Biomedical subjects

M R Wick

Publications and source records attributed to M R Wick.

At least 253 records · Page 14Linked to original sources

PubMed1986

Neuroendocrine differentiation in müllerian neoplasms. An immunohistochemical study of a "pure" endometrial small-cell carcinoma and a mixed müllerian tumor containing small-cell carcinoma.

Two neoplasms of the endometrium exhibiting histologic features of small cell carcinoma (SCC) were studied immunohistochemically for the presence of antigens indicative of neuroendocrine differentiation. The first case, a pure SCC, was positive for neuron-specific enolase (NSE), Leu-7, and chromogranin. The second case, a mixed müllerian tumor, had an extensive SCC component; the latter element was reactive for NSE and Leu-7. The first patient has had an unexpectedly long survival, while the second patient died with multiple distant metastases, containing only SCC.

Aged↗

PubMed1986

Duodenal gangliocytic paraganglioma. Clinicopathologic and immunocytochemical study of 11 cases.

The clinicopathologic features of 11 cases (8 in men) of duodenal gangliocytic paraganglioma are presented. The patients averaged 56 years of age; none showed evidence of phakomatosis. Ten tumors occurred in the second portion of the duodenum, and one arose in the third portion. All tumors were polypoid, and half presented with gastrointestinal bleeding. The neoplasms were composed of paraganglioma and carcinoid-like elements, neurons, and Schwann as well as sustentacular cells. All tumors behaved in a benign fashion after local resection or snare polypectomy; long-term follow-up (1-25 years; mean, 8.3 years) showed no recurrence in any case. Immunocytochemical examination demonstrated the presence of somatostatin, serotonin, and human pancreatic polypeptide within endocrine cells and neurons.

Aged↗

PubMed1986

Primary adenoid cystic carcinoma of the skin. A clinical, histological, and immunocytochemical comparison with adenoid cystic carcinoma of salivary glands and adenoid basal cell carcinoma.

An adenoid cystic carcinoma of the skin was compared with three similar neoplasms of salivary glands and with an adenoid basal cell carcinoma, from unrelated cases. The histological and immunocytochemical details of these tumors were analyzed in an attempt to determine whether or not their differing clinical behaviors would be reflected in pathologic dissimilarities. Although the single adenoid cystic carcinoma of the skin did not recur or metastasize over a 10-year follow-up period, its morphologic and biochemical features were identical to those of biologically aggressive salivary gland tumors. All four adenoid cystic carcinomas contained carcinoembryonic antigen, epithelial membrane antigen, salivary-type amylase, and alpha-lactalbumin, and all bound peanut agglutinin. Three of four expressed positivity for S100 protein, and two contained low-molecular-weight cytokeratin. In contrast, none was immunoreactive for beta-2-microglobulin, and only one displayed blood group isoantigen positivity. The adenoid basal cell carcinoma was negative for all immunological determinants, but it bound peanut agglutinin. Although these results should be regarded as preliminary, it appears that adenoid cystic carcinoma is a pathologically distinct and uniform entity, whether it occurs in the skin or in salivary glands. However, the clinical behavior of this tumor cannot be predicted on the basis of immunohistochemical or morphological studies. Finally, adenoid basal cell carcinoma is histopathologically and immunocytochemically separable from cutaneous adenoid cystic carcinoma.

Aged↗

PubMed1986

Disseminated lobular capillary hemangioma (pyogenic granuloma). A clinicopathologic study of two cases.

The eruption of multiple lobular capillary hemangiomas (granulomata pyogenicum) is a previously documented but uncommon phenomenon. Reported cases have featured the recurrence of multiple satellite lesions after surgical removal of, or trauma to, a solitary capillary hemangioma. Sporadic cases of multifocal lesions arising de novo in both previously traumatized and uninjured skin have been described as well. We describe herein two unusual patients with disseminated lobular capillary hemangioma. One patient developed skin nodules in several sites, including the mouth, knee, thumb, and foot, after surgical removal of a solitary oculocutaneous neoplasm. The second patient had more than 700 skin lesions, distributed over the entire body. Unlike those in most previously reported examples of this condition, these two patients were elderly. Both were misdiagnosed clinically as having malignant vascular neoplasms, but the behavior of the lesions was benign, despite conservative surgical excisions in one patient and relative lack of therapeutic intervention in the other.

