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Biomedical subjects

H Tobon

Publications and source records attributed to H Tobon.

At least 19 recordsLinked to original sources
PubMed1996

Breast cancer measurements with magnetic resonance imaging, ultrasonography, and mammography.

BACKGROUND: Accurate measurement of the size of breast cancers becomes more important as breast cancer therapy advances. This study reports the accuracy of magnetic resonance imaging (MRI), ultrasonography and mammography for measuring the largest breast cancer diameter in comparison to the pathology measurement. MATERIALS AND METHODS: Fourteen breast cancers were examined in 13 women with MRI, ultrasonography and mammography. The age range was 31-73 (mean 56). Six of the cancers were in premenopausal women. The MRI was performed with the intravenous injection of gadolinium based contrast agent and a three dimensional fast spoiled gradient echo sequence with fat suppression. The largest cancer diameter was measured with each imaging technique and compared to the largest cancer diameter measured at pathology. RESULTS: At pathological examination cancers ranged from 0.6 to 6 cm (mean 2.2) in largest diameter. MRI measurements had the highest correlation coefficient (r = 0.98) and the smallest standard error (0.34). Ultrasonography measurements had a correlation coeffient of r = 0.45 and a standard error of 0.78. Mammography measurements had a correlation coefficient of r = 0.46 and a standard error of 1.04. CONCLUSIONS: MRI was more accurate than ultrasonography and mammography in measuring the largest cancer diameters in this group of women. This was particularly evident for several larger cancers, and a postchemotherapy cancer.

Adenocarcinoma↗
PubMed1995

Automated large-core needle biopsy of surgically removed breast lesions: comparison of samples obtained with 14-, 16-, and 18-gauge needles.

PURPOSE: To determine the needle size that would consistently enable the pathologist to correctly diagnose tissue core biopsy specimens. MATERIALS AND METHODS: Fifty-seven surgically removed mass lesions of the breast were sampled with a short-throw automated biopsy gun and an 18-gauge needle first, followed by a 16- and a 14-gauge needle. Samples were evaluated independently by three pathologists, and findings were compared with the final diagnosis made at surgical excision biopsy. RESULTS: The sensitivity for the diagnosis of all 26 malignant lesions was 100%, 92%, and 65% for biopsy samples obtained with 14-, 16-, and 18-gauge needles, respectively. Specificity for malignancy was 100% for all three needle sizes. All of the benign diseases were correctly diagnosed in samples obtained with all three size needles except for two samples that did not survive processing. CONCLUSION: Biopsy samples obtained with a 14-gauge needle provide the most accurate diagnosis, which correlates with the diagnosis made with the surgical excision biopsy technique.

Automation↗
PubMed1993

Silicone implant rupture: detection with US.

The authors evaluated the ability of ultrasound (US) in detection of silicone implant ruptures and compared US detection with that of mammography and physical examination in 22 women with 29 sites of implant leakage. On sonograms, leaks were evident from a highly echogenic pattern of scattered and reverberating echoes with loss of detail posterior to the echogenic area. The area appears as a "snowstorm" and has a well-defined anterior margin but a poorly defined posterior margin. Twenty-five sites in 19 women were surgically confirmed. Mammograms obtained with various views and sonograms were available for comparison in 20 of 25 surgically confirmed leaks. Of all 29 leaks, 14 were detected at physical examination as palpable masses. Six of these 20 leaks were not detected with mammography. With US, only one leak was not detected. US allowed more accurate prediction of the extent of free silicone in the breast and enabled detection of silicone within axillary nodes. Recognition of the characteristic highly echogenic sonographic appearance of microglobules of free silicone in the soft tissues can improve detection of implant rupture.

Adult↗
PubMed1992

Cytogenetic analysis of a uterine lipoleiomyoma.

We cytogenetically analyzed a uterine lipoleiomyoma. A primary chromosomal abnormality, t(12;14), was found in all 62 cells studied. A secondary change involving chromosomes 1 and 5 was detected in 15 of 62 cells. These findings suggest that lipoleiomyomas share the same chromosomal abnormalities found in common leiomyomas. We speculate that the secondary chromosomal change involving chromosomal 5 may be responsible for the lipomatous change.

Chromosomes, Human, Pair 1↗
PubMed1991

Oncogene amplification in breast cancer.

