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D H Dail

Publications and source records attributed to D H Dail.

At least 19 recordsLinked to original sources
PubMed2001

Neoplasms of the ampulla of vater with concurrent pancreatic intraductal neoplasia: a histological and molecular study.

Adenoma and adenocarcinoma of the ampulla of Vater are uncommon neoplasms of the gastrointestinal tract. Only one report has analyzed the relationship between ampullary adenocarcinoma and pancreatic intraductal neoplasia (PanIN), the precursor lesion of pancreatic adenocarcinoma. An association between PanIN and ampullary adenoma has not been reported previously. Case reports have documented the progression of PanIN to invasive pancreatic adenocarcinoma. We reviewed five resected ampullary adenoma and 17 ampullary adenocarcinoma cases and evaluated the pancreas for PanIN. Pancreatic sections from 35 autopsies were reviewed as a control group. Immunohistochemistry for overexpression of p53 and COX-2 proteins was performed in selected cases, as was PCR analysis for K-ras mutations. Follow-up clinical data were obtained. All 22 ampullary neoplasms were associated with PanIN, which was high grade in two (40%) adenoma cases and seven (41%) adenocarcinoma cases. In 16 (73%) evaluable cases, PanIN extended to the pancreatic resection margin; two of which had high grade PanIN. Among the autopsy controls eight (23%) had low-grade PanIN. Seven of the 22 ampullary cases but none of the autopsy controls had coexistent pancreatitis. A smoking history was present in two of four autopsy cases in which this history was available. Overexpression of the p53 and COX-2 proteins was present in only one case of high-grade PanIN. K-ras mutations were present in four of four of the PanIN lesions evaluated, including one autopsy case. Clinical follow-up revealed no progression of PanIN to invasive carcinoma in the remnant pancreas, although the follow-up period was too short to adequately assess that risk (an average of 3.8 y for adenoma cases and 2.5 y for adenocarcinoma cases). We conclude that adenomas and carcinomas of the ampulla are associated with PanIN, and often high-grade PanIN. Although its malignant potential has not been fully established, PanIN is underreported and often unrecognized. PanIN may be analogous to colorectal adenoma in that both are prevalent in the older adult population, but few progress to carcinoma.

Adenocarcinoma↗
PubMed1999

Histological and anatomic changes in Barrett's esophagus after antireflux surgery.

OBJECTIVE: The best treatment approach for patients with documented Barrett's esophagus remains controversial. There is currently no well designed prospective study examining the effect of successful antireflux surgery on Barrett's esophagus. METHODS: Fourteen patients with histologically proven Barrett's esophagus underwent standard antireflux surgery followed by careful endoscopic, histological, and symptomatic follow-up beginning at 2-4 wk after surgery. Pre- and postoperative symptoms, patient functional assessment scores, lower esophageal sphincter pressure, and 24-h pH studies were compared, in addition to monitoring patients for evidence of squamous re-epithelialization and dysplasia. RESULTS: Patients demonstrated statistically significant improvement in symptoms, functional assessment scores, lower esophageal sphincter pressure, and 24-h pH assessments after antireflux surgery. Two patients had complete disappearance of short segments (2 and 3 cm) of Barrett's esophagus. Ten additional patients demonstrated evidence of squamous re-epithelialization, although biopsies often showed mixed components of squamous and columnar epithelium. No patients showed progression of dysplastic change, and four patients demonstrated the disappearance of low grade dysplasia throughout the period of the study. CONCLUSION: Successful antireflux surgery can produce at least partial squamous re-epithelialization in Barrett's metaplasia and stabilization or apparent improvement in dysplasia in some patients without the need for long term medication. Continued long term endoscopic and histologic follow-up is still required in all patients with Barrett's esophagus after antireflux surgery.

Adult↗
PubMed1999

Thyroid transcription factor-1: immunohistochemical evaluation in pulmonary neuroendocrine tumors.

