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Biomedical subjects

M R Hendrickson

Publications and source records attributed to M R Hendrickson.

46 records · Page 3Linked to original sources
PubMed1985

Conservative treatment of borderline ovarian tumors.

Of 61 patients with stage IA borderline ovarian tumors, 41 were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy, and 20 were treated by a variety of more limited operations, including cystectomy with (one patient) and without (three patients) a contralateral ovarian wedge biopsy, and unilateral salpingo-oophorectomy with (six patients) and without (ten patients) a contralateral wedge biopsy. In the group treated conservatively, there were 11 serous, seven mucinous, and two mixed seromucinous borderline tumors, whereas in the total abdominal hysterectomy and bilateral salpingo-oophorectomy treatment group there were 26 serious, 12 mucinous, and three mixed seromucinous borderline tumors. After a mean follow-up of 89 months (range 36 to 244 months), subsequent borderline neoplasms had developed in three patients (15%) with serious borderline tumors initially treated conservatively and in two patients (5%) with serous or mixed seromucinous borderline tumors initially treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy. No patient with a mucinous borderline tumor treated either conservatively or with total abdominal hysterectomy and bilateral salpingo-oophorectomy developed a subsequent neoplasm. All 61 patients in the study group are alive and free of disease, including those who developed recurrent neoplasm.

Adult↗
PubMed1983

Ciliated carcinoma--a variant of endometrial adenocarcinoma: a report of 10 cases.

Ten examples of endometrial adenocarcinoma composed predominantly of ciliated cells were studied. Four of these neoplasms were examined ultrastructurally to confirm the presence of cilia. Hysterectomy was the treatment for all 10 patients; 4 patients received intracavitary radiation prior to surgery. All 10 of the resected uteri contained residual ciliated adenocarcinoma, and in five ciliated carcinoma invaded the myometrium. A microscopic focus of endometrioid carcinoma, thought to be a second simultaneous primary neoplasm, was present in the ovary of one of the patients. Although ciliated cells are almost always limited to benign endometrial proliferations, this study clearly demonstrates that rare carcinomas, some of which invade the myometrium, are composed of ciliated cells. The light microscopic appearance of these rare ciliated carcinomas is sufficiently distinctive to permit their recognition.

Adenocarcinoma↗
PubMed1983

Primary mucinous adenocarcinoma of the endometrium. A clinicopathologic and histochemical study.

Of 256 patients with carcinoma confined to the uterine corpus at the time of hysterectomy treated in the period 1959-1975 at Stanford University Hospital, 98 patients (38%) had neoplasms which demonstrated at least focal intracytoplasmic mucin. In 21 carcinomas (9%), intracytoplasmic mucin production was the dominant form of differentiation--a group which we designate primary mucinous carcinoma of the endometrium. Freedom from relapse and frequency of myometrial invasion were not statistically different for patients whose neoplasms contained intracytoplasmic mucin, regardless of the amount of mucin present, when compared with cases of nonmucin-containing carcinoma. Using histochemical methods, it was impossible reliably to distinguish between the intracytoplasmic mucin produced by carcinomas arising in endometrium and that produced by carcinomas primary in the endocervix. Differential biopsy and fractional curettage are stressed as useful tools in making this clinically important distinction. Since both benign mucinous metaplasia and mucinous carcinoma may arise in the endometrium, it is important to establish histopathologic criteria by which the malignant lesions may be recognized. The use of criteria illustrated in this paper (which include architectural complexity of proliferation, epithelial stratification, loss of epithelial polarity, and nuclear atypicality) resulted in the recognition of mucin producing proliferations which as a group manifest a 50% incidence of myometrial invasion.

Adenocarcinoma↗
PubMed1983

Optically clear nuclei. An alteration of endometrial epithelium in the presence of trophoblast.

