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Biomedical subjects

W Hanna

Publications and source records attributed to W Hanna.

At least 37 records · Page 2Linked to original sources
PubMed1996

Proliferative activity and p53 expression in adenoid cystic carcinoma of the breast.

Adenoid cystic carcinoma is a rare type of invasive breast carcinoma that has a good prognosis. We studied a series of four cases of adenoid cystic carcinoma in which we correlated the clinical and pathological features. The pathological features examined included light microscopy; electron microscopy; immunohistochemistry using antibodies to keratin, vimentin, S100 protein, actin, estrogen and progesterone receptors, and proliferation marker MiB-1, and p53 suppressor protein; image cytometric analysis for measurement of DNA ploidy; and molecular analysis using polymerase chain reaction single strand conformation polymorphism to assess point mutation of the p53 gene. All of the cases had a low nuclear grade, were negative for estrogen and progesterone receptors, and were DNA diploid. Three of the cases showed no evidence of metastases and had small primary tumors with low proliferative activity and absence of p53 protein expression. In contrast, one of the cases showed axillary lymph node metastases and in this case the primary tumor was large with a higher proliferative activity and expression of p53 protein, suggesting that these factors might play a role in the biological behavior of adenoid cystic carcinoma.

Adult↗
PubMed1995

Primary angiosarcoma of the spleen: a case report and review of the literature.

We describe a 47-year-old man with shoulder pain, multiple bony lesions, and a 1-cm lesion in the spleen. T-1 facetectomy revealed a poorly differentiated malignant neoplasm. Several months after chemotherapy, multiple splenic lesions were found by computed tomography and liver-spleen scan. A splenectomy showed a malignant spindle-cell neoplasm forming irregular vascular spaces. Tumor cells were positive for factor VIII-related antigen and vimentin. This patient died of extensive metastases from this primary angiosarcoma of the spleen. Splenic angiosarcoma is a rare neoplasm that often has a cryptic presentation and a dismal prognosis.

Hemangiosarcoma↗
PubMed1994

Sclerosing peritonitis associated with luteinized thecomas of the ovary. A clinicopathological analysis of six cases.

Six cases of a distinctive ovarian lesion associated with sclerosing peritonitis were found in patients 13 to 76 years of age. Five patients presented with abdominal swelling; on examination, three were found to have unilateral or bilateral pelvic masses, one had ascites and evidence of small bowel obstruction, and one had ascites alone. The sixth patient presented with small bowel obstruction. At operation, 1 to 9 L of ascitic fluid were found in five patients. Five patients with bilateral ovarian enlargement underwent bilateral oophorectomy or, in one case, bilateral ovarian wedge resection. The sixth patient had unilateral ovarian enlargement treated by unilateral oophorectomy. All had fibrotic thickening of the peritoneum, most prominently involving the omentum and small bowel, four at initial operation and two at a second operation performed shortly thereafter. One or more episodes of small bowel obstruction subsequently occurred in three of the five patients with follow-up. One woman died of pulmonary embolism 2 months after her initial operation; four were alive without clinical evidence of disease 8 months to 6 years postoperatively. Gross examination revealed unilateral (one case) or bilateral (two cases), predominantly solid ovarian tumors 12 to 31 cm in maximum dimension in three cases and slight enlargement and nodularity of both ovaries in the other three cases. Microscopic examination of the ovaries revealed a cellular proliferation of spindle cells with focal differentiation into nests of luteinized or partially luteinized cells; one case also had occasional foci of sex cord elements. The process was confined to the ovarian cortex in the three cases with slight ovarian enlargement. Residual ovarian follicles were entrapped by the proliferation in three cases, but were prominent in only one of them. Additional features included brisk mitotic activity, predominantly in the spindle cells, in three cases, and striking edema in the three cases with significant ovarian enlargement. The ovarian lesions were interpreted as luteinized thecomas, although a closely related hyperplasia with luteinization, instead of early neoplasia, cannot be excluded in the three cases with only slight ovarian enlargement (and in one, prominent entrapment of follicles). The peritoneal process consisted of a variably cellular proliferation of fibroblasts and myofibroblasts separated by collagen, fibrin, and occasional chronic inflammatory cells. These cases and two similar cases from the literature suggest a unique association between some luteinized thecomas (or a closely related proliferative lesion of the ovary) and sclerosing peritonitis, although the relation between the ovarian and peritoneal processes is presently enigmatic.

