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Biomedical subjects

L Barnes

Publications and source records attributed to L Barnes.

At least 145 records · Page 8Linked to original sources
PubMed1979

Eosinophilic fasciitis. A pathologic study of twenty cases.

This report presents a detailed light-microscopic evaluation of biopsies obtained from 20 patients with eosinophilic fasciitis, a newly recognized disorder characterized by inflammation and thickening of the deep fascia, hypergammaglobulinemia, and peripheral and tissue eosinophilia. Early in the course of the disease, the deep fascia and lower subcutis are edematous and infiltrated with lymphocytes, plasma cells, histiocytes, and eosinophils; these features are associated with impressive peripheral eosinophilia. As the illness progresses, these structures and eventually the dermis become collagenized, thickened, and sclerotic. Tissue eosinophilia may be focal or diffuse and is usually observed in the fascia and/or lower subcutis. Extracutaneous involvement has been limited to a chronic synovitis and tenosynovitis, the latter frequently associated with the carpal tunnel syndrome. Deposits of immunoglobulin and/or complement were found in five of eight biopsies studied by direct immunofluorescence, which suggests that an immunologic stimulus may be responsible for initiating this syndrome. Differential diagnoses are discussed.

Adult↗
PubMed1978

Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases.

A retrospective clinicopathologic evaluation of 42 patients with cystosarcoma phyllodes was undertaken to determine if tumor size, contour, degree of stromal atypia and mitotic activity were reliable indicators of clinical behavior. Excluding size, the latter three determinants showed a positive correlation with prognosis and served as the basis of a classification in which 18 benign, 5 borderline and 19 malignant cystosarcomas were diagnosed. The tumors occurred in women averaging 44.3 years of age who most often presented with a palpable occasionally painful mass with a median diameter of 5 cm. Excision or simple mastectomy were the more frequent forms of therapy. Local recurrences were experienced by 6 patients and occurred in all 3 categories of tumor. Only malignant neoplasms developed systemic metastases which was observed in 4 patients 3 of which have died. On borderline tumor recurred 14 times and eventually proved fatal as a result of contiguous pulmonary involvement. A plea is made to label the stroma of malignant cystosarcomas as to the cell(s) of origin so future investigators may evaluate the effect of various soft tissue patterns on prognosis.

Adolescent↗
PubMed1978

Rhabdomyosarcoma arising within a cystosarcoma phyllodes. Case report and review of the literature.

Rhabdomyosarcoma of the breast is a rare tumor that is characterized by its rapid growth, large size, and poor prognosis. It most often presents as a pure neoplasm and infrequently as the stromal component of a cystosarcoma phyllodes. The clinical and pathological features of a cystosarcoma with a rhabdomyosarcomatous stroma occurring in a 45-year-old woman are presented, and the results are discussed in reference to the 24 published cases of mammary rhabdomyosarcoma. The patient was treated by radical mastectomy and died 2.5 years later with pulmonary and cerebral metastases. Though two long-term survivors have been reported, cures are infrequent and no form of therapy has been uniformly successful.

Adolescent↗
PubMed1977

Pleomorphic adenoma of the epiglottis: report of a case.

We describe the clinical and pathologic aspects of an unusual case of pleomorphic adenoma of the epiglottis. A 69-year-old man had impaired speech and a "lumpy sensation" in the throat. Following clinical evaluation and a diagnostic biopsy, the tumor was totally excised with excellent results. Pleomorphic adenoma of the larynx is most uncommon. To our knowledge, no report describing the clinical and pathologic features of this entity in the epiglottis or larynx has been previously reported. This is the only example of an epiglottic pleomorphic adenoma among 391 cases seen at Presbyterian-University Hospital and the Eye and Ear Hospital of Pittsburgh during a 21-year period.

Adenoma↗
PubMed1977

Sarcomas of the breast: a clinicopathologic analysis of ten cases.

