PubMed Health⌕ Search

Biomedical subjects

A Churg

Publications and source records attributed to A Churg.

At least 181 records · Page 10Linked to original sources
PubMed1980

Small cell squamous and mixed small cell squamous--small cell anaplastic carcinomas of the lung.

Five patients are presented who had neoplasms which, by light microscopy and in two cases cytologically, appeared to be small cell anaplastic (polygonal and fusiform cell type) carcinomas of the lung. However, by electron microscopy, four of the carcinomas exhibited squamous characteristics including desmosomes and tonofilament bundles, and lacked demonstrable neurosecretory granules, suggesting that they were small cell squamous carcinomas. The fifth carcinoma contained cells with neurosecretory granules as well as cells demonstrating squamous differentiation. One patient died within 3 months of presentation. Three patients survived for approximately 18 months each; two received chemotherapy but one was treated by surgical resection alone. The fifth patient had a peripheral coin lesion which was treated by surgical resection only; he is alive without evidence of recurrent carcinoma 1 year after operation. We suggest that some carcinomas of the lung with the light-microscopic and cytologic appearance of small cell anaplastic carcinoma are actually small cell variants of squamous cell carcinoma and lack the characteristic neurosecretory granules of classic small cell carcinoma. The behavior of these tumors needs to be determined.

Aged↗
PubMed1980

Oncocytic carcinoid tumor of the lung.

We report a bronchial tumor composed of a mixture of oncocytes and carcinoid tumor cells; the latter formed ribbons and pseudoglandular structures in the fashion of a carcinoid tumor. Ultrastructurally, the oncocytic cells showed large numbers of mitochondria but no neurosecretory granules. Although the stem cell of the pulmonary K-cell is unknown, our findings support the notion that both the pulmonary endocrine cells and the oncocytes arise from it.

Adenoma↗
PubMed1980

The benefits of open lung biopsy in patients with previous non-diagnostic transbronchial lung biopsy. A guide to appropriate therapy.

In a 17-month period, 20 immunosuppressed patients underwent transbronchial biopsy of the lung for diagnostic evaluation of a pulmonary infiltrate of unknown etiology. In 19 patients, the transbronchial biopsy was nondiagnostic. Thirteen of the 19 patients were critically ill and were referred for an open lung biopsy. Eleven (85 percent) of these 13 patients left the hospital after open lung biopsy and appropriate medical treatment. Two patients who were receiving mechanical ventilation at the time of open biopsy succumbed to the combination of their underlying disease and respiratory failure. There were no deaths directly attributed to the open lung biopsy. Of the six patients whose condition appeared stable and who did not undergo open lung biopsy, two died from unrecognized progress of their underlying malignant disease. The remainder recovered. We conclude that open lung biopsy is safe in and beneficial to the diagnosis and subsequent treatment of unknown pulmonary infiltrates in immunosuppressed patients who previously had a nondiagnostic fiberoptic transbronchial biopsy of the lung.

Adult↗
PubMed1980

Pulmonary hemorrhage and immune-complex deposition in the lung. Complications in a patient with systemic lupus erythematosus.

A patient with systemic lupus erythematosus (LE) was admitted with an acute illness characterized by dyspnea, hemoptysis, fever, and diffuse infiltrates revealed by chest roentgenograms. An open-lung biopsy specimen showed massive intrapulmonary hemorrhage, and immunofluorescence and electron microscopic examinations showed granular deposits of IgG within the alveolar walls and pulmonary vessels. Rare, widely scattered foci of infiltration of vessel and alveolar walls by polymorphonuclear leukocytes were also observed. The patient was treated with large doses of prednisone and her condition improved, but she had a second episode of massive hemorrhage eight days after discharge despite maintenance of the prednisone therapy. Her condition again improved over several days, and she has had no pulmonary symptoms for nine months. In some instances, pulmonary hemorrhage in patients with systemic LE may be mediated by polymorphonuclear leukocytes attracted by immune-complex deposits.

Adult↗
PubMed1979

Analysis of the cores of asbestos bodies from members of the general population: patients with probable low-degree exposure to asbestos.

Asbestos bodies were isolated from the lungs of 21 patients who had 300 to 9,000 of such bodies/g of lung tissue, a concentration frequently found in manual laborers in the general population who are not primary asbestos workers. All of the 123 bodies examined by electron diffraction produced diffraction patterns consistent with amphibole varieties of asbestos. Electron microprobe analysis (energy dispersive x-ray spectroscopy) of 46 bodies revealed that 38 of the cores were composed of the commercial amphiboles, amosite and crocidolite, whereas only 8 were composed of the noncommercial amphiboles, anthophyllite and tremolite. Review of the occupations of these patients revealed that all but one had blue-collar jobs. For many of these persons, putative sources of asbestos exposure such as construction work could be defined, but for some, the source could not be determined. One woman was apparently exposed to asbestos in the practice of her hobby of ceramics, in which she used anthophyllite-contaminated clay. We concluded that commercial amosite/crocidolite asbestos forms the cores of most asbestos bodies in manual laborers in the general population and that the source is usually occupational.

