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L J Layfield

Publications and source records attributed to L J Layfield.

At least 127 records · Page 7Linked to original sources
PubMed1989

Discrimination of benign versus malignant mixed tumors of the salivary gland using digital image analysis.

Seven benign and four malignant mixed tumors of the salivary gland, biopsied using fine-needle aspiration, were analyzed using digital image analysis. Mean nuclear form factor, perimeter, and area were significantly increased in malignant cases. Better separation between diagnostic categories, however, was achieved by utilizing the coefficient of variation (CV) within a case rather than mean value. Form factor CV alone divided cases into nonoverlapping diagnostic categories. This quantitative analog of "pleomorphism" provided a useful marker for malignancy in mixed tumors.

Adenoma, Pleomorphic↗
PubMed1989

The relationship of deoxyribonucleic acid content to conventional prognostic factors in Wilms tumor.

Deoxyribonucleic acid ploidy as determined by flow cytometric analysis was compared to histological findings and tumor stage for accuracy of prediction of patient survival in a series of Wilms tumors. While anaplastic tumors were more likely aneuploid or tetraploid than diploid, no statistically significant relationship was found between deoxyribonucleic acid ploidy and patient survival in our series. Tumor histology and stage as defined by the National Wilms Tumor Study were more accurate predictors of patient survival than deoxyribonucleic acid ploidy.

Adolescent↗
PubMed1989

Invasive giant condylomata acuminata: a case report.

We report on a patient with invasive giant condylomata acuminata (Buschke-Loewenstein tumor). This tumor is an exophytic human papilloma viral lesion with downward growth without histological malignancy. The aggressive progression of this lesion requires early surgical excision with clear margins. Delay in recognition of this tumor can otherwise lead to a fatal clinical course.

Adult↗
PubMed1989

Morphometric analysis of the homogeneity of lymphoid cell populations in fine-needle aspiration cytology smears.

Quantitative morphometry was used to evaluate the homogeneity of lymphoid cell populations in fine-needle aspiration cytology smears of lymph nodes from eight non-Hodgkin's lymphomas and four benign lymphoid proliferations. Using the standard deviation of log-transformed nuclear areas as the measure of lymphoid cell homogeneity, diffuse small cell lymphomas were found to be significantly more homogeneous than diffuse large cell lymphomas or benign lymphoid proliferations, but there was no significant difference in the homogeneity of the latter two groups. Two of four large cell lymphomas showed a bimodal distribution of nuclear areas. Methodologic issues--including the random selection of cells, the number of cells that should be counted in each case, the significance of microscopic field-to-field variation in this setting, and the significance of drift in observations during the examination of individual cases--are discussed.

Adult↗
PubMed1989

Flow cytometric measurements of proliferation-associated nuclear antigen p105 and DNA content in non-Hodgkin's lymphomas.

Non-Hodgkin's lymphomas are characterized by heterogeneity in cell kinetics, which may be related to differential expression of proliferation-associated nuclear antigens. We have performed two-color flow cytometric quantitation of nuclear antigen p105 and DNA content in nuclear suspensions from 80 paraffin-embedded lymphomas. High-grade lymphomas with diploid DNA histograms tended to express high levels of p105 in all phases of the cell cycle. Aneuploid populations, observed in 14 of 80 cases, showed high p105 expression compared with diploid cells of the same case, with the highest aneuploid:diploid p105 ratios in the high-grade group. We conclude that high-grade or DNA aneuploid lymphomas tend to have increased expression of p105; but considerable variations within each histologic subtype were observed, and the differences between histologic grades were not statistically significant. Further studies that correlate p105 expression and clinical outcome will help to determine the prognostic value of this marker.

Antigens, Neoplasm↗
PubMed1989

Fine-needle aspiration in the management of breast masses.

