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Biomedical subjects

T W Bauer

Publications and source records attributed to T W Bauer.

At least 109 records · Page 6Linked to original sources
PubMed1986

Erdheim-Chester disease. Case report and review of the literature.

Erdheim-Chester disease is a distinctive pathologic and radiographic entity characterized by bilateral, symmetric sclerosis of the metaphyseal regions of long bones and infiltration of foamy, lipid-laden histiocytes. Clinically, it ranges from an asymptomatic, focal process to a fatal, systemic disease. All previously reported cases of Erdheim-Chester disease are reviewed and a new case with diabetes insipidus, partial hypopituitarism, histiocytic skin lesions, and retro-orbital tumors is presented. An 11-year follow-up reveals progression from a benign, limited process to a progressive, systemic disease. Patients with Erdheim-Chester disease show markedly disparate clinical courses and some features similar to Hand-Schüller-Christian disease. They need careful monitoring and further attempts at treatment.

Adult↗
PubMed1986

Partial mastectomy: pathologic findings and prognosis.

In an attempt to identify patients best suited for limited surgery as well as those at risk for recurrence and increased mortality, the authors reviewed the clinical and pathologic features of 130 patients who had undergone partial mastectomy as primary treatment for breast cancer (adjuvant therapy was administered only after disease recurrence). Patients were followed up for 57 to 128 months (mean, 85 months). Univariate and multivariate analyses were performed for the entire group and repeated for the large subgroup of patients with infiltrating ductal cancer, not otherwise specified. Three features were independently significant in correlating with poor survival and/or tumor recurrence: lymph node metastasis, mitotic rate, and nuclear atypia. Combinations of these factors further separated survivors from non-survivors. These prognostically significant pathologic features may be helpful in both selecting patients for partial mastectomy and identifying those who may require adjuvant therapy.

Adult↗
PubMed1986

Epithelioid hemangioendothelioma of bone. A clinicopathologic, ultrastructural, and immunohistochemical study.

In a review of 29 cases of solitary and multicentric hemangioendothelial sarcomas of bone, 14 were found to have histologic features of epithelioid hemangioendotheliomas. These were characterized by the presence of epithelioid or "histiocytoid" endothelial cells that were either round or spindle-shaped. Intracytoplasmic vacuolization was noted, and some showed nesting of cells, mimicking metastatic adenocarcinoma. The presence of a myxoid matrix suggested the diagnosis of chondrosarcoma in some cases. Some of the tumors strongly resembled the lesions formerly designated as intravascular bronchioloalveolar tumor, angioglomoid tumor of bone, or malignant myxoid angioblastoma of bone. Factor VIII-related antigen was detected in five of the six cases examined, and ultrastructural study in five cases confirmed the endothelial nature of the tumor cells; Weibel-Palade bodies were present in three cases. There were 11 men and three women, and the tumors were seen predominantly in patients who were under 30 years of age (10 cases). Four cases involved solitary tumors, and nine were multicentric in bone. The multicentric tumors had a predilection for the bones of one lower extremity (five cases). The total series had a protracted clinical course, and the multicentric tumors appeared to follow a less aggressive course.

Adolescent↗
PubMed1985

Factors that affect antiferritin localization in four rat hepatoma models.

The effect of tumor size, vascularity, ferritin content and the amount of injected 131I-antiferritin on tumor localization was studied in four hepatoma models with varying growth rates, histology, vascularity, and ferritin content. Separate groups of 12 animals with the H-4-II-E, 7800, 7777, and 3924A rat hepatomas with less than 2 g or greater than 2 g tumors were injected with escalating doses of 131I-antiferritin or 131I nonspecific IgG (control). Tumor vascularity was measured by 51Cr-labeled erythrocyte injection, ferritin content of tumors by radioimmunoassay and immunoperoxidase staining, and the histological location of 131I-antiferritin by autoradiography. 131I-antiferritin specifically localized in the H-4-II-E and 7800 models and correlated with the tumor size, vascular content, and amount of injected antiferritin. No localization took place in the 7777 or 3924A tumors despite the presence of ferritin in these models. The only factor that correlated with localization in the models was vascularity. The vascularity of 3924A and 7777 tumors was significantly reduced in comparison to the H-4-II-E and 7800 tumors. The dependence of targeting on vascularity was demonstrated with autoradiography as well. These findings indicate the correlation of vascularity and tumor localization with 131I-antiferritin.

Animals↗
PubMed1985

The effect of iron dextran on ferritin content and 131I-antiferritin localization in experimental hepatomas.

