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Biomedical subjects

M R Wick

Publications and source records attributed to M R Wick.

At least 289 records · Page 16Linked to original sources
PubMed1984

Leiomyoblastomas and their relationship to other smooth-muscle tumors of the gastrointestinal tract. An electron-microscopic study.

Twelve cases of gastrointestinal leiomyoblastoma were studied by electron microscopy, and the findings were compared with those in 12 cases of leiomyoma and nine cases of leiomyosarcoma of the gastrointestinal tract. All of the "classic" ultrastructural features of smooth-muscle tumors, including subplasmalemmal dense patches, pinocytotic vesicles, cytoplasmic microfilaments and dense bodies, and focal basement membrane formation, were present in the leiomyoblastomas ; however, extensive sampling was commonly necessary to demonstrate such findings. In contrast, these features were more prominent in leiomyomas and leiomyosarcomas.

Adult↗
PubMed1984

Sebaceous carcinoma of the eyelid. Errors in clinical and pathologic diagnosis.

Sebaceous carcinoma of the eyelid is commonly misdiagnosed because it simulates other entities both clinically and pathologically. In a review of all pathologic material removed from the eyelids of patients at the Mayo Clinic between 1905 and 1981, 43 sebaceous carcinomas were discovered. The tumors manifested most frequently on the upper eyelid; the onset of symptoms occurred in 31 women and 12 men at a mean age of 61.5 years (range, 28-82 years). Of the 43 patients, 11 had an associated second malignant tumor or exposure to irradiation. The microscopic diagnosis was based on finding a proliferation of basophilic neoplastic cells with foamy cytoplasm and a positive fat stain. Intraepithelial neoplasia in the form of pagetoid change or carcinoma in situ was found in more than 80% of cases. Histologically, the tumor tended to be moderately differentiated. A high degree of infiltration was frequently observed cases with metastases. When intraepithelial neoplasia is observed microscopically, we recommend a fat stain on a frozen section and a full-thickness eyelid biopsy to exclude sebaceous carcinoma.

Adult↗
PubMed1983

Cutaneous malignant histiocytosis: a clinical and histopathologic study of eight cases, with immunohistochemical analysis.

Eight cases of autopsy-proved malignant histiocytosis (MH) are reported, in which cutaneous involvement was a prominent finding at initial clinical presentation. In two patients, the disease remained confined to the skin for significant periods before systemic dissemination appeared. Immunohistochemical analysis of cutaneous infiltrates of MH showed uniform negativity of the atypical cells for lysozyme, immunoglobulin light chain, glycogen, and chloroacetate esterase content. In five cases, cytochemical stains for acid phosphatase, butyrate (nonspecific) esterase, chloroacetate esterase, and peroxidase activity were performed on bone marrow aspirates containing malignant cells; all demonstrated diffuse positivity for acid phosphatase and nonspecific esterase, and negativity for peroxidase and chloroacetate esterase. Touch-imprint preparations of cutaneous lesions in one of these cases yielded identical results. These findings indicate that cytochemical methods are preferable to immunohistochemical technics in identification of histiocytic malignancies and that foci of skin involvement may provide a useful source for such diagnostic evaluation.

Acid Phosphatase↗
PubMed1983

Primary neuroendocrine carcinomas of the skin (Merkel cell tumors). A clinical, histologic, and ultrastructural study of thirteen cases.

Neuroendocrine carcinomas of the skin have recently been recognized, and clinicopathologic information on these tumors is accumulating rapidly. We studied 13 such lesions by light and electron microscopy, and eight were subjected to immunohistochemical analysis. The ages of the patients (five women and eight men) ranged from 24 to 84 years. Nine patients had neoplasms occurring in sun-exposed areas; one patient had metachronous symmetric lesions on the arms, and another had antecedent hypohidrotic ectodermal dysplasia. Eight tumors metastasized, and six spread to regional or distant lymph nodes. Three patients died with visceral metastases to the liver, bones, and brain. All patients had their primary tumor confined to the corium and subcutaneous tissue without involvement of overlying epidermis. Tumor cells were round and uniform in size, with delicate nuclear chromatin and a high mitotic rate. An organoid growth pattern was seen in all tumors, with focal trabeculation and rare rosette formation. Ultrastructurally, peripheral cytoplasmic dense-core granules were evident, and perinuclear filament whorls could be seen in all 13 tumors. The latter feature was stable, even in specimens taken from paraffin blocks for electron microscopy. Immunoperoxidase studies failed to reveal serotonin, calcitonin, or adrenocorticotrophin within tumor cells.

Adenocarcinoma↗
PubMed1983

Neuron-specific enolase in neuroendocrine tumors of the thymus, bronchus, and skin.

