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Biomedical subjects

B M Egbert

Publications and source records attributed to B M Egbert.

33 records · Page 2Linked to original sources
PubMed1985

Differential diagnosis of Kaposi's sarcoma.

The biopsies of all lesions clinically thought to be suspicious for Kaposi's sarcoma (KS) were reviewed over a 15-month period. A diagnosis of KS was made in 40 of 106 biopsies (38%). The cases in which a diagnosis other than KS was made included dermatofibroma, hemangioma, and scar. This second group comprised 59 of 106 cases (56%). A third group included some lesions that had an atypical vascular proliferation, but in which the changes were insufficient for a definite diagnosis of KS. The presence of abnormally shaped vessels, especially those classified as irregular, was the best single criterion to diagnose KS in its early stages. In later stages, the neoplasm assumes a nodular configuration with typical, slitlike vascular channels. At the periphery of such nodules dilated, irregularly shaped vessels similar to those of the early lesions are often seen. The histologic features which help in the diagnosis of KS from other histologic entities are reviewed.

Adolescent↗
PubMed1985

Lymphomatoid papulosis associated with plaque-stage and granulomatous mycosis fungoides.

A 47-year-old black man had typical papulonodular lesions of lymphomatoid papulosis (LyP) with concurrent plaque-stage mycosis fungoides (MF). Both diagnoses were confirmed histologically. This supports the concept that LyP is part of the spectrum of cutaneous T-cell lymphoproliferative disorders. The patient also had a large nodule and a deeply infiltrated plaque, each of which exhibited a deep granulomatous reaction. These were interpreted as representing granulomatous MF. Clinically, there was an evolution from a predominance of LyP lesions to a predominance of MF plaques. Topical carmustine therapy resulted in a substantial decrease in the number and size of both LyP and MF lesions. Both lesion types involuted with hypopigmentation.

Administration, Topical↗
PubMed1984

Pigmented spindle cell nevus. Clinical and histologic review of 90 cases.

A clinical and histologic review of 90 patients with melanocytic lesions termed pigmented spindle cell nevi (PSCN) is reported. The lesions are small in surface diameter, sharply confined both clinically and histologically, and often occur on the proximal extremities of young adults. They are generally of recent onset, moderately to heavily pigmented, and made up of nests of spindled cells confined to the epidermis and papillary dermis. There were 30 male and 60 female patients. Their average age was 25.3 years (ranging from 2.5 to 56 years). Lesions were located on the extremities in 61 cases (67%). Follow-up was possible in 38 cases seen more than 6 months after histologic diagnosis and ranged up to 40 months (average 14 months). No local recurrence or distant spread was found. The importance of recognizing this lesion lies in differentiating it from malignant melanoma. Conservative but complete excision has resulted in no recorded instances of local recurrence or distant spread.

Adolescent↗
PubMed1983

Morphologic and clinical determinants of response to therapy in small cell carcinoma of the lung.

The authors reviewed a series of 29 cases of small cell carcinoma of the lung in order to determine the influence of histologic type and other prognostic factors on response to combination chemotherapy and survival. Comparing classical (lymphocyte-like and fusiform) versus nonclassical histologic types (polygonal and other), no significant difference could be found in response to therapy (CR + PR 11/16 versus 8/11), median survival (7 versus 6 months) or median survival of responders (9 versus 10 months). Furthermore, tumors with atypical histology ("other") behaved similar to the overall series. Of clinical factors investigated, only decreased performance status and presence of metastatic disease were significant prognostic indicators. The results suggest that tumor histologic type is not a useful prognostic indicator in small cell carcinoma, and that atypical tumors resembling small cell carcinoma appear to respond similarly to classical small cell carcinoma and should probably be treated as such.

Antineoplastic Agents↗
PubMed1982

Cutaneous cytomegalovirus vasculitis: an unusual clinical presentation of a common opportunistic pathogen.

A case of cutaneous leukocytoclastic cytomegalovirus (CMV) vasculitis arising in a man with acute myelogenous leukemia is described. An antemortem biopsy specimen of ulcerated skin and an open lung biopsy specimen showed leukocytoclastic vasculitis and nonspecific diffuse interstitial pneumonitis, respectively, neither tissue demonstrating viral infection. Autopsy material revealed CMV vasculitis with typical intranuclear inclusions identified in enlarged endothelial cells associated with thrombus formation and luminal narrowing, in addition to florid CMV pneumonitis. This case represents an unusual although clinically relevant expression of a common opportunistic pathogen.

Cytomegalovirus Infections↗
PubMed1982

Radiation injury of the normal and neoplastic prostate.

Tissue samples from 40 patients with prostatic adenocarcinoma treated by radiation therapy were evaluated simultaneously by three observers to establish criteria for distinguishing residual tumor from radiation-induced atypia. Sections from 10 patients irradiated for nonprostatic pelvic neoplasms served as controls in addition to pretreatment biopsies from the determinate group. Patients had been treated by external x-irradiation, the majority receiving 6200-7400 rad to the prostate and pelvis over 7 to 8 weeks. Positive (tumor) biopsy incidence in the determinate group was 80% at 18 months, 40% at 36 months, and 43% in later samples. The following features were characteristic of radiation injury in the prostate: decreased ratio of the number of tumor glands to stroma, atrophy and squamous-like metaplasia of non-neoplastic glands with or without atypia, stromal fibrosis, arterial lumenal narrowing due to myointimal proliferation, foam cells within vessel walls, and fibrosis and atrophy of seminal vesicles. Criteria not useful for diagnosing radiation injury included architectural pattern or differentiation of tumor, cytologic features of tumor cells, inflammatory infiltrate, and ratio of normal glands to stroma. Ionizing radiation produced characteristic lesions in neoplastic and non-neoplastic prostatic glands, stroma, and blood vessels, and the sum of these changes was a reliable indicator of prior radiotherapy. An understanding of the morphologic effects of radiation injury of the prostate allowed distinction between residual prostatic adenocarcinoma and radiation-induced atypia of non-neoplastic glands.

