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Biomedical subjects

R M Austin

Publications and source records attributed to R M Austin.

At least 19 recordsLinked to original sources
PubMed1992

Fine-needle aspiration cytology of an endometrioid-like variant of yolk sac tumor.

A 36-year-old male with a history of immature teratoma and embryonal carcinoma of the testis was admitted to the hospital for abdominal pain and fever. A CT scan revealed a large right abdominal mass. The patient's serum alpha-fetoprotein (AFP) was 46.8 ng/ml (reference < 25 ng/ml). Fine-needle aspiration (FNA) of the mass revealed malignant glandular cells. Chemotherapy was instituted, followed by resection of the large abdominal mass. The tumor was grossly encapsulated, consisting of large areas of necrotic, hemorrhagic tissue surrounded by smaller, multiloculated cysts. Microscopically, the tumor had a villoglandular pattern and variably stratified tall columnar cells. A prominent feature of the columnar cells was supranuclear and subnuclear vacuolization. Intracytoplasmic PAS-positive, diastase-resistant hyaline globules were occasionally present. AFP by immunoperoxidase was prominent within the tumor. This recurrence of the previously diagnosed testicular teratoma with embryonal carcinoma represents a yolk sac tumor with components strongly resembling endometrioid carcinoma, a variant only recently described in eight cases of ovarian origin (Clement et al.: Am J Surg Pathol 1987; 11(10):767-778). We believe this is the first reported case of an endometrioid-like variant of testicular yolk sac tumor and also the first report of the FNA cytology findings in this variant.

Adenocarcinoma↗
PubMed1990

Multicentric adult secretory breast carcinoma: DNA flow cytometric findings, prognostic features, and review of the world literature.

A case of multicentric secretory breast carcinoma in a 39-year-old white female is described. Mammograms, DNA analysis, touch preparation cytology, and positive estrogen receptors are reported for the first time in this rare favorable mammary carcinoma. A review of the 33 reported cases with follow-up in adult females, including the present case, has revealed lymph node metastases in nine (27%), recurrence in four (12%), and distant metastases leading to death in two cases (6%). In patients treated with less than simple mastectomy there has been local recurrence in 4 (33%) of 12 cases and in three of the four cases (75%) greater than or equal to 2.0 cm. Increased size and lack of gross circumscription of the neoplasm and presentation in the adult age group appear to identify cases with an increased risk of disease progression. In patients over 20 years old, especially with neoplasms greater than 2 cm in diameter, modified radical mastectomy has to date achieved the most favorable outcome. Minimal experience (two cases) is available regarding treatment with limited surgery and radiation therapy, and there is no available data regarding possible benefit from adjuvant chemotherapy.

Adult↗
PubMed1990

Histologic sampling requirements in ovarian carcinoma: a review of 51 tumors.

In a review of 29 serous and 22 mucinous adenocarcinomas of the ovary, we quantitated the various histologic patterns seen in these neoplasms in order to document histologic variability and assess current anecdotal recommendations (one section per 1-2 cm of maximum tumor diameter) for adequate histologic sampling of epithelial ovarian neoplasms. Mucinous carcinomas showed more histologic variation than serous carcinomas, but both showed substantial portions with benign or borderline histology in many neoplasms. One serous and one mucinous carcinoma were likely to have been classified as borderline tumors if only current sampling recommendations had been followed. The remaining adenocarcinomas were adequately sampled by current standard practice. The two tumors in question had unusual clinical and histological features which prompted additional sampling. Caution is particularly warranted when initial frozen section sampling shows features of borderline tumor histology or low grade epithelial atypia, especially in mucinous epithelial neoplasms where histologic variability is greatest.

Adenocarcinoma, Mucinous↗
PubMed1988

Cholecystojejunostomy intussusception.

Intermittent prolapse of a jejunal loop into the gallbladder lumen was observed following cholecystojejunostomy in a patient with advanced carcinoma of the pancreas. This unusual complication was documented by cholangiography and sonography.

Aged↗
PubMed1987

Fibromatosis of the breast. A clinical and pathological study of 28 cases.

