Biomedical subjects

Q J Valensi

Publications and source records attributed to Q J Valensi.

15 recordsLinked to original sources

PubMed1989

Primary hyperparathyroidism associated with two enlarged parathyroid glands.

An increasingly recognized although small percentage of patients with primary hyperparathyroidism have enlargement of two parathyroid glands. We have treated nine patients with primary hyperparathyroidism associated with such double parathyroid gland enlargement. In four of these patients, marked asymmetry of the two enlarged glands was noted and the failure to recognize and excise a second enlarged parathyroid gland resulted in persistent or recurrent hyperparathyroidism. In one of these patients, the second enlargement was present in a super-numerary mediastinal gland. The subsequent excision of the second enlarged parathyroid gland resulted in normocalcemia in each instance. This contrasts with five patients in whom initial excision of two enlarged glands resulted in normocalcemia with no recurrence of hypercalcemia. Only three patients fulfilled the histologic criteria of true double adenomas. The remainder showed multiglandular hypercellularity. This experience supports identifying all parathyroid glands and recognizing that even minimal enlargement of a gland may be important pathophysiologically, regardless of its histopathologic classification. Excision of both enlarged glands, even if asymmetric, is appropriate.

Adult↗

PubMed1989

Diagnosis of adrenal ganglioneuroma in pregnancy with magnetic resonance imaging and ultrasonography. A case report.

A right adrenal gland mass was found during sonographic examination of the right upper quadrant during a workup for hyperemesis gravidarum. Magnetic resonance imaging was used to clarify the origin of the mass. The tumor was nonfunctional. Because of the possibility of a malignancy, the patient underwent a successful second-trimester exploratory laparatomy with right adrenalectomy. Pathology demonstrated a benign ganglioneuroma.

Adrenal Gland Neoplasms↗

PubMed1982

Primary melanoma thickness correlated with regional lymph node metastases.

We studied 119 patients with stage I primary cutaneous malignant melanoma, who were undergoing regional lymph node dissection, to determine the relationship of lymph node metastases to thickness of the primary lesion. The lymph nodes in the dissection specimen were each evaluated by serial sections. None of the patients with lesions less than 1.0 mm thick had nodal micrometastases. When lesions exceeded 1.0 mm in thickness, there was no appreciable increase in the incidence of nodal metastases until a thickness greater than 4.0 mm was reached, in which cases the incidence of metastases was 50%. Predictive variables were determined by multiple logistic regression analysis. Only lesions that were at least 4.0 mm thick and were not located on the upper extremities were significant predictors of lymph node metastases; within this category there was a 64% incidence of lymph node metastases.

Biopsy↗

PubMed1982

Transmural fluid movement in the freshly excised human gallbladder.

Direct information concerning the incidence and nature of gallbladder dysfunction in symptomatic cholethiasis was obtained by examining the rate and direction of transmural fluid movement in the freshly excised gallbladder. Each specimen was emptied of bile, cannulated and filled with a measured volume of bicarbonated Ringer's solution, suspended in the same solution at 37 degrees C., gassed with 95 per cent oxygen and 5 per cent carbon dioxide and weighed at ten minute intervals for at least one hour. Of the 42 human gallbladders examined, concentrating activity, ranging from 1 to 20 per cent of intraluminal volume per hour, was found in 14 and no activity in 17. Direction of fluid transport was found to be completely reversed in 12 additional gallbladders, four of which presented as hydrops. Histologic alterations ranged from mild to severe and could not be correlated with functional status. Application of indomethacin to the solution bathing both surfaces of 13 nonfunctioning, or partially functioning, gallbladders restored or increased function in eight. It can be concluded from this study that the concentrating activity is retained in approximately 30 per cent of patients with symptomatic cholelithiasis; cholesterol stones form in gallbladders with normal concentrating activity; the spectrum of gallbladder dysfunction ranges from simple loss of concentrating activity to hydrops, the latter reflecting complete loss of this activity plus secretion into the lumen, and dysfunction is probably induced by chemical mediators of inflammation rather than by structural changes.

Absorption↗

PubMed1981

A method for the dissection of lymph node specimens (anatomic method).

A method called the "anatomic method" of dissecting lymph nodes in a variety of cancer specimens, is presented. It is found to be comparable to the clearing method in terms of detecting lymph nodes and is unencumbered by the slow turnaround time and economic inconvenience. The anatomic method is described in four steps, illustrated by a schematization of the technique. Its advantages over the clearing method include: 1) it is time saving; 2) it is conducted on the fresh state specimen; 3) it is economical; 4) it reduces the monotony often associated with such dissections; 5) it serves as a teaching exercise. Adoption of the method by pathologists is recommended.

