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C Zaloudek

Publications and source records attributed to C Zaloudek.

At least 19 recordsLinked to original sources
PubMed2000

An approach to analysis of large-scale correlations between genome changes and clinical endpoints in ovarian cancer.

This report describes analyses of associations of genome copy number abnormalities in ovarian cancers with clinical features using genome-wide graphical and analytical procedures. These studies show that tumor grade is a better indicator of the extent of genomic progression than stage, that loss of chromosome 4 occurs preferentially in high-grade tumors, and that gains of 3q26-qter, 8q24-qter, and 20q13-qter occur frequently in low-grade and low-stage tumors and thus may be early events in ovarian cancer development. In addition, loss of chromosome 16q24 and a total number of independent genome copy number aberrations >7 are associated with reduced survival duration. The association of loss of 16q24 (D16S3026) with decreased survival duration was confirmed by quantitative PCR. Regions that frequently are abnormal and associated with altered survival duration are strong candidates for higher resolution analysis and gene discovery and may be useful markers for prediction of clinical outcome.

Chromosome Aberrations↗
PubMed2000

MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review.

OBJECTIVE: To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts). DESIGN AND PATIENTS: MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study. RESULTS: On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody. CONCLUSIONS: Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images.

Adolescent↗
PubMed2000

Epithelioid trophoblastic tumor of the uterus in a postmenopausal woman: a case report and review of the literature.

We report an epithelioid trophoblastic tumor (ETT), a recently delineated type of gestational trophoblastic tumor (GTT), discovered in the uterus of a 66-year-old woman. She had been treated for a hydatidiform mole 17 years previously without chemotherapy. The resected uterus contained a solid/cystic tumor located entirely within the myometrium. Microscopically, there was an epithelial-like growth pattern. The tumor was circumscribed, with a pushing border, and the tumor cells grew in cords, nests, and sheets within which were aggregates of hyaline material and necrotic debris. Most tumor cells were mononuclear and had an epithelioid appearance with distinct cell borders, eosinophilic cytoplasm, and nuclei with occasional indistinct nucleoli. Scattered multinucleated cells consistent with syncytiotrophoblastic cells were also present. Immunohistochemical staining revealed strong diffuse reactivity for cytokeratins (CK7, AE1/AE3, CAM 5.2, CK18) and epidermal growth factor receptor, and focal reactivity, mainly in syncytiotrophoblastic cells, for beta-human chorionic gonadotropin, human placental lactogen, and inhibin-alpha. The histologic and immunohistochemical features were characteristic of ETT, and helped to distinguish the tumor from other trophoblastic tumors and squamous cell carcinoma. An unusual observation was a high mitotic count, reflected in a Ki-67 proliferative index of 68.6%. Our findings indicate that ETT, like other types of GTT, can occur in postmenopausal women, even years after a gestational event.

Aged↗
PubMed2000

Prediction of deep myometrial invasion in patients with endometrial cancer: clinical utility of contrast-enhanced MR imaging-a meta-analysis and Bayesian analysis.

PURPOSE: To determine if, in a patient with an endometrial cancer, in addition to the knowledge of tumor grade, preoperative magnetic resonance (MR) imaging findings contribute to treatment stratification and specialist referral. MATERIALS AND METHODS: By using a MEDLINE literature search and institutional pathology reports, pretest probabilities for myometrial invasion were correlated with tumor grade. Likelihood ratios (LRs) were obtained through summary receiver operating characteristics. RESULTS: The mean pretest probabilities of deep myometrial invasion were derived from seven articles (1,875 patients) and from 125 institutional pathology reports. LRs for the prediction of myometrial invasion with contrast-enhanced MR imaging were derived from nine studies (742 patients); positive and negative LRs were 10.11 and 0.1, respectively. The mean weighted pretest probabilities of deep myometrial invasion in patients with tumor grades 1, 2, or 3 were 13%, 35%, or 54%, respectively. Posttest probabilities of deep myometrial invasion for grades 1, 2, or 3 increased to 60%, 84%, or 92%, respectively, for positive and decreased to 1%, 5%, or 10%, respectively, for negative MR imaging findings. CONCLUSION: Use of contrast-enhanced MR imaging significantly affects the posttest probability of deep myometrial invasion in patients with all grades of endometrial cancer and could be used to select patients for specialist referral.

Bayes Theorem↗
PubMed2000

In vivo and in vitro ovarian carcinoma growth inhibition by a phosphatidylinositol 3-kinase inhibitor (LY294002).

