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J Srigley

Publications and source records attributed to J Srigley.

16 recordsLinked to original sources
PubMed2003

[Mucinous spindle cell carcinoma of the kidney. A molecular analysis].

The new WHO-classification of renal tumors includes new subtypes, one of which is the mucinous, tubular, and spindle cell carcinoma. Many of these tumors had been previously diagnosed as sarcomatoid carcinoma. There are areas of cord-like growth and spindle cell configuration, sometimes with a clear cell appearance. The cells have low-grade nuclear features. It has been postulated that these tumors are related to the loop of Henle. In this study, 21 tumors were immunohistochemically and genetically analyzed. The analysis showed complex genomic aberrations, but no chromosome 3p losses. Fluorescence in situ hybridization detected no von Hippel-Lindau gene deletions on chromosome 3p25, which are characteristic for clear cell renal carcinomas. These findings show that there is no genetic relationship to clear cell renal carcinomas. The results of the immunohistochemical analyses showed a complex immunophenotype, but could not prove a derivation from the loop of Henle. The prognosis of these tumors seems to be favorable.

Adenocarcinoma, Mucinous↗
PubMed1999

Seminal plasma biochemical markers and their association with semen analysis findings.

OBJECTIVES: To examine the clinical value of six seminal plasma components in the evaluation of sperm quality and in the differential diagnosis of men with infertility. METHODS: We analyzed 202 seminal plasmas for prostate-specific antigen, glucose, pepsinogen C, insulin-like growth factor binding protein-3, prostaglandin D synthase (PGDS), and BRCA1-like immunoreactive protein (BRCA1-LIP) using quantitative immunofluorometric procedures. The semen donors were categorized in four clinical groups: normal, oligospermic, azoospermic, and vasectomy patients. We then evaluated whether any of these biochemical markers were associated with other parameters of sperm quality, including patient age, total cell concentration, percentage of motility, and percentage of normal morphology. RESULTS: We found that only PGDS concentration was significantly associated with other parameters of sperm quality. PGDS concentration correlated positively with total cell concentration (r = 0.55), percentage of motility (r = 0.31), and percentage of normal morphology (r = 0.31). Median PGDS concentration in seminal plasma decreased progressively from normal to oligospermic to azoospermic to vasectomy patients (P <0.001). There was no overlap between seminal plasma PGDS concentration of normal subjects versus vasectomy patients. The only other parameter that was moderately decreased in vasectomy patients was BRCA1-LIP. The source of PGDS in seminal plasma was determined with various techniques, including immunohistochemistry. This protein is produced and secreted by the Sertoli cells. CONCLUSIONS: Our findings suggest that PGDS concentration in seminal plasma correlates with other known indicators of semen quality and is a new marker of post-testicular obstruction. This biochemical parameter could be used to aid in the differential diagnosis of obstructive and nonobstructive azoospermia in men with infertility.

Adult↗
PubMed1997

Interobserver variation in prostate cancer Gleason scoring: are there implications for the design of clinical trials and treatment strategies?

A series of prostate cancer histological slides from 71 patients were used to measure the interobserver variation among three pathologists awarding a Gleason score. The study was prompted on account of the use of histological grade to stratify patients prior to randomization within two clinical trials currently recruiting at our centre, and a proposed study that would allocate treatment depending upon the score awarded. The pathologists were expected to award a score based upon their day to day experience, there being no consensus meeting before-hand to agree on the grey areas of the Gleason grading system. We used the kappa statistic to assess the level of agreement. This was calculated both for comparison of the raw scores awarded by the three observers, as well as the grouped scores corresponding to those groupings used for the purposes of stratification in the two trials. The extent of the interobserver variation (weighted kappa) for the raw scores (Gleason scores 2-10) was 0.16 to 0.29 and for the grouped scores (Gleason scores < or = 7 or > or = 8), kappa was 0.15 to 0.29. For the raw scores, the total agreement rate was 9.9% and the total disagreement 26.8%; for the grouped scores the total agreement rate was 43.7%. It is concluded that, despite this level of agreement there is no concern regarding stratification using the Gleason score, because of the subsequent randomization. However, using a reported Gleason score to determine treatment might be inappropriate. These data indicate the value of a central review process for pathology grading in clinical trials, especially where the treatment is directly affected by this information.

Adenocarcinoma↗
PubMed1996

Randomized, prospective, controlled study comparing radical prostatectomy alone and neoadjuvant androgen withdrawal in the treatment of localized prostate cancer. Canadian Urologic Oncology Group.

