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Biomedical subjects

P J Slootweg

Publications and source records attributed to P J Slootweg.

At least 19 recordsLinked to original sources
PubMed1992

Cause of death in squamous cell carcinoma of the head and neck. An autopsy study on 31 patients.

A series of 31 autopsied patients, with a history of head and neck squamous cell carcinoma is reported, with the emphasis on the cause of death. There were 26 males and 5 females; mean age being 64 years (range 44-88 years). Locoregional disease (LRD) was the cause of death in 19 patients (61%) and was present in 2 patients dying of an unrelated cause. Distant metastasis (DM) was found in 8 patients (26%) but had caused death in only 1 of them. A shorter survival time for patients with DM than for those without (8 months versus 13 months) indicates that DM is established early in the course of the disease. Therefore, a longer survival time will not result in an increase in DM and we infer that a better locoregional control will also not result in a real increase in DM but only in an apparent one, due to a shift of cause of death from LRD to DM in a group of patients that formerly would have died of LRD before the already present DM had become manifest.

Adult↗
PubMed1992

Heterologous tissue elements in melanotic neuroectodermal tumor of infancy.

Two cases of melanotic neuroectodermal tumor of infancy (MNTI) contained highly cellular stromal areas consisting of spindle cells exhibiting mitotic activity. In one case, single spindle cells exhibited the same immunohistochemical profile as tumor cells forming part of the epithelial component. In the other case woven bone was formed in a dense fibroblastic stroma. These tumor parts were judged to be heterologous tissue elements that also may be observed in other kinds of neuroectodermal tumors and that reflect the potential of the neural crest to differentiate into various mesenchymal tissue types.

Cell Nucleolus↗
PubMed1992

Adenomatoid odontogenic tumorlike lesion in a male Wistar rat.

An odontogenic tumor in the maxilla of a male Wistar rat is described. The tumor consisted of large epithelial areas with peripheral palissading and with juxtaepithelial material resembling dentin. The neoplastic odontogenic epithelium seems capable of inducing peridental mesenchyme to form a kind of dental hard tissue normally not present at that site.

Animals↗
PubMed1992

Oral alimentary tract cyst.

A cyst in the floor of the mouth of a 2-yr-old boy was characterized by smooth muscle tissue with an overlying epithelial lining of varying morphology including gastric mucosa. The combination of smooth muscle with a variety of epithelial linings argues against the "misplaced anlage" histogenesis.

Child, Preschool↗
PubMed1992

Cementoblastoma and osteoblastoma: a comparison of histologic features.

Three cases of cementoblastoma (CB) and three cases of osteoblastoma (OB) were histologically compared. The aim of the study was to investigate whether CB and OB are different in other aspects than being connected with a tooth. CB cases were the following: maxillary lesions in a 23-year-old woman and a 22-yr-old man and a mandibular lesion in a 28-yr-old man. In one case the tumor was fused to the roots of two teeth. Of the OB cases, one occurred in the mandible of a 27-yr-old man, one in the ankle of a 19-yr-old male and one in the thoracic vertebrae of a 27-yr-old man. Histologically, CB and OB had the same appearance including peripheral spiculae rimmed by swollen blasts. This histologic similarity between OB and CB indicates that the diagnosis CB should not be made unless the lesion is connected with a tooth.

Adult↗
PubMed1991

The status of the resection margin as a prognostic factor in the treatment of head and neck carcinoma.

The value of the status of the resection margin as a prognostic factor after surgical treatment was investigated in 80 patients with squamous cell carcinoma of the oral cavity, oropharynx and laryngohypopharynx. The relation of locoregional recurrence with the presence or absence of tumour at the surgical margin was analysed together with other indications for postoperative radiotherapy. Locoregional recurrence was observed in 20% and was correlated with tumour thickness over 5 mm, spidery growth and tumour-positive margins. Tumour-positive margin as a single indication for postoperative irradiation was not related to an increased recurrence rate. When however occurring together with other indications for postoperative irradiation, the recurrence rate was higher than in the patient group with the same number of indications for postoperative radiotherapy but without tumour at the surgical margins.

Adult↗
PubMed1991

Bone and cementum as stromal features in Pindborg tumor.

A case of calcifying epithelial odontogenic tumor (CEOT) occurring in the left mandible of a 50-yr-old man was characterized by the presence of large masses of calcified collagen. Calcified amyloid acted as the nucleus for the deposition of this material. Because of the close association between both types of calcified material, it is presumed that the calcified amyloid is an inductive stimulus for the stromal cells to differentiate towards production of a collagenous matrix destined to calcify and resembling cementum. The stromal component of CEOT thus seems to be just as odontogenic as the epithelium is.

Amyloid↗
PubMed1990

Epicardial cryosurgery as used in ablation of accessory atrioventricular pathways: effect on valvular function in the dog.

