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D R Salomao

Publications and source records attributed to D R Salomao.

13 recordsLinked to original sources

Characterization of a spontaneously arising murine squamous cell carcinoma (SCC VII) as a prerequisite for head and neck cancer immunotherapy.

BACKGROUND: To develop novel therapeutic approaches for patients with head and neck malignancies, poorly immunogenic murine models of squamous cell carcinoma (SCC) need to be defined. METHODS: The phenotype, growth characteristics, and responsiveness to tumor-specific T-cell transfer of a spontaneously arising murine SCC (SCC VII) were characterized. RESULTS: SCC VII expresses major histocompatibility complex (MHC) class I molecules yet is resistant to tumor-specific T-cell killing and relatively insensitive to killing mediated by lymphokine-activated killer (LAK) cells. Intradermal tumors are reproducibly established after vaccination of 5 x 10(4) cells, and systemic micrometastases are apparent after intravenous administration of 2.5 x 10(4) cells. Immunotherapy of 3-day lung metastases using tumor-specific T cells and systemic interleukin-2 (IL-2) was ineffective in reducing the number of metastases in vivo. CONCLUSIONS: SCC VII is a poorly immunogenic murine squamous cell cancer, which represents an ideal model for preclinical testing of immunotherapeutic approaches for patients with SCC of the upper aerodigestive tract.

Animals↗

Radiation-induced meningiomas involving the orbit.

PURPOSE: To review the clinical features and outcomes of patients with radiation-induced meningiomas involving the orbit. DESIGN: Retrospective case series. PARTICIPANTS: Eight patients with radiation-induced meningiomas affecting the orbit. METHODS: Clinical and pathologic data of the patients were reviewed. MAIN OUTCOME MEASURES: Age at diagnosis, mean interval between radiation therapy and meningioma diagnosis, tumor recurrence, histologic atypia, and mean follow-up time after initial diagnosis. RESULTS: The mean age at diagnosis was 42 years (range, 21 years to 70 years). The mean interval between radiation therapy and meningioma diagnosis was 26 years (range, 3 years to 54 years). All patients underwent gross total resection or subtotal resection of the meningioma. Five tumors (62.5%) recurred, based on clinical findings and CT imaging. The mean interval between resection of the meningioma and recurrence was 3 years (range, 9 months to 9 years). Three patients (37.5%) had atypical meningiomas. One patient (12.5%) had multiple tumors. The mean follow-up interval was 7 years after initial diagnosis of the meningioma (range, 15 months to 19 years). CONCLUSIONS: This series of radiation-induced meningiomas, the first in the ophthalmic literature, illustrates the aggressive nature of this tumor.

Adult↗

Paraneoplastic and metastatic neurologic complications of Merkel cell carcinoma.

Merkel cell carcinoma is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and frequently accompanied by distant metastases. Neurologic complications of Merkel cell carcinoma are rare. We describe a 69-year-old man who presented with Lambert-Eaton myasthenic syndrome and was found to have Merkel cell carcinoma. The paraneoplastic syndrome improved with initial treatment of the malignancy. He subsequently developed a solitary brain metastasis and died of leptomeningeal carcinomatosis.

Aged↗

Laser pointers and the human eye: a clinicopathologic study.

We report the absence of photic retinal injury after exposing the retina to light from class 3A laser pointers for durations of up to 15 minutes. Three patients with uveal melanomas were scheduled to have an enucleation. Each agreed to have his or her retina exposed to laser light from a class 3A laser pointer prior to enucleation. Continuous exposure was directed to the fovea for 1 minute, to the retina 5 degrees below fixation for 5 minutes, and to the retina 5 degrees above fixation for 15 minutes. Ophthalmoscopic evaluation of the cornea, lens, and retina and fluorescein angiographic studies of the retina were conducted before, 24 hours after, and 11 days after laser exposure in the first case; before and 86 hours after exposure in the second case; and before, 96 hours after, and 15 days after exposure in the third case. Other than transient afterimages that lasted only a few minutes, we were unable to document any functional, ophthalmoscopic, fluorescein angiographic, or histologic evidence of damage to any structures of the eyes. Transmission electron microscopic studies of retinal sites targeted by the laser pointers in the second and third cases revealed ultrastructural abnormalities in the outer retina and the pigment epithelium that were similar to abnormalities seen in the retina approximately 8 mm away from the targeted sites. The risk to the human eye from transient exposure to light from commercially available class 3A laser pointers having powers of 1, 2, and 5 mW seems negligible.

Adult↗

Papillary thyroid cancer with pulmonary metastases in children: long-term prognosis.

