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Biomedical subjects

N G Ordoñez

Publications and source records attributed to N G Ordoñez.

At least 19 recordsLinked to original sources
PubMed1997

Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?

PURPOSE: The objectives of this study were to assess clinical outcomes and prognostic factors in unselected, consecutive patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA). PATIENTS AND METHODS: The 1,400 patients analyzed were referred to our unknown-primary tumor (UPT) clinic from January 1, 1987 through July 31, 1994. Clinical data from these patients were entered into a computerized data base for storage, retrieval, and analysis. Survival was measured from the time of diagnosis; survival distribution was estimated using the product-limit method. Multivariate survival analyses were performed using proportional hazards regression and by recursive partitioning. RESULTS: Nine hundred seventy-seven patients were diagnosed with unknown-primary carcinoma (UPC) and 337 of these patients had PDC or PDA. No clinical differences were identified among patients with PDC, PDA, or UPC patients with other carcinoma or adenocarcinoma subtypes. PDC patients enjoyed better survival than PDA patients. Poor cellular differentiation was not an important prognostic variable. Variables predictive of survival included lymph node metastases, sex, number of metastatic sites, histology (PDC v PDA), and age. Although chemotherapy did not appear to influence survival for the entire group of PDC or PDA patients, a subset of patients with good prognostic features experienced median survival durations of up to 40 months. CONCLUSION: The long median survival and chemotherapy responsiveness of UPC patients with PDC and PDA could not be confirmed. However, subpopulations with prolonged median survival durations could be defined, and the value of chemotherapy in this group remains to be determined. Identification and exclusion of treatable or slow-growing malignancies may account for the poor survival of the PDC and PDA patients reported in this study.

Adenocarcinoma↗
PubMed1995

c-erbB-2/neu oncogene and Ki-67 analysis in the assessment of palatal salivary gland neoplasms.

To evaluate the role of the Ki-67 proliferation antigen and c-erbB-2/neu oncogene expression in the clinical assessment of salivary gland tumors, we followed up 71 patients with minor salivary tumors of the palate. All benign neoplasms (n = 18) showed low Ki-67 scores (< 12%), whereas 26% (14 of 53) of malignant neoplasms manifested high Ki-67 scores (> 12%). A significant statistical difference between Ki-67 scores for benign and malignant neoplasms was observed (p < 0.001). Ki-67 index also correlated significantly with malignant tumor grade (p = 0.04) and patient survival (p = 0.02). Only 1 of the 18 benign tumors had c-erbB-2/neu oncogene overexpression. A significant difference between c-erbB-2/neu overexpression in benign and malignant tumors was observed (p = 0.01). Overexpression of c-erbB-2/neu oncogene was noted in 38% (16 of 42) of malignant tumors and was significantly associated with aggressive tumor behavior (p < 0.001). Multivariate analysis of significant factors revealed that gender, tumor stage, and c-erbB-2/neu oncogene overexpression were jointly predictive of survival. Our data indicate that although the Ki-67 proliferating antigen and c-erbB-2/neu oncogene expression may reflect certain intrinsic biologic properties of these neoplasms, only c-erbB-2/neu overexpression is significantly associated with their biologic aggression.

Adolescent↗
PubMed1994

Nephrogenic adenoma of the prostatic urethra involving the prostate gland: a clinicopathologic and immunohistochemical study of eight cases.

Nephrogenic adenoma (NA) of the prostatic urethra with involvement of the prostate gland can mimic other small-gland proliferations of the prostate, particularly adenocarcinoma of the prostate. To further characterize this lesion and refine diagnostic criteria we retrospectively reviewed the clinicopathologic features and immunohistochemical findings of eight cases of NA involving the prostate gland seen at The University of Texas M.D. Anderson Cancer Center from 1987 to 1992. The patients' ages ranged from 44 to 76 years (average age, 65 years). Six patients had lower genitourinary tract operations. Follow-up information was available for six patients (follow-up period, 5 to 38 months); only one patient had clinical evidence of recurrence (5 months after surgery). The remaining patients were alive and well with no evidence of disease. Histologically, NA was characterized by a proliferation of small tubules lined by a single layer of cuboidal or flattened cells with clear or eosinophilic cytoplasm. The nuclei were round with fine chromatin and there was no mitotic activity. Nucleoli were generally small, but occasionally prominent. All NA extended into the prostatic parenchyma, raising the possibility that these lesions may represent prostatic small-gland proliferations, particularly prostate adenocarcinoma. However, all cases tested were negative for prostate-specific antigen and prostatic acid phosphatase. Our findings indicate that the histologic features and the use of prostate-specific antigen and prostatic acid phosphatase immunostains will help to distinguish NA of the urethra involving the prostate from other small-gland proliferations (eg, small-acinar adenocarcinoma of the prostate, clear cell adenocarcinoma of the urethra, sclerosing adenosis, atypical adenomatous hyperplasia, florid hyperplasia of mesonephric remnants, simple lobular atrophy, and incomplete basal cell hyperplasia).

