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J Kollin

Publications and source records attributed to J Kollin.

13 recordsLinked to original sources

Contribution of emphysema and small airways in COPD.

BACKGROUND: The contribution and role of emphysema and small airways disease in causing expiratory airflow limitation in COPD is controversial. METHODS: We obtained high-resolution thin-section 2-mm CT scans of the lung for emphysema grading and lung function in 116 consecutively seen COPD outpatients with fixed expiratory airflow limitation. In this group, inflated whole lung(s) were subsequently obtained in 24 patients (23 autopsy, 1 surgery) for morphologic studies and results compared with lung CT. Airway histologic condition was studied in 17 of the 24 patients. RESULTS: There was fair to weak negative correlation between CT emphysema score and either FEV1/FVC percent (r = -0.51, p = 0.001) or FEV1 percent predicted (r = -0.31, p = 0.001). In only 24 of the 81 patients (30%) with FEV1 less than 50% predicted, the CT emphysema score was 60 or more, indicating severe emphysema. In the 24 patients studied, there was a good correlation (r = 0.86, p = 0.001) between CT and pathologic grade of emphysema. While respiratory bronchioles (RBs) and membranous bronchioles (MBs) demonstrated marked morphologic abnormalities, there was a weak correlation with emphysema grade (for RB, r = 0.36, p = 0.16; for MB, r = 0.41, p = 0.10) or with FEV1 percent predicted (for RB, r = -0.21, p = 0.42; for MB, r = -0.28, p = 0.28). There was no correlation between emphysema and FEV1 percent predicted (r = -0.13, p = 0.54). CONCLUSIONS: High-resolution CT lung scans are an in vivo surrogate to quantitate moderate to severe morphologic emphysema. Emphysema does not appear to be primarily responsible for severe expiratory airflow limitation in most patients with severe COPD. There was no correlation between severity of small airway histologic condition and emphysema or FEV1 percent predicted. The causes of the lesions responsible for small airways obstruction need to be identified.

Aged↗

Pathology review in an early prostate cancer detection program: results from the American Cancer Society-National Prostate Cancer Detection Project.

Biopsy materials obtained in the American Cancer Society National Prostate Cancer Detection Project were reviewed at the Central Pathology Laboratory at the Armed Forces Institute of Pathology. Of 265 cases submitted, 177 were diagnosed as prostatic carcinoma, 7 as prostatic intraepithelial neoplasia (PIN), 13 as atypical glands or atypical hyperplasia, and the remaining 68 were benign hyperplasias. Irrespective of the means of detectin or the grading system used (Gleason or WHO-Mostofi), a large majority of the cancers were detected as low-grade tumors. Of 27 cases of PIN reported, 20 were associated with cancer, leaving 7 cases with the sole diagnosis of PIN. These data may indicate the increased use of prostate-specific antigen (PSA), digital rectal examination (DRE), and transrectal ultrasound (TRUS) in the United States is shifting the spectrum of prostate cancer pathology toward early low-grade tumors.

Biopsy↗

Hemihypertrophy as possible sign of renal cell carcinoma.

In infants and children there is a well-recognized association of hemihypertrophy with visceral malignancies, including those of the kidney as well as benign renal disorders. As a result of our report on an adult with segmental hemihypertrophy and renal cell carcinoma, we suggest that if this combination represents an association similar to that found in children, a radiographic-urologic evaluation is needed to diagnose renal neoplasms at an early stage, and to disclose the presence of treatable benign renal disease.

Carcinoma, Renal Cell↗

Pyocele of scrotum: consequence of spontaneous rupture of testicular abscess.

We report 2 cases of spontaneous rupture of the testis secondary to suppurative epididymo-orchitis. Both cases presented with pyoceles and were treated conservatively by scrotal incision and drainage of the pyoceles. This prolonged hospital stay and increased morbidity, since both patients ultimately required orchiectomy. We believe that a pyocele is an indication for prompt surgical exploration, and if the testis is ruptured, an orchiectomy should be done.

Abscess↗

Primary pulmonary angiosarcoma associated with multiple synchronous neoplasms.

A 60-year-old man presented with a 3-month history of shortness of breath. He was found to have a right thoracic mass involving the right middle and lower lobes, pulmonary hilum, and mediastinum. Diagnosis could not be established by pleural fluid cytology, pleural biopsies, bronchoscopy, and ultrasound-guided needle biopsies. A diagnostic exploratory thoracotomy was performed. Massive hemorrhage was encountered upon opening the pleura, and bleeding was controlled by performing a radical pneumonectomy. Histology revealed angiosarcoma, pulmonary primary. The patient survived for 68 days. At autopsy, he was found to have adenocarcinoma of the prostate, adenocarcinoma of the rectum, carcinoid of the ileum, and leiomyoblastoma of the stomach as well as diffuse metastases from the angiosarcoma. This represents the fourth reported case of primary pulmonary angiosarcoma.

