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E G Bernacki

Publications and source records attributed to E G Bernacki.

13 recordsLinked to original sources
PubMed1997

Spindle epithelial tumor with thymus-like differentiation: a case report with cytologic, histologic, immunohistologic, and ultrastructural findings.

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare and distinctive low-grade neoplasm of thymic or related branchial pouch differentiation. The tumor usually presents in the thyroid or lateral neck of children and adolescents and could mimic spindle-cell carcinoma, synovial sarcoma, or malignant teratoma. We report the clinical, cytologic, histologic, immunohistochemical, and ultrastructural features of a SETTLE present for 10 years in a 15-year-old boy. The fine-needle aspirate, initially interpreted as synovial sarcoma, contained numerous clusters of bland spindle cells, with a few detached sheets of columnar mucous cells in a homogeneous background of dissociated spindle cells. Mitoses, necrosis, and atypia were not present. The excised tumor was a well-circumscribed, white-tan mass, with occasional microcysts. Microscopically, the mass consisted of a lobulated, highly cellular, spindle-cell neoplasm arranged in intersecting, whorled, and storiform fascicles separated by fibrous bands. Entrapped within the fibrous bands were squamous-lined cysts and benign-appearing glands lined by columnar epithelium with goblet cells or ciliated pseudostratified epithelium. Immunohistochemically, the spindle cells showed diffuse reactivity for cytokeratins, smooth muscle actin, muscle-specific actin, and MIC-2, and they were negative for epithelial membrane antigen, calcitonin, and thyroglobulin. Ultrastructurally, numerous perinuclear tonofilaments, some aligned with mature desmosomes, were identified in the spindle cells. Occasional cells showed thin filaments with fusiform dense bodies occupying the peripheral cytoplasm. These findings distinguish SETTLE from ectopic thymoma, synovial sarcoma, medullary carcinoma, and teratoma, and they support a thymic epithelial origin for SETTLE, possibly with myoepithelial differentiation.

Adolescent↗
PubMed1994

Elastofibroma dorsi: diagnostic problems and pitfalls.

The diagnostic cytomorphologic findings in a case of elastofibroma dorsi are described in this report. The correct diagnosis was initially overlooked on fine-needle aspiration, and was subsequently made by open biopsy. Review of the FNA material, however, demonstrated scanty but diagnostic material. Cytologic examination revealed a mixture of fibroblasts, adipose tissue, and swollen lightly staining cyanophilic elastic fibers in a background of collagenous matrix. Cross sections of the elastic fibers had the typical serrated and globular appearance. These fibers stained positive with elastin stains. The cytomorphology of elastofibroma dorsi with diagnostic pitfalls and differential diagnostic dilemmas are discussed in this article.

Aged↗
PubMed1994

Fine-needle aspiration cytology of salivary duct carcinoma.

Salivary duct carcinoma (SDC) is an extremely rare and highly aggressive primary epithelial neoplasm of the salivary glands associated with increased tendency for lymph node and vascular metastases. Histologically, this lesion resembles intraductal cribriform and comedo carcinoma of the breast. Fine-needle aspiration (FNA) cytology of SDC in two patients with parotid masses (ages 65 and 67) is presented. The aspirates were sparsely to richly cellular and contained predominantly broad flat and branching sheets of large polygonal epithelial cells with abundant eosinophilic cytoplasm, round to oval nuclei, finely granular chromatin and prominent nucleoli. Few sheets showed cribriforming and papillary configuration. The cytologic differential diagnosis included oncocytoma, acinic cell carcinoma, muco-epidermoid carcinoma, and metastatic adenocarcinoma. To the best of our knowledge, this is the first report to describe a spectrum of cytologic features that may allow a specific FNA diagnosis of SDC. Preoperative diagnosis of this neoplasm may warrant a more extensive radiologic workup and therapy including radical surgery and neck dissection followed by radiation therapy.

Adenocarcinoma↗
PubMed1986

Diffuse choroidal melanocytoma in a child. A lesion extending the spectrum of melanocytic hamartomas.

