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Biomedical subjects

J G Lucas

Publications and source records attributed to J G Lucas.

30 records · Page 2Linked to original sources
PubMed1989

Cystic ovarian enlargement resulting from autoimmune oophoritis.

Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have not been emphasized. Herein, we describe a 35-year-old woman with autoimmune oophoritis who presented with symptoms referable to a right cystic adnexal mass. She underwent a diagnostic laparotomy and right salpingo-oophorectomy for removal of an 8.0-cm-diameter, twisted multicystic ovary. Microscopically, mononuclear inflammatory cells infiltrated multiple follicular and luteal cysts. We have seen two additional patients with histologically verified autoimmune oophoritis who underwent diagnostic laparotomy and oophorectomy because of cystic enlargement of the ovaries. Stimulation of ovarian follicles by elevated levels of pituitary gonadotropins probably causes the cystic changes. Recognition of this aspect of autoimmune oophoritis may help to prevent oophorectomy in patients whose functioning ovarian tissue is already compromised by autoimmune destruction.

Adult↗
PubMed1988

Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation.

A retrospective evaluation of magnetic resonance (MR) imaging for the detection of avascular necrosis (AVN) of the femoral head was performed in 49 patients (85 hips) with clinical suspicion of AVN. Positive findings at bone biopsy or evidence on plain radiographs was considered proof of AVN. Absence of clinical symptoms and of radiographic findings for a minimum of 18 months after MR imaging was considered evidence of the absence of AVN. All patients were studied with plain radiography and technetium-99m methylene diphosphonate bone scintigraphy. Five hips had negative MR images, positive findings at bone marrow biopsy, positive bone pressure measurement (BMP), and positive bone scans. A comparison between MR images and bone scans showed MR imaging to be superior, with a sensitivity of 88.8% (vs. 77.5%) and a specificity of 100% (vs. 75%). BMP was the most sensitive (92%) but least specific test (57%).

Adolescent↗
PubMed1987

Diagnostic histochemical and immunohistochemical studies in malignant mesothelioma.

This study was undertaken to evaluate the relative utility of histochemical and immunohistochemical stains in diagnosing malignant mesothelioma of the thorax. We performed a battery of histochemical stains, including periodic acid Schiff (PAS) with and without diastase, mucicarmine, colloidal iron (Coll Fe) with and without hyaluronidase, and immunohistochemical stains for keratin and carcinoembryonic antigen (CEA) on 12 pleural mesothelioma specimens obtained from 11 patients, five primary pulmonary adenocarcinomas, and one metastatic adenocarcinoma each to pleura and pericardium. All diagnoses were established by autopsy or thorough clinical and surgical evaluation. The diagnosis of mesothelioma was established following rigid anatomic criteria. All tissue was formalin fixed and paraffin embedded. Commercially available reagents and antisera were used in all cases. Results showed a high rate of positivity for keratin and hyaluronidase-sensitive Coll Fe in the mesotheliomas while adenocarcinomas were uniformly positive for CEA and keratin and generally positive for PAS-D (diastase) and mucicarmine. Mesotheliomas were negative for CEA, mucin, and PAS-D. Positive keratin staining was also seen in the spindle cell components of mesotheliomas. Immunohistochemical stains often added significantly to our ability to establish the diagnosis of mesothelioma with confidence, since they were more frequently and more clearly positive than histochemical stains.

Adenocarcinoma↗
PubMed1987

Extra-adrenal paraganglioma and pulmonary chondroma: a case report and review of the literature.

This report describes the findings of an extra-adrenal paraganglioma and chondroma of the lung in an elderly man. Tissue analysis of the paraganglioma showed a high level of catecholamines, as well as the presence of somatostatin and small amounts of other peptide hormones. Immunoperoxidase staining demonstrated the distribution of peptide hormones in the tumor. This case illustrates two important points. First, it confirms the ability of paraganglionic tissue to secrete peptide hormones. Secondary, it adds yet another case to the unusual group of patients described by Carney (Carney JA: Cancer 43:374-382, 1979).

Aged↗
PubMed1985

Alveolar soft part sarcoma of the vagina: an immunohistochemical and electron microscopic study.

Alveolar soft part sarcoma is a soft tissue neoplasm of unknown histogenesis which has a distinctive morphology. It is a relatively rare tumor with approximately 200 cases described in the literature. Only two cases have previously been reported as occurring in the vagina. The purpose of this paper is to report the third case of alveolar soft part sarcoma occurring in the vagina and to emphasize the role of electron microscopy in the differential diagnosis.

Adenocarcinoma↗
PubMed1985

Adult bronchiolitis. Evaluation by bronchoalveolar lavage and response to prednisone therapy.