The exact role of FNA in the diagnosis of palpable breast lesions is still uncertain. False-positive and false-negative cytological diagnoses occur and raise questions regarding the diagnostic utility of FNA as a replacement for open biopsy in many clinical situations. False-positive diagnoses may result from atypical epithelial proliferations, fibroadenomas, or inflammatory lesions. False-negative aspirates may occur because of technical errors, cystic lesions, and underdiagnosis of low grade neoplasms. The triple diagnosis protocol has been suggested as a replacement for open biopsy of palpable breast masses in many clinical situations. Following this algorithm, the results of palpation, mammography, and cytology are combined to guide management. Mammography should precede FNA or follow the cytologic procedure by 2 or more weeks. Patients with a positive triple diagnosis should undergo open biopsy or confirmatory intraoperative frozen section. Positive FNA results would be useful for preoperative counselling as well as serving as a diagnostic procedure for clinically suspicious lesions in patients wishing a confirmatory test before open biopsy is performed. Patients with discordant triplet results should be referred for open biopsy. The management of patients with negative triplet results is less clear. From the available data, it appears that approximately 2 percent of patients with negative triplet results have carcinoma. Based on these results, we cannot recommend replacing open biopsy by the triple diagnosis method in most patients with a persistent dominant mass. In most cases, a biopsy is indicated. Surgeons, who plan to follow a breast mass with clinical examination, may be able to reduce their false-negative rate by performing FNA. Further study is necessary to establish the best way to use FNA in the diagnosis of breast carcinoma, to determine the cost effectiveness of the triple diagnosis method as a substitute for open biopsy, and to assess the utility of aspiration cytology in the mammographically directed diagnosis of nonpalpable breast lesions.

Adenofibroma↗
PubMed1988

Practical aspects in the diagnosis and management of cystosarcoma phyllodes.

Thirty-five cases of benign cystosarcoma phyllodes, 13 cases of malignant cystosarcoma phyllodes, and ten cases of giant fibroadenoma were studied. The diagnosis of benign or malignant cystosarcoma phyllodes was based on a combination of histological features. Clinical and gross pathologic findings were not found to be useful in distinguishing between benign and malignant tumors. Giant fibroadenomas occurred primarily in black adolescents and were histologically distinct. Positive surgical margins were found to be the best predictor of local recurrence of benign or malignant cystosarcoma phyllodes. Systemic metastases occurred in only one case of malignant cystosarcoma phyllodes. Most benign and malignant cystosarcoma phyllodes may be treated by wide local excision with tumor-free margins. Giant fibroadenomas should be treated by simple excision to preserve normal breast tissue.

Adolescent↗
PubMed1988

Keratin immunoreactivity in fine-needle aspiration of the prostate: an aid in the differentiation of benign epithelium from well-differentiated adenocarcinoma.

The efficacy of utilizing immunocytochemical staining of prostatic basal cells in separating benign from malignant prostatic epithelium was tested by staining fine-needle aspiration smears of prostatic lesions with the monoclonal antibody EAB-903. This antibody has been shown to stain keratin subtypes present in the prostate only in basal cells. The study utilized 12 benign, nine malignant, and four suspicious-for-carcinoma cases. Ten of 12 benign cases showed an intermingled pattern of staining, which was not found in the malignant cases. Our findings indicate that this distinctive pattern of staining may assist in distinguishing benign epithelium from well-differentiated prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1988

Fine-needle aspiration cytology of histiocytosis X: a case report.

The cytologic features of a case of histiocytosis X diagnosed by fine-needle aspiration biopsy of a right cervical lymph node in a 15-mo-old girl are reported. Characteristic reticuloendothelial cells with abundant cytoplasm and grooved nuclei were observed. Electron microscopy of the aspiration-derived specimen revealed Birbeck granules. The cytologic pattern and electron microscopic demonstration of Birbeck granules allowed definite diagnosis of lymph node involvement by histiocytosis X, negating the need for open biopsy. The cytologic differential diagnosis and current diagnostic criteria for histiocytosis X are discussed.

Biopsy, Needle↗
PubMed1988

Fine-needle aspiration cytology of chondromyxoid fibroma: a case report.