Dissection↗

PubMed1979

Desmoplastic malignant melanoma: A light and electron microscopic study of two cases.

This light and electron microscopic study of two recent cases of desmoplastic malignant melanoma (DMM) attempts to resolve the conflict in views regarding the nature of the cells responsible for the desmoplasia associated with this clinicopathologic entity. On the basis of evidence presented, it is concluded that the cells are dedifferentiated tumor cells with fibroblastic features and probably functions, rather than host engendered fibroblasts in response to invasive melanoma. The evidence includes: observation of macular desmosomes between tumor cells, an unheralded feature previously noted in amelanotic and melanotic melanomas; electron microscopic observation of fibroblast-like cells by others in spindle cell squamous carcinomas; and light microscopic features of malignancy including vascular invasion in one of the two cases. A reproducible light microscopic pattern diagnosis of this variant of malignant melanoma is reaffirmed in both cases.

Aged↗

PubMed1979

Desmoplastic malignant melanoma: study of a case by light and electron microscopy.

This article is a study by light and electron microscopy of a case of desmoplastic malignant melanoma that attempts to resolve the conflict in views regarding the nature of the cells responsible for the desmoplasia associated with this clinico-pathologic entity. On the basis of evidence presented, it is concluded that the cells are dedifferentiated cells of the malignant melanoma with fibroblastic features and probably fibroblastic functions rather than host-engendered fibrolbasts in response to invasive melanoma. The evidence consists of the finding of macular desmosomes between those cells, a feature previously noted in amelanotic and melanotic melanomas, the finding of others by electron microscopy of fibroblast-like cells in spindle-cell squamous carcinomas, and the finding by light microscopy of features of vascular invasion of the malignancy. That the diagnosis of this variant of malignant melanoma by pattern can be made by light microscopy is reaffirmed.

Aged↗

PubMed1978

Angiographic patterns in renal oncocytomas.

Renal oncocytomas are benign tumors arising from proximal tubular epithelial cells. They appear radiographically as solid masses which are vascular on angiography. Angiograms of 13 cases of renal oncocytomas were reviewed, as well as those of 155 renal-cell carcinomas. The classic angiographic findings for the oncocytoma include a spoke-wheel pattern, a homogeneous nephrogram, and a sharp, smooth rim. The finding of a homogenous blush and/or a spoke-wheel pattern greatly increases the possibility of an oncocytoma, though a renal-cell carcinoma may have any or all of the classical findings described for an oncocytoma.

Adenocarcinoma↗

PubMed1977

Desmoplastic malignant melanoma: a report on two additional cases.

Two cases of desmoplastic malignant melanoma are described, bringing the total reported to nine. The first developed in a lentigo maligna melanoma and contains the seed of its local recurrence in the primary lesion. The second developed in a clinically apparent congenital nevus and unites the histologic features of the desmoplastic variant with the epithelioid and spindle cell histology of its primary, side by side in a local recurrence. Both primaries were clinically recognized pigmented lesions while the desmoplastic recurrences were amelanotic. Other clinico-pathologic characteristics of DMM as previously described, are confirmed. Light microscopic evidence is presented supporting the view that the desmoplastic reaction is a rare manifestation elicited by a highly invasive spindle cell component of malignant melanoma.

Ankle↗

PubMed1976

Proximal tubular adenomas of kidney with so-called oncocytic features. A clinicopathologic study of 13 cases of a rarely reported neoplasm.

Four renal "oncocytomas" were observed between July 1974 and January 1975 at University Hospital. A review of all renal cell neoplasms previously classified as carcinomas since 1952 was conducted to determine whether this cluster of tumors represented a recent increase in incidence or whether other renal "oncocytomas" had gone unrecognized in the past. The 23-year review of 194 carcinomas yielded an additional nine "oncocytomas." None had appeared prior to 1964, whereas almost half were found in the 1973-1975 interval alone. While it appears that some "oncocytomas" of the kidney have gone unrecognized in the past, it is also evident that their recent increased incidence is epidemiologically significant. Renal "oncocytomas" and renal cell carcinomas are compared with respect to morphology, clinical presentation, and biologic behavior. Evidence derived from this comparison permits the conclusion that these neoplasms originate from proximal tubular epithelium, are benign clinicopathologic entities, and henceforth should be called proximal tubular adenomas with so-called "oncocytic" features.

Adenocarcinoma↗

PubMed1973