Pure epidermoid cysts of the ovary.
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Biomedical subjects
Publications and source records attributed to M J Sworn.
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Two cases of primary malignant lymphoma of the uterine cervix are reported. Both were confirmed by histology as high grade B cell lymphomas. In one case, the diagnosis was made on a second colposcopic biopsy after an initial cervical smear and colposcopic biopsy were negative. In the second case, dyskaryotic cells of uncertain type were identified in a cervical smear taken at colposcopy performed as part of follow up for previous cervical intraepithelial neoplasia (CIN)I. The cytologic features and differential diagnosis of this rare cervical neoplasm are discussed, with emphasis on the role of the Papanicolaou smear in the initial diagnosis of this tumour.
A case of squamous intraepithelial neoplasia in an ovarian cyst in association with cervical intraepithelial neoplasia (CIN) III is described. In view of the association of human papillomavirus (HPV) and CIN, the possibility that HPV infection could be associated with similar changes in the ovary was postulated. The HPV genome was shown in formalin-fixed tissue of the cervical lesion by nonisotopic in situ hybridization (NISH) and by the polymerase chain reaction (PCR). However, HPV could not be shown in the ovarian lesion by NISH or PCR. On the basis of these findings there appears to be no association between HPV infection and squamous intraepithelial neoplasia in an ovarian cyst.
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Tumour cells from three cases of malignant histiocytosis of the intestine (MHI) have been studied immunologically and cytochemically. The cells did not form E rosettes and showed weak Fc gamma surface receptors. They contained non-specific esterase and acid phosphatase in diffuse granular distribution. In one case tumour cells showed no staining by an immunoperoxidase technique with two monoclonal anti-T cell antibodies but positive staining with a monoclonal anti-Ia-like antibody. The malignant cells from all three cases could be shown to contain alpha-1-antitrypsin. These are the first cases of MHI to have been studied in this way and the results confirm the true histiocytic--that is, monocyte/macrophage, derivation of the tumour cells in this disease.
The light microscopic and ultrastructural characteristics of a hormonally active Leydig cell tumor are described. Evidence is adduced that strongly suggests that the Leydig cell tumor was malignant and that functioning metastases were present.
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A vascular tumour involving the trapezius muscle is described. In addition to proliferating blood vessels with perithelial cuffing, there was a distinctive stroma of lymphoid aggregates, plasmacytoid cells, some mast cells and large numbers of eosinophils, many with a perivascular distribution. This solely intramuscular lesion was considered to be an example of angiolymphoid hyperplasia with eosinophilia. The aetiology and pathogenesis are discussed.
A patient with vaginal carcinoma in situ was treated with 5-fluorouracil in a less intensive regimen that previously recorded. This appeared to be effective and did not cause serious vaginal discomfort or dyspareunia.
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Four cases of malignant histiocytosis of the intestine (MHI) are described in detail, with emphasis on the clinical features and laboratory findings that may lead to a diagnosis. MHI is a rapidly progressive, usually fatal condition, which may occur in a setting of adult celiac disease or apparently spontaneously; all patients, however, have villous atrophy and crypt hyperplasia of the jejunum. Characteristic symptoms are malaise, weight loss, abdominal pain, and diarrhea followed, after a period of weeks or months, by acute small intestinal obstruction, perforation, or bleeding. Because of the high mortality associated with MHI, suggestive symptomatology and investigations should, in the absence of a definitive diagnosis, lead to an urgent laparotomy with a view to chemotherapy if the diagnosis is made.
A 55-year-old patient who presented with a pelvic mass was found to have a mixed mesenchymal sarcoma of the broad ligament. The histogenesis and diagnostic criteria of this rare tumour are discussed.
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A 27-year-old patient who became pregnant whilst fitted with an intrauterine contraceptive device developed an intrauterine Candida albicans infection and aborted. The diagnostic (and other inconspicuous) features of C. Albicans infection in the fetus are described. The presence of the intrauterine contraceptive device may have predisposed to the establishment of the infection.
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