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Biomedical subjects

W R Hart

Publications and source records attributed to W R Hart.

At least 91 records · Page 5Linked to original sources
PubMed1977

Endometrial stromal sarcomas.

This study is a clinicopathologic evaluation of seven patients with endometrial stromal sarcoma of pure homologous type. Histologic distinction from endometrial stromatosis was based on the presence of high mitotic activity and nuclear anaplasia. One sarcoma appeared to have originated from invasive stromatosis. All patients died within 27 months although the tumor was judged to have been confined to the uterus at the time of hysterectomy in five patients. The aggressive clinical behavior and high mortality rate documented in this and other studies indicate that stromal sarcoma should be distinguished from the better differentiated and more indolent endometrial stromal tumor known as stromatosis or endolymphatic stromal myosis. It is suggested that surgery be supplemented by irradiation and/or chemotherapy as primary treatment for stromal sarcoma in view of its dismal prognosis.

Adult↗
PubMed1977

Progression of intraepithelial Paget's disease of the vulva to invasive carcinoma.

Sequential progression from intraepithelial Paget's disease of the vulva to invasive carcinoma after an interval of 10.8 years is documented in this report. Infiltration of the dermis with permeation of lymphatics and metastasis to regional lymph nodes are believed to have resulted directly from foci of intraepidermal Paget's cells that persisted after a simple vulvectomy. No underlying primary sweat gland carcinoma was present. Hence, this case establishes the invasive potential of intraepithelial vulvar Paget's disease and substantiates the notion that it is indeed a type of carcinoma in situ.

Aged↗
PubMed1977

Ovarian epithelial tumors of borderline malignancy (carcinomas of low malignant potential).

Ovarian epithelial neoplasms that have morphologic features intermediate between those of clearly benign and unquestionably malignant lesions are currently classified as tumors of borderline malignancy (carcinomas of low malignant potential). Patients with stage I lesions of this type have an excellent prognosis following conservative surgery. Survival rates are remarkably good even when extraovarian spread has developed. The clinicopathologic features and histologic criteria for the diagnosis of borderline tumors of serous and mucinous cell types are detailed in this presentation.

Cystadenoma↗
PubMed1977

Endodermal sinus tumor of the anterior mediastinum.

An endodermal sinus tumor presenting as a lobulated anterior mediastinal mass in a 20-year-old white man is reported. The clinical implications, histology, and origin of this rare germ cell tumor are discussed. The invasive nature of this highly malignant neoplasm prevented complete surgical resection.

Adult↗
PubMed1977

Endometrial stromatosis of the uterus.

This study details the clinicopathologic features of 9 patients with endometrial stromatosis of the uterus, including 1 with the circumscribed variant. The potential of stromatosis for local invasion, intravascular penetration, and pulmonary metastasis is documented. Recurrent lesions often develop late, are amenable to surgical therapy, and do not necessarily portend a fatal outcome. Our findings and those of others indicate that the histopathologic appearance and relatively indolent behavior of stromatosis are sufficiently characteristic to justify its separation from the more aggressive homologous endometrial stromal sarcomas.

Adolescent↗
PubMed1976

Histopathologic spectrum of vaginal adenosis and related changes in stilbestrol-exposed females.

A total of 98 colposcopically directed biopsies were obtained from the vagina, cervix, and cervicovaginal ridge (hood) of 80 young women believed to have had intrauterine exposure to stilbestrol (DES). Specific investigation of the patient's medical records corroborated the history of maternal stilbestrol administration in 36 patients (45%), while in the remainder the drug history was regarded as presumptive since medical records were unavailable for review. The findings did not differ significantly in those biopsies taken from patients with confirmed or presumptive drug histories. Histologic evidence of vaginal adenosis was detected in vaginal biopsies from 43 patients. In 30 cases (70%) benign Müllerian-type glandular epithelium was in the superficial vaginal wall, residing on the mucosal surface and/or in the lamina propria. The glandular epithelium predominantly was of endocervical type, but in six instances it resembled endometrial or fallopian tubal epithelium. The glands were accompanied by varying degrees of squamous metaplasia in 22 cases. When extensive the metaplasia produced transformation zones similar to those seen in the normal cervix. Vaginal biopsies of adenosis from the other 13 patients (30%) revealed squamous metaplasia without demonstrable glands due to complete transformation of all antecedent glandular epithelium by squamous metaplasia. Our studies indicate that squamous metaplasia is a component of major importance in the natural history of adenosis and that the concept of adenosis should be broadened to include those examples comprised exclusively of metaplastic epithelium. In such examples metaplasia is identified by the immaturity and poor glycogenation of the squamous cells and their accompanying squamous pegs which often contain residual gland openings or squamous "eddies." Similar findings were present in biopsies of seven cervicovaginal ridges and in cervical biopsies from 37 patients, except for the absence of endometrial or tubal type glands in the latter site. Although no adenocarcinomas were detected, six patients had squamous dysplasia of the vagina and/or cervix. In no case were premalignant or dysplastic changes of glandular cells found. Our findings support the thesis that stilbestrol-associated adenosis represents anomalous embryologic localization of the original squamocolumnar junction in the vagina rather than in the cervix. It is closely related to so-called cervical "erosions." The development of squamous metaplasia accounts for modifications in the clinical and histologic appearances by producing transformation zones which then may be subject to the same oncogenic stimuli for squamous neoplasia as are their counterparts in the cervix.