Thyroid transcription factor-1 (TTF-1), a nuclear transcription protein selectively expressed in the thyroid, the diencephalon, and respiratory epithelium, is expressed in more than 90% of pulmonary small cell carcinomas (SCLCs) and in almost 75% of pulmonary non-small cell carcinomas (NSCLCs), but it is absent in typical pulmonary carcinoids (TCs). Therefore, it was thought that SCLC and NSCLC might share a common lineage, different from that of TC. TTF-1 expression in atypical pulmonary carcinoids (ACs) and large-cell neuroendocrine carcinomas (LCNECs) was not studied previously. We examined TTF-1 expression in 51 TCs, 9 ACs, 8 LCNECs, and 21 SCLCs with use of formalin-fixed material and heat-induced epitope retrieval. TTF-1 expression was seen in 18 (35%) of 51 TCs, all of the 9 ACs, 6 (75%) of the 8 LCNECs, and 20 (95%) of the 21 SCLCs. These results reinforce earlier findings of the excellent sensitivity of TTF-1 for SCLC, and they show similar sensitivity for AC and LCNEC, but they argue against the hypothesis that SCLC and TC are of different cell lineages. The ubiquity of TTF-1 expression in pulmonary NECs demonstrated in this study also argues against its use in their subclassification.

Carcinoid Tumor↗
PubMed1998

Pulmonary epithelioid haemangioendothelioma in 21 patients, including three with partial spontaneous regression.

This investigation studied the general conditions and prognostic factors of pulmonary epithelioid haemangioendothelioma (PEH), which is a rare disease. Twenty-one patients were collected throughout Asia by a questionnaire. Age at the detection or onset of symptoms of PEH was 14-64 yrs (mean 44 yrs). Males were more likely to be detected by symptoms (4/8, 50%) than were females (1/13, 8%). Fifteen showed bilateral multiple nodular opacities. Partial spontaneous regression occurred in three asymptomatic patients (one male and two females, all with bilateral multiple nodular opacities) 5, 13 and 15 yrs after detection. Two of the three patients with pleural effusion died within 1 yr, while the 16 patients with no effusion were alive more than 1 yr later (p<0.05). Histologically, two patients with fibrinofibrous pleuritis and extrapleural proliferation of tumour cells died within 2 yrs, while only one of 14 patients lacking such manifestations died within the same period (p<0.05). All three patients without spindle tumour cells survived for 12 yrs after the diagnosis, while all four patients with such cells died during the same period (p<0.05). In conclusion, 21 patients with pulmonary epithelioid haemangioendothelioma were reported, of whom three demonstrated partial spontaneous regression, and adverse prognostic features were identified.

Adolescent↗
PubMed1997

Reproducibility of the histologic diagnosis of pneumonia among a panel of four pathologists: analysis of a gold standard.

STUDY OBJECTIVE: To establish a histologic diagnosis of pneumonia by consensus of a panel of pathologists, to test the interobserver and intraobserver variation in the histologic diagnosis of pneumonia, to compare the diagnostic accuracy of diagnosing pneumonia with and without preselected histologic criteria, and to establish more specific histologic criteria for the diagnosis of pneumonia. METHODS: The study group consisted of 39 patients who died after a mean of 14 days of mechanical ventilation. A postmortem open lung biopsy was performed on all patients. The tissue was reviewed independently by four pathologists who categorized the slides from each patient as showing or not showing pneumonia. Interobserver variation was calculated using the kappa statistic. Six months following the initial evaluation, the same slides were resubmitted to one of the pathologists for reevaluation to look for intraobserver error. Finally, the slides were reviewed and categorized by the criteria of Johanson et al into no pneumonia, mild, moderate, or severe bronchopneumonia. A comparison was made of the patients selected as demonstrating histologic pneumonia by each of the examinations. RESULTS: The reliability coefficient (kappa) measuring agreement among the four pathologists was good at 0.916. However, the prevalence of pneumonia as determined by each of the four pathologists varied; pathologist A, 15 of 39 (38%); pathologist B, 12 of 39 (31%); pathologist C, 9 of 39 (23%); and pathologist D, 7 of 39 (18%). Resubmitting the same slides to the same pathologist 6 months later resulted in reclassification of 2 of 39 patients. Using the histologic criteria of Johanson and colleagues, 14 patients were selected as having pneumonia compared with only nine patients selected by consensus of three of four pathologists. CONCLUSIONS: Recognition of histologic pneumonia varies among pathologists. The preselected criteria of Johanson and colleagues detected histologic pneumonia in eight of nine patients picked by consensus of pathologists, but six additional patients classified as "no histologic pneumonia" by the consensus of pathologists were judged to have histologic pneumonia by these criteria. The results established the necessity for standardization of histologic criteria for studies using biopsy as the gold standard for bacterial pneumonia. An atlas showing the criteria used in our selection was developed.

