Pulmonic valve stenosis, atrial septal defect and left-to-right interatrial shunting with intact ventricular septum. A distinct hemodynamic-morphologic syndrome.
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Aged↗
Biomedical subjects
S C Aisner
Publications and source records attributed to S C Aisner.
Inflammatory changes related to active tuberculosis: confusion with oat cell carcinoma of the lung on cytology specimens.
One case of small cell lung carcinoma diagnosed on cytology specimens could not be confirmed histologically. We feel this likely represents cytopathologic changes induced in response to the patient's active tuberculosis. To avoid aggressive systemic therapy in such cases, patients with localized lesions should have further diagnostic procedures to confirm the cytologic diagnosis histologically.
Adult↗
Clinical and pathological studies in a growth hormone-deficient dwarf.
Postmortem studies were performed in one of three closely related dwarfs. Repeated arginine infusions and insulin tolerance tests never resulted in plasma levels of human growth hormone (HGH) greater than 2.0 ng/ml in any of these three dwarfs. However, pituitary somatotropes in the autopsied subject were well granulated and were reduced in number to 20% of normal. In the absence of a second defect, there should have been substantially higher HGH levels in plasma after provocative stimulation. The clinical and pathological data appear most compatible with (a) deficiency of growth hormone releasing factor, or (b) insensitivity of somatotropes to this material. It seems reasonable to postulate that a major group of dwarfs clinically simulating HGH deficiency can be explained by one of these mechanisms rather than by an absolute deficiency of HGH.
Adult↗
Synovial sarcoma: frequency of nonaggressive MR characteristics.
PURPOSE: Our objective was to examine the MR characteristics of synovial sarcoma and determine the frequency of a nonaggressive imaging appearance. METHOD: Fifteen patients with histologically confirmed cases of synovial sarcoma and prior MR examinations were seen. Retrospective analysis of imaging features included assessment of size, margins, homogeneity, internal architecture, T1- and T2-weighted signal intensities, and bone invasion. RESULTS: Five of 15 patients (33%) had well circumscribed, homogeneous lesions with a mean length of 4.8 cm. The T1-weighted signal intensity was either isointense to muscle or greater in signal intensity than muscle. The T2-weighted images demonstrated signal intensity equal to or greater than fat. The remaining 10 lesions were larger (mean length of 11.3 cm) with mild to complex levels of inhomogeneity and margins that varied from well circumscribed to infiltrating. CONCLUSION: There are two sets of MR features seen with synovial sarcoma. Small lesions of -5 cm can demonstrate a nonaggressive appearance with well circumscribed margins and homogeneous signal intensity. These tumors could be confused with benign lesions, resulting in inappropriate surgical intervention like excisional biopsies through transverse incisions. This would make future surgery more difficult. Larger lesions tend to be more heterogeneous in signal intensity.
Adipose Tissue↗
Aspiration cytology of 131I-induced thyroiditis. A case report.
BACKGROUND: Fine needle aspiration (FNA) has become an indispensable diagnostic tool for the investigation of thyroid nodules. Although 131I may induce morphologic changes similar to those associated with external radiation, a known diagnostic pitfall, the cytology literature on the subject is very sparse. This case exemplifies the thyroid cytologic changes associated with 131I exposure. CASE: A 50-year-old male with a remote history of 131I exposure had an indurated thyroid on routine physical examination. FNA was interpreted as positive for malignant cells, and subsequently a total thyroidectomy was performed. Review of the cytologic sample revealed follicular cells with focal, marked cytologic atypia, abundant colloid, stromal fragments, and lymphocytes. The thyroidectomy specimen consisted of an indurated and nodular gland showing architecture distortion by micronodule formation, lymphocytic infiltrates, interstitial fibrosis and follicular atrophy. Marked nuclear atypia was seen in the follicular cells. CONCLUSION: FNA of thyroid glands exposed to 131I may show significantly large, atypical follicular cells in addition to classical changes of nodular goiter and/or chronic lymphocytic thyroiditis. Although the clinical history and the diffuse nature of the process may favor a benign process in most cases, the presence of marked atypia could lead to a malignant diagnosis. Pathologists, therefore, should exercise extreme caution in interpreting cases with 131I exposure.
