The pathology of pancreatic cancer.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
J Rode
Publications and source records attributed to J Rode.
Development of gastric dysplasia in pernicious anaemia: a clinical and endoscopic follow up study of 80 patients.
The development of gastric dysplasia and neoplasia in patients with pernicious anaemia has been evaluated in a prospective clinical and endoscopic follow up study. After initial screening of 80 patients between 1978 and 1980, one patient underwent total gastrectomy for a gastric malignancy and 12 were kept under surveillance and underwent endoscopy at a mean interval of 14 months. In the remaining 67 patients further investigation was attempted six to seven years after the initial investigation. The continuous follow up study identified carcinoids in one patient and an adenoma with severe dysplasia in a further patient. The grade and site of mucosal dysplasia differed from one investigation to the next, but no overall progression was observed. Of the 79 patients, eight had died by the time of the reinvestigation, two of unknown cause and six of causes unrelated to pernicious anaemia. In 38 of the remaining 71 patients, clinical data only were available, with no evidence of new gastric malignancy. In 27 patients it was possible to perform an upper gastrointestinal endoscopy, when no change in the degree of dysplasia was detected. In six patients no follow up information was obtainable. In conclusion, patients with pernicious anaemia should be investigated by upper gastrointestinal endoscopy soon after diagnosis. Polyps should be removed wherever possible. In the presence of severe mucosal dysplasia or polyps that are not removed, frequent reinvestigation should be performed, provided the patient is eligible for gastric surgery. In the remaining patients, follow up endoscopies at about five year intervals would seem sufficient.
Adenoma↗
Villous adenoma of the common hepatic duct: the role of ultrasound in management.
A case of villous adenoma of the common hepatic duct causing obstructive jaundice, where the diagnosis was made by ultrasound guided percutaneous biopsy is reported. At surgery ultrasonography was used to define the extent and operability of the tumour.
Adenoma↗
Paraganglial cells of urinary bladder and prostate: potential diagnostic problem.
A transurethral prostatic resection for prostatism in a 73 year old man showed a cluster of richly capillarised clear cells originally thought to be indicative of invasive carcinoma. Immunohistochemical studies were carried out on this tissue specimen and three similar cases using a variety of antibodies--Neuron specific enolase, PGP 9.5, chromogranin, synaptophysin, serotonin, somatostatin, substance P, calcitonin, calcitonin gene related peptide, met-enkephalin, VIP, neurofilament, CAM 5.2, S100 protein, prostatic specific antigen and prostatic acid phosphatase. The cellular foci were shown to be composed of paraganglionic cells. The cell clusters were well defined and predominantly comprised clear cells with scanty, fine eosinophilic cytoplasmic granules in three cases. The cell nuclei were round to oval, moderately pleomorphic, with evenly dispersed dense chromatin. It is concluded that the presence of minute foci of paraganglial cells in the bladder wall and prostate gland may be misinterpreted as malignant because of their close association with nerves and their relative rarity. Immunohistochemical staining with neuroendocrine markers should dispel any doubt about their identity.
Aged↗
Ultrasound-guided core biopsy.
Between February, 1986, and September, 1988, 404 biopsies have been done, under ultrasound guidance, with a cutting needle fired by a spring-loaded device. Sensitivity for a diagnosis of malignancy was 92.7%; overall accuracy was 94.1%; the predictive value of a positive result was 100% and the complication rate was low. An exact diagnosis could be made from histological examination of the specimen obtained from 98% of positive tumour biopsies. This technique is a simple and safe way to obtain specimens for accurate histological diagnosis.
Adult↗
Detection of human probombesin mRNA in neuroendocrine (small cell) carcinoma of the lung. In situ hybridization with cRNA probe.