The clinical and pathologic findings of 28 examples of fibromatosis of the breast not involving the deep fascia or chest wall are reported. Five of the 20 lesions treated by local excision recurred. Recurrences developed within a 4 to 8 month period following surgery in four of the five instances, and 6 years after surgery in one instance. One lesion recurred five times over a period of 3 years. None of the patients died from their disease, and none developed a metastasis. Those lesions that recurred had been inadequately excised initially, since surgical margins showed fibromatosis. Specific histological features, such as size, cellularity, atypia, and mitotic figures, were not helpful in predicting recurrence. Although local excision appears to have been adequate in the majority (75%) of the patients, the infiltrative nature of fibromatosis necessitates documentation of tissue margins in order to avoid the possibility of recurrence. The differential diagnosis includes benign reactive processes (such as keloid and nodular fasciitis), fibrous histiocytoma, low-grade spindle-cell (metaplastic) carcinoma, and fibrosarcoma.

Adolescent↗
PubMed1987

Malignant Brenner tumor and transitional cell carcinoma of the ovary: a comparison.

The clinical and pathologic features of 16 malignant Brenner tumors (MBT) having an associated benign Brenner component were compared with 29 primary ovarian transitional cell carcinomas (TCC), neoplasms differing from MBT only in that a benign Brenner component was absent. Transitional cell carcinoma represented a more aggressive neoplasm. Twenty of twenty-nine (69%) presented in advanced stages (II-IV) compared with only three of sixteen (19%) MBT. Among stage IA tumors, only three of seven (43%) patients with TCC were well at last contact, compared with nine of eleven (88%) patients with Stage IA MBT. In addition to not having a benign Brenner component, TCC lacked the prominent stromal calcification common in most benign and malignant Brenner tumors. Transitional cell carcinoma is sufficiently different from MBT in that it is reasonable to suppose that ovarian TCC arises directly from pluripotential surface epithelium of the ovary and from cells with urothelial potential, rather than from a benign or proliferative Brenner tumor precursor.

Adult↗
PubMed1986

Liposarcoma of the breast: a clinicopathologic study of 20 cases.

The clinical and pathologic features of 13 patients with pure liposarcomas of the breast and seven patients with liposarcomas that had arisen in cystosarcomas are reviewed. Metastases occurred in three of the 13 patients with pure mammary liposarcomas, and two women died of tumor. One of the patients with a liposarcoma that had arisen in a cystosarcoma had a local recurrence one year after diagnosis but was subsequently lost to follow-up study. Fourteen of the 20 patients for whom follow-up information was available for as long as 14 years had no evidence of recurrence. Features associated with the development of recurrence, based on the cases studied here and previous reports, included the pleomorphic liposarcoma pattern and an infiltrative margin. Features associated with tumor-free survival included the well-differentiated liposarcoma pattern, male gender (two patients), and a circumscribed microscopic tumor margin. There were no axillary lymph node metastases. Follow-up data indicate that complete surgical excision of tumor with tumor-free margins is necessary, but total mastectomy and removal of the axillary tail are not required unless these procedures are needed for complete excision.

Adult↗
PubMed1986

Muscle anatomy of the human esophagus.

We studied the esophageal musculature of 11 cadavers to assess the distribution of striated and smooth muscle. The lower 54-62% of the esophagus was found to be exclusively smooth muscle, the proximal 4.1-5.6% to be exclusively striated, and the remainder to be mixed. The area in which striated and smooth muscle portions were approximately equal, the 50/50 point, was found to be 4.7 +/- 0.6 cm from the proximal portion of the cricopharyngeus muscle. This point corresponds to the previously described physiologic low pressure zone in the proximal esophagus.

Adult↗
PubMed1985

Computed tomography of axillary and supraclavicular adenopathy.

The normal cross-sectional anatomy of the axillary and supraclavicular regions is demonstrated. One hundred and sixty chest computed tomography scans were reviewed and criteria for differentiating normal axillary and supraclavicular structures from enlarged lymph nodes established. Axillary structures 14 mm or larger are suggestive of axillary adenopathy. Axillary structures 10-13 mm in size raise the possibility of adenopathy.

Aged↗
PubMed1984

Catheter hysterosalpingography.

The authors describe a 5-F catheter which is simpler to use than the standard vacuum cannula when performing hysterosalpingography.

