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W T McCaughey

Publications and source records attributed to W T McCaughey.

At least 37 records · Page 2Linked to original sources

Analysis of hyaluronic acid in the diagnosis of malignant mesothelioma.

Using a modified papain digestion cetylpyridinium salt precipitation method, glycosaminoglycans were isolated from 21 mesotheliomas, 34 primary lung carcinomas, 12 carcinomas of other sites, and 7 soft tissue sarcomas. Qualitatively, hyaluronic acid (HA) was present in 20 of 21 mesotheliomas, about half of the primary lung adenocarcinomas, and all of the soft tissue sarcomas. On the average, HA constituted 45% of the total glycosaminoglycans in the mesotheliomas and 28% of the total in the lung cancers. Quantitatively, mesotheliomas contained statistically greater amounts (mean value, 0.74 mg/g) of HA than primary lung adenocarcinomas (mean value, 0.08 mg/g), but were not statistically different from soft tissue sarcomas (mean value, 2.01 mg/g) or primary ovarian serous neoplasms (mean value, 0.92 mg/g). The study concludes that, contrary to previous reports, HA is neither the sole nor the predominant glycosaminoglycan in most mesotheliomas, but, given the proper clinical and histologic setting, the finding of sufficiently high levels (greater than 0.4 mg/g dry tissue extract) supports the diagnosis of mesothelioma when the alternative diagnosis is primary adenocarcinoma of lung.

Adenocarcinoma↗

Ultrastructural aspects of the histogenesis of diffuse and localized mesothelioma.

During an ultrastructural review of 30 diffuse and 10 localized mesotheliomas, it was apparent that some micrographs showed various stages in the developmental processes involved in the formation of histological patterns in diffuse mesotheliomas and a histogenetic link between diffuse and localized mesotheliomas. Cells in the stromal or sarcomatous regions of diffuse mesothelioma often show varying degrees of mesothelial differentiation and a gradual transition to cells with typical mesothelial characteristics that organize into structures recapitulating the surface layer of serosal membranes. Tumor cells in localized mesotheliomas had many similarities to the "stromal" cells in the diffuse counterpart including intercellular junctions, rare microvilli and occasional foci of basal lamina. It is postulated that diffuse and localized mesotheliomas share a common histogenetic origin as a result of neoplastic induction of specialized submesothelial cells. In this concept, tumor cells in diffuse mesotheliomas reflect stages in the differentiation and organization of normal serosal membranes and localized mesotheliomas mirror the earliest phases of this process.

Humans↗

Nuclear morphologic and morphometric analyses of large noncleaved cell and immunoblastic non-Hodgkin's lymphomas.

Both morphologically and immunologically, non-Hodgkin's lymphoma (NHL) of the large cell type has been shown to be a heterogeneous category. However, the homogeneity of the nuclear parameters, particularly size and condensed chromatin organization, used to classify this subtype of NHL has not been investigated. In fact, objective morphologic techniques have not been systematically applied to verify the segregation of NHL on the basis of nuclear parameters, a concept common to all current classification systems. In this study morphometric image analysis was used to compare the nuclei in 20 specimens from NHLs of the large cell type with those in mantle zone and germinal center lymphocytes from lymph nodes with reactive hyperplasia. Results of the assessment of mean nuclear area in large cell lymphomas revealed that this class is also heterogeneous, with some of the specimens having a nuclear size in the upper range of that for normal small lymphocytes. In addition, in only a few of these specimens was the mean nuclear area within the range of that for fully transformed germinal center lymphocytes. The majority of large cell lymphomas have a nuclear size more characteristic of partially transformed lymphocytes in germinal centers. In addition to indicating inconsistencies in the current diagnostic criteria used in NHL classifications, the results indicate reasons for interobserver variations in clinicopathologic trials; the validity of nuclear size as a prognostic indicator and the biologic basis for classifying NHL as a reflection of normal lymphocyte transformation are also questioned. In terms of patient management, the classifications of NHL currently used require objective reappraisal.

