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Biomedical subjects

H J Norris

Publications and source records attributed to H J Norris.

At least 19 recordsLinked to original sources

Expression of the HER-2/neu proto-oncogene in serous ovarian neoplasms.

BACKGROUND: It is unclear whether HER-2/neu proto-oncogene expression in ovarian epithelial neoplasms is related to prognosis. METHODS: The authors performed immunohistochemical stains on 20 serous tumors of low malignant potential (STLMP) in Stages I and II and 19 serious carcinomas in the same stages. They used three different commercial antibodies to make comparisons. RESULTS: Two of four Stage I STLMP in patients who experienced disease progression showed positive staining for the gene product, whereas none of seven Stage I nonprogressive STLMP showed positive staining. Five of the six Stage III nonprogressive STLMP showed positive staining, whereas none of three Stage III STLMP that progressed showed positive staining. Three carcinomas (one Stage I and two Stage III) also showed positive staining. CONCLUSIONS: Expression of HER-2/neu may be associated with high stage in serous ovarian neoplasms, but it is not likely to identify the small fraction of patients with STLMP who will experience disease progression.

Adult

Flow cytometric analysis of endometrial stromal sarcoma.

Twenty-two endometrial stromal sarcomas were studied by flow cytometric analysis and the results were correlated with surgical stage, nuclear grade, mitotic index, and recurrence. Ploidy determination was not helpful in predicting recurrence in patients with Stage I disease because all 14 were diploid. Only 2 of the 22 tumors were aneuploid; both were high-stage neoplasms. Cell proliferation (%S or %S + %G2/M) did not significantly correlate with vascular invasion, nuclear grade, mitotic index, or surgical stage. Of the 13 Stage I neoplasms with follow-up data, three recurred. The mean proliferation index (%S + %G2/M) of those that recurred was 12.81 +/- 0.47, which did not differ from those that did not recur (mean 12.25 +/- 4.11).

Aneuploidy

Fibrosarcoma-malignant fibrous histiocytoma of the breast. A clinicopathological study of 32 cases.

We report the clinical and pathologic features of 32 sarcomas of the breast with features spanning the spectrum of fibrosarcomas-malignant fibrous histiocytomas. Neoplasms were categorized as high- or low-grade lesions depending on a combination of the degrees of atypia and mitotic activity. The majority of high-grade lesions had marked (3+) nuclear atypia and at least five mitotic figures per 10 hpf. High-grade lesions with moderate (2+) nuclear atypia had a mitotic activity of six or more mitotic figures per 10 hpf. All low-grade lesions had five or fewer mitotic figures per 10 hpf, and none had a score of the nuclear grade times mitotic figures of more than 10. The average mitotic activity in low-grade lesions was two mitotic figures per 10 hpf; the high-grade lesions had 12 mitotic figures per 10 hpf. Sixty-nine percent of the low-grade fibrosarcomas-malignant fibrous histiocytomas showed mild (1+) cytologic atypia, and 69% of the high-grade lesions showed severe (3+) cytologic atypia. The herringbone pattern was associated with a more favorable prognosis than the malignant fibrous histiocytoma pattern. Compared to the high-grade lesions, low-grade fibrosarcomas-malignant fibrous histiocytomas were slow-growing, produced fewer recurrences, and did not metastasize. Of the 16 women with low-grade lesions, all were free of tumor at last contact, despite recurrence in more than half of the patients. In contrast, 31% of the patients with high-grade lesions died of tumor, and 13% were alive with disease. Twenty-five percent of women with high-grade lesions developed distant metastases.

Adult

Amebiasis complicating carcinomas: a diagnostic dilemma.

Two black African women and one black American man had carcinomas of cervix, perineum, and sigmoid colon, respectively. In each of these patients, trophozoites of Entamoeba histolytica had invaded the surface of the tumor, and in some areas had invaded more deeply into the stroma between the tumor cells. Although it is well known that cutaneous amebiasis of anus, penis, vulva, and cervix can mimic squamous cell carcinoma, it may be, perhaps, less well known that carcinomas at these sites may be colonized by trophozoites of E. histolytica. In patients with amebiasis but without an associated carcinoma, a correct diagnosis of amebiasis spares the patient unnecessary and sometimes mutilating surgery. But a diagnosis of amebiasis, when there is an unrecognized underlying carcinoma, delays effective treatment of the carcinoma. A smear that establishes a diagnosis of cutaneous amebiasis, therefore, should be followed by biopsy to exclude or confirm an underlying carcinoma.

Adenocarcinoma

Hamartomas of the breast.

