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Biomedical subjects

P J Grases

Publications and source records attributed to P J Grases.

At least 19 recordsLinked to original sources

Myometrial trophoblastic implant as a complication of surgically induced first-trimester termination of pregnancy.

Persistent trophoblastic tissue has been described in the abdominal cavity after surgical treatment of tubal ectopic pregnancy. More infrequently the cause of the ectopic trophoblast is linked to uterine perforation due to surgically induced termination of pregnancy (TOP). Ultrasonographic images may suggest an ectopic pregnancy. A case of myometrial trophoblastic tissue implantation following surgically induced first-trimester TOP is described.

Abortion, Therapeutic↗

Morphologic changes in breast biopsies after duct endoscopy.

Duct endoscopy is a recent technique used for a direct view of the breast ductal system. The aim of this study is to determine any morphological changes in breast tissue attributable to low-pressure irrigation with saline solution that the technique requires. A total of 26 breast biopsies from patients who underwent ductal endoscopy before surgery were compared with 26 breast specimens from the retroareolar region. Breast specimens from duct endoscopy showed more frequent epithelial detachment (73%), epithelial loss (35%), periductal clefts (77%), stromal disaggregation (46%) and displacement of epithelial cells into the stroma (27%) than the control group in which epithelial detachment was seen in 4% of patients, periductal clefts in 15%, and stromal disaggregation in 15%. Epithelial loss and epithelial displacement where not seen in the control group. Although low-pressure fluid perfusion used for duct endoscopy induced morphological changes in breast tissue, these can easily be distinguished from malignancy, and are most likely to occur as the result of duct rupture.

Journal Article↗

Cervical ectopic twin pregnancy: diagnosis and conservative treatment: case report.

A case of cervical ectopic twin pregnancy with cardiac activity in both embryos is presented. It was diagnosed in the eighth week of gestation by ultrasonography, and treated conservatively with intra-amniotic administration of methotrexate under ultrasonographic guidance followed by curettage. This procedure allows subsequent gestations.

Abortifacient Agents, Nonsteroidal↗

Role of color Doppler ultrasonography in the diagnosis of endometriotic cyst.

We studied the role of color Doppler ultrasonography in the distinction between endometriomas and other adnexal masses. Three hundred and fifty-two ovarian lesions were studied, comparing sonographic diagnosis with pathologic findings. On color Doppler sonography, an endometriotic cyst usually appeared as a cystic lesion with diffuse internal echoes and low vascularization. The sensitivity and specificity of color Doppler transvaginal sonography in detecting endometriotic cysts were 91.8% and 95.3%, respectively. The positive and negative predictive values were 95.5% and 91.5%, respectively. In our experience, transvaginal sonography with color Doppler interrogation is a useful technique in the diagnosis of pathologic ovarian conditions, including cystic endometriosis.

Adult↗

Morphological changes in hysterectomies after endometrial ablation.

Electrosurgical ablation of the endometrium is a therapeutic choice for those patients having abnormal uterine bleeding. When ablation is followed by a hysterectomy, tissue damage due to thermal effect can be seen. From a total of 350 women with endometrial ablation, 12 required subsequent hysterectomy. The histological features found in these specimens are described and related to the elapsed time between the two surgical procedures. The mean elapsed time between ablation and hysterectomy was 19 +/- 17.3 months. Scarring with formation of additional endometrial cavities was seen in five cases, and endocervical stenosis in two cases. In seven patients, endometrial regrowth was seen at hysterectomy. Necrosis, granulomatous and foreign-body giant cell reaction, eosinophilic infiltrate and pigment-containing macrophages in the myometrium were seen in the long-term post-ablation hysterectomies. Necrosis was seen in short period post-ablation hysterectomies. Six of the seven patients with endometrial regeneration had adenomyosis in the hysterectomy specimen. Endometrial ablation induces thermal effects in the endometrium and granulomatous reaction with foreign-body giant cell reaction, fibrosis and deposition of pigment within macrophages in the myometrium. Adenomyosis is a possible explanation for endometrial regeneration in cases of ablation failure.

Adult↗

Invasive micropapillary carcinoma. Distinct features of a poorly recognized variant of breast carcinoma.

INTRODUCTION: Invasive micropapillary carcinoma (IMC) is a histological variant of breast cancer with a poor prognosis. MATERIAL AND METHODS: Pathological findings of 15 cases of IMC are compared with those of 144 invasive duct carcinoma (IDC) and 10 invasive papillary carcinoma (IPC). RESULTS: Only 33% of cases were diagnosed in stage I. Mean tumor size was 2.3 cm. Nuclear grade 3 was found in 60% of cases, aneuploidy in 78%, and 92% had hormone receptors. Nine patients showed lymph node metastasis. Tumor size, nuclear grade, mitotic rate and lymph node involvement were higher in IMC when compared with IDC grade I and IPC, but not when compared with IDC grade II and III. Four cases of IMC (27%) recurred before two years. Recurrences and lymph node metastases showed the same architectural pattern as the primary tumor. DISCUSSION: IMC shows a high incidence of lymph node involvement and a high early recurrence rate.

Adult↗

Histological features of the contralateral ovary in patients with unilateral ovarian cancer: a case control study.

