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W L Ho

Publications and source records attributed to W L Ho.

At least 55 records · Page 3Linked to original sources
PubMed1995

Pulmonary carcinoid tumor--tumorlet type: a case report.

A rare case of bronchiectasis with carcinoid tumor, tumorlet type, is reported. The patient was a 53-year-old female who underwent lobectomy of the right middle and lower lobes for severe hemorrhage secondary to bronchiectasis. No tumor was seen on chest X-ray or by gross examination of the lung. Microscopically, there were multiple tumorlets in the pulmonary parenchyma surrounding the bronchiole and small bronchus. The tumor cells stained positive for neuron-specific enolase, keratin and chromogranin stain. The morphology, and staining properties suggested that the pulmonary tumorlets were carcinoid tumor. No tumor cells were identified in the four peribronchial lymph nodes. The patient is disease-free after four years of follow-up.

Carcinoid Tumor↗
PubMed1994

Hepatocellular carcinoma with adjacent organ extension: the enhancement of preoperative transcatheter arterial embolization and the results of surgical resection.

A review was conducted on 93 patients with hepatocellular cellular carcinoma (HCC) who underwent a collective total of 98 resections. A total of 24 hepatic resections were performed on 22 patients who had a serosa-exposed tumor (group A), for which combined resection of the adjacent organs was also required due to gross tumor invasion. The tumors of the group A patients were larger, had a higher incidence of intrahepatic vascular involvement, and were in a more advanced stage than those of the other patients (group B). Nevertheless, there were no differences in operative morbidity and mortality between the two groups. Only ten of the group A patients, who each underwent one operation, had concomitantly resected adjacent organs histologically invaded by HCC, while histological examination revealed adhesions in the remaining surgical specimens of concomitantly resected adjacent organs. More of the group A patients had undergone a preoperative transcatheter arterial embolization (TAE), which may enhance the histological invasion of HCC to the adjacent organs. The median survival times of the group A and B patients were 15.3 months and 40.1 months, respectively (P < 0.05), although whether the concomitantly resected organs were truly invaded by HCC did not influence the prognosis. Thus, en bloc combined resection of HCC-invaded adjacent organs is still advocated even for recurrent tumors; however, for serosa-exposed HCC after TAE, earlier resection is recommended whenever possible to avoid invasion of the adjacent organs.

Adult↗
PubMed1994

Malignant peripheral nerve sheath tumor: a study of 21 cases.

BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is an aggressive tumor of neural origin. To improve our experience with this rare tumor, we reviewed 21 patients seen during a 12-year period at the pathological department of Taichung Veterans General Hospital. METHODS: Clinical data including age, sex, presence or absence of von Recklinghausen's disease, tumor location and size, presenting symptoms, surgical management and surveillance were summarized. Microscopically, we examined necrosis, mitosis, differentiation, the resection margin, and the presence or absence of neurofibromatous component. RESULTS: There were 15 males and 6 females with age range of 9-86 years. Seven cases were associated with neurofibromatosis and 14 cases were solitary MPNST: Patients with coexistent neurofibromatosis were younger (mean age at diagnosis, 32 years) than patients with solitary MPNST (mean, 60.2 years). Tumors of the former group tended to be centrally located. Anaplastic alteration was found in the recurrent tumors of two patients both of whom died of the disease. Of the 21 cases, epithelioid differentiation and osteoid metaplasia were seen in two tumors respectively by optical microscopy. Patients with von Recklinghausen's disease and large incompletely resected tumors had the most dismal prognosis. Of five patients with neurofibromatosis who were observed for more than two years, only one survived and no recurrence was found. The remaining four patients died within 3-9 months. However, of 14 cases of solitary MPNST, only two patients died of disease and ten of them had survived beyond two years. CONCLUSIONS: Our work revealed that patients with von Recklinghausen's disease, a large unresectable centrally located tumor with diffuse anaplastic alteration, had frequent recurrences and poor prognosis. Aggressive surgical procedure with free resection margin is suggested. Malignant transformation should be highly suspected when a painful, rapidly growing tumor developed.

