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W B Laskin

Publications and source records attributed to W B Laskin.

17 recordsLinked to original sources
PubMed1996

Aggressive angiomyxoma: a clinicopathologic study of 29 female patients.

BACKGROUND: Aggressive angiomyxoma is an uncommon mesenchymal tumor that preferentially involves the pelvic and perineal regions of females. Since its initial description in 1983, approximately 65 cases have been reported in the English literature. METHODS: The clinical and pathologic features of 29 cases of aggressive angiomyxoma were evaluated in a review of archival material from the Armed Forces Institute of Pathology (1960-1992). Histochemical stains for mucosubstances and immunohistochemistry (avidin-biotin complex method) were utilized to characterize the neoplasms further. RESULTS: All patients were females, between 16 and 70 years (median; 34 years). The soft tissues of the pelvis, perineum, vulva, buttock, retroperitoneum, and inguinal regions were involved. The majority of the tumors were > or = 10 centimeters in greatest dimension. Follow-up ranging from 8 to 198 months (mean, 93 months; median, 95 months) was available for 22 patients. Eight patients developed recurrent tumor, from 10 months to 7 years after the initial resection. No patient developed metastases and there were no tumor related deaths. Histologically, the neoplasms were sparsely to moderately cellular and predominantly composed of bland, relatively nondescript. stellate and spindled cells embedded in a loosely collagenized matrix with scattered vessels of varied caliber. A few cases contained some tumor cells with more abundant eosinophilic cytoplasm that raised the possibility of focal smooth muscle differentiation. The tumor matrix was no more than weakly reactive for mucosubstances; thus, while glycosaminoglycans are present to a limited extent, edema fluid appears to be a major component of the noncollagenous stroma. The neoplastic cells were at least focally immunoreactive for desmin (22/22), smooth muscle actin (19/20), muscle specific actin (16/19), vimentin (17/17), CD34/QBEND-10 (8/16), and estrogen (13/14) and progesterone (9/10) receptor. All of the examined tumors were negative for S100 protein (20/20). Ki67 (MIB1) immunoreactivity was present in <1% of the tumor nuclei in all 16 cases tested. CONCLUSIONS: Aggressive angiomyxoma is a distinctive, locally aggressive, mesenchymal tumor that appears to be relatively site specific and has a peak incidence in females in the fourth decade of life. There is a strong propensity for local recurrence but metastatic disease has not been reported. Since the first evidence of recurrence may be many years after the initial resection, long term follow-up is required. The neoplastic cells of aggressive angiomyxoma exhibit fibroblastic and myofibroblastic features and appear to be hormonally influenced. The possibility that the progenitor cell has a capacity for smooth muscle differentiation is raised.

Adolescent↗
PubMed1996

Tumors in dogs exposed to experimental intraoperative radiotherapy.

PURPOSE: The frequency of radiation-induced neoplasms was determined in dogs enrolled in the National Cancer Institute canine trials of intraoperative radiotherapy (IORT). METHODS AND MATERIALS: Twelve protocols assessing normal tissue response to IORT involved 238 dogs in a 15-year trial. Eighty-one dogs were followed for > 24 months postoperatively and were assessed for tumor development; 59 of these animals received IORT. RESULTS: Twelve tumors occurred in the 59 dogs receiving IORT. Nine were in the IORT portals and were considered to be radiation induced. No tumors occurred in 13 sham animals or in 9 animals treated with external beam radiotherapy alone. The frequency of radiation-induced malignancies in dogs receiving IORT was 15%, and was 25% in animals receiving > or = 25 Gy IORT. Frequency of all tumors, including spontaneous lesions, was 20%. CONCLUSIONS: Intraoperative radiotherapy contributed to a high frequency of sarcoma induction in these dogs. Unknown to date in humans involved in clinical trials of IORT, this potential complication should be looked for as long-term survivors are followed.

Animals↗
PubMed1995

Expansion of the Ki-67 proliferative compartment correlates with degree of dysplasia in Barrett's esophagus.

