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Biomedical subjects

B Czernobilsky

Publications and source records attributed to B Czernobilsky.

At least 73 records · Page 4Linked to original sources
PubMed1986

Vaginal adenosis in women born prior to the diethylstilbestrol era.

Vaginal adenosis was evaluated in 41 women, all of whom had been born prior to the diethylstilbestrol (DES) era, and compared with the adenosis commonly encountered in DES-exposed progeny. The patients were 24 to 88 years of age (median, 44 years). Six of the women were symptomatic, and in four of these six the glands were enmeshed in a marked inflammatory infiltrate. In an additional 26 women the adenosis was discovered as incidental, nonsymptomatic macroscopic nodules or cysts. The remaining nine cases of adenosis were discovered by pathologists. Three types of epithelia characterized the glands: mucinous, tuboendometrial, and embryonic. Mucinous columnar cells resembling the lining of the normal endocervix and tuboendometrial cells resembling the lining of the normal fallopian tube or endometrium constituted the glands exclusively in 22 and eight specimens, respectively, and as a mixture in seven. The glands lined by mucinous cells most often presented clinically as cysts or nodules. The specimens composed of tuboendometrial cells were most often discovered on microscopic examination. The third type of epithelium, composed of embryonic columnar cells, was encountered in four specimens. These glands, less than 30 micron in greatest diameter, were located at the junction between the lamina propria and the squamous epithelium, and were incidental microscopic findings. It is concluded that the microscopic appearances of adenosis in women born prior to the DES era are identical to those encountered in young women exposed in utero to DES.

Adult↗
PubMed1986

[Medroxyprogesterone acetate in adenomatous hyperplasia of the uterine endometrium. Clinical and morphologic studies on the duration and dosage of gestagen therapy].

To learn how effective medroxyprogesterone-acetate is for treating adenomatous hyperplasia of the endometrium, we prescribed a controlled therapy in a randomly selected group of 60 women in whom we had diagnosed adenomatous hyperplasia histologically. The endometria of these women were histologically evaluated before therapy was started and again after three months of therapy. The greatest rate of regression was shown by the 40-59 year old women with adenomatous hyperplasia of grade I (15 of 23 patients). The regression occurred with 50 mg/day within three to eight months. For the women with adenomatous hyperplasia of grade II severity, 100 mg per day were required to obtain a similarly good result. For those with adenomatous hyperplasia of grade III severity, 150 mg per day were needed. The over 60-year old patients required higher doses of MPA over longer time periods for equally good therapeutic results. The patients younger than 40 years of age received lower doses (10-40 mg daily) to maintain or regain their fertility. Their adenomatous hyperplasias regressed with 20-40 mg of MPA daily, whereas with a daily dose of 10 mg their adenomatous hyperplasias recurred. The number of cases here, however, is too small for a statistical analysis. Summarising our results we recommend treating patients with adenomatous hyperplasias of grade I and II severity with MPA until it can be proved histologically that the hyperplasia has regressed. The daily dose needed for grade I hyperplasias is between 50 and 100 mg per day, whereas for grade II between 100 and 150 mg are needed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Cytokeratin expression in squamous metaplasia of the human uterine cervix.

The expression of cytokeratin polypeptides in squamous metaplasia of the human uterine cervix was investigated by immunocytochemical labeling with polypeptide-specific antibodies against cytokeratins. Immunofluorescence microscopic examination of cervical tissues using various monoclonal antibodies indicated that squamous cervical metaplasia expresses a unique set of cytokeratin polypeptides, this being distinctively different from that expressed by all of the normal epithelial elements of the exo- and endocervix. The development of metaplastic foci was accompanied by the expression of cytokeratin polypeptide no. 13, which is commonly detected in stratified epithelia, and by a reduction in the level of polypeptide no. 18, which is typical of simple epithelia. The 40-kilodalton cytokeratin (no. 19) described by Moll et al., which is abundant in the columnar and reserve cells of the endocervix, was found throughout the metaplastic lesions. Only in 'well-differentiated' metaplasias did we detect polarity of cytokeratin expression reminiscent of the staining patterns in the exocervix. This was manifested by the exclusive labeling of the basal cell layer(s) with antibodies KB 8.37 and KM 4.62, which stain the basal cells of the exocervix. Furthermore, a comparison of cervical metaplasia with squamous areas occurring within endometrial adenocarcinomas pointed to a close similarity in the cytokeratin expression of the two. We discuss the use of cytokeratins as specific markers of squamous differentiation, the relationships between squamous metaplasia and cervical neoplasia, and the involvement of reserve cells in the metaplastic process.

