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Biomedical subjects

V L Roggli

Publications and source records attributed to V L Roggli.

At least 19 recordsLinked to original sources
PubMed1992

Absence of correlation between nuclear morphometry and survival in stage I non-small cell lung carcinoma.

To evaluate the utility of nuclear morphometry as a prognostic indicator in lung cancer, 5-year follow-up information was obtained in 46 cases of surgically resected Stage I non-small cell lung cancer (NSCLC). Nuclear area, perimeter, major diameter, minor diameter, and nuclear shape factor were determined from representative histologic sections of the tumors with a computer-assisted digitizing system. The morphometric parameters were compared between patients with favorable outcome (Group I: alive with no evidence of disease, n = 17) and those with poor outcome (Group II: dead of disease or with recurrence of disease, n = 29). No significant differences in any of the morphometric parameters were found between tumors in Groups I and II for individual tumor cell types or the combined cases. Failure to demonstrate a correlation between morphometric parameters and prognosis in Stage I NSCLC indicates that future efforts to determine objective prognostic factors should concentrate on other variables, such as specific genetic abnormalities.

Aged↗
PubMed1992

Malignant mesothelioma in the jewelry industry.

We conducted a clinical, environmental, pathologic, and mineral lung burden investigation of a 61-year-old man with malignant mesothelioma. For 35 years, up until three weeks prior to pneumonectomy, the patient made asbestos soldering forms at a costume jewelry production facility. Only chrysotile asbestos was used at the plant during the last decade of the patient's employment, and recent environmental sampling of the work-place identified no other asbestos fiber type. Anticipating that the patient would add to the very small number of cases of mesothelioma attributable solely to chrysotile, we found instead that the patient's lung tissue contained large numbers of both coated and uncoated amosite asbestos fibers but, surprisingly, no chrysotile. We subsequently learned that a distributor of both chrysotile and amosite supplied the company during the first 25 years the patient was fabricating soldering forms. The findings underscore the futility of estimating environmental exposure to chrysotile on the basis of fiber counts in lung tissue. Although we previously described non-neoplastic asbestos-related disease among patients engaged in similar work, this case, to the best of our knowledge, represents the first report of mesothelioma in the commercial jewelry industry. As such, it prompted us to initiate a public health campaign to replace asbestos soldering forms in this industry with readily available, safer alternatives.

Air Pollutants, Occupational↗
PubMed1992

Deposition, clearance, and translocation of chrysotile asbestos from peripheral and central regions of the rat lung.

We investigated the pulmonary deposition, clearance, and translocation of chrysotile asbestos in the context of our previously developed model of asbestosis in the rat. Adult male rats were exposed for 3 hr to an aerosol of chrysotile asbestos. Subgroups were sacrificed up to 29 days postexposure and the lungs of the animals fixed. Peripheral and central regions of the left lung were resected, digested, and analyzed for fiber content by scanning electron microscopy. Pulmonary deposition did not differ between peripheral and central regions. There was no evidence of translocation of fibers from central to peripheral regions. The average diameter of retained fibers decreased over time, consistent with longitudinal splitting. The average length of retained fibers increased over time, consistent with slower clearance of longer fibers. We employed a novel counting scheme to ensure accurate fiber number measurements, allowing the calculation of clearance rates for fibers 0.5 to greater than or equal to 16 microns in length. Fibers of length greater than or equal to 16 microns were cleared slowly, if at all. These findings could have important implications for the pathogenesis of asbestos-related pleural disease. Many fibers are deposited in the peripheral region, and the longest (greater than or equal to 16 microns) will persist there for extended periods.

Aerosols↗
PubMed1992

Pulmonary oxalate deposition associated with Aspergillus niger infection. An oxidant hypothesis of toxicity.

Tissue injury by Aspergillus niger infection is associated with the deposition of calcium oxalate crystals. Oxalate is recognized to function as a ligand for numerous metal cations and will react with ferric ion to form a coordination complex. We describe oxalate deposition in the lung of a patient with A. niger infection and quantify surface-complexed Fe3+. Crystals collected from lung tissue demonstrated considerable concentrations of surface iron. In addition, we tested the hypothesis that this surface coordination of Fe3+ by oxalate is associated with increased in vitro oxidant generation. Calcium oxalate crystals (1.0 mg/ml) complexed all available Fe3+ from solutions of ferric chloride to concentrations of as much as 1.0 mM. Oxidant generation in both a chemical and a cellular system, measured as thiobarbituric-acid-reactive products of deoxyribose and chemiluminescence, respectively, increased with coordination of higher concentrations of inorganic iron. We conclude that calcium oxalate associated with A. niger infection complexes iron cations onto the crystalline surfaces and may generate oxidants at the solid-solution interface, which could result in tissue injury.