In order to better define the use of neuron-specific enolase (NSE) as a marker for neuroendocrine neoplasms, we studied 11 thymic carcinoid tumors, three bronchial small-cell carcinomas (all with cutaneous metastases), and 10 trabecular carcinomas of the skin for its presence, using the peroxidase-antiperoxidase (PAP) technic with an antiserum directed at NSE. All 11 carcinoid tumors stained positively, as did two of the bronchial small-cell carcinomas and seven of the trabecular carcinomas. We conclude that PAP staining for NSE content may be a useful adjunct to morphologic analysis in diagnostically identifying the tumors we studied and that our results support the concept of a functionally unified APUD system, as reflected in the tumors originating from it. Nevertheless, because of the vagaries of the PAP method, exemplified by the results in our small series, it cannot be relied upon as a sole indicator that a tumor contains NSE and is therefore neuroendocrine. Also, since it is hypothesized that NSE is present in all tumors of this type, staining for its presence would seem to be of little benefit in distinguishing primary from secondary neuroendocrine tumors or in identifying the origin of metastatic lesions that have a neuroendocrine histologic appearance.

Bronchial Neoplasms↗
PubMed1983

Immunologic, clinical, and pathologic aspects of human graft-versus-host disease.

The three necessary factors in the development of graft-versus-host disease are the histoincompatibility of the host and the effector cells of this process, the immunoincompetence of the host, and the capability of effector cells to proliferate and attack host tissues protractedly in vivo. The disease may affect the alimentary tract, liver, bronchopulmonary tree, bone marrow, reticuloendothelial system, vascular endothelial cells, or epidermis. Graft-versus-host disease is potentially reversible or controllable if prompt, aggressive therapy is instituted. The recommended treatment is a combination of methotrexate, high-dose prednisone, and antithymocyte globulin.

Aged↗
PubMed1983

Multifocal Merkel's cell tumors associated with a cutaneous dysplasia syndrome.

Multifocal Merkel's cell tumors developed in a 24-year-old patient with an unusual cutaneous dysplasia syndrome. The neoplasms behaved in an aggressive fashion, with the development of multiple lymph node metastases. In this case, the dermatologic syndrome had features of both dyshidrotic ectodermal dysplasia and the basal cell nevus syndrome. In addition to Merkel's cell tumors, basal cell carcinomas and actinic elastosis were seen in sun-exposed skin sites. These findings, in conjunction with a known tendency for Merkel's cell tumors to arise in solar-damaged areas, suggest a pathogenetic relationship between these neoplasms and the underlying cutaneous syndrome in this patient.

Adenocarcinoma↗
PubMed1982

Oat-cell carcinoma of the thymus.

Oat-cell carcinoma of the thymus gland is exceedingly rare as a primary lesion, and only a few cases have been reported. We report a case in which a neoplasm interpreted as an oat-cell carcinoma was intimately associated with and arose in transition from a carcinoid tumor of the thymus. Ultrastructural features of this lesion were unusual compared with previous descriptions of thymus neuroendocrine neoplasms.

Adult↗
PubMed1982

Adamantinoma of bone. An electron microscopic and immunohistochemical study.

Adamantinoma of bone is a rare tumor, and fine structural analysis has been done in only a few cases. We report four cases studied by electron microscopy and immunohistochemical methods. Ultrastructural evaluation revealed a characteristic constellation of features, including intracellular bundles of type I microfilaments, moderate numbers of evenly dispersed mitochondria, scattered profiles of rough endoplasmic reticulum, occasional Golgi bodies and lysosomes, and scattered glycogen particles. Microvillous processes and desmosomes were identified in all tumors. Well-formed basement membranes enveloped cell clusters but did not surround individual cells. Intercellular basement membrane-like material also was found focally in pools. Ultrastructural features of endothelial differentiation, including Weibel-Palade bodies, micropinocytotic vesicles, and tight junctions, were not identified. Immunoperoxidase stains for coagulation factor VIII (von Willebrand factor) and blood group antigens were negative, whereas similar stains for keratin were positive. Our findings strongly suggest that adamantinoma is a neoplasm expressing definite epithelial, rather than endothelial, characteristics.

Adolescent↗
PubMed1982

Primary mediastinal carcinoid tumors.

A study of 15 cases of carcinoid tumor of the thymus, diagnosed and treated at the Mayo Clinic, revealed histopathologic features of the neoplasm that might cause it to be confused with other mediastinal tumors, both primary and secondary. The tumor was associated with ectopic ACTH production in six patients, of whom five had Cushing's syndrome. Metastasis, which occurred in 11 patients (73%), was delayed for as long as 8 years after initial diagnosis. Eleven patients underwent surgical resection of their primary thymic neoplasms, and nine of these received postoperative radiotherapy or chemotherapy or both. One patient was treated with chemotherapy alone, and three had no treatment for their neoplasms, which were discovered at autopsy. Eight patients are still alive. Of these, five have developed metastases, and only one is free of metastatic disease more than 5 years after diagnosis. In the two remaining cases, the discovery of the thymic tumor was recent and follow-up is not yet meaningful. Overall, four of the seven patients who died had proven metastatic disease. The mean survival after the appearance of extrathymic tumor in this group was 3 years. Of the five patients who are still alive with metastasis, all have survived at least 2 years since that spread of their disease.