Adolescent↗
PubMed1994

[The correlation between cytology and histopathology of primary adenocarcinoma of the uterine cervix].

Cytodiagnosis is a simple, non-invasive and economical screening method for uterine cervical malignancy. Adenocarcinoma as a primary tumor of uterine cervix, although relatively rare, is increasing recently. The first part of the study consisted of 113 patients, seen during a 10-year period, with adenocarcinoma of the uterine cervix proven by tissue diagnosis with prior and/or coincident Papanicolaou smears available in our hospital. Their cytology were as follows: positive/suspicious for adenocarcinoma in 72 cases (63.7%) and incorrect diagnosis for adenocarcinoma in 41 cases (36.3%). These included epidermoid carcinoma, 21 cases (18.6%); atypia, 8 cases (7.1%); negative smears, 8 cases (7.1%); inadequate specimens, 3 cases (2.7%) and radiation effect, 1 case (0.8%). The second part of the study is concerned with the 82 cases whose smear diagnosis was adenocarcinoma in the same period. The results of their tissue diagnosis and accuracy were as follows: adenocarcinoma in 62 cases (75.6%); epidermoid carcinoma in 9 and epidermoid carcinoma in situ in 3 cases totalling 12 cases (14.6%); and false positive in 8 cases (9.8%). The cytomorphology and its correlation to underdiagnosis and overdiagnosis is discussed. Our data revealed that cervicovaginal smears served as a routine for the screening of primary adenocarcinoma of the uterine cervix and for follow-up and detection of recurrence. In order to increase the accuracy, screening cytotechnicians and cytopathologists should acquaint themselves with the morphology of cervical adenocarcinoma by comparing cervicovaginal smear with histopathology.

Adenocarcinoma↗
PubMed1994

Intramedullary cryptococcal granuloma of spinal cord: a case report.

The budding yeast, Cryptococcus neoformans, is widely distributed throughout the world and causes opportunistic and non-contagious infections in man. Involvement of the central nervous system has been found in 70% of patients at the time of diagnosis, and meningitis or meningoencephalitis are the most common manifestations. Space-occupying cryptococcal granuloma, on the other hand, is infrequently encountered in the brain and extremely rare in the spinal cord. Seven cases of spinal torulomas (cryptococcal granuloma) have been reported in the available literature. Only one was intramedullary. Here an isolated case of intramedullary cryptococcal granuloma in the spinal cord in an immunocompetent patient is reported; diagnosis was by intraoperative frozen section. After two months of post-operative antifungal treatment, the clinical condition has received markedly improvement.

Aged↗
PubMed1994

A retrospective study of DNA ploidy of transitional cell carcinoma of urinary bladder using flow cytometry.

Transitional cell carcinoma is the most common malignancy of urothelial origin in urinary bladder. Its aggressive potential cannot be reliably predicted from the histologic appearance alone. Recently, there has been extensive studies of DNA ploidy using flow cytometry in prospective analysis of bladder tumors with fresh tissue. Techniques for the preparation of paraffin embedded tissue have been developed and successfully applied in retrospective evaluation of bladder tumors. These studies had demonstrated the correlation between histological grading and DNA ploidy, and between clinical staging and DNA ploidy. Our retrospective study showed that the cytometric method is superior to histologic grading in the predictability of patient's survival, especially in the low grade (grades 1 and 2) group. In the preparation of paraffin embedded tissue, the high background debris and wide range of coefficients of variation had some interference in the interpretation for the histogram of FCM (only 80% of the cases studied are interpretable). This interference might be due to the variation of conditions of tissue processing and fixation. The evaluation of S phase fraction and G2/M fraction is also difficult to perform because of the same problem. There was an encouraging result in the evaluation of DNA ploidy using flow cytometry with paraffin embedded tissue, although a relatively small number of patients were included in this study. The value of this technique application in clinical evaluation of the prognosticity was obvious.

Adult↗
PubMed1993

[Intraoperative cytology: the use of Liu's stain for immediate diagnosis].