The production of human bombesin (gastrin-releasing peptide), a peptide with mitogenic action, is a recognized feature of neuroendocrine (small cell) carcinoma of the lung. However, immunostaining of bombesin is not always possible in these tumors, probably because of poor storage mechanisms or rapid release of hormone. Molecular biological analysis of the gene encoding human bombesin has revealed the DNA sequence of human pro-bombesin. We have used in situ hybridization to study the expression of the human bombesin gene at the cellular level in small cell carcinoma of the lung. Probombesin cDNA was subcloned in pSP64 vector, linearized with Bam HI and transcribed in the presence of phosphorus 32(32P)-cytosine triphosphate (CTP) and SP6 polymerase. The cRNA probe was applied to tissue sections (from six cases of small cell carcinoma of the lung, freshly fixed in 4% paraformaldehyde), cell culture preparations (two different cell lines of small cell carcinoma), and cytologic specimens (smears of cells from three different cases of small cell carcinoma). Hybridization of probombesin mRNA was detected in tumor cells in all samples. Specificity of the signal was determined by control experiments, including the use of a probe which has a sequence identical to probombesin mRNA. Our results provide evidence for the expression of the bombesin gene in small cell carcinoma of the lung at a cellular level and show that probombesin mRNA is highly expressed in these tumors.
Bombesin↗
Elastic fibres in patients with systemic sclerosis. A morphological study.
Dermal elastic fibres in biopsies taken from sun-exposed involved digital skin and sun-protected uninvolved skin on the medial aspect of the upper arms from 13 patients with systemic sclerosis were examined by light and transmission electron microscopy. For controls, biopsies were taken from similar sites from 4 age- and sex-matched healthy volunteers and 4 patients with primary Raynaud's phenomenon. On light microscopy only the control digital biopsies showed mild actinic changes of the elastic fibres whereas in all the biopsies from patients with systemic sclerosis identical changes of thickening, clumping and fragmentation of the elastic fibres were observed. Quantitative assessment of the dermal elastic fibres using microdensitometry and video image analysis showed no significant difference between the patients and controls. On electron microscopy more advanced abnormalities similar to those seen in actinic damage and chronological aging were found in the biopsies from all the patients with systemic sclerosis compared to the controls.
Adult↗
Neuroendocrine cell proliferations in gastric antral vascular ectasia.
Gastric antral vascular ectasia is a recently recognized cause of chronic gastrointestinal blood loss. Immunohistochemical and electron-microscopic studies were performed on the surgically resected antrum of a patient with antral vascular ectasia. These revealed extraepithelial and intraepithelial neuroendocrine cell proliferations. Staining for a wide range of neural and endocrine markers demonstrated that these cells contain large quantities of 5-hydroxytryptamine and vasoactive intestinal polypeptide. Gastric vascular ectasia is of unknown etiology but has been associated with achlorhydria and liver cirrhosis. The findings suggest that locally released neurotransmitters may be responsible for local vasodilation and hence a propensity to bleed.
Aged↗
Fine needle cytology versus histology.
Explore the source record for details and available documents.
Biopsy, Needle↗
Annular pancreas: a clinical, endoscopic, and immunohistochemical study.
A patient with annular pancreas presenting with severe upper abdominal pain is discussed. Endoscopic retrograde cholangiopancreatography (ERCP) was diagnostic, with successful injection of major and minor papillae showing pancreas divisum, an annular duct emptying at the major papilla and changes of severe chronic pancreatitis in all duct systems. Pylorus preserving pancreatoduodenectomy gave complete pain relief. The annulus was shown immunohistochemically to be entirely of ventral gland origin. Chronic pancreatitis was histologically less severe in the dorsal gland. Antegrade dye injection with x-ray showed dorsal to ventral connection in the resected specimen.
Adult↗
Pernicious anaemia and Campylobacter like organisms; is the gastric antrum resistant to colonisation?
