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Biomedical subjects

G M Farrow

Publications and source records attributed to G M Farrow.

At least 73 records · Page 4Linked to original sources

Transitional cell carcinoma of the renal pelvis: nuclear deoxyribonucleic acid ploidy studied by flow cytometry.

Nuclear deoxyribonucleic acid ploidy analysis by flow cytometry was performed successfully on 109 formalin-fixed paraffin-embedded tissue specimens of transitional cell carcinoma of the renal pelvis. Tumor tissues were from patients who were operated upon between 1960 and 1975, so that long-term clinical followup was available. There were good correlations among deoxyribonucleic acid ploidy pattern and histological grade, pathological stage and clinical outcome. For high grade, high stage tumors deoxyribonucleic acid ploidy pattern provided no additional prognostically important information. However, for the more common low grade, low stage tumors the occasional detection of deoxyribonucleic acid aneuploidy patterns identified an important subgroup of patients who experienced significantly poorer survival.

Actuarial Analysis↗

Neodymium:YAG laser treatment of cystitis glandularis.

We report a case of severe cystitis glandularis of the entire bladder, which caused a large retrovesical mass and bilateral hydronephrosis. Treatment included whole bladder neodymium:YAG laser therapy, a technique not previously reported for this extent of disease. The etiology, diagnosis, treatment and malignant potential of cystitis glandularis are discussed.

Adult↗

Stage D1 prostatic adenocarcinoma: significance of nuclear DNA ploidy patterns studied by flow cytometry.

Flow cytometric analysis of nuclear DNA ploidy pattern was performed on 91 samples of prostatic adenocarcinoma from patients with stage D1 disease (metastatic deposits in pelvic lymph nodes). All patients had undergone radical retropubic prostatectomy and bilateral pelvic lymphadenectomy. Clinical follow-up ranged from 5 to 19 years. Nuclei were extracted from paraffin-embedded archival material. Isolated nuclei were stained with propidium iodide. The DNA ploidy pattern was diploid (normal) in 42% of tumors, tetraploid in 45%, and distinctly aneuploid in 13%. Only 15% of DNA diploid tumors progressed locally or systemically, whereas 75% of tumors with an abnormal DNA ploidy pattern (tetraploid or aneuploid) subsequently progressed (P less than 0.0001). Among low-grade tumors, ploidy analysis detected a subgroup associated with a poor prognosis; among high-grade tumors, a subgroup associated with a favorable prognosis was detected. None of the patients with a DNA diploid tumor died of prostatic cancer during the period of observation. In contrast, 43% of patients with DNA tetraploid tumors and 44% of those with DNA aneuploid tumors had died of prostatic cancer 10 years after surgical treatment (P less than 0.001). Determination of nuclear DNA ploidy pattern by flow cytometry provides objective, highly significant, prognostic information for patients with stage D1 prostatic carcinoma.

Adenocarcinoma↗

The clinical spectrum of granulomatous prostatitis: a report of 200 cases.

Granulomatous prostatitis, reviewed in 200 tissue-diagnosed cases, occurred in 0.8 per cent of the benign inflammatory prostatic specimens. Often the disease followed a recent urinary tract infection (71 per cent) and was suspicious clinically for prostatic cancer (59 per cent). The diagnosis usually was made by needle biopsy or at transurethral prostatectomy (94 per cent). Most cases of granulomatous prostatitis were classified as nonspecific. The recently identified entity of post-transurethral resection granulomatous prostatitis was found in 49 patients. A proposed new category of granulomatous prostatitis that is secondary to systemic granulomatous diseases was documented in 6 patients. Most cases of granulomatous prostatitis resolved spontaneously and required no specific therapy.

Adult↗

Wilms tumors: relationship of nuclear deoxyribonucleic acid ploidy to patient survival.

Nuclear deoxyribonucleic acid ploidy studies with paraffin-embedded archival tumor specimens were performed by flow cytometry on extracted nuclei from 56 Wilms tumors. Before the era of chemotherapy 9 patients had a 33 per cent survival rate at 5 years. No significant correlation between deoxyribonucleic acid ploidy pattern and survival was seen in this early group of patients. Since 1960, 47 patients underwent radical nephrectomy and received chemotherapy. Deoxyribonucleic acid histograms in this group were normal in 13 tumors, while 23 tumors exhibited a tetraploid pattern (greater than 10 per cent nuclei in the G2 peak) and 11 showed an aneuploid pattern. Survival rates according to deoxyribonucleic acid ploidy pattern showed that 100 per cent of the patients with a normal or aneuploid histogram pattern were alive at 2 and 5 years. Patients with a deoxyribonucleic acid tetraploid pattern had a significantly worse survival of 74 and 69 per cent at 2 and 5 years (p less than 0.02 and less than 0.01), respectively. Tumors with a normal or aneuploid histogram pattern for all stages and a deoxyribonucleic acid tetraploid pattern for pathological stage I or II were associated with a 2 and 5-year survival rate of 100 and 97 per cent, respectively. However, patients with stages III and IV tumors with a deoxyribonucleic acid tetraploid pattern had a significantly worse survival of 25 per cent at 2 and 5 years (p less than 0.0001). Measurement of nuclear deoxyribonucleic acid ploidy identifies a patient group who are at high risk for treatment failure, that is stages III and IV tumors with a deoxyribonucleic acid tetraploid pattern.