BACKGROUND: Papillary thyroid cancer (PTC) in young patients may rarely be encountered with pulmonary metastases. Previous studies have suggested that, in the pediatric population, this may not portend a lethal outcome. Our present study, children with pulmonary metastases, was designed to clarify this issue. METHODS: Fourteen children and young adolescents (mean age, 13.5 years; range, 9.8-17 years) with PTC and pulmonary metastases were treated at our institution between 1937 and 1998. Surgical treatment consisted of total thyroidectomy (n = 10 patients), subtotal thyroidectomy (n = 3 patients), and a biopsy only procedure (n = 1 patient). All patients who underwent thyroidectomy also underwent a variety of cervical lymph node dissections, and all patients proved to have regional nodal disease. After the operation, 12 patients were treated with ablative doses of (131)I, 1 patient was treated with external beam irradiation, and all patients were placed on suppressive thyroid hormone therapy. The mean length of follow-up was 19.3 years (range, 1-45 years). RESULTS: Regional recurrent disease developed in 2 patients (15%). No patient experienced the development of worsening pulmonary disease or extra-pulmonary metastases. All patients with recurrent disease underwent selective nodal resections. No patient died of metastatic PTC. Seven patients (50%) remain completely free of disease and are probably cured; 7 patients (50%) are asymptomatic with residual pulmonary disease. CONCLUSIONS: A stepwise treatment approach allows long-term survival and frequent cure for young patients with PTC and concomitant pulmonary metastases.

Adolescent↗

Effect of clinical history on diagnostic accuracy in the cytologic interpretation of bronchial brush specimens.

There has been little study of the effect of clinical history on pathologic diagnostic accuracy. Five pathologists retrospectively examined 97 bronchial brush specimens with and without clinical historic information. Forty-nine patients had a biopsy-proven malignant lesion, and 48 had a benign lesion. Diagnostic accuracy with and without history for each pathologist was determined with likelihood ratios and receiver operating characteristic curves. The overall diagnostic accuracy with and without history was 0.84 and 0.76, respectively. The average negative predictive value of a benign diagnosis decreased from 89.2% (with history) to 74.0% (without history). Overall, the cytopathologists were more reluctant to make a definitive malignant diagnosis without history compared with history. The average positive predictive value of a malignant diagnosis with and without history was almost identical. The absence of history leads to lower diagnostic accuracy in the cytologic interpretation of bronchial brush specimens partly because pathologists underdiagnose malignant lesions.

Bronchi↗

Fine-needle aspiration cytology of esophageal leiomyomatosis.

Leiomyomata are the most common benign neoplasms of the esophagus, but they are still very rare in comparison to malignant tumors of this organ. We report on the aspiration cytology findings of a case of esophageal leiomyomatosis in a 19-yr-old man. Diagn. Cytopathol. 1999;21:197-199.

Adult↗

Hepatocellular carcinoma: needle biopsy findings in 74 cases.

Needle aspiration specimens from 74 cases of hepatocellular carcinoma (HCC) diagnosed between January 1986 and December 1992 were reviewed and compared with 57 other lesions. The most specific cytologic findings for HCC included capillaries separating tumor cells (34%), bile associated with malignant cells (19%), and endothelial cells lining clusters of neoplastic cells (18%). Less specific findings included polygonal cells with central nuclei resembling normal hepatocytes and intranuclear inclusions. Tissue core fragments available in 53 cases of HCC disclosed that a weak keratin (AE1/AE3) stain (75% of HCC), a canalicular pattern of polyclonal carcinoembryonic antigen (54%), and a positive alpha-fetoprotein stain (58%) are diagnostic of HCC. All HCCs were negative for monoclonal carcinoembryonic antigen. In situ hybridization for albumin mRNA was positive in 27 of 33 cases of HCC. The diagnosis of HCC by needle biopsy should include cytologic findings and the appropriate immunohistochemical profile, along with detection of albumin mRNA by in situ hybridization.

Adult↗

Determination of silicon in breast and capsular tissue from patients with breast implants performed by inductively coupled plasma emission spectroscopy. Comparison with tissue histology.