PURPOSE: A prospective, multicenter, randomized study was done to test the hypothesis that neoadjuvant androgen withdrawal decreases the incidence of positive margins following radical prostatectomy for localized prostate cancer. MATERIALS AND METHODS: Observations were made of 213 patients randomized to undergo radical prostatectomy alone (101) or to receive a 12-week course of 300 mg. cyproterone acetate daily followed by surgery (112). Groups were similar at baseline in terms of clinical stage, serum prostate specific antigen and Gleason score. Of 192 patients available for efficacy analysis 9 had stage T1b, 8 stage T1c, 63 stage T2a, 36 stage T2b and 76 stage T2c disease. RESULTS: One or more positive surgical margins were found in 59 of 91 patients (64.8%) in the surgery only group compared to 28 of 101 (27.7%) in the cyproterone acetate group (p = 0.001). Patients who received preoperative therapy had a statistically significantly lower rate of apical margin involvement than those who did not (17.8 versus 47.8%, respectively, p < 0.0001). There was no statistically significant difference in surgical (p = 0.8645) or postoperative (p = 0.173) complications between the 2 groups. CONCLUSIONS: Neoadjuvant androgen withdrawal with a 12-week course of 300 mg. cyproterone acetate daily results in a lower rate of positive margins without adversely affecting postoperative recovery. The impact on patient survival will be determined by long-term followup.

Aged↗
PubMed1995

Inverted papilloma of the upper urinary tract.

Inverted papillomas of the upper urinary tract are rare lesions that have a male predominance. The associated symptoms are similar to those of other urothelial neoplasms. The tumors are considered benign and local excision has been advocated by many but long-term followup is lacking. We present a case of a locally excised inverted papilloma of the renal pelvis with a 3.5-year followup. While local excision appears to be ideal treatment, the difficulty with preoperative diagnosis and the reported coexistence of malignancy demand careful patient selection and close long-term followup. The biological potential of recurrence, multicentricity and malignancy is addressed.

Humans↗
PubMed1993

Atypical adenomatous hyperplasia of the prostate: morphologic criteria for its distinction from well-differentiated carcinoma.

Atypical adenomatous hyperplasia (AAH) is a localized proliferation of small glands within the prostate that may be mistaken for carcinoma. To determine the diagnostic criteria for separating AAH from carcinoma, seven observers independently evaluated 54 selected lesions from 44 transurethral resection specimens. Three patterns of glandular proliferation were observed, all arising in association with nodular hyperplasia: AAH (38 foci), atypical small acinar proliferation of uncertain significance (eight foci), and well-differentiated carcinoma (eight foci). Of 24 architectural and cytologic features evaluated, the following were useful in separating these three patterns: variation in nuclear size (14%, 22%, and 25%, respectively), mean nucleolar diameter (0.69 micron, 1.43 microns, and 1.78 microns, respectively), largest nucleolar diameter (mean, 1.66 microns, 2.71 microns, and 2.81 microns, respectively), percentage of nucleoli greater than 1 micron in diameter (17.6%, 58.1%, and 77.5%, respectively), crystalloids within suspicious glands (16%, 13%, and 75%, respectively), luminal basophilic mucinous secretions, infiltrative borders, discontinuity of the basal cell layer in AAH (compared with complete absence in carcinoma; shown with basal cell-specific anti-keratin monoclonal antibody 34 beta E12 immunostaining), and intact basement membrane in AAH (compared with discontinuity in carcinoma; shown with type IV collagen immunostaining). Features that could not reliably separate AAH from carcinoma included lesion shape, circumscription, multifocality, average gland size, variation in gland size and shape, nuclear shape, chromatin pattern, and amount and tinctorial quality of cytoplasm. Although the biologic significance of AAH is uncertain, its light microscopic appearance and immunophenotype allow it to be distinguished from carcinoma in most cases.

Adenoma↗
PubMed1992

Paneth cell-like change of the prostate gland. A histological, immunohistochemical, and electron microscopic study.

Paneth cell-like change (PCLC) of the prostatic glandular epithelium was focally observed in one case of normal glandular epithelium, two cases of glandular and stromal hyperplasia, one case of prostatic intraepithelial neoplasia, and four cases of prostatic adenocarcinoma. The distinctive cells were characterized by bright, eosinophilic cytoplasmic granules on routine hematoxylin and eosin-stained material. The cytoplasmic granules in the benign prostatic epithelium were periodate-Schiff's procedure (PAS)-positive and diastase resistant and immunohistochemically negative for lysozyme, neuron-specific enolase, chromogranin, and serotonin. The eosinophilic granules in the prostatic intraepithelial neoplasia and adenocarcinoma cases were immunohistochemically positive for chromogranin, serotonin, and neuron-specific enolase, and negative for lysozyme. By electron microscopy the eosinophilic granules represented exocrine-like or lysosomal-like vesicles in the benign epithelium and neuro-endocrine granules in the malignant epithelium. The lesion represents a prostatic epithelial PCLC rather than a Paneth cell metaplasia. PCLC is the common histological manifestation of two different phenomena: (a) a PAS-positive and diastase-resistant eosinophilic cytoplasmic granular change in benign prostatic epithelium, and (b) endocrine differentiation with neuroendocrine granules in dysplastic and malignant prostatic epithelia. The importance of recognizing PCLC lies in its differentiation from other possible prostatic cytoplasmic inclusions.