Acid Phosphatase↗
PubMed1993

Granulosa cell tumor of the adult testis: a clinicopathologic study of seven cases and a review of the literature.

We report a study of seven men, aged 16 to 76 years (average age, 47.4 years) with granulosa cell tumor (GCT) of the testis. Three patients presented with testicular enlargement of several years' duration and a fourth presented with a testicular enlargement of unknown duration. The tumors in three patients were detected during routine physical examination. None of the patients had endocrine-related symptoms. All tumors were well circumscribed and showed the solid, cystic, microfollicular, gyriform, insular, and trabecular patterns typical of GCT of the ovary. Call-Exner bodies were present in three tumors and two tumors had a focal spindle-cell component. In one case the surrounding testicular parenchyma showed Leydig's cell hyperplasia and a Sertoli cell nodule. The tumor cells revealed strong immunoreactivity for vimentin but showed no expression for keratin or epithelial membrane antigen. One patient developed liver and retroperitoneal lymph node metastases 121 months after initial diagnosis and died 13 months later. Another patient initially presented with retroperitoneal lymph node metastasis and developed metastasis to the inguinal lymph nodes 12 months later. Three patients are alive at 1, 4, and 37 months with no evidence of disease. Another patient died of an unrelated condition. Follow-up information was not available for the seventh patient. Twelve cases of GCT of the adult testis have been reported in the literature, with metastases occurring in two: one of these two patients had a tumor for 8 years and died of disease 5 months after diagnosis with multiple metastases and the other had metastasis at the time of diagnosis, but was free of disease for 14 years. Our findings and a review of the literature indicate that GCT of the adult testis is a rare and slow-growing neoplasm with the potential to form distant metastases. Because recurrence or distant metastasis may occur late in the clinical course, long-term follow-up of these patients is recommended.

Adolescent↗
PubMed1991

Adenomatous hyperplasia of the rete testis. A clinicopathologic study of nine cases.

Adenomatous hyperplasia of the rete testis is an uncommon lesion that has recently been described. Nine cases of adenomatous hyperplasia were identified in two institutions from 1980 to 1989. At diagnosis the nine patients ranged in age from 30 to 74 years (mean, 59 years; median, 66 years). Three patients presented with a grossly identifiable solid or cystic testicular hilar mass. In six cases adenomatous hyperplasia was an incidental microscopic finding--five from orchiectomy specimens and one from an autopsy specimen. Microscopically, the hyperplasia consisted of a tubulopapillary epithelial proliferation of rete testis. The lining cells were cuboidal to low columnar and lacked nuclear pleomorphism or mitotic figures. The involvement of the rete testis was predominantly diffuse. In seven cases the seminiferous tubules showed atrophic changes. Ultrastructural and immunohistochemical (keratin, epithelial-membrane antigen: positive; vimentin, muscle-specific actin, desmin, and S-100: negative) studies done on one case showed similar features to those of nonhyperplastic rete testis epithelium. No patient with adenomatous hyperplasia showed local recurrence or metastasis. Possible pathogeneses include hormonal imbalance or stimulatory influence that remains as yet unidentified.

Adenoma↗
PubMed1991

Thyroglossal duct carcinoma.

Thyroglossal cysts are common developmental abnormalities of the thyroid gland. The malignant form of these cysts, however, is extremely rare, with fewer than 100 cases reported since 1915. Here we add 10 cases of malignant thyroglossal cysts, nine women and one man, encountered at M.D. Anderson Cancer Center, based on a retrospective review of 51 recorded cases of thyroglossal cysts between 1950 and 1990. All 10 patients underwent a primary Sistrunk procedure. Histologic findings showed nine papillary and one follicular carcinoma. Based on review of the histopathologic material, four patients required no additional therapy. Five patients underwent total thyroidectomy; three of the five also underwent neck dissection. A single microscopic focus of carcinoma in the thyroid gland was found in only two instances. No evidence of nodal metastases was found. One patient with an abnormal thyroid scan is awaiting further treatment. Based on these findings, the Sistrunk procedure is an effective form of therapy for malignant thyrogloassal cysts.

Adenocarcinoma↗
PubMed1990

Myofibroblastoma of the tongue. An immunohistochemical, ultrastructural, and flow cytometric study.

A case of myofibroblastoma arising in the tongue of a 77-year-old man is described. The patient presented with a submucosal tongue mass without other associated symptoms. The tumor was 2 cm in diameter, well circumscribed, and composed of uniform spindle cells arranged in fascicles. Electron microscopic examination and immunohistochemistry demonstrated a myofibroblastic origin for the tumor cells. DNA flow cytometric analysis showed a diploid DNA content of this tumor. To the authors' knowledge, this is the first report of myofibroblastoma occurring in the tongue.

