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Biomedical subjects

R E Fechner

Publications and source records attributed to R E Fechner.

At least 55 records · Page 3Linked to original sources
PubMed1989

Intra-osseous ganglion. Report of four cases and review of the literature.

Intraosseous ganglia are histologically identical to their soft tissue counterparts. Most commonly seen adjacent to the hip, ankles, knee, or wrist, they are often mistaken for other neoplasms occurring in the epiphysis. We discuss the characteristic clinical, radiological, and pathologic features of four cases of intraosseous ganglia. Intraosseous ganglia should be included in the differential diagnosis of well-demarcated lucent epiphyseal lesions of bone.

Adult↗
PubMed1989

Idiopathic punctate necrosis of the phalanges of the feet.

Small areas of discrete radiolucency surrounded by well-defined margins of sclerosis are incidental asymptomatic findings in the proximal phalanges of the feet, usually in young males. Histologic examination of similar lesions discovered in the feet of cadavers shows fat necrosis. Although the etiology of these lesions is as yet unproven, musculoskeletal stress is suggested.

Cadaver↗
PubMed1989

Mediastinal fibrin glue: hemostatic effect and tissue response in calves.

There is continued controversy regarding the effectiveness and potential adverse effects of fibrin glue. Thus, we chose to evaluate it in a model of experimental calf aortic valve replacement that has been previously well established. Concentrated fibrinogen and topical thrombin were sprayed to form a thin layer of fibrin glue over the mediastinal tissues of 20 consecutive calves undergoing aortic valve replacement. Chest tube outputs of these animals were compared with those of the preceding 20 consecutive calves undergoing aortic valve replacement without fibrin glue. All procedures were performed by the same surgeon, and no other technical changes were made between the two series. Total postoperative chest tube output (mean +/- standard error) was 553 +/- 50 mL for the calves treated with fibrin glue and 1,155 +/- 103 mL for the control calves (p less than 0.001). On histological examination of mediastinal tissues from 5 treated calves killed 6 weeks after operation, there was no evidence of inflammation, fibrosis, or residual fibrin. To our knowledge, this is the first controlled laboratory study to show that fibrin glue spray is an effective hemostatic agent and that it produces no long-term tissue reaction.

Animals↗
PubMed1989

Serous papillary carcinomas arising from the peritoneum and ovaries. A clinicopathologic and immunohistochemical comparison.

Primary papillary serous carcinoma arising from the peritoneal surface (serous surface papillary carcinoma; SSPC) is a distinctive neoplasm with a histomorphologic resemblance to serous ovarian papillary carcinoma (SOPC). To determine if these tumors are similar antigenically, we studied 13 examples of SSPC and 31 of SOPC immunohistochemically. Antibodies to several determinants known to occur in the Müllerian epithelium were employed. Both neoplasms were uniformly positive for cytokeratin and epithelial membrane antigen (EMA); in addition, SSPC and SOPC were similar in quantitative and qualitative reactivity for B72.3 antigen, carcinoembryonic antigen, Leu M1, CA-125 antigen, LN1, LN2, MB2, S100 protein, placental alkaline phosphatase, and amylase. Residual nonneoplastic mesothelium failed to express any of these antigens except for cytokeratin, EMA, and CA-125. The clinical behavior of SSPC was similar to that of high-stage SOPC; all patients with adequate follow-up died of their tumors. These results suggest that SSPC and SOPC are analogous lesions, with respect to their cellular differentiation. Moreover, it would appear that both neoplasms display only a limited immunophenotypic homology to the mesothelium.

Adult↗
PubMed1989

Suspected recurrent rectosigmoid carcinoma after abdominoperineal resection: MR imaging and histopathologic findings.

Eleven patients who underwent abdominoperineal resection for rectosigmoid carcinoma were examined with magnetic resonance (MR) imaging for suspected recurrent tumor in the presacral space. There were 12 suspected masses in the 11 patients. Ten lesions were malignant, and in two lesions only nonneoplastic inflammatory tissue was found. The signal intensity (SI) of each lesion relative to that of muscle was determined visually and correlated with the histologic findings at surgery or biopsy. The SIs of malignant and benign lesions were indistinguishable. All lesions showed areas of high SI that correlated with carcinoma and tumor necrosis or with non-neoplastic inflammation and edema. Areas of low SI corresponded to reactive fibrous tissue (desmoplastic reaction) with small islands of tumor or to nonneoplastic fibrosis. MR imaging can be useful in determining the extent of suspected tumors, but SIs on T2-weighted images do not permit histologic diagnosis. In particular, distinction of benign from malignant tissue is difficult in tumors with a desmoplastic reaction.

