PubMed Health⌕ Search

Biomedical subjects

D Govender

Publications and source records attributed to D Govender.

At least 19 recordsLinked to original sources
PubMed2005

Microsatellite analysis of the adenomatous polyposis coli (APC) gene and immunoexpression of beta catenin in nephroblastoma: a study including 83 cases treated with preoperative chemotherapy.

AIMS: To determine whether microsatellite mutations of the adenomatous polyposis coli (APC) gene have pathological or prognostic significance in nephroblastomas and to correlate APC alterations with beta catenin immunoexpression. METHODS: One hundred nephroblastomas were analysed, 83 of which received preoperative chemotherapy. Normal and tumour DNA was isolated using standard proteinase K digestion and phenol/chloroform extraction from paraffin wax embedded tissue. Polymerase chain reaction using four APC microsatellite markers-D5S210, D5S299, D5S82, and D5S346-was performed and the products analysed. Immunohistochemistry was performed using the LSAB kit with diaminobenzidine as chromogen. Results were correlated with clinicopathological data using the chi(2) test. RESULTS: Allelic imbalance/loss of heterozygosity was more frequent than microsatellite instability, with 30% of cases showing allelic imbalance/ loss of heterozygosity and 16% showing microsatellite instability. Although there was a significant correlation between the results for individual markers and the clinicopathological data, the overall results do not support a prognostic role for APC in nephroblastoma. Expression of beta catenin was seen in 93% of cases. Staining was predominantly membranous, with epithelium, blastema, and stroma being immunoreactive. Cytoplasmic redistribution was seen in 58% of cases, but no nuclear staining was detected. No significant associations between beta catenin expression and the clinicopathological parameters were found. Kaplan-Meier survival plots showed that patients with loss of membranous staining and pronounced cytoplasmic staining (score, 3) had a significantly shorter survival (p = 0.04; median survival, 5.87 months). CONCLUSION: Microsatellite analysis of APC and immunoexpression of beta catenin did not provide significant pathological or prognostic information in this cohort of nephroblastomas.

Adolescent↗
PubMed2004

Primary tumours of the liver in children: an African perspective.

Primary tumours of the liver present diagnostic and management difficulties. In Africa, outcomes reflect limitations imposed by comorbidity and lack of resources, both human and material, for major liver resection. Whilst hepatoblastoma and hepatocellular carcinoma can be readily distinguished on clinical and biochemical grounds, there is a high incidence of sarcomatous tumours that mandate biopsy. In our experience, hepatocellular carcinoma in childhood is a lethal condition, usually bilateral and associated with hepatitis B infection. Sarcomatous tumours are often resectable but have a high rate of local recurrence. Hepatoblastoma is a surgically curable tumour in many patients. Resection for benign liver tumours can be safely accomplished and augments institutional experience with major liver surgery.

Carcinoma, Hepatocellular↗
PubMed2004

Sertoli cell nodules in the undescended testis: a histochemical, immunohistochemical, and ultrastructural study of hyaline deposits.

AIMS: To document the morphology, immunohistochemical staining properties, and ultrastructural features of hyaline material in Sertoli cell nodules of undescended testis and contrast them with those of sex cord tumour with annular tubules (SCTAT), which is histologically similar. To highlight the need to distinguish these nodules from other Sertoli cell hyperplasias, such as intratubular Sertoli cell proliferations, which occur in specific clinical contexts. MATERIALS/METHODS: A retrospective study of 46 orchidectomy specimens from cryptorchid testes, 27 of which contained Sertoli cell nodules. Special histochemical stains, immunohistochemical stains for type IV collagen and fibronectin, and ultrastructural examination of the hyaline material were performed using tissue from paraffin wax embedded tissue blocks. RESULTS: The hyaline deposits in SCTAT and Sertoli cell nodules had similar staining patterns-periodic acid Schiff (PAS) and PAS-diastase positivity with variable staining of Martius scarlet blue and Masson trichrome. Type IV collagen immunoreactivity was seen in hyaline areas, although fibronectin was negative. Electron microscopy of hyaline areas confirmed a compact matrix identical to components of the basement membrane in the adjacent seminiferous tubules. CONCLUSION: This study describes an unusual form of Sertoli cell proliferation in undescended testes, which must be distinguished from Sertoli cell tumours and other forms of proliferation. In addition, the hyaline material within Sertoli cell nodules in the cryptorchid testis is histochemically, immunohistochemically, and ultrastructurally consistent with both matrix and fibrous components of seminiferous tubule basement membranes. Increased production of basement membrane material, with subsequent invagination into tubules, is the most likely origin of this material.