Actins↗
PubMed1990

Uncommon types of thyroid cancer.

Anaplastic carcinoma of the thyroid is rare, making up 5% to 14% of primary malignant thyroid neoplasms. Lymphoma of the thyroid is even rarer, accounting for only 1% to 2% of thyroid malignancies. Other even rarer tumors of the thyroid, such as liposarcoma and angiosarcoma, have also been described. Although these thyroid tumors are rare, it is very important to recognize them because they may present as medical emergencies and constitute a challenge for endocrinologists, surgeons, radiotherapists, and oncologists. Anaplastic carcinoma grows rapidly and has a dismal prognosis. A significant number of patients with anaplastic carcinoma have areas of well differentiated thyroid carcinoma, which supports the hypothesis that anaplastic thyroid carcinoma arises from a pre-existing well differentiated thyroid carcinoma. Younger patients do better than older patients, and those diagnosed at an earlier stage do better than those with metastases at presentation. Multimodality therapy with surgery, radiotherapy, and chemotherapy appears to be of value. Lymphoma of the thyroid may be a primary disease or may involve the gland as part of a systemic disease. It is not usually suspected before surgery or fine-needle aspiration biopsy. Radiotherapy alone, if the disease is limited to the neck, produces good results; however, in patients with mediastinal extension, chemotherapy is indicated.

Carcinoma↗
PubMed1989

A monoclonal antibody cocktail for detection of micrometastatic tumor cells in the bone marrow of breast cancer patients.

We investigated whether monoclonal antibodies (MoAbs) reactive against both acidic and basic cytokeratins alone were sufficient to detect minimal numbers of contaminating epithelial tumor cells in the bone marrow of breast cancer patients. Monoclonal anti-cytokeratin antibodies (AE1 and AE3) were used to stain 14 breast carcinomas by the avidin-biotin-peroxidase technique. Nine tumors (64.3%) showed high reactivity and five (35.7%) showed low or moderate reactivity. Nine MoAbs that proved to be unreactive to light density bone marrow cells by immunoalkaline phosphatase histochemistry were screened for reactivity to breast carcinomas having only low or moderate positivity to cytokeratin antibodies. Three of nine MoAbs showed high percentages of positivity and were selected to supplement the anti-cytokeratin antibodies for immunohistochemical detection of minimal marrow disease in breast cancer patients. A MoAb cocktail was prepared, further tested for reactivity to another five breast carcinomas, and compared with cytokeratin staining alone. The cocktail labeled 100% of carcinoma cells in all the examined specimens. To determine the sensitivity of this panel for detecting minimal numbers of contaminating tumor cells in bone marrow, in vitro mixing experiments were performed. T47D breast carcinoma cells were mixed with bone marrow mononuclear cells at ratios from one tumor cell per 10 bone marrow cells up to one tumor cell per 1 x 10(6) marrow cells, and cytospin preparations were subsequently stained with the MoAb cocktail by the immunoalkaline phosphatase method. Our approach could detect one tumor cell in 1 x 10(5) hematopoietic cells.

Antibodies, Monoclonal↗
PubMed1988

Basal cell hyperplasia, adenoid basal cell tumor, and adenoid cystic carcinoma of the prostate gland: an immunohistochemical study.

Basal cell hyperplasia (BCH) is an uncommon proliferative lesion of the prostate gland. We studied ten cases of BCH, one case of an unusual adenoid basal cell tumor (ABT), and one case of a prostatic adenoid cystic carcinoma (ACC), using a panel of antibodies to define the histogenesis of these lesions. Monoclonal antibodies (MoAb) directed against a cytokeratin, which selectively stains basal cells (34 beta E12), and against muscle-specific actin, which stains myoepithelial cells (HHF35), were used. In addition, antibodies directed against prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), S-100 protein, and vimentin were used. In the normal prostate, epithelial cells reacted positively with 34 beta E12, PAP, and PSA, and negatively with the actin, S-100 protein, and vimentin antibodies. In BCH, positive staining was seen for 34 beta E12, PSA, and PAP, with no reactivity for actin, S-100 protein, and vimentin. In ABT and ACC, positive reactivity was demonstrated for all antibodies except actin and vimentin. These findings indicate that the basaloid cells of BCH, ABT, and ACC are derived from basal cells of the normal prostate gland and suggest a continuum among the three lesions. The presence of S-100 protein in ABT and ACC may be related to the lack of this antigen's specificity for myoepithelial cells. The absence of reactivity with the HHF35 MoAb supports our belief that the S-100 positivity does not necessarily indicate myoepithelial cell differentiation.