Gastric biopsies from 86 patients with pernicious anaemia were examined for Campylobacter like organisms with particular attention to those showing an antral gastritis in addition to the usual pattern of body gastritis. All the patients had chronic atrophic gastritis in the body but Campylobacter like organisms were found at this site in only three patients. Thus the Type A pattern of gastritis (autoimmune) seen in patients with pernicious anaemia is only rarely associated with Campylobacter like organisms. Forty four of these patients had biopsies from body and antrum, 16 showed an antral gastritis of whom only one had Campylobacter like organism present. Twenty five of this latter group of patients were rebiopsied after five years. There was no change in the pattern of gastritis, and the same single patient remained colonised. The frequency of an antral gastritis in patients with pernicious anaemia was 36% yet the frequency of antral colonisation by Campylobacter like organisms was very low (6%). These results show that, as in the body, Campylobacter like organisms are not associated with gastritis when it occurs at this site in pernicious anaemia. The antral gastritis that may accompany body gastritis in pernicious anaemia seems more likely therefore to be an extension of primary type A body gastritis (autoimmune) rather than a secondary type B (chronic) gastritis and, it is argued, the antrum may exhibit resistance to colonisation.
Adult↗
Percutaneous fine needle aspiration cytology of the pancreas: advantages and pitfalls.
Fine needle aspiration of the pancreas was performed in 62 patients with radiological suspicion of malignancy. All fine needle aspirates were taken under computed tomography or ultrasound guidance. Fine needle aspirates were positive in 31 of 41 patients with histologically or clinically confirmed pancreatic carcinoma. There were no false positive results. The sensitivity of this method for detecting malignant disease was 86%. Cytology was not able to provide conclusive results of benign conditions. Difficulties were encountered in diagnosing well differentiated carcinoma and neuroendocrine tumours and distinguishing them from reactive epithelium and islet cell hyperplasia, respectively. This resulted in a 12.1% false negative rate. There were no complications in our series. Percutaneous fine needle aspiration proved a reliable method of diagnosing pancreatic carcinoma.
Adenoma, Islet Cell↗
Repopulation of guinea-pig skin by melanocytes during wound healing: a morphometric study.
Epidermal keratinocytes and melanocytes have a close functional interrelationship. In order to study this relationship we used computer-assisted three-dimensional morphometry (CAM) to investigate the shape and size changes of the cutaneous melanocyte in healing guinea-pig skin. The combination of CAM with osmium iodide staining and resin embedding of tissue gave excellent results and allowed qualitative and quantitative morphometric assessment of melanocytes in vertical epidermal sections. The changes in melanocytes and keratinocytes during healing of a standard 1 cm full thickness wound in the guinea-pig were studied. After an initial decrease, more melanocytes per mm2 of epidermis were seen (from 36 days). These were smaller in volume with shorter, less branched dendrites compared to controls. An unexpected finding was a late phase of melanocyte proliferation, at the end of our study period (99 days). Clearly, the complex changes in the melanocyte-keratinocyte relationship during wound healing continue throughout and beyond the period of our study.
Animals↗
Effects of ketamine, xylazine, and a combination of ketamine and xylazine in Pekin ducks.
Effects of ketamine, xylazine, and a combination of ketamine and xylazine were studied in 12 male Pekin ducks (7 to 12 weeks old; mean [+/- SD] body weight, 3.1 +/- 0.3 kg). After venous and arterial catheterization and fixation of a temperature probe in the cloaca, each awake duck was confined, but not restrained, in an open box in a dimly lit room. Blood pressure and lead-II ECG were recorded. Three arterial blood samples were collected every 15 minutes over a 45-minute period (control period) and were analyzed for pHa, PaCO2 and PaO2. After the control period, each duck was assigned at random to 1 of 3 drug groups: (1) ketamine (KET; 20 mg/kg of body weight, IV), (2) xylazine (XYL; 1 mg/kg, IV), and (3) KET + XYL (KET 20 mg/kg and XYL, 1 mg/kg; IV). Measurements were made at 1, 5, 10, 15, 30, 45, 60, and 90 minutes after drug administration. All ducks survived the drug study. Cloacal temperature was significantly (P less than or equal to 0.05) increased above control cloacal temperature at 90 minutes after the administration of ketamine, and from 10 through 90 minutes after administration of ketamine plus xylazine. In ducks of the KET group, pHa, PaCO2, and PaO2, remained unchanged after administration of the drug. In ducks of the XYL group, pHa and PaO2 decreased significantly (P less than or equal to 0.05) from control values for all time points up to and including 15 minutes after drug administration.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Isoflurane anesthesia in sandhill cranes (Grus canadensis): minimal anesthetic concentration and cardiopulmonary dose-response during spontaneous and controlled breathing.
