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Biomedical subjects

L From

Publications and source records attributed to L From.

At least 55 records · Page 3Linked to original sources
PubMed1987

Predictive value of staging investigations in patients with clinical stage I malignant melanoma.

We reviewed the charts of 393 consecutive patients referred to the Toronto-Bayview Regional Cancer Centre and the Ontario Cancer Institute between January 1, 1978, and December 31, 1982, with clinical stage I malignant melanoma to determine the predictive value of routine staging investigations. The investigations reviewed included physical examination, liver function tests, radionuclide liver-spleen and bone scans, chest x-ray, whole-lung tomograms, CT chest scans, CT brain scans, and bipedal lymphangiograms. The clinical stage of nine patients was changed, eight as a result of physical examination and one as a result of lymphangiogram. No other investigations detected metastatic melanoma at referral. We recommend that staging investigations for patients referred with clinical stage I malignant melanoma be restricted to a complete physical examination and a baseline chest x-ray for all patients.

Humans↗
PubMed1987

Benign lymphoid hyperplasia of the palate.

Seven patients with benign lymphoid hyperplasia of the palate are reported. Clinically, these lesions presented as painless non-ulcerated masses that were unilateral in 6 of the cases and bilateral in one. Microscopically, the lesions were characterized by a mixed lymphoid infiltrate, germinal centres and vascular channels with hyperplasia of endothelial cells. The patients were followed for 3-10 years subsequent to diagnosis. One patient had 2 sequential lesions on opposite sides of the palate. Another patient with lesions of both submandibular salivary glands in addition to the palate developed rheumatoid arthritis, xerophthalmia and serologic changes consistent with systemic autoimmune disease. To date, none of the patients developed signs and symptoms of lymphoma or leukemia. The etiology of these lesions is unknown. Their distinction from lymphoma of the palate, as well as their possible relationship to the benign lymphoepithelial lesion of palatal mucous glands, is discussed.

Adult↗
PubMed1987

Removal of congenital nevi--cons.

Reviews of the literature support the view that melanomas arise in LCHN as well as other types of nevi and normal skin. The cases reported in the literature show a pediatric predominance. It is impossible to develop predictable figures by combining incidences of nevi with historical data from case reports. A long-term registry and follow-up are needed. In the meantime, each case should be treated individually, keeping in mind that especially in LCHN, it may be impossible to remove all melanocytes both in skin and in the CNS. Associated neuromelanosis may be present. Whether or not surgery is done, the patient must be carefully followed. Large nevi may be observed and changes that are noted should be biopsied early. Even with biopsy, the diagnosis may be unclear because some changes may be pseudomalignancies rather than true malignancies. Parents of infants should be informed of all possibilities and the complications of surgery adequately outlined. The adult with a LCHN should be informed that there is some risk. (It has been our experience that most adults prefer cosmetic revision of small areas and elect observation rather than excision.) As new techniques such as tissue expanders and more refined investigations to delineate extent of the nevus are found, it may be possible to adequately ablate more lesions in the future if a prospective study shows a convincing incidence of melanoma.

Adolescent↗
PubMed1986

Signet ring lymphoma of the skin: ultrastructural and immunohistochemical features.

Signet ring lymphoma is a recently described morphologic variant of B cell lymphoma. We are reporting the first case of this subtype of follicular lymphoma that was initially confined to the skin and remained so. Light microscopy showed the tumor to be composed of monomorphous plump epithelioid cells with abundant eosinophilic cytoplasm involving the dermis and subcutaneous fat. Cytoplasmic vacuoles were present within some of the tumor cells, suggesting the diagnosis of adenocarcinoma with a signet ring appearance. Some of the vacuoles were positive on periodic acid-Schiff with diastase staining, and no mucin was identified. Immunostaining showed the presence of intracytoplasmic IgG heavy chains and kappa light chains. Characteristic intracytoplasmic inclusions, which were formed by saccules and microvesicular bodies, were seen by electron microscopy. The diagnosis of signet ring lymphoma was made. No systemic involvement was found. Over a period of 7 years, multiple new skin lesions occurred, all of which responded to radiation therapy. This rare variant of follicular center cell lymphoma, which can occur in the skin, should not be confused with metastatic mucinous adenocarcinoma and malignant melanoma.

Aged↗
PubMed1986

Role of immunohistochemistry in the diagnosis of undifferentiated tumors involving the skin.

Twenty undifferentiated skin tumors were examined by immunostaining in an attempt to achieve more precise identification. Light microscopy yielded only a differential diagnosis, whereas immunostaining of formalin-fixed, paraffin-embedded tissue sections with a panel of antibodies to intermediate filaments and other cell components led to a definitive diagnosis. Four cytokeratin-positive epithelial tumors were subtyped into squamous cell carcinomas and adenocarcinomas with the use of antibodies to different cytokeratin polypeptides. Fifteen vimentin-positive tumors were subdivided into malignant melanomas with the use of antibody to S-100 protein, lymphomas with the use of antibody to immunoglobulin, and mesenchymal tumors (angiosarcomas, atypical fibroxanthomas, dermatofibrosarcoma protuberans, and meningiomas) with the use of antibody to S-100 protein, factor VIII, and lysozyme. One desmin-positive tumor was diagnosed as a leiomyosarcoma of the skin. A scheme is presented for using immunohistochemistry to facilitate the diagnosis of undifferentiated tumors involving the skin.

