Biomedical subjects

J L Walloch

Publications and source records attributed to J L Walloch.

9 recordsLinked to original sources

PubMed1998

Simplified immunophenotypic analysis by laser scanning cytometry.

Immunophenotypic analysis of hematologic specimens is a useful laboratory adjunct to surgical pathology and cytology to confirm or further characterize diagnoses of leukemia or lymphoma. Laser scanning cytometry is a new laboratory technology that has been adapted to perform immunophenotypic analysis of hematologic specimens, with numerous advantages as compared with flow cytometry. In order to make full use of the laser scanning cytometer's capabilities, a new method of specimen preparation and means of performing the immunofluorescent reactions was developed. The technique described in this report, specific only to laser scanning cytometry, enables panels of up to 36 different antibodies to be used on specimens as small as 50,000 total cells. The laboratory methodology is simple, requires 85% less antibody than flow cytometric methods, and allows individual cell cytologic morphology to be correlated with objective physical and fluorescent measurements on a cell-by-cell basis. Other advantages are described in the text. Over the course of nine months in our community hospital, we have used this technique clinically to analyze 172 cases of suspected leukemia or lymphoma. The method has proven remarkably useful, particularly for extremely small specimens such as fine needle aspiration biopsies.

Antigens, CD↗

PubMed1997

Multiparameter analysis of DNA content and cytokeratin expression in breast carcinoma by laser scanning cytometry.

OBJECTIVE: The objective of this study was to test a new laboratory technology, laser scanning cytometry, for the purpose of performing multiparameter DNA content analysis of breast carcinomas. DESIGN: We developed a simplified method of multiparameter DNA content analysis using cytokeratin expression to positively gate epithelial cells. Over 300 consecutive cases of breast carcinoma were analyzed by multiparameter laser scanning cytometry. The first 73 cases were analyzed in parallel by single parameter flow cytometry. SETTING: The Department of Pathology, Christ Hospital and Medical Center, Oak Lawn, Ill. SPECIMENS: Three hundred eighteen consecutive cases of breast carcinoma presenting between March 1994 and December 1995. MAIN OUTCOME MEASURES: Outcome measures included the percentage of cases for which DNA content analysis could be successfully performed given the limitations of specimen size. Additionally, for the first 73 cases, laser scanning cytometry results were compared with flow cytometry results. RESULTS: All of the first 73 cases were successfully analyzed by laser scanning cytometry, but for 8 cases (11%) there was insufficient material for flow cytometry. Correlation of DNA content for the remaining 65 cases analyzed in parallel by the two methods was nearly perfect (p = .994). Five seemingly discrepant cases highlighted the importance of cytokeratin gating of epithelial cells by any technique, as well as other advantages specific to laser scanning cytometry, such as the ability to examine individual cells microscopically and correlate cytologic morphology with DNA content results. CONCLUSIONS: Laser scanning cytometry is a promising new technology for DNA content analysis of solid tissue tumors. Further work needs to be performed to validate the prognostic potential of the laser scanning cytometric assay results and to generate methodologies aimed at providing highly objective determinations of tumor cell S-phase fraction.

Biomarkers, Tumor↗

PubMed1996

Immunophenotypic analysis of hematologic malignancy by laser scanning cytometry.

The authors tested a newly-developed computerized laser scanning cytometer (LSC) as a means of performing immunophenotypic analysis of hematologic specimens within their community hospital. Results were compared on a case-by-case basis with parallel flow cytometric and immunohistochemical data. A total of 71 specimens analyzed include 22 excised lymph nodes or other tissue biopsies, 18 peripheral bloods, 17 bone marrow aspirates, 7 body fluids, and 7 fine-needle aspiration biopsies of lymphoid tissue. The LSC proved to be a useful instrument capable of generating simultaneous two-color immunofluorescent data directly analogous to that obtained via conventional flow cytometry. However, laser scanning cytometric analysis provides advantages over flow cytometric analysis, because the LSC measures cells on a slide rather than in a fluid stream. Specifically, cells can be microscopically examined at any time--before, during, or after automated immunofluorescent analysis. In addition, specimen preparation techniques are less restricted and more cost efficient. Lastly, even extremely small and/or hypocellular specimens (such as body fluids and fine-needle aspiration biopsies) can be successfully analyzed.

Diagnosis, Computer-Assisted↗

PubMed1993

Prostatic cystic epithelial-stromal tumors: a report of 2 new cases.

The case records of 2 patients recently treated at our medical centers with prostatic cystic epithelial-stromal tumor (ages 22 and 62 years), as well as 14 cases previously reported in the literature were reviewed to obtain a consensus as to the therapy for this uncommon malignancy. Patients with prostatic cystic epithelial-stromal tumor often present with obstructive voiding symptoms and a palpable suprapubic mass. Computerized tomography typically reveals a huge, complex retrovesical mass with displacement of surrounding pelvic and abdominal structures, which may invade locally into the bladder, ureters or rectal wall. Our experience with immunohistochemical staining of these tumors suggests an epithelial component that is positive for prostate specific antigen, prostatic acid phosphatase, epithelial membrane antigen, chorioembryonic antigen and cytokeratin, and a stromal component that is positive for vimentin, desmin, cytokeratin and myosin. Rapid recurrences are the rule in patients in whom the tumor is incompletely resected. Histological evidence of malignant transformation and distant metastases has been reported in these neoplasms. An aggressive surgical approach aimed at total removal of this pelvic tumor will be discussed.

