Flow cytometry in melanoma.
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Aneuploidy↗
Biomedical subjects
S M Kheir
Publications and source records attributed to S M Kheir.
Prognostic significance of DNA aneuploidy in stage I cutaneous melanoma.
The prognostic significance of DNA aneuploidy was studied restrospectively in 177 Stage I cutaneous melanomas. DNA content was determined by flow cytometry of propidium iodide-stained nuclei recovered from formalin-fixed, paraffin-embedded material. Of 162 evaluable histograms, 124 were diploid, 35 aneuploid, and 3 tetraploid. Aneuploidy strongly correlated with established predictors of unfavorable prognosis, namely, thickness p less than .005, level p less than 0.005, ulceration p less than 0.005, and presence of vertical growth phase p less than 0.02. Overall, aneuploidy was strongly correlated with recurrence (p less than 0.005) and shorter disease-free survival (p less than 0.0001). Aneuploidy was an independent predictor of recurrence for tumors less than 1.5 mm thick (p less than 0.0001) and greater than or equal to 3 mm thick (p = 0.031). For melanomas 1.5-2.9 mm thick, aneuploid tumors had a 27% higher recurrence rate than diploid tumors (63% vs. 36%). This was not statistically significant (p = 0.247). In a multivariate analysis of common predictors stratified by thickness, DNA aneuploidy was the most significant independent parameter (p less than 0.002). DNA content appears to be an important stratification parameter for Stage I cutaneous melanoma.
Actuarial Analysis↗
Histologic variation in the skin lesions of the glucagonoma syndrome.
Three cases of glucagonoma syndrome were seen in 1 year. Study of the skin biopsies from the first two cases led to a correct diagnosis from skin biopsy of the third case, although it was not suggested clinically. In each case serum glucagon levels were high and a pancreatic tumor was found, with complete remission of symptoms in cases 1 and 3 after resection; case 2 refused surgery and has died. A total of nine skin biopsies from the three patients showed a variety of findings: epidermal necrosis; subcorneal pustules, either isolated or associated with necrosis of the epidermis; confluent parakeratosis, epidermal hyperplasia, and marked papillary dermal angioplasia; and suppurative folliculitis. The clinical lesions in this syndrome vary from bright red macules to annular superficial erosions and flaccid pustules. Similarly, several histopathologic features of the disease can occur, which may represent the progression of the disease. No single histologic feature was specific for the disease, but a combination of the features is probably diagnostic. Therefore, multiple skin biopsies are recommended when this diagnosis is suspected.
Adenoma, Islet Cell↗
Significance of DNA abnormalities in primary malignant melanoma and nevi, a retrospective flow cytometric study.
DNA ploidy of melanocytic skin tumors from 87 patients (53 primary melanomas, 34 nevi) was determined by flow cytometry from routinely prepared paraffin blocks. Ploidy data correlated strongly with conventional morphological parameters. Only 1 of 34 nevi, but 13 of 53 melanomas were aneuploid. Among the melanomas, none of 21 levels I-III melanomas was aneuploid, but 13 of 32 levels IV and V melanomas were aneuploid. There was also a significant correlation between increasing Breslow thickness and the presence of DNA aneuploidy. For 33 melanoma patients with over 2 yr of follow-up (average, 7.1 yr), only 4 of 23 diploid tumors have recurred, but 9 of 10 aneuploid tumors have recurred. We conclude that the biological potential of melanocytic skin tumors is strongly linked to DNA aneuploidy. Since this parameter can be conveniently determined from paraffin blocks, determination of ploidy abnormalities in these tumors may be clinically useful.
Aneuploidy↗
Paraganglioma of the duodenum in association with congenital neurofibromatosis. Possible relationship.
A case of a duodenal paraganglioma in a patient with von Recklinghausen's disease is presented, along with a review of the common clinical features of the 26 cases of duodenal paraganglioma and related neurogenic tumors reported in the literature. There was no reported evidence of recurrence or metastasis. Local excision was the most commonly employed method of treatment. It is proposed that duodenal paraganglioma with its admixed components and variable histologic features may represent hamartomatous hyperplasia of the paraganglia and the supporting neuroid tissue in this area. This would explain the benign behavior of these tumors as compared with carcinoids. Its association, in this case, with neurofibromatosis supports the neural crest origin of duodenal paragangliomas.
Cytoplasmic Granules↗
Tsetse and trypanosomiasis survey of Southern Darfur province, Sudan. II. Entomological aspects.
Atsetse survey of Southern Darfur province, Sudan showed that the distribution of the only species present, Glossina morsitans submorsitans, had not appreciably altered over 10 years. Fly populations are most dense south of the Wadi Umbelasha but light infestations are found in the woodlands north of this riverine system to a latitude of about 10 degrees 15' N. Data are given on host availability which is thought to be the major factor determining tsetse distribution. The relative importance of tsetse and of tabanids as transmitters of bovine trypanosomiasis in the province is discussed. The evidence indicates that tsetse are very much more important and that cattle are most at risk of contracting infections during their dry season southerly migrations to the tsetse belts especially during their "Rushash" migration at first rains. Possibilities of tsetse control are discussed but in the short term trypanosomiasis control is most likely best achieved by chemical prophylaxis/therapy of cattle at risk.
Animals↗
Recurrent Spitz's nevus.
A recurrence of a spindle- and epithelioid-cell nevus following partial removal is described. Clinical and histologic photographs of the original and recurrent lesion and an immunohistochemical stain (S-100) which highlights melanocytic cells and their pattern of growth are included. This nodular recurrence of a Spitz's nevus is contrasted with macular recurrence of ordinary melanocytic nevi that may follow partial removal by shaves. It is presented in order to promote recognition and prevent misdiagnosis of such a recurrence as a malignant melanoma.