A method for analysis of silicon in tissue was developed to determine silicon content in breast parenchymal and periprosthetic capsular tissues of patients with silicone or saline implants and to compare levels in tissues from normal (nonaugmented) breasts. It is of interest to determine whether increased silicon content in tissues can be associated with morbidity in patients who have received silicone implants. This manuscript addresses the issues involved in analysis of breast tissue samples for silicon and compares silicon levels with tissue histologic findings and patient morbidity. One hundred sixty tissue samples were obtained for silicon analysis from 72 patients during augmentation, capsulectomy with or without replacement mammoplasty, mastectomy, or biopsy procedures and were frozen in acid-washed polystyrene tubes at 220 degrees C until analysis. Samples were thawed, sectioned to approximately 0.1 g (dry weight), and digested in nitric acid before analysis by inductively coupled plasma emission spectroscopy, monitoring emission intensity at 251.6 nm. Tissue silicon levels (breast parenchymal and periprosthetic capsular tissue) in patients with silicone gel implants were much higher (mean, 9,287 micrograms/g, n = 106) than in patients with saline implants (mean, 196 micrograms/g, n = 37) or nonaugmented breasts (mean, 64 micrograms/g, n = 17). Histologic examination was performed on 54 tissue samples stained with hematoxylin-eosin. Tissue samples were rated as to degree of inflammation and calcification, and amount of giant cells, foamy histiocytes, and vacuoles containing a colorless refractory material. Vacuolization and foamy histiocyte ratings correlated significantly with tissue silicon concentration. No correlations were found between tissue silicon concentration and inflammation, calcification, or giant cell rating. Implant age (number of years an implant was in place before sampling) correlated with capsular tissue silicon concentration in patients with intact implants but not in those with ruptured implants. No difference in tissue silicon concentration was found between patients with or without signs or symptoms of morbidity. Using 0.1 g of tissue, the method was linear to 1,000 micrograms/g, and sensitivity was 3.7 micrograms/g. Precision between runs (mean, 5.1 micrograms/g; coefficient of variance, 13.7%; n = 13) was calculated from multiple analyses of a bovine liver standard (National Bureau of Standards, reference material 1577a). Significant biologic variability (21.4% to 52.5%) was seen in tissues with high silicon levels. Paraffin-embedded, formalin-fixed tissues are not amenable to silicon analysis by this method, because of leaching of silicone from the tissues during preparation. Thus only fresh frozen tissue samples were used.

Age Factors↗

Plexiform fibrohistiocytic tumor with systemic metastases: a case report.

A case of plexiform fibrohistiocytic tumor with pulmonary metastases is presented. The tumor developed on the left wrist of a 4-year-old girl and metastasized to an axillary lymph node and lungs after an episode of local recurrence. This is the first report of systemic metastasis secondary to this neoplasm.

Axilla↗

Microvascular invasion in prostate cancer correlates with pathologic stage.

OBJECTIVE: To determine the incidence of microvascular invasion in prostatic carcinoma and its correlation with other prognostic factors. DESIGN: Evaluation of the frequency and extent of microvascular invasion by routine light microscopy in 210 whole-mounted radical prostatectomies with cancer. RESULTS: Microvascular invasion was identified in 111 (53%) of 210 specimens. Focal microvascular invasion (involvement of fewer than three high-power fields) was present in 42 cases (20%); extensive microvascular invasion (involvement of three or more high-power fields) was present in 69 cases (33%). Capsular perforation was present in 43% and 62% of cases with focal and extensive microvascular invasion, respectively. Seminal vesical involvement was observed in 23% and 47% of cases with focal and extensive microvascular invasion, respectively. Lymph node metastases were only observed in cases with microvascular invasion and were present in 7% and 23% of cases with focal and extensive invasion, respectively. There was also a strong positive correlation of microvascular invasion with surgical margin status, Gleason score, and cancer volume. Tumors ranged in volume from 0.14 cc to 47.25 cc (mean, 9.09 cc), and the volume in cases without microvascular invasion was lower than in those with invasion (mean, 5.4 cc and 12.7 cc, respectively); also, the volume in cases with focal invasion was lower than in those with extensive invasion (mean, 9.4 cc and 16.1 cc, respectively). CONCLUSIONS: Microvascular invasion in prostatic carcinoma correlates positively with virtually all measures of pathologic stage. Its presence should be reported in all prostate specimens according to the Cancer Committee of the College of Americans Pathologists.

Disease Progression↗

Pancreatic cystic neoplasms: the role and sensitivity of needle aspiration and biopsy.

BACKGROUND: The proper evaluation of patients with pancreatic cystic neoplasms remains controversial. Although computed tomography (CT) and sonography can differentiate the majority of these tumors, needle aspiration and biopsy can be helpful in selected patients. The purpose of this study was to (1) determine the sensitivity of needle aspiration and biopsy of cystic pancreatic neoplasms, (2) assess the complications after needle aspiration and biopsy, and (3) assess the indications for needle aspiration and biopsy by using the radiographic appearance as a guide. METHODS: The histories, imaging studies, and pathologic specimens of 18 patients with serous cystadenoma (10 patients) or mucinous cystic tumor (eight patients) of the pancreas who also underwent CT-guided (n = 16), sonographically guided (n = 3), or intraoperative (n = 4) needle biopsy (n = 23 total biopsies) between 1976 and 1996 were retrospectively reviewed. RESULTS: The histologic diagnosis of the serous subtype was made with needle aspiration and biopsy in five of 10 patients with serous cystadenoma. The histologic diagnosis of the mucinous subtype was made with needle aspiration and biopsy in six of eight patients with mucinous cystic neoplasms. Of the 23 biopsies performed, one patient experienced significant intraperitoneal hemorrhage. Indications for needle biopsy include an atypical cystic mass on diagnostic imaging studies, confirmation of a serous cystadenoma before observation, and confirmation of mucinous cystadenocarcinoma in patients with nonresectable disease. CONCLUSION: Needle biopsy and aspiration is a helpful and safe procedure to aid in the diagnosis of cystic pancreatic neoplasms before surgery.

Aged↗