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Biomedical subjects

L E Zimmerman

Publications and source records attributed to L E Zimmerman.

At least 19 recordsLinked to original sources
PubMed1995

William Thomson and Joseph Janvier Woodward.

William Thomson and Joseph Janvier Woodward were two of several exceptionally versatile and highly productive young physicians who volunteered for service with the Union Army at the outbreak of the Civil War, and then were subsequently assigned to the Washington Area where they played significant roles and made major contributions towards the development of the Army Medical Museum. Both pioneered in photomicrography. While Thomson deserves priority, Woodward was the more prolific contributor whose work and publications helped draw attention to the Army Medical Museum as a center for excellence in pathology. After the War Thomson returned to Philadelphia where his interests in photography stimulated his pursuit of optics and eventually his becoming one of the first American physicians to specialize in ophthalmology. He became Professor of Ophthalmology at Jefferson Medical College.

History, 19th Century↗
PubMed1990

Rhabdomyosarcoma of the ciliary body.

Rhabdomyosarcoma is the most common malignant orbital tumor of childhood. It has twice been reported to arise within the globe from the iris. In addition, teratoid medulloepithelioma, a tumor arising from the ciliary epithelium, can contain a rhabdomyoblastic component, often in combination with other heteroplastic elements. The authors report what may be the first recorded case of an embryonal rhabdomyosarcoma of the ciliary body, possibly representing a one-sided differentiation of a malignant teratoid medulloepithelioma.

Actins↗
PubMed1990

Reticulohistiocytoma of the limbus and cornea. A clinicopathologic study of two cases.

Reticulohistiocytoma is a rare, benign histiocytic lesion usually occurring as an isolated skin nodule or as part of a systemic disorder known as "multicentric reticulohistiocytosis." The clinical and histopathologic findings of two women who presented with a single, painless mass localized to the cornea and limbus without skin lesions or systemic disease are reported. Histopathologically, the lesions were composed predominantly of large mononuclear and a few multinucleated cells with finely granular, "ground-glass" cytoplasm and large nuclei with prominent nucleoli. Immunohistochemical and electron microscopic studies conformed the histiocytic nature of these cells. Reticulohistiocytoma should be included in the differential diagnosis of epibulbar benign histiocytic lesions.

Adult↗
PubMed1990

Pleomorphic adenocarcinoma of the ciliary body. Immunohistochemical and electron microscopic features.

An 80-year-old man was evaluated for an epibulbar tumor on a phthisical eye. The initial biopsy diagnosis of the epibulbar tumor was poorly differentiated neoplasm. Exenteration of the phthisical eye and orbital contents showed an extensive pleomorphic adenocarcinoma of the nonpigmented epithelium of the ciliary body with extraocular extension. There was evidence of hyaluronic acid secretion and immunohistochemical staining was strong for vimentin, focal for epithelial membrane antigen and S-100 protein, and weak for neuron-specific-enolase. Electron microscopy demonstrated desmosomes between tumor cells, areas of thick, multilaminar basement membrane production surrounding individual tumor cells, and occasional intracytoplasmic intermediate filaments.

Adenocarcinoma↗
PubMed1990

Bilateral orbital involvement in fatal giant cell polymyositis.

The case of a young woman with giant cell polymyositis is described. She had bilateral, severe, midly painful proptosis and ophthalmoplegia. Extensive pharyngeal, laryngeal, and cardiac muscle involvement occurred 18 months later coincident with fatal cardiac arrhythmia. At autopsy, extensive muscle necrosis and giant cells were noted in extraocular, pharyngeal, laryngeal, and cardiac muscle with only minimal involvement of other striated muscles.

Adult↗
PubMed1990

Retinoblastoma. The relationship of proliferating cells to blood vessels.

In 150 retinoblastomas the authors found a uniform thickness of the cuff of viable retinoblastoma cells that surrounds blood vessels. The mean thickness was 98.7 microns with a standard deviation of 11.9 microns. The cross-sectional area of the cuff was negatively correlated with the mitotic activity in the cuff and positively correlated with the diameter of the central vessel. The mitotic activity in the cuff of cells was inversely related to the distance from the central blood vessel. When the cuff was divided into three concentric rings, the inner ring contained a mean of 6.2 mitotic figures, the middle ring contained a mean of 2.9 mitotic figures, and the outer ring contained a mean of 0.6 mitotic figures. This pattern of growth is similar to that observed in other rapidly growing neoplasms in humans and experimental animals. In these tumors this pattern results from reduction in oxygen tension with increased distance from the central blood vessel.

Blood Vessels↗
PubMed1989

Metastatic melanoma within and to the conjunctiva.