To refine the analysis of gene amplification in breast cancer, the authors have developed sensitive methods that can be used to screen nucleic acid prepared from a variety of sources. In their analysis, Southern hybridization and DNA dot-blot analysis were used to screen 49 breast cancer DNAs for Myc, Neu, and Int-2 gene amplification. The analysis detected minimal one extra gene copy) as well as expanded (two or more extra gene copies) gene amplifications, and in addition, distinguished between gene amplification and aneuploidy as the cause of extra gene copies. These quantitative methods were adapted to patient specimens routinely available in the anatomic pathology laboratory, including fresh tumor tissue, tumor nuclei discarded during estrogen receptor analysis, and paraffin blocks. One minimal gene amplification was found in three cases of intraductal cancer. Of 25 cases of nonmetastatic invasive cancer, 28% had at least one extra Myc gene, whereas 24% had Neu, and 21% had Int-2 gene amplification. Of 21 cases of metastatic invasive cancer, 43% had Myc, 43% had Neu, and 40% had Int-2 gene amplification. Among the nonmetastatic cancers, 47% had one, 12% had two, and 4% had three amplified genes. Within the metastatic cancers, 48% had one, 28% had two, and 5% had three amplified genes. Our data suggest relationships between tumor progression and both incidence and size of Myc, Neu, and Int-2 gene amplification.

Breast Neoplasms↗
PubMed1991

Squamous cell carcinoma in situ arising in an ovarian mature cystic teratoma. Report of one case with histopathologic, cytogenetic, and flow cytometric DNA content analysis.

A squamous cell carcinoma in situ arose in an ovarian mature teratoma (ie, dermoid cyst) in a 62-year-old woman. Flow cytometric DNA content analysis of paraffin-embedded in situ carcinoma showed a normal DNA content with moderate to high proliferative activity (S-phase fraction estimate, 16% to 18%). Cytogenetic analysis of the in situ cancer and the benign cystic portion of the tumor revealed a 46,XX karyotype. In addition, the benign cystic portion of the tumor revealed homozygous chromosomal heteromorphisms, compared with heterozygous markers found in peripheral blood lymphocytes. These results show that this squamous cell carcinoma in situ was euploid and suggest that the mature cystic teratoma was derived from a single germ cell after meiosis I.

Carcinoma in Situ↗
PubMed1989

Infiltrating lobular carcinoma: mammographic patterns with pathologic correlation.

Of the five identified radiographic patterns of ILC, the most common was a poorly defined asymmetric density with architectural distortion. Areas of ILC frequently are of low density, not much greater than that of the surrounding parenchyma. The mammographic appearance may reflect the behavior of ILC tumor cells, which travel in linear array ("single file") along and around the arborizing ducts that serve as scaffolding for these small, malignant cells that permeate the parenchyma without a central nidus. This feature of ILC may also help explain why tumors may be palpable as areas of vague induration or thickening rather than as discrete masses. When tumors are hidden in dense breast tissue (pattern 3) and not well imaged by mammography or when there are subtle mammographic changes (pattern 1), sonography may help confirm the presence of a solid mass. Most of the suspected tumors imaged by sonography were palpable as discrete masses or areas of induration.

Adult↗
PubMed1989

'Polyposis vaginalis' of pregnancy.

Clinical and pathologic findings in a pregnant 15-year-old with vaginal polyposis disclosed numerous polyps throughout the vagina and portio of the cervix that disappeared spontaneously 6 weeks post partum. These polyps can be confused microscopically with sarcoma botryoides, although they are benign and may regress completely.

Adolescent↗
PubMed1987

Mucinous adenocarcinoma of the endometrium: a clinico-pathological review of 18 cases.

We reviewed 18 cases of mucinous adenocarcinoma of the endometrium seen at this hospital during 1969-1985. Tumor histology was studied in curettage and hysterectomy material; the Hospital Tumor Registry provided follow-up data. All women were postmenopausal, 47-89 years of age, and presented with vaginal bleeding; few had abdominal pain; four of the 18 were nulliparous. Eight patients had been receiving estrogen therapy. The disease was in Stage IA in 15 patients and Stage IB in three patients. All patients had total hysterectomy and salpingo-oophorectomy; six had preoperative radium implants, and four had postoperative radium plus progesterone treatment. Histologically the tumor was grade 1 in 13 (72%) women, only five being grade 2 or 3 (28%). All tumors were positive for mucicarmine and carcinoembryonic antigen (CEA). Only two cases showed adjacent benign endometrial mucinous metaplasia. Myometrial invasion varied from 5-60% and was absent in three cases. The degree of invasion did not appear to affect the rate of recurrence. The tumor recurred 54 weeks after treatment in one of 13 patients with grade 1, in none in grade 2 and in two of two patients with grade 3 within 10 months of diagnosis. In summary, mucinous endometrial carcinoma is a rare tumor (1% of endometrial carcinomas in our hospital) of postmenopausal women; it tends to be well differentiated and has a relatively good prognosis.

Adenocarcinoma, Mucinous↗
PubMed1986

Vaginal cysts: a clinicopathological study of 41 cases.

