Biomedical subjects
Publications and source records attributed to J J Gillespie.
A 21-year-old man with a history of an excised soft tissue mass of the groin and spotty cutaneous pigmentation underwent excision of nodules of the right lower and left upper eyelids. The patient subsequently had a cutaneous mass of the left ear removed. All excised lesions were classified as myxomas. A diagnosis of multiple myxoma, spotty pigmentation, and endocrine overactivity (Carney's) complex was made.
The ultrastructure, differential diagnosis, and biologic behavior of the peripheral pulmonary spindled carcinoid tumor are reviewed. Electron microscopy is useful in distinguishing the spindled carcinoid from a variety of neoplasms with similar histologic features. The spindled morphology is a rare expression of the carcinoid tumor that is almost exclusively confined to the lung periphery. It appears that the spindled carcinoid without atypical features is fully capable of regional lymph node metastases in approximately 20 per cent of the cases.
The histologic and ultrastructural morphology of three cases of Ewing's sarcoma of soft tissue are described and the fine structural features of extraskeletal Ewing's sarcoma are compared to those of similar round-cell tumors that are considered in the differential diagnosis. By light microscopy, these tumors are indistinguishable from Ewing's sarcoma of bone. Ultrastructurally, the salient features are also comparable to Ewing's sarcoma of bone and include: 1) absence of surface modifications; 2) cell-contact sites in the form of small thickenings of apposed membranes and large desmosome-like specializations; 3) undifferentiated cytoplasm usually containing abundant glycogen and occasionally nonspecific microfilaments; 4) significant variation in shape and irregularity of nuclear profiles. The ultrastructural features of extraskeletal Ewing's sarcoma are sufficiently distinctive to allow separation from from other small-cell malignant neoplasms in the majority of cases.
A rare case of rapidly evolving dysgerminoma produced death by tumor in less than two months after onset of symptoms. It is important to recall that dysgerminoma possesses considerable malignant potential, which infrequently is manifested by rapidly progressive disease. Certain risk factors, present in the pathological specimen, serve to indicate the aggressive potential of such neoplasms.
The fine structural morphology of the anal transitional zone is described and is compared to the ultrastructure of urothelium and anal squamous epithelium. Electron microscopic observations in eight cases of cloacogenic carcinoma are also presented. Anal transitional epithelium is not highly specialized and incorporates features of both urothelium and squamous epithelium; slight urothelial differentiation is considered vestigial. Cloacogenic carcinoma is a specific morphologic entity, which can be distinguished from urothelial and squamous carcinoma. The "transitional" variant is composed of cells similar to the intermediate zone cells of anal transitional epithelium, an observation confirming the concept that the transitional form of cloacogenic carcinoma is derived from the anal transitional zone. The "basaloid" and pleomorphic variants appear to represent less differentiated forms of cloacogenic carcinoma.
Thirty cases of diffuse large-cell ("histiocytic") lymphoma were studied with the electron microscope. The purpose was to define the criteria requisite for the ultrastructural diagnosis of large-cell lymphoma. The fine structural features of the lymphoma cells were compared to those of similar appearing reticuloendothelial neoplasms and other tumors that may simulate large-cell lymphoma by light microscopy. Two variants of large-cell lymphoma were recognized, each composed of neoplastic lymphoid cells with the morphologic features of transformed lymphocytes. The larger group represents large noncleaved cell lymphoma of Lukes and Collins' functional classification, while the second type corresponds to lymphoma of large cleaved cells. The ultrastructural features of large-cell lymphoma are uniform and usually easily identified. By utilizing diagnostic electron microscopy, large-cell lymphoma can often be distinguished from similar appearing tumors presenting as diagnostic problems at the light microscopic level.
A case is presented of meningeal melanocytoma that invaded the thoracic spinal cord of a 71-year-old woman. The light and electron microscopic features of the lesion indicate that it derives from melanocytes normally found in the leptomeninges. This tumor closely resembles the dermal cellular blue nevus and does not have the ultrastructure of a meningioma. "Melanotic meningioma" is consequently a misnomer and the name "meningeal melanocytoma" is more appropriate. These tumors may appear to be benign histologically, but they are locally aggressive. Total surgical excision offers the best chance for cure.
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A 31-year-old woman had cholecystectomy for recurrent acute cholecystitis. Pathologic examination of the resected gallbladder revealed unsuspected histiocytic lymphoma. A staging laparotomy seven weeks after cholecystectomy revealed disseminated disease. Lymphomatous involvement of the gallbladder is rarely diagnosed antemortem and indicates disseminated disease until proved otherwise.
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A newborn presented with airway obstruction due to a large nasopharyngeal mass extending into the oropharynx. A diagnosis of teratoma was made by transoral fine needle aspiration (FNA) biopsy and confirmed by subsequent histologic studies. The cytologic features of nasopharyngeal teratoma are presented, and the diagnostic utility of FNA biopsy in evaluating such lesions is discussed.