Two patients with epibulbar juxtalimbal primary conjunctival melanomas experienced local intralymphatic metastases to the inferior cul-de-sac, and a hematogenous metastasis to the conjunctiva developed in five other patients with cutaneous melanomas. Whether reflective of a local or distant metastasis, all of the lesions histopathologically were located in the substantia propria, and were separated from the overlying epithelium by a thin mantle of collagen. There was no evidence of atypical intraepithelial melanocytic proliferation, as would be expected in association with a primary conjunctival melanoma. Two of the cutaneous metastases exhibited a binodular or multinodular appearance that correlated histopathologically with variably confluent micronodules suggestive of the origin of the clinical lesion from a shower of tumor cell emboli. Patients with local intralymphatic spread from a primary conjunctival melanoma may experience additional lesions in the conjunctival sac or eyelid skin and are at risk for regional or distant metastases. They should be examined closely several times a year. The patients with the distant metastases all had their previously diagnosed primary cutaneous tumors on the truncal skin (a similar tendency emerges from a review of previous ocular cases), typically had myriad other cutaneous lesions, and two of them had a neoplastic iridocyclitis and vitreitis. These patients tended to die of the disseminated tumors within 1 year after conjunctival metastases developed.

Adult↗
PubMed1988

Toxic endothelial degeneration in ocular surface disease treated with topical medications containing benzalkonium chloride.

We examined a 56-year-old man with keratoconjunctivitis sicca and marked ocular surface disease in whom the prolonged frequent use of topical medications containing the preservative benzalkonium chloride was associated with corneal endothelial damage requiring corneal transplantation in one eye. The histopathologic findings on examination of the excised button were consistent with toxic endothelial disease. Postoperatively, the patient's symptoms continued until the preservative-containing medications were substituted with nonpreserved saline eyedrops.

Benzalkonium Compounds↗
PubMed1988

Cutaneous malignant melanoma in survivors of heritable retinoblastoma.

Six survivors of bilateral retinoblastoma developed cutaneous malignant melanoma 20 to 51 years (average, 31 years) after initial therapy for the ocular tumor. Five patients received radiation therapy to the orbital area. In two patients the cutaneous malignant melanoma developed in the field of irradiation. Two patients developed multiple cutaneous melanomas and are thought to have the dysplastic nevus syndrome. At this writing two patients are alive and well after wide resection of their skin tumors. A review of the literature suggests that cutaneous malignant melanoma accounts for about 7% of second malignant neoplasms in survivors of heritable retinoblastoma.

Adult↗
PubMed1988

Sinus histiocytosis presenting as an epibulbar mass. A clinicopathologic case report.

Sinus histiocytosis is a well-recognized condition that mainly affects children in the first decade of life. Although this usually benign disease often features massive cervical lymphadenopathy, numerous extranodal sites of involvement can be seen. We describe a new presenting manifestation for sinus histiocytosis. A 13-month-old infant developed a rapidly growing unilateral epibulbar tumor that involved the cornea. A complete physical examination revealed only mild inguinal lymphadenopathy. A diagnosis of sinus histiocytosis was made by histologic examination of the lesion after surgical excision.

Corneal Diseases↗
PubMed1988

Incidence of second neoplasms in patients with bilateral retinoblastoma.

The cumulative incidence of second neoplasms in 215 patients with bilateral retinoblastoma was calculated using the life-table method. Second tumors developed in 4.4% of the patients during the first 10 years of follow-up, in 18.3% after 20 years, and in 26.1% after 30 years. The 30-year cumulative incidence was 35.1% for the 137 patients who received radiation therapy compared with an incidence rate of 5.8% for the 78 patients who did not receive radiation. In the 137 patients who received radiation, second tumors developed both inside and outside the field of therapy. There was a 30-year incidence rate of second tumors of 29.3% within the field of irradiation and 8.1% outside the field. The rate outside the field of irradiation (8.1%) was similar to that observed in nonirradiated patients (5.8%). Our findings indicate that carriers of the retinoblastoma gene have an increased incidence of second tumors, and that the incidence rate is further increased in patients who receive radiation therapy.

Child, Preschool↗
PubMed1988

Unusual eyelid tumors with sebaceous differentiation in the Muir-Torre syndrome. Rapid clinical regrowth and frank squamous transformation after biopsy.

An unusual eyelid tumor with sebaceous differentiation developed in two 70-year-old men and each had an earlier history of one or more colonic carcinomas--the so-called Muir-Torre syndrome. These eyelid tumors were both behaviorally and histopathologically different from previously documented cutaneous neoplasms in this syndrome. In the first case, a sebaceous adenoma took multifocal origin from the epidermis and exhibited an interanastomosing retiform growth pattern in the underlying dermis; the lesion rapidly recurred as a keratoacanthoma after subtotal excision. In the second case, a conjunctival tumor with features of a poorly differentiated squamous cell carcinoma manifested focal evidence of sebaceous differentiation. Again, after an incisional biopsy, the latter tumor rapidly regrew and transformed into a well-differentiated squamous cell carcinoma with massive central necrosis. Although sebaceous carcinoma of the eyelids does not appear to presage the Muir-Torre syndrome, any benign sebaceous or transitional squamo-sebaceous neoplasm should be considered a possible manifestation of this syndrome. Both clear-cut benign and transitional sebaceous neoplasms should also be recognized as having the potential to undergo an ominous clinical regrowth upon subtotal excision and a complete squamous transformation.

Adenoma↗