A 10-year-old white boy presented with a diffuse pigmented lesion of the choroid of his right eye that had led to a partial secondary retinal detachment. Because of the fear of a diffuse choroidal melanoma (a lesion never before reported in an individual within the first two decades of life), the eye was enucleated. An incisional P-32 study, compared with an uninvolved region, was positive at 154% uptake. Pigmented tissue was discovered surrounding the distal meninges of the optic nerve, on the posterior surface of the eye, and within the orbital soft tissues adherent to the globe. This led to fear of extraocular extension of a malignant melanoma. Light microscopic examination of the enucleated globe demonstrated that the choroid was diffusely and massively thickened by polygonal, hyperpigmented tumor cells that were also present in compressed spindled forms between the lamellae of scleral collagen, in the scleral emissaries, on the surface of the eyeball, and in the distal optic nerve dura. The choroidal tumor cells had the features of those normally encountered in localized optic nerve head benign melanocytomas. Electron microscopy demonstrated the presence of large, well-melaninized melanosomes (but no macromelanosomes), confirming the diagnosis of a diffuse uveal melanocytoma. The differential diagnosis of this new entity and its relationship to previously reported pigmented lesions of the uvea is discussed.

Child↗
PubMed1983

Congenital subungual nevus.

A 4-month-old infant with a congenital, darkly pigmented, macular lesion involving the subungual and periungual areas of the right ring finger is described. The lesion was excised when the infant was 6 months old in order to rule out a congenital pigmented nevus as well as a congenital acrolentiginous melanoma. Histopathologic examination revealed a compound nevus. Nevi in this location are very rare in Caucasians at any age and should probably be excised to rule out malignant melanoma.

Humans↗
PubMed1981

Malignant Brenner tumor of the ovary. Report of three cases.

A clinico-pathological study of 48 malignant Brenner tumors (MBT) includes three new cases and 45 cases from the literature since 1945. Construction of a profile of this neoplasm was undertaken. The mean age of patients was 60 years, and most were postmenopausal with abdominal symptoms and a unilateral abdominopelvic mass. Only one case had bilateral tumors. The pattern of spread of this tumor is usually regional with only occasional distant metastases. Diffuse peritoneal seeding is not a characteristic feature of MBT. 56% of the patients with MBT died of their tumor, usually within 3 years of initial diagnosis. Mean survival in fatal cases was 1 year. Microscopically, foci of characteristic benign Brenner tumor may or may not be seen in individual examples of MBT. Admixture of adenocarcinoma (often mucinous carcinoma) and squamous carcinoma may also be seen. diagnostic problems can arise when a mixture of histologic patterns is present. In order to establish the diagnosis of malignant Brenner tumor a prominent histologic pattern of malignant urothelium is usually necessary.

Adult↗
PubMed1976

Gastroduodenal Crohn disease.

Symptomatic involvement of the stomach and duodenum is an uncommon manifestation of Crohn disease. Our experience with three young women who had upper gastrointestinal tract symptoms indicates the seriousness of the condition. All three patients required operation for relief of symptoms. Two operations were performed for gastric outlet obstruction and one for massive hemorrhage (a rare complication of gastric involvement). All patients had roentgenographic or gastroscopic evidence suggestive of Crohn disease, and in each the diagnosis was confirmed by histopathologic means. The operative procedures consisted of distal gastrectomy in two cases and gastrojejunostomy in the third. All three patients have or have had evidence of Crohn disease of the small intestine and none of them responded to medical management. (In the most recent case, medical management included intravenous hyperalimentation.) In our experience, symptomatic involvement of the stomach in Crohn disease will not respond to medical treatment and will require surgical measures for relief.

Adolescent↗
PubMed1975

Malignancy and the benign lymphoepithelial lesion.

