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I K Kline

Publications and source records attributed to I K Kline.

15 recordsLinked to original sources

Metaplastic carcinoma of the breast--diagnosis by aspiration biopsy cytology: report of two cases and literature review.

The unusual metaplastic carcinomas have a variety of names, each emphasizing the dominant histologic pattern. Components may include features of ductal, spindle, or squamous carcinoma with pseudosarcomatous, cartilaginous, or boney areas. A few reports from individual tumors examined by fine-needle aspiration biopsy have emphasized an array of findings. This study includes two of our cases with a review of 12 others from the literature. The breast neoplasm has a characteristic pattern on aspiration biopsy cytology (ABC). The cell-rich aspirate reveals benign multinucleated giant cells intermingled with malignant spindled or squamous cells on a background of necrotic debris, inflammatory cells, and blood. Additionally, cells from infiltrating ductal carcinoma and mesenchymal fragments are often seen.

Aged↗

Lymphadenopathy and aspiration biopsy cytology. Review of 376 superficial nodes.

The results of aspiration biopsy from 376 superficial lymph nodes were reviewed. Diagnosis of metastatic carcinoma based on "alien" cells and melanoma was easily made with an accuracy of 95%. The results of aspiration biopsy from lymphoma was much less accurate, and led to retrospective analysis of aspirates from 51 histologically verified cases of benign lymphadenopathy and lymphoma. Features suggestive of lymphoma included large immature lymphocytes, large histiocytes, abundant mitoses, and Reed-Sternberg cells. Thus, this safe office procedure, which immediately differentiates the lymph node from a cyst, inflammatory mass, or mesenchymal tumor, provides an important tool for diagnosis.

Biopsy, Needle↗

Early gastric cancer in a United States hospital.

Early gastric cancer (EGC) confined to mucosa and submucosa, described by Japanese physicians over 20 years ago, yields about 90% 5-year postoperative survival. EGC has been increasingly reported from centers outside Japan, but rarely from the United States. Between 1976-1981, EGC was found in six patients or about 8.5% of all gastric carcinomas diagnosed in our hospital. Diagnoses were established by following suspicious upper gastrointestinal series or negative x-rays in patients with dyspepsia by means of gastroscopy and gastroscopically obtained biopsies, brush, and/or wash cytology. All six patients underwent subtotal gastrectomy with histological findings of EGC not invading the muscularis and with no metastases. So far no tumor recurrences have been found in these six patients. The results suggest that EGC as defined by Japanese investigators occurs in our hospital and presumably across the United States more often than heretofore appreciated. Previous fatalistic attitudes toward diagnosing gastric cancer should be replaced by efforts at early diagnosis. Patients with symptoms suggestive of gastric carcinoma, including unexplained dyspepsia, should undergo early upper gastrointestinal x-ray and endoscopic examinations with biopsies and cytological tests of any suspicious raised, flat, or depressed area.

Aged↗

Bile reflux gastritis and esophagitis in patients without prior gastric surgery, with pilot study of the therapeutic effects of metoclopramide.

We reviewed our upper endoscopic records over a 27-month period, retrospectively for 23 months and prospectively for four months and identified patients with substantial bile reflux. Patients with prior gastrectomies were excluded. Of the remaining 36 patients, 23 had prior cholecystectomies. Bile reflux gastritis and esophagitis were found in the majority of patients with bile reflux and occurred more often than is generally appreciated. Patients were seen with a fairly consistent and protracted clinical pattern, usually with severe early postprandial epigastric pain, tenderness and frequent heartburn. Cholecystectomy appeared to be a most important predisposing factor. The correct diagnosis can only be made by upper gastrointestinal endoscopic inspection and biopsies. A pilot therapeutic trial of metoclopramide suggests beneficial effects of this drug in the majority of afflicted patients. A randomized controlled trial of metoclopramide is being prepared to define more clearly the role of this drug in bile reflux gastritis and esophagitis.

Adult↗

Canine lung allograft lymphatic alterations.

Lymphatic obstruction has not been emphasized as a feature of lung allograft rejection. However, accumulation of fluid and cellular infiltrate, aggravated by lymph stasis, results in impaired lung function. In this study, lung specimens were recovered at varying times up to 133 days after either reimplantation (7 dogs) or allografting (29 dogs). Azathioprine and prednisone were administered to 17 allograft recipients. The presence of abnormally dilated perivascular, peribronchiolar, and subpleural lymphatic channels was a consistent histological finding, most striking in specimens recovered from untreated allograft recipient dogs. Attenuated lymphatic alterations were noted in immunosuppressed allograft recipients. In these animals the pulmonary lymphatics seemed to be ineffectual in clearing the allograft of the accumulating cellular infiltrates and fluid during rejection.

Animals↗

Appraisal and cytomorphologic analysis of common carcinomas of the breast.

This work is based on 15 years experience with more than 9000 needle aspiration biopsies from the breast performed by a number of clinicians without syringe guns. From 1981 through 1983, 329 carcinomas were detected with a sensitivity of 90%. A positive or suspicious report was issued in 17 of the 32 minimal carcinomas. There were no false-positive diagnoses. A retrospective comparative study was made on the aspiration biopsy cytology specimens from 65 histologically verified carcinomas: 30 infiltrating ductal, 16 infiltrating lobular, 10 medullary, and 10 colloid carcinomas. Parameters included the pattern, major malignant criteria, and cell measurements by calibrated ocular micrometry. The classic features of each carcinoma and the differential cytomorphology are described.

Adenocarcinoma, Mucinous↗