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D R Gnepp

Publications and source records attributed to D R Gnepp.

At least 55 records · Page 3Linked to original sources
PubMed1990

Small cell carcinoma of the major salivary glands. An immunohistochemical study.

Small cell carcinomas of the major salivary glands are rare tumors, accounting for less than 1% of malignant neoplasms at these sites. To date, approximately 41 such tumors have been described. They recently have been classified into two groups, based on the ultrastructural presence or absence of intracytoplasmic neuroendocrine (NE) granules, "small cell neuroendocrine carcinoma" and "small cell ductal carcinoma". This study concerns 11 primary small cell carcinomas that had been previously studied ultrastructurally; it was undertaken to determine whether these lesions possessed a neuroendocrine phenotype, using a battery of immunohistochemical stains. Antibodies to epithelial membrane antigen (EMA), cytokeratin (CK), Leu 7, vimentin (VIM), synaptophysin (SYN), chromogranin (CHR), and neuron-specific enolase (NSE) were employed, with the avidin-biotin-peroxidase complex technique and paraffin sections. All tumors in this study expressed at least one neuroendocrine marker. In eight tumors EMA was found; CK was present in all 11 cases, seven of which demonstrated focal paranuclear staining. Leu 7 was seen in eight tumors, VIM was expressed in two cases, SYN was found in three tumors, and CHR was detected in three neoplasms. Anti-neuron-specific enolase labeled eight tumors. From the preceding data one may conclude that all small cell salivary gland carcinomas have neuroendocrine characteristics, even though dense core granules cannot be demonstrated in some of them ultrastructurally.

Animals↗
PubMed1990

Focal mucinosis of the upper aerodigestive tract in children.

Cutaneous mucinosis is an uncommon lesion characterized by mucin accumulation in the dermis. Rarely, mucinosis may arise in the oral cavity; reported cases have been observed in patients older than 16 years. We identified two children younger than 5 years of age with focal mucinosis of the upper aerodigestive tract. A 3-year-old boy had been intubated at age 2 months, suffered from recurrent respiratory infections, and developed mucinosis of the larynx, a previously unreported site for this unusual lesion. The second patient, a 4-year-old girl with a cleft palate, developed palatine mucinosis.

Child, Preschool↗
PubMed1990

Laryngeal and hypopharyngeal liposarcoma. A clinicopathologic study of 10 cases with a comparison to soft-tissue counterparts.

We report the clinicopathologic findings of 10 cases of primary laryngeal and hypopharyngeal liposarcoma. The tumors occurred in patients ranging in age from 37 to 77 years. They showed a marked male to female predominance of 9 to 1. The tumors, which occurred exclusively in the supraglottic larynx or hypopharynx (pyriform sinus), caused airway obstruction; this was the most common presenting symptom. All of the cases were well-differentiated liposarcomas (grade I). Atypical cells, scattered lipoblasts, and infiltration differentiated malignant laryngeal fatty tumors from benign ones. To date, none of these tumors has metastasized; however, multiple recurrences are common. Surgery is the treatment of choice; radiotherapy should be decided on an individual basis.

Adult↗
PubMed1989

Synchronous tumors arising in a single major salivary gland.

Multiple separate tumors arising in the major salivary glands are distinctly unusual. The records on 25 patients with synchronous unilateral salivary gland tumors on file at St Louis University and at the Armed literature. Bilateral tumors arose more frequently than multiple unilateral ones. The most common tumors with bilateral synchronous or metachronous development are the Warthin tumors, with more than 100 reported cases; the mixed tumor with at least 34 cases; and the acinic cell carcinoma, with 12 reported cases. The Warthin tumor also was the most likely to present with multifocal unilateral involvement with 29 tumors having three or more separate foci of tumor. The next most common tumor combinations are a Warthin tumor and a mixed tumor (20 cases), the multifocal membranous basal cell adenoma (12 cases), and multiple oncocytomas (nine cases). Numerous other tumor combinations were found covering the range of salivary gland neoplasia, however one of the tumors usually was a mixed tumor or a Warthin tumor.

Adult↗
PubMed1989

Hepatic granuloma resulting from Enterobius vermicularis.

A nodule of the liver was incidentally noted during left colectomy for a large villous adenoma in a 74-year-old man. Microscopic examination disclosed a granuloma of the liver containing numerous Enterobius vermicularis ova and a cross-section of the nematode. This is the fourth reported case of hepatic oxyuriasis and the second case reported in North America.

Aged↗
PubMed1989

Fat-containing lesions of the thyroid gland.