Adolescent↗
PubMed2002

Malignant solid tumours in neonates: an African perspective.

Malignant tumours in the neonate are distinct pathologically, clinically, and therapeutically from those in older children or adults. Behaviour cannot be directly implied from the histological appearance, and risk stratification is therefore difficult and complex. We review 42 patients seen over a 20-year period. Neuroblastoma (NB) was the commonest tumour seen (11), but the soft-tissue sarcomas were the dominant group (14). The initial management was surgical when possible. Chemotherapy, despite appropriate dose reduction, had significant morbidity and mortality. Whilst the outcome for congenital fibrosarcoma was good (6/7, 86%), there were no survivors amongst 5 patients with rhabdomyosarcoma. In the absence of cytogenetic and biochemical markers, risk stratification amongst babies with NB was based upon INSS staging. Stage I disease was associated with a good prognosis, whilst stage IV disease was uniformly fatal. Stage IVs disease had only 50% early survival. Patients with renal tumours, whether nephroblastoma or mesoblastic nephroma, did well. Only patients with morphologically immature teratomas were included, amongst whom there are 2 of 7 (29%) known survivors, but 43% have been lost to follow-up and their status is unknown. These figures are consistent with other reports from Africa.

Female↗
PubMed2002

ALK protein expression in rhabdomyosarcomas.

AIMS: The ALK p80 chimeric protein is thought to be up-regulated as a result of the t(2;5) as classically seen in anaplastic large cell lymphoma. However, rhabdomyosarcomas (in particular, the alveolar subtype) have also been noted to show expression of this protein. This study set out to examine ALK expression in a large number of rhabdomyosarcomas. METHODS AND RESULTS: Eighty-three cases of rhabdomyosarcomas and 16 cases of malignant mixed müllerian tumours with a rhabdomyosarcomatous component were retrieved from the archives of the Department of Anatomical Pathology for the period 1983-2001. The sections were stained with polyclonal ALK antibody. There were 52 male and 30 female patients. In one case, the gender of the patient was not indicated. The ages ranged from 1 week to 77 years. The most common site was the head and neck region, followed by the pelvis and extremities. Thirty-one cases were of the alveolar subtype while 40 cases were embryonal. There were four mixed embryonal/alveolar, six pleomorphic and two unclassifiable rhabdomyosarcomas. Fourteen of the 31 (45%) alveolar rhabdomyosarcomas stained positively for the ALK protein, while only six of the 40 embryonal (15%) cases showed positivity. One case each of the mixed embryonal/alveolar, pleomorphic and unclassified cases was also immunopositive. The rhabdomyosarcomatous component in the malignant mixed müllerian tumours was positive in four of the 16 cases. CONCLUSION: We conclude that a proportion of alveolar rhabdomyosarcomas (in particular) exhibit ALK protein expression. However, ALK expression is not restricted to this subtype. An extension of this study is to determine if this over-expression is as a result of the t(2;5) translocation.

Adolescent↗
PubMed2002

Rectal gastric heterotopia in infancy.

Heterotopic gastric mucosa is rare in children with most cases presenting in association with Meckel's diverticulum. The authors present a 2-year-old boy with gastric heterotopia of the anorectum, who presented with painless, intermittent rectal bleeding.

