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At least 1,639 records · Page 91Linked to original sources
PubMed1997

Cytologic features of papillary serous adenocarcinoma of the uterine cervix.

BACKGROUND: The cytologic features of papillary serous carcinoma of the cervix (PSCC) have not been described in detail previously. In this study the cytologic features of primary, pure PSCC are described and correlated with the histology. Comparison is made with papillary serous ovarian carcinoma metastatic to the cervix. METHODS: Seven cases of primary pure PSCC and five cases of ovarian PSCC metastatic to the cervix were retrieved from the pathology files. The cytology records and slides, and clinical charts were traced and examined retrospectively. RESULTS: Five of the 7 patients with PSCC were younger than 40 years. The smears of PSCC contained many groups of atypical glandular cells. Monolayered sheets of mildly atypical glandular cells with papillary branches were observed only in the cases of primary PSCC. All cases contained multilayered sheets of mildly to moderately pleomorphic glandular cells, pseudopapillary fragments, and tight balls of cells resembling endometrial glandular cells. Squamoid cells with abundant densely staining cytoplasm were also encountered. Free-lying dissociated atypical cells were also present, some of which were markedly atypical. A marked tumor diathesis of inflammatory cells, cell debris, and blood was encountered with primary PSCC but was scanty in cases of papillary serous ovarian carcinoma metastatic to the cervix. CONCLUSIONS: PSCC has a relatively characteristic cytologic appearance which usually differs from other endocervical adenocarcinomas and from metastatic papillary serous carcinoma. However, some features may lead to underdiagnosis or confusion with other entities such as squamous carcinoma or endometrial carcinoma.

Adult↗
PubMed1999

The cytomorphology of papillary serous carcinoma of the endometrium in cervical smears.

BACKGROUND: An investigation into the determination of cytomorphologic criteria that may distinguish papillary serous carcinoma of the endometrium (PSC) from typical endometrioid carcinoma (TEC) in cervical smears was undertaken. Preoperative identification of this poor prognostic variant of endometrial carcinoma may influence the surgical management of these cases and the choice of adjuvant therapy. METHODS: The cervical smears of 12 cases of histologically confirmed PSC; 12 cases of TEC, including 2 villoglandular/papillary variants, and 6 cases of mixed PSC and papillary endometrioid carcinoma were reviewed. In all cases an initial diagnosis of malignancy had been made on the cervical smears. Twenty-seven criteria were evaluated and the relation between the cytologic characteristics and the type of adenocarcinoma, the degree of association, and the intergroup homogeneity were tested. RESULTS: Features strongly associated with PSC were hypercellular smears with a background tumor diathesis, papillae, bare nuclei, and cells with large pleomorphic nuclei and bulky dense cytoplasm. In contrast, TEC showed a relatively monomorphic population of cells with moderately enlarged oval nuclei and delicate cytoplasm. In the mixed tumors, the features were similar to those of PSC, suggesting preferential exfoliation of the PSC component of the tumor. CONCLUSIONS: Assessment of the cytomorphology of PSC and TEC of the endometrium in Papanicolaou stained cervical smears is possible using statistically significant diagnostic criteria.

Carcinoma, Endometrioid↗
PubMed1996

Combination chemotherapy for breast carcinoma using a combination of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) causes a platelet aggregation defect.

Various coagulation parameters including platelet aggregation were evaluated during the course of treatment in 25 patients with breast carcinoma receiving a combination of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). No significant changes were found in whole blood clotting time (WBCT), prothrombin time (PT), kaolin cephalin clotting time (KCCT), platelet count (PC) and prothrombin consumption index (PCI). The CMF combination induced a significant reduction in platelet factor-3 (PF3) availability and reduction in platelet aggregation to ADP and adrenaline. These defects occurred without development of thrombocytopenia. The changes occurred on the 8th day of chemotherapy and a progressive suppression in platelet aggregation was noted during subsequent follow-up. This acquired abnormality in platelet aggregation and PF3 availability may be responsible for various hemorrhagic manifestations such as mucositis, epistaxis and hemorrhagic cystitis following CMF therapy. Further, these changes precede the onset of life-threatening complication of thrombocytopenia. The study of platelet aggregation should be considered besides platelet counting in patients on CMF combination to assess bleeding diathesis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Successful stent implantation for acute myocardial infarction after failed thrombolytic therapy associated with massive hemorrhage.