Aged↗
PubMed1994

Four varied cases of intravascular lymphomatosis and a literature review.

BACKGROUND: Intravascular lymphoma (IVL) is an uncommon malignancy defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of capillaries, small veins, and arteries, with little or no adjacent parenchymal involvement. The nature of IVL has been the subject of considerable controversy. Recent immunohistochemical studies have demonstrated clearly that the tumors bear the immunophenotype of neoplastic lymphoid cells of either B-cell or T-cell lineage. IVL commonly affects the central nervous system, resulting in progressive dementia and multiple neurologic deficits; skin is the second most common site of involvement, in the form of cutaneous plaques and nodules. METHODS: In a retrospective review of all cases of non-Hodgkin's lymphoma seen at our institution, four cases of IVL were identified. Case 1 was fixed in methacarin, and Cases 2-4 were fixed in 10% formalin. Standard fixation, tissue processing, sectioning, and hematoxylin and eosin staining were used. Immunophenotypic studies were performed using a modified avidin-biotin complex technique. The specimen in Case 1 was stained by Giemsa stain using standard techniques. RESULTS: Four cases of IVL are presented. One patient experienced hypoxemia and fevers of unknown origin; the second, dementia and a vasculitislike illness; the third rapidly progressive dementia, nonlocalizing neurologic deficits, and panhypopituitarism; the fourth Kaposi-like skin lesions. Case 1 relapsed shortly after completing chemotherapy. Salvage chemotherapy has yielded good initial response. Autopsy findings in cases 2, 3 and 4 confirmed IVL in many vessels, including the brain, lung, liver, heart, gastrointestinal tract, glomerulus, central nervous system, and skin. Malignant lymphoid cells marked as B-cells in all cases. CONCLUSIONS: Unusual and interesting clinical presentations may occur in patients with IVL. The medical literature indicates that few cases are diagnosed ante mortem. Although isolated patients may respond favorably to chemotherapy, most will deteriorate rapidly and the diagnosis of IVL not contemplated until necropsy.

Adult↗
PubMed1994

Tc-99m sulfur colloid demonstration of diffuse pulmonary interstitial extramedullary hematopoiesis in a patient with myelofibrosis. A case report and review of the literature.

A 60-year-old man with a myeloproliferative syndrome and extramedullary hematopoiesis had progressive respiratory and cardiac insufficiency during the previous 18 months, with advancing interstitial pulmonary disease on chest x-ray. During analysis of his respiratory disease, results of a transbronchial biopsy showed interstitial involvement with increased numbers of megakaryocytes and other panhematopoietic staining elements. Results of a bone marrow scan demonstrated diffuse replacement of pulmonary interstitium with bone marrow, as a component of known ongoing extramedullary hematopoiesis.

Bone Marrow↗
PubMed1993

Nesidioblastosis as a mechanism to prevent fibrosis-induced diabetes after pancreatic duct obstruction.

