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Biomedical subjects

S L Strobel

Publications and source records attributed to S L Strobel.

12 recordsLinked to original sources

The incidence and significance of pseudoparaproteins in a community hospital.

Pseudoparaproteins were observed in 129 (10.5%) of 1,229 high resolution protein electrophoretic fractionations of serum (N = 847), urine (N = 368), or cerebrospinal fluid (N = 14) performed in this laboratory during a 12-month period. The pseudoparaproteins identified in serum electrophoretic patterns included fibrinogen, C-reactive protein, hemoglobin-haptoglobin complex, elevated beta-globulins (transferrin and C3), lysozyme (muramidase), and an extended migration artifact. In the electrophoretic patterns of urine, the pseudoparaproteins consisted of nonspecific gamma zone bands of varying intensity. Gamma zone trace protein in the cerebrospinal fluid was often of sufficient intensity to cause potential confusion with oligoclonal bands. Awareness of the characteristic electrophoretic migration positions of these pseudoparaproteins helps to avoid unnecessary ancillary testing and expense.

Adult↗

Infiltrating lobular carcinoma of the breast treated with segmental and modified radical mastectomy.

Conservative treatment of infiltrating lobular carcinoma (ILC) has previously been examined only in terms of general breast carcinoma studies. However, this lesion has been shown to differ from the more common infiltrating ductal carcinoma (IDC) in estrogen receptor (ER) status, metastatic patterns, and bilaterality. Therefore, it is necessary for the physician to consider these distinctions when planning both pre- and post-operative treatment. To determine the effectiveness of both segmental and modified radical mastectomies, the medical records of 26 patients with ILC were reviewed, and follow-up information was obtained. In addition to surgical treatment, hormonal manipulation and/or radiotherapy were used when appropriate. We found the results of a conservative approach in the treatment of this disease to be comparable to the more radical procedures with respect to overall survival and disease-free intervals. The single factor that most affected a patient's prognosis was involvement of the axillary nodes.

Adult↗

Splenic rupture in leukemia.

We present a review of the incidence, differential diagnoses, mechanism of rupture, laboratory findings, and signs and symptoms of splenic rupture in leukemia. The types of leukemia most often associated with ruptured spleen are described. The treatment of splenic rupture in leukemia is splenectomy, with careful evaluation of the need for transfusion with appropriate blood products. The issue of whether such cases should be referred to as "pathologic" or "spontaneous" is discussed. Indications for prophylactic splenectomy in leukemia are also addressed.

Adult↗

Hemoglobin C acquired via a blood transfusion. Detection by automated blood counter.

Hemoglobin C was acquired by a 52-year-old man via a blood transfusion. The presence of nonlysis of erythrocytes on the Technicon H6000 (Tarrytown, NY) scattergram after blood transfusions and the absence of this process in the admission peripheral blood count confirmed that this abnormal hemoglobin was acquired and not endogenous to the patient. Homozygous hemoglobin C disease was confirmed in one of the donors of blood received by the patient.

Blood Cell Count↗

The value of the Wright-Giemsa stain for diagnosing hairy cell leukemia in body cavity fluids.

We compared the value of the Wright-Giemsa stain with the Papanicolaou stain for diagnosing hairy cell leukemia in the body cavity fluids of three patients. The cytological features of the leukemic cells were much clearer on the Wright-Giemsa-stained preparations. This allowed for the accurate diagnosis of leukemic involvement of the body cavity fluids in 3/3 patients using the Wright-Giemsa stain but only 1/3 using the Papanicolaou stain. A tartrate-resistant acid phosphatase stain was used to confirm the diagnosis in each case.

Adult↗

Prostatic carcinoma metastatic to bone: sensitivity and specificity of prostate-specific antigen and prostatic acid phosphatase in decalcified material.

Decalcified bone marrow biopsies containing metastatic tumor from 36 patients were stained for prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) using the avidin biotin complex (ABC) immunoperoxidase technique. Of these patients, 22 had known prostate primaries, ten had known nonprostatic, and four female patients had unknown primaries. Prostate-specific antigen was identified in 86% (19/22) of the metastatic prostatic carcinomas. Prostatic acid phosphatase was present in only 36% (8/22). None of the patients with nonprostatic primaries or unknown primaries showed positive staining for either antigen (0/14). This study indicates that immunoperoxidase staining for PSA is very sensitive and specific in the diagnosis of metastatic prostate carcinoma, while PAP was less sensitive using decalcified bone marrow specimens. We believe that immunostaining with PSA should be of great value in diagnosis of prostatic carcinoma metastatic to the bone.

