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Biomedical subjects

R L Kempson

Publications and source records attributed to R L Kempson.

At least 73 records · Page 4Linked to original sources
PubMed1977

Smooth muscle tumors of the gastrointestinal tract and retroperitoneum: a pathologic analysis of 100 cases.

One hundred smooth muscle tumors arising in the gastrointestinal tract and retroperitoneum were reviewed in an attempt to define criteria for the diagnosis of leiomyosarcoma in these sites. On the basis of aggressive behavior, 56 of these neoplasms were diagnosed as leiomyosarcoma. Mitoses were found to be the most useful indicator of malignancy; all of the tumors with five or more mitoses/10 HPF behaved aggressively and smooth muscle tumors with this degree of mitotic activity should be diagnosed as leiomyosarcoma. A paucity of mitoses, however, is no assurance of benignity as nearly 40% of the leiomyosarcomas in this series had fewer than five mitoses/10 HPF. Tumor cell necrosis was closely associated with aggressive behavior even when mitoses were infrequent and it is doubtful that benign smooth muscle tumors develop extensive tumor cell necrosis. In the absence of the requisite number of mitoses or tumor necrosis, it is difficult to distinguish some leiomyosarcomas from leiomyomas, but tumor size, cellularity and cellular atypia may be helpful parameters when assessed together. The importance of these criteria in different anatomical sites is discussed. It is emphasized that the criteria for the diagnosis of leiomyosarcoma of the uterus do not apply to non-uterine smooth muscle tumors. The actuarial 2-year survival rate was as follows: gastric leiomyosarcoma, 40%; small intestinal leiomyosarcoma, 60%; and retroperitoneal leiomyosarcoma, 16%.

Diagnosis, Differential↗
PubMed1977

Ovarian sex cord tumors with annular tubules: an ultrastructural study.

The ultrastructural features of two "sex cord tumors with annular tubules" are presented. The findings are compared with the reported fine structure of ovarian and testicular stromal cells and the cells of gonadal stromal neoplasms. The predominant cell in the "sex cord tumor with annular tubules" has some of the ultrastructural features found in gonadal stromal cells of either ovarian or testicular type; however, no Charcot-Bottcher crystals, lamellar bodies, crystalloids of Reinke, abundant smooth endoplasmic reticulum or complex plasma membrane interdigitations are observed in the tumor cells to suggest wither Sertoli or Leydig cell origin. The striking similarity between the predominant cell type and granulosa cells, as well as the presence of fibrillary material of the type seen in Call-Exner bodies, suggests a granulosa cell origin for these neoplasms. However, the presence of a sparsely distributed second cell type which closely resembles the dark cells in normal nonluteinized ovarian stroma indicates these tumors may arise from the nonspecialized ovarian stroma.

Adult↗
PubMed1977

Kartagener syndrome: report of a case with mesangiocapillary glomerulonephritis.

The first known case of Kartagener syndrome associated with glomerulonephritis is reported. Mesangiocapillary glomerulonephritis was diagnosed in this patient several months before her death. This report also includes a review of the recent literature dealing with Kartagener syndrome and mesangiocapillary glomerulonephritis and a consideration of the possible relationship of infection to the cause of mesangiocapillary glomerulonephritis.

Adolescent↗
PubMed1976

Steroid therapy in severe viral hepatitis. A double-blind, randomized trial of methyl-prednisolone versus placebo.

The efficacy of corticosteroid therapy in severe viral hepatitis has never been demonstrated in a controlled clinical trial. For this reason, patients with severe viral hepatitis were randomly assigned to methyl-prednisolone or placebo treatment groups. The two groups were comparable in clinical findings, laboratory results and the presence of bridging necrosis on liver biopsy. Seven of the 14 patients assigned to methyl-prednisolone and two of the 15 assigned to placebo died during the 16-week study period. Although the apparent excess mortality in the steroid-treated patients is not quite statistically significant (P = 0.08), the trend persists when only patients positive for hepatitis B surface antigen (P = 0.04) are analyzed separately. Methyl-prednisolone does not enhance survival in patients with severe viral hepatitis, and it may be detrimental.

Acute Disease↗
PubMed1976

Inflammatory fibrous histiocytoma. An aggressive and lethal lesion.

During an investigation of soft tissue fibrohistiocytic tumors, seven cases were found which we believe represent a new and specific diagnostic subgroup of fibrous histiocytomas. All patients were adults (mean 52.6 years), only one of whom was younger than age 40. There were four females and three males; all were Caucasian. The tumors which occurred in the retroperitoneum, anterior chest wall, anterior abdominal wall, femoral area, and oral cavity, were large, averaging 8.5 cm., and although appearing encapsulated, were microscopically infiltrative. The common histologic feature of all cases was a diffuse and at times intense neutrophilic infiltrate unassociated with tissue necrosis, in combination with bland and anaplastic appearing histiocytes. The presence of this acute exudative reaction is a unique feature of these lesions, and was present not only in the original tumors, but in recurrences and metastatic foci as well. Other cell types including foam cells, lymphocytes, plasma cells, eosinophils, Reed-Sternberg-like and ganglion-like cells were commonly present. A storiform fibrous pattern, a hallmark of the fibrous histiocytomas was seen at some time in all but one case. The treacherous aspect of these lesions was their bland initial histologic appearance. The foci of foam cells associated with the inflammatory elements often led to a diagnosis of a benign inflammatory reaction or xanthogranuloma. However, follow-up has confirmed the aggressive and neoplastic nature of these lesions. The clinical course was usually protracted with multiple recurrences and eventual metastases. All patients died of their tumor, the average survival being 53 months; four patients survived over 5 years. At this time, we propose the term inflammatory fibrous histiocytoma to designate these lesions.

