Biomedical subjects
P Bannatyne
Publications and source records attributed to P Bannatyne.
Autoimmune oophoritis: a clinicopathologic assessment of 12 cases.
Twelve cases of histologically confirmed autoimmune oophoritis are described. Eight presented with symptoms and laboratory evidence of premature ovarian failure (POF). Four were diagnosed unexpectedly after hysterectomy for endometrial pathology or for sequelae of cystic enlargement of the ovaries. Two of eight patients tested had serum anti-ovarian autoantibodies (Aab), while five of seven had anti-adrenal Aab. Two women had, or subsequently developed, Addison's disease, and two patients had Hashimoto's disease at presentation. All women with this disease risk the development of adrenal failure and hypothyroidism. Microscopically, 11 cases showed a lymphoplasmacytic infiltrate that spared primordial follicles but involved, with progressive intensity, early and late preovulatory follicles and corpora lutea. Sparse perivascular and perineural inflammatory infiltrates were also present. The twelfth case appeared to be a unique case of granulomatous oophoritis, considered autoimmune because of the folliculotropic nature of the inflammatory process. Three cases showed evidence of follicular dysplasia.
Composite mucinous and granulosa-cell tumor of ovary: case report of a unique neoplasm.
A 63-year-old woman presented with signs and symptoms of an estrogen-producing ovarian tumor. At laparotomy, this tumor proved to be a multilocular right ovarian mass 20 cm in greatest diameter. The cystic spaces were lined by typical benign mucinous epithelium of the endocervical type, while the greatly thickened cyst walls contained a diffuse proliferation of granulosa cells. These two disparate components were intimately mixed at a variably complex interface to form a composite tumor. While composite tumors showing sex cord-stromal and epithelial elements are well documented, they have all, to date, been of moderately to poorly differentiated androblastomatous or Sertoli-Leydig cell type, associated with heterologous mucinous elements of intestinal differentiation. The combination of granulosa-cell tumor with mucinous elements of endocervical or müllerian type has not hitherto been reported and is of uncertain histogenesis.
Cytogenetic studies in perinatal death.
Following tissue culture cytogenetic studies were performed on tissue obtained from 136 fetuses who died in the perinatal period (98 stillbirths and 38 neonatal deaths). The gestational age of the stillbirths was evenly distributed between 20 and 40 weeks (1 was 42 weeks) while 74% of the neonatal deaths were term babies. Analyzable metaphases were obtained in 45 stillbirth specimens (46%) and 32 neonatal specimens (84%). Abnormal karyotypes were identified in 7 of the stillbirths (15.5%) and 8 of the neonatal deaths (25%) and all these were from babies with congenital anomalies identified at autopsy. Time delays were crucial to the success of culture from stillbirths, but specimens obtained from neonatal deaths could be grown successfully up to 3 days after death. Generally the placenta was more viable than other tissues, including skin, cartilage and muscle. Whereas growth was obtained in 69% of fresh unexplained stillbirths, no tissue from the macerated stillbirths grew. This is a group which may have a high abnormality rate. We recommend that if fetal assessment during pregnancy suggests a compromised fetus and there are no maternal factors to account for this, an amniocentesis be performed.
Extraovarian peritoneal serous papillary carcinoma. A clinicopathologic study of 31 cases.
The rate and clinical features of patients admitted to King George V Hospital with extraovarian peritoneal serous papillary carcinoma during a 9-year period were reviewed. In this time, 31 of 236 (13%) patients with an initial diagnosis of invasive serous ovarian carcinoma fulfilled the surgicopathologic criteria for this entity. All patients had disseminated tumor equivalent to ovarian Stage III and IV disease (International Federation of Gynecology and Obstetrics [FIGO]) and with predominantly high-grade neoplasms. They were managed by surgical exploration, tumor debulking where possible, and postoperative chemotherapy. A comparison with a contemporaneous series of 139 patients with primary epithelial ovarian carcinoma matched for stage and grade of disease and managed similarly showed no difference in actuarial survival. The median survival times were 11.3 months for patients with extraovarian serous papillary carcinomas and 13.5 months for patients with equivalent primary ovarian neoplasms. The features of the disease and the treatment regimens used are discussed.
Hypercalcemia in association with mucinous adenocarcinoma of the ovary: a case report.
Hypercalcemia in association with mucinous adenocarcinoma of the ovary has not previously been reported. Such a case is presented.
Vulvar adenosquamous carcinoma arising in a hidradenoma papilliferum, with rapidly fatal outcome: case report.