Adult↗
PubMed1985

Characterization of a feminizing testicular Leydig cell tumor by hormonal profile, immunocytochemistry, and tissue culture.

A patient with gynecomastia and a nonpalpable testicular Leydig cell tumor is presented. Estradiol and progesterone levels were elevated whereas serum testosterone was reduced. Following removal of the tumor the hormonal values returned to normal with reduction of gynecomastia. Tumor tissue was maintained in culture for 9 days during which high estradiol levels as well as lesser quantities of testosterone and progesterone were demonstrated in the culture medium. Elevation of progesterone supports a block of 17 alpha-hydroxylase activity caused by increased endogenous estradiol. This is the first case of a cultured feminizing testicular Leydig cell tumor in which hormone production was demonstrated. The freshly removed tumor as well as the cultured tissue material were studied by immunocytochemical methods and biochemical analysis of cytoskeletal proteins. These methods revealed vimentin as the exclusive type intermediate sized filament in both. This is the first demonstration of vimentin in a Leydig cell tumor, in agreement with its occurrence in normal Leydig cells.

Adult↗
PubMed1985

Ovarian Brenner tumors. I. Metaplastic, proliferating, and of low malignant potential.

In several studies, attempts were made to establish criteria for distinguishing malignant Brenner tumors from proliferating and low malignant potential ones. Although these criteria can be applied to the majority of cases, there still exist tumors that present problems in classification. In applying the World Health Organization (WHO) criteria for Brenner tumors, the most important feature for distinguishing the intermediate forms from the malignant ones is the presence of stromal invasion in the latter. This feature has generally been considered difficult to employ because of the fundamental fibroepithelial nature of Brenner tumors, the stroma being derived from the ovarian stroma. A logical and relatively easily applicable classification of Brenner tumors is presented in this report. Although more complex than the WHO classification, it includes newly recognized variants of the Brenner tumor and avoids using the same terminology to describe different types and degrees of epithelial abnormalities. Fourteen unusual Brenner tumors were studied, intermediate between typical benign and frankly malignant ones, and were classified into 3 categories representing progressive epithelial abnormalities. These include metaplastic, proliferating, and tumors of low malignant potential. In none of these does stromal invasion occur. Each of these categories corresponds to a particular urothelial abnormality or neoplasm. Through this classification, a better understanding of the morphology and biologic behavior of unusual types of Brenner tumors can be expected.

Aged↗
PubMed1985

Ovarian Brenner tumors. II. Malignant.

In this study, nine malignant Brenner tumors were reviewed and divided into well and poorly differentiated types. To meet the criteria for malignancy, stromal invasion must be observed. A component of typical benign, metaplastic, and/or proliferating Brenner tumor should be identified. The presence of these latter elements is necessary because the malignant component is often too poorly differentiated to be identified as a Brenner tumor, and a metastatic lesion cannot otherwise be ruled out on pathologic grounds. Well-differentiated tumors often occurred in close relationship to proliferating and occasionally to metaplastic areas, and poorly differentiated ones in relationship to low malignant potential areas. The malignant component may consist of transitional cell, squamous, or undifferentiated carcinoma or an admixture of these. A component of adenocarcinoma may be associated with other malignant elements, but pure mucinous or serous adenocarcinomas would be regarded as separate neoplasms. Although the number of cases is small, the well-differentiated tumors appear to have a better prognosis than the poorly differentiated ones.

Adenocarcinoma↗
PubMed1985

Endometrioid differentiation in ovarian sex cord tumor with annular tubules accompanied by gestagenic effect.

A case of ovarian sex cord tumor with annular tubules (SCTAT) without Peutz-Jeghers syndrome is presented in which portions of the neoplasm showed endometrioid differentiation. In addition, histologic examination of endometrium obtained from curettings and hysterectomy specimen revealed atrophic glands and a decidual type stroma, indicating a possible gestagenic effect of the ovarian tumor. The latter has so far been only briefly alluded to in the literature, whereas to the best of the authors' knowledge, endometrioid differentiation has not yet been reported to occur in SCTAT.

Adenocarcinoma↗
PubMed1985

Embryonal rhabdomyosarcoma: immunohistochemical characterization.