Facial Neoplasms↗

PubMed1986

Choroid plexus neoplasms. Clinicopathologic and immunohistochemical studies.

Choroid plexus neoplasms account for less than 1% of all intracranial tumors, with papillomas (CPPs) more frequent than carcinomas (CPCs). Immunocytochemical characterization of these neoplasms has been limited. Glial fibrillary acidic protein (GFAP), S100 protein, and keratin have been variably demonstrated by others. Ten cases were identified at two hospitals over a 25-year period; six were children and four were adults. There were seven cases of CPP and three of CPC. Extracranial metastases occurred in one case of CPC and multiple local recurrences were common. Immunohistochemical examination was performed with polyclonal antibodies to keratin, alpha-fetoprotein (AFP), desmin, neurofilament, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), and S100 protein, and with monoclonal antibodies to vimentin, 45- to 54-kd cytokeratin (CKER), and carcinoembryonic antigen (CEA). Among the seven cases of CPP, five were positive for CKER, three for keratin, two for CEA, two for NSE, and five for S100. Three cases of CPC were positive for CEA, three for CKER, and two for keratin. With one exception, when a neoplasm was positive for CEA and S100 it was also positive for CKER. Positivity for CEA in this group was associated with a more aggressive histologic pattern and heralded a worse prognosis. S100 immunoreactivity appeared to predominate in well-differentiated neoplasms. Keratin and CKER were found in both CPP and CPC, but may be useful in the distinction from ependymomas. Statistical analysis resulted in the following classification rule: If the CEA stain is positive and the S100 stain is negative, then the tumor is malignant; otherwise, the tumor is benign.

Adolescent↗

PubMed1986

The occurrence of sarcomatous components in primary mediastinal germ cell tumors.

The occurrence of a sarcomatous component in germ cell tumors is an uncommon phenomenon; seven cases with such an association are presented. The sarcomatous elements were rhabdomyosarcomatous in four cases, angiosarcomatous in two, and a combination of these two types in one case. Immunohistochemical studies supported the endothelial and skeletal muscle differentiation of the sarcomatous components. All patients were treated surgically, and some received various chemotherapeutic agents and radiation. On follow-up, four patients had died of their disease, one developed recurrence and pulmonary metastases, one was free of disease after 4 years, and one is a recent case. Chemotherapy protocols may need to be altered to include sarcoma-oriented drugs for this particular group of patients.

Adolescent↗

PubMed1986

Pilomatrix carcinoma: an immunohistochemical comparison with benign pilomatrixoma and other benign cutaneous lesions of pilar origin.

Two new cases of pilomatrix carcinoma are reported. They were studied immunohistochemically for the presence of high and low-molecular weight cytokeratins, beta-2-microglobulin, S-100 protein, carcinoembryonic antigen, epithelial membrane antigen, blood group isoantigens, and peanut agglutinin binding. Results of these studies were compared with those obtained in immunohistologic analysis of 13 typical pilomatrixomas, and 4 other benign lesions with hair follicle differentiation. An attempt was made to correlate antigenic expression with malignant transformation; however, there were no consistent differences between the 2 groups. It would seem that immunocytochemistry is of no assistance in differential diagnosis between benign and malignant hair matrical tumors. Hence, the pathologist must rely on morphological criteria alone to make a diagnosis of pilomatrix carcinoma.

Adult↗

PubMed1986

Primary neuroendocrine carcinoma and small-cell malignant lymphoma of the skin. A discriminant immunohistochemical comparison.

