Biomedical subjects

S R Granter

Publications and source records attributed to S R Granter.

50 records · Page 3Linked to original sources

PubMed1997

CD99 (p30/32MIC2) immunoreactivity in the diagnosis of leukemia cutis.

The diagnosis of leukemia cutis and distinction of early myeloid cells and blasts from lymphoblasts or other lymphoid cells can be difficult, particularly if only fixed tissue is available. O13, a monoclonal antibody that recognizes CD99, the p30/32MIC2 gene product, has been used to identify a number of cell types, including lymphoblasts, in paraffin sections. To evaluate the usefulness of CD99 immunoreactivity in the diagnosis of leukemia cutis, we analyzed cases of cutaneous involvement by acute lymphoblastic leukemia/lymphoblastic lymphoma and acute myelogenous leukemia for the presence of this marker. Without the use of antigen retrieval methods, lymphoblasts in cases of cutaneous involvement by acute lymphoblastic leukemia/lymphoblastic lymphoma were immunoreactive for CD99 in 9 of 9 cases. Myeloblasts and early myeloid cells in cases of cutaneous involvement by acute myelogenous leukemia were immunoreactive for CD99 in 12 (80%) of 15 cases. We conclude that CD99 is a sensitive but nonspecific marker for cutaneous involvement by acute lymphoblastic leukemia/lymphoblastic lymphoma and that CD99 is immunoreactive in the vast majority of cases (21 [88%] of 24 cases) of leukemia cutis.

12E7 Antigen↗

PubMed1996

CD99 reactivity in mesenchymal chondrosarcoma.

CD99 reactivity has been reported to be a sensitive and specific marker for Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET). However, within the group of "small round blue cell tumors," the specificity has not been extensively examined. We investigated the immunoreactivity of mesenchymal chondrosarcoma to CD99 using the O13 antibody and found reactivity in 11 of 11 (100%) of cases, specifically in the "small round blue cell" component. All cases showed strong reactivity involving more than 50% of the small round blue cells with a distinct membrane pattern of staining. Staining was either absent or focal and weak in cartilaginous areas. We conclude that mesenchymal chondrosarcoma cannot be distinguished from ES/PNET on the basis of CD99 immunoreactivity.

12E7 Antigen↗

PubMed1996

Cytologic findings in minimal deviation adenocarcinoma (adenoma malignum) of the cervix. A report of seven cases.

Minimal deviation adenocarcinoma (MDA) is a rare extremely well-differentiated form of invasive cervical adenocarcinoma. Because of its rarity and perhaps because cytologic changes are subtle and may be missed, there are only a few reports that illustrate the cytologic features of this neoplasm. To better understand the presentation of MDA in cervical smears and the role of cytology in diagnosing this lesion, the authors reviewed the clinical, histologic, and cytologic finding in seven patients. In two cases, MDA was an incidental finding in the a hysterectomy specimen. Three patients had a vaginal discharge and one patient had a "beefy red" cervix noted on pelvic examination. Although all 7 patients had cervical smears taken within 1 to 17 months before biopsy, in only one of the patients did the cervical smear lead to the diagnosis. On review, all smears from four patients were considered normal. In six smears from the remaining three patients, there were abnormal glandular cells that ranged from atypical to suspicious for well-differentiated adenocarcinoma in retrospect. All of these patients had minor foci of less well-differentiated carcinoma in their tumors. In 11 smears from 5 patients, including the smears with diagnostic cells, there were cells that we believe were from the MDA, but may not be diagnosable as malignant even in retrospect. These cells have not been described before in association with MDA. They are enlarged glandular cells, usually in honeycombed sheets with abundant cytoplasm. Nuclei are uniform with fine chromatin and small nucleoli. They lack pleomorphism and mitoses are only occasionally seen. We believe that in the absence of focal areas of more poorly differentiated adenocarcinoma, these cells are not sufficiently distinct from reactive endocervical cells to allow for a definitive diagnosis. However, awareness of their appearance, especially if seen in large sheets may allow the smear to be diagnosed as abnormal and lead to the correct diagnosis on a biopsy.

Adenocarcinoma, Mucinous↗

PubMed1996

Predominance of neutrophils in the cerebrospinal fluid of AIDS patients with cytomegalovirus radiculopathy.