BACKGROUND: Barrett's esophagus is a histologically defined premalignant lesion of the esophagus in which normal squamous epithelium is replaced by intestinalized columnar epithelium. In a multistep progression from Barrett's esophagus to fully developed carcinoma, accelerated proliferation may indicate or precede genomic instability and, therefore, may be an important factor in the pathogenesis and/or prediction of malignant transformation. Ki-67 is a nuclear antigen expressed in proliferating cells, (G1, S, G2, and M phases) but not in resting cells (G0 phase). This study was undertaken to determine if Ki-67 expression correlates with the degree of dysplasia and if Ki-67 expression can help to differentiate those patients with or without dysplasia. METHODS: The Ki-67 proliferation fraction in 87 paraffin embedded esophageal biopsies from 43 patients with the Ki-67 antibody (MIB-1) was analyzed using immunohistochemistry. Using a computerized proliferation index program (QNA v2.54, Becton Dickinson Cellular Imaging Systems, Inc., Elmhurst, IL), a Ki-67 score was derived for the luminal surface, upper esophageal crypt, lower crypt, and underlying glandular zone of the columnar-lined esophagus. RESULTS: Significant differences in Ki-67 scores were noted in each zone among different histologic categories: normal gastric ([NG] n = 17); Barrett's without dysplasia ([ND] n = 17); low grade dysplasia ([LG] n = 21); high grade dysplasia ([HG] n = 14); and adenocarcinoma ([CA] n = 5). The pattern of Ki-67 expression was associated strongly with each histologic category. The percentage of Ki-67 positive nuclei in each mucosal zone statistically separated high grade from low grade dysplasia (P < 0.001). In high grade dysplastic tissues, the Ki-67 positive nuclei were found predominantly on the surface epithelium and upper crypt zones, whereas in low grade dysplasia, the majority of Ki-67 positive nuclei were found in the lower crypt zone. The number of Ki-67 positive nuclei in each mucosal component also was significantly different in Barrett's esophagus without dysplasia when compared with Barrett's esophagus with low grade dysplastic tissues. (P < 0.001) Staining patterns of indefinite for dysplasia by H & E staining separated into several distinct patterns (five LG, seven ND, one NG) whereas six biopsies with low grade dysplasia had a Ki-67 expression pattern more consistent with that of high grade dysplasia. CONCLUSION: The Ki-67 staining pattern correlated with histologic findings in Barrett's esophagus and may represent an additional parameter for differentiating patients with or without dysplasia.

Adult↗
PubMed1995

Desmoplastic malignant melanoma.

BACKGROUND: Desmoplastic malignant melanoma (DMM) is an uncommon variant of malignant melanoma and often is difficult to diagnose. Because of the relative rarity of this tumor, it has not been well studied and controversy remains concerning its biologic potential. OBJECTIVE: We compared survival rates of DMM with those of other malignant melanomas and determined what clinical and/or histologic features, if any, correlated with survival. METHODS: The files of the Armed Forces Institute of Pathology were searched for cases of DMM or related tumors with adequate material for further histologic and immunohistochemical evaluation. Follow-up on each patient was requested from the pathologist, clinician, and/or the patient. The follow-up was correlated with the histologic findings in each case. The relationship of histologic features to disease-free survival was evaluated. RESULTS: Adequate material for evaluation was available in 128 cases. The overall histologic features were similar to those previously reported. Immunohistochemical studies showed that all lesions were negative for HMB-45, a marker for premelanosomes. Factors that correlated with survival included tumor location, sex, tumor depth, and the presence of stromal mucin. The 5-year disease-free survival rate was 68% for all cases and 61% for lesions more than 4 mm deep. CONCLUSION: With a 5-year disease-free survival rate of 61%, DMM has a significantly better prognosis than other melanomas that have a 5-year disease-free survival rates of 40% to 41%. This may be related to neural differentiation of these tumors.

Adolescent↗
PubMed1994

Epithelioid hemangioendothelioma with multiple site involvement. Literature review and observations.

This report is a case of epithelioid hemangioendothelioma presenting as multiple lytic lesions of the ilium with radiographic findings of diffuse, bilateral lung involvement and biopsy-proven scalp involvement. Histologically, the tumor within bone and skin exhibited cords and nests of plump, epithelioid-appearing cells exhibiting rudimentary vascular differentiation within a myxohyaline stroma. Aggressive histologic features were not present. Immunohistochemical reactivity for Factor VIII-related antigen, Q-bend 10 (CD34), and cytokeratin were demonstrated. Ultrastructural studies revealed abundant intermediate cytoplasmic filaments, pinocytotic vacuoles, and Weibel-Palade bodies. The concurrent bone, skin, and lung involvement, low-grade histologic type, and female sex of the patient aroused speculation about the role of hormones in the development and possible treatment of the tumor, but estrogen and progesterone receptors were not detected. Despite intense combination chemotherapy, the patient died of widely metastatic disease. This report demonstrates the aggressive potential of histologically low-grade epithelioid hemangioendothelioma and the need for a thorough evaluation for metastases.

Adult↗
PubMed1991

Epithelioid variant of malignant peripheral nerve sheath tumor (malignant epithelioid schwannoma).