Epicardial cryosurgery for ablation of atrioventricular accessory pathways has surgical advantages. However, it is applied directly to the valve base. To assess the risk of valve impairment, 10 anaesthetized dogs were subjected to standardized epicardial cryosurgery of the right atrioventricular junction. Two of these underwent sham procedure (dissection only). Valve function was assessed by colour Doppler echocardiography preoperatively and at 2 days, 1 week, 2 weeks and 10 weeks postoperatively. Three out of the eight animals subjected to cryosurgery developed moderate (grade 2/4) tricuspid insufficiency, which appeared at 1 week postoperatively, following regression of congestive oedema. Two out of the three cases of TI were associated with leaflet prolapse. No tricuspid insufficiency was seen in the sham-operated animals. At the end of each interval two animals were killed for histological examination. Histological examinations showed that cryolesions extended a maximum of 3 mm into the valve leaflet. The tricuspid insufficiency is attributed to the extensive scarring (including chondroid metaplasia), which causes retraction and restricted motion of the annulus. It is concluded that cryolesions may impair atrioventricular valve function. Patients undergoing cryosurgery should be monitored postoperatively by echocardiography for atrioventricular valve insufficiency.

Animals↗
PubMed1990

Mandibular invasion by oral squamous cell carcinoma. Clinical aspects.

In this paper we have tried to correlate the clinical and radiological aspects to the histological findings in squamous cell carcinomas of the oral cavity, in relation to bone involvement in the mandible. 52 patients were analyzed and we conclude that there is a positive indication for mandible sparing surgery, even if there is fixation to the jaw or radiologically visible bone involvement.

Alveolar Process↗
PubMed1990

Juvenile ossifying fibroma. Report of four cases.

The present investigation concerns 4 patients with juvenile ossifying fibroma (JOF) whose data are analyzed together with 30 cases from the literature. The tumour mainly occurs in juveniles, 79% of the patients being 15 years or younger. Radiologically as well as at surgery, the lesion is demarcated from its surroundings. Histologically, JOF is unique in showing a loose-fibroblastic stroma that contains garland-like strands of osteoid with entrapped osteoblasts, the latter feature not being observed in other fibro-osseous lesions. JOF responds very well to conservative treatment that provided permanent cure in all cases with adequate follow-up data.

Child↗
PubMed1990

Differential diagnosis of fibro-osseous jaw lesions. A histological investigation on 30 cases.

A series of 30 fibro-osseous jaw lesions was evaluated for histological parameters that enable appropriate diagnostic classification. Special emphasis was laid upon the histomorphology of the lesion-jawbone interface, blending of lesional bone with adjacent jawbone being employed as the decisive factor in distinguishing between fibrous dysplasia and other fibro-osseous jaw lesions. Using this feature as a discriminative tool, other histological aspects that were useful in differential diagnosis could be identified. Fibrous dysplasia (n = 11) shows a rather uniform appearance with a constant ratio bone: fibrous tissue throughout the entire lesion; acellular mineralized particles are virtually absent. Juvenile ossifying fibroma (n = 3) is characterized by a highly cellular fibroblastic stroma and garland-like strands of cellular osteoid. Ossifying fibroma (n = 12) shows a high variability in stromal cellularity and types of mineralized material. Localized periapical fibro-osseous cemental lesions (n = 4) are histologically almost similar to ossifying fibroma although more heavily mineralized. It is concluded that there is full agreement between histology and radiology in indicating whether a fibro-osseous jaw lesion is demarcated or blends into its surroundings. Moreover, an appropriate diagnosis can be reliably made on histological grounds.

Adolescent↗
PubMed1989

Orbital exenteration in surgery of malignant neoplasms of the paranasal sinuses. The value of preoperative computed tomography.

The extension of paranasal sinus malignant neoplasms into the orbit presents one of the arguments for carrying out orbital exenteration. One method of assessing the extension is computed tomography (CT), but its reliability is still questionable. Therefore, the preoperative CT images were compared with the pathoanatomic features of the surgical specimens in 15 patients who underwent orbital exenteration as part of a procedure for paranasal sinus malignant neoplasm. Ophthalmic symptoms were present in eight patients and in each instance the CT images documented the extension of the tumor accurately. In only four of seven patients without ophthalmic symptoms did CT scanning appear to match the factual situation. Apparently CT scanning is not always reliable in patients without ophthalmic symptoms.

Adult↗
PubMed1989

A new and highly sensitive immunohistologic diagnostic criterion for Sjögren's syndrome.

Immunohistologic investigation of the sublabial salivary glands of 65 surgical patients who were free of systemic disease (control) and 19 patients with Sjögren's syndrome resulted in a new diagnostic criterion for SS that was more disease-specific than the widely used lymphocytic focus score criterion. Our bivariate classification criterion, which is based on the percentages of IgA- and IgG-containing plasma cells, has a specificity of 95.4% and a sensitivity of 100%, while its overall percentage of misclassification is 3.6%. This immunohistologic diagnostic criterion results in a reduction of the percentage of false-positive diagnoses from 9% to 4.6%.

