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R E Scully

Publications and source records attributed to R E Scully.

At least 163 records · Page 9Linked to original sources
PubMed1989

Uterine leiomyomas with lymphoid infiltration simulating lymphoma. A report of seven cases.

Seven women, 35-50 years of age, had uterine leiomyomas with lymphoid infiltration. The leiomyomas ranged from 2 to 12 cm in greatest dimension and contained a variably dense infiltrate of small lymphocytes with scattered larger lymphoid cells and occasionally, numerous plasma cells; germinal centers were identified in some cases and ranged from large and florid to inconspicuous; rarely, eosinophils were present. Most of the tumors contained focal to extensive areas of sclerosis. In all the cases in which adjacent myometrium was available for examination, the lymphoid infiltrate was confined to the leiomyoma or was present to only a minor extent in the adjacent myometrium. Significant lymphoid infiltration of uterine leiomyomas, which appears to be a reactive process, has not been described previously. The polymorphous nature of the infiltrate and its confinement to the leiomyoma distinguish it from malignant lymphoma.

Adult↗
PubMed1989

Liesegang rings in the female genital tract. A report of three cases.

Three cases of Liesegang rings (LRs) within the female genital tract are reported; only one similar case has been previously documented. The patients were 32-57 years of age and underwent operations for ovarian endometriosis (two cases) and uterine leiomyomas (one case). Innumerable eosinophilic, acellular, ring-like structures, similar to previously described LRs, were found on microscopic examination and were confined to an endometriotic cyst (two cases) or the mucosa of a fallopian tube involved by chronic salpingitis (one case). Liesegang rings within the female genital tract, as in other sites, occur within cysts or within areas of inflammation. These structures have been confused with and should be distinguished from parasites and foreign material on histologic examination.

Adult↗
PubMed1989

Ovarian endometrioid carcinomas resembling sex cord-stromal tumors. An immunohistochemical study.

Ovarian endometrioid carcinomas resembling sex cord-stromal tumors (ECSCSs) may simulate Sertoli cell tumors, Sertoli-Leydig cell tumors (SLCTs), and adult granulosa cell tumors (AGCTs), both clinically and pathologically. Differing clinical features and histologic findings are almost always successful in distinguishing these tumor types, although in some cases the differential diagnosis is difficult. Immunohistochemical staining of 17 ECSCSs, 14 Sertoli cell tumors or SLCTs, and 15 AGCTs was performed with the use of antibodies against cytokeratins (AE1/AE3, 902, and CAM 5.2), epithelial tumor-associated antigens (EMA, OM-1, B72.3, and carcinoembryonic antigen B1.1), vimentin, S-100, neuron-specific enolase, and lysozyme to determine the immunohistochemical profile of each tumor type and to define further the nature of the sex cord-like components in ECSCSs. All 17 ECSCSs, none of the 15 AGCTs, and one of 14 Sertoli cell tumors or SLCTs stained with EMA. Staining for OM-1 was almost as helpful diagnostically, with positive results for 15 of 17 ECSCSs, 0/15 AGCTs, and 1/14 Sertoli cell or SLCTs. Antikeratins were immunoreactive with all the ECSCSs as well as some of the AGCTs and Sertoli cell tumors or SLCTs. The B72.3 and B1.1 were immunoreactive with some ECSCSs and Sertoli cell tumors, but were nonreactive with AGCTs. Neuron-specific enolase was demonstrated in 11 of 17 ECSCSs, two of 14 Sertoli cell tumors or SLCTs, and 0 of 15 AGCTs. Vimentin, S-100, and lysozyme were least helpful in the differential diagnosis. These studies suggest that an immunohistochemical approach may be useful in the differentiation of ECSCSs and sex cord-stromal tumors. Furthermore, it supports the conclusion that the sex cord-like cells in ECSCSs are not Sertoli or granulosa cells, but cells of surface epithelial type growing in architectural patterns similar to those of sex cord-stromal tumors.