Information on species differences in responses to inhalation anesthetics has been established in a variety of mammalian and non-mammalian species, but comparable studies have not been reported in birds. The purpose of this study was to determine minimal anesthetic concentration and cardiopulmonary concentration-response effects of isoflurane in Sandhill cranes. Six cranes were anesthetized with isoflurane in oxygen. Gases sampled through a polyethylene tube inserted to the distal end of an endotracheal tube were used for measurements of isoflurane concentrations using an infrared gas analyzer. Body temperature was maintained at 40 +/- 0.5 degrees C. The minimal anesthetic concentration for isoflurane was determined during spontaneous ventilation, and concentration-response data were collected at 1, 1.5, and 2.0 times the minimal anesthetic concentration. Concentration-response data were repeated during mechanically controlled breathing with PaCO2 maintained between 27 and 35 mm Hg. The minimal anesthetic concentration for isoflurane was 1.34 +/- 0.14 vol% (mean +/- SD). Concentration-dependent respiratory depression during spontaneous breathing was evidenced in all cranes by an increase in PaCO2. Isoflurane induced apnea in two of the cranes during spontaneous ventilation at 2 times the minimal anesthetic concentration. As the concentration of isoflurane was increased, mean arterial blood pressure decreased during both spontaneous and controlled ventilation. Mean arterial blood pressure was higher during controlled ventilation than during spontaneous ventilation. The minimal anesthetic concentration for isoflurane in Sandhill cranes is similar to values for isoflurane minimal anesthetic concentration in mammals. Isoflurane has dose-dependent effects on cardiopulmonary function qualitatively similar to those observed in mammals.
Anesthesia↗
Obstructive pancreatitis: unusual causes of chronic pancreatitis.
Fifty-eight consecutive surgical pancreatic resections for chronic pancreatitis were examined. Eight cases were identified with obstructive pancreatopathy; all underwent pancreato-duodenectomy. Histological examination revealed that obstruction in three cases was due to duodenal wall cysts, and in two patients it was associated with pancreas divisum (the accessory papilla was obstructed by a neuroendocrine tumour in one case and by ectopic pancreatic tissue in the other). One case each was due to obstruction of an anomalous duct by vegetable matter, to segmental pancreatitis, and to an intraductal carcinoma. Obstructive pancreatitis has many causes and diligent pre-operative assessment is required as surgical resection may be beneficial. Special efforts should be made to identify ductal anomalies, duodenal cysts, ectopic pancreatic tissue, and small ampullary tumours of exocrine and endocrine origin in order to define the aetiology of pancreatitis.
Adult↗
Endocrine differentiation in inflamed urinary bladder epithelium with metaplastic changes.
Several types of metaplasia can occur in human bladder epithelium under certain pathological conditions. We investigated 65 cases of cystitis, associated with different types of metaplasia, for the presence of endocrine cells, using histochemical and immunocytochemical methods. Tissues were obtained at cystoscopy and were routinely fixed in 10% buffered formalin. Endocrine cells were demonstrated, between the epithelial cells, in 40 out of 50 cases of cystitis glandularis or cystica. These cells were positive by the Grimelius' silver impregnation technique and were immunoreactive for protein gene product (PGP 9.5), a new general neuroendocrine marker, chromogranin and serotonin. No endocrine cells were detected in any of the specimens of normal epithelium nor those showing squamous metaplasia. Eighteen of these cases showed prominent nerve bundles in the subepithelial tissue, as revealed by PGP immunoreactivity.
Cystitis↗
Inflammatory pseudotumour of the liver.
A case of inflammatory pseudotumour of the liver is described, the twelfth such case reported. Although these lesions are benign and self-limiting, they may encroach upon the biliary tree or portal vein and may be confused with true hepatic neoplasia. In the presence of single or multiple hepatic deposits seen on radiologic examination, a history of fever (or other systemic symptoms) and a negative fine needle aspiration biopsy should raise the possibility of inflammatory pseudotumour and prompt formal biopsy to guide further treatment.
Adult↗