Thyroid lesions containing adipose tissue are rare; only scattered case reports are recorded. This study of 17 lipomatous thyroid lesions on file at the Armed Forces Institute of Pathology was undertaken to better document the full range of these abnormalities. Patient ages ranged from 11 to 75 years; nine patients were female and eight were male. Fat-containing thyroid neoplasms included seven papillary carcinomas, four adenomatoid nodules, one follicular adenoma, and one minimally invasive follicular carcinoma. Nonneoplastic conditions associated with adipose tissue included four cases of amyloid goiter, two cases of lymphocytic thyroiditis, one case of dyshormonogenetic goiter, and one case of thyroid atrophy. This study documents the presence of adipose tissue in a wider range of benign and malignant thyroid lesions than has previously been reported.

Adipose Tissue↗
PubMed1989

Adenoid cystic carcinoma metastasizing before detection of the primary lesion.

Although adenoid cystic carcinomas are occasionally manifested in atypical ways, metastatic disease preceding detection of the primary tumor has not been previously reported. We have described a patient in whom multiple pulmonary metastatic nodules were found one year before identification of primary adenoid cystic carcinoma of the maxilla. This case illustrates the need to include adenoid cystic carcinoma in the differential diagnosis of patients with metastatic disease and an unknown primary lesion. The use of special stains and electron microscopy can be helpful in confirming a diagnosis of adenoid cystic carcinoma.

Aged↗
PubMed1989

Mucosal origin of sinonasal tract adenomatous neoplasms.

One hundred seven sinonasal tract adenomatous neoplasms on file at the Armed Forces Institute of Pathology were reviewed in order to determine what percentage of and what type of nonsquamous epithelial neoplasms arise from surface mucosa. Seventy-seven percent of tumors were localized to the nose or maxillary sinus. Fifty-nine of the 107 tumors (55%) including 32 (50%) of the 64 adenocarcinomas and 19 (59%) of the 31 adenoid cystic carcinomas arose from the surface mucosa. Five of the six mucoepidermoid carcinomas also appeared to arise from the surface in a diffuse fashion, as did both mixed tumors, one of the oncocytic adenomas and the papillary cystadenoma. One can conclude that the majority of sinonasal tract adenomatous neoplasms arise from the mucosal lining of the sinonasal tract.

Adenocarcinoma↗
PubMed1989

The spectrum of neuroendocrine carcinomas of the larynx.

The purpose of this review is to delineate the spectrum of neuroendocrine (NE) carcinomas of the larynx, thereby highlighting the histologic criteria differentiating these lesions. The importance of the histologic type impacts on and correlates with appropriate treatment modalities, and ultimately reflects on prognosis. A morphologically based classification scheme that incorporates both the histology and biology of each subtype is recommended. In this way, a more standardized nomenclature for these NE tumors is suggested, especially for NE carcinomas previously designed as atypical, pleomorphic, or malignant carcinoids. The distinction between laryngeal NE carcinomas (LNEC) and other malignant proliferations may be difficult when based solely on the morphologic appearance. An analysis incorporating clinical, histochemical, immunocytochemical, and ultrastructural parameters of the NE carcinomas as well as similar appearing lesions is detailed.

Adenocarcinoma↗
PubMed1989

Palisaded myofibroblastoma. A benign mesenchymal tumor of lymph node.

We report 22 examples of an unusual and distinctive benign mesenchymal tumor arising exclusively from lymph nodes of the groin. The tumor, which presents clinically as a swelling, is composed of spindled cells arranged in solid sheets or short, vaguely palisaded fascicles similar to a neurilemoma. The spindled cells blend gradually with large mats of eosinophilic material that appear as thick bands, ellipses, or circular profiles, depending on the plane of section. These eosinophilic structures, which represent a highly characteristic feature of the tumor, contain deeply eosinophilic, collagen-rich cores surrounded by a weakly eosinophilic, actin-rich cuff. The actin within these eosinophilic structures is derived by coalescence of intracellular actin globules extruded from neighboring cells. In all cases, a thin, compressed rim of normal lymph node was identified. Immunohistochemical analysis indicates that the cells express actin but lack S-100 protein, synaptophysin, desmin, keratin, and epithelial membrane antigen. Delicate, linear striations were identified in only two cases by conventional histochemical techniques. The foregoing features suggest that the tumor is related to a myofibroblast or a specialized smooth-muscle cell. These tumors, therefore, probably arise from smooth-muscle-like cells, which are normally present in some lymph node capsules or stroma. Follow-up information on 17 patients indicated that all are alive and well without any evidence of recurrence or metastasis.

Adult↗
PubMed1988

Epidemiology of carcinoma in situ of the upper aerodigestive tract.

