Polymyalgia rheumatica and giant-cell arteritis in a black woman.
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Aged↗
Biomedical subjects
B F Banner
Publications and source records attributed to B F Banner.
Hepatic granulomas following ileal bypass for obesity.
A review of liver biopsy specimens from patients undergoing ileojejunal bypass for obesity showed granulomas in follow-up biopsy specimens from six of 25 patients (24%) three months to four years after the procedure. The incidence was significantly greater than that seen in obese patients at the time of surgery (4%), (P less than .02). Their origin could not be attributed to systemic infections, medications, or nutritional factors. It would seem that hepatic granulomas in such patients may be due to factors associated with the surgical procedure.
Adult↗
An ultrastructural study of acinic cell carcinomas of the canine pancreas.
Four cases of spontaneous adenocarcinoma of the canine exocrine pancreas were studied by thin section and freeze-fracture electron microscopy. The neoplastic cells in all 4 cases were of acinar origin and showed many alterations of cytoarchitecture compared with normal acinar cells. In the neoplastic cells, zymogen granules varied in number and appearance and contained an abnormal secretory product characterized by 24-nm-thick microtubules. The nuclear volume and surface area and the nuclear cytoplasmic ratio were increased; although the nuclear pore density per nuclear surface area was significantly decreased, there was no change in the nuclear pore density per nuclear volume. There was a decrease in number and size of gap junctions; focal proliferation, fragmentation, and discontinuation of the tight junctions were also noted. The basal lamina (BL) of the neoplastic cells was discontinuous. The tumor microvasculature often appeared as sinusoids and had sparse discontinuous BL. Finally, the endothelium in both tumor and normal tissue contained "tubulo-reticular inclusions" (TRI) which simulated distemper virus and were located in the rough endoplasmic reticulum (RER) and the perinuclear cisternae.
Animals↗
Temporal arteriography. Analysis of 21 cases and a review of the literature.
To define the role of temporal arteriography in the diagnosis of giant-cell arteritis, the results of temporal arteriography in 21 patients who had temporal artery biopsies were reviewed. Abnormal angiography was found in all patients with biopsy-proven giant-cell arteritis, in some patients with polymyalgia rheumatica and normal biopsy, and in some patients with neither polymyalgia rheumatica nor giant-cell arteritis. No pattern of angiographic abnormality typical for giant-cell arteritis could be found. Results suggest temporal arteriography is a sensitive but nonspecific procedure in the diagnosis of giant-cell arteritis and must be coupled with biopsy of angiographic abnormalities for confirmation of diagnosis.
Giant Cell Arteritis↗
Application of monoclonal antibody 44-3A6 in the cytodiagnosis and classification of pulmonary carcinomas.
Thirty-five pulmonary carcinomas were studied retrospectively with monoclonal antibody (MCA) 44-3A6 raised against a human adenocarcinoma cell line. The antibody was applied to cytologic smears of bronchial brushings originally stained with the Papanicolau method, and to conventional tissue sections. Ten of 12 adenocarcinomas (ADC) immunostained strongly in sections and smears, as did five of seven large-cell "undifferentiated" carcinomas (LCUC). Eight neuroendocrine carcinomas (NEC) and eight squamous-cell carcinomas (SCC) were negative, except for rare weakly positive foci. We conclude that MCA 44-3A6 can be effectively applied on cytologic smears, and that it could be valuable in the precise classification of pulmonary carcinomas. The immunoreactivity of the ADC and SCC was predictable. Positive immunostaining in some LCUC confirms that these constitute a heterogeneus tumor class that includes cases that are phenotypically ADC despite the absence of obvious glands. Occasional immunostaining in NEC suggests focal exocrine differentiation as previously noted by electron microscopy.
Adenocarcinoma↗
Endoscopic ultrasound appearance of watermelon stomach.
Gastric antral vascular ectasia (GAVE) seen endoscopically has characteristic thickened, red vascular folds radiating from the pylorus to the antrum. The endoscopic ultrasound findings are described and correlated with the visual appearance, computed tomographic (CT) scans, and histologic findings. Hyperechoic focal thickening of the inner layers of the gastric wall are noted and may reflect the diagnosis of GAVE.
Angiodysplasia↗
Colonic mucosal appearance of Tangier disease in a new patient.
