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Biomedical subjects

R E Scully

Publications and source records attributed to R E Scully.

At least 199 records · Page 11Linked to original sources
PubMed1987

Ovarian steroid cell tumors (not otherwise specified). A clinicopathological analysis of 63 cases.

The clinical and pathological features of 63 steroid cell tumors, not otherwise specified, were reviewed. The patients ranged in age from 2 1/2 to 80 years. The most common initial manifestation was virilization (41%); four patients had estrogenic manifestations, and four had hypercortisolemia with Cushing's syndrome. The tumors, 6% of which were bilateral, ranged from 1.2 to 45 cm in greatest dimension. Microscopic examination revealed two types of cells, which had overlapping features: those with abundant eosinophilic cytoplasm and those with vacuolated cytoplasm. Fat stains were positive in 75% of the 16 cases in which they were performed. Follow-up data ranging from 1 to 19 years (average 5.2 years) in duration were available for 50 patients. In 24 cases, the tumor was designated probably benign (no evidence of spread beyond the ovary within 3 or more years postoperatively). In 18 patients, the tumor was clinically malignant. The best pathological correlates of malignant behavior were: the presence of two or more mitotic figures per 10 high power fields (92% malignant); necrosis (86% malignant); a diameter of 7 cm or greater (78% malignant); hemorrhage (77% malignant); and grade 2 or 3 nuclear atypia (64% malignant).

Adolescent↗
PubMed1987

Relation of ovarian dermoid cysts and immature teratomas: an analysis of 350 cases of immature teratoma and 10 cases of dermoid cyst with microscopic foci of immature tissue.

Three hundred fifty cases of immature teratoma of the ovary and 10 cases of ovarian dermoid cyst containing microscopic foci of immature tissue were analyzed to evaluate the relation between the two tumors. Twenty-six percent of the immature teratomas contained grossly visible dermoid cysts, 10% of them were associated with a dermoid cyst in the contralateral ovary, and 9 (2.6%) were preceded by resection of a dermoid cyst from the same ovary. Microscopic foci of slightly or moderately immature tissue were found in the walls of two of the previously excised cysts. Follow-up information available in nine of the 10 cases of dermoid cyst containing microscopic foci of immature tissue revealed no evidence of recurrence 11 months to 7 years postoperatively. Dermoid cysts that were followed by immature teratomas were characterized by high frequencies of multiplicity and rupture of the cysts. The findings suggest a relation between dermoid cysts and immature teratomas that warrants further investigation.

Adolescent↗
PubMed1987

Stromal luteoma of the ovary: a clinicopathological analysis of 25 cases.

The clinical and pathological features of 25 stromal luteomas were reviewed. The patients ranged in age from 28-74 (average 58.4) years. The most common initial manifestation (60%) was abnormal vaginal bleeding; three patients (12%) were virilized. The tumors, only one of which was bilateral, ranged from 0.25-2.9 (average 1.3) cm in greatest diameter. They were all well circumscribed. Microscopic examination revealed unencapsulated nodules composed of rounded polyhedral cells that were arranged either diffusely or in nests and cords. Twenty percent showed degeneration within aggregates of cell resulting in the formation of pseudoacinar structures. The cytoplasm of the neoplastic cells was generally eosinophilic and granular, and lipochrome granules were present in over half the tumors. In 92% of the cases hyperthecosis was present in the adjacent ovarian stroma. Follow-up of 6 months to 17 years was available for 19 patients. Sixteen of them were alive and free of disease; the remaining three died of other causes. The benign course in all the cases in which follow-up data were available was expected in view of the small size of the tumors and their benign microscopic appearance.

Adult↗
PubMed1987

The spectrum of abnormal patterns of gonadotropin-releasing hormone secretion in men with idiopathic hypogonadotropic hypogonadism: clinical and laboratory correlations.