Adult↗
PubMed1979

Necrotizing sarcoid granulomatosis.

Twelve cases of necrotizing sarcoid granulomatosis are presented as a retrospective study. The population of patients consisted of ten women and two men, with an average age of 50 years. Nine patients initially had a variety of pulmonary and nonpulmonary complaints, while three were asymptomatic. Chest roentgenograms demonstrated bilateral nodules in seven patients, solitary nodules in four, and a miliary pattern progressing to nodules in one. Enlarged hilar nodes were found in six. Histologically, all biopsies showed a combination of individual granulomas, confluent masses of granulomas which formed the nodular masses seen on the roentgenograms, a variable amount of necrosis of tissue and hyalinization, and a granulomatous vasculitis. Follow-up periods ranged from four months to 11 years. Eleven patients are alive and asymptomatic. The sole death occurred in a patient treated with an immunosuppressive agent (cyclophosphamide). We conclude that the clinical behavior of necrotizing sarcoid granulomatosis is not similar to that of the other angiocentric granulomatoses and that most patients with this disease can be left untreated or be treated with steroids alone. We suggest the possibility that necrotizing sarcoid granulomatosis may be the histologic counterpart of so-called nodular sarcoid.

Adult↗
PubMed1978

Ultrastructural observations on the histogenesis of alveolar rhabdomyosarcoma.

Ultrastructural examination of an alveolar rhabdomyosarcoma revealed that the bulk of the tumor was composed of small polygonal cells containing polyribosomes, short strands of rough endoplasmic reticulum, and variable amounts of glycogen; the cells were joined by small desmosome-like structures. Similar cells, as well as a variety of larger forms which appeared to be derived from the small cells, were observed along the septa; the larger forms developed a copious cytoplasm and occasionally produced myofilaments. Some of these cells were separated from the septa by basement membranes. Giant cells were also present in the alveolar spaces; these formed neither basement membranes nor myofilaments. The septa themselves were composed largely of collagen and fibroblasts. It is suggested that the commonly proposed correspondence of alveolar rhabdomyosarcoma to the myotube stage of muscle differentiation is incorrect; if anything, the overall pattern of the tumor is epithelial-like, and may correspond to the organization of mesenchymal cells at the stage of somite differentiation. The resemblance of the masses of small tumor cells to the cells of Ewing's sarcoma is discussed.

Basement Membrane↗
PubMed1978

Malignant fibrous histiocytoma of the heart presenting as an atrial myxoma.

A 37-year-old woman presented with signs and symptoms suggestive of mitral stenosis and insufficiency. Subsequent evaluation demonstrated a left atrial tumor which was suspected clinically and at the time of initial surgery to be an atrial myxoma. Histologic examination revealed that the tumor was actually a malignant fibrous histiocytoma. Despite near total removal at surgery and subsequent radiotherapy, the tumor recurred within six months in the left atrium. Re-excision was followed by a third recurrence in the same site.

Adult↗
PubMed1978

The fine structure of large cell undifferentiated carcinoma of the lung. Evidence for its relation to squamous cell carcinomas and adenocarcinomas.

The light microscopic diagnosis of large cell undifferentiated carcinoma of the lung is known to be highly subjective and shows poor interobserver reproducibility; the very existence of this tumor as a separate entity has been challenged. The ultrastructure of seven large cell undifferentiated carcinomas was examined in an attempt to determine whether they were merely poorly differentiated adenocarcinomas and squamous cell carcinomas, or actually represented an entirely separate class of tumors. Four large cell undifferentiated carcinomas demonstrated intra- and intercellular lumina and were designated adenocarcinomas. In three cases there were well formed desmosomes with numerous tonofilaments and intercellular bridges. These tumors were classified as squamous cell carcinomas. An eighth tumor metastatic to the abdominal wall also showed the features of squamous carcinoma. In addition, all tumors contained a variable population of primitive cells without identifying features. The large cell undifferentiated carcinomas were compared ultrastructurally with eight cases of poorly differentiated adenocarcinomas and squamous cell carcinomas classified by light microscopy. These tumors were morphologically similar, but contained fewer primitive cells and greater numbers of differentiated cells. Cells with a clear cytoplasm as seen by light microscopy were present in both the large cell undifferentiated and poorly differentiated groups; these cells contained variable amounts of glycogen but were otherwise similar to the nonclear cells. It is suggested that most of the subcategories of large cell undifferentiated carcinoma represent very poorly differentiated adenocarcinomas and squamous carcinomas.

Adenocarcinoma↗
PubMed1978

Malignant mesothelioma arising after direct application of asbestos and fiber glass to the pericardium.