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Adenomatous Polyps↗
Bosentan, an endothelin antagonist, augments hepatic graft function by reducing graft circulatory impairment following ischemia/reperfusion injury.
Endothelin is a potent hepatic vasoconstrictor. We evaluated the role of an endothelin antagonist in hepatic ischemia/reperfusion injury. Bosentan, a novel endothelin receptor antagonist, was infused directly into the portal vein prior to cold ischemia and immediately on reperfusion, in five porcine livers. Five other pigs underwent routine liver harvest and reperfusion without bosentan treatment. Hepatic vascular resistance and liver tissue blood flow, as measured by thermistor flow probes, were determined following reperfusion. Hepatocellular damage was assessed through hepatic venous levels of sorbitol dehydrogenase and lactate dehydrogenase. Endothelial cell damage was determined in sections immuno-stained for factor VIII. Graft function was determined through oxygen consumption, bile production, and response to bile acid challenge. Organs treated with bosentan demonstrated lower vascular resistance and enhanced tissue blood flow (P < 0.05) as compared to untreated organs. Portal vein inflow to hepatic tissue was significantly enhanced (4.4-fold) in the bosentan-treated organs (P < 0.05). No difference was observed in hepatocellular damage. Pathology scores for factor VIII immunohistochemical staining were 2.3-fold higher in the bosentan-treated livers as compared to untreated livers (P < 0.05). The bosentan-treated livers also demonstrated enhanced oxygen consumption, increased bile production, and augmented biliary response to a bile acid challenge (P < 0.05). These results indicate that administration of bosentan before and after ischemia/reperfusion reduces hepatic circulatory disturbances, diminishes endothelial cell damage, and augments hepatic graft function.
Animals↗
Iron and chronic viral hepatitis: emerging evidence for an important interaction.
Iron is an essential element for cell survival; it serves as a cofactor for essential enzymes in oxidative metabolism and (in the form of heme) as the major oxygen transporter in most forms of life on earth. Both deficiency and excess of iron often lead to disease. Iron is necessary for the proliferation of microorganisms and neoplastic cells. The presence of iron overload facilitates infection, as evidenced by the increased risk of persons with hemochromatosis to certain infections and by the fact that patients with lesser amounts of hepatic iron appear to respond better to interferon therapy for chronic viral hepatitis than those with larger amounts of hepatic iron. Viral hepatitis is a common cause of morbidity and mortality. Recent studies suggest that there is a key link between iron metabolism and the pathophysiology of viral hepatitis. The lobular and cellular distribution of iron in the liver may be as important as the total quantity of iron present. Whether iron removal will prove useful in the long-term management of chronic viral hepatitis is an issue in need of further well-designed, randomized, controlled trials.
Chronic Disease↗
Carcinoma with multidirectional differentiation arising in Barrett's esophagus.
Four cases of esophageal carcinoma arising in metaplastic Barrett's epithelium are presented in which multidirectional differentiation was demonstrated by light and/or electron microscopy and immunohistochemistry. All tumors and adjacent mucosa produced both neutral and acidic mucins, as well as one or more hormones indigenous to the gut, including gastrin, bombesin, substance P, somatostatin, and serotonin. Gastrin and somatostatin were the peptides most frequently identified in the tumors, while somatostatin and serotonin predominated in Barrett's epithelium. Ultrastructurally, neurosecretory-type granules, 80-250 nm in diameter, were present in 2 cases; squamous features also were present in one of these cases. One patient displayed hypertrophic osteoarthropathy, which disappeared after the tumor was resected. These cases represent the majority of the Barrett-associated carcinomas in our material. Compared to the "pure" esophageal adenocarcinomas not included in this report, these tumors behaved more aggressively, with wider local involvement and nodal and systemic metastases at the time of presentation. The incidence of multidifferentiation in esophageal carcinomas is not known nor is its possible significance, particularly with regard to tumors arising in metaplastic epithelium. This group may merit further study to detect true differences, if any, between these esophageal carcinomas and their apparently more common counterparts.
Aged↗
Expression of adhesion molecules in the host response to colon carcinoma.