Adenocarcinoma↗
PubMed1989

Hilus cell tumor of the ovary. A clinicopathological analysis of 12 Reinke crystal-positive and nine crystal-negative cases.

The clinical and pathological features of 12 Reinke crystal-positive and nine probable (crystal-negative) hilus cell tumors of the ovary were reviewed. The patients' ages ranged from 32 to 82 years. The initial manifestation was androgenic in 62% of the cases. The levels of testosterone were high (200-2,400 ng/dl) even though the tumors had a mean diameter of only 2.1 cm. All the tumors were centered in the hilus of the ovary, extending for varying distances into the ovarian stroma. They were composed of polyhedral to rounded cells with generally abundant eosinophilic cytoplasm and often showed a perivascular aggregation of nuclei with avascular pooling of cytoplasm or hyalinization of stroma. Fibrinoid changes in the vessels of the tumors were frequently noted. None of the 10 patients for whom follow-up data of 1-17 years were available died of tumor; virilizing symptoms regressed but did not completely disappear in five of the 10 patients after the removal of the tumor.

Adult↗
PubMed1989

Nontrophoblastic pathology of the female genital tract and peritoneum associated with pregnancy.

This report reviews the clinical and pathological features of nontrophoblastic lesions that involve the female genital tract and peritoneum and are typically or exclusively associated with pregnancy or the puerperium. The majority of them are nonneoplastic lesions that may be confused with a neoplasm on clinical or pathological examination. Pregnancy-related changes within gynecological tumors that may create problems in histological interpretation also are discussed briefly.

Diagnosis, Differential↗
PubMed1989

Tubular seminoma. Report of a case.

A 34-year-old man had a 1.5-cm-diameter solid, tan, right testicular tumor. Microscopic examination revealed a predominance of solid tubular structures containing cells with the characteristic features of seminoma cells. The neoplasm, which had a sparse lymphocytic infiltrate, was a rare tubular variant of seminoma, the architecture of which closely resembled that of a Sertoli cell tumor.

Adult↗
PubMed1988

Peritoneal implants of ovarian serous borderline tumors. Histologic features and prognosis.

The clinicopathologic features of 56 cases of ovarian serous borderline tumors (SBT) associated with peritoneal implants were reviewed. Data from 368 person-years of follow-up (median follow-up, 6.0 years) were analyzed to investigate the possibility that the histologic features of implants of this type of tumor may correlate with the prognosis. Eighty-five percent of the 56 patients were clinically free of tumor at the time of death or at last contact. Thirteen percent of the patients died of tumor, and one patient (2%) was alive with widespread progressive tumor. The product-limit estimate of the probability of death from tumor (+/- standard error) was 4% (+/- 3%) at 5 years and 23% (+/- 9%) at 10 years. The following three histologic features of the implants correlated with an adverse prognosis: (1) invasion (P = 0.0004), (2) severe cytologic atypia in both invasive and noninvasive implants (P = 0.0008) and in noninvasive implants alone (P = 0.02), and (3) the presence of mitotic activity in both types of implants (P = 0.02) and in noninvasive implants alone (P = 0.02). The only other feature that correlated with the prognosis was the presence of residual tumor postoperatively as assessed by the surgeon (P = 0.01). The product-limit estimate of death of tumor in patients with at least one of these four adverse prognostic factors was 56% (+/- 20%) at 10 years. Whether or not the patients received radiation therapy, chemotherapy, or both had no statistically significant effect on the outcome. These data and the results of a stratified analysis suggest that patients may benefit from additional therapy if adverse prognostic factors are present, especially invasiveness or severe cytologic atypia. It is unlikely that additional therapy is necessary in patients without adverse prognostic features, because no deaths occurred in this group.

Adult↗
PubMed1988

Extraovarian pelvic yolk sac tumors.