Adolescent↗
PubMed1993

The predictive value of ERICA in breast cancer recurrence. A univariate and multivariate analysis.

In breast cancer, primary tumor size (T), the number of lymph node metastases (#N), the biochemical estrogen (ER), and progesterone (PGR) receptor status have all been important prognostic variables. We evaluated the significance of the immunocytochemical measurement of estrogen receptors suing the ERICA method. To determine the relative prognostic value of these variables T, #N, ER, PGR, ERICA and adjuvant treatment, (ADJ), univariate and multivariate analyses of disease-free survival (DFS) were performed for 154 primary breast cancer patients who were diagnosed in 1985 to 1986 at Women's College Hospital and followed prospectively. We analyzed ERICA results using different classification systems, and assessed clinical cut points for the univariate and multivariate context. The variables consistently included in the best Cox stepwise regression are T, (p < 0.01), ADJ (p < 0.01), #N (p < 0.01), and ERICA (p < 0.01). There was weaker evidence of an association between DFS and the biochemically determined ER; ER was not included in the model with a cut point at 10 fmol mg of protein. This illustrates the value of the ERICA method in predicting outcome, and suggests the need to consider ERICA values for clinical decision making.

Adult↗
PubMed1992

Antibody drug carrier for immunotherapy of superficial bladder cancer: ultrastructural studies.

Superficial bladder cancer represents a promising target for intravesical, antibody-guided therapy. The construction of an optimum antibody-cytotoxic drug conjugate depends mostly on the appropriate selection of a monoclonal antibody (mAb). We have used immunogold labeling and SEM to specifically map the distribution of antigens expressed on three bladder cancer cell lines and on the luminal surface of biopsies from human transitional cell carcinoma of various grades and from normal bladder mucosa. The 48-127 mAb, which recognizes a M(r) 54,000 surface glycoprotein (gp54), was found to be very promising as a potential drug carrier. This antibody reacts with the surface of cells from low- and high-grade tumors; it does not react with the normal urothelium. Labeling of normal bladder mucosa was observed, however, on microvillous intermediate urothelial cells occasionally exposed by small areas of desquamation. The 48-127 mAb could target drugs to all areas of transformed urothelium while avoiding drug delivery to the normal, undesquamated bladder mucosa. Kinetics of gp54/48-127/gold complexes were tested in vitro with T24 and RT4 human bladder carcinoma cell lines incubated in the presence of the 48-127 mAb directly conjugated with 17.7-nm gold particles. Internalization of the gp54/48-127/gold complex was readily demonstrated by transmission electron microscopy. These results suggest that the 48-127 mAb represents a valuable drug carrier for intravesical therapy, allowing specific tumor targeting and internalization of various cytotoxic agents.

Aged↗
PubMed1992

Case-control study of factors associated with failure to detect breast cancer by mammography.

BACKGROUND: Although mammography is widely used to detect breast cancer, it is recognized that not all cancers can be seen on mammographic images. PURPOSE: Our purpose was to examine factors associated with failure to detect breast cancer by mammography. METHODS: A case-control study was carried out in which subjects in whom histologically verified breast cancer was not detected by mammography (false negatives) were contrasted with subjects in whom breast cancer had been detected by mammography (true positives). Mammograms from individuals with histologically confirmed breast cancer were classified independently by two radiologists who were unaware of the clinical or other characteristics of the subjects. Histologic slides of all tumors were reviewed by one pathologist. RESULTS: Three variables were found to be independently and significantly associated with failure to detect breast cancer by mammography. Breast cancer was less likely to be detected by mammography in the presence of extensive parenchymal densities (odds ratio [OR] = 9; 95% confidence interval [CI] = 1.8-44.3), a tumor of lobular histology (OR = 7; 95% CI = 2.2-22.1), and tumors of small size (OR = 0.10; 95% CI = 0.0-0.9). CONCLUSION: Our results indicate that biologic factors are associated with failure to detect some breast cancers by mammography and indicate directions for future research in breast imaging.

