Biomedical subjects
Publications and source records attributed to E Spaun.
Twenty-one patients seen in a temperate climate who had a clinical diagnosis of brachioradial pruritus are presented. The history and clinical manifestations of the patients indicate that the symptoms were neuralgiform and caused by cumulative sun exposure.
Forty melanocytic lesions were examined in a pilot study, which was followed by a final series of 100 consecutive melanocytic lesions, in order to evaluate the inter-observer reproducibility of the histological criteria proposed for the dysplastic naevus. The specimens were examined in a blind fashion by four observers. Analysis by kappa statistics showed poor reproducibility of nuclear features, while reproducibility of architectural features was acceptable, improving in the final series. Consequently, we cannot apply the combined criteria of cytological and architectural features with any confidence in the diagnosis of dysplastic naevus, and, until further studies have documented that architectural criteria alone will suffice in the diagnosis of dysplastic naevus, we, as pathologists, shall avoid this term.
Carcinogenic studies were performed on the skin of inbred male Lister rats using 7,12-dimethylbenz[alpha]anthracene (DMBA) in low doses (2.5 mg and 5.0 mg), followed by promotion with croton oil (CO) in one half of the animals. The clinically observed tumour rate did not differ after the two carcinogen doses and was practically unaffected by promotion, only a marginal increase in effect being noted after DMBA 2.5 mg. Also the latency periods were alike. The total tumour crop was increased by promotion, but histologically the predominant clinical skin tumour was a sebaceous proliferation with or without associated papillomatous squamous cell hyperplasia. This lesion did not in microscopic structure or cellular characteristics fulfil the criteria of a neoplastic tumour. Basal cell carcinomas, adnexal tumours and pure squamous cell tumours were rare and were not promoted by CO. CO had a marked promotion effect, but only on the mixed sebaceous-papillomatous hyperplasias, which were more than doubled in number. In conclusion, carcinogenesis was weak after the low DMBA-doses, and promotion by CO of neoplastic tumours was not seen.
Metastases from basocellular carcinomata in the skin are extremely rare. A case of recurrent basocellular in the skin with regional lymph gland metastases and metastases to the parotid gland is presented. The clinically common features in metastasizing basocellular carcinoma are emphasized.
We report a case of a benign monodermal cystic teratoma in a 19-year-old woman. The tumor was purely neurogenic, containing glial tissue, ganglionic cells, melanotic cells, and choroid plexus. The cyst tumour is the first of its kind described in the literature.
It is suggested that oncocytoid changes in glandular tissue represent a continuum in the development from metaplasia via increasing hyperplasia to neoplasia. This theory, which is supported in the literature, is based on three of the authors' own cases of oncocytoid changes in the larynx. The significance of differentiating between hyperplasia and neoplasia is emphasized as the neoplastic changes such as the oncocytoid papillary cystadenoma should be extirpated radically in order to avoid recurrence.
A case of oncocytic papillary cystadenoma in the larynx in an elderly woman forms the basis for a discussion of the causes of, the symptoms and diagnosis of chronic obstructive conditions of the upper respiratory tract.
The aim of this study was to investigate various approaches to the grading of malignancy in pre-treatment biopsies from patients with supraglottic laryngeal squamous cell carcinoma. The prospects of objective malignancy grading based on stereological estimation of the volume-weighted mean nuclear volume, nuclear Vv, and nuclear volume fraction, Vv(nuc/tis), along with morphometrical 2-dimensional estimation of nuclear density index, NI, and mitotic activity index, MI, were investigated and compared with the current morphological, multifactorial grading system. The reproducibility among two observers of the latter was poor in the material which consisted of 35 biopsy specimens. Unbiased estimates of nuclear Vv were on the average 385 microns3 (CV = 0.44), with more than 90% of the associated variance attributable to differences in nuclear Vv among individual lesions. Nuclear Vv was positively correlated with MI, negatively with NI, whereas no correlation with Vv(nuc/tis) was found. No relationship between nuclear Vv and the morphologically interpreted degree of nuclear dedifferentiation was demonstrated. Nuclear Vv showed no differences between lesions in different clinical T-stage of disease. None of the investigated categorical and quantitative parameters (cutoff points = means) reached the level of significance with respect to prognostic value. However, nuclear Vv showed the best information concerning survival (2p = 0.08), and this estimator offers optimal features for objective malignancy grading. Further analyses of larger series of patients are needed to establish the prognostic value of nuclear Vv for objective malignancy grading of supraglottic laryngeal squamous cell carcinoma.