Does obstruction of the main pancreatic duct that results in exocrine atrophy also result in diabetes? We followed 11 mongrel dogs for 3 years after approximately three-fourths of the pancreas had been removed and the main pancreatic duct obstructed in the pancreatic tail remnant. At 3 years after surgery, all dogs showed total exocrine atrophy (remnants weighed 0.2-1.2 g). None of the animals became diabetic despite only 6% of the original pancreatic tail remaining. During the 3-year period, fasting blood insulin increased during the last half of the study, and this was associated with islets that were 1,300% larger than in control animals (nesidioblastosis). An in situ pancreatic remnant with an obstructed duct and total exocrine atrophy can maintain a nondiabetic state for > 3 years. Perhaps the mechanism is associated with the observed nesidioblastosis.

Animals↗
PubMed1992

Surgical treatment of ductal carcinoma in situ of the breast. 10- to 20-year follow-up.

Between 1967 and 1977, 36 patients received treatment at the Virginia Mason Medical Center in Seattle, Wash, for ductal carcinoma in situ of the breast. Twenty-five patients had modified radical mastectomies, 10 had radical mastectomies, and one had a simple mastectomy. Twenty-seven patients have been followed up for at least 10 years and are without known recurrence (mean follow-up, 17.7 years; range, 8 to 24 years), eight patients died without known recurrence (mean follow-up, 10.6 years; range, 6 to 14 years), and one patient with a prior contralateral mastectomy for infiltrating cancer of the breast had a recurrence in the scalene nodes on the side of the infiltrating cancer and died of metastatic cancer. No patients with ductal carcinoma in situ had local recurrences in the ipsilateral breast or chest wall, and no patients developed cancers in the contralateral breast; one patient had axillary metastasis. Twenty-eight (78%) of 36 patients had multicentric ductal carcinoma in situ in their mastectomy specimens. Twenty-three (88%) of 26 patients with comedocarcinoma-type ductal carcinoma in situ had multicentric lesions. Conversely, patients with low-grade nuclear papillary ductal carcinoma in situ did not have multicentric lesions. Five (14%) of 36 patients had incidental microinvasion discovered in the mastectomy specimens; all had comedocarcinoma. In summary, our study of patients with ductal carcinoma in situ revealed that (1) mastectomy provided excellent local and systemic control; (2) cancer in the contralateral breast was infrequent; (3) axillary metastasis was rare; and (4) histologic features of tumors markedly affected the frequency of multicentricity and chance for microinvasion.

Breast Neoplasms↗
PubMed1991

Lacunae: a urographic finding in chronic obstructive uropathy.

Lacunae, small spaces in the renal sinus that communicate with the caliceal fornices, have been mentioned rarely in the radiologic literature. These lesions have been reported to opacify during excretory urography in patients with current or previous urinary obstruction. Lacunae have been presumed to form in response to urine extravasation through the fornices, but there has never been gross anatomic or histologic proof of their existence. In two patients with obstructive uropathy, urographic-pathologic correlation confirmed the existence and nature of lacunae. On excretory urography, the appearance is likely to be confused with papillary necrosis.

Chronic Disease↗
PubMed1986

Epithelioid hemangioendothelioma and related lesions.

Epithelioid hemangioendothelioma (EH) is the prototype of a group of vascular tumors characterized by an epithelioid or histiocytoid endothelial cell. This family also includes the epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) and epithelioid forms of angiosarcoma. This review discusses the principal clinical, pathologic, and biologic differences among these three lesions. In particular the various manifestations of EH of soft tissue, bone, lung (previously called intravascular bronchioloalveolar tumor), and liver are discussed. Long-term follow-up data of EH of soft tissue and lung are provided.

Bone Neoplasms↗
PubMed1985

Bowel injuries during laparoscopy. Gross anatomy and histology.