We prospectively studied 305 fresh specimens submitted for intraoperative frozen section diagnosis. Three types of cytologic preparations, namely touch imprint, smearing, and crush method, were performed to obtain adequate material. Liu's stain, which takes only two minutes and is one of the rapid staining methods of the Romanowsky series, was used for immediate interpretation. The accuracy of diagnosis was measured by comparison with final histological diagnosis. Sensitivity and specificity of intraoperative cytology were 94.9% and 95.6% respectively. The false-positive rate, false-negative rate, and suspicious rate were 0.3%, 1.3%, and 1.6%. In combination of intraoperative cytology and frozen section, sensitivity and specificity became 96% and 96.3% respectively. The cytomorphology of breast, thyroid, lymph node, and ovary is briefly described. Most cases of cytological diagnostic error are found in sarcomas and ovarian tumors. We conclude that Liu's stain is a simple, rapid, and reliable staining method in intraoperative cytological diagnosis. It is apparent that intraoperative cytology is able to provide a useful adjunct to the frozen-section diagnosis and an excellent teaching file for cytopathology.

Breast↗
PubMed1993

[MRI of postmortem brains].

We studied 18 formalin-fixed brains using MRI, and correlated our data with subsequent gross and microscopic examinations. 9 of our patients died from brain diseases (stroke due to infarction 4, stroke due to hemorrhage 1, encephalitis 2, head injury 1, brain tumor 1). 9 of our patients died from non-CNS diseases (stomach cancer 1, colon cancer 1, liver cirrhosis 1, myocardial infarction 2, trauma 4). In MRI of postmortem brain, T1WI and T 2WI was able to clearly show the myelination process of brainstem, basal ganglia, internal capsule and optic radiation in a 2 months-old-boy. The findings were similar to MRI of live infants. In normal adult postmortem brains, the T1WI showed a relatively low signal intensity of white matter as compared to gray matter. The pictures were similar to proton density images, not T1WI of normal adult brains. The reason why the signal intensity of the white matter was lower than the gray matter may have been due to lysis of lipid of myelin sheath in the formalin solution. Postmortem MRI was able to detect the periventricular hyperintensity (corresponding to arteriosclerotic encephalopathy) and subcortical hyperintensity spots (which corresponding to the widening of the Virchow-Robin perivascular space because of arteriosclerosis) in the brains of our elderly patients. Postmortem MRI detected the intracerebral hemorrhage, which appeared as a dark signal in both short and long TR images. However, MRI did not show blood in the ventricles, sulci, or superficial hemorrhages in the cortex of brain. Brain edema was revealed in the postmortem MRI and appeared as low signal intensity in T1WI and hyperintensity in T2WI. It was associated with a significant mass effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Glomus tumor of the stomach: a case report.

The histologic and ultrastructural features of a gastric glomus tumor are presented with a brief review of the literature. Initially interpreted as carcinoid, the tumor occurred in a 41-year-old female who was first diagnosed by radiological examination and microscopic histological study of an endoscopic biopsy specimen. Glomus tumor was confirmed by further study of multiple sections of a surgical specimen and by electron microscopy. Correct identification of this essentially benign, very rare gastric tumor can prevent unnecessary radical operative procedures.

Adult↗
PubMed1993

[The immediate interpretation for fine-needle aspiration cytology].

From December 1990 to November 1992, 2005 cases of immediate interpretation for fine-needle aspiration (FNA) cytology were performed, of which 727 cases were confirmed by surgical pathology. A mobile cytologic laboratory (a cart loaded with a dual viewing microscope, Liu's staining solutions, hair dryer, and slides) can be moved to the Out-patient Department, wards and Computed Tomography room, where clinicians perform aspiration and pathologists read smears. Immediate verbal diagnoses are documented to patients' charts and listed in cytopathologic files. Immediate interpretation in this entire series yielded a sensitivity 92.5%; specificity, 98.1%; false-positive rate, 1.1%; false-negative rate, 3.2%; positive predictive value (PV), 97.3%; negative PV, 94.7% and efficiency, 95.7%. The cause of false-negative results in the 23 cases probably came from the hesitation in making an immediate diagnosis. Most of these cases were malignant lymphoma or breast carcinoma. The roles of immediate cytodiagnosis are (1) to decrease the inadequate rate of FNA specimens; (2) to render preliminary diagnosis for clinicians to make decisions; (3) to provide on-site teaching material for both clinicians and pathology residents to better understand clinicopathological correlations; (4) to act as the initial diagnostic procedure in the evaluation of a superficial palpable mass. This study shows that immediate interpretation for FNA cytology is a simple, rapid, accurate and noninvasive diagnostic procedure that can be routinely used for superficial palpable masses.