Phosphatidylinositol 3-kinase (PI3-K) induces mitogenesis, cell growth, and cell transformation. Amplification of the gene encoding the P110alpha subunit likely is an important event in ovarian cancer progression, and PI3-K inhibitors are possible therapeutic agents for this disease. We evaluated effects of LY294002, a potent inhibitor of PI3-K, on growth of ovarian carcinoma in vivo and in vitro, and on ascites formation in vivo. Athymic mice were inoculated i.p. with the ovarian cancer cell line OVCAR-3. Seven days after inoculation, mice were treated with or without LY294002 (100 mg/kg of body weight) for 3 weeks. Body weight and abdominal circumference were measured twice weekly. At the end of the experiment, mice were sacrificed, ascites volume was measured, and tumors were excised. Mean tumor burden in the LY294002-treated group was reduced by approximately 65% versus controls. Virtually no ascites developed in the treatment group; mean volume of ascites in controls was 3.3 +/- 0.38 ml. OVCAR-3 cells also were cultured in vitro without and with LY294002 (1, 5, and 10 microM) for 24 h. The number of cells in 1, 5, and 10 microM LY294002-treated wells was reduced by 27, 56, and 75%, respectively, versus controls. In vivo and in vitro morphological studies demonstrated that LY294002 induced marked nuclear pyknosis and diminished cytoplasmic volume in the tumor cells, confirmed as apoptosis. Thus, LY294002 significantly inhibits growth and ascites formation of ovarian carcinoma in vivo and markedly inhibits ovarian cancer cell proliferation in vitro, suggesting an important role of PI3-K inhibitors as a potentially useful treatment for women with ovarian carcinoma.

Animals↗
PubMed1998

Chorionicity inaccurately predicted by early ultrasound: a case report.

Ultrasound has been found to be extremely accurate in diagnosing the chorionicity of multiple gestations. Prenatal counselling and/or planning for selective termination is most often based on the sonographic prediction of chorionicity. We present a case of triplet pregnancy in which early sonographic prediction of chorionicity did not match the pathological diagnosis at delivery.

Adult↗
PubMed1997

Microglandular adenocarcinoma of the endometrium: a form of mucinous adenocarcinoma that may be confused with microglandular hyperplasia of the cervix.

Microglandular adenocarcinoma of the endometrium may cause diagnostic problems because of its bland cytologic appearance and its histologic similarity to benign microglandular hyperplasia of the cervix. We present two cases of microglandular adenocarcinoma and discuss the clinical, pathologic, and immunohistochemical findings. Both patients were postmenopausal women, one of whom was taking exogenous hormones. Endometrial biopsy specimens contained polypoid tissue fragments, within which were microcystic spaces lined by flattened, cuboidal, or columnar cells. Solid nests or sheets of tumor cells surrounded glands in some tissue fragments. The nuclei were uniform and bland, and mitotic figures, although readily identifiable, were infrequent (1 per 10 high-power fields). A majority of tumor cells contained intracytoplasmic mucin. Numerous neutrophils were present in gland lumens and tissues. Immunohistochemical stains for carcinoembryonic antigen and TAG72 (B72.3) revealed focal moderate to intense apical and cytoplasmic staining; immunostains for p53 protein were negative. One carcinoma was confined to the endometrium, whereas the other invaded into the inner one-third of the myometrium. Both patients were well after a limited follow-up of 1 year. Microglandular adenocarcinoma is a distinctive variant of endometrial carcinoma that is most likely a form of mucinous adenocarcinoma.

Adenocarcinoma, Mucinous↗
PubMed1996

Postarthroplasty histiocytic lymphadenopathy in gynecologic oncology patients. A benign reactive process that clinically may be mistaken for cancer.