Stent implantation in the setting of failed rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction is considered a high-risk procedure, because of the possibility of stent thrombosis. Withholding anticoagulation in such a patient who also has a bleeding diathesis may further increase the risk of stent thrombosis. This case demonstrates the feasibility of stent implantation after failure of thrombolytic therapy and rescue angioplasty for acute myocardial infarction in the setting of massive intra-abdominal hemorrhage.

Angioplasty, Balloon, Coronary↗
PubMed1996

Fine-needle aspiration cytology of bronchocentric granulomatosis: a potential diagnostic pitfall.

Bronchocentric granulomatosis (BCTG) is a rare disease associated with bronchial asthma and bronchopulmonary aspergillosis. Idiopathic forms are rarely encountered. We report on a case of BCTG showing clinical, radiological, and cytological evidence suggestive of adenocarcinoma of the lung. The patient is a 69-yr-old female, lifetime nonsmoker with multiple sclerosis who was admitted with a history of ascending cholangitis. Admission chest X-ray documented a 1.5-cm nodule in the left upper lobe of the lung. This was confirmed by CT scan. The lesion was slowly growing. Bronchoscopic examination was normal. Bronchial brushings were inconclusive. A transthoracic fine-needle aspiration showed sheets of highly atypical epithelium with occasional small dyshesive clusters. There was an inflammatory background that was believed to represent tumor diathesis. The cytological interpretation was "suspicious for adenocarcinoma." The patient underwent left upper lobectomy. The lung showed multiple peribronchial granulomas with intense peribronchial lymphoid infiltrate extending into the bronchial mucosa, causing cytological atypia and focal ulceration. Special stains for microorganisms were negative. The patient recovered from surgery and shows no signs of infection. We conclude that BCTG and related lesions can give cytological features that are suggestive of malignancy. Cytological material obtained from these lesions should be interpreted with caution.

Aged↗
PubMed1997

Fine-needle aspiration cytology of sarcomatoid carcinoma of the breast: a cytologically overlooked neoplasm.

Sarcomatoid carcinoma of the breast is a very uncommon neoplasm. Fine-needle aspiration findings have been rarely reported. We report a case of sarcomatoid carcinoma of the breast that was diagnosed as a typical ductal carcinoma cytologically. The patient was a 45-year-old female who had a right breast mass for a short duration. Fine-needle aspiration (FNA) showed smears predominantly composed of single cells exhibiting plasmacytoid features with moderate degree of pleomorphism. A granular bluish background was noted on the Papanicolaou-stained smears. This background was thought to represent tumor diathesis, and the diagnosis of grade II ductal carcinoma of the breast was rendered. The patient underwent a subsequent lumpectomy with axillary node dissection. Histological examination of the lumpectomy revealed a neoplasm predominantly composed of a grade II chondrosarcoma with increased cellularity. A small (10%) component showed grade II invasive ductal carcinoma of the breast. No in situ component was seen. The sarcomatoid component was positive for S-100 protein and vimentin and negative for keratin, whereas the carcinomatous component was positive for vimentin, epithelial membrane antigen, and low molecular weight keratin. Ultrastructurally, the tumor showed features of a poorly differentiated epithelial neoplasm without evidence of chondrosarcoma. Metastases were seen in seven of ten axillary lymph nodes with exclusive epithelial component. Retrospective evaluation of the FNA smears revealed an extensive metachromatic stroma of the DIFF QUIK-stained smears. Our findings and review of the literature suggest that sarcomatoid carcinoma of the breast will be very frequently overlooked or misdiagnosed either because of the subtlety of the stroma or the predominance of the mesenchymal component. Our findings also provide supportive evidence that the use of the DIFF QUIK stain can be very helpful in the identification of the stroma in this neoplasm. The predominance of epithelium in the metastases in our case is further proof that tumors with dual differentiation such as sarcomatoid carcinomas and mixed muellerian tumors are truly carcinomas with metaplastic features.