Several lines of evidence indicate that hypothalamic-pituitary-gonadal activity varies among men with idiopathic hypogonadotropic hypogonadism (IHH). To test the hypothesis that a spectrum of abnormalities of GnRH secretion underlies the syndrome of IHH, we characterized the patterns of GnRH-induced gonadotropin secretion during periods of frequent sampling in 50 consecutive men with IHH and contrasted them with those in 20 normal men. The largest group of IHH patients (n = 42) had no detectable LH or FSH pulsations and could be categorized into 2 subsets according to the presence or absence of evidence of spontaneous puberty. The most severely affected subset (n = 32), who recalled no history of puberty, had testes with a mean volume of 3.3 +/- 0.5 (+/- SEM) ml, with a prepubertal appearance on biopsy, and often were anosmic (n = 17). The second subset of apulsatile IHH men (n = 10) had histories of partial or complete spontaneous sexual development with subsequent isolated loss of sexual function, testes with a mean volume of 13.3 +/- 1.9 ml (P less than 0.01 compared to the first subset), a pubertal or adult appearance of the testes on biopsy, and an intact sense of smell. In a second group of IHH patients (n = 3), LH was secreted predominantly in a nighttime pattern similar to that of normal children during early puberty. These men were aged 18-24 yr, had a mean testicular volume of 10.5 +/- 2.3 ml, pubertal changes on testicular biopsy, and an intact sense of smell. A third group of IHH men (n = 4) had LH pulses of abnormally low amplitude. Only one patient in this group had a history of spontaneous sexual development. The mean testicular volume of these patients was 5.6 +/- 1.9 ml, and the testes appeared prepubertal (n = 3) or pubertal (n = 1) on biopsy. In addition to these groups, another patient had apparent LH pulsations and nearly normal amplitude, but the LH was bioinactive and appeared to consist chiefly of alpha-subunit. Testing of other anterior pituitary hormone functions did not distinguish IHH men from normal men. However, those IHH patients with some evidence of endogenous GnRH secretion had higher basal and stimulated serum PRL levels than IHH men without such evidence (P less than 0.05), suggesting an influence of GnRH on PRL secretion.

Adolescent↗
PubMed1987

Classification of human ovarian tumors.

Most human ovarian tumors are classified into one of several categories based on presumed histogenesis and direction of differentiation. Separate categories are reserved for neoplasms composed of cells of several origins and for nonneoplastic disorders that simulate neoplasms. Using the World Health Organization Histologic Classification of Ovarian Tumors, histologic features for common and rare human ovarian tumors are described and illustrated.

Cell Differentiation↗
PubMed1987

Pseudosarcomatous lesions of the urinary bladder, prostate gland, and urethra. A report of three cases and review of the literature.

Three pseudosarcomatous lesions of the genitourinary tract are described. One that arose in the urinary bladder of a 59-year-old man was composed of atypical spindle cells admixed with inflammatory cells in an edematous stroma. The second lesion occurred in the stroma of a hyperplastic prostate gland of a 51-year-old man and was characterized by the presence of numerous atypical mesenchymal cells with large, hyperchromatic nuclei. The third case was that of a 57-year-old woman with a urethral caruncle that contained numerous atypical mesenchymal cells in its stroma. All three patients were treated conservatively, and follow-up for periods ranging from 18 months to eight years has revealed no evidence of recurrence. Knowledge of the various atypical mesenchymal cell proliferations that are encountered in the genitourinary tract may prevent the misdiagnosis of a malignant tumor.

Aged↗
PubMed1987

Pathology of the testis in intersex syndromes.

This report reviews the pathologic, clinical, and cytogenetic aspects of various forms of male pseudohermaphroditism, mixed gonadal dysgenesis, true hermaphroditism, and Klinefelter's syndrome.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1987

Myxoid leiomyosarcoma of the urinary bladder.

A 16-year-old male patient with hematuria was found to have a 3-cm mass on the right posterolateral wall of the urinary bladder. After a biopsy specimen disclosed a myxoid tumor, a partial cystectomy was performed. The specimen contained a gelatinous tumor that, on microscopic examination, was a myxoid leiomyosarcoma similar to the neoplasm recently described in the uterus and several other locations. This tumor, which is the first of its type (to our knowledge) reported to occur in the bladder, must be distinguished from other neoplasms and nonneoplastic lesions that occur in this organ. The patient is well two years postoperatively.

Adolescent↗
PubMed1986

Malignant schwannoma of the ovary. Report of a case.

A malignant schwannoma, apparently arising in the left ovary of a 71-year-old woman is described. The patient had no stigmata of von Recklinghausen's disease. The tumor was located in the position of the left ovary and had metastasized throughout the peritoneal cavity. The neural sheath origin of the tumor was confirmed by electron microscopic examination. The tumor is thought to have arisen from small nerves in the ovarian hilus.

Aged↗
PubMed1986

Differential cyclic AMP responses to calcitonin among human ovarian carcinoma cell lines: a calcitonin-responsive line derived from a rare tumor type.