The clinical and pathologic features of four extraovarian pelvic yolk sac tumors (YST) are described. The women, 17 to 39 years of age, were found to have a pelvic mass on physical examination, or in one case, at cesarean section. The tumors were bulky and arose within, or in close proximity to, the uterus. One tumor involved the endometrial cavity and myometrium extensively, another was attached to the anterior uterine serosa, another was in the cul-de-sac, and one lay between the lower uterine segment and urinary bladder. The ovaries were grossly unremarkable in all cases. Peritoneal metastases were present at the time of operation in two patients and were documented on histologic examination in a third. The serum alpha fetoprotein (AFP) level was elevated postoperatively in the three patients in whom it was determined. Three of the YST were pure and had a typical histologic appearance, whereas the fourth had an endometrioid-like glandular pattern and was associated with a teratoma. Immunohistochemical stains performed in three cases all showed AFP and alpha-1-antitrypsin (AAT). All patients received postoperative combination chemotherapy. Two of them died of tumor 14 and 24 months, respectively, postoperatively and two were disease-free 6 and 8.5 years, respectively, postoperatively.

Adolescent↗
PubMed1988

Ovarian mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type. A clinicopathologic analysis.

Borderline tumors with papillae that are architecturally similar to those of serous tumors but with a lining of more than one mullerian cell type have not been well characterized in in the literature. We have studied 36 such tumors. The patients averaged 35 years of age. Twenty-two percent of the tumors were bilateral; all were confined to the ovaries as confirmed at operation. Fifty-three percent were associated with endometriosis. Follow-up information was available on 34 patients for a mean interval of 4.8 years. A tumor developed in the contralateral ovary in one patient 2 years after unilateral salpingo-oophorectomy. Three patients had pelvic recurrences between 7 months and 3 years, but all of them were successfully treated and none have died. These tumors differ clinically and pathologically from intestinal-type mucinous borderline tumors, but they have many similarities with mullerian mucinous borderline tumors and, to a lesser extent, with serous borderline tumors.

Adolescent↗
PubMed1988

Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy. A clinicopathologic analysis.

Ovarian mucinous cystadenomas of borderline malignancy that contain foci of intestinal differentiation are well recognized. Borderline tumors lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors, however, have not been described in the literature. We have studied 30 tumors of this type. The patients averaged 34 years of age. Forty percent of the tumors were synchronously bilateral and 30% were associated with endometriosis. Four tumors were complicated by peritoneal implants, one by both peritoneal implants and lymph node metastasis and one by lymph node metastasis alone. No patient had pseudomyxoma peritonei. Follow-up information was available on all the patients for a mean interval of 3.7 years. In two cases tumors developed in the conserved contralateral ovary; no deaths occurred. These tumors have important clinical and pathologic differences from mucinous borderline tumors with intestinal differentiation, but have many similarities to mixed-epithelial borderline tumors of Mullerian type.

Adult↗
PubMed1988

Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases.

Although the clinical and pathological features of sarcoma botryoides of the vagina in infancy are well documented in the literature, only occasional cases of a histologically similar tumor of the uterine cervix have been described, mostly as individual case reports. We have reviewed 13 cases of sarcoma botryoides of the cervix. The patients range in age from 12 to 26 years, with a mean of 18 years. All presented with vaginal bleeding, "something" protruding from the introitus, or both. On gross examination the tumors were polypoid, smooth, glistening, and focally hemorrhagic. Microscopic examination revealed the presence of a cambium layer and cells showing the features of rhabdomyoblasts in all the cases. Six of the 13 tumors (45%) contained foci of mature cartilage. All the patients were alive and well 1 to 8 years (average 3.5 years) postoperatively except for one who died of the tumor after 1 year. Although most of the patients had a radical operation, sometimes followed by chemotherapy, three had excellent results after polypectomy or cervicectomy. The findings indicate that, unlike its counterpart in the vagina, which has a poor prognosis, sarcoma botryoides of the cervix in young women has a favorable outlook.

Adolescent↗
PubMed1988

Ovarian granulosa cell proliferations of pregnancy: a report of nine cases.