Age Factors↗
PubMed1989

Lymphocyte status in endomyocardial biopsies and blood after heart transplantation.

We performed immunological phenotyping of mononuclear cells in tissue sections of 84 endomyocardial biopsies (EMB) showing infiltrates, which were taken from 21 patients after heart transplantation. Data were correlated with histology (grading following Billingham) and cyto-immunologic monitoring (CIM) on blood samples (grading into negative, rejection, or infection, based on leukocyte morphology and T-cell phenotype). Few T lymphocytes were observed in 35 biopsies, and many in 49 biopsies. The semi-quantitative estimate of T cells and CD4/CD8 ratio did not correlate with EMB histology but was related to CIM data. For example, 31 out of 42 cases with a CIM indicative of infection (14 of which showing no rejection on histology) manifested large numbers of T cells. In most cases, the CD4/CD8 ratio was less than 1. The presence of activated cells (bearing interleukin-2 receptors or the CD30 antigen) was not related to EMB histology or to CIM data. The number of T cells (subsets) in EMB was not related to relative or absolute numbers in the blood.

Biopsy↗
PubMed1989

Quantitative immunohistologic and histomorphometric diagnostic criteria for Sjögren's syndrome.

Sjögren's syndrome (SS) is a chronic auto-immune exocrinopathy, especially affecting the lacrimal and salivary glands. The aim of this study is to improve the diagnostic possibilities of the sublabial salivary gland (SSG) biopsy. The SSG biopsies of 19 patients with SS and 65 healthy control subjects were used in a quantitative immunohistologic and histomorphometric study. Statistical analysis of the immunohistochemical data resulted in a diagnostic criterion, which is based on the percentages of IgA- and IgG-containing plasma cells. Statistical analysis of 3 immunohistologic and 6 histomorphometric features resulted in a combined immunohistologic and histomorphometric criterion, which is based on 2 immunohistologic parameters (the percentages IgA- and IgG-containing plasma cells) and 3 histomorphometric parameters (the volume percentages of acini, intralobular ducts and diffuse lymphoplasmacytic infiltrate). The immunohistologic diagnostic criterion has a specificity of 95.4%, a sensitivity of 100% and an overall percentage of misclassification of 3.6%. The combined diagnostic criterion has a specificity of 98.5%, a sensitivity of 100% and an overall percentages of misclassification of 1.2%. Furthermore it reduces the number of false positive diagnoses with a factor 6 from 9% to 1.5%.

Biopsy↗
PubMed1989

Mandibular invasion by oral squamous cell carcinoma.

Forty-five specimens consisting of mandibular bone and adjacent squamous cell carcinoma were histologically investigated. In 23 of them, there was no involvement of the mandibular bone: a continuous periosteal layer separated the tumour from the bone. Tumour spread through periosteal lymphatics was not observed in any of these cases and therefore there is no reason to sacrifice bone when the tumour is not fixed to the jaw. Twenty-two specimens exhibited bony involvement. In 10 of them, the bone was eroded by an advancing tumour front. None of these cases exhibited tumour invasion into cancellous spaces, dental canal or periodontal ligament space. Tumours with this type of bony involvement are amenable to mandible-sparing surgical treatment. The other 12 exhibited diffuse growth into cancellous bone, dental canal and, if present, periodontal ligament space. Cases like these are to be operated on by removing the entire thickness of the involved mandibular part. Tumours involving bone were slightly larger than those leaving bone uninvolved. The tumours eroding bone were of a smaller size than those infiltrating bone. The differences, however, are too small to have a predictive value in treatment planning. Attention is drawn to the presence of dental epithelial rests that should not be mistaken for invading tumour nests.

Alveolar Process↗
PubMed1989

Spindle-cell carcinoma of the oral cavity and larynx. Immunohistochemical aspects.

Five cases of monophasic and 7 cases of biphasic spindle-cell carcinomas were analyzed immunohistochemically for the presence of vimentin and keratin type intermediate filaments in the pleomorphic spindle cells. Vimentin reactivity proved to be a consistent feature but keratin reactivity was more variable, this latter filament being lost in two cases initially presenting as pure squamous cell carcinomas showing dedifferentiation towards a pure monophasic spindle-cell tumour when recurring. The converse was also noted: acquisition of keratin in a monophasic spindle-cell tumour that recurred as squamous cell carcinoma. These results were considered to support the concept that spindle-cell tumours of the upper aerodigestive tract are a peculiar type of carcinoma and not a product of a pluripotent stem cell exhibiting bidirectional differentiation. Diagnostic implications are as follows: keratin positivity in a spindle-cell tumour substantiates its carcinomatous nature but its absence does not rule out a diagnosis of spindle-cell carcinoma.

Aged↗