Adenocarcinoma↗
PubMed1982

Kaposi's sarcoma in young homosexual men: a histopathologic study with particular reference to lymph node involvement.

Recent reports indicate an increased incidence of Kaposi's sarcoma in young homosexual men. In contrast with the form of the disease seen in the elderly, in which skin involvement is usually confined to the lower extremities, lymph node involvement is rare, and disease progression is relatively slow, Kaposi's sarcoma in young homosexual men is characterized by diffuse skin and lymph node involvement and a fulminant disease course.

Adult↗
PubMed1979

Steatocystoma multiplex. Report of a florid case and a review.

A patient had numerous cysts over almost all of his skin surface. The lesions were persistently infected, painful, and odorous, and were contributory to the patient's psychological problems. The cysts were histologically determined to be of the steatocystoma multiplex variety. Several therapeutic modalities were used but only surgical incision, drainage, and electrocautery were beneficial.

Epidermal Cyst↗
PubMed1978

Optic nerve head involvement with cytomegalovirus in an adult with lymphoma.

An optic nerve swelling that was thought clinically to represent a lymphomatous infiltrate of the nerve head developed in a 51-year-old man with histiocytic lymphoma. Histologic examination of the eyes showed the presence of cytomegalovirus (CMV) in the nerve head, but no lymphoma cells. Tru lymphomatous invasion of the nerve head in systemic lymphoma is probably very rare. This case points out an unusual manifestation of adult CMV infection, and a new concern in patients with compromised immune systems.

Adult↗
PubMed1978

Ewing's sarcoma of the spinal epidural space: report of two cases.

Two new cases of primary extraosseous Ewing's sarcoma of the spinal epidural space, and their histogenesis and differential diagnosis are described. The diagnosis of Ewing's sarcoma, which is essentially an undifferentiated tumour, depends largely on the exclusion of several other neoplasms with morphological similarities. With these two cases, 43 extraosseous Ewing's sarcomas have been reported to date, seven of which were epidural in location.

Adolescent↗
PubMed1978

Superior vena caval syndrome.

The two cases of the superior vena caval syndrome described illustrate the problem of making a diagnosis and of determining the etiology of this syndrome. The cutaneous manifestations were typical of the syndrome and included the sudden onset of facial and upper extremity edema, erythema, and telangiectasia. The causes of the syndrome cannot be recognized from the clinical presentation. In one of our cases, the cause was only determined at autopsy and proved to be an unusual benign cause, idiopathic thrombosis, masquerading as a malignant tumor; the other case was caused by an actual malignancy. The manifestations of the syndrome should alert the physician to determine its cause in order that appropriate therapy may be instituted as rapidly as possible.

Edema↗
PubMed1977

Kartagener syndrome: report of a case with mesangiocapillary glomerulonephritis.

The first known case of Kartagener syndrome associated with glomerulonephritis is reported. Mesangiocapillary glomerulonephritis was diagnosed in this patient several months before her death. This report also includes a review of the recent literature dealing with Kartagener syndrome and mesangiocapillary glomerulonephritis and a consideration of the possible relationship of infection to the cause of mesangiocapillary glomerulonephritis.

Adolescent↗
PubMedDate not supplied

The validity of ex vivo laser skin treatment for histological analysis. A prospective controlled study.

BACKGROUND: Laser treatment of skin following removal from human subjects has been the staple of laser research. However, no study has been done to assess the efficacy of ex vivo skin for predicting the behavior of laser treatments in living human tissue. OBJECTIVE: To assess the validity of the ex vivo model by comparing histological characteristics of skin treated with laser prior to and following its removal in rhytidectomy. STUDY DESIGN: Nonrandomized controlled intervention study in which each patient served as both experimental subject and control for different skin sites. PATIENTS: Ten patients with actinic skin changes. INTERVENTIONS: Patients underwent laser treatment to 4 left preauricular sites 1 hour prior to rhytidectomy as follows: carbon dioxide laser treatment alone, carbon dioxide laser treatment followed by erbium:YAG laser treatment, erbium:YAG laser treatment alone, and erbium:YAG laser treatment followed by carbon dioxide laser treatment. The skin was examined by a dermatopathologist blinded to the identity of each specimen. Untreated skin was also removed and immediately subjected to laser treatment identical to that employed in the in vivo skin. This skin was examined histologically. MAIN OUTCOME MEASURES: Regularity of ablation, depth of the necrotic zone, amount of skin removed, degree of collagen injury, and degree of inflammation. RESULTS: There were significant differences between the ex vivo and in vivo groups. The ex vivo specimens demonstrated more than 10 times the irregularity of ablation of the in vivo specimens (irregularity index of 3.0 for the ex vivo group vs 0.25 for the in vivo specimens; P < .05). The incidence of collagen injury was slightly lower for the ex vivo group (1.0 vs 1.3), as was the degree of inflammation (1.4 vs 1.5). The greatest differences were the significantly smaller necrotic zone in the ex vivo specimens (51 vs 71 microns) and the smaller amount of skin removed (118 vs 234 microns). These findings were consistent for all 4 laser treatment regimens studied. CONCLUSIONS: Significant differences were found between the in vivo and ex vivo models. Irregularity of ablation in the ex vivo specimens was 10 times that in the living specimens, limiting histological accuracy in the ex vivo model. The ex vivo skin model underestimated the amount of tissue ablation. This suggests that an in vivo model should be adopted as the standard for laser research.

Adult↗