A case of mesothelioma, apparently arising in the pericardium, is reported in a patient who, 15 years previously, had been treated for angina pectoris by dusting of the pericardial cavity with a mixture of fibrous dusts. At autopsy, transparent fibers and ferruginous bodies were present within the pericardium. Electron diffraction and microprobe analysis indicated that approximately two thirds of the fibers were tremolite and anthophyllite asbestos, and the remainder, fiber glass. Development of mesothelioma in laboratory animals has been reported after intrapleural deposition of asbestos and other fibers, but in humans, the link between exposure to asbestos and mesothelioma has always been based on epidemiologic data and the retrospective finding of asbestos in tissues. To our knowledge, this is the first example of a malignant mesothelioma in a human associated with direct mesothelial contact with fibrous dusts.

Angina Pectoris↗
PubMed1978

Clinicopathologic correlations demonstrating the failure of 67gallium scanning in determining response to radiotherapy.

Scanning of the chest using radioactive 67gallium citrate was performed in 12 patients with stage 3MO bronchogenic carcinoma prior to and following preoperative radiotherapy (3,000 rads). This was done to determine if scanning with 67gallium would be predictive in determining radiotherapeutic response. All 12 patients underwent resection of their primary bronchogenic carcinoma, and comparisons of chest x-ray films and 67gallium scans obtained before and after irradiation and of surgical specimens were made. The scan using 67gallium showed improvement in nine of the 12 patients; however, in five of these nine patients, the improvement on the scan using 67gallium was not paralleled by objective regression of the tumor on the chest x-ray film. Viable tumor was observed in the resected specimen in all 12 patients. We conclude that a scan with 67gallium should not be used to evaluate radiotherapeutic response.

Carcinoma, Bronchogenic↗
PubMed1977

A simple method for preparing ferruginous bodies for electron microscopic examination.

A new method of preparing ferruginous (asbestos) bodies for electron-optical examination is described. Pulmonary tissue is dissolved in bleach and the residue collected on a Millipore filter. The ferruginous bodies are localized by light microscopy, and a portion of the filter containing a body is cut out and mounted on a coated electron microscope grid. The filter is dissolved in acetone vapor in a condensation washer, leaving the bodies, as well as uncoated submicroscopic fibers, on the grid. This method can be used to obtain bodies from the lungs of individuals after all degress of asbestos exposure, but it is particularly useful when dealing with minimally exposed or non-exposed individuals whose lungs contain very few bodies. The procedure allows easy identification of body cores by electron diffraction or electron microprobe analysis.

Asbestos↗
PubMed1977

Large spindle cell variant of peripheral bronchial carcinoid tumor.

I report a case of peripheral bronchial carcinoid tumor composed of bundles of large spindle cells, very much resembling cells of smooth muscle or neural tumors. Despite the unusual appearance, argyrophil staining and electron microscopic examination demonstrated small secretory granules of the type found in other peripheral carcinoid tumors. The histologic heterogeneity of peripheral bronchial carcinoid tumors is emphasized.

Adult↗
PubMed1977

Correlation of quantitative asbestos body counts and occupation in urban patients.

Asbestos bodies were quantified in digests of lung from 252 urban patients who were over 40 years of age. Patients were assigned to six occupational categories that had been determined without knowledge of asbestos body counts. Asbestos bodies were present in the lungs of 96% of the total population. Fewer than 12% of the white-collar men and the blue- and white-collar women had more than 100 asbestos bodies per gram of lung, whereas 32% of the blue-collar men not working in steel mills or construction, 45% of steelworkers, and 65% of construction workers had more than 100 asbestos bodies per gram lung. This distribution suggests that almost everyone in our population has some exposure to asbestos, and certain persons are subject to an additional occupational exposure. Whether asbestos bodies in low concentration are related to disease remains to be determined.

Adult↗
PubMed1977

Analysis of the cores of ferruginous (asbestos) bodies from the general population. I. Patients with and without lung cancer.

Ferruginous (asbestos) bodies may be found in the lungs of almost everyone in the population, but little information is available as to whether such bodies are nucleated on asbestos or on some other fibrous dust. In this study morphologically "typical" ferruginous bodies were isolated from the lungs of 23 autopsy and surgical patients, none of whom had primary asbestos exposure. Eleven patients had carcinoma of the lung. To determine the nature of the core, 328 bodies were examined by electron diffraction. Of these, 264 (80%) showed the diffraction patterns of amphibole asbestos, whereas six showed the pattern of chrysotile asbestos. No amorphous cores or crystalline nonasbestos cores were identified. Fifty-eight (18%) bodies could not be diffracted because of the thickness of the iron-protein coat. No differences were seen between patients with and without lung cancer. We conclude that typical ferruginous bodies have asbestos cores, which are usually amphibole type. The findings suggest widespread exposure to asbestos dust; occupational histories appeared to indicate the source of exposure in some but not all patients.

Aged↗