The cytologic presentation of a case of chondromyxoid fibroma studied by fine-needle aspiration in a 17-yr-old black male is described. The cytologic features of chondromyxoid fibroma are presented, and the differential diagnosis of intraosseous cartilaginous neoplasms is reviewed, emphasizing the cytomorphologic differentiation of chondromyxoid fibroma from chondrosarcoma, enchondroma, and chondroblastoma.

Adolescent↗
PubMed1988

Spontaneous regression of liver metastasis from renal carcinoma.

Idiopathic regression of metastases from renal carcinoma is rare and usually involves lung metastases in men with a good performance status following removal of the primary tumor. We report a case of spontaneous regression of a biopsy proved liver metastasis that had appeared several months after removal of primary renal carcinoma.

Carcinoma, Renal Cell↗
PubMed1988

The significance of atypia in fine needle aspiration cytology of the prostate.

Of 411 fine needle aspirates of the prostate 208 could be matched with conventional pathological material. Cytological diagnosis had a complete sensitivity of 94 per cent, specificity 99 per cent and efficiency 74 per cent. Corresponding figures for 36 patients who underwent total prostatectomy were complete sensitivity 100 per cent, specificity 100 per cent and efficiency 78 per cent. Atypical cytology results not amounting to frank malignancy were the main reasons for reduced efficiency and, therefore, analysis of the significance of atypia was performed. In 50 aspirates from 43 patients atypia of varying degree was noted but the degree of atypia did not allow for a diagnosis of malignancy. Subsequent diagnosis of carcinoma was made by cutting needle biopsy or transurethral resection in 7 of 14 specimens (50 per cent) of severe, 3 of 9 (33 per cent) moderate, 3 of 7 (43 per cent) mild and 3 of 16 (19 per cent) reactive atypia. Thus, specific cytological diagnoses have a high degree of accuracy but atypia and attempts to categorize it did not predict accurately the final diagnosis. Pathological conditions that may account for atypia in fine needle aspiration cytology are reviewed.

Adenocarcinoma↗
PubMed1988

The effect of bacillus Calmette-Guerin on the urinary system of pigs.

An experimental study was conducted to determine the changes in structure and function of the pig kidney and renal pelvis following intrarenal infusion of bacillus Calmette-Guerin (BCG). Bilateral nephrostomy tubes were inserted in six pigs through a subcostal (flank) retroperitoneal approach. One week later, antegrade pyelograms and renal scans with hippuran I-131 were obtained. The left kidney was then infused weekly for six weeks with two ampules of BCG (Tice strain) dissolved in 75 cc of saline. The right kidney, serving as a control, was infused concomitantly with 75 cc of saline. On week 7, bilateral antegrade pyelograms and renal scans were repeated. Two pigs were sacrificed at four, eight and 12 weeks after completion of BCG therapy. In all pigs, antegrade pyelograms of the left kidney before BCG instillation were identical to those obtained after completion of treatment and to those of the saline infused kidneys. The isotope renal scan in five pigs showed no significant change in image appearance or relative renal plasma flow in the pre-treatment and post-treatment images. In one pig, there was a decrease in the relative clearance of hippuran in the saline infused kidney. In this kidney, an upper pole abscess was found. Microscopic examination of the renal cortex, medulla, pelvis and ureter of the BCG infused kidneys was normal and identical to the saline infused kidneys. The urothelium was intact and no inflammatory changes were noted in the renal cortex or medulla. These results show that direct infusion of BCG into the renal collecting system has no adverse effect on the structure and function of pig kidneys when followed one to three months after treatment.

Animals↗
PubMed1988

Use of fine needle aspiration cytology for the diagnosis of testicular relapse in patients with acute lymphoblastic leukemia.