Adult↗

PubMed1992

Female urethral diverticular with clear cell adenocarcinoma.

Clear cell adenocarcinoma in a urethral diverticulum in the female is a very rare and unusual tumor. We recently treated two patients with this tumor. Their presentation, histologic evaluation, and management are reviewed in light of the limited experience in the literature.

Adenocarcinoma↗

PubMed1990

Pulmonary plasma cell granuloma (inflammatory pseudotumor) with invasion of thoracic vertebra.

Plasma cell granulomas (inflammatory pseudotumors) frequently appear as localized benign tumors of the lung in patients under 30 years of age. We describe the case of a 54-year-old woman with a plasma cell granuloma originating in the left lower lobe of lung and extending into the posterior mediastinum with destruction of the T8 vertebral body and pedicle. Distinctive histologic features included granulomatous aggregation of mature plasma cells around small blood vessels and direct invasion of the posterior mediastinum with subsequent dense fibrosis and bony destruction. Immunohistochemical studies revealed polyclonal kappa- and lambda-light chains in the proliferation of plasma cells.

Female↗

PubMed1989

Decreased dehydroepiandrosterone sulfate in pigmented nodular adrenal dysplasia.

Previous reports on patients with endogenous Cushing's syndrome describe low concentrations of the adrenal androgen dehydroepiandrosterone sulfate (DHEA-S) in adrenal adenoma and in a case of feminizing macronodular hyperplasia. Here we present hormonal data from two adult sisters with Cushing's syndrome as a result of pigmented nodular adrenal dysplasia. Corticotropin concentrations were in the mid-normal range, cortisol production was unaffected by administration of dexamethasone (8 mg/24 h), and baseline concentrations of DHEA-S were less than 0.5 mumol/L. A low concentration of DHEA-S in these and other previously reported patients with Cushing's syndrome correctly predicts the results of dynamic testing. Decreased DHEA-S in a patient with endogenous Cushing's syndrome can be ascertained by assay of a single sample and should prompt consideration of the diagnosis of autonomous bilateral nodular disease as well as adrenal adenoma.

Adrenal Glands↗

PubMed1988

Needle biopsy of nodular thyroid disease.

To evaluate nodular thyroid disease, 150 patients underwent 169 fine needle biopsies (FNB) and recently 28 have also had core needle biopsies (CNB). Multiple biopsies were required in 19 patients because of multiple lesions, reaccumulation of cysts, follow-up of nodules failing to regress, or inadequate material. Adequate material was obtained in 97 per cent of FNB and 92 per cent of CNB. FNB and CNB agreed in 20 of 28 cases. There were no complications with FNB and one patient (4%) hemorrhaged with CNB. Forty nine patients underwent thyroidectomy. Postoperative diagnoses include papillary carcinoma (9), follicular carcinoma (2), lymphoma (2), medullary carcinoma (1), metastatic carcinoma (1), benign nodular goiter (14), follicular neoplasm (15), and thyroiditis (5). Sixty per cent of patients avoided surgery, 61 per cent of operated specimens contained neoplasia and 31 per cent contained malignancy. Eighty seven per cent of malignancies were identified at the initial evaluation. FNB had 86 per cent sensitivity for neoplasia and 44 per cent specificity for neoplasm (94% for papillary carcinoma). CNB had 89 per cent sensitivity and 67 per cent specificity for neoplasm. FNB and CNB are useful means of assessing thyroid nodules for the presence of cancer. They can decrease the need for diagnostic thyroidectomy. However, clinical evaluation must still be used in conjunction when determining the need for thyroidectomy.

Biopsy, Needle↗

PubMedDate not supplied

Multiparameter immunophenotypic analysis of fine needle aspiration biopsies and other hematologic specimens by laser scanning cytometry.

OBJECTIVE: To test the new laboratory technology of laser scanning cytometry with respect to immunophenotyping of all types of hematologic and lymphoreticular specimens and particularly those of limited size, such as fine needle aspiration biopsies and hypocellular body fluids. STUDY DESIGN: Over the course of two years, 343 hematologic and lymphoreticular specimens of all types were immunophenotyped by laser scanning cytometry using methodologies modified from those of conventional flow cytometric immunophenotyping. Results for all cases were corroborated with histology and/or cytology and, for some cases, immunohistochemistry and/or flow cytometric immunophenotyping. RESULTS: Over 98% of the 343 cases were successfully immunophenotyped by laser scanning cytometry. These included many hypocellular specimens, such as 38 fine needle aspiration biopsies and 33 body fluid specimens. CONCLUSION: Laser scanning cytometry is a new laboratory technology with several significant advantages relative to flow cytometry for immunophenotypic analysis of hematologic malignancy. The laboratory techniques are simplified, and antibody usage is reduced by 80%. Even more important, full-panel immunophenotyping with multiple antibodies can be performed on specimens as small as 50,000 cells total, making the technology particularly relevant to cytopathology. After immunophenotypic analysis, specimens can be stained for light microscopic examination, and individual cells meeting user-defined antigenic or physical characteristics can be automatically relocalized.

Adult↗