Biopsy, Needle↗
PubMed1997

Comparison of ThinPrep and conventional preparations: nongynecologic cytology evaluation.

ThinPrep processing, an automated cytopreparatory method, has been reported to show good correlation with conventional preparations and to reduce the rate of false-negative diagnoses. In a retrospective review of 230 consecutive nongynecologic cytology cases, we compare the ThinPrep (TP) method with conventional preparations (CP). There were 129 fine-needle aspiration (FNA) specimens from various sites, including 51 breasts, 40 thyroids, 14 lungs, 8 livers, and 16 miscellaneous sites. The sources of 101 body cavity fluids included 68 pleural/peritoneal effusions, 25 peritoneal/pelvic washings, and 8 miscellaneous sites. Each case was evaluated for cellularity, morphologic, details, and obscuring background material. Diagnoses of the TP slides were classified as insufficient, normal, benign, suspicious, or malignant. Each case was then correlated with the tissue diagnosis when available. In TP slides, cellular arrangements, nuclear details, and nuclear cytoplasmic ratio were preserved, while blood and diathesis were eliminated. There was no statistically significant difference between TP and CP in the diagnostic categories. However, in six cases of "insufficient for diagnosis" on FNA by CP, TP yielded sufficient cells and tissue fragments for diagnosis. One case each of FNA and body fluid with a diagnosis of "suspicious for malignancy" by CP was considered "positive" on TP slides. The overall sensitivity of TP was 97.6%, and the specificity was 92.9%. The positive predictive value was 93.0%. We conclude that the ThinPrep method shows good correlation with conventional preparations in both FNA and body fluids.

Biopsy, Needle↗
PubMed1997

Psychotic features and combat-associated PTSD.

Psychotic symptoms and psychotic disorder diagnoses have occasionally been reported in association with chronic posttraumatic stress disorder (PTSD). Although psychotic features may be related to core PTSD symptoms, i.e., part of the reexperiencing phenomena, it is possible that they are secondary to certain comorbid disorders which are also prevalent in this patient population, e.g. major depression or substance abuse. In a prospective study, combat associated PTSD patients (n = 25) were administered clinical ratings, including the Structured Clinical Interview for DSM-III-R with psychotic screen (SCID-P), Clinician Administered PTSD Scale (CAPS) and the Impact of Events Scale (IES). Thirty-six percent (n = 9) endorsed psychotic symptoms with associated comorbidity including: major depressive episode, bipolar disorder, alcohol or polysubstance abuse panic disorder, and phobias. All but one of the patients with psychotic features also met criteria for major depressive episode. None had a primary psychotic disorder diagnosis. There were no significant differences in total CAPS scores between patients with or without psychotic features (82.6 +/-0 17.6 versus 75.3 +/- 22.4, p ns), nor for the different symptom cluster subscales. There were also no differences in the IES scores between groups (34.8 +/- 10 versus 32.6 +/- 10 p ns). This suggests that these psychotic features may not necessarily reflect severity of PTSD symptoms. PTSD may share a common diathesis with mood disorders including psychotic depression. Further study is needed of these phenomena.

Adult↗
PubMed2001

Bernard-Soulier syndrome associated with 22q11.2 microdeletion.

We describe a Japanese girl with Bernard-Soulier syndrome and 22q11.2 microdeletion. She had viral infections and recurrent thrombocytopenia and hemorrhagic diathesis after cardiac surgery. As congenital heart defects and abnormal immunity are the most common clinical manifestations associated with 22q11.2 deletion, patients with this association may have a greater risk of developing a severe bleeding disorder.

