchymal lymphoid infiltrates with variable cytologic atypia were identified in 12 patients. None of these patients had liver involvement by Hodgkin's disease. All 12 patients were alive with no clinical evidence of liver disease at last follow-up examination; however, two had extrahepatic relapses of Hodgkin's disease. Parenchymal lymphoid aggregates, a nonspecific finding in the livers of patients with Hodgkin's disease, may show some degree of cytologic atypia, but they do not represent lymphoma. Such aggregates may be relatively common and they may be overinterpreted as neoplastic, particularly in patients with non-Hodgkin's lymphoma.
Biopsy↗
Lymphocyte predominant Hodgkin's disease: clinical presentation and results of treatment.
The records of 59 patients with lymphocyte predominant Hodgkin's disease (LPHD) evaluated and treated at Stanford University Medical Center between 1963 and 1983 were reviewed. Of these 59 patients, 92% are alive at 10 years following treatment, 78% are relapse-free, and none have died of Hodgkin's disease. Compared with the other histologic subtypes of Hodgkin's disease, LPHD presents more frequently as stage I or II disease (78% vs. 55%) and less frequently with constitutional symptoms (7% vs. 32%). Despite these factors, there is no statistically significant difference in either survival or freedom-from-relapse (FFR) between the histologic subtypes when comparisons are made on a stage-for-stage basis. Analysis of sites of presentation and relapse reveals that LPHD rarely involves intrathoracic structures. Patients with C.S. I disease presenting in inguinofemoral or high cervical lymph nodes do not require staging laparotomy as none of these patients were upstaged by surgery. Patients with stage I disease involving high cervical lymph nodes may be treated with limited field irradiation employing fields no more extensive than a mantle and Waldeyer's ring field, as no relapses have been seen in such patients treated in this fashion. Although limited field irradiation was used successfully for LPHD presenting in other localized sites, inadequate patient numbers preclude assessment of this treatment for those clinical presentations.
Adolescent↗
Differential diagnostic features of nodular L & H Hodgkin's disease, including progressive transformation of germinal centers.
The histologic features in 171 cases of nodular lymphocyte-predominant (L&H) Hodgkin's disease are presented and the association with an abnormal form of follicular hyperplasia termed "progressively transformed germinal centers" (PTGC) by Lennert is discussed. PTGC may closely resemble the nodules of L&H Hodgkin's disease and in 18% of our cases the two processes coexisted in the same lymph node. In addition, two patients had lymph node biopsies showing PTGC prior to biopsies showing nodular L&H Hodgkin's disease and three patients with histologically proved Hodgkin's disease were found to have PTGC in subsequent lymph node biopsies. Immunologic studies on frozen tissue sections from three cases of nodular L&H Hodgkin's disease showed that the neoplastic nodules contained abundant dendritic reticulum cells and B-lymphocytes with scattered T-lymphocytes. These findings suggest that the association between PTGC and nodular L&H Hodgkin's disease is more than coincidental and that this form of Hodgkin's disease preferentially involves B-cell areas of the lymph node, in contrast to the T-zone distribution in other forms of this disorder.
Adolescent↗
Infantile digital fibromatosis occurring outside the digit.
This report illustrates an extradigital fibromatosis located in the right upper arm. The clinical, light-, and electron-microscopic features were identical to those found in the recurrent digital fibromatosis of childhood. As is typical for infantile digital fibromatosis, this reported lesion recurred once. Light microscopy showed eosinophilic, perinuclear inclusions which by electron microscopy were nonmembrane-bound, compact fibrillary structures. Whereas major reviews state that infantile digital fibromas occur exclusively on the digits, this unique case describes the rare occurrence outside the digit.
Child, Preschool↗
The role of radiation therapy in the management of stage III follicular lymphomas.
Between 1961 and 1982, 66 patients with stage III follicular small cleaved (FSC) and follicular mixed small cleaved and large cell (FM) lymphoma were treated at Stanford University. Treatment consisted of total-lymphoid irradiation (TLI) to a total dose of about 4,000 rad in 61 patients or whole-body irradiation (WBI) followed by boost irradiation to sites of involvement in five patients. In addition, 13 patients treated with TLI received adjuvant chemotherapy, consisting of six cycles of cyclophosphamide, vincristine, and prednisone (CVP). Median follow-up was 9.6 years. Kaplan-Meier actuarial survival at five, ten, and 15 years was 78%, 50%, and 37%, respectively. Freedom from relapse at five and ten years was 60% and 40% with no relapses after ten years. In a prospective randomized study of 16 patients who all underwent staging laparotomy comparing TLI with or without adjuvant chemotherapy with CVP, there was no significant difference in either survival or freedom from relapse between the two groups. Patients with limited stage III disease (without B symptoms, less than five sites of involvement, and maximum size of disease less than 10 cm) had an excellent prognosis with a 15-year survival and freedom from relapse of 100% and 88%, respectively. Radiation therapy may be a potentially curative modality in patients with stage III follicular lymphomas.
Actuarial Analysis↗