The clinical and pathologic features of ten mammary sarcomas are discussed. Tumor size, contour, degree of cellular atypia, and mitotic activity were specifically evaluated to determine if they are important indiced of clinical behavior. Results indicate that infiltrating margins, 2-3+ stromal atypia, and eight or more mitoses per 10 HPF are characteristics of neoplasms associated with a poor prognosis. Tumor size was an unreliable criterion. A classification of breast sarcomas is presented with an appeal to avoid use of the term "stromal sarcoma" as a specific pathologic diagnosis. Since a diagnosis based upon cell of origin and correlated with the above morphologic features is fundamental to an intelligent therapeutic approach to this rare group of neoplasms, future reports dealing with this subject should include these details.

Adult↗
PubMedDate not supplied

Angiosarcoma of the maxillary sinus: literature review and case report.

A rare case of angiosarcoma of the maxillary sinus is reported. Review of the literature concerning angiosarcoma of the head and neck revealed 14 previously published cases involving the nose, nasal sinuses, and nasopharynx. Angiosarcoma of the skin and soft tissues of the head and neck differs in behavior from that affecting the nose, nasal sinuses, and nasopharynx. The case reported presents the protracted clinical course of this malignant tumor.

Aged↗
PubMedDate not supplied

Angiolymphoid hyperplasia with eosinophilia: a disease that may be confused with malignancy.

Twelve new cases of an unusual, benign vasoproliferative and inflammatory disorder of unknown etiology, angiolymphoid hyperplasia with eosinophilia (ALHE), are described and contrasted clinically and pathologically with those appearing in the literature. Only recently recognized in the United States, the disease is of singular importance because the vascular component may be confused histologically with angiosarcoma, thereby resulting in unwarranted aggressive therapeutic measures. ALHE characteristically affects adults and presents in the head and neck region as either solitary or multiple cutaneous tumors. The lesions are pruritic, frequently bleed after minor trauma, and may be associated with peripheral eosinophilia and regional lymphadenopathy. On rare occasions, the disease may masquerade as a salivary-gland tumor, cause stenosis of the external auditory canal, or present as an osseous lesion of the skull. Extrafacial tumors are uncommon. Excision is the most frequent form of therapy; however, local irradiation, corticosteroids, electrodessication with curettage, and chemotherapy have also had varying degrees of success.

Adolescent↗
PubMedDate not supplied

Non-Hodgkin's lymphoma of the nose and paranasal sinuses: a study of 17 cases.

Non-Hodgkin's lymphoma of the nose and paranasal sinuses occurred in 14 men and 3 women with a mean age of 61 years. Nasal obstruction, unilateral facial swelling, and nasal discharge were frequent initial manifestations. The maxillary sinus and nose were the commonest primary sites. Using Rappaport's classification, there were 9 histiocytic, 5 poorly differentiated lymphocytic, and 3 mixed histiocytic-lymphocytic lymphomas. Sixteen patients had radiation therapy to the primary site, and 9 patients later received chemotherapy. Eleven patients (69%) are dead, with a median survival time of 11 months after diagnosis. Dissemination of lymphoma was the most common cause of death. Five patients (29%) are alive up to 40 months after diagnosis. Patients with poorly differentiated lymphocytic lymphoma survived longer than those with histiocytic or mixed histiocytic-lymphocytic lymphomas (medium survival times 35, 9, and 12 months, respectively). Poor response to radiation therapy and dissemination of lymphoma were poor prognostic indicators.

Adult↗
PubMedDate not supplied

Disseminated herpes zoster in the elderly.

We describe three cases of disseminated herpes zoster occurring in the elderly, and discuss the investigation and diagnosis of this condition. The presentation may be atypical with excoriated papular lesions. We suggest that disseminated herpes zoster does occur in the non-immunocompromised elderly patient, and is sometimes overlooked.

Acyclovir↗
PubMedDate not supplied

Analysis of ultraviolet phototherapy and photochemotherapy resources in Ireland.

BACKGROUND: Ultraviolet (UV) phototherapy is widely used and very successful in the treatment of skin conditions. As such a safe and efficient service is essential. At present, there are no standard Irish guidelines regarding the operation, calibration or inspection of UV equipment nor is there an Irish policy on staff/patient safety or training issues. AIM: To survey all known phototherapy centres in Ireland. METHODS: A postal questionnaire was sent to all known phototherapy centres in Ireland addressed to the consultant dermatologist or the physiotherapist-in-charge. It was divided into six sections: Instrumentation, Quality Assurance, UV meters, equipment maintenance, patient/staff safety and training. Comments on current practice were invited. Non-respondents were contacted by telephone, in some cases the survey was mailed a second time. RESULTS: This study demonstrated a substantial quantity of suboptimal equipment in use and a lack of consensus regarding quality assurance inspection and UV meter calibration frequency. CONCLUSIONS: Guidelines must be established for calibration of UV equipment and standardisation of phototherapy protocols in Ireland.