Antibodies↗
PubMed1985

The value of staging and serial follow-up investigations in patients with completely resected, primary, cutaneous malignant melanoma.

The purpose of this study was to determine the value of staging and serial follow-up investigations in newly diagnosed patients with completely excised primary cutaneous malignant melanoma. We reviewed the records of the 393 patients with completely excised primary malignant melanoma who were referred to the Ontario Cancer Institute and the Toronto-Bayview Regional Cancer Centre between 1 January 1978 and 31 March 1982. Initial investigations included history and physical examination in all 393 patients, complete blood count (199 patients), liver function tests (198 patients), urinary melanins (159 patients), chest X-rays (345 patients), whole lung tomography (182 patients), radionuclide liver-spleen scans (207 patients), and bone scans (116 patients), bipedal lymphangiograms (78 patients), CT scans of the chest (59 patients), and CT brain scans (51 patients). The clinical stage of ten patients was changed as a result of history and physical examination or lymphangiogram. All other investigations failed to detect metastatic melanoma. Follow-up investigations included history and physical examinations, complete blood counts, liver function tests, radionuclide liver spleen and bone scans. History and physical examinations, chest X-rays and patients' awareness of abnormalities were responsible for detection of subsequent melanoma recurrences. All other tests failed to identify metastatic melanoma at the time of its occurrence. Therefore, we recommend that initial staging investigations be limited to history and physical examination with clinical photographs, and baseline chest X-ray. We recommend that subsequent follow-up include only history and physical examinations and chest X-rays.

Follow-Up Studies↗
PubMed1985

Immunohistochemical staining of macrophages in the skin lesions of leprosy: the role of antibody to mycobacteria in human serum and various polyclonal immune rabbit antisera.

Immunohistochemical staining of tuberculoid and lepromatous leprosy skin lesions was performed using various rabbit antisera. Macrophages in both stained with serum containing antibodies against lysozyme and alpha-1-antitrypsin, while macrophages in lepromatous leprosy also reacted with other antibodies. An immunoglobulin fraction of positive serum stained following pepsin digestion, indicating that reactivity was not Fc dependent. Positive serum contained antibody against Mycobacterium butyricum, which caused macrophage staining, since affinity-purified antibody did not stain and absorption with M. butyricum removed staining. Staining was also produced by serum of subjects with leprosy or a positive tuberculin test. By immunoblotting, the anti-mycobacterial antibody was directed against surface components of M. butyricum of molecular weights 20 000-70 000. Electron microscopy showed M. leprae in phagolysosomes of macrophages, while immunoelectron microscopy demonstrated labelling along bacterial cell membranes. Therefore, macrophages in lepromatous leprosy skin lesions stain because they contain M. leprae, which reacts with antibody to either M. leprae, M. tuberculosis or atypical mycobacteria in human serum and with antibody to M. butyricum in serum from rabbits immunized with various antigens and Freund's complete adjuvant. These results indicate that immunohistochemical studies on leprosy are misleading if performed using intact polyclonal immune sera rather than affinity purified or monoclonal antibodies.

Antibodies, Bacterial↗
PubMed1985

Metamorphosis of dermal cylindroma: possible relation to malignant transformation. Case report of cutaneous cylindroma with direct intracranial invasion.

A case of locally invasive cutaneous cylindroma is reported. This neglected scalp tumor, 6.5 cm in greatest dimension, initially invaded the calvaria at the time of the first operation. A recurrence infiltrated the dura and presented as an intracranial space-occupying lesion. No brain invasion was present and distant metastases were not documented. The patient remains well 2 1/2 years after tumor resection. Light and electron microscopic appearance of the recurrent tumor revealed distinct morphologic features, which may be of use in predicting the biologic behavior of cutaneous cylindromas. This case documents the low biologic aggressiveness of cylindroma and stresses the necessity of complete surgical excision of neoplasms with atypical morphologic features.

Aged↗
PubMed1984

Lichen amyloidosus. Ultrastructure and pathogenesis.

The ultrastructure of six cases of lichen amyloidosus was studied with special attention to epidermal keratinocytes and the role of tonofilaments as precursors of fibrils of amyloid. Through the process of apoptosis, keratinocytes undergo degeneration and become filamentous cells and then filamentous masses or Civatte bodies. These bodies then drop into the dermis through a damaged basement membrane. In the papillary dermis, islands of amyloid become closely associated with Civatte bodies. In some cases, conversion to straight nonbranching filaments, characteristic of fibrils of amyloid, was found within whorled, densely packed filamentous masses. The transformation into fibrils of amyloid was not observed in keratinocytes or Civatte bodies situated in the epidermis. This final step of conversion may be aided by dermal fibroblasts that are frequently lodged around deposits of amyloid.