Adenocarcinoma↗
PubMed1989

Vascular adrenal cysts. A clinicopathologic and immunohistochemical study of endothelial and hemorrhagic (pseudocystic) variants.

Three endothelial cysts and five hemorrhagic cysts (pseudocysts) arose in the adrenal glands of seven patients aged 23-73 years. Four patients were male and three were female. Five were symptomatic and gave abdominal pain as their chief complaint. Endothelial cysts were collapsed or filled with serous fluid, multiloculated, had an endothelial lining, and often contained adrenal cortex in their outer walls. The endothelial lining reacted only weakly for Factor VIII-related antigen (FVII-RAg), but it stained strongly for collagen type IV (C-IV). The lack of hemorrhage and the FVIII-RAg/C-IV staining pattern in endothelial cysts suggest lymphatic differentiation. Hemorrhagic cysts were spherical, firm masses containing clotted blood and hyalinized thrombus with attenuated adrenal cortex in the outer fibrous wall. Islands of intact cortical cells were present deep within the thrombi of four hemorrhagic cysts. Three of five hemorrhagic cysts stained strongly for FVIII-RAg and C-IV in irregular vascular channels of the attenuated cortex and within the cyst contents. These channels suggest that at least some hemorrhagic cysts arise when hemorrhage occurs in a preexisting blood vascular anomaly. Entrapment of cortical islands by extravasated blood in hemorrhagic cysts may be misdiagnosed as necrotic cortical neoplasm. To avoid confusion, one must recognize the normality of the entrapped cortical cells, identify an intrinsic vascular anomaly, and distinguish thrombus from necrotic tumor.

Adrenal Gland Diseases↗
PubMed1989

Characterization of tissue from the bone-polymethylmethacrylate interface in a rat experimental model. Demonstration of collagen-degrading activity and bone-resorbing potential.

In previous studies, we described a layer of tissue that formed around methylmethacrylate cement that had been implanted into the posterior cervical spine of dogs. We are now reporting on a rat model in which we induced, in the interface between the bone of the posterior elements of the dorsal spine and methylmethacrylate, the formation of a layer of tissue that was morphologically similar to the tissue that had been produced in the dogs. As in the dogs, we noted macrophages and giant cells and we demonstrated that the interface tissue synthesized several basement-membrane components (type-IV collagen, laminin, and fibronectin). In addition, we demonstrated the synthesis of an additional extracellular-matrix protein--type-VI collagen. We also showed that extracts of organ cultures of tissue from the rat model degraded type-I collagen into three-quarter and one-quarter-length fragments. Such enzymatic activity is characterized of mammalian collagenase, an enzyme that is known to play a critical role in the resorption of bone.

Animals↗
PubMed1989

"Undifferentiated" neoplasms of the sinonasal region: differential diagnosis based on clinical, light microscopic, immunohistochemical, and ultrastructural features.

Sinonasal neoplasms and neoplasm-like proliferations composed of light microscopically poorly differentiated or undifferentiated, small- to medium-sized cells cause considerable diagnostic confusion. Lesions in this category include lymphoepithelioma (undifferentiated carcinoma), olfactory neuroblastoma, small-cell undifferentiated (oat cell) carcinoma, sinonasal undifferentiated carcinoma, malignant melanoma, pituitary adenoma, lymphoid hyperplasia, malignant lymphoma, plasmacytoma, lymphomatoid granulomatosis, rhabdomyosarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, Ewing's sarcoma, and synovial sarcoma. Many of these lesions can be definitively diagnosed based on light microscopic features alone, but, in some instances, additional techniques such as immunohistochemistry are of value. The authors review the pertinent clinicopathologic features of the above lesions, with emphasis on light microscopic, immunohistochemical, and ultrastructural features of particular utility in differential diagnosis.

Carcinoma, Squamous Cell↗
PubMed1989

Problematic lesions of the craniofacial bones.

Osseous lesions of the craniofacial bones, such as osteosarcoma, often have different microscopic features than their counterparts in other bones. For craniofacial fibro-osseous lesions, the radiographic findings are usually more diagnostic than the microscopic observations. It requires clinical findings to arrive at a definitive pathologic diagnosis for abnormalities characterized by a fibro-giant cell background. Radiographic and clinical findings in patients with lesions of any bone are important, but in patients with craniofacial lesions, they are especially critical for arriving at the best pathologic diagnosis.

Chronic Disease↗
PubMed1988

Aggressive papillary middle-ear tumor. A clinicopathologic entity distinct from middle-ear adenoma.