Adenocarcinoma↗

The coexistence of carcinoid tumor and Crohn's disease.

We report what we take to be the ninth case of an intestinal carcinoid tumor coexisting with Crohn's disease; we believe that it is also the first case of Crohn's disease in which the carcinoid tumor involved both the small and large bowel, as well as the appendix. The two lesions may be remarkably similar in their clinical presentation, gross appearances, and radiologic features. We suggest that the actual incidence of their coexistence may be greater than the few reports suggest.

Carcinoid Tumor↗

Recurrence of papillary thyroid carcinoma presenting as a focal neurologic deficit.

Papillary-follicular thyroid carcinoma usually remains localized to the thyroid bed and, in cases of metastasis, almost always involves the lung, bone, or liver. The two patients described here presented with papillary carcinoma and neurologic dysfunction. Total body iodine 131 scans disclosed cerebral uptake, and cerebral masses were confirmed by computed tomographic scan. Both patients presented diagnostic and therapeutic dilemmas, and ultimately underwent craniotomy. One patient's cerebral metastasis recurred and was treated by a second craniotomy. The other patient received postoperative external cerebral radiotherapy and a novel intraoperative treatment: implantation of 22 iodine 125 seeds in the tumor bed, estimated to yield 16,000 rad (160 Gy) in one year. To date, cerebral metastases have not recurred in the latter patient, although tumor has reappeared in other sites. There is little reported in the medical literature concerning cerebral metastases of thyroid carcinoma, and the present report reviews this experience and discusses treatment alternatives.

Adenocarcinoma↗

Carcinoma of the thyroid with a mixed medullary, papillary, follicular, and undifferentiated pattern.

While papillary and follicular thyroid carcinomas are frequently mixed, this is a case of a medullary, papillary, follicular, and undifferentiated carcinoma of the same gland. In addition, all four tumor types were metastatic to regional lymph nodes. The patient described herein did not demonstrate features of the multiple endocrine neoplasia type 2 syndrome. Immunoperoxidase staining for calcitonin and thyroglobulin was positive in the follicular and medullary areas of tumor. Because the embryologic origin of the thyroidal follicular cells is from the endoderm and the origin of the parafollicular cells of the medullary carcinoma is from the ectodermal neural crest, this case seems noteworthy for demonstrating mixed metastatic tumor of composite embryologic origin. Alternatively, this case may represent an extension of what has recently been termed differentiated thyroid carcinoma, intermediate type by Ljungberg and co-workers.

Calcitonin↗

Secondary carcinoma of the penis.

Secondary tumors of the penis are rare. The genitourinary and gastrointestinal tracts are the most common sites of origin. Immunoperoxidase tissue stains are useful in determining the primary site of secondary tumors of the penis. We report 2 such cases with primary tumors in the colon and rectum.

Adenocarcinoma↗

I-131 total-body scan: localization of disseminated gastric adenocarcinoma. Case report and survey of the literature.

This is a case of striking radioiodine and [99mTc]pertechnetate uptake by disseminated nonthyroidal (gastric) adenocarcinoma. A 65-yr-old man was euthyroid and serum thyroglobulin concentration was normal at 11 ng/ml. Bone-marrow biopsy showed that the metastatic tumor cells were negative for thyroglobulin on immunoperoxidase stain and the secretory product was mucicarmine-positive. We estimate that radioiodine uptake in the normal thyroid gland was less than 10% of total tumor uptake. At autopsy, the stomach was the site of the primary tumor, which had the same cellular and histochemical characteristics as the metastatic lesions in bone and liver. It is emphasized that the use of pertechnetate for screening patients with gastric adenocarcinoma may be clinically useful in the early detection of metastatic lesions.

Adenocarcinoma, Mucinous↗

Alpha-feto protein in the serum of patients with primary gastric cancer and liver metastases.

The authors presented a patient with primary gastric cancer and liver metastases. They permanently observed the AFP concentrations before, during and after cytostatic therapy. At the same time they examined possible sites of AFP production. It is supposed that AFP neo-synthesis takes place in the secondary site with participation of altered liver cells. In such cases it is important to watch the AFP values, and this is also necessary when the primary source of the secondary liver cancer is not known. Cytostatic drugs act only in a palliative way i.e. AFP concentrations drop to a lower level and the patient feels temporarily better.

Adenocarcinoma↗