Actuarial Analysis↗

Well differentiated clear cell renal carcinoma: significance of nuclear deoxyribonucleic acid patterns studied by flow cytometry.

Nuclear deoxyribonucleic acid ploidy was determined in 206 samples of well differentiated clear cell renal carcinoma via a previously described technique on paraffin-embedded archival material. Grade 2 tumors had a higher incidence of abnormal deoxyribonucleic acid patterns than grade 1 tumors. Of stage 1 well differentiated clear cell renal tumors 60 per cent had a normal deoxyribonucleic acid histogram pattern, whereas 67 per cent of higher stage tumors had an abnormal pattern. The existence of abnormal nuclear deoxyribonucleic acid histogram patterns in the primary tumor tissue had a significant correlation with subsequent development of metastatic disease, independent of tumor grade and stage. The 10-year actuarial survival rate was 62 per cent for patients with normal deoxyribonucleic acid histograms and 37 per cent for patients with abnormal patterns. These results demonstrate that nuclear deoxyribonucleic acid ploidy measured by flow cytometry is an important variable in the classification and determination of prognosis for patients with clear cell renal carcinoma.

Adult↗

Renal epithelial hyperplastic and neoplastic proliferation in autosomal dominant polycystic kidney disease.

The early v late occurrence of tubular epithelial hyperplasia and the frequency and malignant potential of renal neoplasms in autosomal dominant polycystic kidney disease (ADPKD) are controversial. The kidneys from 87 patients with documented or presumed ADPKD, removed at autopsy (n = 49) or prior to transplantation (n = 38), were thoroughly sectioned and examined. Hyperplastic polyps were found in 90.8% of the patients, even in the absence of renal insufficiency or marked renal enlargement. However, their number was significantly higher in the patients with advanced stages of the disease, and especially in those with a history of dialysis. Hyperplastic polyps were not detected in eight cases, seven of which had no evidence of epithelial hyperplasia, despite thorough examination of multiple sections. A total of 42 neoplasms were observed in 24.1% of the patients. One patient had bilateral low-grade clear cell adenocarcinoma. Another patient had a transitional cell neoplasm. The remaining 39 neoplasms were microscopic adenomas. Neoplasms tended to occur more often in men and older patients. None of these neoplasms had been clinically diagnosed, and no metastasis had occurred. Nonneoplastic mass lesions were observed in two patients: one had malacoplakia and the other had xanthogranulomatous pyelonephritis.

Adenoma↗

Adrenocortical carcinoma: nuclear deoxyribonucleic acid ploidy studied by flow cytometry.

Nuclear deoxyribonucleic acid (DNA) ploidy studies with use of paraffin-embedded specimens were performed by flow cytometry on 52 adrenocortical carcinomas. Specimens were prepared by the combined techniques of Hedley and Vindeløv. Clinical course was obtained by chart review and follow-up examination. Nine (17%) tumors had a normal (diploid) DNA pattern, 13 (25%) were DNA tetraploid, and 30 (58%) were DNA aneuploid. The DNA aneuploid group was subdivided: 18 tumors with one stemline and 12 tumors with two stemlines of abnormal DNA cells. For tumors that were resected for cure, the 5-year Kaplan-Meier disease-free survival rates of the five patients with DNA diploid tumors and of the six patients with DNA tetraploid tumors were 80% and 33%, respectively. For 21 patients of whom 12 had one-stemline and nine had two-stemline DNA aneuploid tumors, the survival was 67% and 0%, respectively. Following palliative resection, the 4-year survival rates of the four patients with DNA diploid, seven with DNA tetraploid, five (omitting one with short follow-up) with one-stemline DNA aneuploid, and three with two-stemline DNA aneuploid tumors were 0%, 0%, 0%, and 33%, respectively. Although adrenocortical carcinoma is in general markedly aggressive, the addition of nuclear DNA ploidy studies may help to identify certain groups of patients who have a relatively favorable prognosis.

Adrenal Gland Neoplasms↗

Prognostic significance of nuclear deoxyribonucleic acid ploidy patterns in resected hepatic metastases from colorectal carcinoma.