Epidemiologic analyses of upper aerodigestive tract (UAT) carcinoma in situ (CIS) are nonexistent, hence only hospital records and surgical pathology resources are available for its descriptive characterization. The National Cancer Institute's Surveillance, Epidemiology and End Results investigation has, however, published valuable raw data pertaining to CIS of the UAT. This information is analyzed here and summarized for the first time, demonstrating the following: a male incidence rate which is four times greater than the female rate (0.8/100,000 males versus 0.2/100,000 females); similar ages at diagnosis for both sexes (62.7 and 60.0 years of age for males and females, respectively); no significant urban/rural incidence differences; that CIS represents 2.8% of all UAT malignancies; that 2.0% of all CIS lesions in humans are found at UAT sites; and that CIS of the uterine cervix is not a good model for CIS of the UAT.

Age Factors↗
PubMed1988

Adenoid cystic carcinoma of the salivary glands: an immunohistochemical analysis.

Adenoid cystic carcinoma is a specific variant of adenocarcinoma with a characteristic cribriform appearance. The tumor may arise from salivary glands and various other sites, but the origin and cellular composition of this unique neoplasm have been controversial. A potential use of immunohistochemistry is to provide additional information on the origin of various cellular components of tumors by comparing them with corresponding normal tissues. Immunohistochemical distributions of carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), keratin, low molecular weight keratin (54 kd), S100 protein, muscle-specific actin, laminin, and type IV collagen were evaluated in 20 adenoid cystic carcinomas arising in major and minor salivary glands. Anti-CEA, anti-EMA, anti-keratin, and anti-S100 antibodies strongly stained cells lining true lumina. Muscle-specific actin, a marker for myoepithelial cells, was found in lining cells of pseudocysts, in tumor cells proper, and in nonluminal cells with a tubular growth pattern. A monoclonal antibody against 54 kd keratin stained almost all cells in the neoplasms. In pseudocysts, replicated basal lamina reacted with antisera to laminin and to type IV collagen. The present study demonstrates that there are at least two populations of tumor cells in adenoid cystic carcinoma: luminal cells that express CEA and EMA, thus indicating their ductal character, and nonluminal cells that express muscle-specific actin characteristic of myoepithelium.

Adult↗
PubMed1988

Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases.

In a demographic and histologic study of 426 oral minor salivary gland tumors, 57.5% were classified as benign and 42.5% were classified as malignant or potentially malignant. There was an overall female preponderance (1.59/1). The mean age for females was 53.1 years and for males was 50.6 years. The mean age for patients with malignant tumors was 5.4 years greater than for patients with benign tumors and was statistically significant. The palate was the most common site for oral minor salivary gland tumors followed by the upper lip and the buccal mucosa. These three sites accounted for 76.1% of all cases. Pleomorphic adenoma was the most common benign tumor (41% of all cases and 71% of benign tumors) followed by monomorphic adenoma of the canalicular and basal cell subtypes (10% of all tumors and 18.9% of benign lesions). Mucoepidermoid carcinoma was the most commonly encountered malignant tumor, accounting for 15.2% of all tumors and 35.9% of malignant lesions. Low-grade (terminal duct, lobular, polymorphous) adenocarcinoma was the most second most common type, making up 11% of all tumors and 26.4% of all malignant tumors. The results of this study are compared with other recent studies.

Adenocarcinoma↗
PubMed1988

Polymorphous low-grade adenocarcinoma of minor salivary gland. An immunohistochemical and clinicopathologic study.

Polymorphous low-grade adenocarcinoma (PLGA) is a minor salivary gland carcinoma usually arising intraorally, primarily in the palate. It is characterized by cytologic uniformity, histologic blandness, and a variable, infiltrating growth pattern. To date, 117 tumors have been reported but the immunohistochemical features of this neoplasm have not been adequately described. This report describes the immunohistochemical distribution of epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), high-molecular-weight keratin, muscle-specific actin (MSA), and S-100 protein in four palatal polymorphous low-grade adenocarcinomas arising in two men and two women. Three patients were treated with a combination of radiation and surgery, and one was treated with just surgery; none of the tumors recurred or metastasized. More than 90% of tumor cells in all four tumors stained with S-100 and EMA, while 75 to 95% stained with keratin. MSA staining intensity was variable; it ranged from less than 10% to 67% of tumor cells staining positively. CEA staining also was markedly variable; it ranged from very focal luminal positivity to 75% of tumor cells staining positive. The diffuse staining pattern of EMA and S-100 and the difference in staining patterns of EMA and CEA in PLGA is distinct from that found in adenoid cystic carcinoma. In the latter neoplasm, EMA and CEA staining patterns are similar and they are localized to ductal lumina; S-100 stains much less diffusely. These differences are useful in the differential diagnosis between these two tumors.

Adenocarcinoma↗