In selected instances, primary cutaneous neuroendocrine carcinoma (PCNEC) and small-cell malignant lymphoma (SCML) of the skin may display similar clinical presentations and microscopic appearances, leading to diagnostic uncertainty. We applied monoclonal antibodies to epithelial membrane antigen (EMA), Ia antigen, and leukocyte common antigen (LCA) to 31 cases of PCNEC and 12 of small-cell lymphoma cutis, using a combined PAP and ABC procedure, to determine whether or not such stains were capable of separating the two neoplasms. All cases of SCML were reactive for LCA, while this determinants was not seen in any example of PCNEC. Anti-Ia antigen labelled 11 of 12 cases of SCML, and also failed to stain neuroendocrine carcinomas. Lastly, EMA was observed in 25 of 31 cases of PCNEC, but it was found in one lymphoplasmacytoid lymphoma as well. Bayes' univariate statistical analysis of these data indicates that anti-LCA, anti-EMA, and anti-Ia antigen are capable of discriminating between the tumors in question, with anti-LCA being the most effective.

Adenocarcinoma↗

PubMed1986

Epithelioid sarcoma and isolated necrobiotic granuloma: a comparative immunocytochemical study.

Epithelioid sarcoma (ES) occasionally may be confused, both clinically and histologically, with isolated necrobiotic granulomas (ING), leading to misdiagnosis and potential mismanagement of these conditions. We studied 11 cases of ES and 11 of ING (6 examples of deep granuloma annulare and 5 of rheumatoid nodule) immunohistochemically, in an attempt to determine whether they could be diagnostically separated by such means. Monoclonal antibodies to cytokeratin polypeptides (CK), epithelial membrane antigen (EMA), and leukocyte common antigen (LCA) were applied to formalin-fixed, paraffin-embedded sections in each case, using the avidin-biotin-peroxidase complex technique. All ES cases stained positively for CK, and 6 expressed EMA, while examples of ING were non-reactive for these antigens. Conversely, the large epithelioid histiocytic cells in cases of ING were immunoreactive with anti-LCA, whereas no case of ES displayed this determinant in tumor cells. In the latter lesions, reactive peritumoral inflammatory cells were LCA-positive, but were readily distinguished from neoplastic cells on morphological grounds, as well as by their negativity with anti-CK and anti-EMA. Based on these data, it is concluded that immunohistologic stains for epithelial and hematopoietic antigens are valuable in the conclusive diagnostic separation of epithelioid sarcoma and necrobiotic granulomas.

Adolescent↗

PubMed1986

Osteosarcoma: role of CT in limb-sparing treatment.

The computed tomographic (CT) examinations of 17 patients undergoing evaluation for limb-sparing treatment of osteosarcoma were evaluated. In all cases information from CT directly affected the operative approach. The CT findings that helped in planning the operative approach included determination of intramedullary extent and evidence of "skip" metastases, direct extension into an adjacent joint, and neurovascular compromise. Performing CT of the affected bone at 1-cm intervals from the joint above through the joint below and including the contralateral side in the field of view allow precise localization of findings that can direct the operative approach. Close and contiguous scanning intervals allow identification of small intramedullary "skip" metastases that affect the resection margins.

Adolescent↗

PubMed1986

Dedifferentiated chondrosarcoma: an ultrastructural study of two cases, with immunocytochemical correlations.

The clinicopathologic features of two cases of dedifferentiated chondrosarcoma (DCS) are presented, in which anaplastic components showed the electron microscopic features of malignant fibrous histiocytoma, as well as immunoreactivity for alpha-1-antitrypsin and alpha-1-antichymotrypsin. Rare cells also displayed S100 protein in high-grade areas of the primary tumors, but a pulmonary metastasis lacked this determinant. These findings could be interpreted as reflecting a retained potential for primitive chondrogenesis in primary DCS, which may be lost in its metastases. In all other respects, this tumor appears to assume the morphological and immunocytochemical attributes of a fibrohistiocytic neoplasm.