Calibration↗
PubMedDate not supplied

Carcinoma ex oncocytic Schneiderian (cylindrical cell) papilloma.

INTRODUCTION: This study reviews the clinicopathologic features of carcinoma presenting in oncocytic Schneiderian papilloma (OSP; cylindrical cell papilloma), a rare histologically distinctive papilloma sharing features with inverted papilloma. MATERIALS AND METHODS: Nine cases of carcinoma ex OSP (1970-1990), six from the files of the Armed Forces Institute of Pathology (Washington, DC) and three from the surgical pathology files, Presbyterian-University Hospital and Eye and Ear Institute (Pittsburgh, PA), were studied. One case was previously reported. Clinical data were obtained from the patients' medical records. All available histologic slides were reviewed. RESULTS: The patients (eight men, one woman) ranged in age from 48 to 83 years (mean age, 74 years). The carcinoma and OSP were synchronous in eight patients. In one case, the carcinoma occurred 8 years after OSP was diagnosed on biopsy. The presenting manifestations included nasal obstruction, "polyps," epistaxis, and proptosis. Radiographically, a sinonasal mass was present, often with extension to adjacent sites and bone destruction. Most patients received postoperative irradiation. Of six patients with follow-up, four died of carcinoma and two were alive without disease at 1.5 and 7 years, respectively. The types of carcinoma were: squamous cell (n = 6), high-grade mucoepidermoid (n = 2), and sinonasal undifferentiated (n = 1). Histologic transition was observed between carcinoma and dysplastic/benign OSP in eight cases. CONCLUSION: Demonstration of histologic continuity between carcinoma and dysplastic OSP epithelium in eight of our nine cases indicates origin of carcinoma from the OSP, rather than a coincidence of the two neoplasms. Although histologically benign, OSP should be totally excised at diagnosis because of a potential for malignant transformation. This is a US government work. There are no restrictions on its use.

Aged↗
PubMedDate not supplied

Basaloid squamous cell carcinoma of the head and neck: a clinicopathologic and flow cytometric study of 10 new cases with review of the English literature.

INTRODUCTION: We describe the clinicopathologic and flow cytometric features of 10 cases of basaloid squamous cell carcinoma (BSCC) of the head and neck to determine if DNA ploidy is a useful prognostic indicator. We also provide a review of 80 cases previously reported in the English language literature. MATERIALS AND METHODS: The 10 cases were obtained from the surgical pathology files of Presbyterian University Hospital and The Eye and Ear Institute, Pittsburgh, PA (1987-1991). In all 10 cases, the microscopic slides and clinical data were reviewed. Flow cytometry was performed using the Hedley technique and formalin-fixed, paraffin-embedded tissue. RESULTS: The mean age of patients with BSCC was 64 years (range, 49 to 75 years). Tumor involved the base of tongue (n = 5), hypopharynx-epiglottis (n = 3), and tonsil (n = 1). One case presented with cervical lymph node metastasis from an unknown primary site. Histologically, BSCC showed a biphasic pattern with basaloid-squamous elements, comedonecrosis, stromal hyalinization, surface dysplasia, and an in situ and/or invasive squamous cell carcinoma component. Flow cytometry revealed six diploid and four aneuploid tumors. Five of six patients with diploid and all four patients with aneuploid tumors developed early regional and/or distant metastases. Of the two patients who died of disease, one had a diploid and the other an aneuploid tumor. CONCLUSION: Our study reaffirms the predilection of BSCC for the base of tongue, pyriform sinus, and supraglottic larynx, and its aggressive biologic behavior with a high incidence of cervical lymph node metastasis (64%), distant spread (44%), and death from disease (38% mortality at 17 months median follow-up). However, in contrast to previous reports, tumor ploidy by flow cytometry provided no additional prognostic information beyond that supplied by routine histologic evaluation.

Aged↗