The clinical and pathologic findings of 17 hamartomas of the breast were studied. All neoplasms were evident as clinically and mammographically discrete masses. The pathologic findings were varied and included circumscribed fibrocystic disease, adenolipoma, fibroadenoma with fat and fibroadenoma with lobules. The heterologous elements identified were cartilage and smooth muscle. All lesions were treated by simple excision. In this study, four different microscopic patterns of hamartoma are described and the necessity for a close clinicopathologic correlation is pointed out in the diagnosis of this lesion.

Adenofibroma

Pathologic effects of oral contraceptives.

The pathologic effects of oral contraceptives have been described in this paper and in other reviews [1, 5, 23, 35, 44, 48, 59, 80, 103, 114]. Approximately 10 million women currently use oral contraceptives in the United States. These drugs are beneficial both to the users and for population control. It is their effect on the health status of women who take them that must continue to have well-organized investigation so that more meaningful conclusions concerning their safety will permit continued use. In some instances, the pathologic effects of oral contraceptives make it necessary that new methods of contraception be found. Intensive research in this area is needed and judiciuos use of oral contraceptives must be maintained. A national registry should be formed to record and investigate the cases of women who die or have adverse reactions while taking these agents. A registry might identify associations no previously known to exist in patients taking oral contraceptives. It would serve to concentrate the data in one area so that more material would be available for the study of pathogenetic mechanisms. It would heighten patient and physician awareness of the untoward effects and increase the responsibilities of the women who take them to monitor their own health.

Blood Glucose

Smooth muscle tumors of the vulva.

The clinical and pathologic features of 32 smooth muscle tumors of the vulva were studied to determine the pathologic characteristics that best relate to the clinical behavior and to define criteria for separating leiomyomas from leiomyosarcomas. The length of follow-up ranged from 16 months to 20 years, with a median of 9 years. None of the tumors metastasized. Of the 4 neoplasms that recurred, the 2 with infiltrating margins recurred within 1 year and of these 2, the one with more than 5 mitotic figures in 10 high-power fields (HPF) recurred 5 times within a 2-year period. Neoplasms were discovered during pregnancy in 7 patients; these were characterized by extensive myxoid change, but none of the tumors that occurred during pregnancy showed significant cellular atypism or mitotic activity. Local excision is recommended as initial therapy and also for recurrences.

Adolescent

Smooth muscle tumors of the vagina.

The clinical and pathologic features of 60 smooth muscle tumors of the vagina were studied to determine the pathologic characteristics which best relate to clinical behavior and to define criteria for the diagnosis of leiomyosarcoma. Cellular atypism, mitotic activity, and tumor size and contour were examined, and their relationship to recurrence was evaluated. Only 5 neoplasms recurred, and these were all greater than or equal to 3 cm, with greater than or equal to 5 mitotic figures per 10 high-power fields (HPF) and various degrees of atypia. The only patient whose tumor had an infiltrating margin died with metastatic tumor in the lungs. With the exception of this 1 neoplasm, all other smooth muscle tumors of the vagina were either benign or only locally aggressive. Local excision is the treatment of choice when the tumor is well circumscribed. A neoplasm with moderate to marked atypism and greater than or equal to 5 mitotic figures per 10 HPF merits the designation of leiomyosarcoma.

Adult

Unusual cystadenofibromas: endometrioid, mucinous, and clear cell types.

Cystadenofibromas are benign ovarian neoplasms containing both epithelial and stromal components. The epithelial component is usually of simple serous type resembling fallopian tube epithelium. Occasionally, tumors with unusual epithelial pattenrs are encountered. In this study, 16 cystadenofibromas with unusual epithelium are described. Twelve are examples of an endometrioid type, 3 of a clear cell (mesonephroid) type, and 1 of a mucinous-type epithelium. The stromal component in all tumors is identical to that of ordinary cystadenofibromas. One of the patients with a tumor containing endometrioid epithelium developed recurrence in the vagina after surgical removal of the ovarian tumor. The rest of the clinical features of these tumors are similar to those of ordinary cystadenofibromas with the exception that the median age is 10--20 years greater in the unusual-epithelium group.

Adenofibroma

Benign and low grade variants of mixed mesodermal tumor (adenosarcoma) of the ovary and adnexal region.

