Invasive lobular carcinoma of the breast. The importance of an alveolar growth pattern.
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Aged↗
Biomedical subjects
T H Grude
Publications and source records attributed to T H Grude.
[Phyllodes tumor].
This very rare breast tumour has been diagnosed in five cases, four females and one male, at our hospital during the last two years. The females all presented tumours with a diameter ranging from 5 to 15 cm. Age at diagnosis ranged from 21 to 54 years. We focus on diagnostic challenges, since 3 of our patients were recently treated by removal of a breast tumour diagnosed morphologically as fibroadenomatosis. Our patients underwent different surgical therapy, and we focus on local treatment modalities advocated in recent literature. Systemic chemotherapy, endocrine treatment and/or radiation therapy, in the adjuvant setting or in advanced disease, do not increase survival in patients with malignant phyllodes tumour.
Adult↗
Magnetic resonance imaging--a method of studying the size and asymmetry of the planum temporale.
The planum temporale is a triangular region on the upper surface of the temporal lobe. This area of the brain is important for language processing and shows a left-right asymmetry of size in most brains. Particular interest has been focused on the size and asymmetry of the planum temporale in brains of individuals with developmental dyslexia. Magnetic resonance imaging (MRI) is a method that produces excellent morphological details of organic structures. We have developed an MRI method of studying the size and asymmetry of the planum temporale in human brains. Because of considerable variation of anatomical landmarks in this cortical region of the brain, an evaluation of asymmetry is not possible in all brains. Furthermore, our experience with this method indicates that any indirect imaging technique of studying asymmetry of the planum temporale must be evaluated with caution. With this in mind, however, MRI may give valuable anatomical information about the planum temporale in individuals with anomalous language function.
Humans↗
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. The consequences of a reclassification of the original group of lentigo maligna melanomas.
A selected series of primary malignant melanoma of the skin, clinical stage I, was originally classified according to Clark's system. The consistency of this classification was tested by two Brisbane pathologists who indicated that we had misinterpreted some cases of superficial spreading malignant melanoma as lentigo maligna melanoma. We have therefore reclassified the original group of 86 lentigo maligna melanomas. This resulted in a total series of 37 (5.5%) lentigo maligna melanomas, 301 (45%) superficial spreading malignant melanomas, 194 (29%) nodular malignant melanomas (unchanged) and 137 (20.5%) unclassifiable malignant melanomas. The diagnosis of lentigo maligna melanoma was not made unless the epidermis was atrophic and dermal solar elastosis was present. The new group of lentigo maligna melanomas is dominated by cases on the head among patients over 50 years of age (especially women). This is in better agreement with other studies than our previous findings. The relationship with tumour cell type, pigmentation, mitotic count, atypia, transsectional profile, level of invasion, ulceration, vascular invasion, lymphocyte infiltration and prognosis shown by the new groups of lentigo maligna melanoma and superficial spreading malignant melanoma indicates that the cases by which the diagnosis has been changed are relatively benign. Our previous conclusions are still valid. The lentigo maligna melanoma is still the most benign type and nodular malignant melanoma still the most malignant type of melanoma. The superficial spreading malignant melanoma still represents an intermediate tumour type, although it has deviated in the benign direction.
Adult↗
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. 4. The relation of cross-sectional profile, level of invasion, ulceration and vascular invasion to tumour type and prognosis.
A selected series of 669 primary cutaneous malignant melanomas, stage I, was studied. The series includes 86 lentigo maligna melanomas, 259 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 130 unclassifiable malignant melanomas. The cross-sectional profile, level of invasion, ulceration and vascular invasion were graded. The relation of these features to each other and to tumour type was studied by X2 tests. The prognostic value was also studied. The most common finding was a slightly elevated surface, level III of invasion, no ulceration and no vascular invasion. Most of these tumours were superficial spreading malignant melanomas. A good prognosis was associated with a flat cross-sectional profile, level II of invasion, no ulceration and no vascular invasion. A poor prognosis was associated with marked protrusion of the surface, level IV--V of invasion, ulceration and vascular invasion. Lentigo maligna melanomas tended to be more benign while nodular malignant melanomas tended to be more malignant than the average. A superficial spreading malignant melanoma could vary in either direction. The prognostic value of level of invasion and ulceration was found to be greater than that of tumour type. The prognostic importance of invasion no further than level III is stressed. Level of invasion ought to be reported to the clinician as well as the tumour type.