Polyclonal 131I rabbit antirat ferritin localizes in certain hepatoma models. The effect of intraperitoneal iron dextran on tumor and sera ferritin content and tumor and normal tissue localization with 131I antiferritin was studied. Separate groups of 10-12 animals were injected with escalating doses of 131I-antiferritin IgG, or nonspecific IgG, one week after injection with iron dextran or normal saline. The results demonstrate that tumor, serum, and normal tissue ferritin content was increased after iron dextran administration but tumor localization increased after administration of 131I-antiferritin in the H4II-E and 7800 models. The 3924A and 7777 models showed no tumor localization with or without iron dextran but did show an increase in normal tissue localization after iron dextran. Immunoperoxidase staining of tissues with antiferritin revealed increased staining in the liver and spleen and only a slight increase in the tumors after iron dextran was administered. The results demonstrate that tumor localization is a complex phenomenon that depends on normal tissue, sera, and tumor-antigen distribution.

Animals↗
PubMed1984

Adenocarcinoma of the hepatic duct junction. A reappraisal of the histologic criteria of malignancy.

The morphologic distinction between benign and malignant sclerotic processes involving the hepatic duct junction may be difficult. To determine reliable histologic criteria of malignancy, the authors reviewed 18 cases of clinically suspected adenocarcinoma of the hepatic duct junction (Klatskin tumor) retrieved from our autopsy and surgical pathology files over the last decade. The lesions were compared histologically to a variety of benign sclerotic biliary duct lesions, including four cases of primary sclerosing cholangitis (PSC) treated surgically over the same time period. A diagnosis of malignancy was confirmed histologically in 16 suspected Klatskin tumors, based on the presence of severe cytologic atypia (13) and/or perineural invasion (15). The tumor patients averaged 59 years of age with a male to female ratio of 2:1. Patients with segmental tumor resection and postoperative radiotherapy have survived as a group 6 months longer (average, 15.7 months) than those treated with drainage procedures alone (average, 9.5 months) (P less than 0.005), but have had extensive postoperative morbidity. In all the surgical specimens, tumor was present at one or more margins of resection. Primary sclerosing cholangitis patients were younger (average, 31 years of age) with a similar male predominance, but with a strong history of inflammatory bowel disease. All are alive up to 6.5 years since disease onset, with comparatively little postoperative morbidity. Two clinically diagnosed Klatskin tumors were not confirmed on histologic review. Both patients are alive at 1 and 3.5 years following onset of disease, having experienced little postoperative morbidity. Data indicate that Klatskin tumors are relatively aggressive malignancies, distinct from more indolent benign sclerotic disease, but occasionally mimicked by it clinically. Malignancy can be diagnosed histologically with adequate tissue sampling, thereby facilitating clinical decisions regarding radiotherapy or other palliative surgical procedures.

Adenocarcinoma↗
PubMed1984

Spindle cell carcinoma of the breast: four cases and review of the literature.

The clinical and morphologic features of four cases of spindle cell carcinoma of the breast are presented, and the comparable features of 35 previously reported cases are reviewed. All tumors contained histologically malignant squamous carcinoma that tended to blend with a spindle cell "pseudosarcomatous" stroma. Patients with this rare tumor tend to present at the same age as patients with other histologic types of breast carcinoma, but the spindle cell tumors are somewhat larger. Although the number of reported patients is too small to serve as a basis for firm conclusions, the prognosis appears similar to that for patients with conventional infiltrating duct carcinoma of the breast.

Aged↗
PubMed1983

Prognostic factors in patients with stage I, estrogen receptor-negative carcinoma of the breast. A clinicopathologic study.

In order to aid in the identification of a group of breast cancer patients at high risk of recurrence in whom the possible value of adjuvant chemotherapy might be most readily demonstrable, the authors reviewed the clinicopathologic features of 74 women with infiltrating, Stage I, estrogen receptor-negative breast carcinoma. They found significant correlations between short-term recurrence (within 2 years) and extensive necrosis (P less than 0.005), anaplastic tumor nuclear morphology (P less than 0.01), a positive family history of breast carcinoma (P less than 0.05), diffuse hyperplasia of axillary lymph nodes (P less than 0.05), and young age (P less than 0.05). Twenty percent of all patients experienced recurrence within 2 years, while recurrence was noted in 32% of patients with highly pleomorphic nuclei, 38% of those with extensive necrosis, and 45% of those with a positive family history. Recurrence was noted in 55% of the small number of patients with both anaplastic nuclear morphology and a positive family history. These apparent risk factors for early recurrence may be helpful in prospectively selecting patients most eligible to receive adjuvant chemotherapy.

Adult↗
PubMed1982

Angioimmunoblastic lymphadenopathy progressing to immunoblastic lymphoma with prominent gastric involvement.