Granulosa cell proliferations that simulated small neoplasms were incidental findings in the ovaries of nine pregnant women. The lesions were typically multiple and associated with atretic follicles. In eight cases, the granulosa cells were arranged in solid, insular, microfollicular, and trabecular patterns, but in the ninth case, there was a prominent sertoliform tubular pattern. The granulosa cells typically contained scanty cytoplasm and grooved nuclei, resembling the cells of adult-type granulosa cell tumors. However, in one case large nodules of markedly luteinized cells with variably sized, round, nongrooved nuclei were present; the nodules in this case superficially resembled pregnancy luteomas. In the case with a sertoliform pattern, the cells had abundant vacuolated cytoplasm. The lesions described probably reflect an unusual physiological response to the elevated chorionic gonadotropin level of pregnancy rather than early stages of neoplasia.

Adult↗
PubMed1988

Spermatocytic seminoma of testis with sarcomatous transformation. A report of five cases.

Five cases of spermatocytic seminoma of the testis associated with a sarcomatous component, one of them of rhabdomyosarcomatous type, are presented. No recognizable teratomatous structures were identified in any of the cases. The presence of the sarcomatous elements transformed the usually innocuous spermatocytic seminoma into a highly aggressive neoplasm, which led to the patients' death in at least two cases. The sarcomatous elements may represent a nonseminomatous germ cell component, but we prefer to view them as an expression of anaplastic transformation of the tumors, analogous to that seen in tumors in other organs.

Adult↗
PubMed1988

"Adenoid cystic" carcinoma and adenoid basal carcinoma of the uterine cervix. A study of 28 cases.

Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) of the uterine cervix are rare tumors that have often been regarded as a single entity. We studied 28 cases of these neoplasms, with 14 cases in each category. Most patients were over 60 years of age, and there was a high proportion of black women. The majority of the women with ACC presented with postmenopausal bleeding and had an obvious mass on pelvic examination. Despite the tumors' architectural similarity to ACC of the salivary gland, microscopic examination of the cervical carcinomas showed necrosis, a high mitotic rate, and greater nuclear pleomorphism. In all but one of the cases, the tumor cells were negative for S-100 protein on immunoperoxidase staining--a finding that provides evidence against a myoepithelial component. However, S-100-positive dendritic cells were present in the stroma of the tumors and among the neoplastic cells. The patients with ABC were usually asymptomatic, without a gross abnormality of the cervix. Microscopic examination disclosed small nests of basaloid cells, almost always beneath, and often arising from, in situ or small invasive squamous cell carcinomas. In contrast to ABC, ACC was often complicated by local recurrence or distant metastasis. We conclude that ACC of the uterine cervix differs from ACC of salivary gland origin and is also distinct clinically and pathologically from cervical ABC.

Aged↗
PubMed1988

Necrotic pseudoxanthomatous nodules of ovary and peritoneum in endometriosis.

The clinical and pathological features of four unusual cases of pelvic endometriosis are described. The patients, who were between the ages of 40 and 72 years, underwent operations for uterine leiomyomas in two cases, endometrial adenocarcinoma in a third case, and an enlarging abdominal mass in a fourth case. In three patients, two of whom had enlargement of one or both ovaries, multiple nodules were either attached to the peritoneum (two cases) or lay free in the peritoneal cavity (one case). In one of these cases, the intraoperative findings mimicked metastatic carcinoma. Histological examination of the peritoneal lesions, as well as the ovaries in all the cases, revealed granulomatous nodules composed of a central focus of necrotic tissue surrounded by histiocytes (pseudoxanthoma cells), hyalinized connective tissue, or both. Endometriotic glands and stroma were typically absent in the nodules and their immediate vicinity. Foci of recognizable endometriosis, however, were found in the ovaries in all the cases. In one of the ovaries, several necrotic nodules lined an endometriotic cyst; in another, a focus had an appearance transitional between endometriosis and a necrotic nodule. These necrotic pseudoxanthomatous nodules are a previously undescribed manifestation of endometriosis; they occur characteristically in older women. On histologic examination, they should be distinguished from other necrotic peritoneal and ovarian granulomas, as well as necrotic tumor.

Adult↗