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S B Kapadia

Publications and source records attributed to S B Kapadia.

At least 55 records · Page 3Linked to original sources
PubMed1992

Pitfalls in the histopathologic diagnosis of pyogenic granuloma.

The term pyogenic granuloma (PG) is a misnomer. The histopathologic appearance is fairly characteristic, the lesion being in fact a lobular capillary hemangioma. The recognition of PG as a clinically polypoid or exophytic, circumscribed lesion is of importance to both the clinician and the pathologist, as this feature distinguishes PG from most malignant vascular tumors. Although PG may be multiple, especially on the skin, and necrosis is not uncommon, invasion of adjacent structures is not seen. Diagnostic pitfalls occur histologically when the characteristic lobular configuration of PG is not recognized because of a solid growth pattern of endothelial proliferation, the presence of brisk mitosis, intervascular stromal fibrosis or spindle cell proliferation, and occasionally an epithelioid appearance of endothelial cells. The different vascular neoplasms that may be confused with PG are discussed, and the clinical and histopathologic features of PG are emphasized.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed1992

Neurotropic malignant melanoma occurring in a stable burn scar.

Malignant melanoma occurring in burn scars is extremely rare. Nine cases are reported in the literature. We report a case of a small malignant melanoma arising in a stable thermal burn scar after a long latent period of 58 years. The case was unique in that it was of the de novo neurotropic variant. Fascicles of amelanotic, S100 protein-positive atypical spindle cells with neuroid appearance infiltrated deeply in the scarred dermis and perineural spaces. The pigmentation of the lesion was due to solar lentigo instead of atypical melanocytic proliferation in the overlying epidermis.

Biopsy↗
PubMed1986

Primary lymphadenopathic Kaposi's sarcoma in an immunocompetent 23-year-old man.

An aggressive visceral form of Kaposi's sarcoma (KS) has been reported in immunosuppressed populations, most notably in patients with acquired immunodeficiency syndrome (AIDS). This presentation contrasts from the indolent skin lesions on the extremities of older males and is distinct enough in the young adult American population to have been included in the working definition of AIDS. The authors describe a case of primary lymphadenopathic KS in an immunocompetent heterosexual 23-year-old man with no epidemiologic, immunologic, or serologic evidence of AIDS. This report emphasizes that a diagnosis of KS in a young American male is not synonymous with the diagnosis of AIDS.

Adult↗
PubMed1985

Primary lymphoma of Waldeyer's ring. Clinicopathologic study of 68 cases.

The clinical and pathologic findings were studied in 68 patients with primary lymphoma of Waldeyer's ring (WR). The initial sites included: tonsil (51%; 9% bilateral), nasopharynx (35%), base of tongue (9%), and multiple areas (4%). The mean age was 58 years, with a male to female ratio of 1.1:1.0. Tonsillar and base of tongue lesions presented with sore throat and dysphagia, whereas nasopharyngeal lymphomas most commonly presented with nasal, auditory, and cranial nerve sympatomatology. A neck mass was the sole presenting symptom in 12% of patients. Work-up showed 42% Stage I, 47% Stage II, 4% Stage III, and 7% Stage IV. All were non-Hodgkin's lymphomas. Diffuse architecture predominated (71%) and 70% had a histiocytic or large cell morphology (diffuse histiocytic 51%, nodular histiocytic 19%). The National Cancer Institute (NCI) Working Formulation grades were 13% low, 81% intermediate, and 6% high. In difficult cases, detection of monoclonal immunoglobulin, absence of keratin staining, and lack of epithelial features by electron microscopy were useful adjuncts aiding in diagnosis. Following complete remission, 28 patients relapsed, 75% of these within 2 years (median, 10 months). Thirty-seven (54%) patients died with disease (median survival, 27 months). Of these, 89% had disseminated lymphoma. Local-regional disease was the direct cause of death in 13%. Recurrence or persistence of disease in WR occurred in 9% of cases, most with initial clinical evidence of soft tissue extension. Stage I patients had a significantly better median survival (67 months) than Stage II patients (20 months) (P = 0.03). Prognostically favorable histologic parameters included lower NCI Working Formulation grade and follicular architecture. Ten patients (15%) developed extranodal disease, eight involving the gastrointestinal (GI) tract, and all died within 1 year of its occurrence. The findings indicate that stage and certain histologic parameters are important prognostic factors in WR lymphoma. The study confirms the association of primary WR lymphoma with other extranodal disease, particularly involving the GI tract, and emphasizes the poor prognosis of patients in whom this occurs.