The clinicopathological features of 43 vaginal cysts in 41 patients treated at Magee-Womens Hospital between 1972 and 1982 were evaluated. Thirty-five of the patients were white and six black; their ages ranged from 19 to 68 years with an average of 37.6 years. Most patients complained of a swelling or mass in the vagina, accompanied in some by stress incontinence, dyspareunia, dysfunctional uterine bleeding, or a history of episiotomies or vaginal lacerations. The majority of the cysts were located in the lateral and posterior walls of the vagina. The most frequent cyst type was mucus-secreting müllerian (19; or 44%), followed by ten (23%) epidermal inclusion cysts; three of the latter were located in a previous episiotomy site. The remainder were five (11%) of Gartner's duct type, three (7%) of Bartholin's duct type, and three (7%) of endometriotic type. The remaining three were unclassified for lack of an epithelial lining in two, and one cystourethrocele was confused with a vaginal cyst. None disclosed atypical epithelial hyperplasia or malignant change.

Adult↗
PubMed1985

Secretory adenocarcinoma of the endometrium.

Secretory adenocarcinomas of the endometrium are uncommon tumors distinct from clear cell carcinomas. We reviewed nine cases that included the original endometrial curettings and the specimens of uteri with both adnexa [total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO)]. The patients' ages ranged from 36 to 79 years (with an average of 55 years). Six women were postmenopausal, and most complained of vaginal bleeding. Two patients were nulliparous and the others had one to four children. Four patients were obese, of whom one was diabetic and hypertensive. Eight tumors were of grade I and one was grade II. The histologic pattern was comparable to that of secretory endometrium, days 17 to 22, and the glands were positive with periodic acid-Schiff (whether predigested or not); they were partly positive with alcian blue and negative with Best Carmine. The carcinoma in one case was positive for carcinoembryonic antigen; all cases were negative with alpha-fetoprotein. Six patients were staged as IA and three as IB. One 47-year-old patient had a concurrent endometrioid adenocarcinoma (grade II) of the right ovary with squamous, clear cell, and mucinous components. Three cases had no tumour penetration of the myometrium while in the others penetration varied from 5 to 70%. One patient received intracavitary radium prior to TAH-BSO and two had postoperative radiation. All patients are alive 11 to 113 months following surgery. Secretory adenocarcinoma of the endometrium should be separated from clear cell carcinoma, as it has the pattern of secretory endometrium day 17 to 22, is very well differentiated, and has a relatively good prognosis.

Adenocarcinoma↗
PubMed1981

Polyps of the vagina: a clinicopathologic study of 18 cases.

Polyps of the vagina are benign, soft tissue tumors composed of loose connective tissue with myxoid changes and containing atypical, pleomorphic, hyperchromatic cells. Because of this bizarre microscopic configuration, they have been confused with sarcoma botryoides. Eighteen cases of polyps of the vagina included in the pathology files of Magee-Womens Hospital from 1972-1979 were compiled. Clinical and pathologic findings were reviewed. All patients except one were white, and median age was 48.5 years. The most common symptom was vaginal bleeding (ten patients) or vaginal "growth" (six patients). All lesions (except one in which only a biopsy was done) were treated with local resection.

Adolescent↗
PubMed1979

Massive ovarian edema: a nonneoplastic pelvic mass of young women.

Two cases of massive ovarian edema are reported in addition to the eight previous cases published in the English literature. The predominance of the right-sided involvement and the histopathological characteristics of this lesion support the hypothesis that the basic pathogenetic mechanism is an impairment of the venous and lymphatic drainage of the ovary, triggered by recurrent partial torsion of the mesovarium. This nonneoplastic lesion should be recognized as a distinct entity in ovarian disease and treated conservatively.

Adolescent↗
PubMed1977

Primary clear cell carcinoma of the ovary. An analysis of 15 cases with review of the literature.

The clinical and pathological findings in 15 primary "pure" clear cell carcinoma of the ovary included in the Magee-Womens Hospital Tumor Registry from 1947 through 1974 are discussed. The ages of the patients ranged from 35 to 75 years (mean 53). The most common clinical finding was an abdominal mass in 14 cases. At surgery, five patients had extraovarian spread, one accompanied by ascitis. The tumors varied in diameter from 4 cm to 17 cm (mean 10.5 cm); grossly, about one-third were cystic, one-third solid and one-third had combined cystic and solid areas. Microscopically, four basic patterns were seen: papillary, tubular, solid, and cystic, and in several an admixture of the above. Clear cells predominated in 48% of the cases and 23% displayed hobnail cells. Most patients were treated by TAH & BSO or variants thereof, some followed by radiation or chemotherapy. Four patients died with cancer within 35 months after diagnosis; two others died of unrelated causes three and 12 years later. The actuarial survival was computed as 55% at five years. Five patients were stages as IIb (FIGO classification); four died with tumor and the remaining patient is alive with recurrent tumor in the pelvis 18 months after the original diagnosis. Three patients with tumors displaying the cystic pattern are still alive; two with a predominantly papillary pattern and vascular permeation are dead. It is suggested that survival rates in these 15 cases may be related more to the extent of the lesion at the initial presentation than to the gross or microscopic pattern.

Adenocarcinoma↗