Catheterization↗
PubMed1984

Leydig cell hypoplasia causing male pseudohermaphroditism: diagnosis 13 years after prepubertal castration.

An 11-yr-old patient with male pseudohermaphroditism who was castrated at nine days of age and raised thereafter as a female was evaluated to determine the cause of abnormal sexual differentiation. Stimulation with ACTH for 8 h revealed no abnormality in the biosynthesis of cortisol or adrenal androgens. The administration of fluoxymesterone (10 mg, orally, daily) for 5 weeks at age 13 yr led to significant decrements in serum levels of sex steroid-binding globulin and T4-binding globulin to a degree similar to that found in 2 normal men, but no change in the basally elevated levels of FSH and LH. LH bioactivity was normal in the rat Leydig cell bioassay. Skin fibroblasts cultured from a labial skin biopsy revealed normal 5 alpha-reductase activity and normal androgen receptors. Reexamination of the original testis specimens by light microscopy failed to reveal Leydig cells. Furthermore, when immunoperoxidase staining for testosterone was performed on the tissue sections, only 30-35 positive cells/10 high power fields were seen. In contrast, examination of testis sections from 4 male infants who died of other causes revealed 94-836 cells/10 high power fields that stained positively for testosterone. Although hCG stimulation testing to confirm Leydig cell hypoplasia could not be done in this patient because of previous castration, this patient demonstrates that the diagnosis can be made without it by the use of immunohistochemical stains and in vivo and in vitro tests to exclude other disorders of androgen biosynthesis or androgen action.

Adrenocorticotropic Hormone↗
PubMed1981

Liquid preservation of baboon red blood cells in acid-citrate-dextrose or citrate-phosphate-dextrose anticoagulant: effects of washing liquid-stored red blood cells.

Autologous baboon RBC stored at 4 C in acid-citrate-dextrose (ACD) or in citrate-phosphate-dextrose (CPD) for 3 weeks after collection had 24-hour 51Cr posttransfusion survival values of about 77%. When 20-day-old ACD and CPD baboon RBC were washed and then stored at 4 C for 24 hours before autotransfusion, the 24-hour 51Cr posttransfusion survival values were about 81%. These values were similar to those seen in studies of human RBC preserved in an identical manner. Our results indicated that the baboon can be used to evaluate RBC preservation techniques before human volunteers are studied.

Animals↗
PubMed1981

Measurement of red blood cell volume, plasma volume, and total blood volume in baboons.

Red blood cell volume was measured directly in baboons by infusion of 51Cr-labeled autologous RBC, and was indirectly estimated from the plasma volume measured with 125I-labeled albumin and the total body hematocrit. The total body hematocrit was calculated from the peripheral venous hematocrit multiplied by a correction factor; for nonanemic baboons the correction factor was 0.87, and for anemic baboons, 0.75. Within 2 weeks after the phlebotomy (150 ml of blood), the baboon's RBC volume was restored to normal. Posttransfusion survival of baboon RBC can be measured accurately in nonanemic baboons; the preserved RBC can be labeled with 51Cr and the RBC volume of the baboon can be measured indirectly from the plasma volume measured with 125I-labeled albumin and the total body hematocrit.

Animals↗
PubMed1980

Infiltrating (intramuscular) lipomas and angiolipomas. A clinicopathologic study of six cases.

Infiltrating (intramuscular) lipomas and angiolipomas are benign mesenchymal tumors that usually appear as a deep, nontender mass within soft tissue, particularly in the extremities. The average tumor size in six cases studied was 11.2 cm (range, 2.0 to 22.0 cm). On gross examination, these tumors are circumscribed but unencapsulated, with infiltration of adjacent skeletal muscle. The correct preoperative diagnosis is seldom made, and the characteristic infiltrating pattern seen microscopically can lead to a mistaken diagnosis of sarcoma. Soft-tissue roentgenograms can be helpful in diagnosis and localization. The recommended mode of therapy is complete local excision with tumor-free soft-tissue margins. None of the six patients described here have experienced recurrence of tumor an average of two years after surgical resection. Prolonged follow-up is recommended, however, since inadequate resection can result in late tumor recurrence.

Adult↗