Biopsy, Needle↗
PubMed1993

Malignant peritoneal mesothelioma: a case report.

Malignant peritoneal mesothelioma is a rare disease, not previously reported in Taiwan. The reported case concerns a 64-year-old veteran who had suffered from abdominal pain and distension for several days. After exploratory laparotomy, segmental resection of the small intestine, excised a mesenteric mass. A characteristic biphasic pattern resulting from the admixture of gland-like area and a sarcomatous stroma presented in the histologic section. A series of histochemical, immunohistochemical and ultrastructural studies proved this to be a malignant peritoneal mesothelioma. The patient died after a course of post-operative chemotherapy. History of asbestos exposure, with which the tumor is usually intimately associated, could not be traced with certainty. Poor prognosis is the rule of the disease; almost all patients die within two years of diagnosis. An effective therapeutic modality is still unavailable. Here the clinical and pathologic characteristics of the tumor are described, with a brief review and discussion of the pathogenesis as well as the obscured therapeutic problem.

Carcinoembryonic Antigen↗
PubMed1993

Ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma: report of a case and review of the literature.

Cases of ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma are very rare. We report on such a case and review the literature. The mural nodules in our case were made up mainly of anaplastic spindle cells and numerous osteoclast-like giant cells. They resembled sarcoma or sarcoma-like mural nodules under light microscopy. The anaplastic cells within the nodules were immunopositive for both cytokeratin and vimentin, and ultrastructurally they displayed desmosomes. This case reaffirms the value of immunohistochemistry and ultrastructural study to establish the nature of such nodules, and the importance of making such distinctions.

Adult↗
PubMed1992

[A study of perigastric lymph node metastasis in patients with early gastric cancer].

The prognosis after a gastrectomy for early gastric cancer (EGC) is favorable. Among 115 patients with early gastric cancer since 1983, 96 patients have received a radical gastrecomy (RG) and 19 have received a simple gastrectomy (SG). The cancer was confined to the mucosa in 47 cases and had invaded into the submucosa in 68 cases. Perigastric lymph nodes metastasis was observed in 17 patients (14.8%). The metastatic rate for mucosal cancer was 2.1% and that of submucosal cancer was 23.5% (p less than 0.005). Advanced nodal metastasis was occasionally visible in a few patients with submucosal cancer. The macroscopic pattern, size, primary site and differentiation of the cancer and the age and sex of the patients did not influence the rate of nodal metastasis. A follow-up study of 61 patients with EGC operated on before 1988 was carried out, the 5-year survival rate of RG was 92.9% and that of SG was 84.2% (p = 0.3109). The 5-year survival rate for mucosal cancer for RG was 100% and that for was 90.9% (p = 0.3048). The 5-year survival rate for submucosa] cancer for RG was 89.3% and that for SG was 75.0% (p = 0.0685). We suggest that RG be mandatory for EGC unless the depth of invasion is confined to the mucosa in the preoperative diagnosis, or if gross advanced metastasis is present to obtain more accurate postoperative staging and to achieve a curative resection. However, SG is still an alternative treatment for EGC if a patient's condition is poor or for extremely old patients.

Adult↗
PubMed1991

Histopathological change of corpora cavernosa after long-term intracavernous injection.