BACKGROUND: A distinctive histiocytosis occurs in the regional draining lymph nodes after large joint replacements, resulting in lymphadenopathy that may mimic cancer both grossly and microscopically. Postarthroplasty histiocytic lymphadenopathy has most often been observed in males during surgery for prostate cancer. METHODS: The authors present three examples of postarthroplasty histiocytic lymphadenopathy that occurred in gynecologic oncology patients. We studied the clinical, histologic, and immunohistochemical features of all three cases and the ultrastructure of one of them. RESULTS: Most involved lymph nodes were enlarged, but histiocytosis was also seen in normal sized lymph nodes. Microscopically, histiocytes with abundant granular cytoplasm were present in the lymph node parenchyma, and, to a lesser extent, in the sinuses. Normal lymph node architecture was variably effaced and the histiocytic infiltrate extended focally into the perinodal tissue. Small, black metal particles were present in the histiocytes in every case. Birefringent polyethylene particles were a prominent finding in all three cases as confirmed by positive modified oil red O staining, and, in one case, by electron microscopy. The histiocytes were strongly immunoreactive for CD68, but immunostains for S100 protein, MAC 387, and cytokeratin were negative. CONCLUSIONS: Enlargement of the lymph nodes in cancer patients who have had large joint replacements may be due to a benign histiocytosis rather than to metastatic cancer. The histologic features of the lymphadenopathy are distinctive and recognizable in routine histologic preparations. Polyethylene wear particles shed from joint prostheses are the most common substances in the histiocytes and are the most likely cause of the histiocytosis.

Aged↗
PubMed1996

Serum concentrations of estradiol, progesterone, and levonorgestrel are not determinants of endometrial histology or abnormal bleeding in long-term Norplant implant users.

The objective of this study was to determine the relevance of serum estradiol, progesterone and levonorgestrel concentrations to endometrial histology and uterine bleeding associated with long-term Norplant implants use. Eighteen five-year users of Norplant implants had endometrial biopsies and determinations of serum estradiol, progesterone and levonorgestrel concentrations. Correlations among these factors and uterine bleeding were calculated. Proliferative endometrium (but not sex steroid levels) was associated with abnormal bleeding. Neither ovarian steroid nor levonorgestrel concentrations was a predictor of abnormal bleeding. Hyperplastic changes were not seen even with high estradiol and low levonorgestrel levels.

Adult↗
PubMed1995

Desmoplastic small cell tumor of the ovary: a unique polyphenotypic tumor with an unfavorable prognosis.

Desmoplastic small cell tumor (DSCT) is a recently described intraabdominal neoplasm of uncertain histogenesis that occurs predominantly in boys and young men. We report a case in a young woman that presented clinically as bilateral ovarian tumors with extensive pelvic and abdominal dissemination. The patient had cytoreductive surgery followed by combination chemotherapy. She had a complete clinical remission, but tumor recurrence was detected 1 year after diagnosis and the patient died of her disease 18 months after presentation. DSCT has a distinctive histologic appearance and a unique immunophenotype. It can present as an ovarian neoplasm and must be considered in the differential diagnosis of small cell tumors of the ovary.

Adult↗
PubMed1995

Myometrial and stromal lesions of the uterus.

This article is an overview of uterine neoplasms that demonstrate mesenchymal differentiation. Major clinical and pathologic features are described, with a focus on those lesions that cause diagnostic difficulty. Brief discussions on more recent observations made concerning these entities are also included.

Adenofibroma↗
PubMed1987

Intraoperative diagnosis of breast lesions. Comparison of cytologic with frozen section technics.

A retrospective double-blind examination of the cytologic smears and frozen section tissue slides from 140 lesions of the breast was performed in order to assess the diagnostic accuracy of each method. The cases with diagnostic errors were reevaluated to define the pitfalls encountered in the intraoperative diagnosis of breast lesions by both methods. Results with the cytologic technics are more variable than with frozen sections, but when read by experienced observers the smears are as accurate as frozen sections and have the additional advantages of rapidity, sparing of tissue for other studies, better correlation with fine-needle aspiration cytologic results, and more complete sampling of large or multiple specimens. The authors recommend that intraoperative cytologic examination be employed routinely in breast diagnosis, initially always in conjunction with frozen section examination but eventually in many cases as an alternative technic.

Adenocarcinoma, Mucinous↗
PubMed1986

Serous carcinoma of the ovary: CT identification of metastatic calcified implants.

The metastasis along peritoneal surfaces of serous cystadenocarcinoma, the most common ovarian malignancy, occurs early and is present in most patients at the time of clinical diagnosis. In many patients, however, computed tomography (CT) is unable to demonstrate peritoneal metastases because of their small size and similarly has been unable to demonstrate metastases in normal sized lymph nodes. Serous cystadenocarcinoma contains histologic calcification in approximately 30% of cases; thus, CT scans were retrospectively reviewed in 15 patients with pathologically proved stage III or IV disease to detect calcified peritoneal metastases. Six patients had calcified peritoneal implants, five of which had perihepatic calcifications. One of the five also had calcified lymphatic metastases, some of which were in normal sized nodes. In three of these five, the examination was otherwise normal. Search for these calcifications should improve the sensitivity of CT in diagnosing metastases from ovarian carcinoma.