Biopsy, Needle↗
Aspiration cytology of heterotopic ossification. A case report.
Heterotopic ossification (myositis ossificans) is usually a posttraumatic reactive process involving new bone formation. This nonneoplastic process can be clinically and radiologically confused with osteosarcoma. A case of heterotopic ossification is reported in which cytologic material was obtained from a partially calcified thigh mass from a 17-year-old, athletic male. Aspiration cytology revealed numerous osteoclastic giant cells containing multiple plump nuclei. These cells were admixed in a benign-appearing stromal background composed of mature fibroblasts and were typified by elongated spindle cells. A small incisional biopsy showed new bone formation, osteoclasts, osteoblasts and fibroblasts consistent with maturing heterotopic ossification. Heterotopic ossification may be distinguished cytologically from osteosarcoma by the presence of numerous uniform benign stromal cells composed of mature fibroblasts and osteoclastic giant cells. The differential diagnosis may be more difficult in the early stages of this reactive and proliferative process. Adequate sampling of suspected heterotopic ossification by aspiration cytology may avoid surgery in a selected group of patients.
Adolescent↗
Meningeal carcinomatosis from small cell carcinoma of the lung. Consequence of improved survival.
The cells of oat cell carcinoma of the lung can be identified in sputum because of their characteristic morphologic appearance. The cells from oat cell carcinomas can also be identified in other body fluids but are seen there less often. Spinal fluid involvement with oat cell carcinoma has been seen very infrequently, presumably because of a poor survival rate. Aggressive systemic chemotherapy has improved survival, and meningeal involvement is now being recognized as a complication. Of 62 patients treated by aggressive chemotherapy protocols, six (10%) were found to have leptomeningeal involvement by cytologic evaluation of cerebrospinal fluid (CSF). Involvement was found 6 to 13 months after the initiation of therapy. Two of the six patients had no evidence of CNS metastases by CAT brain scan. Necropsy was performed in three of the six cases and showed excellent histologic correlation with the cytologic findings. Because of most therapeutic drugs' poor penetration into the CSF, and because the spinal cord is not routinely irradiated, cytologic examination of the CSF from patients with oat cell carcinoma is necessary when there are new neurologic signs or symptoms to ensure proper, specific therapy.
Carcinoma, Small Cell↗
Sputum cytology in pulmonary sarcoidosis.
Sputum cytology in patients with pulmonary sarcoidosis has been investigated. All cases of pulmonary sarcoidosis with roentgenographic evidence of pulmonary interstitial fibrosis and scarring have revealed diagnostically significant cytologic features in their pulmonary material. These include multinucleated epitheloid giant cells, epithelioid cells and lymphoid mononuclear cells in an otherwise noninflammatory, clean specimen. The characteristic cells occur in streaks, either singly or as syncytium. They are dark, cyanophilic with little phagocytic activity. Schaumann and asteroid bodies may be present. Cytologic examination of induced sputum specimens in asymptomatic patients of suspected pulmonary sarcoidosis with interstitial involvement can help in diagnosis and management of these cases.
Cell Nucleolus↗
Aspiration cytology of biphasic and monophasic synovial sarcoma. A report of two cases.
Two cases of synovial sarcoma diagnosed by aspiration cytology are described. A 15-year-old, athletic female presented with a tender midthigh mass clinically thought to be a hematoma. Aspiration cytology revealed numerous clusters of spindle cells admixed with small groups of epithelial cells. Cytokeratin and vimentin stains were positive in the epithelial and spindle components, respectively. Resection of the mass revealed a biphasic synovial sarcoma. Second, a 53-year-old male presented with a recurrent soft tissue mass 10 years after synovial sarcoma of the knee had been resected. Aspiration cytology revealed neoplastic spindle cells. Cytokeratin and vimentin preparations showed focal positivity. Resection revealed a predominantly monophasic synovial sarcoma. These cases demonstrate the utility of aspiration cytology in diagnosing both unsuspected and recurrent synovial sarcoma.
Adolescent↗