Repeated intracavernous injections in healthy monkeys with 2 kinds of vasoactive agents [papaverine and prostaglandin E1 (PGE1) 3 monkeys each] and normal saline (2 monkeys) were conducted in this study. The purpose was to observe the effect of long-term injection on histopathological changes of the cavernous tissue, as well as the change in drug sensitivity (dosage dependence). Different dosages of the same volume (double, single and half dose) of these 3 agents were injected, twice weekly, 10 times alternatively, with rigidity and maintenance of erection recorded. After long-term injection (papaverine group: 37, 60, 60 times; PGE1 group: 26, 60, 60 times; normal saline group: 60, 60 times), all monkeys were sacrificed and the penises were collected for light-microscopic (LM) and electron-microscopic (EM) examinations. Dose-dependent response with reversed drug sensitivity was found in the papaverine group, but only elongation to tumescence was found in the PGE1 group, even with double dosage (probably because of scarce PGE1 receptors in monkey's penile tissue). Histopathologically, mild to moderate fibrotic changes and distortion of normal architecture were predominant findings in LM while aggregation of mitochondria, irregular shape or atrophy of cells were obvious in EM observation in the papaverine group. On the other hand, limited fibrosis with preservation of corpora cavernosa and hypertrophy of smooth muscle were noted in the PGE1 group. This study indicated that less histopathological change occurred in the PGE1 group after long-term intracavernous injection.

Alprostadil↗
PubMed1991

Malignant papillary cystic tumor of the pancreas: report of a case and review of the literature.

Papillary cystic tumor of the pancreas almost always occurs in young female patient and metastasis is extremely rare although local recurrence may occur. Prognosis is excellent and the tumor can be considered to be curable by surgery. Reported here is an unusual case of malignant papillary cystic tumor of the pancreas that occurred in a 51 Y/O man with metastasis to bilateral inguinal soft tissue at the time of diagnosis. Beside distal pancreatectomy, subtotal gastrectomy and excision of the inguinal masses were also performed because of the presence of a separate tumor in the lesser sac, which was unrelated to the pancreas. Immunohistochemical staining for NSE was positive in tumor cells. However, electron microscopy failed to reveal neurosecretory or zymogen granules but there were abundant mitochondria, rough endoplasmic reticulum and annulate lamellae. These findings show that a ductal origin is more likely in our case but the hypothesis of an origin from a primitive cell capable of acinar, ductal or endocrine differentiation should also be considered.

Carcinoma, Papillary↗
PubMed1991

[MRI of white matter pathways].

CT scan shows some relatively large white matter pathways such as corpus callosum or internal capsule, while MRI provides more sophisticated display of cerebral white matter pathways, based partly on difference in the water content, which improves contrast resolution of structures that cannot be appreciated on CT scanning. The white matter shows slightly high signal intensity in T1WI as compared with the peripheral gray matter. In contrast, it is relatively low signal intensity in long TR sequence. The signal intensity is correlated with myelination, density of myelin fibers and possibly iron deposition. In this study, we collected data on 30 patient, aged from 3 to 60 years average 38 years of normal MRI study of the brain. We routinely obtained T1 Weighted image (T1WI, TR/TE 500-600/20 msec), dual echoes image of proton density image (PDI, TR/TE 2000-3000/20 msec), T2 weighted image (T2WI, TR/TE 2000-3000/80-120 msec), in axial and coronal sections. In some cases sagittal section was also imaged. We identified the white matter pathways based on the data from the axial and coronal sections of 2 autopsy specimens. We also consulted several textbooks and literature reviews of gross and MRI anatomy. The following white matter pathways could be clearly observed on MRI: 1. Projection fibers: corona radiata and internal capsule; 2. Commissural fibers: corpus callosum and anterior commissure; 3. Associated fibers: superior occipito-frontal fasciculus, superior longitudinal fasciculus, ucinate fasciculus, cingulum bundle, optic radiation fornix and mammillothalamic tract.

Adolescent↗
PubMed1990

Rhinocerebral mucormycosis: report of two cases.

Rhinocerebral mucormycosis developed in two poorly controlled diabetic patients with clinical manifestations of frontal headache, ophthalmoplegia, ptosis, proptosis, epistaxis and facial numbness. Early computed tomography (CT) of the head revealed fluid accumulation in paranasal sinuses. The diagnosis of this disease relied upon CT of the head, and biopsy or culture of the mucosa of sinuses. Remarkable improvement was noted following prompt surgical debridement and amphotericin-B therapy. We conclude that early diagnosis and aggressive treatment is the only way to save patient's life.

Aged↗