Adult↗
PubMed1992

Expression and amplification of neu oncogene in pleomorphic adenomas of salivary gland.

Amplification of the neu oncogene and overexpression of its product was found to be a potential marker for aggressive biological behavior in breast cancer. However, the expression of the neu oncoprotein in normal breast ducts and myoepithelial cells has also been demonstrated. Hence, we examined normal salivary gland tissue and 15 cases of pleomorphic adenoma for the expression of the neu oncoprotein by immunohistochemistry using two polyclonal antibodies and 12 cases for the amplification of the neu oncogene using slot blot hybridization. Immunohistochemistry in the normal salivary gland revealed positive staining of all ductal cells. In the pleomorphic adenomas all cellular elements stained to a variable degree. The positive staining was seen in the ductal cells, in the solid sheets, and in chondroid, myxoid, and metaplastic foci. The normal salivary gland and 11 of 12 cases of pleomorphic adenoma showed no increase in copy number of the neu oncogene, whereas one case showed threefold amplification. These results indicate that the neu oncoprotein is expressed but the neu copy number is not increased in normal salivary gland epithelium and in most pleomorphic adenomas. The threefold amplification of the gene in one case may indicate an aggressive biological behavior.

Adenoma, Pleomorphic↗
PubMed1991

Poorly differentiated skin tumors. Beyond hematoxylin-and-eosin staining.

Although many tumors may be diagnosed by light microscopy alone, a few require further investigation. Selective use of antibodies by immunohistochemical techniques solves most diagnostic problems. The explosive discovery of many new antibodies often raises more questions than it answers, and electron microscopy still plays a significant role when used judiciously. It is important to recognize that every new antibody must be adequately assessed in the clinical situation and that its specificity, or lack thereof, is appreciated by both clinician and pathologist. With every new antibody, we increase our knowledge of basic disease processes. In the future, antibodies will be part of the pathologist's armamentarium for predicting disease outcomes. Not only will the cell of origin be identified but proliferation rates and production of various factors that influence metastatic potential will be delineated.

Humans↗
PubMed1990

Pretibial epidermolysis bullosa: report of a case.

Pretibial epidermolysis bullosa is a rare variant of hereditary epidermolysis bullosa that is characterized by the delayed onset of a blistering eruption limited to the pretibial area. We present a case in a 48-year-old woman. Immunofluorescence mapping demonstrated blister formation below the basement membrane. This was confirmed by ultrastructural investigations that also revealed rudimentary anchoring fibrils similar to those described in the dominant dystrophic forms of epidermolysis bullosa.

Basement Membrane↗
PubMed1990

Distribution and patterns of staining of Neu oncogene product in benign and malignant breast diseases.

Amplification of the Neu oncogene (c-erbB-2) has been reported by various researchers as a marker for poor clinical outcome in patients with breast cancer. We have performed immunohistochemical staining using a polyclonal antibody to the Neu oncoprotein on formalin-fixed material from normal breast, benign breast lesions, and 102 stage I node-negative breast cancers. Hybridization studies were also performed on 66 of the breast cancer cases. In the cancers 33% of cases showed positive staining of the in situ and invasive component, whereas only 25% of cases showed amplification of the Neu oncogene. The staining pattern in the tumor cells was cytoplasmic with plasma membrane accentuation. Focal positive cytoplasmic staining was noted in some cases of fibrocystic disease, fibroadenoma, and normal breast duct epithelium. Myoepithelial cells and smooth muscle of blood vessels also showed a positive reaction. This study shows that the Neu oncoprotein can be demonstrated on formalin-fixed material from normal, benign, and malignant breast lesions. In the breast cancers the differences in the number of cases showing amplification and those showing a positive immunohistochemical reaction could be due to increased transcriptional activity. It is possible that the node-negative patients whose tumors express the Neu oncogene may correspond to the group of patients who are expected to have a poor prognosis.