Expression of the adhesion molecules LFA-1, ICAM-1, and VCAM-1 was studied in five resected colon carcinomas, one villous adenoma, and normal colon mucosa to determine whether expression of these markers is increased in response to tumor. Frozen tissue samples were stained by a labeled avidin-biotin technique using primary antibodies to LFA-1 (CD11a), CD2, CD4, CD8, CD20, CD68, HLA-DR, ICAM-1 (CD54), and VCAM-1. For each marker, the number of positive mononuclear cells was graded semiquantitatively, and stromal and endothelial cells were scored as either positive or negative. Overall grade of inflammation was increased in tumor compared with normal mucosa in five cases. Cells positive for LFA-1, CD2, CD4, CD8, and CD20 were increased in the tumors in the same cases. ICAM-1 was expressed in vessels, inflammatory cells, and stromal cells in normal mucosa. It was markedly increased in tumor stroma in all six cases. VCAM-1 was negative in normal mucosa, and focally expressed in tumor vessels and stroma. We conclude that increased expression of adhesion molecules occurs around colon neoplasms, particularly in stromal cells, and may be a mechanism for the recruitment of activated leukocytes as part of the inflammatory response to colon carcinomas.
Adenoma, Villous↗
Neuroendocrine carcinoma of the pancreas diagnosed by aspiration cytology. A case report.
Cytologic criteria for distinguishing endocrine from exocrine carcinomas of the pancreas have not been previously elucidated. A case is presented in which the diagnosis of neuroendocrine carcinoma was made on fine needle aspirates of a pancreatic mass and hepatic metastases in a 33-year-old female. Cytologically, the aspirated tumor resembled an intermediate-cell neuroendocrine carcinoma of the lung rather than the usual duct-cell adenocarcinoma of the pancreas. Histologic sections of the subsequently resected primary pancreatic mass revealed a neuroendocrine carcinoma of an intermediate-cell type. Ultrastructurally, the characteristic interlacing cytoplasmic processes with scanty granules were seen. Immunoreactive neuron-specific enolase (NSE), leuenkephalin, substance P and somatostatin were present in the tumor cells in Bouin's-fixed cell blocks of the aspirate; neuron-specific enolase, somatostatin and gastrin were detected in the paraffin-embedded sections of the resected tumor. This variant of pancreatic carcinoma merits recognition as a cytologically distinct group, which shares many of the features described in its bronchopulmonary and gastrointestinal counterparts.
Adult↗
Cytomorphology and marker expression of malignant neuroendocrine cells in pleural effusions.
Three cases of pulmonary neuroendocrine carcinoma with malignant pleural effusions were retrospectively studied to determine if cellular morphology and expression of neuroendocrine markers were the same in the fluid as in the solid milieu. In fluids, changes were noted in cell grouping, shape and cytoplasm. Neuroendocrine markers expressed in both solid and dispersed tumors were neuron-specific enolase (NSE) in all cases and leu-enkephalin in one case. Vasoactive intestinal polypeptide (two cases) and serotonin (one case) were detected only in the solid tumor. ACTH, bombesin and calcitonin were not expressed. We tentatively conclude that, in effusions, neoplastic neuroendocrine cells may alter their cytostructure, growth patterns and marker expression capabilities. NSE appears to be the most reliable neuroendocrine marker for use in small samples and with varying preparatory methods.
Aged↗
Neuroendocrine neoplasms in unusual primary sites.
Primary neoplasms arising in the liver (3 cases), skin (3 cases) and larynx (2 cases) were studied with a combination of light microscopy, immunohistochemical and electron microscopic techniques. Clinically, only one case exhibited a hormonal syndrome (Zollinger-Ellison) while another had elevated levels of calcitonin in the serum. By light microscopy only one tumour appeared characteristically neuroendocrine ('carcinoid'). The other cases showed variable patterns of small to intermediate size cell carcinomas at times admixed with exocrine appearing areas. Immunoperoxidase studies showed reactivity for various peptides including gastrin, calcitonin, somatostatin and ACTH. Several tumours were positive for more than one peptide. Electron microscopy revealed variable populations of neurosecretory type granules either in the main cytoplasmic mass or in cytoplasmic processes. We conclude that some 'undifferentiated' neoplasms from the aforementioned sites may prove to have neuroendocrine differentiation if the proper techniques are applied to their study. Clinical hormonal syndromes appear to be rare in these tumours;s however, determination of various amine and/or peptide materials, or possibly their metabolites, may be valid aids for their recognition and monitoring. The structural patterns of these tumours are very variable and may include cells with squamous features as well as exocrine differentiation with occasionally prominent production of mucosubstances.
Adult↗