Adult↗
PubMed1983

Origin of the desmoplasia in desmoplastic malignant melanoma.

Four cases of desmoplastic malignant melanoma were examined light microscopically and immunohistochemically. Electron microscopy was performed in three cases. Light microscopy showed that all tumors were composed of neoplastic spindle cells that infiltrated between mature collagen bundles in the reticular dermis. Some of the spindle cells had bizarre nuclei, whereas other spindle cells resembled normal fibroblasts. Melanin could not be demonstrated in any of the tumors by histochemical techniques. Electron microscopic examination of the spindle cells showed prominence of rough endoplasmic reticulum, which was dilated and filled with flocculent material and occasional collagen fibrils. The same cells contained aggregates of non-membrane-bound melanin granules and pre-melanosomes. Some cells also showed features of myofibroblasts. Immunoperoxidase staining with anti-S100 protein antibody demonstrated positivity of the spindle cells as well as of melanocytes in the basal layer of the epidermis. Scar tissue and fibroblasts did not stain. These findings show that the desmoplastic component of these malignant melanomas derives from melanocytes that have undergone adaptive fibroplasia. Therefore, in assessing depth of invasion in a malignant melanoma, measurements should include the desmoplastic areas.

Adult↗
PubMed1982

Profile of malignant disease in the mouth clinic.

Between 1973 and 1981, 2,056 new patients were seen in the Mouth Clinic at Sunnybrook Hospital. Of these 109 proved to have malignant disease, with squamous cell carcinoma being the commonest type. Lower lip and floor of mouth were the most frequent sites. There was a high proportion of small tumors and local surgical excision was the most widely employed primary method of treatment. Radiation and combined treatment were used in larger lesions. Twenty-four patients have so far died of mouth cancer and the presence of enlarged lymph nodes at presentation was an ominous sign. Although containing the usual high proportion of heavy smokers and drinkers this group of patients at present exhibits a lower incidence of second primary malignancies than in some published series. It is concluded that surgery and radiotherapy have equivalent effectiveness in treating small primary lesions, where a policy of observation of the clinically negative neck appeared justified. The best treatment for large lesions and the most appropriate management of the clinically negative neck in intermediate size lesions has not been determined.

Adult↗
PubMed1981

Neonatal Behçet's syndrome in an infant of a mother with the disease.

Behçet's disease is reported in a newborn infant of a mother with the disease. The mother had recurrent orogenital ulcers, pustulonecrotic skin lesions, arthritis, thrombophlebitis, and colonic ulcers. Shortly after birth the infant presented with transient orogenital ulcerations and pustular cutaneous lesions. On healing, depressed scars developed which were very similar to those of the mother. The finding of circulating immune complexes in the mother's serum gives some support to the hypothesis that the infant's transient illness was caused by transplacental passage of maternal antibodies.

Adult↗
PubMed1980

Diagnosis and management of long-standing benign oral ulceration.

The authors formed a Mouth Clinic at Sunnybrook Hospital in 1973 since when there have been 3025 patient visits. Those patients with chronic ulceration present a challenge, the diagnosis sometimes being difficult and therapy not rapidly effective. The differential diagnosis includes lichen planus, pemphigus vulgaris, benign mucous membrane pemphigoid, discoid lupus erythematosus, erythema multiforme, aphthous ulcers, Behcets disease, periadenitis mucosa necrotica recurrens, specific infections and iatrogenic causes. It is possible to reach a definite diagnosis in virtually every case by means of a good history and careful clinical examination supplemented by biopsies and in some cases direct and indirect immunofluorescent studies. Treatment emphasizes scrupulous attention to oral hygiene with baking soda mouthwashes and careful teeth cleaning to minimize the accumulation of dental plaque. Specific therapy includes topical steroids in lichen planus, intra muscular gold in benign mucous membrane pemphigoid, a previously unreported treatment which considerably improved seven out of ten patients, and tetracycline mouthwashes in aphthous ulcers.

Behcet Syndrome↗
PubMed1978

Toxic epidermal necrolysis in Stevens--Johnson syndrome.

Three cases are described in which Stevens-Johnson syndrome progressed in the course of a few days to toxic epidermal necrolysis. Trimethoprim-sulfamethoxazole, allopurinol in combination with hydrochlorothiazide, phenytoin and possibly ampicillin were implicated in the causation of the disease.

Adult↗
PubMed1978

The diagnosis of melanotic and other pigmented lesions of the lips and oral mucosa (dark spots in the mouth).

Pigmented lesions of the oral mucosa may be due to collections of blood, metallic particles of melanin. Any of these substances will appear of a blue tinge if at any depth in the tissues, while superficial collections may be red, black or brown respectively. Lesions associated with blood will be hematomas, dilated veins, hemangiomas or telangiectases. Metallic particles are found in amalgam tattoos. Melanotic pigmentation may occur as a normal variation, following hormonal disturbance and inflammation, and sometimes iatrogenically. Benign and malignant melanoma of the oral cavity is highly lethal. 25% of malignant melanomas in this site present as nondescript brown spots, and isolated broid overlooking an early malignant melanoma.

Dental Amalgam↗