Cytomegalovirus (CMV) radiculopathy has been associated with both viral cytopathic inclusions and an increased number of neutrophils in the cerebrospinal fluid (CSF) of patients with AIDS. The significance of these findings is unknown. To evaluate this, the authors reviewed all CSF cytology specimens from patients with a history AIDS or HIV infection over a 9-year period. Of 193 specimens identified, 42 (22%) had neutrophils present. Neutrophils were rare (<6 per slide) in the majority of specimens (57%). Occasional neutrophils (<2/hpf) were observed in three patients; one with suspected CMV myelitis, one with bacterial meningitis, and one with cryptococcal meningitis. All 6 cases (3 patients) with numerous neutrophils (>10/hpf) had positive CMV CSF cultures and symptoms of radiculopathy. Definite viral inclusions were not seen. The prognosis was poor in all cases. The authors conclude that diagnostic CMV inclusions are quite rare. However, the presence of elevated numbers of neutrophils in the CSF of a patient with AIDS without an identified infectious agent is highly suggestive of CMV radiculopathy.

AIDS-Related Opportunistic Infections↗

PubMed1996

Cytology of typical and atypical Ewing's sarcoma/PNET.

The cytologic appearance of both typical and atypical Ewing's sarcoma (ES)/PNET has been described, but predominantly in small series. The authors reviewed the cytology of 22 cases (5 fine-needle aspirates, 17 intraoperative smears) of confirmed ES/PNET. Fifteen cases had typical cytologic features, including small round cells, scant cytoplasm, round nuclei, fine chromatin, and inconspicuous, but distinct basophilic nucleoli. Two cases were atypical (large cell) variants, with abundant eosinophilic cytoplasm, large irregular nuclei, vesicular chromatin, and prominent eosinophilic nucleoli. Both cases had the immunophenotype of ES/PNET, including reactivity for CD99. Five cases had features intermediate between typical and atypical ES/PNET, including abundant cytoplasm, intranuclear grooves, and pale vesicular nuclei. All cases had the characteristic immunophenotype of ES/PNET, including reactivity for CD99 or demonstrated a t(11;22)(q24;q12) cytogenetically. The authors conclude that although atypical ES/PNET is rare, a significant proportion of cases may exhibit unusual cytologic features. Ancillary studies are recommended to establish the correct diagnosis.

Adolescent↗

PubMed1996

Borrelial fasciitis: diffuse fasciitis and peripheral eosinophilia associated with Borrelia infection.

We present four cases of diffuse fasciitis (DF) associated with peripheral eosinophilia in which spirochetal organisms were identified. Two patients had borderline positive results on serologic evaluation for Borrelia burgdorferi. Deep biopsy showed dermal sclerosis associated with variable degrees of perivascular mononuclear inflammation. Diffuse fasciitis, septal panniculitis, and myositis with mononuclear cell infiltrates and varying numbers of eosinophils were observed. All cases showed a striking lymphocytic vasculopathy associated with atypical reactive endothelial cells. Using modified Dieterle and Steiner silver stains, multiple organisms were seen in one specimen, a single unequivocal organism detected in two specimens. In one case, no organisms were detected on silver stain; however, organisms were demonstrated using rabbit polyclonal antibodies against B. burgdorferi. B. burgdorferi-specific DNA was identified in one patient by the polymerase chain reaction. These results indicate that some cases of eosinophilic fasciitis are an expression of Lyme disease. We have previously proposed the more specific term "borrelial fasciitis" to describe such lesions.

Adult↗

PubMed1995

Cytologic diagnosis of papillary cystic neoplasm of the pancreas.

The diagnosis of papillary cystic neoplasm of the pancreas (PCNP) on cytologic material allows important therapeutic decisions to be made before surgery. We report two cases in which PCNP was diagnosed preoperatively by fine-needle aspiration biopsy, and review the cytologic features of PCNP previously reported in the literature. The distinctive cytologic features of this tumor included papillary structures composed of tumor cells surrounding myxoid material with delicate central vascular cores, and globoid structures composed of amorphous myxoid material. The cytologic characteristics of PCNP are reviewed here. Definitive diagnosis of PCNP can be reliably achieved by fine-needle aspiration cytology.

Adult↗

PubMed1994

Identification of Borrelia burgdorferi in diffuse fasciitis with peripheral eosinophilia: borrelial fasciitis.