Aspergillosis↗
PubMed1992

Morphometric quantitation of tumor necrosis in stage 1 non-small cell carcinoma of lung: prognostic implications.

We objectively examined the extent of tumor necrosis by computer-assisted morphometry in 28 patients with surgically resected Stage I non-small cell carcinoma of lung. Fourteen of the 28 patients were long-term survivors (mean survival after diagnosis 94 mo) and 14 were short-term survivors (up to 62 mo after diagnosis). The extent of tumor necrosis was determined by means of a computer assisted digitizing system. The two sample t test and the two-tailed Wilcoxon rank score tests were used for statistical analysis of comparison of the extent of tumor necrosis between the two groups of patients. This morphometric study showed that the extent of tumor necrosis was significantly associated to the probability of long-term survival, with long surviving patients having a lesser degree of tumor necrosis (t = 2.75, p < 0.02, 2 sample t test, two-tailed, df = 26). These findings reaffirm previous subjective data, derived from pathologist assessment of tumor necrosis, and suggest that morphometric evaluation of tumor necrosis may play a useful adjunct role in predicting prognosis of carcinoma of lung.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

Quantitative and analytical studies in the diagnosis of mesothelioma.

The vast majority of patients with malignant mesothelioma of the pleura or peritoneum have an abnormal tissue asbestos content as assessed by digestion techniques. These procedures allow for the quantification of asbestos bodies, as well as numbers and types of mineral fibers. In general, analyses of mineral fiber content correlate well with occupational exposure history. Such analyses are useful for the identification of asbestos-related mesotheliomas and separation from those due to other causes.

Asbestos↗
PubMed1991

Mineral fiber content of lung tissue in patients with environmental exposures: household contacts vs. building occupants.

Analysis of tissue mineral fiber content in patients with environmental exposures has seldom been reported in the past. Our studies of six household contacts of asbestos workers indicate that these individuals often have pulmonary asbestos concentrations similar to some occupationally exposed individuals. In contrast, our studies of four occupants of buildings with asbestos-containing materials indicate that these individuals often have pulmonary asbestos burdens indistinguishable from the general nonoccupationally exposed population. However, one such building occupant exposed for many years and who later developed pleural mesothelioma was studied in detail, and it was concluded that her exposure as a teacher's aide in a school building containing acoustical plaster was the likely cause of her mesothelioma.

Adult↗
PubMed1991

Scanning electron microscopic analysis of mineral fiber content of lung tissue in the evaluation of diffuse pulmonary fibrosis.

The mineral fiber content of lung parenchyma in 24 cases of diffuse pulmonary fibrosis of unknown cause was determined by scanning electron microscopy and compared with that of 36 autopsy cases of histologically confirmed asbestosis and 20 autopsy cases of patients with normal lungs. Fibers were isolated from the lung using a hypochlorite digestion technique and collected on the surface of a polycarbonate filter. In addition, the types of fibers present (asbestos vs. other mineral fibers) were determined by energy dispersive x-ray analysis (EDXA). When the histologic grade of fibrosis in the cases of asbestosis was compared with the uncoated fiber content by means of linear regression analysis, it was determined that the fiber content of the 24 cases of diffuse pulmonary fibrosis of unknown cause was below the 95% confidence limit for asbestosis in every instance. Furthermore, the majority of fibers analyzed by EDXA were not asbestos in the cases with diffuse pulmonary fibrosis of unknown cause, whereas more than 90% of the fibers from the asbestosis cases were commercial amphiboles (amosite or crocidolite). It was concluded that most patients with advanced pulmonary fibrosis whose tissue samples do not meet histologic criteria for asbestosis do not have asbestos-induced fibrosis, even though there may be some history of exposure to asbestos. In such cases, scanning electron microscopic analysis of mineral fiber content and EDXA of the types of fibers present often provide useful information with regard to the correct classification of these cases.

Adult↗
PubMed1991

Diagnosis of diffuse malignant mesothelioma: experience of a US/Canadian Mesothelioma Panel.