Abnormalities, Multiple↗
PubMed2000

Splenomegaly and chronic disseminated intravascular coagulation in Osler-Weber-Rendu disease: a case report.

A 45-year-old Japanese woman with splenomegaly and thrombocytopenia was referred to our hospital. The diagnosis of Osler-Weber-Rendu disease (Osler's disease) was made because of spotty telangiectasia on her tongue, recurrent epistaxis since childhood, and a diathesis indicated by her family history. The patient's laboratory examination revealed anemia, thrombocytopenia, and other data consistent with chronic disseminated intravascular coagulation (DIC). Bone marrow examination was normal. Abdominal computed tomography showed marked enlargement of the spleen with deformity and calcified plaque, not homogeneously enhancing. Hypersplenism was not observed. Platelet scintigraphy indicated a remarkable uptake in the spleen. She was diagnosed as having chronic DIC associated with vascular lesions of Osler's disease in the spleen. Splenectomy was performed and the subsequent pathological findings indicated that fragility of the fine vascular architecture of the splenic red pulp might have been responsible for pathogenesis. The large pooling of blood with coagulation was thought to be secondary.

Disseminated Intravascular Coagulation↗
PubMed1976

Late effects of cancer therapy: the role of the clinical pharmacologist.

The clinical pharmacologist, by increasing our knowledge of the molecular mode of action of drugs and their specific anticancer mechanisms, can help to predict which therapies would be expected to have late effects that were progeric, infectious, or oncogenic, and in which organs such effects could arise. By insisting upon the inclusion of appropriate controls, the pharmacologist can help attribute any observed late effects to a primary host-disease diathesis, or to the direct effects of therapy, or to the indirect effects of prolongation of the life of the host. Finally, by participating in the design and including appropriate control groups from the start of new clinical trials, the clinical pharmacologist can help restrict clinical therapies whose antitumor effects are absent or small but whose late toxic potentials are high.

Antineoplastic Agents↗
PubMed1977

Leukocytic fibrinolysis in myelomonocytic leukemia.

A case of myelomonocytic leukemia is described in which an increase in primary fibrinolytic activity produced a severe hemorrhagic diathesis. The leukemic cells were demonstrated to be the source of the fibrinolytic activity. Utilizing a fibrin coated slide technique, the intact leukemic cells were shown to release their fibrinolytic activity and to induce local lysis. Intact leukocytes from normal subjects and other patients with acute leukemia of varied cell types were unable to release fibrinolytic activity although in some of the leukemic preparations, increased fibrinolytic activity was demonstrated after in vitro disruption of the cells.

Animals↗
PubMed1977

Multicentric dermal-type cylindromas of the parotid glands in a patient with florid turban tumor.

Dermal-type cylindromas of parotid glands in a patient with turban tumor, and various adnexal tumors, represent a rare diathesis, apparently not reported previously. A Caucasian man, born in 1916, had a scalpectomy for turban tumor in 1957. In 1957, 1960, and 1974, dermal type cylindromas were excised from portions of both parotid glands, developing from intercalated and striated ducts; they were considered benign, based on long term followup. Adrexal tumors included multiple dermal cylindromas, trichoepitheliomas, eccrine spiradenomas, and Bowen's disease, and occurred on almost all skin surfaces. In November, 1976, a portion of a right parotidectomy included a 3.5 X 3-cm malignant tumor having the characteristics of an invasive poorly differentiated spindle cell epidermoid carcinoma, which showed no evidence of originating from a malignant basal cell tumor. Several encapsulated and developing benign basal cell tumors were included in the specimen. Dermal-type cyclindromas of the parotid gland are considered to be a variant of basal cell ademona, or monomorphic adenoma, basal cell type, since they consist of similar cell components, although of somewhat different arrangement and with prominent focal deposition of hyaline. Dermal-type cylindromas should be excised conservatively as they appear. They must be differentiated from adenoid cystic carcinoma, which is an infiltrating neoplasm and requires a radical surgical approach.

Adolescent↗
PubMed1978

Acquired platelet dysfunction following mithramycin therapy.

