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Biomedical subjects

S M Katz

Publications and source records attributed to S M Katz.

At least 19 recordsLinked to original sources
PubMed1992

Adenomyoepithelioma of the breast. A spectrum of biologic behavior.

Adenomyoepitheliomas of the breast have been considered to have limited metastatic potential; axillary node metastasis has been reported, but there has been no report of distant metastasis. We report six cases, including two malignant adenomyoepitheliomas, one of which metastasized to the lung and brain. Patient age ranged from 26 to 63 years (mean 46). Primary tumors were solitary and measured 0.9-3.5 cm (mean 1.7). Five of six tumors presented as palpable masses. Two patients treated by local resection have no evidence of disease at 5 and 18 months' follow-up. Two patients treated by local resection had recurrences, one at 48 the other at 60 months. The fifth patient had a spindle-cell type adenomyoepithelioma diagnosed as malignant because of high mitotic rate and cytologic atypicality of the myoepithelial component. This patient was treated by mastectomy and has no evidence of disease at 18 months. The sixth patient, initially treated by local excision, had six local recurrences over 52 months treated by reexcisions, mastectomies, and radiation. A lung metastasis was resected at 54 months and brain metastases were identified at 60 months with death occurring at 64 months. Both malignant adenomyoepitheliomas had high mitotic rates [11-14/10 high-power fields (HPF)] diffusely throughout the tumors and foci of cytologically malignant cells. The malignant adenomyoepithelioma that metastasized had an infiltrative growth pattern that increased with successive local recurrences. The four other tumors had only isolated areas of mitotic activity (maximum 1-9/10 HPF) and minimal cytologic atypia. Immunohistochemistry performed on five of six cases confirmed dual epithelial/myoepithelial cell populations in all tumors examined, including the metastasis. Electron microscopic examination of the malignant adenomyoepithelioma that metastasized also confirmed dual epithelial/myoepithelial cell populations in a local recurrence and the lung metastasis. We conclude that there is a spectrum of behavior for breast adenomyoepitheliomas with potential for local recurrence and, rarely, distant metastasis.

Adult↗
PubMed1992

Choriocarcinoma of the kidney.

Choriocarcinoma is a malignant germ cell tumor that usually arises from a previous gestation, but may also arise from germ cells anywhere along their known migratory pathway during fetal development. Gestational choriocarcinoma is highly sensitive to chemotherapy. This malignancy is known to undergo spontaneous regression of the primary tumor, which, in the face of metastases, may obscure the primary tumor site. The authors report the case of a patient with choriocarcinoma who was seen with pulmonary metastases and a single large lesion in the kidney 5 years posthysterectomy. The problems in resolving the primary site and the importance of a tissue diagnosis before nephrectomy are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1979

Myelolipoma in a heterotopic adrenal gland: light and electron microscopic findings.

A symptomatic myelolipoma of the heterotopic adrenal gland was diagnosed as the cause of nephrotic syndrome and was surgically removed. Remission of the nephrotic syndrome promptly ensued. Ultrastructurally, the tumor consisted of well-differentiated cells resembling adrenal cortical cells, bone marrow cells in various stages of differentiation, and lipid cells. Some cells that contained fat were of adrenal cortical origin, but the derivation of most lipid cells and of bone marrow elements could not be deduced from the present ultrastructural findings.

Adrenal Gland Neoplasms↗
PubMed1979

Pineoblastoma: an electron microscopic study.

The ultrastructure of a human pineoblastoma is described. Tumor cells formed nests, palisading row and rosettes. Cells within nests were undifferentiated. Palisade and rosette forming cells had polarized cytoplasms and showed signs of differentiation and surface membrane specialization which included surface end-bulb-like protrusions of the cytoplasm, bulbous cilia with a 9 + 0 microtubular skeleton, and blunted microvilli. In the cytoplasm of tumor cells there were characteristic granular bodies, whorls of smooth endoplasmic reticulum and annulate lamellae. Some of these findings appear to be unique to pineal tumor and are reminiscent of photoreceptor cells in the pineal glands of lower vertebrates and human fetal pineal glands.

Brain Neoplasms↗
PubMed1979

Urinary myelin figures in gentamicin nephrotoxicity.

The nephrotoxicity of gentamicin is associated with formation of myelin figures within the proximal convoluted tubules of experimental animals and man. By electron microscopy, the authors studied urinary sediments of patients who were treated with gentamicin to detect the occurrence of myelin figures. All three patients who had renal impairment and were treated with gentamicin had numerous urinary myelin figures. By contrast, myelin figures were not observed in urinary sediments of four patients who had no renal impairment despite gentamicin therapy, or nine patients who had no renal impairment and did not receive gentamicin therapy. Occasional myelin figures were detected in a urinary sediment of one of eight patients who had renal impairment and no gentamicin therapy. When the urinary sediments of patients who had gentamicin nephrotoxicity were compared with those of patients with Fabry disease, morphologic differences between the myelin figures of the two groups were detected. The study demonstrates the presence of myelin figures in urines of patients with acute renal failure receiving gentamicin, and suggests that the finding of these myelin figures within urine samples may contribute to the diagnosis of gentamicin-induced nephrotoxicity.

Cell Membrane↗
PubMed1979

Clinically occult diffuse proliferative lupus nephritis. An age-related phenomenon.