Adolescent↗
PubMed1984

Epstein-Barr virus-induced lymphoma in a cardiac transplant recipient.

A monoclonal diffuse histiocytic lymphoma developed during the course of a serologically documented primary Epstein-Barr virus infection in a 22-year-old cardiac transplant recipient taking cyclosporine and prednisone. Throat washings revealed the virus at tumor presentation, and the tumor was shown to contain Epstein-Barr nuclear antigen-positive cells and the viral genome. Prolonged inversion of the T cell helper/suppressor ratio was demonstrated. A brief course of acyclovir appeared to halt viral shedding in the throat but had no apparent effect on the tumor.

Acyclovir↗
PubMed1984

Postmenopausal ureteral endometriosis with atypical adenomatous hyperplasia following hysterectomy, bilateral oophorectomy, and long-term estrogen therapy.

Endometriosis of the ureter is rare. The authors describe a case of ureteral endometriosis presumed on clinical and radiologic grounds to be a primary ureteral malignancy. The unique feature of the present case is the development, after long-term estrogen therapy, of postmenopausal ureteral endometriosis with extensive atypical adenomatous hyperplasia. The present case demonstrates that reactivation of endometriosis and the development of atypical hyperplasia may occur after menopause with prolonged estrogen therapy.

Age Factors↗
PubMed1981

Thyroid-gland plasma cell neoplasm (plasmacytoma).

A 61-year-old man with a primary thyroid plasmacytoma was studied. Intracytoplasmic monoclonal immunoglobulin (IgG-kappa) was demonstrated in tissue sections, using the immunoperoxidase technique. After histologic diagnosis of plasmacytoma, serum immunoelectrophoresis revealed a monoclonal component (IgG-kappa). Roentgenographic skeletal survey and bone marrow examination gave normal results. The patient received postoperative therapy with radiation and drugs. As of this writing, he is alive 20 months after diagnosis, without evidence of tumor.

Adult↗
PubMed1980

Induced acute non-lymphocytic leukemia following long-term chemotherapy: a study of 20 cases.

Twenty individuals developed acute non-lymphocytic leukemia (ANLL) following long-term chemotherapy for other disorders. The primary disorders included non-Hodgkin's lymphoma (five), Hodgkin's disease (five), carcinoma (four), multiple myeloma (three), chronic leukemia (two), and rheumatoid arthritis. Leukemia developed from 11-132 months (mean approximately 60 months) following institution of chemotherapy and all cases have occurred since 1974. Pre-leukemic cytopenias were present in 15 individuals. Fifteen of the 20 patients had chromosome analyses and 14 were abnormal. The leukemia was invariably refractory to chemotherapy with a median survival of only two months. Of the patients autopsied, only one individual had any evidence of the primary malignancy. This study illustrates the need for surveillance for secondary ANLL following long-term chemotherapy with/without radiotherapy. Duration of optimal chemotherapy for the primary disease must be determined by control trials and weighed against the risk of developing a secondary leukemia.

Adult↗
PubMed1980

Tuberculous bacillemia, hyperpyrexia, and rapid death.

Hyperpyrexia, followed rapidly by multiple organ failure and death, developed in a previously healthy man. Postmortem examination indicated disseminated tuberculosis with adrenal involvement, but also evidence compatible with heat stroke. Mycobacterium tuberculosis was isolated from a routine blood culture. The patient's symptoms may have been the result of his bacillemia or the result of unapparent tuberculous chronic adrenocortical insufficiency that made him unusually sensitive to heat.

Adrenal Gland Diseases↗
PubMed1980

Multiple myeloma: a clinicopathologic study of 62 consecutively autopsied cases.

The clinical, laboratory and pathologic findings were studied in 62 consecutively autopsied patients with multiple myeloma between 1954 and 1975. All patients were 40 years of age or older. Bone pain was the initial symptom in 2/3 of patients. Anemia (81%), thrombocytopenia (29%), azotemia (41%), hypercalcemia (46%) and hyperuricemia (52%), were common laboratory findings at diagnosis. Ninety-seven percent had a monoclonal protein in serum or urine. Extensive plasma cell replacement of marrow was invariably seen at autopsy although in 15% of patients no abnormality was found on skeletal survey. Extraskeletal spread (67%) was due to direct extension to paraosseous tissue resulting from cortical destruction and to distant organ involvement mainly of splenic red pulp and hepatic sinusoids. The patients were susceptible to bacterial infection, mainly gram-negative, of the lung (56%), urinary tract (35%), and blood (24%). Fungal infection was less frequent and usually consisted of superficial candidal overgrowth of gastrointestinal tract ulcerations (18%). Amyloidosis (10%) was perivascular and associated with light chain proteinuria. Renal failure as a cause of death (21%) was secondary only to infection (52%). Severity of histologic findings in the kidney at autopsy had little correlation to initial BUN concentration. The median survival was 11.5 months with alkylating agent therapy (responders, 29 months; non-responders, 6 months), and 6 months with urethan. Initial azotemia (greater than 80 mg/dl) and hypercalcemia (greater than 12 mg/dl) were important prognostic indicators (median survival, less than 1 month and 3 months, respectively). A good response to alkylating agent therapy, initial BUN less than 40 mg/dl and serum calcium less than 12 mg/dl were favorable to prognostic indicators.

