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Biomedical subjects

M M Grimes

Publications and source records attributed to M M Grimes.

14 recordsLinked to original sources
PubMed1992

Fine-needle aspiration cytology of localized fibrous tumor of pleura.

Fine-needle aspiration (FNA) biopsy findings are presented in three cases of localized fibrous tumor of pleura (LFTP). Clinically, two of the tumors behaved benignly, although one showed frequent mitoses and foci of necrosis. The third tumor exhibited local aggressiveness as evidenced by rib destruction. Cytologically, these tumors exhibited a wide range of cellularity, composed mainly of small, bland oval to spindle cells with moderate numbers of stripped nuclei. Small bits of collagen were seen in the smears. In all cases, cell blocks were instrumental in making the diagnosis. Previous cytologic descriptions of the tumor are briefly reviewed and the cytologic differential diagnosis is discussed. The peripheral location of this uncommon tumor makes it an ideal target for FNA biopsy.

Aged↗
PubMed1992

Cystosarcoma phyllodes of the breast: histologic features, flow cytometric analysis, and clinical correlations.

The histologic features of 187 cases of cystosarcoma phyllodes of the breast were reviewed. The tumors were divided into histologically benign, borderline, and malignant categories. Correlation with clinical outcome was available in 100 cases. Overall rate of local recurrence was 28% (benign, 27%; borderline, 32%; malignant, 26%). Metastases occurred in eight of 100 cases (two borderline and six malignant). Although no histologic features were predictive of local recurrence, stromal overgrowth, mitotic rate greater than 15 per 50 high-power fields, and cytologically atypical stromal cells characterized seven of the eight tumors that metastasized. These features were not evident in the eighth case. Flow cytometric analysis of eight tumors (four benign, two borderline, and two malignant) showed discordance between histology and DNA content in three cases. There was slightly better correlation of histology and S-phase fractions. Based on these results demonstrating the difficulty in predicting clinical outcome, wide local excision remains an appropriate initial method of treatment. Simple mastectomy may be necessary for very large tumors and should be considered in histologically malignant tumors and cases with multiple recurrences, since some recurrent tumors in this series showed increasingly unfavorable histologic features.

Adolescent↗
PubMed1991

Detection of cytomegalovirus in lung allografts. Comparison of histologic and immunohistochemical findings.

Although the histologic manifestation of cytomegalovirus (CMV) is usually characteristic intracellular inclusions and cytomegaly, some investigators, using immunohistochemical or in situ hybridization techniques, have demonstrated the presence of histologically occult infections in certain tissues. A series of lung biopsy specimens from pulmonary transplant recipients were studied using a monoclonal antibody (CCH2) to CMV early viral antigen and the results were compared with routine histologic findings. Occult infection could not be demonstrated in any of these cases. These results may reflect the relative sensitivity of the monoclonal antibody used in this study, although other possible factors are discussed. The results suggest that, in lung allograft biopsy specimens, immunohistochemical analysis using monoclonal antibody CCH2 is not likely to increase significantly the yield of positive cases compared with examination of multiple levels of hematoxylin-and-eosin-stained sections. Additional studies are needed to compare the sensitivity of monoclonal antibodies to CMV antigens using a variety of sampling techniques and clinical settings.

Biopsy↗
PubMed1991

Bronchial carcinoid tumors: assessment with CT of location and intratumoral calcification in 31 patients.

Bronchial carcinoid tumors (BCT) have long been regarded as predominantly central and rarely calcified. The authors retrospectively reviewed computed tomographic (CT) findings in 31 patients (thin-section CT studies in 18) who were seen at their institution with the histopathologic diagnosis of BCT (27 typical, four atypical) during the years 1978-1989. Eighteen BCT (58%) were central and 13 (42%) peripheral, with peripheral defined as located more than 2 cm distal to the origin of the appropriate segmental bronchus. CT scans revealed varied patterns of calcification in seven (39%) of the 18 central BCT and in one (8%) of the 13 peripheral BCT (P less than .1); overall, CT scans revealed calcification in eight (26%) of the BCT. The eight calcified tumors were each of the typical histopathologic type. Peripheral BCT (42%) were nearly as common as central BCT (58%), and CT detection of calcification in BCT was not uncommon (39% of central lesions; 26%, overall).

Adolescent↗
PubMed1991

Bronchogenic cyst: a case report emphasizing the role of magnetic resonance imaging.

The article describes a patient with a right paratracheal bronchogenic cyst in whom the preoperative diagnosis was unclear. The fluid component of the cyst was not readily apparent by CT or T1-weighted MR images. Very intense signal on T2-weighted MR images suggested a cystic lesion. Inhomogeneities evident on MR but not CT images provided further soft tissue characterization. These soft tissue elements correlated with a macroscopic ring of hyaline cartilage in the resected specimen. The usefulness of MRI for the differential diagnosis of mediastinal tumors is discussed.

Adult↗
PubMed1991

Diagnosis of diffuse malignant mesothelioma: experience of a US/Canadian Mesothelioma Panel.