Anus Diseases↗
PubMed2001

Right pulmonary artery sarcoma.

A 57-year-old man presented with cough, chest pain and dyspnea. Peripheral lung opacities detected radiologically on admission were surgically resected and histologically confirmed as pulmonary infarcts. Subsequent radiological examinations revealed a stricture of the right pulmonary artery with evidence of pulmonary hypertension. The patient was commenced on anticoagulant therapy, which resulted in some clinical improvement. A hilar mass detected later was resected together with the right lung. Pathological examination of the hilar mass revealed a tumour within the lumen of the pulmonary artery causing almost total occlusion of the artery. Histology showed angiosarcomatous and osteosarcomatous areas. The patient is well and disease-free 9 months following resection.

Disease-Free Survival↗
PubMed2000

An unusual presentation of solitary fibrous tumor.

STUDY DESIGN: Case report of a lumbar extradural solitary fibrous tumor. OBJECTIVE: To describe the clinical manifestations and successful treatment of a patient with solitary fibrous tumor of the lumbar spine. SUMMARY OF BACKGROUND DATA: Solitary fibrous tumor usually occurs on the pleura but has been described in a growing number of sites. Although this is the first case in a lumbar extradural location, clinicians should be aware of the many guises in which this entity appears. Most cases are benign and cure is effected by surgical extirpation. METHODS: The diagnosis, treatment, and outcome of a patient with a lumbar extradural solitary fibrous tumor are reviewed. RESULTS: A patient showing signs of myeloradiculopathy was found, by means of magnetic resonance imaging, to have an intensely enhancing extradural lesion in the region of L1. Excision biopsy revealed features of a solitary fibrous tumor. The patient made a rapid, complete recovery. CONCLUSIONS: Solitary fibrous tumor has protean clinical manifestations and should be be considered in the differential diagnosis of intraspinal enhancing lesions on either side of the dura.

Adult↗
PubMed2000

Primary lumbosacral Wilms tumour associated with occult spinal dysraphism.

A 4-year-old child presenting with sudden-onset paraplegia and a sacral tumour in association with spina bifida occulta is reported. There were no stigmata of spinal dysraphism at birth. Imaging studies confirmed a sacral tumour with extradural extension up to T10 and spinal dysraphism. The histological features of the extradural and sacral components of the tumour were consistent with a Wilms tumour. The differential diagnosis included a primary sacral teratoma containing Wilms tumour elements or a primary extrarenal Wilms tumour arising in association with a spinal dysraphism. There was no clinical response to chemotherapy or radiotherapy.

Child, Preschool↗
PubMed2000

Extraskeletal osteosarcoma of the scalp.

A rare case of extraskeletal osteosarcoma of the scalp in a 56-year-old woman is described. At presentation she was found to have an 8-cm diameter, tender, firm, exophytic scalp tumor. MRI scan confirmed absence of underlying skeletal origin and showed extension along the subcutaneous plane. The tumor was excised and the patient received post-operative chemotherapy. Histologically, the tumor showed classical features of an osteogenic osteosarcoma with focal fibroblastic areas. In addition, there were rhabdoid cells present, which showed paranuclear cytoplasmic immunoreactivity for epithelial membrane antigen. The patient developed metastatic disease 6 months after surgical excision.

Antineoplastic Agents↗
PubMed1999

Ectomesenchymoma of the prostate: histological diagnostic criteria.

A 5-month-old infant with an ectomesenchymoma (EMCH) of the prostate is described. The tumour was composed of embryonal rhabdomyosarcoma (RMS) and ganglioneuroma. Eight months after presentation the patient died of recurrent tumour, which caused intestinal obstruction. The tumour was initially diagnosed as an embryonal RMS on trans-rectal needle biopsies. The diagnosis of an EMCH is difficult if not impossible to make on needle-biopsy specimens. We suggest that pathologists should always consider an EMCH when confronted with a RMS or neuroectodermal tumour, and the use of immunohistochemical stains is recommended in this situation.