Thirteen patients with systemic lupus erythematosus (SLE) who had normal results of urinalysis, absence of proteinuria, and normal serum creatinine values underwent renal biopsy. Three of 13 patients had diffuse proliferative glomerulonephritis (group 1). Biopsy specimens showed segmental fibrinoid necrosis, diffuse mesangial hypercellularity, and substantial immunoglobulin deposition. Group 2 comprised those patients whose histologic findings did not portend a poor prognosis. Four had mesangial proliferative glomerulonephritis, three had focal proliferative glomerulonephritis, and three had minimal mesangial widening. The values of inulin clearance in group 1 did not differ significantly from those in group 2. Patients in group 1 had a mean age of 19 years, a value significantly lower than in group 2 (41.8 years). Review of previous reports also supports the thesis that this phenomenon is age related. Our study underscores the importance of renal biopsy in patients with SLE despite the absence of clinical evidence of renal involvement, particularly in patients under 30 years of age.

Adult↗
PubMed1979

Glomerular lesions in benign essential hypertension. A study of eight biopsy specimens with laboratory evidence suggestive of glomerular abnormalities.

We performed renal biopsies on eight patients who had benign essential hypertension but laboratory abnormalities suggestive of glomerulonephritis. Persistent microscopic hematuria was detected in four patients, proteinuria in five, RBC casts in two, and decreased glomerular filtration in seven. In all eight biopsy specimens, we detected hyaline arterionephrosclerosis, focal glomerular obsolescence, and segmental, afibrillar thickening of glomerular basement membranes. Direct immunofluorescence studies performed on all eight samples were negative for immunoglobulins, complement, and fibrinogen. Although the patients in our study had laboratory findings suggestive of glomerulonephritis, the morphologic changes were indicative of benign essential hypertension.

Adult↗
PubMed1979

Legionnaires' disease: ultrastructural appearance of the agent in a lung biopsy specimen.

During the Legionnaires' disease epidemic that occurred in Philadelphia in 1976, we performed a transbronchial lung biopsy on a patient who suffered from Legionnaires' disease that was confirmed by serology. The biopsy was performed in an attempt to detect a causal agent for the patient's pneumonia at a time when the cause of the epidemic was a mystery. We detected pleomorphic microbial structures that were both intracellular and extracellular in location. By electron microscopy, they ranged in size from 350 nm to 2.5 mu. Some displayed cell walls and fine cytoplasmic granules that resembled ribosomes. Our findings illustrate the appearance of the Legionnaires' disease agent in acutely infected, antibiotic-treated human lung obtained from biopsy specimens.

Biopsy↗
PubMed1978

Legionnaires' disease: structural characteristics of the organism.

The Legionnaires' disease organism was isolated from lung tissue taken from two fatalities of the Legionnaires' disease epidemic that occurred in Philadelphia during 1976. In yolk sac tissue the agent grew as a small coccobacillary microorgansim, which was Gram variable and Giménez positive. Intracellular coccoid and bacillary forms, detected by electron microscopy, within and without vacuoles, underwent multiplication by septate binary fission. Some of the intracellular forms resembled obligate intracellular pathogens. On defined bacteriologic media, the organisms were predominantly bacillary. The organism conforms to the morphologic criteria of a prokaryocyte.

Humans↗
PubMed1978

The morphology of the Legionnaires' disease organism.

The Pennsylvania Department of Health, Bureau of Laboratories, has isolated the Legionnaires disease organism from two patients with Legionnaires' disease proved by serologic techniques. We have studied the morphology which the isolate assumes in yolk sac tissue and on bacteriologic media. The organism was Giménez-positive and gram-variable. Using an indirect immunofluorescent procedure, it was shown to react with convalescent serum samples taken from patients who had Legionnaires' disease. The organism multiplies by binary fission extracellularly and intracellulary; is both coccoid and bacillary in form; and contains characteristic cytoplasm, nucleoids, a cytoplasmic membrane, and a small cell wall of variable size. It may produce spores of unusual appearance. Intracellular replication characteristically occurs within vacuoles. The Legionnaires' disease organism conforms to the morphologic criteria for a prokaryocyte.

Bacteria↗
PubMed1977

Immune complex glomerulonephritis in a case of retroperitoneal fibrosis.

The nephropathology associated with retroperitoneal fibrosis has been commonly related to compression of the ureters and hydronephrosis. This assumption has been made without the use of immunofluorescent microscopy and electron microscopy. The authors studied renal tissue from a patient with retroperitoneal fibrosis by light microscopy, immunofluorescent microscopy and electron microscopy. In addition to the gross and microscopic changes of obstructive nephropathy, histologic findings of glomerular immune-complex deposition were also present. It is postulated that in some cases of retroperitoneal fibrosis, destruction may be mediated by both obstructive and immunologic processes.

Adult↗
PubMed1977

Report of a case of gross thymic hyperplasia in a child.

A large thoracic mass and a mediastinal lymph node were excised from an infant with a peripheral blood and bone marrow lymphocytosis. The 224-mass was composed of histologically normal thymus, and the lymph node architecture was partially effaced. Hypogammaglobulinemia was detected two years after thymectomy. The enormous thumus in this case fits the classic gross pathologic definition of hyperplasia. The possibility of associated thymic hyperfunction in this case is discussed.

Humans↗
PubMed1976

Thymoma in a 12-year-old boy.

A case of thymoma in a 12-year-old boy is presented. The patient had a history of thymic irradiation in infancy, and a family history of leukemia. The mass was readily resected and the patient is well 10 years later. The tumor contained an unusual admixture of normal thymic tissue with the neoplastic epithelial elements. This peculiar histologic pattern is discussed in relationship to the patient's age and history.

Child↗