Adolescent↗
PubMed1982

Primary nonlymphoreticular malignant neoplasms of the spleen.

Primary sarcomas of the spleen are exceedingly uncommon neoplasms, approximately 90 substantiated cases having been reported. We report on six cases of primary splenic angiosarcoma and three cases of primary malignant fibrous histiocytoma of the spleen which have been seen at the Mayo Clinic during the last 51 years. In one of the cases of splenic angiosarcoma, the lesion was manifested by spontaneous rupture and hemoperitoneum; interestingly, two cases of splenic malignant fibrous histiocytoma were of the inflammatory type and showed corresponding clinical features of a systemic nature. Five patients with angiosarcoma of the spleen died of metastatic tumor within 3 years after diagnosis; one patient with splenic malignant fibrous histiocytoma is alive with metastasis 11/2 years after splenectomy. One case of splenic angiosarcoma and two of malignant fibrous histiocytoma of the spleen have been diagnosed only recently. All three patients are alive and currently tumor-free, from 3 to 7 months after diagnosis.

Adolescent↗
PubMed1982

Primary thymic carcinomas.

Within a 75-year period, 20 patients with primary nonteratomatous carcinomas of the thymus were seen at the Mayo Clinic. Fourteen were males and six were females, with a mean age of 48 years. Thirteen of the lesions were classified as poorly differentiated or spindling squamous cell carcinomas. One neoplasm was a sarcomatoid carcinoma, and two showed both squamous cell and neuroendocrine ultrastructural features. The remaining four tumors had both light- and electron-microscopic features of neuroendocrine carcinomas. In all 20 patients, careful clinical and pathologic examinations, including autopsy in fatal cases, excluded malignant lymphomas and metastasis to the thymus from epithelial tumors in other anatomic sites. Thirteen patients underwent surgery, with or without postoperative radiotherapy; of these, one was alive and apparently disease-free 43 months after diagnosis. There were two operative deaths. The remaining patients received primary radiotherapy or chemotherapy, or both. The mean survival of the 16 patients who died (excluding operative deaths) was 18.7 months for the 14 patients with tumors of squamous cell differentiation and 36.0 months for the two patients with pure neuroendocrine carcinomas. Among patients with squamous cell carcinoma, 11 developed metastases to lungs, liver, bones, adrenal glands, or extrathoracic lymph nodes; nine of these died of massive local growth within the mediastinum. Among patients with neuroendocrine carcinomas, two of four patients died of local growth within the mediastinum; one of these also had metastases to the liver and adrenal glands. One patient with oat cell carcinoma was alive with residual thoracic tumor and cervical lymph node metastasis 18 months after diagnosis.

Adolescent↗
PubMed1982

Roentgenologic diagnosis of primary corticotropin-producing carcinoid tumors of the mediastinum.

A study was undertaken of five patients with Cushing syndrome due to adrenocorticotropin (ACTH) production by thymic carcinoid tumor (primary mediastinal APUDomas), including two recent patients examined by computed tomography (CT) of the chest. Plain roentgenography of the chest initially failed to detect tumor in four of the five patients, while CT of the chest yielded definitive diagnostic information in both patients in whom it was employed. For one of these patients, a mediastinal tumor could be seen retrospectively on plain roentgenograms of the chest, although it had been missed on the first examination. One of the tumors appeared to be partially calcified on CT scan, a finding not previously reported. Blastic osseous metastasis, which is common when malignant carcinoid tumors spread to bone, was seen in one patient. Our data suggest that in patients with suspected ectopic ACTH production, CT scanning of the mediastinum should be performed early in order to avoid delay in diagnosis of an ACTH-secreting carcinoid tumor of the mediastinum.

Adolescent↗
PubMed1982

Cerebral angioendotheliomatosis.

Angioendotheliomatosis is a rare, often disseminated proliferation of malignant intravascular cells of presumed endothelial origin. The disease may primarily affect the cerebral vasculature and lead to confusing symptoms and signs that often defy accurate clinical diagnosis.

Adult↗
PubMed1982

Primary pulmonary leiomyosarcomas. A light and electron microscopic study.

Fewer than 100 cases of primary leiomyosarcoma of the lung have been reported, few of which have been studied by electron microscopy. We performed clinicopathologic studies, including fine structural analysis, of two such cases. Their ultrastructural features differed in part from those of other smooth-muscle tumors, which may help exclude other malignant pulmonary lesions from the differential diagnosis.

Adult↗