Blood Vessels↗
A retrosepctive histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. 6. The relation of dermal solar elastosis to sex, age and survival of the patient and to localization, histological type and level of invasion of the tumour.
A selected series of primary malignant melanoma of the skin, clinical stage I, was studied. The series includes 37 lentigo maligna melanomas, 301 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 137 unclassifiable malignant melanomas. Dermal solar elastosis was graded. The most common finding was lack of solar elastosis which together with slight elastosis was mostly found on the trunks of young men and on the legs of young women in cases of superficial spreading malignant melanoma. Marked and moderate elastosis was found almost exclusively on the head, especially in old women with lentigo maligna melanoma. Nodular malignant melanoma was related neither to any special grade of solar elastosis, nor to localization, but showed some relation to the male sex after 50 years of age. The present study does not permit any conclusions to be made about a possible causal relationship between the three types of malignant melanoma and previous sun-exposure, because of lack of clinical information and a control series concerning solar elastosis in the normal population. Level of invasion and prognosis of the patient did not show any covariation with grade of solar elastosis.
Adult↗
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. I. Histological classification, sex and age of the patients, localization of tumour and prognosis.
A selected series of 669 primary malignant melanomas of the skin, stage I, has been classified according to Clark's system into lentigo maligna melanoma (86), superficial spreading malignant melanoma (259), nodular malignant melanoma (194) and unclassifiable malignant melanoma (130). It was often difficult to distinguish between lentigo maligna melanoma and superficial spreading malignant melanoma, and sometimes also between this last type and nodular melanoma. There seem to be borderline cases between the respective types. The 10-year specific cumulative survival rate (approximately the cure rate) was 98.3% for the lentigo maligna melanomas, 78.6% for nodular malignant melanomas and 76.7% for the unclassifiable group of melanomas. The 5-year observed prognosis ofthe 3 main types is satisfactory compared with other investigations. As the prognosis of the 3 types of cutaneous malignant melanoma differs considerably the use of this classification is recommended. The number of unclassifiable cases is likely to be reduced in the routine work when several sections of each tumour are studied.
Adolescent↗
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. 2. The relation of cell type, pigmentation, atypia and mitotic count to histological type and prognosis.
A selected series of 669 primary malignant melanomas of the skin, stage I, was studied. The series includes 86 lentigo maligna melanomas, 259 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 130 unclassifiable malignant melanomas. The tumour cell type was classified and the tumour cell pigmentation, the cellular atypia and the mitotic count was graded. The relation of these four tumour cell features to each other and to the tumour type was studied by X2tests. The prognostic value of these features in relation to the total series as well as to each tumour type was also examined. The most common features were mixed cellularity, little pigment, moderate atypia and low mitotic count. Most of these tumours were superficial spreading malignant melanomas. A good prognosis was related to spindle-shaped tumour cells, marked pigmentation, slight atypia and few mitoses. A bad prognosis was related to epithelioid tumour cells, little pigment, marked atypia and many mitoses. Variations of lentigo maligna melanoma tended to be more benign while variations of nodular malignant melanoma tended to be more malignant than the average. A superficial spreading malignant melanoma might vary in either direction.
Humans↗
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. 3. The relation between the tumour-associated lymphocyte infiltration and age and sex, tumour cell type, pigmentation, cellular atypia, mitotic count, depth of invasion, ulceration, tumour type and prognosis.
A selected series of 669 primary malignant melanoma of the skin, stage I, was studied. The series included 86 lentigo maligna melanomas, 259 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 130 unclassifiable malignant melanomas. The adjacent lymphocyte infiltration was graded and its prognostic value and its relation to the sex and age of the patient, tumour cell type, pigmentation, cellular atypia, mitotic count, depth of dermal invasion, tumour type and ulceration was studied. There was no significant relationship between lymphocyte response and sex and age of the patient and the tumour cell type. There was a highly significant relationship between a dense lymphocyte infiltration and superficial tumour invasion as far as the papillary-reticular interface in contrast to the weak response associated with deeper invasion. When only tumours with invasion of the papillary-reticular interface were considered, there was no significant relationship between lymphocyte infiltration and pigmentation, cellular atypia, mitotic count, tumour type and ulceration. At the same level of invasion there was no difference in prognosis in relation to the density of lymphocyte infiltration. Nodular malignant melanomas surrounded by a dense lymphocyte infiltration had a significantly worse prognosis than was associated with a simular lymphocyte response against the two other types of melanoma.
Age Factors↗