Adenofibroma↗
PubMed1990

HLA antigens and nailfold capillary microscopy studies in patients with insulin dependent and noninsulin dependent diabetes mellitus and limited joint mobility.

We investigated the HLA status of patients with diabetes associated with limited joint mobility and microvascular complications. An increased frequency of HLA-B8, DR3 and DR4 in patients with insulin dependent diabetes mellitus (IDDM) compared to controls and patients with noninsulin dependent diabetes mellitus (NIDDM) was confirmed. HLA antigen DQw1 was detected less frequently in patients with IDDM and was negatively associated with limited joint mobility and retinopathy. Limited joint mobility was significantly correlated with disease duration in IDDM, and was associated with neuropathy in both IDDM and NIDDM and with retinopathy in IDDM. No correlation was found between DR3, DR4 and limited joint mobility or diabetic complications. We also investigated the usefulness of nailfold capillary microscopy in a large group of patients with IDDM and NIDDM. Although capillary enlargement and avascular areas were noted in a few patients, nailfold capillary microscopy was not felt to be a useful tool in the evaluation of diabetes.

Adolescent↗
PubMed1990

Scanning electron microscopy of immuno-gold labeled antigens associated with bladder cancer.

Scanning electron microscopy (SEM), in the backscattered electron imaging (BEI) mode, has been used to study the topographical distribution of colloidal gold labeled antigens expressed on the luminal surface of the bladder urothelium in biopsies from three categories of patients: 1) normal controls; 2) patients with a history of bladder cancer but no pathological diagnosis at time of cystoscopy; and 3) patients with overt transitional cell carcinoma (TCC) of various histopathological stages and grades. Cold cup biopsies were processed for immuno-SEM according to a previously described method. Antigens under investigation were: 1) ABH blood group antigens; and 2) those identified by the following murine monoclonal antibodies (mAbs): LEU-M1, T16, 19A211, G4 and E7. In most cases labeling patterns were correlated with the surface features of the superficial urothelial cells as revealed in the secondary electron imaging (SEI) mode of the SEM. Results, to date, indicate that the immuno-gold labeling method is more sensitive than immuno-peroxidase, and that phenotypic heterogeneity of antigenic expression (or deletion) is a frequent observation of potential diagnostic or prognostic value.

ABO Blood-Group System↗
PubMed1989

Acral localized acquired cutis laxa.

We report the first case of acral localized acquired cutis laxa. The skin laxity was preceded by swelling of the fingers and toes and by the appearance of papular urticaria. Dapsone therapy was effective in controlling the swelling. Examination of skin biopsy specimens showed fragmentation and almost total loss of elastic fibers in the areas of cutis laxa. Electron microscopy showed no abnormalities in elastic structure and function in unaffected skin. In addition, electron microscopic examination of an urticarial lesion showed a neutrophilic dermatosis with polymorphonuclear leukocytes attached to the surface of either normal elastic fibers or fibers showing early degenerative changes. These findings suggest that there is no primary defect in the elastic fibers and that the polymorphonuclear leukocytes play a significant role in the destruction of the elastic fibers and the subsequent development of cutis laxa in this case.

Adult↗
PubMed1989

Alterations of serum and urinary carnitine profiles in cancer patients: hypothesis of possible significance.

The present study examined the serum and urinary carnitine concentrations of 21 cancer patients with metastatic disease and 13 healthy age-matched controls by taking three consecutive samples during an 8-week period. The serum concentrations of all fractions of carnitine were significantly lower in the female cancer patients than in the female controls. The concentrations of urinary carnitine fractions were relatively higher in the total cancer population; however, only acid-insoluble acylcarnitine (AIAC) was statistically significant. The renal clearance of acid-soluble acylcarnitine (ASAC) and AIAC was significantly greater in cancer subjects than in controls. Significant inverse relationships were established between the ASAC and AIAC clearances and their respective serum concentrations. The renal tubular reabsorption of AIAC was significantly less in cancer patients than in control subjects as indicated by the fractional excretion of carnitine. The increased clearance of acylcarnitine and excretion of large amounts of AIAC are proposed to be a response to chemotherapy and represent a loss of energy to the cancer patient.