A 15-year-old boy was referred to the ear, nose, and throat clinic because of a swelling in the upper premolar region. The initial diagnosis of a poorly differentiated soft-tissue sarcoma was made. Further immunohistochemical studies established a definitive diagnosis of embryonal rhabdomyosarcoma. The tumor cells coexpressed both desmin, the component of muscle type intermediate filaments, and vimentin, which is typically found in mesenchymal tissues. Such coexpression is found in the early stages of myogenic differentiation. Another cytoskeletal protein, actin, was also found in relatively high concentrations. These results suggested the possible use of antibodies to these cytoskeletal proteins as histogenetic markers for the diagnosis of poorly differentiated rhabdomyosarcoma.

Actins↗
PubMed1985

DNA flow cytometry of ovarian tumors with correlation to histopathology.

Tissue samples from 49 women with seven benign and 42 malignant ovarian tumors were examined by means of DNA flow cytometry (FCM). The FCM data (DNA-ploidy and the number of S-phase fractions) were compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, the histologic grade of differentiation and in some cases with the clinical outcome. The benign ovarian tumors were all diploid with a mean of 2.1% (+/- 1.66) S-phase fractions. Adenocarcinomas with the histologic grade 1 were diploid and had a mean of 2.1% (+/- 1.17) S-phase fractions. Grade 2 adenocarcinomas were aneuploid in eight of nine cases and revealed an increased proliferative activity (7.7% +/- 2.67 S-phase fractions). A high number of aneuploid cases (nine of 13) and an increased DNA synthesis were found in grade 3 adenocarcinomas (12.0% +/- 5.72 S-phase fractions). Four of six malignant nonepithelial tumors also had high numbers of S-phase fractions (9.7-14.5%). A significant correlation between the histologic grade and the DNA synthesis, FIGO stage, and DNA-ploidy was found. DNA-FCM may be used as an additional diagnostic tool supplementing routine histopathologic examination of ovarian tumors for better biological characterization, especially for those with uncertain grading, for grade 2 neoplasms, and for malignant nonepithelial tumors.

Adenocarcinoma↗
PubMed1985

Co-expression of cytokeratin and vimentin filaments in mesothelial, granulosa and rete ovarii cells of the human ovary.

The intermediate filament (IF) system of the various cells of human, pig and rat ovaries was studied by electron microscopy, by immunolocalization using antibodies to cytokeratins, vimentin, desmin and desmoplakin, and by two-dimensional gel electrophoresis of cytoskeletal proteins from microdissected tissue samples. In human ovaries, surface epithelial cells (mesothelium) were stained by antibodies against cytokeratins, desmoplakins and vimentin. Biochemical analysis revealed cytokeratins Nos. 8, 18 and 19, together with variable amounts of No. 7. Granulosa cells of follicles of all stages were also positive for cytokeratins, desmoplakins and vimentin, in agreement with the electron microscopic finding of desmosomes in these cells. As the follicle matured, the cytokeratin content usually appeared to decrease, whereas vimentin remained unchanged. On gel electrophoresis, granulosa cells presented cytokeratins Nos. 8 and 18 and vimentin. Rete ovarii cells were also positive for both cytokeratins, desmoplakins and vimentin, and the electron microscopy revealed numerous desmosome-tonofilament complexes. Oocytes appeared to be devoid of IFs. Corpus luteum cells were rich in vimentin but biochemical analysis also revealed small amounts of cytokeratins Nos. 8 and 18. In contrast, cells of the ovarian stroma and luteinized stromal nodules were positive for vimentin only. A certain type of scattered stromal cells, especially around tertiary follicles and corpora lutea, and also desmin-positive. Pig and rat ovaries differed from human ones in that vimentin was not detected in ovarian mesothelium and cytokeratins were not seen in granulosa cells. The latter, however, contained significant amounts of vimentin. These results indicate that three cell types of human ovary, i.e. surface epithelial, granulosa and rete ovarii cells, can be regarded as true epithelial cells which, however, simultaneously express vimentin, a phenomenon frequently seen in cultured epithelial cells but uncommon in epithelial tissues. The presence of cytokeratins in granulosa cells in all types of human follicles is discussed with regard to the development of these cells. In contrast, granulosa cells of the other two mammalian species only display vimentin IF. Such differences between different mammalian species in IF composition of ovarian components present an example which precludes extrapolation of data from one species to another. The results are discussed in relation to current views of the histogenesis of various ovarian tumors.

Animals↗
PubMed1984

Primary ovarian carcinoid with marked heterogeneity of microscopic features.

