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D R Gnepp

Publications and source records attributed to D R Gnepp.

At least 73 records · Page 4Linked to original sources
PubMed1987

Intramuscular (infiltrating) lipoma of the tongue.

A patient with an intramuscular lipoma (infiltrating lipoma) located within the tongue is presented. There is only one previously reported case of an intramuscular lipoma located within the oral cavity. Because of its infiltrating nature, this tumor may be mistaken for a liposarcoma. Here, as in other sites, the important characteristics serving to distinguish an infiltrating lipoma from a liposarcoma are the absence of lipoblastic proliferation, myxoid differentiation, cellular pleomorphism, increased vascularity, and mitotic activity. Achievement of adequate surgical margins is essential, as the recurrence rate may be as high as 62.5% without complete excision.

Adult↗
PubMed1987

Accuracy of frozen section diagnosis of the salivary gland.

Three hundred and one salivary gland lesions (162 benign, 72 malignant, and 67 benign non-neoplastic) of 677 cases were evaluated by use of intraoperative frozen sections by 66 pathologists. In seven patients, the diagnosis was deferred for permanent sections. In four cases (1.3%), the diagnosis at permanent section changed from one category of benign tumor to another, and in five cases (1.7%), from one category of malignant tumor to another. In four tumors, a frozen section diagnosis of benign was changed to malignant on permanent sectioning; all four involved acinic cell carcinomas. Only two tumors were incorrectly diagnosed as malignant. We conclude that diagnoses of most salivary gland lesions based on frozen section examination are reliable and accurate. However, the literature does indicate that caution should be exercised when malignant tumors are dealt with.

Diagnosis, Differential↗
PubMed1987

Vascular endothelial markers of the human thoracic duct and lacteal.

Factor VIII-related antigen (F8) and Ulex europaeus lectin (UEL) are accepted markers for human blood vessel endothelium. However, disagreement exists as to whether lymphatic vessels stain for F8, and accordingly this study was undertaken to address this issue. Moreover, another vascular endothelial marker, angiotensin converting enzyme (ACE) was also examined in lymphatics. Segments of human thoracic duct and portions of small bowel containing lacteals with post-mortem intervals of less than 15 hours, were removed at autopsy and fixed in B5 or formalin. The specimens were processed routinely and sections examined by indirect immunohistochemical techniques for F8 (Dako Corp.), ACE and for UEL (EY Lab). F8, UEL, and ACE positivity was uniformly found in thoracic ducts and lacteals; however, the staining intensity was less in lymphatic vessels with F8 and UEL than with comparable arteries or veins. ACE staining intensity, on the other hand, was similar in blood vessels and lymphatics. Both formalin and B5 fixation preserved antigenicity; however, background staining was greater with B5 fixation whereas tissue staining was slightly more intense with formalin fixation.

Antigens↗
PubMed1986

Small cell carcinoma of the major salivary glands.

Small cell carcinoma is primarily a pulmonary neoplasm that rarely arises in extrapulmonic sites including salivary glands of the head and neck. Twelve cases of small cell carcinoma of salivary gland origin were retrieved from the Armed Forces Institute of Pathology files. Six tumors occurred in the parotid gland and six in the submandibular gland. Tumors were classified into two categories: those with areas of histologically typical small cell carcinoma (7 cases) and those with areas of typical small cell carcinoma with foci of ductal differentiation (5 cases). Follow-up information was available in all 12 cases. Electron microscopy was done on eight tumors; only one demonstrated round electron dense intracytoplasmic neurosecretory granules. These observations further support evidence in the literature suggesting most of the small cell carcinomas of salivary gland origin are not true neuroendocrine ("oat cell") carcinomas, but actually are small cell ductal carcinomas. These tumors appear to have a better prognosis than small cell carcinoma of the lung or nonsalivary gland sites in the head and neck region, with an estimated 2- and 5-year survival of 70 and 46%, respectively.

Adult↗
PubMed1986

Nerve sheath myxoma (neurothekeoma): a case involving the lip.

This case report describes an unusual benign neural tumor involving the lip. It appeared clinically as a gradually enlarging, painless growth arising on the lower lip. Microscopically, it was characterized by whorls of spindle-shaped cells with abundant myxoid cytoplasm and stroma.

Adult↗
PubMed1986

Myoepithelioma of the palate in a child.

Salivary gland myoepitheliomas are rare tumors accounting for less than 1% of neoplasms of the salivary glands. We report a myoepithelioma arising in the palate of an 8-year-old female, the youngest case in the literature. Electron microscopic and immunohistochemical studies support the myoepithelial origin of this tumor.

Carcinoembryonic Antigen↗
PubMed1985

Tissue culture of human and canine thoracic duct endothelium.

Endothelial cells from the canine or human thoracic duct were harvested using 0.2% collagenase digestion and grown in Media 199 supplemented with fetal bovine serum. The canine endothelial cells grew to confluence (4.4 to 12 X 10(4) cells/cm2) in 6 to 10 d; doubling times ranged from 1.5 to 2.8 d. There was a minimum critical density for cell growth between 5000 and 10 000 cells/cm2. The canine endothelial cells have been maintained in culture for periods up to 11 mo. The human thoracic duct endothelial cells are more difficult to grow and maintain. Endothelial cells were isolated from 5 out of 35 human thoracic ducts and grew for periods of up to 2 wk before degenerating. Both human and canine endothelial cells were Factor VIII positive. It has thus been demonstrated that it is possible to grow canine and, less easily, human thoracic duct endothelium in tissue culture.