The experience of the US/Canadian Mesothelioma Panel with its first 200 cases is reviewed. The light microscopic diagnosis, histochemical findings, immunohistochemical findings, and electron microscopic features of malignant mesotheliomas are reviewed in the context of differential diagnosis. Reasons for referral of case material to the panel and lessons from follow-up of difficult and controversial cases are reported. Recommendations to general pathologists are made regarding evaluation and review of possible mesotheliomas.

Adenocarcinoma↗
PubMed1990

Human disease consequences of fiber exposures: a review of human lung pathology and fiber burden data.

Inhalation of asbestos fibers results in a variety of neoplastic and nonneoplastic diseases of the respiratory tract. Some of these diseases, such as asbestosis, generally occur after prolonged and intensive exposure to asbestos, whereas others, such as pleural mesothelioma, may occur following brief exposures. Inhalation of nonasbestiform mineral fibers can occur as well, and these fibers can be recovered from human lung tissue. Thus, there has been considerable interest in the relationship between mineral fiber content of the lung and various pathologic changes. Techniques for fiber analysis of human tissues have not been standardized, and consequently results may differ appreciably from one laboratory to another. In all reported series, extremely high fiber burdens are found in the lungs of individuals with asbestosis. Although there is a correlation between the tissue concentration of asbestos fibers and the severity of pulmonary fibrosis, further studies of the mineralogic correlates of fiber-induced pulmonary fibrosis are needed. Mesothelioma may occur with fiber burdens considerably less than those necessary to produce asbestosis. More information is needed regarding the migration of fibers to the pleura and the numbers, types, and dimensions of fibers that accumulate at that site. Patients with asbestosis have a markedly increased risk for lung cancer, but the risk of lung cancer attributable to asbestos in exposed workers without asbestosis who also smoke is controversial. Combined epidemiologic-mineralogic studies of a well-defined cohort are needed to resolve this issue. In addition, more information is needed regarding the potential role of nonasbestos mineral fibers in the pathogenesis of lung cancer.

Asbestos↗
PubMed1990

Asbestos bodies in pulmonary hilar lymph nodes.

Asbestos bodies (AB) have long been recognized in light microscopic (LM) sections of pulmonary hilar lymph nodes (LN) from patients with asbestos-related diseases, but the presence of AB on LM has not been correlated with the lung AB burden. The purpose of the present study was to determine whether AB in histologic sections of LN are indicative of heavy lung asbestos burdens. Twenty cases (17 with asbestosis, 15 with carcinoma of the lung, and two with malignant pleural mesothelioma) with at least one AB on a hilar LN section were identified. Bleach digestion of lung tissue in 15 cases demonstrated a median of 24,000 AB/g by LM and 44,000 AB/g by scanning electron microscopy. Digestion of hilar nodes demonstrated 21,800, 15,500, and 3,200 AB/g by LM in three cases which had lung burdens of 22,000, 481,000, and 5470 AB/g, respectively. A fourth LN specimen contained 322,000 AB/g in a case with no lung available to digest. Mean AB lengths in the LN in three cases were 48, 45, and 27 microns. Fourteen control cases of men over 50 without known asbestos exposure or asbestos-related disease had no AB in LN sections even after staining for iron. Among fourteen patients with parietal pleural plaques and an elevated lung asbestos body content, AB were observed in iron-stained LN sections in only two cases. These two patients had 3240 and 610 AB/g lung tissue, respectively (normal range 0 to 20 AB/g). We conclude that the finding of AB on a histologic section of hilar LN is generally indicative of a heavy lung AB burden.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Eosinophilic intracytoplasmic globules in pulmonary adenocarcinomas: a histochemical, immunohistochemical, and ultrastructural study of six cases.

Intracytoplasmic globules have been described in a variety of neoplastic and nonneoplastic conditions, but remain poorly defined. In a review of 100 consecutive cases of lung carcinomas, six cases of mucin-positive adenocarcinoma demonstrated eosinophilic intracytoplasmic globules that ranged in size from less than 1 to 20 mu in diameter. The globules were often located adjacent to areas of tumor necrosis, and occurred either singly or multiply within individual tumor cells. Globules were similar in morphologic appearance to Russell bodies in plasma cells or the eosinophilic globules in hepatocytes of patients with alpha-1-antitrypsin deficiency, but were morphologically distinct from intracytoplasmic mucin vacuoles. The globules were brightly positive with PAS stain with diastase, were brick red with Masson's trichrome stain, and showed variably positive staining with Mallory's phosphotungstic acid-hematoxylin and Ziehl-Nielson stains. Immunoperoxidase staining showed slight staining of some globules with albumin, IgG, IgA, and alpha-1-antitrypsin. Ultrastructurally the globules had a homogeneous density and were often associated with profiles of rough endoplasmic reticulum. We suggest that these globules represent secretory glycoprotein accumulated in the cytoplasm of tumor cells in areas of tumor cell injury.