Adult↗
PubMed1979

Histiocytic lymphoma of the ileocecal region after chemotherapy for multiple myeloma.

Histiocytic lymphoma of the ileocecal region developed in a patient with multiple myeloma following successful long-term alkylating agent therapy. Five and one-half years after the diagnosis of myeloma, while in remission on cyclophosphamide therapy, the patient experienced severe abdominal right lower quadrant pain due to a large cecal lymphoma. A right hemicolectomy was performed with relief of symptoms. However, 9 months later, while still asymptomatic, routine physical examination revealed a recurrent right lower quadrant tumor. Radiation therapy decreased the size of the mass, but five months later partial small bowel obstruction occurred because of recurrent lymphomatous infiltration. The patient died 7 years after the diagnosis of myeloma with extensive abdominal lymphoma. There was no evidence of recurrent myeloma after the initial remission on cyclophosphamide therapy. This patient adds to the growing literature of a second malignancy occurring after prolonged successful chemotherapy of a primary neoplasm.

Cecal Neoplasms↗
PubMed1979

Tumor-simulating retrorectal heterotopia of bone marrow.

A retrorectal tumor-simulating mass of extramedullary hematopoiesis was discovered during work-up for uterine bleeding in a 40-year-old woman. It was excised in toto. The only hematologic abnormality at the time was iron deficiency, which was corrected. Six years later the patient is free of recurrence or any hematologic abnormality. It is suggested that this case represents heterotopic marrow arising either as a remnant of embryonic hematopoiesis or from activated primitive cells retaining the embryonic potentiality of hematopoiesis. The difficult diagnostic problems, pathogenesis and treatment are discussed, and the importance of recognizing the trilineage of hematopoiesis using Wright's-stained imprints of the mass is emphasized.

Adult↗
PubMed1979

The specificity of the S1 and S2 subsites of elastase.

Esters of tetrapeptides of the general formula ethoxycarbonyl-prolyl-alanyl-X-Y where either X or Y was an alanine residue were synthesised and their cleavage by elastase studied. It was found that variation of the alcohol moiety between methyl, cyclohexyl and nitrophenyl residues had no effect on the catalytic rate constant for cleavage of ethoxycarbonyl-prolyl-dialanyl-alanine esters demonstrating that acylation is much faster than deacylation for this system and also that non-productive binding is not kinetically significant. The effect of changing the amino acid residue in position X was small compared with that of change in position Y. The presence of valine and serine residues in position Y produced the highest specificity constant but the highest catalytic rate constant was found for a leucine residue in this position. The results are discussed in terms of the binding of the substrate to the enzyme.

Binding Sites↗
PubMed1979

Chronic granulocytic leukemia occurring in blast crisis.

Cytogenetic studies of marrow using chromosomal banding techniques revealed the presence of the Philadelphia (PH1) chromosome in two patients with clinical and hematologic findings of acute myelogenous leukemia (AML). A review of the literature since the use of chromosomal banding techniques revealed about 15 patients with Ph1)-positive acute leukemia that we consider to be chronic granulocytic leukemia (CGL) occurring in blast crisis. We describe two additional patients, one of whom we believe is unique in that the initial blast crisis contained Auer's rod-positive cells.

Bone Marrow↗
PubMed1978

Granulocytic sarcoma of the uterus.

The presenting features of vaginal bleeding and abnormal cytologic smears in a elderly patient with simultaneously occurring acute myelogenous leukemia (AML), were due to massive infiltration of the uterine cervix and endometrium by immature myeloid elements or granulocytic sarcoma. The abnormal cytologic smears and uterine mass were initially believed to represent a poorly differentiated lymphocytic lymphoma. The diagnosis of granulocytic sarcoma was confirmed with the naphthol AS-D chloroacetate stain that demonstrated activity in the cytoplasm of the neoplastic cells.

Diagnosis, Differential↗