PubMed Health⌕ Search

Biomedical subjects

I Dahl

Publications and source records attributed to I Dahl.

At least 19 recordsLinked to original sources
PubMed1999

Prognostic evaluation in multiple myeloma: an analysis of the impact of new prognostic factors.

We have analysed the prognostic information for survival of presenting features in an unselected series of 394 myeloma patients. 15 variables with significant prognostic information were identified, among these were some not previously or only recently reported: serum levels of hepatocyte growth factor (HGF), interleukin-6 (IL-6), C-terminal cross-linked telopeptide of collagen I (ICTP) and soluble interleukin-6 receptor (sIL-6R). In a multivariate Cox analysis six variables were significantly and independently associated with poor survival: high age, low W.H.O.-performance status (PS), high serum levels of calcium, beta-2-microglobulin (beta-2M), IL-6 and sIL-6R. A risk score formed to predict survival for each percentile of the patient population allowed an efficient separation of prognostic groups. The discriminating power of the model compared favourably with three other previously published staging systems applied to the study population. Exclusion of IL-6 and sIL-6R from the model only marginally decreased the efficacy of the separation. The predictive value of some variables (sIL-6R, beta-2M and W.H.O.-PS) decreased significantly over time. We conclude that formation of a risk score based on independent variables is an efficient way to separate prognostic groups, that the contribution of new and not easily available parameters should be thoroughly evaluated before inclusion in prognostic models for clinical use and that the predictive value of parameters may decrease over time.

Humans↗
PubMed1986

Ewing's sarcoma of bone. A correlative cytological and histological study of 14 cases.

A correlative cytological and histological study of 14 cases of Ewing's sarcoma is presented. All smears from the fine needle aspirates were performed during the diagnostic investigation before treatment of the patients. The smears were very cellular with relatively small, round to oval tumour cells which appeared rather uniform. Two cell types could be distinguished, however. There was a predominance of relatively light, so-called principal or chief cells, but smaller and darker cells, so-called dark cells, were also observed. We found that Ewing's sarcoma has a characteristic appearance in smears and that fine needle aspiration cytology can be used in its primary diagnosis. A conclusive diagnosis may be made when the clinical and radiographic findings are also consistent.

Adolescent↗
PubMed1984

Benign solitary neurilemoma (Schwannoma). A correlative cytological and histological study of 28 cases.

A correlative histological and cytological study of 28 cases of solitary neurilemoma is presented. The typical histological mixture of Antoni type A and B tissue correlated well with the cytological findings. In the smears, the Antoni type A tissue was represented by tissue fragments with a fibrillar ground substance and slender, spindle-shaped cells forming obvious Verocay bodies in 24 cases, and the Antoni type B tissue by loose, microcystic fragments with single, elongated nuclei sometimes looking like fish-hooks and with indistinct, slender, cytoplasmic processes. The ancient neurilemomas, a variant of the ordinary neurilemomas, in this series were characterised both histologically and cytologically by nuclear hyperchromasia and polymorphism, which it is important to be aware of in order to avoid an erroneous diagnosis of sarcoma or probable sarcoma. The differential diagnosis is discussed and it is concluded that diagnosis of neurilemoma by fine-needle aspiration biopsy is possible, particularly when Verocay bodies and/or a fibrillar ground substance are present in the smears. It is stressed that fine-needle aspiration biopsy is an important aid to pre-operative diagnosis of neurilemoma, and thus to planning of the operative treatment.

Adolescent↗
PubMed1981

Leiomyosarcoma of the soft tissue. A correlative cytological and histological study of 11 cases.

Leiomyosarcoma of the soft tissues is a well-defined and characteristic entity histologically but correlative cytomorphological studies are lacking. A correlative histological and cytological study of 11 cases is presented. The leiomyosarcomas were characterized histologically by elongated tumour cells arranged in bundles intersecting each other at wide angles. The nuclei were elongated and often blunt-ended, tending to be aligned in tandem-position or in rows. The smears from leiomyosarcoma were poor in tumour cells and most cells were arranged in clusters of strands. The characteristic blunt-ended cells and nuclei of leiomyosarcoma could be identified in the smears and the nuclei were focally arranged in rows and sometimes in parallel. Nuclear atypia permits diagnosis of malignancy, although the atypia was generally not very pronounced. We consider that a knowledge of the corresponding histological features is mandatory for differentiating cytologically between various soft tissue sarcomas, including leiomyosarcomas. Further correlative cytological and histological studies of other soft tissue sarcomas are necessary for a more valid interpretation of the smears from leiomyosarcomas.

