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Biomedical subjects

S B Kapadia

Publications and source records attributed to S B Kapadia.

72 records · Page 4Linked to original sources
PubMed1978

Ovarian carcinoma terminating in acute nonlymphocytic leukemia following alkylating agent therapy.

Rapidly fatal acute myelogenous leukemia (AML) occurred in a woman with advanced (Stage III) ovarian carcinoma who was treated with thiotepa for 30 months. This patient was 1 of 10 long term survivors and represented less than 2% of patients with advanced ovarian carcinoma with regional metastases who received long term chemotherapy during the period 1947-1975. Acute leukemia developed 44 months after initial diagnosis and was preceded by a 10 month period of pancytopenia following cessation of thiotepa. The leukemia did not respond to treatment and the patient expired 3 weeks after its onset. At autopsy, leukemic infiltration of organs was seen, but there was no evidence of carcinoma. A review of the literature suggests that the development of AML reported in ovarian cancer patients is related to alkylating agent therapy.

Adult↗
PubMed1978

Acute myelogenous leukemia following immunosuppressive therapy for rheumatoid arthritis.

A 51-year-old woman had acute myelogenous leukemia following log-term cyclophosphamide therapy for rheumatoid arthritis. After standard methods of management had failed, the rheumatoid arthritis showed considerable improvement in response to approximately 25 mg cyclophosphamide per day over a four-year period. At the end of this period, pancytopenia developed, and cyclophosphamide was discontinued. A bone-marrow aspirate showed nonspecific changes. However, four months later because of severe progressive pancytopenia, another bone-marrow examination was performed; it showed acute myelogenous leukemia. Therapy failed to induce a remission, and two months after diagnosis the patient died of aspergillosis. Autopsy confirmed the presence of leukemic infiltration of bone marrow, lymph nodes, liver and spleen. These findings suggest a possible leukemogenic role of cyclophosphamide in this case and suggest that caution should be exercised in treating non-fatal diseases with antitumor drugs.

Arthritis, Rheumatoid↗
PubMed1977

Kaposi's sarcoma after long-term alkylating agent therapy for multiple myeloma.

Described is a patient with multiple myeloma who, during long-term treatment with alkylating agents, developed cutaneous Kaposi's sarcoma. Patients with multiple myeloma, unlike those with malignant lymphoma, do not usually develop Kaposi's sarcoma during the natural course of the disease. It is suggested that the immunosuppression resulting from the long-term alkylating agent therapy for multiple myeloma may have prediposed this individual to the development of Kaposi's sarcoma.

Aged↗
PubMed1977

Cytological diagnosis of malignant pleural effusion in myeloma.

The cytological examination of pleural fluid established the malignant etiology of the effusion in two patients with multiple myeloma. In contrast to patients with lymphoma, mediastinal lymph node enlargement in myeloma is an uncommon factor in fluid formation. As in patients with metastatic carcinoma, pleural and underlying lung involvement by myeloma is the main cause of pleural effusion. The two cases in this report, and similar cases in the literature, probably represent distal dissemination from skeletal multiple myeloma.

Aged↗
PubMed1976

Simultaneous occurrence of non-Hodgkin's lymphoma and acute myelomonocytic leukemia.

The simultaneous occurrence of nodular poorly differentiated lymphocytic lymphoma (NLPD) and acute myelomonocytic leukemia (AMML) was confirmed by the histologic examination of lymph node section, peripheral blood, and bone marrow. This association in the absence of previous chemotherapy or radiotherapy has not been previously documented. There have been six previous case reports of patients with non-Hodgkin's lymphocytic lymphoma who, during treatment with alkylating agents or radiotherapy, developed acute myeloid leukemia (AML). These methods of therapy may have had a leukemogenic role in such patients. The possible relationship between these two diseases is discussed.

Acute Disease↗
PubMedDate not supplied

Non-Hodgkin's lymphoma of the nose and paranasal sinuses: a study of 17 cases.