Eleven examples of a rare group of neoplasms composed of both epithelial and mesenchymal components are reported. Ten arose from the ovary and one arose separately in the para-ovarian region. The neoplasms are distinctive in that the stoma is more cellular than that of adenofibromas, but epithelial component is not malignant, as in carcinosarcoma and mixed mesodermal tumors, and the stoma is not sarcomatous in the low grade varieties. The 11 cases were highly variable in the cellularity and atypism of the stromal cells. The term, adenosarcoma, for these tumors is not acceptable because some were too low a grade to be regarded as sarcomas, and reports of the uterine counterpart disclose that some contain heterologous elements. For that reason, a term that will embrace the full spectrum of changes in the stroma--benign through sarcomatous--is needed. We propose that they be regarded as variants of mixed mesodermal tumor so that both the benign neoplasms and low grade sarcomas can be accommodated under one designation. Of the 11 cases, five lowest grade examples were all confined to the ovary and did not recur after surgical excision, but some of these were borderline in malignancy and probably would have progressed if untreated. Two of the 3 intermediate grade neoplasms extended beyond the ovary but were arrested by surgical excision. The 3 highest grade neoplasms were overly sarcomatous. One of these extended beyond the ovary but was arrested by combination chemotherapy. The para-ovarian adenosarcoma (also high grade) metastasized and proved fatal.

Adenofibroma

Cystadenofibromas of the ovary with epithelial atypia.

Epithelial atypia is rarely encountered in ovarian cystadenofibromas. Ten examples are reported with cytological features identical to serous tumors with low malignant potential. In two neoplasms the epithelium resembled an atypical endometrial hyperplasia, and one of these had squamous metaplasia. These two neoplasms probably qualify as endometrioid tumors of low malignant potential. None of the 10 patients had recurrence following excision of their neoplasm, and no similar patients have been encountered with neoplasms in more advanced stages. Even though aggressive behavior has not yet been established, the histologic features suggest a low degree of malignant potential and long-term follow-up of patients is warranted. Cystadenofibromas iwth epithelial atypia probably have less malignant potential than serous tumors of low malignant potential possessing the same epithelial characteristics because cystadenofibromas with atypia have less epithelial surface area and the epithelium is enveloped by connective tissue more than it is in serous tumors of low malignant potential.

Adenofibroma

Malignant germ cell tumors of the ovary.

This article reviews 281 malignant germ cell tumors of the ovary from the Armed Forces Institute of Pathology and highlights their distinctive clinical and pathologic features. Emphasis is placed on the importance of a combined therapeutic approach utilizing surgery, chemotherapy, and radiation. The rationale for unilateral salpingo-oophorectomy in conjunction with chemotherapy for certain types of neoplasm confined to one ovary (stage 1a) is emphasized, and the role of human chorionic gonadotropin and alpha-fetoprotein as tumor markers in the management of patients with these tumors is discussed.

Adolescent

A critical review of the frequency of lymph node metastasis and death from microinvasive carcinoma of the cervix.

The lack of a uniform, specific definition of microinvasive carcinoma of the cervix has made it difficult to extract from the literature a sufficient number of cases similarly defined from which to estimate the risk of nodal metastasis or death from tumor. Factors potentially biasing the frequency of nodal metastasis and death from tumor are examined, and series lacking such factors are used to provide estimates of the risk of metastasis or death from tumor for various specific definitions, but the number of cases fitting each definition are too few at present to give reliable estimates.

Cervix Uteri

Primary trabecular carcinoid of the ovary.

Eighteen cases of primary trabecular carcinoid of the ovary were analyzed from a clinicopathologic viewpoint. The patients ranged in age from 24 to 74 years and presented with symptoms of an ovarian mass; none had the carcinoid syndrome. Although the carcinoid always proved to be unilateral, the contralateral ovary was sometimes enlarged by a dermoid cyst. The carcinoid usually formed a small mass in an otherwise obvious dermoid cyst, but in six instances it formed a large, solid mass, and in 2 of these cases no other teratomatous elements could be demonstrated. The prognosis was nearly always favorable after removal of the neoplasm, although 1 patient had a recurrence after 2 years and died after 51/2 years. Primary trabecular carcinoids are characterized by a distinctive pattern of ribbons of argentaffin cells and should not be confused with a Sertoli-Leydig cell tumor, a strumal carcinoid, or a metastatic trabecular carcinoid.

Adult

Familial male breast cancer.

Infiltrating ductal carcinoma of the breast occurred in a total of six men from two families. In one family specimens from three men who had prophylactic mastectomies revealed focal intraductal hyperplasia, suggesting a familial tendency toward proliferation of mammary-duct epithelium. In the other family, benign and malignant breast lesions also developed in several women. Preliminary data suggest elevated urinary oestrogen excretion in three men from these families, implicating a defect in oestrogen production or metabolism in the pathogenesis of male breast neoplasms.

Aged