A primary ovarian carcinoid tumor in a 54-year-old patient with the carcinoid syndrome is reported. On histologic examination there were, in addition to typical insular and atypical ribbon-like areas, solid and papillary growth patterns with pleomorphic and clear cells, some with anaplastic features. The heterogeneity seen in this case has not been reported in an ovarian carcinoid. However, since argentaffine and some argyrophil granules were demonstrated by special stains and ultrastructural studies in all of the various cellular elements, it was concluded that the entire tumor represented a carcinoid. This case demonstrates that ovarian carcinoids are not necessarily insular, trabecular, or mixtures thereof, but can also be extremely heterogeneous. In order to identify more tumors of this kind and also to avoid a diagnosis of an anaplastic or unclassifiable carcinoma in such cases, it is recommended that special stains for neurosecretory granules and electron microscopic examination be carried out in a larger number of poorly differentiated ovarian neoplasms, especially in those in which some of the microscopic features are suggestive of a carcinoid.

Carcinoid Tumor↗
PubMed1984

Ovarian clear cell adenofibromatous tumors. Benign, of low malignant potential, and associated with invasive clear cell carcinoma.

The authors have studied 17 cases of ovarian clear cell tumors having an adenofibromatous pattern and classified them on a histologic basis into three categories: benign, of low malignant potential, and associated with invasive clear cell carcinoma. Clear cell adenofibroma is characterized by orderly tubules and glands lined by uniform epithelium with little or no nuclear atypia set in an abundant stroma with an interlacing pattern resembling ovarian stroma. Clear cell adenofibromatous tumors of low malignant potential had a similar stroma, but exhibited moderate to marked degrees of epithelial proliferation and atypia. In the third category there were cases of invasive clear cell carcinoma in which a distinct portion of the tumor met the criteria for clear cell adenofibroma, or clear cell adenofibromatous tumor of low malignant potential. Cases of invasive clear cell carcinoma exhibiting a desmoplastic reaction or a diffuse fibrous stroma, but lacking typical adenofibromatous areas, were not included in this study. The benign and low malignant potential tumors showed no clinical evidence of aggressive behavior, whereas those associated with invasive clear cell carcinoma often did. Although there have been no recurrences in our small group of patients with tumors of low malignant potential, the histologic similarity of the epithelium in these tumors to that seen in invasive carcinomas justifies such a categorization. Further studies of larger series using the proposed classification should yield more information concerning the biologic behavior of these types of clear cell adenofibromatous tumors.

Adenocarcinoma↗
PubMed1984

Intermediate filaments of normal and neoplastic tissues of the female genital tract with emphasis on problems of differential tumor diagnosis.

Cytokeratins of normal epithelia and of some neoplasms of the female genital tract were studied by immunofluorescence microscopy of frozen sections and by two-dimensional gel electrophoresis of cytoskeletal proteins from microdissected tissues. All normal epithelia were stained with the monoclonal cytokeratin antibody KG 8.13 whereas certain monoclonal antibodies stained only simple epithelia. As revealed by gel electrophoresis the normal epithelia of the ovarian surface, oviduct, endometrium and endocervix contained cytokeratin polypeptides Nos. 7, 8, 18 and 19. In contrast, stratified exocervical epithelium showed a much more complex pattern (polypeptides No. 1, 2, 4, 5, 6, 11, 13, 14, 15, 16, 17 and 19). A similar pattern was found in the vagina. All epithelial neoplasms studied, regardless of the degree of histologic differentiation, were stained with antibody KG 8.13 as well as with conventionally obtained guinea pig antibodies to bovine muzzle prekeratins. The ovarian, endometrial and endocervical epithelial tumors maintained the pattern of their cells of origin, i.e. they expressed only cytokeratins Nos. 7, 8, 18 and 19. In one type of endocervical adenocarcinoma an additional cytokeratin polypeptide (No. 17) was detected. In contrast, the epithelial tumors of the lower genital tract showed a more complex pattern which also showed some differences with respect to that described for the corresponding normal tissue. Thus, in non-keratinizing squamous cell cervical carcinomas, cytokeratins Nos. 5, 6, 7, 8, 13, 14, 15, 16, 17, 18 and 19 were present, whereas the keratinizing cervical cancers showed polypeptides Nos. 5, 6, 13, 14, 16, 17 and 19.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytoskeleton↗
PubMed1984

Prognostic parameters in patients with advanced ovarian malignant tumors.