Adult↗
PubMed1980

Nodular fasciitis in the head and neck. A clinicopathological study of 18 cases.

Nodular fasciitis, a benign, pseudosarcomatous proliferative lesion of the soft tissue, is frequently misinterpreted as sarcoma, both clinically and microscopically. A series of 18 cases of nodular fasciitis in the head and neck region is presented. The clinical observations and the light microscopy are described. Ten out of the 18 cases were situated deep in the soft tissue; six were located close to the mandible and another 6 along the sternocleido mastoid muscle, seeming to support the view that nodular fasciitis may be ascribed to a reparative response to local mechanical events caused by injury. The diagnosis and differential diagnosis in relation to other benign and malignant tumours occurring in the region are discussed. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. Follow-up information for 12 of the patients confirmed a perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is therefore the treatment of choice.

Adolescent↗
PubMed1978

Recurrent and metastasizing gastric leiomyoblastoma (epithelioid leiomyosarcoma) associated with multiple pulmonary chondro-hamartomas: long survival of a patient treated with repeated operations.

A 15-year-old girl was operated for gastric leiomyoblastoma (epithelioid leiomysocarcoma) with metastasis to a regional lymph node. She has subsequently been operated on twice: once for local recurrence and metastases 9 years after her initial operation and once for an intraabdominal lymph node metastasis. Now, 13 years after her first operation for gastric leiomyoblastoma she is free from symptoms and signs of disease. Preoperative angiography was helpful in diagnosing the recurrence and planning the second operation. Our observations speak in favor of surgical treatment of recurrent and metastasizing gastric leiomyoblastoma. This patient was also operated for multiple pulmonary chondro-hamartomas, primarily suspected to be metastases. Coincidence of gastric leiomyoblastoma and pulmonary chondro-hamartoma does not seem to be due to chance alone.

Adolescent↗
PubMed1978

Intravascular papillary endothelial hyperplasia in the oral mucosa.

An intraluminal reactive hyperplastic lesion from the lower labial mucosa of an adult male patient is described. It has been termed intravascular papillary endothelial hyperplasia and may have arisen in an organizing thrombosed vein. The importance of distinguishing it from a malignant vascular neoplasm is stressed, and the differential diagnosis is discussed.

Diagnosis, Differential↗
PubMed1977

Ancient neurilemmoma (schwannoma).

A clinical and light microscopic study of 11 patients with ancient neurilemmoma is presented. Ancient neurilemmoma is a cellular form of ordinary neurilemmoma, showing nuclear polymorphism and hyperchromasia. Seven patients were female and 4 were male; their ages ranged between 37 years and 81 years, with a median of 59 years. Seven tumours were 2.5 cm or larger in the widest diameter, and had been slowly enlarging for one year or more. All tumours were solitary, encapsulated showing nuclear polymorphism and hyperchromasia without any mitotic activity. The differential diagnosis is discussed. Follow-up information available on all patients confirmed that the clinical course is benign.

Adult↗
PubMed1977

Pseudosarcomatous lesions of the soft tissues reported as sarcoma during a 6-year period (1958-1963).

Pseudosarcomatous lesion of the soft tissues is a term used in the present study for various soft tissue lesions and tumours easily clinically or histologically, or both, misinterpreted as sarcoma. Eighty-one cases, that is to say 10 per cent of all tumours classified and reported to the Swedish Cancer Registry as malignant soft tissue tumours during the 6-year period studied (1958-1963), were reclassified as pseudosarcomatous lesions of the soft tissues. Forty-seven cases were classified as pseudoarcomatous proliferative lesions of the soft tissue with or without bone formation; 38 cases of nodular fasciitis, 1 of proliferative fasciitis and 8 of proliferative myositis. In 3 of these cases there were mixed forms of proliferative fasciitis and proliferative myositis with areas compatible with the diagnosis of nodular fasciitis evident in all cases. Twenty-two cases of atypical fibroxanthomas of the skin were next in frequency, followed by 7 ancient neurilemmomas, 2 spindle cell lipomas, 1 pseudomalignant osseous tumour of the soft tissues, 1 pigmented villonodular synovitis and 1 juvenile xanthogranuloma. An attempt is made to explain the reasons for these erroneous diagnoses of sarcoma and it is stressed that for these lesions the conventional histological criteria for malignancy are not valid. The awareness and knowledge of the existence of these particular entities are therefore considered mandatory for an accurate diagnosis.

Adult↗
PubMed1976

Spindle cell lipoma.