OBJECTIVE: To determine if spirochetes could be localized in biopsy specimens of patients with diffuse fasciitis and peripheral eosinophilia. PATIENTS: Tissue from two patients received in consultation and retrieved from hospital files. One patient had a history of tick bite and erythema migrans. SETTING: Tertiary care center and pathology consultation practice. METHODS: Multiple tissue sections were examined for spirochetes using the modified Dieterle or Steiner technique. One case was examined using rabbit polyclonal antibodies against Borrelia burgdorferi. One case had sufficient tissue to study for B burgdorferi DNA by polymerase chain reaction. RESULTS: We identified two cases of diffuse fasciitis associated with peripheral eosinophilia in which spirochetal organisms were identified. The two patients had positive or borderline B burgdorferi serological findings. Deep biopsy was diagnostic of diffuse fasciitis with eosinophilia. In one patient, multiple organisms were seen using a modified Dieterle silver stain, and B burgdorferi-specific DNA was amplified by polymerase chain reaction. In the other patient, no unequivocal organisms were detected on silver stain; however, organisms were detected using rabbit polyclonal antibodies against B burgdorferi. CONCLUSION: Some cases of what has previously been described as "eosinophilic" fasciitis may be an expression of Lyme disease, and we propose the more specific term borrelial fasciitis to describe such lesions.

Antibodies, Bacterial↗

PubMed1987

Tumor vasculature in young and old hosts: scanning electron microscopy of microcorrosion casts with microangiography, light microscopy and transmission electron microscopy.

Tumor growth in vivo is dependent upon new blood vessel formation. When B16-F10 melanoma cells are implanted subcutaneously in young (3 mo) and old (24 mo) C57BL/6 mice the rate of growth is dependent on the age of the mice. This study involved a wide range of histological and microscopic techniques but was limited primarily to the initial phase of tumor growth. Stereological point counting from light microscopy (LM) of standard histological sections has been used to yield data regarding blood content. Tumor-bearing mice were perfused through the aorta with a fixation solution and were infused with a low-viscosity radiopaque gel (Microfil) or resin (Mercox). Soft x-rays of the whole animal were used for identifying the feeding vessels to the tumor. Tumors with Microfil were sliced and used for microangiography and light-microscopic observation while those with resin were used to make corrosion casts for scanning electron microscopy (SEM). The different characteristics of the tumor blood vessels in different aged mice were most obvious through SEM of vascular corrosion casts. In comparison with tumors in young mice those of similar size in old hosts had more necrosis, reduced presence of angiogenic features, decreased vessel density, reduced penetration into the tumor, and enhanced tortuosity of the vessel lumen. Transmission electron microscopy (TEM) revealed incompletely developed wall structure of the vessels regardless of host. The above results are consistent with the hypothesis that retarded angiogenesis may be responsible in part for the limited growth of tumors in old hosts.

Animals↗

PubMed1985

Effect of thymosin alpha one on specific antibody response and susceptibility to infection in young and aged mice.

The antibody response to a variety of antigens has been shown to diminish with age. We investigated the capacity for Thymosin Alpha One (T alpha 1) treatment to augment antibody production in tetanus toxoid (TT) and pneumococcal capsular polysaccharide (PN) inoculated young and old mice. We also measured survival of these immunized mice after aerosol exposure to Streptococcus pneumoniae. As predicted antibody response to TT, but not PN, was significantly reduced in the old animals and T alpha 1 augmented antitetanus antibody in both young and old mice. T alpha 1 did not have an effect on anti pneumococcal antibody production. All mice that had received PN did have an antibody response, yet survival after exposure to the organism was strikingly less in the old animals. Our data support the contention that antibody response to T-dependent antigens (such as tetanus toxoid) falls with aging but can be reconstituted somewhat by thymic factors. Furthermore, for T-independent antigen (such as pneumococcal capsular antigens) the age-related changes are less evident. In the latter situation, the presence of a brisk antibody response after vaccination was not sufficient to prevent pneumonia and death in old animals.

Aerosols↗

PubMedDate not supplied

CT and ultrasound features of metanephric adenoma in adults with pathologic correlation.