Acid Phosphatase↗
PubMed1987

Lewis and related tumor-associated determinants on ovarian carcinoma.

Monoclonal antibodies that defined blood group and related determinants bind to sections of fixed tissues from epithelial ovarian carcinoma in immunoperoxidase assays. Seventy-eight carcinomas and 27 normal tube and ovarian tissues were examined. Lewis (Le)a and Leb determinants were expressed on 58% of the serous carcinomas, on 60% of the endometrioid tumors, and on 78% of the mucinous carcinomas. Sialylated Lea, gastrointestinal cancer-associated antigen (GICA), and lacto-N-fucopentaose (LNF) III, another Le-related determinant, have a similar distribution pattern. Of 10 normal ovaries and fallopian tubes tested from patients without cancer, one reacted with anti-Lea, anti-Leb, or anti-LNF III monoclonal antibodies. Anti-GICA antibodies reacted with tissue from one patient. Le and Le-related antigenic determinants could be useful markers for ovarian cancer.

Antibodies, Monoclonal↗
PubMed1987

Soft-tissue tumors.

A variable number of soft-tissue tumors, depending largely on the experience of the pathologist, cannot be precisely classified by light microscopy, and electron microscopy and/or immunocytochemistry may be required. The applications and limitations of these techniques in the diagnosis of selected soft-tissue tumors are briefly reviewed.

Humans↗
PubMed1986

Capillary hemangioblastoma. An immunohistochemical study.

Previous studies using immunohistochemical methods to determine the presence of glial fibrillary acidic protein (GFAP) and Factor VIII-related antigen (FVIIIR:Ag) in stromal cells of capillary hemangioblastomas have yielded conflicting results with respect to the possible astrocytic and endothelial origins of these cells. This study included Ulex europaeus I lectin (UEAI), a more sensitive marker of endothelial cells. Antibodies were also used as markers of pericytes and a variety of markers were employed to identify different populations of histiocytes. Results of this investigation indicate that FVIIIR:Ag and UEAI are limited only to endothelial cells, and that GFAP is present in entrapped astrocytes only. Positivity of stromal cells was found with some of the histiocytic markers, but the authors were unable to conclude that these cells have a histiocytic origin. It was concluded that currently there is no evidence that stromal cells are derived from endothelial, pericytic, or astrocytic cells-their origin remains uncertain.

Antibodies, Monoclonal↗
PubMed1983

Immunoperoxidase study of uncommon parathyroid tumors. Report of two cases of nonfunctioning parathyroid carcinoma and one intrathyroid parathyroid tumor-producing amyloid.

Nonfunctioning carcinomas of the parathyroid gland are rare and difficult to diagnose. They are often confused with thyroid tumors or with metastasis from other sites. We report two cases of nonfunctioning parathyroid carcinomas; one was originally diagnosed as follicular carcinoma of the thyroid gland. The immunohistochemical demonstration of parathormone in the tumor cells established the parathyroid origin of these neoplasms. An intrathyroid parathyroid tumor, associated with large amounts of interstitial amyloid, mimicking medullary carcinoma of the thyroid, in a patient with primary hyperparathyroidism is also reported. Positive immunoreaction in the tumor cells for parathormone, negative staining for calcitonin, and the return of patients' serum calcium levels to normal after tumor resection, confirmed the parathyroid nature of this neoplasm. Immunohistochemistry studies proved to be extremely helpful in establishing the diagnoses of these unusual parathyroid tumors.

Adult↗
PubMed1982

Immunoperoxidase localization of prostatic acid phosphatase in prostatic carcinoma with sarcomatoid changes.

Immunoperoxidase staining of tissue for prostatic acid phosphatase has been useful in confirming the prostatic origin of metastatic deposits. This technique was used on the prostate tumors of 2 patients to differentiate between a true carcinosarcoma and a pure epithelial carcinoma with sarcomatoid changes. Positive staining for prostatic acid phosphatase in both the sarcomatoid element, as well as the area of well-differentiated carcinoma, confirmed the common epithelial cell origin of these components. Electron microscopy further confirmed these findings by demonstrating desmosomes in the sarcomatoid areas. Although each type of tumor is rare, differentiation between true carcinosarcomas and true carcinomas with sarcomatoid changes is important to elucidate further their different clinical behaviors and responses to therapy.

Acid Phosphatase↗
PubMed1981

The ultrastructure of glomerular haematoxylin bodies.

The ultrastructural features of haematoxylin bodies, present in a patient with active lupus glomerulonephritis, appear to include cellular elements, especially dense chromatin of probable neutrophil leucocyte origin and electron-dense, immune complex-like material. Although the participation of immune complexes in the formation of haematoxylin bodies has been previously proposed, this is the first reported demonstration of such deposits in haematoxylin bodies.

Adult↗