Adolescent↗
PubMed1976

Malacoplakia of the prostate in an immunosuppressed patient.

Malacoplakia predominantly affects the bladder but occasionally involves other sites. The third case of malacoplakia of the prostate, occurring in a renal transplant patient who was receiving prednisone for immunosuppression, is reported. Modification of phagocytosis and the normal inflammatory response to bacterial infection by the steroid may have been of major importance in the genesis of malacoplakia.

Humans↗
PubMed1976

Isolated coccidioidomycosis of the uterus.

Coccidioidomycosis rarely involves the female genital tract. This report describes a case of coccidioidomycosis that was incidentally discovered involving the uterus of an asymptomatic 70 year old woman who had squamous carcinoma of the cervix. Reports of the few previously documented examples of coccidioidomycosis of the female genitalia are reviewed. Although the uterine lesion probably resulted from a solitary focus of dissemination from a clinically inapparent and completely resolved primary pulmonary infection, evidence is presented that it may have been a primary uterine infection.

Aged↗
PubMed1976

Metaphyseal chondroblastoma of bone.

This report documents the ninth example of a chondroblastoma localized to the metaphysis of a long bone. The tumor appeared as a lytic lesion in the femoral neck of an 18-year-old boy and was associated with a periosteal reaction. When such neoplasms occur in an unusual location with associated periosteal reaction, chondroblastoma should be considered in the differential diagnosis.

Adolescent↗
PubMed1975

Primary endodermal sinus (yolk sac) tumor of the liver. First reported case.

A primary endodermal sinus (yolk sac) tumor of the liver occurring in an 18-month-old boy is described. Although several examples of extragonadal endodermal sinus tumors have occurred in other sites, this is believed to be the first reported instance of origin in the liver. An additional important feature was the detection of alpha-fetoprotein in a preoperative serum sample. Although no metastases were identified at the time of celiotomy, widespread metastases developed, and he died 6 1/2 months after an extended right hepatectomy was performed. Neither triple chemotherapy nor radiation therapy appeared to deter progressive spread of the neoplasm, although the metastases exhibited some radiosensitivity.

Alpha-Globulins↗
PubMed1975

Ataxia-telangiectasia with ovarian gonadoblastoma and contralateral dysgerminoma.

Although neoplasms are unusually frequent in patients with ataxia-telangiectasia, the occurrence of primary tumors of the ovary in such patients is exceedingly rare. This report describes a 17-year-old phenotypic female with ataxia-telangiectasia, who was found to harbor an ovarian gonadoblastoma and a contralateral dysgerminoma. The latter tumor has occurred in only one other patient with ataxia-telangiectasia, while an association with gonadoblastoma has never been documented previously. Additional unusual features rarely encountered in patients with gonadoblastoma included origin of the tumor within a histologically proven ovary, and a 46,XX karyotype. The possibility that the dysgerminoma also arose from a gonadoblastoma is discussed.

Adolescent↗
PubMed1975

Benign polyps with prostatic-type epithelium of the urethra.

Benign polyps of the male urethra may be composed of prostatic-type epithelium and acini. Usually located in the prostatic portion of the urethra, they have been reported to be a major cause of hematuria in young men. Three new cases are described to foster an awareness of this distinctive clinicopathologic entity.

Adult↗
PubMed1975

Relation of lichen sclerosus et atrophicus of the vulva to development of carcinoma.

One hundred and seven patients with lichen sclerosus et atrophicus (LS&A) of the vulva were studies to determine the malignant potential of the LS&A. Five patients had coexisting invasive carcinoma of the vulva or perineum with the LS&A, and 1 patient had coexisting intraepithelial vulvar carcinoma on the clitoris. None of these, however, was known to have LS&A prior to the biopsy for carcinoma of the vulva. The high association of carcinoma and LS*A is probably a result of selection of 2 unusual lesions sent for consultation and evaluation. Squamous hyperplasia in the vulva occurred in association with LS&A in 37 (35%) patients, but only 6 patients had areas of dysplasia coexisting with LS&A. These areas of dysplasia, like the 5 invasive carcinomas, occurred in an area of the vulva where the LS&A was minimal or absent. Follow-up data were obtained on 92 patients with LS&A. Only 1 developed carcinoma of the vulva, which occurred 12 years after identification of the LS&A. When carcinoma arises in the vulva in a patient with vulvar LS&A, it tends to arise in areas of minomal LS&A or isolated areas of relatively normal vulvar skin. This study did not provide evidence of carcinoma arising from LS&A. Five of the 92 patients developed 6 malignant neoplasms in other sites, including carcinoma of the endometrium (3 patients), lung (1 patient), and simultaneous carcinomas of the colon and cervix (1 patient).

Adolescent↗