The benign lymphoepithelial lesion of salivary glands is now considered the histological hallmark of a variety of clinical and pathological disorders affecting salivary tissues. Malignancy arising in the lesion is uncommon, but may take origin in either the epithelial or lymphoreticular components. Lymphomas and pseudolymphomas associated with salivary gland lymphoepithelial lesions have been predominately extra-salivary and strongly correlated with Sjögren's syndrome. Epithelial malignancy has not been associated with autoimmunity and with few exceptions has been of the anaplastic type. This report presents two patients with intra-salivary lymphomas arising in a benign lymphoepithelial lesion of salivary glands and a patient with anaplastic carcinoma arising in the epithelial islands of the lesion. The fourth patient manifested pseudolymphomatous lymphoreticular hyperplasia in lung and submandibular gland and illustrates the possible multiple organ involvement that may occur in patients with benign lymphoepithelial lesion, even without clinical evidence of concommitant autoimmune disorders.

Aged↗
PubMedDate not supplied

Abdominal fine needle aspiration biopsies with CT and ultrasound guidance: techniques, results and clinical implications.

Experience with fine needle aspiration biopsy (FNAB) of solid intraabdominal masses with computed tomography and ultrasound guidance in 117 patients at a large community hospital is described. An overall accuracy of 86%, sensitivity of 86%, and specificity of 93% was obtained. FNAB was found to be safe and accurate and obviated the need for surgery in nearly 50% of patients. Further experience is required to assess the value of FNAB in solid renal masses and in abdominal lymphoma.

Abdominal Neoplasms↗
PubMedDate not supplied

Fine needle aspiration cytology of cellular pleomorphic adenoma.

OBJECTIVE: To study the spectrum of cytologic changes seen in cellular pleomorphic adenoma (CPA) and to determine features that would allow a more specific diagnosis. STUDY DESIGN: We reviewed 11 fine needle aspirates of surgically confirmed salivary gland CPA in addition to three discrepant cases in which CPA was strongly considered in the cytologic diagnosis. RESULTS: Pleomorphic adenoma was considered in the differential diagnosis, but a difinitive cytologic diagnosis was not made in the 11 cases. Acinic cell carcinoma, basal cell adenoma, adenoid cystic carcinoma; myoepithelioma and spindle cell neoplasm accounted for most of the other diagnostic considerations. The three discrepant cases included a malignant myoepithelioma, acinic cell carcinoma and mucoepidermoid carcinoma. CONCLUSION: Familiarity with the variable aspirate appearance of CPA in addition to well-defined cytologic and architectural criteria can help establish the proper diagnosis in the majority of cases. There remain, however, few cases in which a definitive diagnosis is not possible.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Fine needle aspiration cytology of renal infarcts. Cytomorphologic findings and potential diagnostic pitfalls in two cases.

The fine needle aspiration (FNA) cytologic features of two cases of renal infarction are presented. Both patients did not have a classic clinical history for infarction, and the radiologic findings were suggestive of neoplasia. In one of our cases, necrotic glomeruli and tubules were present, which suggested the correct diagnosis of renal infarction and permitted appropriate early treatment. In the other case, groups of atypical renal tubular cells undergoing repair secondary to the infarction was misinterpreted as renal cell carcinoma. This case illustrates that renal infarction, like pulmonary infarction, can be a potential pitfall for a false-positive cytologic diagnosis of malignancy in FNA biopsy. A conservative approach is warranted when there is scanty cellularity and atypical cells having features of a repairlike reaction are present.

Adult↗
PubMedDate not supplied

Diagnosis of pancreatic lesions by percutaneous aspiration biopsy.

Fifteen patients suspected of having pancreatic disease were studied by transabdominal percutaneous fine needle aspiration biopsy guided by computed tomography. Ten patients had aspirates positive for carcinoma: seven had clinically advanced disease, and the diagnostic procedure spared them laparotomy; two patients underwent laparotomy for choledochoduodenostomy; and one underwent exploratory laparotomy resulting in pancreatoduodenectomy. Four aspirates were negative for malignancy, but one patient was found ultimately to have carcinoma. One specimen was unsatisfactory. We conclude that transabdominal percutaneous fine needle aspiration cytology is a safe and simple procedure for distinguishing benign from malignant lesions. There were no complications from the procedure. We experienced no false positives and one false negative.

Aged↗