PURPOSE: The purpose of this work was to correlate the CT, ultrasound, and pathologic features of metanephric adenoma, a rare benign renal tumor in adults. METHOD: Retrospective review of medical records (1990-1997) revealed three adult female patients who had both preoperative imaging and nephrectomy with pathologic diagnosis of metanephric adenoma performed at our institution. CT (n = 3) and ultrasound (n = 2) features were reviewed in consensus by two radiologists and correlated with pathologic findings. RESULTS: In all three cases, the metanephric adenoma was of increased attenuation relative to adjacent renal parenchyma on unenhanced CT scans. No septa or calcifications were seen. Ultrasound images showed both tumors to be hyperechoic with enhanced through-transmission. CONCLUSION: The CT and ultrasound findings correlate with the pathologic features of a high nuclear-to-cytoplasmic ratio and psammomatous calcifications. In the adult population, it is unlikely that metanephric adenoma can be prospectively differentiated from renal cell carcinoma based on imaging features.

Adenoma↗

PubMedDate not supplied

Accuracy of fine needle aspiration in distinguishing subtypes of renal cell carcinoma.

OBJECTIVE: To evaluate the cytologic features of each subtype of renal cell carcinoma (RCC) for separating the various subtypes. STUDY DESIGN: Thirty-eight renal fine needle aspiration (FNA) specimens with surgical resection follow-up were retrospectively reviewed and classified without knowledge of the resection specimen diagnosis. These included 18 clear cell RCCs, 8 papillary RCCs, 4 oncocytomas, 2 chromophobe RCCs, 2 sarcomatoid RCCs and 4 metastases to the kidney. RESULTS: Seventy-four percent of the primary renal lesions were correctly classified. All 4 oncocytomas and the 2 chromophobe tumors were correctly classified, while both sarcomatoid RCCs and 3 of 8 papillary RCCs were misclassified as clear cell RCC. One clear cell RCC was misclassified as papillary type. Two clear cell and one papillary RCC were nondiagnostic; in each case the tumor had a prominent cystic component. All four metastases were correctly identified. CONCLUSION: Subclassification of RCC by FNA is relatively accurate. In this study, the most common error was to misclassify papillary and sarcomatoid RCC as clear cell RCC.

Adenocarcinoma↗

PubMedDate not supplied

Intracytoplasmic eosinophilic inclusions (Melamed-Wolinska bodies). Association with metastatic transitional cell carcinoma in pleural fluid.

OBJECTIVE: To determine if eosinophilic cytoplasmic inclusions (Melamed-Wolinska bodies) (ECIs) can help to distinguish metastatic transitional cell carcinoma (TCC) from pulmonary carcinoma (PC) in pleural effusions. STUDY DESIGN: The presence of ECIs was evaluated in malignant pleural effusions from 8 cases (5 patients) of TCC and 38 cases of pulmonary carcinoma (PC). ECIs were categorized as absent, rare (< 2 per case), occasional (2 per case to < 1 per high-power field), frequent (1-2 per high-power field) or numerous (> 2 per high-power field). RESULTS: In pleural fluids with TCC, ECIs were numerous in 1 case, frequent in 2 cases, occasional in 3 cases and absent in 2 cases. In contrast, in pleural fluids with PC, ECIs were occasional in 1 case, rare in 5 cases and absent in 32 cases. CONCLUSION: While not present in every case, frequent ECIs in a malignant pleural effusion are suggestive of TCC rather than PC.

Adult↗

PubMedDate not supplied

Fine needle aspiration of chromophobe renal cell carcinoma.

OBJECTIVE: To report the fine needle aspiration (FNA) features of both a typical and an eosinophilic variant of chromophobe renal cell carcinoma. STUDY DESIGN: The files of Brigham & Women's Hospital were searched for renal FNAs of chromophobe renal cell carcinoma with surgical follow-up. RESULTS: Both tumors had single cells and small groups of cells with frequent binucleation, nuclear hyperchromasia, nuclear outline irregularity, significant nuclear size variation, abundant cytoplasm and a thickened cytoplasmic membrane. Hale's colloidal iron was strongly positive in a diffuse cytoplasmic pattern. The typical variant resembled clear cell renal cell carcinoma; differentiation was best accomplished by noting the predominance of single cells rather than large groups, binucleation, nuclear atypia and thickened cytoplasmic membranes. The eosinophilic variant resembled oncocytoma. Differentiation was best accomplished by noting the nuclear atypia and lack of uniform granularity of the cytoplasm. CONCLUSION: Chromophobe renal cell carcinoma has distinctive cytologic features on FNA; Hale's colloidal iron can be helpful in difficult cases.

Aged↗