Cell Nucleus↗

A new precursor lesion of Wilms' tumour (nephroblastoma): intralobar multifocal nephroblastomatosis.

Almost half of the kidneys containing Wilms' tumours also contain persistent renal blastema in one or more of its forms. Persistent renal blastema is present in almost all cases of bilateral nephroblastoma. Multifocal superficial nephroblastemomatosis is the best known form of persistent renal blastema, and there is good evidence that it is a precursor of nephroblastoma. This paper reports four cases of a second, deep cortical type of nephroblastomatosis. This type of persistent renal blastema appears to be a precursor of a distinct histologic subtype of nephroblastoma, and differs from multifocal superficial nephroblastomatosis also in its teratological background.

Child↗

Peritoneal epithelial lesions associated with proliferative serous tumours of ovary.

The peritoneal epithelial lesions in 40 cases of proliferating ovarian serous tumour are described. The lesions were varied and of both neoplastic and non-neoplastic form. The most common was serous tumour similar to that in the associated ovarian neoplasm. Tumour of this type was present in some or all of the peritoneal lesions in 77.5% of cases. In nearly two-thirds, the tumour was superficial; in the rest it invaded omentum. Occasionally, the infiltrating tumour was poorly differentiated. Benign tubular lesions resembling endosalpingiosis occurred in 16 (40%) of the 40 cases, but in seven it was associated with serous tumour. Psammoma bodies frequently accompanied serous tumour and endosalpingiosis and in occasional cases the majority of lesions consisted of psammomatous foci. The duration of follow up is too short to adequately assess the biological significance of these findings but it is clear that the peritoneal tumour occasionally may kill the patient within a few years. 'Serous tumour of low malignant potential' is the most appropriate term to describe the general group of ovarian serous tumours of so-called 'borderline malignant' type.

Adolescent↗

Ultrastructure of poorly differentiated diffuse epithelial mesotheliomas.

In differentiating diffuse epithelial mesothelioma from metastatic adenocarcinoma in pleural and peritoneal biopsies, the number and form of microvilli and the amount and distribution of tonofilaments are thought to be the most useful criteria. This report details 5 cases of diffuse epithelial mesothelioma in which the characteristic fine structural features of neoplastic mesothelial cells were markedly modified. The majority or all tumor cells were poorly differentiated in electron micrographs, particularly with reduced prominence or absence of intermediate filaments, desmosomes, intracytoplasmic lumina, and microvilli. Immunohistochemistry revealed the absence of carcinoembryonic antigen and the presence of cytokeratin in all cases. Comparison with a better differentiated case suggests cytologic details that are useful in distinguishing the poorly differentiated type of epithelial mesotheliomas from adenocarcinoma. These include a mosaic pattern of closely associated tumor cells with a few long, narrow cytoplasmic processes lying parallel to adjacent plasma membranes, abundant cytoplasm with limited organelles usually having a polar arrangement, and nuclei with markedly disaggregated chromatin and prominent nucleolonemal-type nuclei.

Biopsy↗

Papillary cystic tumor of the pancreas.

We studied three cases of papillary cystic tumor of the pancreas and reviewed the literature concerning this uncommon neoplasm. This tumor almost always behaves in a benign fashion and occurs predominantly in young women. The histogenesis remains uncertain, but results of electron microscopic and immunocytochemical studies are consistent with an origin from a primitive cell capable of differentiating along both acinar and endocrine lines.

Adolescent↗

Angiosarcoma of serous membranes.

Three angiosarcomas of serous membrane are described. One originated in peritoneum, one in pleura, and one in pericardium. The tumor arising in peritoneum was a cystic lymphangiosarcoma and may have been caused by previous therapeutic irradiation for carcinoma of the endometrium. This tumor invaded the peritoneal and right pleural cavities extensively and thus resembled diffuse mesothelioma in its behavior. The tumors arising in pleura and pericardium were hemangiosarcomas.

Aged↗

Desmoplastic diffuse mesothelioma.