Bowel injuries during laparoscopy can result from either electrical damage or direct trauma. When electrocoagulation is used with laparoscopy, it is frequently assumed that any bowel injury is from that source. That assumption might not be accurate. In animal studies we evaluated the histologic characteristics of both electrical and traumatic bowel injuries. A consistent difference in injury pattern, both gross and microscopic, was noted. With a high degree of accuracy, those histologic and gross characteristics can be used to distinguish traumatic from electrical injuries following operative laparoscopy.

Animals↗
PubMed1984

Lymphangiography and fine-needle aspiration biopsy: ineffective for staging early prostate cancer.

Four hundred thirty-six patients with carcinoma of the prostate had lymphangiography (LAG) as part of their initial evaluation before treatment. Fine-needle aspiration biopsy (FNAB) of abnormal opacified lymph nodes was performed routinely. The positivity rate of LAG and FNAB in each clinical stage was compared with the positivity rate predicted for that stage, based on published series of patients with carcinoma of the prostate who underwent pelvic lymph node dissection (LND). Within each clinical stage, the relation of the outcome of LAG/FNAB to histologic tumor grade (Gleason score) and serum acid phosphatase levels was evaluated. LAG/FNAB was of very limited value in patients with less than clinical stage C disease and of no value in patients with a Gleason score of less than 6. Although LAG/FNAB is insensitive even in clinical stage C disease, a positive result will avoid the morbidity and expense of a staging LND and allow confident selection of appropriate treatment. A negative LAG/FNAB, on the other hand, is meaningless, because of the high false-negative rate of LAG. Since no two study populations are exactly alike, any evaluation or comparison of tests used to stage patients with carcinoma of the prostate should state the distribution of its patients by clinical stage.

Acid Phosphatase↗
PubMed1984

Type II pneumocytes in pulmonary tumors. Implications for histogenesis.

Bronchioloalveolar carcinomas (n = 45), intravascular bronchiolo-alveolar tumors (n = 8), and sclerosing hemangiomas of the lung (n = 2) were stained for surfactant apoprotein by the immunoperoxidase method. Of the bronchiolo-alveolar carcinomas, 12 were found to be carcinomas of type II pneumocytes and the remaining 33 tumors were designated as nontype II pneumocytic bronchiolo-alveolar carcinomas. Twenty-five of these tumors displayed trapped benign type II pneumocytes within the tumor masses. In the case of intravascular bronchioloalveolar tumors, none of the tumors demonstrated staining of tumor cells for surfactant apoprotein. In the two cases of sclerosing hemangiomas, the type II pneumocytes were exuberant and numerous, and in one case contained intranuclear inclusions of surfactant apoprotein. This article discusses the implication of the presence of benign type II pneumocytes in pulmonary tumors.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1983

Intravascular, bronchiolar, and alveolar tumor of the lung (IVBAT). An analysis of twenty cases of a peculiar sclerosing endothelial tumor.

Twenty cases of an unusual tumor of the lung are described. This tumor usually presents with multiple small, slowly growing pulmonary nodules. Many cases are detected incidentally. Eighty percent are women, and 50% are less than 40 years of age. Survival with tumor can be quite long. However, one half the patients have died, usually of progressive pulmonary insufficiency. This is a peculiar sclerosing tumor of endothelial cell origin.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1983

Renal oncocytoma--bilateral, multifocal.

One hundred thirteen cases of "grade I renal oncocytoma" are reported from several centers. All centers report absence of associated metastatic disease. In the present review of 219 radical nephrectomy specimens, 11 renal oncocytomas were identified, an incidence of 5 per cent. No diagnostic angiographic features could be identified. Multifocal potential is exemplified by study of a bilateral case and 2 cases of 2 independent oncocytomas in the same kidney. The fine histologic criteria distinguishing oncocytoma from malignant renal tumors suggest that the oncocytomas may have the potential of malignant degeneration. The possible "premalignant classification" of oncocytomas and the lack of dependable diagnostic features radiographically force the management to be the same as for Stage I renal carcinoma. The prognostic information available after histologic definition of renal oncocytoma is valuable.

Adenoma↗