A 65-year-old woman with adenosquamous carcinoma of the vulva arising in a hidradenoma papilliferum died from disseminated tumor 2 months after local excision. The light and electron microscopic features of the lesion are presented. The possible origins of vulvar adenosquamous carcinoma are discussed.
Intestinal heterotopia: an unusual cause of vulval ulceration. Case report.
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King George V Memorial Hospital, Sydney-Ovarian Cancer Programme (1978-1982).
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Argyrophilia and endometrial carcinoma.
The incidence and patterns of argyrophilia in 25 endometrial carcinomas were analysed and correlated with other pathological features. In addition, the frequency with which argyrophilia was identified within nonneoplastic endometrium and cervix from this carcinoma group was compared with that of a control group of 25 patients without malignant disease. Using the Grimelius stain, argyrophilia was observed in 68% of endometrial carcinomas, although in 28%, only rare positive cells were identified. Seven tumours (six argyrophilic carcinomas and one small-cell undifferentiated carcinoma) were examined by electron microscopy, which revealed neurosecretory granules. Argyrophilia was also found at the ultrastructural level. ACTH and calcitonin were revealed by the immunoperoxidase technique in four of the nine argyrophilic tumours examined. Argyrophilic cells in nonneoplastic endometrium were found in 10% of the carcinoma cases and 8% of the control cases; this has not been described previously. No correlation could be established between the presence or degree of argyrophilia and histological type or grade of carcinoma, extent of tumour infiltration, or argyrophilia in nonneoplastic endometrium or cervix. We conclude that argyrophilia in endometrial carcinomas has no clinicopathological significance. The histogenesis of endometrial and cervical argyrophilic cells is discussed.
Adenocarcinoma of the fallopian tubes: a clinicopathological study of eight cases.
Eight cases of clinically evident adenocarcinoma of fallopian tubes were encountered in King George V Memorial Hospital between Jan. 1950 and Dec. 1981. The tumours occurred predominantly in postmenopausal women and usually presented with vaginal bleeding and/or abdominal pain. A pelvic mass was invariably present. The tubal carcinomas were associated with peritoneal endosalpingiosis, ovarian serous neoplasms and epithelial lesions of the breast. Tumour spread was mainly by invasion of the tubal wall with direct involvement of adjacent organs and subsequent transcelomic dissemination. Prognostic factors are discussed. One patient presented with cerebellar disturbance which was considered to be a paraneoplastic syndrome. We believe this to be the first case of such a syndrome in association with tubal carcinoma and the case history is presented in detail.
Premature hypergonadotropic ovarian failure: clinicopathological study of 19 cases.
During the 5-year period 1977-1982, 57 patients below 35 years of age with secondary amenorrhea were assessed for hypergonadotropic (primary) ovarian failure. The histological findings within the ovaries as well as pertinent clinical and laboratory correlates are described. Nineteen had diagnostic ovarian biopsies performed. The importance of this technique is stressed. The ovaries of 14 patients showed absence of primordial follicles (true premature menopause); three others showed "resistant ovary syndrome" characterized by the presence of primordial follicles but little or no follicular development (including a case of galactosemia, in which the associated ovarian failure has been ascribed to follicular atresia). The remaining two revealed florid chronic perifollicular inflammatory reactions in the presence of both primordial and also developing follicles--one lymphoplasmacytic and the other granulomatous. The former has been previously suggested as evidence of an autoimmune process, but the latter has not hitherto been reported.
Chronic consumptive coagulopathy with a uterine leiomyoma.
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Early adenocarcinoma of the fallopian tubes. A case for multifocal tumorigenesis.
Seven cases of carcinoma in situ and/or early invasive carcinoma of the fallopian tube found in association with serous carcinoma of the ovary are described. These cases are considered to represent examples of multicentric tumorigenesis in Müllerian epithelia which have a common origin and have responded to a common carcinogenic influence. Early neoplastic lesions of the tube may be overlooked unless the tube is serially blocked. If this is done, such lesions may be expected in 5-10% of patients with serous carcinoma of the ovary. Criteria for diagnosis of carcinoma in situ are discussed, viz., a noninvasive proliferative epithelial lesion with disorganization of cellular relationships, significant mitotic activity and nuclear atypia (especially prominence of nucleoli). Criteria for diagnosis of invasive carcinoma of fallopian tube are also referred to particularly with respect to establishing a primary site of tumor origin in cases where masses are present in both ovaries and tubes.