Bone Neoplasms↗

PubMed1986

Primitive cerebral neuroectodermal tumor with rhabdomyoblastic differentiation.

A case is presented of a primitive neuroectodermal tumor located in the left frontal cerebrum, which demonstrated electron microscopic and immunocytochemical evidence of rhabdomyoblastic differentiation. Within the group of supratentorial primitive neuroectodermal tumors, only medulloepithelioma has previously been shown to manifest "divergent" differentiation. In several respects our case is analogous to infratentorial "medullomyoblastoma."

Brain Neoplasms↗

PubMed1986

Cisplatin chronotherapy and disulfiram rescue reduce toxicity without interfering with anticancer activity: animal findings and preliminary clinical experiences.

Cisplatin-induced mortality and nephrotoxicity are each predictably worse when the drug is given at certain points within the circadian schedule. Oral disulfiram protects rats from toxic effects at some circadian stages but not others. This manuever does not diminish the anticancer activity of cisplatin in these rats. Human beings given 2 g of oral disulfiram and high doses of cisplatin at the circadian stage associated with least cisplatin nephrotoxicity (prospectively determined potassium excretion acrophase) suffer little or no kidney damage. Disulfiram administration apparently does not interfere with the antineoplastic activity of cisplatin in humans. This is the first demonstration of the feasibility of assignment of treatment time according to a measure of the patient's 'internal clock' as assessed by pretreatment marker rhythmometry. It also establishes the feasibility of giving disulfiram to human beings.

Aged↗

PubMed1986

Adrenocortical carcinoma. An immunohistochemical comparison with renal cell carcinoma.

The diagnosis of adrenocortical carcinoma (ACC) is often difficult, because this tumor may present with direct extension into adjacent renal parenchyma or with metastatic disease. Renal cell carcinoma and other histologically similar tumors are potentially confused with ACC by conventional light microscopy, and their separation from the latter is often impossible without the aid of additional studies. Furthermore, the distinction between adrenal cortical adenoma and ACC may also be problematic. Because of these factors, the authors studied 10 cases each of ACC, adrenocortical adenoma, and renal cell carcinoma (RCC) immunohistochemically, in an attempt to develop objective parameters which may aid in this differential diagnostic dilemma. Nontrypsinized, formalin-fixed, paraffin-embedded specimens were used in all cases, and tissue from the adrenocortical tumors was also studied for intermediate filament content after protease digestion. All 20 nontrypsinized adrenocortical neoplasms were positive for vimentin, but not for cytokeratin, epithelial membrane antigen, or blood group isoantigens. Conversely, each of 10 cases of RCC expressed epithelial membrane antigen, cytokeratin, and blood group isoantigens, but none was immunoreactive for vimentin. Two adrenocortical carcinomas and three adenomas manifested cytokeratin positivity after trypsin digestion. There were no significant differences between the immunostaining profiles of ACC and adrenocortical adenoma, which suggest that this distinction must still rely upon clinical and morphologic criteria.

Adenoma↗

PubMed1986

Reassessment of malignant "angioendotheliomatosis". Evidence in favor of its reclassification as "intravascular lymphomatosis".