Several human tumor cell lines have been reported to have specific receptors for calcitonin (CT) and CT-responsive adenylate cyclase. In order to correlate patterns of responsiveness to CT, parathyroid hormone (PTH) and prostaglandin E2 (PGE2) with tumor morphology and intermediate filament protein expression, we examined four human ovarian tumor cell lines (BIN-16, BIN-22, BIN-53, BIN-67) which had been cultured from cells of metastatic foci. In two cell lines (BIN-53 and -16) there were small increases in cAMP content after exposure to CT and in three cell lines (BIN-53, -16, and -22) larger increases with PGE2. There was no cAMP response in any of the cells to PTH. In BIN-67 cells, however, CT induced a striking (greater than 20-fold) increase in cAMP content. Histologically, the CT-nonresponsive tumor lines were derived from serous adenocarcinomas while the CT-responsive tumor line was from a rare small cell carcinoma. Gel electrophoretic and immunofluorescence microscopic analyses had previously disclosed that the CT-nonresponsive cell lines contained high levels of simple epithelial keratins and no or very low levels of vimentin (characteristic of ovarian surface epithelial cells), while the CT-responsive cell line contained almost exclusively vimentin. Thus, cells cultured from a rare type of ovarian tumor were CT-responsive and were distinguishable from CT-nonresponsive ovarian tumor cells by initial tumor histology and intermediate filament protein expression.

Calcitonin↗
PubMed1986

Management of high-grade stage I adenocarcinoma of the endometrium: hysterectomy following low dose external beam pelvic irradiation.

Sixty-eight patients with FIGO stage I, grade 2 or 3 adenocarcinoma of the endometrium were treated according to a protocol involving 10 Gy external pelvic irradiation, prompt hysterectomy with surgical staging, and postoperative therapy individualized according to surgical-pathologic findings. Five-year survival for the entire group was 78%, 87% for those with grade 2 disease, and 59% for those with grade 3 disease. For patients whose disease was found to be confined to the uterus, surgical stage I, the 5-year survival was 98%. Patients with surgical stage I, grades 2 and 3 disease had 97 and 100% probabilities of surviving 5 years, respectively. Five-year disease-free probability was 96% for all patients with surgical stage I carcinoma, 97% for patients with grade 2 disease, and 94% for patients with grade 3 disease. Myometrial penetration influenced survival; no patient with less than 50% myometrial penetration died or suffered a relapse, while only 40% of patients with deeper penetration survived 5 years. Twenty-three percent of patients with surgically confirmed disease spread beyond the corpus survived 5 years; 29% remained disease-free at this interval. Ten of the 68 patients developed recurrences, none has had a known pelvic recurrence. Two major complications, one requiring surgery, were seen, both in patients receiving postoperative external beam irradiation. The rationale behind low-dose, preoperative external pelvic irradiation is described, and an approach to high-grade, FIGO stage I adenocarcinoma of the endometrium is outlined.

Adenocarcinoma↗
PubMed1986

Immunohistochemical demonstration of chromogranin in endometrial carcinomas with argyrophil cells.

Forty-five endometrial carcinomas, 36 of which contained argyrophil cells and nine of which were nonargyrophilic by the Grimelius method, were examined immunohistochemically for chromogranin. Chromogranin immunoreactivity was present in 19 of the 36 tumors with argyrophil cells (53 per cent) and in none of the nine tumors lacking these cells. All six of the tumors that contained argyrophil cells resembling enterochromaffin cells were chromogranin-positive, with the staining corresponding to the argyrophilia. In contrast, only 13 of the 30 tumors in which argyrophilia was present in the apical region or throughout the cytoplasm of the cells showed chromogranin immunoreactivity. In seven of these tumors, an excellent correlation existed between the distribution of argyrophilia and chromogranin positivity, but in the other six tumors argyrophilia was more pronounced than chromogranin immunoreactivity. Adjacent to one tumor, unusual cells in which argyrophil granules were packed predominantly in the basal portion of the cytoplasm were encountered in a focus of atypical hyperplasia; these cells were also chromogranin-positive. The present observations suggest that endometrial carcinoma cells with diffuse or apical chromogranin immunoreactivity may represent an early stage in the development of cells resembling those of the enterochromaffin type.

Carcinoid Tumor↗
PubMed1986

Atypical polypoid adenomyoma of the uterus. A report of 27 cases.