Nuclear deoxyribonucleic acid (DNA) ploidy studies of paraffin-embedded archival tumor specimen blocks were performed by flow cytometry on extracted nuclei from 101 surgically resected hepatic metastases from colorectal cancer. In 28 patients, the corresponding primary carcinoma of the metastases was also studied. Tumor clinicopathology and clinical course of the patients were reviewed. Preparation of paraffin-embedded tissue specimens was performed by the technique of Hedley et al. and stained with propidium iodide according to the method of Vindelov et al. Eighty-eight of 101 metastatic tumors and 26 of 28 primary tumors yielded evaluable DNA histograms. Twenty-six metastases showed a DNA diploid pattern, 25 showed a significantly increased 4C peak (DNA tetraploid/polyploid), and 37 had a DNA aneuploid peak. Ploidy pattern was constant between primary and metastases in 84.6% of tumors. No significant relationship between host and tumor characteristics and ploidy pattern was found except for a correlation between grade 3 metastases and DNA aneuploid. Survival of patients with DNA aneuploid metastases was significantly less than that of patients with DNA diploid metastases (p = 0.03). However, among DNA nondiploid metastases, survival was significantly less for low DNA index metastases (less than or equal to 1.5) than for high DNA index (greater than 1.5) metastases (p less than 0.05). Flow cytometric DNA ploidy measurements may have prognostic value for patients with resected hepatic metastases from colorectal carcinoma.

Colonic Neoplasms↗

Long-term followup of young patients with stage A adenocarcinoma of the prostate.

A total of 23 men less than 60 years old with stage A adenocarcinoma of the prostate who were managed expectantly (that is untreated) and were at risk for 10 to 25 years form the basis of this study. The original amount of tissue obtained at transurethral resection, number of chips involved and examined, and tumor grade (Mayo grades 1 to 4) were recorded and compared in an in-depth analysis whereby the entire tissue removed was examined without knowledge of previous grading attempts. On the basis of volume estimation of the amount of cancer present 8 patients were reclassified as having stage A2 disease. Of these 8 patients 2 had disease progression and 1 died of metastatic adenocarcinoma of the prostate. At review 15 patients remained with stage A1 disease and 4 had disease progression (3 systemically and 1 locally) an average of 10.2 years after diagnosis. Because of longer life expectancy the young patient with stage A1 disease is at increased risk for local and/or systemic disease progression. Therefore, when incidental adenocarcinoma of the prostate is found in young patients consideration should be given to examination of all tissue resected, and to repeat transurethral resection and biopsy to ensure accurate staging. Lifelong careful followup is mandatory not only to detect local recurrence owing to heterogeneous adenocarcinoma of the prostate but also to detect a possible secondary clinical lesion.

Adenocarcinoma↗

Testicular seminoma metastatic to the prostate.

A 43-year-old man had clinically manifest prostatic involvement by a metastatic testicular seminoma. The signs, symptoms, diagnosis and treatment of this entity, as well as a hypothesis regarding its development, are discussed.

Adult↗

Flow cytometry of renal oncocytoma: common occurrence of deoxyribonucleic acid polyploidy and aneuploidy.

Flow cytometry was performed on 51 typical specimens of renal oncocytoma. Nuclei were extracted from paraffin-embedded archival material and isolated nuclei were stained with propidium iodide. Of the 51 available tissue blocks 86 per cent were evaluable and 50 per cent of these samples showed a deoxyribonucleic acid (DNA) histogram that was approximately the same as normal renal parenchyma. Of the oncocytoma samples 39 per cent showed a marked increase (more than 10 per cent of the nuclei) in the tetraploid DNA peak, while 11 per cent showed a distinct DNA aneuploid peak. Among 21 evaluable grade 2 oncocytic renal tumors 33 per cent showed a normal DNA histogram, 43 per cent showed a marked increase in the DNA tetraploid peak and 24 per cent showed a DNA aneuploid peak. The common presence of polyploid nuclei containing double quantities of chromosomal DNA may correlate with the long-standing pathological observation that oncocytic tumors often contain a distinct population of large nuclei. Indeed, 86 per cent concurrence was seen between the detection of an abnormal DNA content by flow cytometry and the histopathological presence of large abnormal nuclei in these specimens. Since renal oncocytomas (grade 1 oncocytic tumors) rarely, if ever, metastasize and are relatively noninvasive locally, their markedly abnormal flow cytometry patterns are of considerable interest. Moreover, DNA polyploidy has not been identified previously in renal tumors. The biological significance and mechanism of DNA polyploidy, and the relationship of DNA polyploidy and DNA aneuploidy to the pathogenesis of oncocytic renal tumors require further laboratory investigation. The clinical use of flow cytometry to classify and to predict the behavior of renal tumors will be complicated, since renal oncocytomas commonly have polyploid and aneuploid DNA histograms.

Adenoma↗

Directed intravascular precipitation of bisantrene for pelvic malignant lesions: preclinical studies.