Twenty-six cases of malignant peripheral nerve sheath tumor with a predominant epithelioid pattern were studied to determine the range of its histologic patterns, immunophenotype, and biologic behavior. The tumor presented as an asymptomatic mass either in superficial (16 cases) or in deep soft tissue (10 cases) of the extremity. Characteristically, those in deep soft tissue were composed of vague nodules of varying cellularity made up of cords or strands of rounded epithelioid cells with prominent nucleoli. Those in superficial soft tissue were uninodular masses composed of tight clusters of cells showing cell-to-cell molding but possessing the same prominence of nuclei and mitotic activity as those in deep soft tissue. Several were associated with a preexisting benign nerve sheath tumor. A number of cases deviated from the above description, including cases that resembled a clear cell carcinoma, a malignant rhabdoid tumor, and a pleomorphic sarcoma. The majority of cases (80%) strongly expressed S-100 protein and neuron-specific enolase, but all lacked a melanoma-associated antigen (as defined by HMB-45) and cytokeratin. Stains for type IV collagen defined linear immunoreactivity around single cells and groups of cells. This pattern did not differ substantially from that of melanomas and therefore did not serve as a reliable discriminant. Follow-up information indicated a more favorable course for those in superficial soft tissue compared with those in deep sites. Two of 16 patients in the former group developed metastatic disease compared with three of 10 in the latter group. Tumors in superficial soft tissue may be eminently treatable and curable, depending on size.

Adolescent↗
PubMed1990

Eccrine spiradenoma occurring in infancy mimicking mesenchymal tumor.

Eccrine spiradenoma (ES) rarely (less than 1%) occurs in infancy. These tumors differ from the conventional ES by the presence of superficial dermal nodules which display a less distinct two-cell pattern of immature adnexal epithelial cells and rarely ductule formation. These tumors may be mistaken for mesenchymal neoplasms involving the skin and subcutis of infants and young adults. Recognition of the histopathologic features and immunostains are required to make a definite diagnosis. We describe 2 cases of ES occurring in patients younger than one year. Detailed histopathologic and histochemical differential features of these tumors and mesenchymal neoplasms of the skin and subcutis commonly occurring in infants and young adults are discussed. The biologic behavior of infantile ES is benign, but complete excision is recommended to prevent recurrence. We speculate that these tumors may represent congenital hamartomatous growths.

Adenoma, Sweat Gland↗
PubMed1989

Solitary cutaneous plexiform neurilemmoma (schwannoma): a clinicopathologic, immunohistochemical, and ultrastructural study of 11 cases.

Plexiform neurilemmoma (PN) is a rare benign peripheral nerve sheath tumor. The tumor is an uncommon nodular variant of schwannoma. Eleven cases of cutaneous plexiform neurilemmoma (CPN) were studied by clinicopathologic correlation, immunohistochemistry, and electron microscopy. The patients' ages ranged from 6 to 80 yr; the median age was 37 yr. The tumors were presented as single, soft to rubbery, movable, nontender, and sometimes painful nodules ranging from 0.5 cm to 2.5 cm. in diameter. The lesions were most commonly located on the extremities. The overlying skin surface was intact. These tumors were not associated with von Recklinghausen's neurofibromatosis or neurilemmomatosis. On gross examination the cut surface of the tumors showed grayish-white to yellow or tan coloration and had a well-defined border, but there was no evidence of a plexiform growth pattern. The microscopic features were characterized by single or multiple well-circumscribed nodules of spindle-shaped tumor cells. The nuclei were irregular and elongated, and the cytoplasm was eosinophilic and fibrillary without distinct cytoplasmic borders. Nuclear palisading was prominent, and Verocay bodies were present. Mitotic figures were rare (fewer than 2 per 20 high-power fields). Bodian stain showed presence of nerve fibers at the periphery of the tumor. The adjacent tissue showed wavy, spindle-shaped cells and collagen fibers in a myxoid stroma rich in hyaluronic acid, a pattern reminiscent of neurofibroma. The tumor cells showed positive reactivity with anti-S-100 protein in both the nuclei and cytoplasm. Glial fibrillary acid protein was focally positive, and neuron-specific enolase was negative. Electron microscopy displayed features of Schwann cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Postradiation soft tissue sarcomas. An analysis of 53 cases.

The clinicopathologic features of 53 cases of postradiation soft tissue sarcoma (PRS) were correlated with the physical characteristics of the administered radiation. All but three patients received radiation for malignant processes. Of the secondary sarcomas, malignant fibrous histiocytoma (MFH) accounted for 36 cases (68%), followed by seven extraskeletal osteosarcomas (13%), six fibrosarcomas (11%), two malignant Schwannomas (4%), one extraskeletal chondrosarcoma, and one angiosarcoma. The sex incidence, age of the patient at time of diagnosis, and location of the PRS correlated only with the clinical characteristics of the initial treated condition. The latency period (mean 10 years) showed an indefinite relationship to patient survival but no definite relationship to the patient's age at the time of the initial radiation. There was no difference between patients treated with megavoltage radiation (39 patients) and with orthovoltage radiation (seven patients) in the type of sarcoma, location, or survival, although the orthovoltage group received a lower mean radiation dose (3880 rads) than the megavoltage group (4446 rads). Megavoltage radiation, however, produced deeper tissue radiation changes and was associated with a shorter latency period. Most PRS were poorly differentiated, produced abundant collagen, and had a dismal prognosis.