A clinical, light- and electronmicroscopic study of 14 patients with spindle cell lipoma is presented. Spindle cell lipoma is considered to be a distinctive lipomatous tumour histologically characterized by a mixture of fat cells and fibroblast-like spindle cells, ultrastructurally similar to fibroblasts, in a matrix with varying amounts of collagen and mucosubstances. The tumours showed a predominance for elderly men and all but one were situated in the posterior neck, shoulder region or upper back. The tumours varied between 1 and 9 cm, with a median value of 5 cm, in the widest diameter and were entirely or almost entirely situated in the subcutaneous tissue. A follow-up study of 11 patients, observed for 1-25 years, confirmed that the clinical course is benign. The differential diagnosis is discussed and it is emphasized that spindle cell lipoma is easily misinterpreted as sarcoma. Three tumours showed a pronounced nuclear polymorphism without mitotic activity, thought to be regressive in nature. The cellular change in these three tumours are presumed to be analogous with those in so called ancient neurilemmoma and therefore the name ancient spindle cell lipoma is proposed for the polymorphic spindle cell lipomas.

Adult↗
PubMed1976

Foetal rhabdomyoma. Case report of a patient with two tumours.

A case report of a girl with two foetal rhabdomyomas is presented. One tumour was a small cutaneous lesion present at birth in the left thigh and the other was located in the chest wall deeply in the subcutaneous tissue and attached to the adjacent intercostal muscle. The patient also had the naevoid basal cell carcinoma syndrome which lends credence to the opinion that foetal rhabdomyoma is a malformation rather than a true neoplasm.

Basal Cell Carcinoma↗
PubMed1976

Atypical fibroxanthoma of the skin. A clinico-pathological study of 57 cases.

A retrospective study of 57 patients with atypical fibroxanthoma of the skin is presented. The light microscopy is described and the differential diagnosis is discussed. Most of the atypical fibroxanthomas (32 out of 57 cases) were originally diagnosed as soft tissue sarcomas, e.g. fibrosarcoma, dermatofibrosarcoma, neurofibrosarcoma, myosarcoma and unspecified sarcoma. The tumour occurred chiefly in middle-aged and elderly patients; three patients were 15 years old or younger. The median age was 73 years in patients in whom the tumour occurred in the head and neck, and 34 years in patients in whom the tumour developed on the extremities and trunk. The sex ratio (male to female) was almost equal. Follow-up information about 43 patients was available. The follow-up period ranged from 1 year to 25 years with a median of 9 years. Eight patients died from intercurrent disease; all the other 35 patients are alive and well. The clinical course was benign in all but one patient in whom a recurrence developed and metastases to the regional lymph nodes appeared 7 years after the initial excision. The tumour in this case did not differ histologically from the other atypical fibroxanthomas with respect to cellularity, cellular and nuclear atypia or mitotic activity. It is suggested that the recurrence per se might be of prognostic importance.

Adolescent↗
PubMed1974

Cutaneous and subcutaneous leiomyosarcoma. A clinicopathologic study of 47 patients.

A retrospective study of 47 patients with leiomyosarcoma of superficial (skin and subcutaneous) soft tissue is presented. The criteria for the light microscopic diagnosis are given and the differential diagnoses are discussed. Forty patients had a solitary tumour which, in 19 patients, was situated entirely or almost entirely in the corium. There were two distinct growth patterns for the leiomyosarcomas. The cutaneous tumours were poorly delimited and the subcutaneous tumours more well-circumscribed or nodular. Some three quarters of the tumours were located in the extremities, the thigh and hip regions being the predilection sites; the highest frequency was noted in patients in their seventies; the ages ranged between 25 and 89 years. The sex ratio (male to female) was 2 to 1. In 37 patients follow-up information was available, the follow-up period ranging from 1 month to 16 1/2 years; the median time was 6 years. One or more local recurrences developed in 15 patients. Seven out of the 47 patients had multiple leiomyosarcomas; 4 of these patients had already been operated on for a retroperitoneal leiomyosarcoma. Fourteen patients in the whole series died with metastases especially in the lungs. Metastases were seen particularly in patients with subcutaneous and multiple leiomyosarcomas. Our study suggest that the size and the mitotic activity of the tumour appear to have some prognostic value. The initial surgical procedure was found to be the most important factor in influencing the outcome of the disease and it is stressed that leiomyosarcoma in superficial soft tissues should be treated by wide surgical excision. It is recommended that patients with multiple leiomyosarcomas in the superficial soft tissues should be subjected to further examination in order to exclude the possible occurrence of a retroperitoneal tumour. Finally, we consider that the use of a trichrome stain, such as the haematoxylin-van Gieson's stain, is superior to the haematoxylin-eosin stain in diagnosing leiomyosarcoma.

Adult↗