Bisantrene, a clinically active anticancer drug with limited solubility at physiologic pH, was delivered by selective injection into the internal iliac artery of male calves. The percutaneous transfemoral angiographic techniques used in the calves were identical to those used in adult human patients. Directed intravascular precipitation of bisantrene at the maximal tolerable clinical dose for intravenous administration (260 mg/m2) caused severe tissue damage in 5 of 10 animals that received these intra-arterial injections. (One calf in this study group died of unknown causes 10 days after the drug infusion). A reduced intra-arterial dose (50 mg/m2) was used in seven calves, and no local tissue damage was evident on gross or microscopic examination. Nevertheless, resultant concentrations of bisantrene deposited in the ipsilateral bladder wall were 10- to 100-fold those concentrations found after intravenous administration of a dose 5 times higher. These animal toxicology and pharmacology data support initiation of a phase I clinical trial of directed intravascular precipitation of bisantrene in humans. This clinical trial will be developed for patients with advanced refractory cancers of the anatomic true pelvis, such as those originating in the urinary bladder, prostate, rectum, and uterine cervix.

Angiography↗

Oncocytic tumours of the salivary gland, kidney, and thyroid: nuclear DNA patterns studied by flow cytometry.

Nuclear DNA ploidy studies were performed by flow cytometry on extracted nuclei from 12 oncocytic tumours of the salivary gland, 65 oncocytic tumours of the kidney, and 37 oncocytic tumours of the thyroid gland from the pathology archives of the Mayo Clinic. In order to provide an interesting clinical spectrum, three different classes of well-differentiated oncocytic tumours were selected for examination. Salivary gland oncocytic tumours were chosen for their generally benign behaviour. Oncocytic thyroid cancers exhibiting malignant potential because of local invasion, were thought to represent the opposite extreme of aggressiveness. Renal oncocytic tumours were known to demonstrate an intermediate degree of malignancy. All of the oncocytic salivary gland tumours showed a 'normal' DNA histogram and had a benign clinical course. For the oncocytic tumours of the kidney, 45% of DNA histograms were normal, 40% exhibited a significant increase in the DNA tetraploid/polyploid (4C) peak, and 15% showed a DNA aneuploid peak. Three patients with a DNA tetraploid pattern developed tumour metastasis and two have died from metastatic renal cancer. Among the oncocytic thyroid cancers, 27% were normal, 22% exhibited an increased DNA tetraploid peak, and 51% had a distinct DNA aneuploid peak. None of the thyroid tumour patients with a normal DNA pattern or with an increased DNA tetraploid peak died as a result of thyroid malignancy. In contrast, 58% of patients whose thyroid tumours showed a DNA aneuploid peak subsequently died from thyroid cancer.

Adenoma↗

Epidermoid cyst of the testis: a critical analysis.

Our experience with 163 patients (11 from our institution) with simple epidermoid cyst of the testis was analysed. The lesion is nearly as common as interstitial cell tumour of the testis. In its simple form it is a benign lesion that usually appears as a solitary, asymptomatic, testicular, 2-cm mass in non-black young men (usually 20 to 40 years of age). It has been suspected on circumstantial clinical evidence in a few patients (17.5%) who have been successfully treated by simple enucleation. In the majority, however, fear of looking for a zebra in a herd of horses or not thinking of zebras at all has led to radical orchiectomy. None of the 80 patients followed up for a maximum of 37 years has suffered any ill effects.

Adolescent↗

Pheochromocytoma: nuclear deoxyribonucleic acid patterns studied by flow cytometry.

Nuclear deoxyribonucleic acid (DNA) ploidy studies with paraffin-embedded archival tumor specimen blocks were performed by flow cytometry on extracted nuclei from 75 pheochromocytomas. Clinical details, specifically including histologic findings, biochemical studies, and ultimate fate, were investigated. Preparation of paraffin-embedded tissue specimens was carried out by the technique of Hedley et al. and stained with propidium iodide according to the method of Vindeløv et al. Twenty-three tumors showed a normal DNA histogram, 31 showed significant increase in the 4C (DNA tetraploid) peak, and 21 exhibited a DNA aneuploid peak. To define a subset of patients who had either died as a result of pheochromocytoma or had been followed for a minimum of 10 years, 13 patients were excluded. Of the remaining 62 patients, all of the 18 patients with a normal DNA histogram followed a benign clinical course, including normal fractionated urinary catecholamines. However, eight (31%) of the 26 patients classified DNA tetraploid/polyploid and seven (39%) of the 18 patients exhibiting a DNA aneuploid peak had evidence of malignancy; these two groups had significantly more malignant tumors (p less than 0.05 and p less than 0.02, respectively) than the normal DNA group. Flow cytometric DNA ploidy measurements of isolated nuclei seem to provide useful prognostic information for patients with pheochromocytoma.

Adrenal Gland Neoplasms↗