Calcinosis↗
PubMed1984

Adenoid cystic carcinoma of the breast.

The clinical, histologic, cytologic, and ultrastructural features of three adenoid cystic carcinomas of the breast are presented. All three neoplasms occurred in postmenopausal women. One patient was treated by wide re-excision of the biopsy site. Two were treated by modified radical mastectomy; no axillary lymph node metastases were found. None of the neoplasms has recurred. Neither estrogen nor progesterone receptors were detected in any of the neoplasms. The histopathologic criteria for the diagnosis of adenoid cystic carcinoma are described, and the differential diagnosis is discussed. Since the cytopathologic features of adenoid cystic carcinoma of the breast appear to be distinctive, the neoplasm can be diagnosed by fine-needle aspiration based upon the presence of the following features: 1) a cellular smear; 2) a uniform population of small, basaloid tumor cells; and 3) small globules of mucoid material surrounded by a rim of neoplastic cells. Ultrastructurally, the predominant cell type has the appearance of a modified myoepithelial cell, but true lumina lined by microvillous epithelial cells are also present. The ultrastructural findings are consistent with the proliferation of neoplastic cells that have the capacity to produce all of the epithelial elements of the breast, i.e., ductal, acinar, and myoepithelial, and so recapitulate the complete ductal or acinar unit.

Aged↗
PubMed1984

Sertoli-Leydig tumors of the ovary. A clinicopathologic study of 64 intermediate and poorly differentiated neoplasms.

The clinical and pathologic features of 64 Sertoli-Leydig tumors of the ovary with intermediate and poor differentiation were studied. The neoplasms occurred mainly in young women. Fifty-four percent of the patients presented with clinical evidence of a hormonally active tumor, and 38% were virilized. The remaining 46% had nonspecific symptoms. Sixty-two patients had tumors confined to one ovary at operation (Stage Ia), while only two patients presented with pelvic metastases (Stage III). The prognosis was generally favorable; the 5- and 10-year actuarial survival rates were 92%. Unilateral salpingo-oophorectomy was effective treatment for Stage Ia Sertoli-Leydig tumors in young women. Microscopically, 44 of the neoplasms were of intermediate differentiation and 20 were poorly differentiated. Heterologous elements (mucinous epithelium, striated muscle, cartilage) were present in 16 neoplasms. The pathologic features that correspond with development of metastases were poor differentiation, the presence of heterologous mesenchymal elements, frequent mitotic figures in stromal cells, and rupture of the neoplasm.

Adolescent↗
PubMed1984

Malignant mesenchymoma of the small intestine.

We present the clinical and pathologic features of a malignant mesenchymoma of the small intestine. Light and electron microscopic studies of the sarcoma revealed multiple patterns of differentiation, including fibrosarcoma, leiomyosarcoma, chondrosarcoma, and osteosarcoma. A recurrence had the morphologic nature of a mesenchymal chondrosarcoma. Clinically, the neoplasm was not detected by barium contrast radiography, but it was readily defined by sonography and computed tomography. Despite aggressive surgery and chemotherapy, the patient died 15 months after the diagnosis was made.

Humans↗
PubMed1982

Granulosa tumors of the ovary in children: a clinical and pathologic study of 32 cases.

Granulosa tumors in children differ histologically from those occurring in adults. Of 32 neoplasms occurring in girls 16 years of age or younger, 26 were juvenile granulosa tumors and three were cystic granulosa tumors; only three neoplasms resembled typical adult granulosa tumors. The juvenile granulosa tumor differs from the typical adult form in that it is composed of larger cells and has luteinization of its cellular components. Two-thirds of the patients had endocrine abnormalities. Fifteen of 20 premenarcheal patients had isosexual precocious pseudopuberty. Of the 12 postmenarcheal girls, seven had menstrual abnormalities and two of the seven were virilized. All 32 patients had Stage Ia tumors. The clinical outcome was generally favorable since only two of 26 patients with follow-up developed a recurrence. Unilateral salpingo-oophorectomy is appropriate treatment for girls with Stage Ia granulosa tumors; 23 of 25 patients treated by unilateral salpingo-oophorectomy were well without recurrence at last contact.

Adolescent↗