Acid Phosphatase↗
PubMed1989

Skeletal lymphoma.

The records of forty-two patients with lymphoma of bone [.11 with Hodgkin disease (HD), 31 with non-Hodgkin lymphoma (NHL)] were retrospectively reviewed to correlate histologic type with sites of osseous involvement, radiographic patterns of bone destruction, and prognosis. The vertebral column was the most frequent site of axial involvement and the femur was the commonest site overall. In HD, the most frequent radiographic pattern was vertebral sclerosis, while periosteal reaction was noted in two focal femoral lesions and hypertrophic pulmonary osteoarthropathy in one patient. In NHL, permeative destruction predominated, while unusual layered periosteal reaction and eccentric cortical destruction were each seen in two patients. Radiographic patterns of bone involvement alone cannot be used to predict histologic type or prognosis. Staging remains the most important prognostic indicator. For skeletal lymphoma, instead of the traditional Ann Arbor Staging System, we prefer the more specific Mayo Staging System which relates the temporal appearance of osseous disease to nodal or soft-tissue disease or both.

Adult↗
PubMed1987

Inverted papilloma: an uncommon benign cause of a ureteral filling defect.

A case of inverted papilloma of the ureter in a 62-year-old man is presented along with a literature review of 14 cases. This rare benign tumor should enter the differential diagnosis of a ureteral filling defect especially when it has a smooth configuration. Preoperative consideration of this diagnosis may lead to intraoperative confirmation of pathology and conservative resection.

Humans↗
PubMed1987

Calcified ganglioneuroma of the bladder.

Ganglioneuromas involving the genitourinary tract are extremely rare but are potentially serious tumors. We describe a patient, known to have von Recklinghausen's disease, who presented with a calcified ganglioneuroma of the bladder demonstrated by intravenous urography, sonography, and computed tomography.

Adult↗
PubMed1985

Verrucous carcinoma of the penis.

We reviewed 13 cases of verrucous carcinoma, accounting for 5 per cent of the penile cancers seen during a 25-year interval. Although the typical verrucous pattern predominated minute foci of invasive squamous carcinoma were identified in 3 patients. All patients were followed for at least 6 years and none has died of the malignancy. Wide surgical excision, usually requiring partial or total penectomy, is the treatment of choice.

Adult↗
PubMed1985

Clinical and pathological comparison of young adult women with hepatocellular carcinoma with and without exposure to oral contraceptives.

We compared the clinical characteristics and histological classifications of young adult women with hepatocellular carcinoma with and without exposure to increased amounts of sex steroids in order to investigate the possibility that sex steroids changed the behavior of the tumor. Fifteen women were found to have a history of exposure to increased levels of sex steroids while 14 did not. One of the women in the exposed group had elements of adenoma next to her carcinoma, allowing speculation as to whether the malignancy arose from a previous adenoma. Statistically significant differences between the two groups were that the exposed group had a higher number of gravida (2.2 compared to 0.9, p = 0.013) and suffered tumor rupture with hemoperitoneum more frequently (4/15 compared to 0/4, p = 0.037). Trends worth noting were that the exposed group tended to survive longer, complain of pain and weight loss less frequently, and have lower alpha-fetoprotein levels. These findings indicate that exposure to sex steroids may change the clinical behavior of hepatocellular carcinoma, producing among other things a hypervascularity and tendency for hemoperitoneum.

Adult↗
PubMed1985

Heterogeneity of non-Hodgkin's lymphoma probed by nucleic acid cytometry.

Flow cytometric analyses of cellular DNA, RNA, and double-stranded RNA content were performed on lymph nodes and extranodal tissue from 177 patients with non-Hodgkin's lymphoma. With increasing histologic grade, a higher incidence of aneuploidy, higher proliferative activity, and higher total and double-stranded RNA content were found. Despite considerable cytometric heterogeneity within histologic grades and morphologic subdivisions, conformity between cytometric and morphologic classifications was observed in 85% of cases. Among intermediate-grade and high-grade lymphomas, increased proliferative activity and diploidy were associated with more frequent responses to treatment. Thus, nucleic acid-derived parameters relate to morphologic subtypes and permit an objective approach to lymphoma classification based on ploidy, proliferation, and RNA characteristics that also had prognostic implications.

Aneuploidy↗