OBJECTIVE: Most of the surface epithelial-stromal tumors of the ovary are thought to arise from epithelial inclusion cysts, thus these cysts, and the original surface epithelium, are precursor lesions of ovarian carcinoma. MATERIAL AND METHODS: The histological features in contralateral ovary from 20 patients with unilateral ovarian carcinoma were compared with 20 ovaries of patients without ovarian pathology and with 12 normal ovaries of women with contralateral benign ovarian pathology. RESULTS: Cortical invaginations were more frequent and numerous in ovaries of patients with contralateral ovarian carcinoma. The presence of cortical invaginations and epithelial inclusion cysts showed correlation in patients with cancer and in those without ovarian pathology, but there were no differences in the number of inclusion cysts when the three groups were compared. Mild cytological atypia was detected more frequently in the surface epithelium of contralateral ovaries of patients with ovarian carcinoma. Ovarian size, cortical thickness, stromal hyperplasia, psammoma bodies, and surface papillae did not show differences when comparing patients with cancer and control groups. CONCLUSION: Cortical invaginations, a previous step in the formation of epithelial inclusion cysts, can also play an important role in the genesis of ovarian carcinoma.

Adult↗

Congenital plate-like osteoma cutis of the forehead: an atypical presentation form.

Cutaneous ossifications or osteoma cutis can be found in many syndromes. Primary osteoma cutis, present since birth or the first months of life, in the absence of metabolic disorders or trauma, is found in congenital plate-like osteoma cutis and progressive osseous heteroplasia, coexisting in the latter with deep connective tissue ossifications. This report documents the case of a 7-year-old female with a plate-like cutaneous ossification of the forehead causing aesthetic deformities. Other dermal ossifications in the inguinal and preauricular region, as well as the left hand and a small focus in the extraocular muscles of the left orbit, were also present. These lesions did not show progression, and most of them were present since birth. The lesion of forehead was treated surgically. The lack of progression and the fact that the orbital lesion was solitary still fits the criteria for the diagnosis of plate-like osteoma cutis. Plate-like osteoma cutis and progressive osseous heteroplasia may represent varieties of the same disorder.

Child↗

Fibroadenoma phyllodes arising in vulvar supernumerary breast tissue: report of two cases.

Ectopic breast tissue, found along the mammary line or sometimes outside it, can exhibit pathologic changes similar to those of the eutopic mammary gland. Fibroadenoma phyllodes, an unusual variant of mammary phyllodes tumor with stromal cellularity similar to a conventional fibroadenoma, rarely arises outside of breast. Its histogenesis is unclear; although some cases suggest an origin in cutaneous adnexa, the presence of normal breast tissue surrounding other tumors favors an ectopic mammary origin. Two cases of fibroadenoma phyllodes arising in ectopic vulvar breast tissue are described.

Adolescent↗

Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection.

PURPOSE: To establish the ultrasonographic (US) characteristics of benign versus metastatic lymph nodes. MATERIALS AND METHODS: One hundred fifty-eight axillary lymph nodes in 40 patients (age range, 31-73 years) surgically treated for breast cancer have been studied in vitro with a 7.5-MHz US probe in a water bath. The long-to-short axis ratio and the hilar and cortical characteristics were evaluated; the US findings were correlated with the histopathologic findings. To estimate the long-to-short axis ratio, all lymph nodes were measured. RESULTS: Of the 158 lymph nodes, 45 showed histopathologic evidence of metastasis; 38 of the 45 revealed US signs of malignancy. The signs that caused malignancy to be suspected were a long-to-short axis ratio of less than 1.5, absence of a hilus, and disruption of the cortical zone. The most specific sign for the diagnosis of metastasis was absence of the hilus. The increase in the long-to-short axis ratio was the finding that caused the most false-negative interpretations. Signs of malignancy were more accurate in lymph nodes 10 mm or larger than they were in lymph nodes smaller than 10 mm. CONCLUSION: Findings of in vitro US studies of axillary adenopathy provide the basis for the evaluation of lymph node metastasis in vivo before surgery, especially in those lymph nodes 10 mm or larger.

Axilla↗

The ultrastructure of alcoholic liver disease: a review and analysis of 100 biopsies.

Liver biopsies from 100 patients with alcoholic liver disease of various grades of severity were examined by light and electron microscopy. A comprehensive account of ultrastructural morphology is presented. The organellar changes were variable both in nature and intensity. The most consistent ultrastructural changes, irrespective of disease severity, were dilatation of endoplasmic reticulum and fat accumulation. The former is the EM counterpart of hepatocyte swelling at the light microscope level. Collagen deposition was detected earlier and more accurately by electron microscopy. A physical relationship between Mallory bodies and intermediate filament was also detected. As is the case with light microscopy, if cellular, stromal and organellar changes are considered independently, some may be regarded as typical, but none as pathognomonic of alcoholic liver disease.

Biopsy↗

Immunology of human gastric cancer: a preliminary report.

The immunological spectrum in fifteen patients with gastric cancer is presented. Patients were divided in three groups. Those with nonadvanced cancer, those with advanced but resectable lesions and those with advanced but nonresectable tumors. Preoperatively, elevated levels of circulating immune complexes (CIC) associated with hyporesponsiveness to phytohemagglutinin (PHA) and in mixed lymphocyte culture (MLC) as well as a positive leukocyte inhibitory serum factor (LIF-S) were found in nearly half of the patients. Inhibitory or enhancing autologous serum factors were detected. Postoperatively, immunologic parameters return to normal in patients with nonadvanced cancer, while in advanced cancer, antibody and cell-mediated immune response remained altered, with some changes associated with chemotherapy. These findings are probably related with the presence or absence of tumor and offer a distinct approach in evaluating the immunologic response of a tumor-bearing patient.

Adult↗