Two unusual cases of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), with progression to immunoblastic lymphoma (IL) and prominent gastric involvement are presented, and detailed immunohistologic studies described. In one case, Bence Jones proteinuria of the kappa type was observed during the course of AILD and was identified immunohistochemically in lymph node biopsy specimens and at autopsy. The potential significance of an M component and the importance of recognizing gastric involvement by AILD are discussed.

Bence Jones Protein↗
PubMed1982

Morphologic evidence for coronary artery spasm in eclampsia.

Vascular spasm has been considered to be an important component of the eclamptic state. If this abnormal vascular reactivity affects the coronary arteries in eclampsia, one might expect to find areas of myocardial contraction band necrosis, a lesion secondary to coronary reflow after periods of no flow. We reviewed the cardiac findings in the 34 patients with fatal eclampsia (hypertension, edema, proteinuria, and convulsions without evident cause) autopsied at The Johns Hopkins Hospital since 1899, and compared each with the next pregnant or puerperal nontoxemic autopsied patient. The eclamptic patients were 15-45 years old (average 27 years). Convulsions began antepartum in 21 patients, intrapartum in eight, and postpartum in five. The hearts weighed 200-407 g (average 312 g). One heart had rheumatic valvular disease and one had myocarditis. Histologic study of heart sections showed the presence of contraction band necrosis in 12 cases (35%). The control cases included two patients with rheumatic valvular disease, two with endocarditis, two with myocarditis, two with pericarditis, and one with leukemic infiltration. Only one control patient (3%) had contraction band necrosis (p less than 0.001). The frequent occurrence of myocardial contraction band necrosis suggests that coronary artery spasm may be common in patients who die with eclampsia.

Adolescent↗
PubMed1982

Intraosseous ganglion: a clinicopathologic study of 11 cases.

The intraosseous ganglion is a cystic lesion of bone most frequently located in the subchondral epiphysis of long bones without direct communication with a joint cavity. Although this entity is becoming well recognized by orthopedic surgeons and radiologists, it has rarely been discussed in the pathologic literature and is frequently overlooked by the surgical pathologist. In this study the clinical and pathologic features of 10 patients, representing 11 instances of intraosseous ganglia, were reviewed with emphasis on the histologic and radiologic features necessary for diagnosis. Common radiologic features usually include a unilocular cyst surrounded by a thin rim of sclerotic bone in the subchondral epiphysis in the absence of other features of degenerative joint disease. Histologically, the ganglia are usually composed of a cystic space without epithelial lining, often filled with gelatinous, mucoid material and occasional foamy macrophages. The radiologic and histologic differential diagnoses, possible etiologic factors, and treatment are discussed.

Adult↗
PubMed1982

Periosteal chondroma. A clinicopathologic study of 23 cases.

The periosteal chondroma (juxtacortical chondroma) is an unusual tumor which usually occurs on the surface of tubular bones in the metaphyseal area. In this study, we reviewed the clinicopathologic features of 22 patients representing 23 instances of periosteal chondroma and discuss the radiologic and histologic features necessary for accurate diagnosis. The characteristic radiologic appearance is of a single cartilaginous mass in the metaphyseal periosteum causing well-defined depression or "saucerization" of the adjacent cortex. The radiologic differential diagnoses include soft-tissue tumors compressing bone, fibrous cortical defect, and periosteal chondrosarcoma or osteosarcoma. Histologic features include lobules of hyaline cartilage with frequent areas of hypercellularity, binucleate chondrocytes, and focal mild cytologic atypia. The histologic features clearly identify the tumor as chondrogenic; however, familiarity with the x-rays may be necessary to recognize the tumor as benign.

Adolescent↗
PubMed1981

Splenic rupture in patients with hematologic malignancies.

Five cases of pathologic rupture of the spleen in patients with hematologic malignancy are presented along with a review of the 48 cases previously described in the English literature. Pathologic splenic rupture occurred most commonly in patients with acute leukemia but has been well documented in chronic leukemias and in lymphoma as well. Nearly all patients experience abdominal pain at the time of rupture; however, this pain was frequently confused clinically with that of biliary tract obstruction, aortic aneurysm, perforated viscus, pancreatitis, and angina pectoris. Pain referred to the left shoulder (Kehr's sign) was present in only 17% of patients. Hypotension was documented in 66%, fever in 74%, and tachycardia in 75%. The most effective diagnostic procedure was paracentesis, which confirmed intraabdominal hemorrhage in each of the nine cases in which the procedure was used. A correct preoperative diagnosis of splenic rupture was reported in only 10 of the 53 cases reviewed. Fifty-two percent of the patients underwent laparotomy; 48% died without operation. Of those that underwent surgery, 78% survived the procedure and the immediate postoperative period. The survival rate of all patients was 38%. There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival. The most important factor in predicting survival was appropriate surgery.

Adult↗