Acid Phosphatase↗

Mitomycin-C induced improvement in superficial bladder tumors: a morphologic and immunohistochemical evaluation.

Twenty bladder biopsies from ten patients with superficial transitional cell carcinoma were obtained prior to and following therapy with intravesical mitomycin-C. Each biopsy was evaluated histologically and immunohistochemically for A, B, H blood group antigen (BGA) expression. A, B and H blood group antigens were identified using monoclonal anti-A, B and H antibody and were localized with the avidin-biotin-peroxidase complex (ABC) technique. Particular attention was directed toward flat urothelial lesions and the urothelium adjacent to papillary tumors. Routine histologic evaluation showed improvement in post-therapy biopsies compared to corresponding pre-therapy biopsies in 7/10 cases but was equivocal in 3/10 cases. Immunohistochemical evaluation, however, showed improvement in all 10 cases, as judged by increased urothelial BGA expression. This increase in urothelial BGA expression after intravesical mitomycin-C therapy suggests a therapy induced improvement in dysplastic urothelium which was not uniformly evident on routine histologic examination.

Biopsy↗

Abnormal hematologic features in a live-born female infant with triploidy.

Complete trisomy is a fatal chromosomal anomaly commonly associated with multiple phenotypic abnormalities. The associated hematologic abnormalities that occur with this disorder are not as well known, however. We present a case of a live-born female infant with this anomaly and discuss in detail the hematologic features of the peripheral blood. Abnormal physical features of the infant and the placenta are also discussed.

Abnormalities, Multiple↗

Primary carcinoma of the renal pelvis and ureter. Evaluation of clinical and pathologic features.

Thirty-eight cases of carcinoma of the renal pelvis and ureter were evaluated for stage, grade, histologic type, location, presence or absence of vascular invasion, abnormalities in the urothelium adjacent to the tumors, clinical appearance, patient survival, and therapeutic intervention. A good correlation between tumor grade and stage was found in the transitional cell carcinomas. Squamous cell carcinomas were high-stage tumors and transitional cell carcinomas with prominent squamous components were of a higher stage than "pure" transitional cell carcinomas of the same grade. Vascular invasion was present in only high-grade tumors and the squamous cell carcinomas. The degree of atypia present in the urothelium adjacent to the tumors corresponded with the grade of the tumors. Hematuria, with or without associated flank pain, was the most common initial symptom in patients with these neoplasms. Survival was good in stage A neoplasms but poor in higher-stage neoplasms. Appropriate treatment for these tumors remains controversial.

Adult↗

Granular-cell tumor of the breast. A cytologic, immunohistochemical and ultrastructural study of two cases.

Two primary granular-cell tumors of the breast are reported. Cytologically and histologically, these tumors had the classic features of small, eccentrically located nuclei and numerous periodic acid-Schiff-positive cytoplasmic granules. The characteristic cytologic features were best appreciated in touch imprints, not in frozen sections. Immunohistochemically, the tumors demonstrated diffuse cytoplasmic staining for S-100 protein but negative staining for myoglobin. The significance of these immunohistochemical staining characteristics, particularly in evaluating the possible histogenesis of these tumors, is discussed. The ultrastructural features of these two tumors are also presented and compared to findings reported by other investigators.

Adult↗

Nonaspiration-needle smear preparations of pulmonary lesions. A comparison of cytology and histology.

Material for cytologic smears was obtained from pulmonary lesions in 146 patients at the Ohio State University between 1979 and 1984 using Rotex or Lee screw needles. Corresponding histologic specimens were available for comparison in 77 of these cases. Diagnoses of malignant neoplasms made by cytologic evaluation (55 cases) were confirmed by the corresponding histologic specimens in 93% of those cases. Possible explanations for the cytologic false-positive diagnoses of malignancy are presented. Correlations between the cytologic and histologic diagnoses of the morphologic type of tumor were 100% for adenocarcinoma, 75% for squamous-cell carcinoma and 20% for large-cell undifferentiated carcinoma. The correlation was 100% for small-cell carcinoma when the histology specimen represented the tumor. Nonneoplastic benign lesions diagnosed cytologically had corresponding benign histologic diagnoses in 94% of the cases. These results compare favorably with those reported for other fine needle aspiration studies of pulmonary lesions. The advantages of using Rotex needles as compared to fine needle aspiration are discussed.

Adenocarcinoma↗