The administration of mithramycin to patients with testicular tumors has been accompanied by a hemorrhagic diasthesis, often in the absence of thrombocytopenia. Bleeding time, platelet aggregation, platelet adenine nucleotide levels, and coagulation factor assays were studied in three patients receiving mithramycin for embryonal testicular carcinomas. These studies demonstrated a drug dependent, reversible hemorrhagic diathesis associated with (1) prolongation of bleeding time, (2) decreased platelet aggregation responses to ADP, collagen, and epinephrine, and (3) depleted platelet stores of ADP in the absence of thrombocytopenia. These abnormalities were temporally correlated with the onset of mucocutaneous bleeding in all patients.

Adenosine Diphosphate↗
PubMed1978

Disseminated intravascular coagulation in childhood acute lymphocytic leukemia with poor prognostic features.

Three children with ALL having poor prognostic features developed clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Two developed a bleeding diathesis associated temporally with a rapid drop in blast cell counts during induction therapy with L-asparaginase, prednisone, and vincristine. One of these children died of massive cerebral hemorrhage. The third patient developed episodes of superficial thrombophlebitis associated with relapses and rising blast cell counts which responded to chemotherapy and treatment with heparin. The unusual association of ALL with DIC and the fact that all 3 patients had multiple poor prognostic signs have led us to monitor carefully the coagulation system and withhold L-asparaginase in patients with massive disease until the white cell count and organomegaly have responded to prednisone and vincristine. The more common association of DIC with non-lymphocytic leukemia and recent reports of the presence of the Ph' chromosome in children with leukemia morphologically resembling ALL suggest that chromosomal evaluation be done in selected leukemic patients.

Adolescent↗
PubMed1979

Cancer in persons with inherited blood coagulation disorders.

In order to assess the influence of an inherited blood coagulation disorder in individuals who developed cancer, a mail survey of physicians who care for individuals with a bleeding diathesis was evaluated. Sixty-one individuals in an estimated population of 10,500 with both disorders were identified. An apparent increase in the incidence of cancer in the genitourinary and musculoskeletal systems was noted. However, in the largest group ( hemophilia) the primary site of cancer was similar to an age and sex matched population. There did not appear to be a change in the onset of metastatic disease in these individuals, as compared to an individual with cancer who did not have an inherited blood coagulation disorder.

Adolescent↗
PubMed1979

Disseminated coagulopathy in chronic myelomonocytic leukemia.

The clinical and laboratory features of nine patients with chronic myelomonocytic leukemia are described. Hepatic or splenic enlargement accompanied by an absolute monocytosis in an older patient with an elevated serum or urine lysozyme and serum vitamin B12 levels were characteristic of the majority of patients in this series. No single clinical or laboratory finding was diagnostic for the disease. Most importantly, seven of nine patients had abnormal coagulation values; in two cases the abnormalities were consistent with disseminated intravascular coagulation and correlated with a hemorrhagic diathesis. It is concluded that patients with chronic myelomonocytic leukemia who have thrombocytopenia or a bleeding tendency should be evaluated for evidence of disseminated intravascular coagulation.

Aged↗
PubMed1986

Acute gastrointestinal bleeding as the presenting manifestation of prostate cancer.

Gastrointestinal bleeding was the presenting manifestation in four patients without readily apparent prostate cancer. Three of these patients had laboratory evidence of acute disseminated intravascular coagulation (DIC) and one patient had a friable rectal mass. The diagnosis of prostate cancer was made in three patients by employing an immunoperoxidase technique for prostatic acid phosphatase in metastatic foci. Dramatic resolution of DIC occurred in two patients following hormone therapy. Radiation therapy was effective in controlling bleeding in another patient. Two patients are alive with no further bleeding episodes at 8 and 18 months follow-up, respectively. In patients who present with a bleeding diathesis and adenocarcinoma of unknown primary, it is important to consider prostate cancer because of its frequent and prolonged responsiveness to hormonal therapy.

Acid Phosphatase↗