The experience of the US/Canadian Mesothelioma Panel with its first 200 cases is reviewed. The light microscopic diagnosis, histochemical findings, immunohistochemical findings, and electron microscopic features of malignant mesotheliomas are reviewed in the context of differential diagnosis. Reasons for referral of case material to the panel and lessons from follow-up of difficult and controversial cases are reported. Recommendations to general pathologists are made regarding evaluation and review of possible mesotheliomas.

Adenocarcinoma↗
PubMed1989

Nodular bleomycin toxicity.

Pulmonary interstitial fibrosis, a well-known toxic effect of bleomycin therapy, usually presents radiographically as diffuse reticularity. The authors report an unusual case of biopsy-proven bleomycin toxicity that presented as pulmonary nodules mimicking metastatic tumor. The histologic findings resembled those seen in the diffuse form of toxicity but notably also included foci of bronchiolitis obliterans.

Adult↗
PubMed1989

Bronchocentric mycosis occurring in transplant recipients.

Although a variety of long-term, probably immunologically induced pulmonary changes have been described in recipients of both combined heart-lung and bone marrow transplantation, pulmonary infections continue to remain causes of significant morbidity and mortality as well. Herein we describe three patients (two heart-lung and one bone marrow transplant recipient) who had bronchocentric granulomatous mycosis, a tissue manifestation of fungal infection not previously described in the setting of a transplant host. Although one patient was being treated successfully with antifungal agents for his mucormycosis, two other patients eventually died of invasive aspergillosis. This emphasizes that although this process is histologically somewhat similar to bronchocentric granulomatosis, a high index of suspicion for infection needs to be maintained when this pathologic process is identified in a transplant host.

Adult↗
PubMed1988

Gastrointestinal histoplasmosis.

Three cases are reported of gastrointestinal histoplasmosis in patients who came from the Caribbean or South America and had lymphoma, acquired immunodeficiency syndrome, and prior local radiation therapy. The patients had small-bowel obstruction with ileal involvement, mucosal erythema, and friability on colonoscopy with colonic involvement and an exophytic rectal mass with rectal involvement. Review of the 77 reported cases of gastrointestinal histoplasmosis shows that this is a clinical subset of disseminated histoplasmosis. With gastrointestinal involvement, pulmonary symptoms are uncommon and gastrointestinal symptoms predominate. Fever is less common than in other forms of dissemination. The most common lesions are a mass or ulcers, which often mimic inflammatory bowel disease or carcinoma. Terminal ileal involvement predominates in one third. The complement fixation test was positive in about three quarters of cases tested, but the skin test is not diagnostically useful. In one quarter of patients there is other evidence of immunosuppression. In the immunosuppressed, gastrointestinal histoplasmosis must be considered, even in a patient from a nonendemic area, who presents with lesions appearing like carcinoma or inflammatory bowel disease. When feasible, endoscopic examination and biopsy with stains and culture for histoplasmosis is recommended for diagnosis. Medical management is recommended, with surgery reserved for acute emergencies or when mandatory for diagnosis.

Adult↗
PubMed1987

Disseminated Pneumocystis carinii infection in a patient with acquired immunodeficiency syndrome.

Pneumocystis carinii, a frequent cause of pneumonia in immunocompromised patients, rarely disseminates to involve other organs. This report describes a patient with acquired immunodeficiency syndrome and pneumocystis pneumonia in whom extrapulmonary P. carinii infection was diagnosed on duodenal and esophageal endoscopic biopsy specimens. Autopsy revealed dissemination to multiple organs.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Parkinson's disease and megacolon: concentric hyaline inclusions (Lewy bodies) in enteric ganglion cells.

Concentric hyaline inclusions (Lewy bodies), found in the cytoplasm of pigmented and nonpigmented neurons, are considered characteristic of idiopathic Parkinson's disease. The finding of cytoplasmic inclusions identical to Lewy bodies in ganglion cells of the colonic myenteric plexus in a patient with idiopathic Parkinson's disease and acquired megacolon suggests primary involvement of the enteric nervous system by Parkinson's disease.

Humans↗
PubMed1985

Cystosarcoma phyllodes. Report of an unusual case, with death due to intraneural extension to the central nervous system.

Cystosarcoma phyllodes tumors of the breast occasionally exhibit malignant behavior, including chest wall invasion, hematogenous spread or, rarely, metastasis by lymphatic routes. An unusual case of cystosarcoma is presented in which death was apparently caused by perineural and intraneural extension of the tumor along intercostal nerves, to the sympathetic chain, and then to the brain stem by spinal roots, with no evidence of embolic metastasis.

Adult↗
PubMedDate not supplied

CT detection of calcified nodal metastases of lung adenocarcinoma.

Computed tomography of a right middle lobe mass showed no evidence of calcification. Focal calcification in the right midhilar and subcarinal regions was presumed to be granulomatous. Thoracotomy revealed a partially psammomatous adenocarcinoma of lung and dense psammomatous deposits of adenocarcinoma in calcified regional lymph nodes.

Adenocarcinoma↗