Antineoplastic Agents↗
PubMed1999

Granuloma inguinale (donovanosis) presenting as a neck mass in an infant.

A case of granuloma inguinale (GI) presenting as a lateral neck mass in a 4-month-old, HIV-positive infant is described. The histological features of the mass were typical of GI, with numerous macrophages containing intracellular organisms with a "closed-safety-pin" appearance. This is a rare occurrence, and the mode of transmission of infection is discussed. An awareness of GI in infants by both clinicians and pathologists is important to prevent morbidity and allow for prompt institution of appropriate treatment.

AIDS-Related Opportunistic Infections↗
PubMed1999

Recurrent Wilms' tumour or retroperitoneal teratoma? A challenging case.

The clinical and pathological features of a left renal tumour and a subsequent retroperitoneal tumour in a 2-year-old boy are presented. The nephrectomy specimen showed typical features of a triphasic Wilms' tumour with focal heterologous elements and intralobar nephrogenic rests. The tumour was assessed as clinical stage III and post-operative chemotherapy and radiotherapy were administered. A retroperitoneal mass, detected following completion of postoperative therapy, was mainly made up of skeletal muscle and mature adipose tissue. Nests of epithelium resembling ameloblastic nests and a unique structure reminiscent of a developing tooth were present.

Child, Preschool↗
PubMed1999

Follicular thyroid carcinoma with rhabdoid phenotype.

The aim of this paper is to highlight the occurrence of an unusual histological variant of follicular carcinoma of the thyroid. Three cases are presented: each of the tumours contained a significant population of rhabdoid cells (accounting for 30-40% of the total tumour content). They were all found in female patients aged 65, 43 and 56 years, who presented with enlarged thyroid glands and were subjected to lobectomies. The tumours contained foci of well-differentiated follicular carcinoma, with areas of capsular and vascular invasion, and an accompanying rhabdoid cell component that merged with the neoplastic follicles. Immunohistochemically, the follicular component was positive with thyroglobulin, but the rhabdoid cells were negative in all three cases. The cytoplasmic aggregates in the rhabdoid cells were strongly positive for epithelial markers and vimentin. Two tumours pursued an aggressive biological course similar to other composite extrarenal rhabdoid tumours. A rhabdoid component accompanying thyroid follicular carcinomas is an adverse prognostic factor.

Adenocarcinoma, Follicular↗
PubMed1999

Malakoplakia and tuberculosis.

A 33 year old woman developed a soft mass in the left anterior neck following treatment for pulmonary tuberculosis. An incisional biopsy was performed and a cold abscess drained. Histology confirmed a diagnosis of tuberculosis. In addition, there were numerous intracellular bodies which resembled the Michaelis-Gutmann bodies of malakoplakia. This case however displayed some atypical histological, histochemical and ultrastructural features, which are highlighted in this report. The mass responded to combination antituberculous treatment.

Abscess↗
PubMed1999

Cytomegalovirus-induced syringosquamous metaplasia.

An unusual case of syringosquamous metaplasia of the eccrine ducts caused by cytomegalovirus (CMV) is presented. The patient was HIV positive and had extensive excoriation of the perineum and vulva. Biopsy revealed the presence of herpes simplex virus (HSV) inclusions in the necrotic exudate, a CMV vasculitis and extensive involvement of the eccrine ducts. In addition to containing typical CMV inclusions, the eccrine ducts showed proliferation and squamous metaplasia. Inclusions of HSV were not seen within the eccrine ducts by light microscopy or immunohistochemistry. The extensive proliferation with accompanying squamous metaplasia superficially can resemble an infiltrating squamous carcinoma, but this was not evident to a great extent in this case. To the best of our knowledge, our case represents the first of syringosquamous metaplasia of eccrine ducts caused by CMV infection.

AIDS-Related Opportunistic Infections↗