A case of persistent cerebellar dysfunction following high-dose cytosine arabinoside (Ara-C) treatment of acute myelogenous leukemia is reported. The symptoms developed after a cumulative dose of 24 g/m2, and 6 months after the start of symptoms, the signs of cerebellar damage were unchanged. The symptoms aggravated during a subsequent low-dose therapy with Ara-C, 15 mg twice daily. This supports the presumption that this adverse effect is caused by the cumulative dose rather than by high plasma concentrations.
Sex cord-stromal tumors comprise approximately 5% of ovarian neoplasms and among these the granulosa cell tumor is the one most commonly seen (1). Two histopathologically well defined patterns of granulosa cell tumor are known: the common adult granulosa cell tumor (AGCT), and the less frequent juvenile granulosa cell tumor (JGCT) (1, 2, 3, 4). In addition to morphological variation, the two tumor types differ in prognosis and clinical course (4, 5, 6, 7, 8).
Transcutaneous oxygen pressure measurements (TcPO2) were performed in ten healthy men (age 30.6 years, range 28-35) in six regions: anterolaterally 10 cm below and above the knee on both legs, 5 cm laterally to umbilicus and on the inside of the left humerus, which was subsequently biopsied for measurements of epidermal thickness from the basal lamina to the uppermost layer of stratum granulosum. Transcutaneous oxygen pressure was on average 70 mmHg (range 42-88 mmHg), and that of epidermal thickness 70 microns (range 43-120 microns). Epidermis was thinnest on the inside of the humerus (mean +/- SD) 61.3 mu +/- 11.0 and about 25% thicker (NS) in the regions above and below the knees. The relationship between TcPO2 (y) and epidermal thickness (x) could be described by the regression equation y = alpha i - 0.26x where the intercept alpha i differed between subjects, the mean value being 88 mmHg (range 77-103). The common regression coefficient of -0.26 was significantly different from zero (p less than 0.01, r2 = 0.49). Although the oxygen gradient across the total epidermis can not be estimated from skin biopsies, correction for the thickness of the living part of the skin may prove beneficial when TcPO2 measurements are used as an indicator of wound healing. The results suggests that the change of oxygen tension across the living part of epidermis is 0.26 mmHg/micron at various skin locations in different subjects.
A papillary mucinous cystadenoma of the ovary with unique benign epithelial atypia is presented. The tumor was removed from a 33-year-old puerperal woman. Morphologically, the lining epithelium of the cystadenoma strikingly resembled the so-called Arias-Stella reaction of the endometrial epithelium, a benign cellular atypia produced by chorionic tissue during pregnancy. The atypical epithelium of the endometrium is known to persist several weeks after parturition or abortion, and should not be misinterpreted as malignancy.
In spite of the very common occurrence of vaginal candidiasis in pregnant women (1), the uterus is seldom affected. There are few reports in the literature of intrauterine infection. The present paper presents a case of placental and fetal candidiasis in association with the presence of an intra-uterine contraceptive device (IUD).
A case of adenocarcinoma of the stomach was initially diagnosed by detection of epididymal metastases. The case is presented and the importance of histologic examination of peroperatively removed tissue is emphasized.
A case of leiomyomatosis of the colon and mesentery in a 35-yr-old man with several noninvalidating congenital malformations and multiple intracranial meningiomas is presented. The leiomyomatosis had been asymptomatic until 2 months before death, even though the lesions suggest a congenital disorder affecting the musculature of the bowel wall.
The occurrence of primary malignant lymphomas of the central nervous system in a population of approximately 1 million people has been analyzed retrospectively. Over a 12-year period, about 1000 tumors of the central nervous system were registered. Among these, 22 were primary malignant lymphomas; incidence, 1.83 per million per year. Thirteen of these tumors were of high-grade malignancy and nine were of low-grade malignancy (Kiel classification of non-Hodgkin lymphomas). The majority of the tumors were B-cell lymphomas, and there were no Hodgkin lymphomas. Neither spinal nor meningeal lymphomas occurred. Nine patients were treated only surgically, whereas 11 received postoperative irradiation or chemotherapy, or both. Of the latter patients, six are alive and well at the time of writing. The importance of making a correct diagnosis preoperatively is stressed, inasmuch as radical operation is unfavorable for these patients. A better prognosis is obtained with combinations of irradiation and chemotherapy.
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