Adenocarcinoma↗
PubMed1989

Dendriform pulmonary ossification. Report of two cases with unique findings.

Dendriform pulmonary ossification (DPO) is a rare condition characterized by branching bony spicules found in association with pulmonary fibrosis. The authors report two cases, the first of which occurred in a patient with acute myeloblastic leukemia and was associated with the unique finding of leukemic involvement of marrow spaces in the metaplastic bone. The second case showed DPO in combination with asbestosis, a heretofore unreported association.

Aged↗
PubMed1989

Immunohistochemical differentiation of sarcomatoid mesotheliomas from other spindle cell neoplasms.

A sizable proportion of pleural malignant mesotheliomas are sarcomatoid (22%) or biphasic (24%) and may need to be distinguished from other spindle cell neoplasms that occur as primary or metastatic tumors of the chest wall or lungs. To determine the utility of immunohistochemistry in the differentiation of sarcomatoid malignant mesotheliomas from other spindle cell neoplasms, the authors studied the immunostaining patterns of nine antibodies in four sarcomatoid mesotheliomas, one desmoplastic mesothelioma, two epithelial mesotheliomas, four spindle cell squamous carcinomas, and eight sarcomas of various differentiation. Three of the four sarcomatoid mesotheliomas and the desmoplastic mesothelioma had positive results for cytokeratin, which distinguishes them from sarcomas but not from spindle cell squamous carcinomas. The immunostaining pattern of 14 examples of benign spindle cell mesothelial proliferation was similar to that of the sarcomatoid mesotheliomas, which supports the theory that these tumors are mesothelial in origin. Although other antibodies occasionally may be helpful, depending on the differentiation of the sarcoma, cytokeratin immunostaining appears to be the best method to discriminate sarcomatoid mesotheliomas from sarcomas.

Aged↗
PubMed1989

The accumulation of nickel in human lungs.

Using data from published studies, lung concentrations of nickel were compare for persons with and without occupational exposure to nickel. As expected, the concentrations were much higher for persons with occupational exposure. To estimate the effects of nickel-containing tobacco smoke and nickel in the ambient air on the amount of nickel accumulated in lungs over time, a model was derived that took into account various variables related to the deposition of nickel in lungs. The model predicted nickel concentrations that were in the range of those of persons without known nickel exposure. Nickel is a suspected carcinogen and has been associated with an increased risk of respiratory tract cancer among nickel workers. However, before the nickel content of cigarettes can be implicated in the etiology of lung cancer, further studies are needed to evaluate the independent effects of smoking and exposure to nickel.

Air Pollutants↗
PubMed1989

Ultrastructural morphology of the lung in cystic fibrosis.

Cystic fibrosis (CF) is the most common lethal genetic disease among Caucasians, with much of the morbidity and most of the mortality related to pulmonary complications. The underlying defect in this disease has yet to be precisely defined, so it is somewhat surprising that a comprehensive study of the ultrastructural morphology of the lung in CF has not heretofore been reported. We used transmission electron microscopy to examine the small airways in 15 patients who had died of CF, and compared the findings with 15 disease controls with non-CF chronic airways disease and 15 patients with normal lung morphology. The lung parenchyma was also examined ultrastructurally in 7 patients with CF, 4 disease controls, and 4 normal lung cases. In addition, the literature regarding the ultrastructural morphology of the large airways in CF was reviewed. Patients with CF showed non-specific ciliary abnormalities, hyperplasia of mucous cells, increased numbers of pulmonary neuroendocrine and indeterminate cells, degeneration and sloughing of epithelial cells, and colonization of bacteria of the mucous layer of the small airways when compared with normal controls. Alveoli showed non-specific injury and regeneration of type II pneumocytes. However, these changes were all similar to those observed in the disease controls. Specifically, no cellular or subcellular ultrastructural abnormality unique to CF was observed. It is probable that the most useful ultrastructural approach to the lung in CF in future studies will involve X-ray microanalytical studies of ionic composition using cryotechniques.

Adolescent↗