The testis frequently is the site of relapse in male patients with acute lymphoblastic leukemia. While many patients with testicular involvement by acute lymphoblastic leukemia have enlarged or firm testes, clinical examination alone is insufficient to establish or exclude the diagnosis completely. Open biopsy generally has been used to document the presence of acute lymphoblastic leukemia. However, this procedure requires general anesthesia and hospitalization. We studied 11 patients with a history and/or physical findings suspicious for testicular acute lymphoblastic leukemia relapse to determine the efficacy of fine needle aspiration cytology in the evaluation of the testes for leukemic infiltration. Of the 11 patients fine needle aspiration cytology correctly identified all 5 patients with histologically proved testicular acute lymphoblastic leukemia, it was negative in 5 with no histological evidence of leukemia and it demonstrated rare atypical cells that were not evident on subsequent histological examination in 1. No adverse effects were encountered in this series. Fine needle aspiration cytology appears to be a safe, reproducible alternative to open biopsy in the evaluation of patients for testicular relapse of acute lymphoblastic leukemia.

Adolescent↗
PubMed1988

Relationship of DNA content to conventional prognostic factors in clinically localised carcinoma of the prostate.

One hundred and nine patients treated by total prostatectomy for apparently localised carcinoma were analysed to investigate the prognostic significance of capsular invasion and penetration, seminal vesicle invasion, lymph node metastases, grade as assessed by the Gleason and MD Anderson Hospital (MDAH) systems and DNA content measured by flow cytometry of nuclear material extracted from paraffin embedded tumour. Comparison of DNA content was made with 36 benign prostates. Mean follow-up/survival was 60.7 months, at which time 21 patients had evidence of recurrence or had died. Only 5 patients had local recurrence. Tumour grade, as assessed by both the Gleason Sum Score and the MDAH system, correlated with anatomical extent and was the most important determinant of time to recurrence. Fifty-nine tumours were diploid, 44 tetraploid and 6 aneuploid. One of 36 benign prostates showed aneuploidy. Ploidy did not correlate with the anatomical extent of the tumour or with grade. Tetraploid tumours recurred earlier than diploid tumours. None of 6 aneuploid tumours have recurred, although only 3 have been followed beyond 5 years. Multivariate analysis showed that after accounting for grade, none of the other variables, including ploidy, contributed any additional significant prognostic information. Although the results must be regarded as preliminary, in view of the small number of patients with recurrence, they suggest that DNA content offers limited prognostic information in clinically localised prostate cancer.

Aged↗
PubMed1987

Fine-needle aspiration cytology of juvenile hemangioma of the parotid gland: a case report.

A 4-mo-old child presented with a 20-day history of swelling of the left cheek. Fine-needle aspiration (FNA) biopsy revealed a spindle-cell neoplasm with a bloody background. Subsequent surgical excision confirmed the presence of a juvenile hemangioma (juvenile hemangioendothelioma). The FNA biopsy and surgical pathology findings are presented along with a discussion of the differential diagnosis of this relatively rare neoplasm.

Biopsy, Needle↗
PubMed1987

Use of fine needle aspiration for detection of stage A prostatic carcinoma before transurethral resection of the prostate: a clinical trial.

The incidence of stage A prostatic carcinoma is approximately 10 per cent. We performed a clinical trial to determine if pre-prostatectomy fine needle aspiration could detect reliably stage A prostatic carcinoma. In 102 men with clinically staged benign disease by digital examination we performed a 4-quadrant fine needle aspiration of the prostate before prostatectomy. The cytological diagnosis of the aspirate was compared to the pathological diagnosis obtained at prostatectomy in all patients. The incidence of stage A prostatic carcinoma in this group of patients was 18.6 per cent (19 of 102 men). Sufficient aspirate material for cytological diagnosis was obtained in 98 of 102 men (96 per cent), including 17 with a diagnosis of carcinoma. When adequate diagnostic material was obtained, fine needle aspiration detected all cases of clinical stage A2 prostatic carcinoma but it did not detect stage A1 prostatic carcinoma. There were no false positive diagnoses. We conclude that routine pre-prostatectomy fine needle aspiration of the prostate can be safe, cost-effective and clinically useful.

Aged↗