Biomedical subjects

J R Oppenheimer

Publications and source records attributed to J R Oppenheimer.

9 recordsLinked to original sources

PubMed1998

Partial atrophy in prostate needle cores: another diagnostic pitfall for the surgical pathologist.

We have seen in consultation a variant of atrophy, which is frequently confused with well-differentiated adenocarcinoma of the prostate. We have designated this entity as partial atrophy to distinguish it from its more common counterpart of fully developed atrophy. Partial atrophy is defined as benign prostate glands with relatively scant cytoplasm, yet the glands are not fully atrophic in that they do not appear basophilic at low magnification. Fifty-one cases of partial atrophy were identified (4 from Johns Hopkins Hospital, 47 from consultation). Within the partial atrophy focus, irregular (crinkled) nuclei were frequent in 23.5% and occasionally present in 33.3% of cases. Visible nucleoli were frequent in 25.4% of cases. Basal cells were not identifiable in 27.4% of cases or were hard to identify in 35.3% of cases. No intraluminal crystalloids or blue-tinged mucinous secretion was identified in partial atrophy. Adenocarcinoma or glands suspicious for cancer were present in other cores in 15.6% of cases. More fully developed atrophy was present in simultaneously obtained needle cores in 35.3% of cases. In the cases in which regular atrophy was the only coexisting condition, it was present within one 10x field from the partial atrophy in 22.2%, farther than one 10x field from the partial atrophy in 11.1%, and present in the same gland as the partial atrophy in 66.7%. Partial atrophy may be confused with low-grade adenocarcinoma because of the focus of crowded glands, irregular nuclei, and visible nucleoli. Clues for recognizing partial atrophy include relatively scant cytoplasm, distinct crinkled nuclei, pale cytoplasm similar to adjacent, more recognizably benign glands, and association with more fully developed benign atrophy.

Adenocarcinoma↗

PubMed1997

Granulomatous prostatitis on needle biopsy.

OBJECTIVE: To assess pathologic findings of granulomatous prostatitis (GP) on needle biopsy. DESIGN: Ninety-four cases of granulomatous prostatitis were culled from 25,852 (incidence 0.36%) consecutive men who underwent needle biopsy; clinical correlations were obtained for 75. Cases were categorized as nonspecific (NSGP, 77.7%), infectious (IGP, 18.1%), or indeterminate (4.3%) granulomatous prostatitis based on histologic and clinical criteria. SETTING: Consecutive cases from a large commercial laboratory and consultation cases. RESULTS: All cases of IGP had a history of prior bacillus Calmette-Guerin therapy for transitional cell carcinoma. Histologically, 57% of NSGP cases mimicked infection and 4% mimicked cancer. Caseating necrosis was identified in 76% of cases of IGP. Significant numbers of eosinophils were found in 68% of NSGP cases, but in only 12% of IGP cases. In no case was eosinophilia documented in peripheral blood. Multinucleated giant cells were absent or rare in 69% of NSGP cases. Significant numbers of neutrophils were found in 53% of NSGP cases, but in only 29% of IGP cases. At the time of biopsy, cancer was clinically suspected in 55% of cases categorized as NSGP and 73% categorized as IGP. Serum prostate-specific antigen ranged from less than 0.5 ng/mL to 114 ng/mL (mean 12.7 ng/mL) in NSGP and from 0.9 ng/mL to 9.7 ng/mL (mean 4.2 ng/mL) in IGP. Digital rectal exam was abnormal in 69% and 91% of NSGP and IGP cases, respectively. Transrectal ultrasound was abnormal in 77% and 100% of NSGP and IGP cases, respectively. There was no correlation between the extent of core involvement with either clinical impression, prostate-specific antigen levels, transrectal ultrasound, or digital rectal exam. Thirty additional granulomatous prostatitis cases on needle biopsy were obtained from the consultation files of one of the authors. The major difference in this group was a higher percentage of cases histologically mimicking cancer (20%); two cases were misdiagnosed by the referring pathologist as high-grade cancer. CONCLUSIONS: While NSGP is the most common granulomatous prostatitis seen on needle biopsy, bacillus Calmette-Guerin granulomas are not seen infrequently. Lesser known histologic features of NSGP were the frequent finding of neutrophils and eosinophils and infrequent multinucleated giant cells. Granulomatous prostatitis may be clinically indistinguishable from cancer, and NSGP may also histologically mimic carcinoma.

Adult↗

PubMed1980

The effect of parental relationships on the management of cystic fibrosis and guidelines for social work intervention.

Cystic fibrosis is a multiple-system chronic disease of genetic origin usually manifested in infancy or early childhood resulting in an abbreviated life span of its victims. Effective management on a daily basis consists of complex regimens which impose a heavy burden on parents. Failure to adhere to them can result in episodes of recurrent lung infection which can further shorten the life span of the patient. The present rate of family breakdown in the United States is a factor that needs to be recognized in the home management of the "CF" patient. This study of 37 families explores the impact of parental relationships on the home care of CF children. Its findings confirm that children living at home with two natural parents received more optimal care and were in better physical condition than those with only one natural parent. This paper suggests guidelines for social work intervention to promote more effective home management of the child with this disease and to counteract when indicated the effect of the loss of traditional parental relationships.

Age Factors↗

PubMed1973