Malignant angioendotheliomatosis (MAE) is a lethal intravascular proliferation which has been thought to be of endothelial origin. In order to characterize its cellular nature, we studied 15 cases of MAE immunocytochemically, using antisera for factor VIII-related antigen, cytokeratin, epithelial membrane antigen, vimentin, blood group isoantigens, thoracic duct lining cell antigens (TDLCA), common leukocyte antigen, and Ulex europaeus I lectin. In 14 of 15 cases, common leukocyte antigen was observed in malignant intravascular cells. Similar reactivity for factor VIII-related antigen was present in 14 cases, but was largely restricted to cells enmeshed in fibrin-platelet thrombi, and probably represents adsorption of platelet-derived factor VIII by tumor cells. All cases failed to bind Ulex europaeus lectin and lacked immunoreactivity for TDLCA, cytokeratin, epithelial membrane antigen, and blood group isoantigens; two manifested positivity for vimentin. Immunofluorescent microscopy of frozen tissue in one case showed monoclonal IgM-kappa immunoglobulin on the surfaces of tumor cells. Electron-microscopic study of three cases disclosed a predominant cell type lacking features of epithelial or endothelial differentiation; a minor cell population displayed endothelial characteristics and was thought to be reactive. Four patients with typical MAE also had extravascular large-cell lymphoma in lymph nodes, spleen, adrenal glands, stomach, or soft tissues. Six patients showed clinical evidence of autoimmune disease. These results suggest that MAE displays lymphoid rather than endothelial differentiation.

Aged↗

PubMed1986

Nephroblastoma. A comparative immunocytochemical and lectin-histochemical study.

Nephroblastomas (Wilms' tumors) from a dog, a bird, a pig, and a child were subjected to comparative immunocytochemical and lectin-histochemical analysis along with normal renal tissues from the same animals. Primary rabbit and mouse anti-human antibodies directed at intermediate-filament proteins, neuron-specific enolase, S100 protein, and epithelial membrane antigen were employed, as were biotinylated peanut agglutinin, soybean agglutinin, wheat germ agglutinin, and lectins from Dolichos biflorus and Ulex europaeus. The human neoplasm showed positivity for cytokeratin and epithelial membrane antigen and bound peanut, soybean, and wheat germ agglutinins in epithelial areas. Among the animal tumors, the porcine and canine nephroblastomas showed immunoreactivity for cytokeratin and vimentin in epithelial and blastematous areas, respectively. In addition, they were positive for S100 protein in epithelial foci. All of these results were substantiated by staining patterns in nonhuman kidneys. None of the neoplasms or renal tissues showed reactivity to the other antigens that were assessed. In the porcine tumor, endothelial cells bound D biflorus lectin, and epithelial areas were stained by U europaeus lectin. The avian nephroblastoma bound peanut, soybean, and wheat germ agglutinins, while the canine neoplasm showed no lectin-histochemical reactivity. These data appear to reflect limited immunohistological and histochemical similarities between nephroblastomas of different vertebrates.

Animals↗

PubMed1986

Primary duodenal small-cell neuroendocrine carcinoma with production of vasoactive intestinal polypeptide.

A primary duodenal small-cell neuroendocrine carcinoma was found in an elderly man who presented with upper abdominal pain. Although metastatic small-cell carcinoma was documented by liver biopsy, the primary lesion was not identified until postmortem examination. The latter tumor, which ulcerated the duodenal mucosa, was composed of small ovoid cells with sparse cytoplasm and granular chromatin. Electron microscopy revealed cytoplasmic dense-core granules. Immunocytochemical study demonstrated the presence of neuron-specific enolase, Leu 7 antigen, chromogranin, epithelial membrane antigen, and vasoactive intestinal polypeptide within tumor cells. However, there was no evidence of a clinical endocrinopathy. This case emphasizes the need to include the duodenum as a possible primary site when metastatic small-cell neuroendocrine carcinoma is seen in the absence of apparent pulmonary disease.

Aged↗

PubMed1986

Cystosarcoma phyllodes of the prostate. A pathologic and immunohistochemical study.

We treated two patients who had lesions in the prostate with histologic features similar to those of cystosarcoma phyllodes of the breast. In one case, the stroma progressed to a clearly sarcomatous appearance, whereas the other tumor had a cellular stroma that was mitotically inactive. This element was immunoreactive for vimentin and desmin in both cases but was negative for epithelial markers. In contrast, the epithelial component was immunoreactive for prostate-specific antigen and epithelial membrane antigen. Following surgical resection, both patients were well two and three years later, without local recurrence or distant metastasis. The histogenesis of these tumors is unknown.

Adult↗