Animals↗
PubMed1984

Sebaceous neoplasms of salivary gland origin. Report of 21 cases.

Primary sebaceous tumors of salivary glands are extremely rare, although sebaceous glands are commonly present in parotid and submandibular glands. A review of the files of the Armed Forces Institute of Pathology yielded 21 cases of primary salivary gland sebaceous tumors. Five were sebaceous adenomas, 9 sebaceous lymphadenomas, 5 sebaceous carcinomas and 2 sebaceous lymphadenocarcinomas. Seventeen tumors were located in the parotid gland and one each in the submandibular gland, the minor salivary glands of buccal mucosa and in ectopic salivary gland tissue in a periparotid lymph node. Thirteen tumors occurred in males and six in females. The peak incidence for all the sebaceous tumors, occurred in the sixth and seventh decades. The influence of age, sex, race, clinical symptoms, and pathology on survival is reviewed for each tumor group. Our histopathologic observations strongly suggest that sebaceous lymphadenoma and sebaceous lymphadenocarcinoma arise from sebaceous glandular rests in a lymph node in a fashion similar to that of a Warthin tumor.

Adenocarcinoma↗
PubMed1984

Primary Kaposi's sarcoma of the head and neck.

Kaposi's sarcoma is a cutaneous neoplasm commonly arising in the extremities, and rarely in the mucosa or skin of the head and neck. We discuss nine cases of Kaposi's sarcoma arising in the head and neck region, retrieved from the files of the Armed Forces Institute of Pathology, together with 74 cases from the literature. The commonest mucosal locations include the conjunctiva, palate, tongue, tonsils, and gums; common cutaneous sites are the eyelids, nose, ears, and face. Prognosis, sex distribution, and susceptible population groups for the head and neck tumor are similar to those for the commoner peripheral cutaneous form. Seventy percent of patients were 50 years or older; 15% of tumors occurred in children under 16 years. Children under 16 years were more likely to have initial head and neck involvement. In our series, 7 of 11 tumors in children initially involved the conjunctiva or skin of the eyelid. Recently the incidence of Kaposi's sarcoma has been increasing in patients with acquired immunodeficiency syndrome. The age of incidence for this group is lower; more tumors occur on the upper body, skin, and mucosal surfaces of the head and neck; and the prognosis is poorer than in traditional cases of Kaposi's sarcoma.

Adolescent↗
PubMed1983

Primary anaplastic small cell (oat cell) carcinoma of the larynx. Review of the literature and report of 18 cases.

Anaplastic small cell (oat cell) carcinoma is a neoplasm commonly arising in the lungs. However, it may also occur, though rarely, in the larynx. A series of 43 cases is presented (ten cases from the Armed Forces Institute of Pathology, eight from the Department of Otolaryngology of the Padua University, and 25 from the literature). The tumor often presents in the sixth and seventh decades of life and appears to be highly aggressive, and metastases develop early. The most common presenting symptom is hoarseness. As in pulmonary small cell carcinoma, prognosis is poor and does not seem to depend upon therapeutic modalities, tumor location or the extent of initial local disease. The tumor seems to derive from the Kulchitsky cell present not only in the bronchial mucosa but also in the laryngeal lining. Like pulmonary anaplastic small cell carcinoma, small cell carcinoma of the larynx should be treated with systemic chemotherapy and radiotherapy. The association of small cell carcinoma with squamous carcinoma of the larynx is also reported and problems connected with the histogenesis of this mixed tumor are discussed.

Adult↗
PubMed1982

Clinical results of early stage prostatic cancer treated by pelvic lymphadenectomy and 125iodine implants.

Eighty patients with clinically early stage adenocarcinoma of the prostate were treated with pelvic lymphadenectomy and interstitial implantation of 125iodine seeds. A new applicator that permits greater accuracy in spacing the seeds has been developed. Postoperative complications were minimal, with urinary irritability being the most common. Multiple transrectal needle biopsies were performed 12 and 18 months after treatment in 46 patients. The prostatic biopsies were negative for carcinoma in 61 per cent and positive in 39 per cent of the patients. Long-term followup is needed to correlate post-treatment biopsies with survival and to determine if patients with positive biopsies should receive further treatment.

Aged↗
PubMed1982

Splenic lymphangioma: luminal surface ultrastructure; a scanning electron microscopic study.

A splenic lymphangioma removed from the abdominal cavity during an exploratory laparotomy in a 16 year old girl was studied by light microscopy and scanning electron microscopy (SEM). The tumor was composed of numerous vascular channels some of which were filled with clotted lymph. SEM revealed these channels to be lined with an uniform endothelial lining composed of two morphologic cell types: one with a smooth surface; the other with numerous microvilli. The literature on the SEM of lymphatic vessels and lymphangiomas is reviewed and compared to the splenic lymphangioma.

Adolescent↗
PubMed1981

Warthin tumor exhibiting sebaceous differentiation and necrotizing sialometaplasia.

A case of Warthin tumor exhibiting sebaceous differentiation and necrotizing sialometaplasia is presented. This case suggests a common histogenesis for the Warthin tumor and sebaceous lymphadenoma. It supports the theory that necrotizing sialometaplasia is caused by factors which compromise or obstruct the blood supply to salivary gland tissues. The literature on sebaceous differentiation in Warthin tumor and on necrotizing sialometaplasia is reviewed.

Adenolymphoma↗