The role of a number of parameters was evaluated in 172 patients with advanced ovarian tumors. The clinical stage appears to be one of the most important of these parameters. Thus 3 years survival of patients in stage II was 40% whereas of those in stage IV only 5%. Granulosa cell tumors and mucinous cystadenocarcinomas presented the best prognosis while patients with undifferentiated and endometrioid carcinomas had a shorter survival. Patients with well differentiated tumors had a 3 year survival of 28% and those with poorly differentiated neoplasms 10%. Women under the age 50 showed a better prognosis than those over 50. The 3 year survival rate with residual tumors measuring less than 2 cm in diameter was 55% and that with residual tumors of more than 2 cm 18%. These parameters should therefore be carefully considered when therapy is being planned and when results of various therapeutic procedures are being compared.

Adenocarcinoma↗
PubMed1983

Ovarian mucinous cystadenocarcinoma with mural nodule of carcinomatous derivation. A light and electron microscopic study.

A case of an ovarian mucinous tumor with a mural nodule is reported. The epithelial elements consisted of benign, low malignant potential, and invasive mucinous carcinoma. The latter was present in one focus near the surface of the mural nodule as well as in some shallow depressed areas in the cyst wall. The nodule itself was made up of highly malignant, anaplastic cells which on light microscopic examination showed some similarities to the cells previously described in the sarcomatous and in some of the sarcoma-like mural nodules. However, analysis of light microscopic features in our case showed continuity and histologic similarities between the malignant mucinous cells and the sarcoma-appearing elements in the mural nodule. Ultrastructural features also supported an epithelial origin of the cells within the mural nodule. This case is the first of its kind with light and electronmicroscopic documentation and supports an epithelial origin for some of the mural nodules in ovarian mucinous tumors.

Aged↗
PubMed1983

Uterine adenosarcoma: a clinicopathologic study of 11 cases with a reevaluation of histologic criteria.

Eleven biphasic uterine tumors with epithelial components and homologous stroma were reevaluated. Originally these were diagnosed as adenofibroma, adenosarcoma, carcinosarcoma, or mixtures thereof, but were now reclassified as adenosarcomas of which seven were "pure" and four mixed with foci of carcinosarcoma. Nine of the tumors arose in the endometrium and two in the endocervix. The mean patient's age was 55 years. The most common complaint was vaginal bleeding. Macroscopically these tumors presented as polypoid masses. The epithelial component consisted mainly of endometrial, endocervical, ciliated, and clear cells. Squamous metaplasia and focal hyperplasia were occasionally observed. Malignant epithelial change was only present in foci of carcinosarcoma. The stroma showed prominent cellular periglandular cuffs, occasionally round solid or perivascular nodules, and areas of focal or diffuse stromal hypercellularity. In all these areas stromal cells were atypical and/or pleomorphic. Stromal foam cells were seen in three cases. Mitotic activity was low ranging from one to three mitoses per 10 high power fields (HPF). Follow-up was negative exept in two cases with recurrence and abdominal metastases. It was concluded that stromal hypercellularity with atypism and pleomorphism in periglandular, perivascular location as well as of focal or diffuse nature, is characteristic of uterine adenosarcoma. Adenofibromas present a fibro-collagenous stroma lacking the crowded cellular areas. Mitotic activity is too variable to serve as a reliable diagnostic criterion. Uterine adenosarcomas are usually tumors of low grade malignancy but the lack of correlation between histologic appearance and biologic behaviour precludes prognostication in the individual patient.

Adult↗
PubMed1983

Endometrial foam cells. Non-estrogenic and estrogenic.

Four patients with endometrial foam cells are described. In one the endometrium was obtained after parturition. It showed decidua and endometritis, whereas in the second patient, who had received birth control medication in the past, the endometrium was proliferative. In both cases there was a considerable amount of endometrial hemorrhage. The foam cells in these two patients had little granularity, and their cytoplasm contained hemosiderin. The other two patients received exogenous estrogen and presented with endometrial hyperplasia and adenocarcinoma. In these latter cases the foam cells were more granular, and contained no hemosiderin. Our findings confirm the presence of two types of histologically similar endometrial foam cell: a histiocytic, "non-estrogenic" reactive type capable of phagocytosis, and a stromal, "estrogenic" non-phagocytic type which is associated with hyperplasia or carcinoma and which may also be related to estrogen administration. Staining for hemosiderin may be particularly helpful in differentiating between the two types of foam cell. Such a differentiation is of practical importance because of the biologic significance attached to the "estrogenic" foam-cells which are usually indicative of endometrial hyperplasia or carcinoma.

Adult↗