A 29-year-old woman had a middle-ear mass that resulted in hearing loss and seventh-nerve palsy. The tumor invaded the petrous bone, the mastoid, at least one semicircular canal, and then extended into the posterior fossa. Microscopically, it consisted of complex, interdigitating papillae lined by uniform, cuboidal to low columnar cells. The cells resembled the epithelium of the normal middle ear and middle-ear adenoma, but the papillary architecture distinguished this neoplasm from the latter, nonpapillary tumors. Papillary middle-ear tumors are locally invasive. We propose the term "aggressive papillary middle-ear tumor" (APMET). Nine other examples of APMET have been reported under various diagnostic terms. All have been locally destructive with frequent intracranial invasion. Although none of the tumors has metastasized, one patient died of uncontrolled local disease. For this reason, APMET must be distinguished from nonpapillary middle-ear tumors.

Adenocarcinoma↗
PubMed1988

Lobular carcinoma in situ of the breast: mammographic features.

Lobular carcinoma in situ (lobular neoplasia; LCIS) of the breast is most commonly an incidental microscopic finding in breast tissue removed for some other reason. The authors reviewed the clinical and mammographic features and surgical findings in 26 cases of LCIS not associated with other breast abnormalities. In 16 instances, needle localization was performed before removal of the tissue, which yielded LCIS on histologic examination. Calcifications were the most common reason for biopsy, although there were no distinctive mammographic features of LCIS.

Aged↗
PubMed1988

Serous surface papillary carcinoma. A clinicopathologic study of 10 cases and comparison with stage III-IV ovarian serous carcinoma.

We compared 10 patients with serous surface papillary carcinoma (SSPC) to a control group of 16 patients with serous ovarian papillary carcinoma (SOPC). By definition, the ovaries were of normal size and shape in SSPC. In six cases, however, at least one ovary had focal surface irregularities. Microscopically, SSPC and SOPC differed only in the nature of their ovarian involvement. SSPC was confined to the ovarian surface or showed focal minimal invasion. Four patients with SSPC had coexistent, nonperitoneal serous-type carcinomas; three had superficial endometrial adenocarcinomas; and one had intramucosal adenocarcinoma of the fallopian tube. There were no associated carcinomas in the SOPC group. SSPC had a significantly worse prognosis than SOPC, as measured by median disease-free interval (SSPC: 3 months, SOPC: 9 months), median survival (SSPC: 12 months, SOPC: 24 months), and predicted 5-year survival (SSPC: all dead at 52 months, SOPC: 22.7%). SSPC is a clinicopathologically distinctive variant of serous carcinoma. Because of its more aggressive clinical course, it should be distinguished from conventional SOPC with peritoneal implants.

Actuarial Analysis↗
PubMed1988

Induction and characterization of an interface tissue by implantation of methylmethacrylate cement into the posterior part of the cervical spine of the dog.

After the implantation of methylmethacrylate cement into the posterior part of the cervical spine of the dog, a thick layer of connective tissue forms at the bone-cement interface. The tissue is six to eight millimeters thick and in all animals it surrounds the dorsal and lateral aspects of the masses of implanted cement, grows between the undersurface of the cement and the bone of the posterior elements, and completely covers that bone. This tissue was examined by light and electron microscopy and its collagenous components were extracted and analyzed biochemically by gel electrophoresis. Specific extracellular matrix proteins in the tissue at the bone-cement interface were also localized by immunohistochemistry. The tissue at the host-cement interface contained zones of fibrocytes and plump and teardrop-shaped cells within a collagenous matrix. Type-I, Type-III, and Type-V collagen were extracted and were identified by gel electrophoresis. Type-V collagen and fibronectin were localized predominantly around the plump and teardrop-shaped cells. Type-IV collagen and laminin were localized predominantly in an area just beneath the teardrop-shaped cells at the surface of the tissue overlying the cement, suggesting that a basement-membrane-like tissue had formed in this area.

Animals↗
PubMed1987

Malignant fibrous histiocytoma in bone infarct. Association with sickle cell trait and alcohol abuse.

A 42-year-old black man with sickle cell trait and a history of alcohol abuse had a malignant fibrous histiocytoma of the distal femur. The tumor developed in a bone infarct that had been present for at least 54 months. This is the first reported association of malignant fibrous histiocytoma and bone infarct in which the infarct was related to sickle cell trait and alcohol abuse. A detailed map of the sections from the resected femur disclosed a spectrum of cytologic changes in the sarcoma that ranged from bland fibroblasts in the center of the tumor to high-grade sarcoma at the periphery. Awareness of this spectrum has diagnostic importance regarding the potential underdiagnosis of well-differentiated malignant fibrous histiocytoma.

Adult↗