Non-Hodgkin's lymphoma of the nose and paranasal sinuses occurred in 14 men and 3 women with a mean age of 61 years. Nasal obstruction, unilateral facial swelling, and nasal discharge were frequent initial manifestations. The maxillary sinus and nose were the commonest primary sites. Using Rappaport's classification, there were 9 histiocytic, 5 poorly differentiated lymphocytic, and 3 mixed histiocytic-lymphocytic lymphomas. Sixteen patients had radiation therapy to the primary site, and 9 patients later received chemotherapy. Eleven patients (69%) are dead, with a median survival time of 11 months after diagnosis. Dissemination of lymphoma was the most common cause of death. Five patients (29%) are alive up to 40 months after diagnosis. Patients with poorly differentiated lymphocytic lymphoma survived longer than those with histiocytic or mixed histiocytic-lymphocytic lymphomas (medium survival times 35, 9, and 12 months, respectively). Poor response to radiation therapy and dissemination of lymphoma were poor prognostic indicators.

Adult↗
PubMedDate not supplied

Malignant lymphoma of the thyroid gland: a clinicopathologic study.

This study reviews 21 cases of thyroid lymphoma diagnosed between 1969 and 1980. The thyroid gland was the primary site in all but two cases. The 20 patients with non-Hodgkin lymphoma had a mean age of 66 years, 75% were women, and all were Caucasian. A rapidly growing thyroid mass with hoarseness, dysphagia, and difficulty in breathing was the initial finding. Most patients had diffuse histiocytic lymphomas. Associated Hashimoto thyroiditis was found histologically in 57% of the cases. Using the immunoperoxidase stain method on tissue sections, intracytoplasmic monoclonal immunoglobulin was demonstrated in 5 of 15 cases. All but two patients received radiation therapy, and 13 received chemotherapy. The median survival was 8 months; 20% died of unrelated causes and 32% are alive (average duration: 27 months). Dissemination, after local control by radiation therapy, was the leading cause of death. The prognosis was better in men, in patients under the age of 65 years, and in those patients who, on biopsy, did not have involvement of the extrathyroid soft tissue or regional lymph nodes.

Adenocarcinoma↗
PubMedDate not supplied

Carcinoma ex oncocytic Schneiderian (cylindrical cell) papilloma.

INTRODUCTION: This study reviews the clinicopathologic features of carcinoma presenting in oncocytic Schneiderian papilloma (OSP; cylindrical cell papilloma), a rare histologically distinctive papilloma sharing features with inverted papilloma. MATERIALS AND METHODS: Nine cases of carcinoma ex OSP (1970-1990), six from the files of the Armed Forces Institute of Pathology (Washington, DC) and three from the surgical pathology files, Presbyterian-University Hospital and Eye and Ear Institute (Pittsburgh, PA), were studied. One case was previously reported. Clinical data were obtained from the patients' medical records. All available histologic slides were reviewed. RESULTS: The patients (eight men, one woman) ranged in age from 48 to 83 years (mean age, 74 years). The carcinoma and OSP were synchronous in eight patients. In one case, the carcinoma occurred 8 years after OSP was diagnosed on biopsy. The presenting manifestations included nasal obstruction, "polyps," epistaxis, and proptosis. Radiographically, a sinonasal mass was present, often with extension to adjacent sites and bone destruction. Most patients received postoperative irradiation. Of six patients with follow-up, four died of carcinoma and two were alive without disease at 1.5 and 7 years, respectively. The types of carcinoma were: squamous cell (n = 6), high-grade mucoepidermoid (n = 2), and sinonasal undifferentiated (n = 1). Histologic transition was observed between carcinoma and dysplastic/benign OSP in eight cases. CONCLUSION: Demonstration of histologic continuity between carcinoma and dysplastic OSP epithelium in eight of our nine cases indicates origin of carcinoma from the OSP, rather than a coincidence of the two neoplasms. Although histologically benign, OSP should be totally excised at diagnosis because of a potential for malignant transformation. This is a US government work. There are no restrictions on its use.

Aged↗
PubMedDate not supplied

Basaloid squamous cell carcinoma of the head and neck: a clinicopathologic and flow cytometric study of 10 new cases with review of the English literature.