Carnitine↗
PubMed1989

Comparative evaluation of ER-ICA and enzyme immunoassay for the quantitation of estrogen receptors in breast cancer.

Evaluation of estrogen receptors (ERs) is essential for the treatment and prognosis of human breast cancer. The authors have undertaken a study of 225 primary breast cancers to compare the receptor values using immunohistochemistry and enzyme immunoassay (EIA) techniques. The results are compared with the biochemical assay with the use of the dextran-coated charcoal (DCC) method done on the same specimens. The overall concordance between ER-ICA and DCC was 77%. Ninety-seven percent concordance was observed for specimens with a positive ER-ICA score (greater than 70 and the DCC more than 10 fmol/mg protein). Ninety-two percent of tumors had negative results by ER-ICA when the DCC was less than 10 fmol/mg protein. When the ER-ICA score was plotted against the DCC or EIA value, a significant correlation was obtained with a P value of less than 0.001. The correlation between the ER-ICA score and the total ER content (cytosol and nuclear) assayed by EIA was similar to comparison with cytosol alone. The authors conclude that the ER-ICA can be useful in assessing ERs in breast especially in hypocellular or small tumors and in assessing the degree of heterogeneity in a given tumor. The immunohistochemical and biochemical assay methods are complementary and provide greatly needed information for the management of breast cancer.

Breast Neoplasms↗
PubMed1989

Cystosarcoma phylloides of the breast and its mimics. An immunohistochemical and ultrastructural study.

Cystosarcoma phylloides of the breast is a tumor composed of breast ducts and a cellular stromal component that can be benign or malignant. The origin of the stromal cells is controversial. We undertook an immunohistochemical and ultrastructural study of 11 cases of cystosarcoma phylloides to assess the histogenesis of the stromal component. By light microscopy, 4 were diagnosed as benign, and 7 were diagnosed as malignant. Antibodies to vimentin, desmin, actin, high- and low-molecular-weight keratins, and S100 protein were used for immunohistochemical staining. In the 4 benign cases of cystosarcoma phylloides, the stromal cells stained positively only for vimentin. In the malignant tumors, the spindle cell component stained for vimentin in all the cases. In addition, the malignant stromal cells coexpressed desmin in two cases and keratin and S 100 protein in another case. By electron microscopy the stromal component in the benign case and in two of five malignant cases was composed of a mixture of fibroblasts and myofibroblasts. The entire neoplastic stroma in two other malignant cases showed features of smooth-muscle differentiation, whereas in another case all the stromal cells showed myoepithelial differentiation. Thus, in benign and malignant cystosarcoma phylloides, the stromal component consists of a mixture of fibroblasts and myofibroblasts. Leiomyosarcomas and myoepitheliomas can mimic malignant cystosarcoma phylloides, but immunohistochemistry and electron microscopy can differentiate these entities. This is important since their biologic behavior is different.

Adolescent↗
PubMed1989

Epithelial proliferation in thymic hyperplasia. An immunohistochemical study and correlation with the developing fetal thymus.

Thymic hyperplasia is a B-cell lymphoid proliferation in which an epithelial component has not, to our knowledge, been previously described. We present a case of thymic hyperplasia in which numerous lymphoid follicles with germinal centers were partially surrounded by small sheets of spindle and epithelioid cells. Electron microscopy confirmed the epithelial nature of these cells. Immunostaining was performed using antibodies to keratins, S100 protein, and two B-cell markers, LN1 and MB2. The proliferated epithelium stained only for high-molecular-weight keratin, whereas the lymphoid tissue stained positively for both B-cell markers. To determine the origin of the proliferated epithelium, the staining was compared with that of the developing fetal and normal adult thymus. We have shown that during fetal development, the keratin composition of thymic epithelium changes from staining predominantly with low- to high-molecular-weight keratin. The immunostaining characteristics of the epithelium in this case of thymic hyperplasia suggest an origin from adult-type epithelium. Furthermore, the association of S100-positive interdigitating reticulum cells with the proliferated epithelium suggests that it is of medullary origin. Our results indicate that epithelial proliferation can be an important component of thymic hyperplasia.

Aged↗