Twenty-seven cases of desmoplastic diffuse malignant mesothelioma (26 pleural, one peritoneal) are described. In 19 cases the tumor cell type was sarcomatous and in six others it was biphasic (malignant elements of both epithelial and mesenchymal aspect). There were only two cases where the tumor cell type was purely epithelial. The clinical course was often rapid; the mean survival period in 11 cases of purely sarcomatous type was 6.18 months. Only one case of purely sarcomatous type lived for more than 1 year as opposed to four of eight cases with an epithelial component. Metastases occurred more frequently in desmoplastic (60.1%) than in nondesmoplastic diffuse mesothelioma (42.5%). The tumor cell type (epithelial, mesenchymal) accompanying desmoplastic mesotheliomas and not the extent of desmoplasia determines their behavior. Desmoplasia in diffuse mesotheliomas is often the result of tumor cells assuming the functional capacity of fibroblasts and has frequently been confused with reactive fibrosis. Cytologic abnormalities, tissue infiltration, and foci of necrosis indicate the neoplastic nature of the process in most instances.

Adult↗

Papillary peritoneal tumors in women.

Twenty-five peritoneal tumors in women are described. All were partly or entirely of papillary or tubulopapillary structure and multifocal. Eight were unusually well-differentiated mesotheliomas. This appearance was associated with indolent behavior. In 10 cases the growth closely resembled serous papillary carcinoma, including the frequent presence of psammoma bodies, but the ovaries were free of primary tumor. The latter group of tumors progress rapidly and are thought to be derived from extraovarian mesothelium with müllerian potential. Four further cases showed some resemblance to ovarian papillary carcinoma. Only three tumors in the entire series (12%) closely resembled papillary or tubulopapillary diffuse malignant mesothelioma of the type that occurs in the pleural cavities in both sexes. The histopathologic spectrum of papillary tumors of peritoneum in women is extensive, and mesothelial tumors of the type known to be associated with asbestos are rare.

Adult↗

Soft-tissue sarcoma of undetermined histogenesis: an ultrastructural study.

A certain proportion of soft-tissue sarcomas are difficult to classify accurately. In this case report, initial light microscope observations of a soft-tissue tumor suggested a diagnosis of a monophasic synovial sarcoma. However, critical evaluation of the histologic features, results of studies with special stains, and ultrastructural observations indicated that this tumor is best categorized as an undifferentiated soft-tissue sarcoma of "undetermined histogenesis."

Adult↗

Angiofollicular lymphoid hyperplasia in an angiolipomatous mass.

A posterior mediastinal mass was composed of angiolipomatous and lymphoid tissue. The lymphoid tissue took the form of multiple nodules with appearances similar to those of angiofollicular lymphoid hyperplasia. The findings support the view that this form of lymphoid hyperplasia may be of hamartomatous nature.

Female↗

A Canadian experience of the pathological diagnosis of diffuse mesothelioma.

A review of 398 pleural and peritoneal tumours suggests that diffuse mesothelioma was probably present in 50-60%. However, objective assessment was frequently impeded by serious deficiencies in data or material, which affect the diagnostic grading of cases seen by panels. Observer variation in diagnosis also remains a significant problem. The value of panels for diagnosis could be greatly increased by the provision of adequate data/material and by meetings.

Canada↗

Localized primary tumors of the pleura: an analysis of 40 cases.

A study of 40 localized primary tumors of the pleura in the files of the Canadian Tumour Reference Centre revealed a considerable diversity in their histologic structure. Collagenized, hemangiopericytoma-like and cellular areas were the main forms of growth pattern, with half of the tumors showing a mixture of two or more of these elements. Inclusions of non-neoplastic bronchioloalveolar epithelium were frequently seen in areas of tumor adjacent to lung substance but in only one tumor was there a neoplastic component of epithelial form. Eight tumors (20%) showed evidence of malignant behavior. All of these were large and cellular at the time of initial surgery and four had mitotic counts of 10 or more/10 H.P.F. in areas. The evidence suggests that the great majority of localized pleural tumors arise from submesothelial mesenchymal elements and it is believed that the term mesothelioma should not be used in reference to these growths.

Adult↗