INTRODUCTION: We describe the clinicopathologic and flow cytometric features of 10 cases of basaloid squamous cell carcinoma (BSCC) of the head and neck to determine if DNA ploidy is a useful prognostic indicator. We also provide a review of 80 cases previously reported in the English language literature. MATERIALS AND METHODS: The 10 cases were obtained from the surgical pathology files of Presbyterian University Hospital and The Eye and Ear Institute, Pittsburgh, PA (1987-1991). In all 10 cases, the microscopic slides and clinical data were reviewed. Flow cytometry was performed using the Hedley technique and formalin-fixed, paraffin-embedded tissue. RESULTS: The mean age of patients with BSCC was 64 years (range, 49 to 75 years). Tumor involved the base of tongue (n = 5), hypopharynx-epiglottis (n = 3), and tonsil (n = 1). One case presented with cervical lymph node metastasis from an unknown primary site. Histologically, BSCC showed a biphasic pattern with basaloid-squamous elements, comedonecrosis, stromal hyalinization, surface dysplasia, and an in situ and/or invasive squamous cell carcinoma component. Flow cytometry revealed six diploid and four aneuploid tumors. Five of six patients with diploid and all four patients with aneuploid tumors developed early regional and/or distant metastases. Of the two patients who died of disease, one had a diploid and the other an aneuploid tumor. CONCLUSION: Our study reaffirms the predilection of BSCC for the base of tongue, pyriform sinus, and supraglottic larynx, and its aggressive biologic behavior with a high incidence of cervical lymph node metastasis (64%), distant spread (44%), and death from disease (38% mortality at 17 months median follow-up). However, in contrast to previous reports, tumor ploidy by flow cytometry provided no additional prognostic information beyond that supplied by routine histologic evaluation.

Aged↗
PubMedDate not supplied

Secondary lymphoma of Waldeyer's ring: natural history and association with prior extranodal disease.

Seven of 16 patients with secondary lymphoma of Waldeyer's ring (15 with non-Hodgkin's lymphoma and one with Hodgkin's disease) had their primary diagnoses made at another extranodal site, usually the gastrointestinal tract. The median interval until development of Waldeyer's ring disease was 37 months. Presenting features were similar to those in previous reports of primary lymphoma of Waldeyer's ring except for the striking degree of cranial nerve dysfunction (83 per cent) in patients with secondary nasopharyngeal disease. Non-Hodgkin's lymphomas were predominantly diffuse (80 per cent) with large cell morphology (53 per cent). Of nine patients who obtained complete remission after Waldeyer's ring involvement, six relapsed (median, 15 months), whereas three remain in complete remission at eight, 32, and 288 months. Twelve patients died (median length of survival, 20 months), eight of whom had disseminated disease, including one patient who also developed massive thyroid lymphoma. Three patients survived at least six years after involvement of Waldeyer's ring. This study confirms the frequent association of secondary lymphoma of Waldeyer's ring with prior extranodal disease, particularly of the gastrointestinal tract. The long latent period and the prolonged survival seen in several patients suggest that occasionally secondary lymphomas of Waldeyer's ring may represent metachronous primary tumors.

Adult↗
PubMedDate not supplied

Fine needle aspiration of pleomorphic adenoma and adenoid cystic carcinoma of salivary gland origin.

OBJECTIVE: To determine the cytologic similarities, distinctive features and diagnostic problems on fine needle aspiration in patients with pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) of salivary gland origin. STUDY DESIGN: We reviewed the preoperative cytology and histologic sections in 22 patients in whom the resected specimens were diagnosed as PA (17 cases) or ACC (5 cases) of salivary gland. RESULTS: Concordant results were noted between cytologic and histologic diagnoses in 20 cases (91%) and discordant results in 2 cases (9%). Both discordant aspirates had been diagnosed as PA; however, their resected specimens were diagnostic of ACC. Although there were cytologic features common to both tumors, each had a unique relationship of epithelial cells to stroma. Aspirates in PA showed cell clusters with a "sunburst" appearance caused by peripheral spindled cells streaming into a fibrillar myxoid stroma. In ACC well-delineated, tightly cohesive, basaloid cells surrounded mucoid/hyaline globules or clear spaces in a honeycomb pattern. CONCLUSION: The cytologic distinction between PA and ACC in most cases was easily made on adequately cellular aspirates. In the two aspirates with discordant results, diagnostic difficulty resulted when the distinctive relationship between epithelial cells and extracellular matrix was not recognized in sparsely cellular specimens, in part due to lack of observer familiarity with the different patterns.

Adenoma, Pleomorphic↗