Four adult patients with biopsy-proven bronchiolitis were identified and prospectively evaluated. Each patient presented with the rapid onset (weeks to months) of severe respiratory disease that was clinically distinct from asthma, chronic bronchitis, bronchiectasis, cystic fibrosis, and emphysema. Bronchiolitis patients were evaluated by pulmonary function testing and bronchoalveolar lavage (BAL) before and after two months of treatment with 1 mg/kg/day of prednisone. Initial BAL results of bronchiolitis patients were compared to those of cigarette smokers with chronic bronchitis (n = 4), asymptomatic cigarette smokers (n = 5), and normal nonsmoking volunteers (n = 5). Neutrophils comprised 53 +/- 13 percent of the cells recovered by BAL in bronchiolitis patients but only 3 +/- 2 percent of the cells in chronic bronchitis patients, 1.5 +/- 0.6 percent of the cells in asymptomatic smokers, and 0.3 +/- 0.3 percent of the cells in normal volunteers (p less than 0.01, all comparisons). Moreover, prednisone produced a striking decrease in lower respiratory tract neutrophils (53 +/- 13 percent to 8 +/- 3 percent, p less than 0.05) in all bronchiolitis patients while lung function either improved (two patients) or remained unchanged (two patients). These findings suggest a central role for the neutrophil in bronchiolitis and argue that BAL may be clinically useful in the diagnosis and management of these patients.

Adult↗
PubMed1983

Pneumocephalus from a frontal-ethmoid neurilemoma.

A 68-year-old man had memory lapse, character change, and unsteady gait. Skull films disclosed a spontaneous pneumocephalus with air in both ventricles. A dense, bony lesion in the right ethmoid area was thought to be an osteoma, a not infrequent cause of dural erosion. The bony lesion, however, proved to be an osteoid reaction around a primary neurilemoma. Neurilemomas arising in the paranasal sinuses are uncommon tumors and, to the best of our knowledge, this is the first reported case of a patient with a neurilemoma who had pneumocephalus. The lesion was excised through a Lynch approach, and the patient has remained free of tumor for the past two years.

Aged↗
PubMed1981

Unusual giant cell tumor arising in a male breast.

An unusual giant cell tumor of the breast of a 72 year old man is reported. The microscopic and ultrastructural features of the tumor are presented in detail. Unusual and previously unreported myofibroblastic an myoepithelial differentiation of the spindle cell component is described. The possible histogenesis of the tumor is discussed.

Aged↗
PubMed1978

Villous adenomas of the duodenum.

A patient with multiple villous adenomas of the duodenum is described. Endoscopy plays an essential role in the management of these neoplasms. If no evidence of invasive malignancy is found on multiple endoscopic biopsies, wide local excision is the initial procedure of choice. Invasive malignancy found in either the endoscopic biopsy or the surgical specimen is indication for pancreaticoduodenectomy.

Adenoma↗
PubMedDate not supplied

Update on intraoperative analysis of mandibular margins.

PURPOSE: Assessing the adequacy of the surgical resection during composite resection of carcinoma is limited by the ability to evaluate the bone margins. The standard pathologic evaluation of bone is by decalcification. PATIENTS AND METHODS: A method of analysis was devised based on histologically proven methods of cortical invasion and subsequent spread. Frozen-section analysis of cancellous bone was investigated as a rapid method of evaluating adequacy of the mandibular resection. This report is an update of previously published results and includes an increase in the sample size as well as the analysis of additional pathology. Subjects consisted of 66 patients undergoing full thickness mandibular resection with 30 cases of histologically proven mandibular invasion qualifying for evaluation. Results on frozen section were then compared to the permanent section analysis on the cancellous bone and to the decalcified specimen. RESULTS: Complete correlation was found between frozen and permanent section results. Frozen section analysis was able to correctly predict adequacy of resection in 60 of 61 margins. CONCLUSION: Based on these results, the oncologic surgeon can evaluate bone margins at the time of the resection and adjust the amount of excision required to eradicate the disease.

Adult↗
PubMedDate not supplied

Granular-cell tumor of the breast. A cytologic, immunohistochemical and ultrastructural study of two cases.

Two primary granular-cell tumors of the breast are reported. Cytologically and histologically, these tumors had the classic features of small, eccentrically located nuclei and numerous periodic acid-Schiff-positive cytoplasmic granules. The characteristic cytologic features were best appreciated in touch imprints, not in frozen sections. Immunohistochemically, the tumors demonstrated diffuse cytoplasmic staining for S-100 protein but negative staining for myoglobin. The significance of these immunohistochemical staining characteristics, particularly in evaluating the possible histogenesis of these tumors, is discussed. The ultrastructural features of these two tumors are also presented and compared to findings reported by other investigators.

Adult↗