Examples of focal clearing of endometrial epithelial nuclei associated with the presence of trophoblastic tissue have been observed recently in our surgical pathology laboratories. These nuclear alterations were initially observed in endometria from first- and second-trimester spontaneous abortions, term pregnancies, and a uterus harboring choriocarcinoma. Subsequently, an identical change was seen in small foci of endometriosis removed during postpartum tubal ligation. The prominent vacuolated appearance to the nuclei resembled, in some cases, the inclusions seen in herpesvirus infection, but electron-microscopic study showed that the nuclear clearing was due to replacement of normal chromatin by a network of fine filamentous material rather than herpesvirus DNA. A subsequent review of 200 consecutive first-trimester abortions found less-striking degrees of this change in 7% of cases. The endometrial nuclear clearing was focal; often the endometrium also contained cells which demonstrated the Arias-Stella reaction. The etiology of this type of nuclear clearing is not known, but the fibrils may represent a thread-like substructure of normal chromatin which forms as a result of hormonal stimulation of endometrial epithelial cells.

Abortion, Spontaneous↗
PubMed1981

Neoplasms arising in congenital giant nevi: morphologic study of seven cases and a review of the literature.

Congenital giant nevi are complex cutaneous malformations composed of melanocytic and occasionally neural supportive elements. Malignant neoplasms arising in this setting are not uncommon, and their histologic appearances often differ significantly from the typical pattern of malignant melanoma. We report six patients with neoplasms arising in congenital giant nevi and one patient with a neoplasm arising in an extensive congenital blue nevus, and present a description of the neoplastic patterns encountered. These patterns include 1) poorly differentiated small round cell cancer, 2) malignant cellular blue nevus, 3) spindle-cell malignant tumor with lamellar cell (pseudomeissnerian) differentiation, 4) so-called minimal deviation melanoma, 5) heterologous malignant mesenchymal differentiation including rhabdomyosarcoma and liposarcoma, and 6) undifferentiated spindle cell cancer. We have reviewed the literature in order to address the question of frequency of malignant transformation in congenital giant nevi, the reported experience with the morphology of these cancers, and the histogenesis of these sometimes complex neoplasms as it is illuminated by our current understanding of the embryology of the neural crest.

Adolescent↗
PubMed1980

The differential diagnosis of endometrial adenocarcinoma. Some viewpoints concerning a common diagnostic problem.

Histological criteria which we have found useful for diagnosing endometrial adenocarcinoma are presented and guidelines are developed for separating adenocarcinoma from benign proliferations which can mimic carcinoma, including endometrial hyperplasia with atypia, endometrial epithelial metaplasias, secretory endometria and disintegrating endometrium. The problem of distinguishing endometrial adenocarcinoma from other malignancies is also discussed.

Adenocarcinoma↗
PubMed1980

Endometrial epithelial metaplasias: proliferations frequently misdiagnosed as adenocarcinoma. Report of 89 cases and proposed classification.

Endometrial epithelial metaplasia refers to the replacement of the normal endometrial glandular epithelium by cells that are either not encountered in the normal endometrium or, if present, are usually inconspicuous elements. Because these cells appear unusual or "atypical" and because they may line architecturally complex glands, this benign process is frequently confused with adenocarcinoma. This report concerns the clinical and light-microscopic findings in 89 patients whose endometria demonstrated some form of metaplasia. Most of these metaplastic changes could be placed in one of the following seven categories: 1) morules and squamous metaplasia; 2) syncytial papillary metaplasia; 3) ciliated cell metaplasia ("tubal" metaplasia); 4) eosinophilic metaplasia; 5) mucinous metaplasia; 6) hobnail metaplasia; or 7) clear cell metaplasia. The defining characteristics of each of these groups and their differential diagnoses are discussed. The majority of women whose endometria demonstrated metaplastic transformation were postmenopausal, and most had received some form of oral estrogen replacement therapy within 3 months of the time of curettage or endometrial biopsy.

Adenocarcinoma↗