Twenty-seven atypical polypoid adenomyomas of the uterus were reviewed. The tumors occurred in women ages 21-53 (average 39.7) years old, who presented with abnormal uterine bleeding in most cases. Two of the patients had Turner's syndrome. The adenomyomas most frequently involved the lower uterine segment, measured up to 6 (average 1.9) cm in greatest dimension, and were characteristically polypoid and well circumscribed. Microscopic examination disclosed endometrial glands with varying degrees of hyperplasia and atypicality up to the appearance of carcinoma in situ within neoplastic smooth muscle. Squamous differentiation was common within the glands; the smooth muscle occasionally was atypical. Follow-up data suggested that the lesion is benign, although it persisted in two patients treated by curettage alone. Atypical polypoid adenomyomas should be distinguished from endometrial carcinomas and other malignant uterine neoplasms with which they are often confused, particularly in curettage specimens.

Adult↗
PubMed1986

Testicular and paratesticular tumors and tumor-like lesions of ovarian common epithelial and müllerian types. A report of four cases and review of the literature.

Three new and eleven previously reported testicular or paratesticular tumors that resembled ovarian tumors of common epithelial type are discussed. The 14 tumors occurred in patients ages 11-68 (average 47) years of age. The exact location for 12 of the tumors is known; 5 involved primarily the testicular parenchyma, 3, the tunica vaginalis, and 4, paratesticular tissue. Five tumors were serous, four of which were in the borderline category. Four tumors were Brenner tumors, admixed in one case with an adenomatoid tumor. Single examples of mucinous cystadenoma, mucinous cystadenocarcinoma, endometrioid adenoacanthoma, clear cell adenocarcinoma, and a benign tumor of mixed cell types complete the list. Follow-up of from 3 months to 14 years is available in eight cases; only one tumor, the clear cell adenocarcinoma, is known to have been clinically malignant. A fourth lesion in this article was a paratesticular mass composed of endometrial glands and stroma and bundles of smooth muscle. It arose in an 82-year-old man who had been treated with estrogens for prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1986

Giant cell arteritis of the female genital tract. A report of three cases.

Three cases of giant cell arteritis involving the female genital tract of postmenopausal women are reported. The patients were 80, 64, and 57 years of age and presented with fatigue and anemia, fatigue and an abdominal mass, and fever and weight loss, respectively. Two of the patients had palpable pelvic masses; one had an ovarian mass visible on ultrasound examination. All three patients were anemic, and the erythrocyte sedimentation rate was elevated in the two women in whom it was tested. Exploratory laparotomy revealed ovarian tumors in two patients; one had a mucinous cystadenoma, and one had bilateral ovarian fibromas. The third patient had a cyst of the rete ovarii. Extensive giant cell arteritis of the small to medium-sized arteries was found unexpectedly in the ovaries and fallopian tubes of two patients who had prior hysterectomies and in the ovaries, fallopian tubes, and uterus of one patient. One patient was treated postoperatively with prednisone with improvement of symptoms and a decrease in the erythrocyte sedimentation rate. Of the two patients who received no therapy, one was found to have a thoracic aortic aneurysm 5 years postoperatively, and the other was alive without symptoms 17 years after the operation. Giant cell arteritis of the female genital tract is a rare finding in elderly women and may occur as an isolated finding or as part of generalized giant cell arteritis.

Aged↗
PubMed1986

Argyrophil cells in Brenner tumors: histochemical and immunohistochemical analysis.

Argyrophil cells were identified by the single-impregnation Grimelius technique in 11 of 28 (39%) Brenner tumors, accounting for less than 1% of the tumor cell population in all the cases. All tumors with argyrophil cells were stained to demonstrate calcitonin, somatostatin, gastrin, adrenocorticotropic hormone, neurotensin, insulin, glucagon, and serotonin; and four of them (three benign and one borderline) were also stained for chromogranins with the monoclonal antibody LK2H10. Serotonin was present in nine of the 11 cases with argyrophil cells. Neurotensin and somatostatin were found in one borderline tumor, which also contained serotonin. Chromogranin reactivity was demonstrated in all four cases in which it was examined. Ultrastructural examination of one tumor revealed that the argyrophil cells contained secretory granules, 80 nm in diameter, and had elongated cytoplasmic processes that extended between the more numerous nonargyrophil tumor cells. The argyrophil cells of Brenner tumors are similar to those of urothelium in the frequency with which they are immunoreactive for serotonin and the rarity with which they are reactive for peptide hormones. These cells differ from those of mucinous ovarian tumors, which often contain both serotonin and peptide hormones. The findings of this study lend additional support to the close similarity of the epithelial components of Brenner tumors and urothelium.

Brenner Tumor↗