Adult↗
Tsetse and trypanosomiasis survey of Southern Darfur Province, Sudan. I. Bovine trypanosomiasis.
During a survey of Southern Darfur Province, Sudan blood samples from over 4,000 migratory cattle were analysed to determine levels of anaemia and trypanosome parasitaemia by buffy coat examination of microhaematocrit centrifuged samples. Levels of trypanosomal infections in the herds correlated well with their risk of exposure to tsetse being significantly lower at increasing distance from tsetse foci. Trypansoma vivax infections predominated in all herds, increasingly so with increasing distance from tsetse foci. Packed cell volume values could not be used to assist in trypanosome diagnosis at either individual or herd levels and the lack of correlation between anaemia and parasitaemia is suggested as evidence of a degree of trypanosomal tolerance in the Western Baggara cattle. Drug use and problems of drug resistance are discussed. Bovine trypanosomiasis is largely under control at present but requires continued surveillance (particularly of drug use) to prevent future problems as tsetse/cattle interactions increase.
Animals↗
Rectal bleeding in a patient with exstrophy of the bladder.
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Adenocarcinoma↗
Primary aspergillosis of the larynx simulating carcinoma.
A case of pseudoepitheliomatous hyperplasia of the larynx secondary to fungal infection is presented. The laryngeal lesion resembled carcinoma both clinically and pathologically. Aspergillus species were identified in tissue sections and confirmed by immunofluorescence studies. The lesion responded well to antifungal therapy. This case is reported because of the extreme rarity of primary aspergillosis of the larynx, its occurrence in an otherwise healthy patient, and its marked resemblance both clinically and pathologically to laryngeal carcinoma.
Aspergillosis↗
North American blastomycosis: an unusual clinical manifestation.
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Aged↗
Eosinophilic granuloma of the palatal mucosa in a nine-week-old infant.
Histiocytosis commonly presents as a disseminated disease in children under one year of age and is rare in infants less than three months of age. This case describes a nine-week-old infant with unifocal eosinophilic granuloma without bone involvement. One year after surgical excision the child is free of disease by roentgenographic and laboratory studies and is growing and developing normally. Thus our patient demonstrates several unique features, which include a young age at presentation without disease dissemination and an unusual site of tissue involvement without bone extension.
Eosinophilic Granuloma↗
Frozen section diagnosis of pancreatic carcinoma: a prospective study of 64 biopsies.
Useful morphologic criteria for frozen section diagnosis of pancreatic and periampullary carcinoma were established by prospective review of 64 frozen sections in this region, with permanent section correlation and patient follow-up. These were divided into three major and five minor criteria based on frequency of occurrence and reproducibility. Major criteria were: 1) nuclear size variation of 4:1 or greater between ductal epithelial cells, 2) incomplete ductal lumens, and 3) disorganized duct distribution. Minor criteria, less frequently and reproducibly observed but valuable diagnostic aids, included: 1) huge, irregular epithelial nucleoli; 2) necrotic glandular debris; 3) glandular mitoses; 4) glands unaccompanied by connective tissue stroma within smooth muscle bundles (periampullary biopsies); and 5) perineural invasion. Combined application of both major and minor criteria is especially helpful in cases complicated by chronic pancreatitis.
Adenocarcinoma↗
Glandular inclusions in lymph nodes. The problem of extensive involvement and relationship to salpingitis.
Para-aortic and pelvic lymph nodes surgically removed from 50 female patients were examined for glandular inclusions. The findings were correlated with fallopian tube changes in patients whose lymph nodes were found to contain inclusions. Seven of the 50 patients had lymph node glandular inclusions; in six, the inclusions were located primarily in the cortical or capsular regions and were few in number. Of these six patients, four had acute or chronic salpingitis. The seventh patient had exuberant lymph node glandular inclusions initially interpreted as metastatic adenocarcinoma and salpingitis isthmica nodosa. This patient is discussed in detail. The association of lymph node glandular inclusions with salpingitis has been reported twice previously; one of these two patients had salpingitis isthmica nodosa. These findings suggest a definite relationship between tubal disease lymph node glandular inclusions. The rare exuberant form of glandular inclusions is benign and should not be confused with adenocarcinoma. It appears definitely associated with salpingitis isthmica nodosa. We suggest two different mechanisms for the pathogenesis of these inclusions. The first is "benign metastasis" from the proliferating tubal epithelium to the draining lymph nodes. The second is a proliferative stimulus responsible for salpingitis isthmica nodosa which also acts on preexisting glandular inclusions to produce the extensive nodal lesion.
Adenocarcinoma, Papillary↗
Basal cell carcinoma. Surgical pathology's perspective.
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Adolescent↗
Calvarial sarcoid mimicking metastatic disease.
A 61-year-old white woman presented with localized cutaneous Boeck's sarcoid and multiple lytic skull lesions mimicking metastatic carcinoma. Complete workup revealed no neoplastic process; biopsy of the skull lesions showed noncaseating granulomas consistent with sarcoid. Although rare, calvarial sarcoid can occur.
Biopsy↗
Follicular occlusion disease with elimination of abnormal elastic tissue.
A case of follicular occlusion disease with notably increased and abnormal elastic tissue and transepidermal elimination of elastic fibers is reported. This combination of findings has traditionally been regarded as unique to elastosis perforans serpiginosa and, to our knowledge, has not previously been described in other follicular diseases. It is hypothesized that the histopathologic changes seen in this case might be a nonspecific secondary alteration in the dermis caused by long-standing chronic inflammation and/or repeated exposure of the dermis to follicular contents.
Acne Vulgaris↗