Adult↗
PubMed1976

Strumal carcinoid of the ovary.

A 45-year-old woman presented with an apparently nonfunctioning strumal carcinoid of the ovary. On ultrastructural examination the cells in the solid parts of the tumor as well as in the "follicular" areas contained dense-core secretory granules, indicating that this neoplasm is a pure carcinoid tumor. The thyroid-like appearance in areas is due to the accumulation of secretory material within unusually dilated acinar spaces. This study raises the question whether any strumal carcinoid contains thyroid tissue since the cells forming the follicle-like spaces in this tumor contain dense-core granules.

Appendiceal Neoplasms↗
PubMed1976

"Endometrial" adenocarcinoma of the prostate: a distinctive tumor of probable prostatic duct origin.

A so-called "endometrial" adenocarcinoma of the prostate has been studied by light and electron microscopy, and by histochemical techniques. The previously proposed utricular origin and estrogen dependence of such tumors is questioned. Strong acid phosphatase staining, and the ultrastructural demonstration of multivacuolated, lipid, and lysosome-containing tumor cells, suggest a prostatic ductal origin for this type of carcinoma despite the histologic similarity to carcinoma of the endometrium.

Acid Phosphatase↗
PubMed1976

Breast adenomas.

True adenomas of the breast are cellular epithelial lesions, which may be confused with carcinoma and are difficult to classify. We have reviewed 28 adenomas of the breast and have developed specific diagnostic criteria, as well as a classification of breast adenomas based on histologic features. Electron microscopic studies confirm that adenomas have ultrastructural features similar to normal breast epithelium and are not variants of fibroadenomas. The association between lactating adenomas and pregnancy has been confirmed; however, clinicopathologic correlation does not suggest a relationship between adenomas and oral hormonal medication. Although adenomas are benign, this study includes the third reported case of an infiltrating carcinoma associated with a lactating adenoma.

Adenofibroma↗
PubMed1976

Operative staging of apparently localized adenocarcinoma of the prostate: results in fifty unselected patients. I. Experimental design and preliminary results.

The design and details of a prospective, randomized study protocol involving bipedal lymphography, and exploratory laparotomy with selective node biopsy in patients with apparently localized adenocarcinoma of the prostate are presented. The analysis includes the results of selected diagnostic tests, and an assessment of the accuracy of clinical vs. surgical staging in 50 unselected patients. Lymphatic metastases were found at the time of diagnostic laparotomy in 18 of the 50 patients (36%). Both increasing size (advanced T stage) and decreasing differentiation of the primary tumor were associated with an increased incidence of lymph node metastases. Of 25 patients with T1 and T2 tumors (Stage B), and 25 patients with T3 tumors (Stage C), lymphatic dissemination was found in 20 and 52%, respectively. Eleven of 20 patients (55%) with poorly differentiated tumors had lymph node metastasis, compared with only 2 or 11 patients (18%) with well-differentiated tumors. Twelve patients had a change in their clinical stage following exploratory laparotomy; in eight the stage was increased and in four it was decreased. Of 18 patients with lymphatic metastases, some of which were extensive and most of which were associated with increased serum acid phosphatase values, no evidence of concurrent bony or visceral dissemination was found. Although preliminary, this finding should stimulate the search for effective treatment in these patients who were previously thought to be incurable on the basis of probable vascular dissemination.

Acid Phosphatase↗
PubMed1975

Clear cell sarcoma with melanin pigment.

A patient with a clear cell sarcoma of tendons and aponeuroses arising in the left sacral area is reported. The tumor grossly contained two black foci that had pigment with the staining characteristics of melanin on light microscopy. Electron microscopy of these areas showed the pigment to be within melanosomes. This is the second report of a neoplasm diagnosed as clear cell sarcoma in which melanin was demonstrated; the possibility that the tumor represents a soft tissue variant of malignant melanoma is discussed. It is suggested that clear cell sarcoma is a heterogeneous entity, and that a number of different soft tissue neoplasms may present with a clear cell pattern, making diagnosis and classification difficult.

Adult↗
PubMed1975

Cytology of the cerebrospinal fluid in patients with Hodgkin's disease or malignant lymphoma.

The cerebrospinal fluids (CSF) of 18 patients with Hodgkin's disease and 33 patients with malignant lymphoma were evaluated for the presence of malignant cells. The CSF cytology was correlated with the neuropathologic findings at surgery or autopsy. In the 51 patients included in the study there were seven false-negative CSF cytodiagnoses. Methods to improve detection in the false-negatives will be discussed. There were two false-positives. Explanations for the two false-positive cytodiagnoses will be presented. It is concluded that cytological examination of the CSF in patients with Hodgkin's disease and malignant lymphoma is a useful and reliable diagnostic tool.

Cerebrospinal Fluid↗
PubMed1975

Results of postoperative megavoltage radiotherapy of malignant surface epithelial tumors of the ovary.

The results of postoperative radiotherapy in 151 patients with malignant epithelial tumors of the ovary are presented. Actuarial survival at five years for patients in FIGO Stage I was 76%; in Stage II, 56%; Stage III, 16%; and Stage IV, 0%. Survival also varied with histopathological type, the best prognoses occuring in the serous (malignant) and endometrioid types (NED survival of 35% and 50%, totalling all stages, respectively). The presence of ascites or intraperitoneal surgical spillage did not adversely affect survival. The role of lymphangiography in staging is discussed. New approaches to diagnosis, staging and treatment are required for improving the prognosis of patients with ovarian carcinoma.

Adenocarcinoma↗