Adult↗
PubMed1988

Malignant fibrous histiocytoma associated with hyperlipoproteinemia.

A unique case of malignant fibrous histiocytoma arising within the thigh of a patient with Type II A (hypercholesterolemic) hyperlipoproteinemia is described. The tumor, which appeared grossly as a benign tuberous xanthoma, demonstrated pleomorphic spindled and multinucleated cells focally in the distinct storiform pattern of a malignant fibrous histiocytoma and areas composed of bland xanthoma cells associated with cholesterol deposits. Foci of xanthoma cells with mildly atypical nuclei admixed with highly pleomorphic cells were also noted. These unusual histologic features--as well as the uniform staining of all the tumor cells with anti-alpha-1-antichymotrypsin and the absence of anti-alpha-1-antitrypsin and of anti-lysozyme staining--support the conclusion that all elements of this malignant tumor were derived from a common mesenchymal precursor. The exaggerated histiocytic capability of the tumor cells in the form of xanthomatous change was probably in response to the hyperlipoproteinemic microenvironment.

Aged↗
PubMed1986

Alpha-fetoprotein-producing pancreatoblastoma. A case report.

A case of pancreatoblastoma, arising in the tail of the pancreas with metastases to the right radius, in an 8-year-old boy is reported. The serum alpha-fetoprotein (AFP) level was over 13 times the normal value before surgery, but returned to normal after removal of the primary tumor. Furthermore, AFP was detected in tumor tissue by immunohistochemistry. This case, representing the second primary non-germ cell pancreatic neoplasm in a child producing elevated serum AFP, supports the use of serum AFP in diagnosing this lesion.

Child↗
PubMed1985

Erythroleukemia in a child: value of immunocytochemistry and transmission electron microscopy in its diagnosis.

A 4 1/2-year-old girl presented with erythroleukemia (EL) that mimicked acute lymphocytic leukemia (ALL). The diagnosis was established with transmission electron microscopy (TEM) and immunocytochemical staining for hemoglobin. Erythroleukemia may present in childhood and may require TEM and immunocytochemistry to make the diagnosis. The correct diagnosis is extremely important since EL has a much poorer prognosis and requires entirely different therapy. Therefore, it is most important to consider EL in those cases of ALL in which the data are not clear-cut and in which the patient fails to respond.

Bone Marrow↗
PubMed1983

Occult papillary carcinoma of the thyroid with pulmonary metastases.

This case report describes an occult papillary adenocarcinoma of the thyroid with pulmonary metastases, discovered at autopsy. Since papillary adenocarcinoma of the thyroid usually invades adjacent structures and cervical lymph nodes in a predictable fashion, the finding of distant hematogenous spread, when the tumor is confined to the thyroid gland, is unusual, as is illustrated by a review of the literature. The patient's history included a poorly differentiated squamous cell carcinoma of the lung, which had been resected 15 years prior to death and had been followed by super-voltage radiation. The possible effects of super-voltage radiation on the pathogenesis and behavior of thyroid cancer are discussed.

Adenocarcinoma↗
PubMedDate not supplied

Anaplastic large cell lymphoma.

Anaplastic large cell lymphoma (ALCL) or Ki-1 lymphoma is a recently described and distinctive non-Hodgkin's lymphoma. Cervicofacial adenopathy caused by ALCL may mimic involvement by metastatic carcinoma or other malignancies common to the head and neck. A case in which ALCL was originally interpreted as metastatic nasopharyngeal carcinoma is presented. The clinicopathologic features of this uncommon entity are discussed.

Adult↗
PubMedDate not supplied

Dermatofibrosarcoma protuberans.

Dermatofibrosarcoma protuberans is an intermediate-grade sarcoma that arises in the dermis of the trunk, proximal extremities, and less commonly, in the head and neck area of adults. Dermatofibrosarcoma protuberans has a deceptively innocuous early clinical appearance and generally exhibits an indolent course for years before entering a rapid growth phase. Its locally invasive behavior results in early recurrence if prompt, wide excision is not performed. Dermatofibrosarcoma protuberans rarely metastasizes through the bloodstream or, less often, to locoregional lymph nodes after multiple local recurrences. Fibrosarcomatous areas within the tumor result in a more aggressive course. Although wide excision is the mainstay of therapy, recent trials using the Mohs' surgical approach suggest that this technique may have a role in the future treatment of this tumor.

Diagnosis, Differential↗