PubMed Health⌕ Search

Biomedical subjects

V Loy

Publications and source records attributed to V Loy.

At least 19 recordsLinked to original sources
PubMed1992

False-negative biopsy for testicular intraepithelial neoplasia.

A routine biopsy of the contralateral testis obtained during orchiectomy for embryonal carcinoma in a 26-year-old patient was negative for testicular intraepithelial neoplasia (TIN; carcinoma in situ of the testis). However, a rebiopsy that was taken because of unexplained elevation of alpha-fetoprotein 15 months later proved to be positive for TIN. Six previously reported cases of false-negative testicular biopsies obtained during a search for TIN are reviewed. In the light of several thousands of biopsies performed world-wide to date, the number of false-negative biopsies is probably very low. Although TIN is obviously not randomly dispersed throughout the testis in all patients, a routine biopsy of the contralateral testicle in patients with testis cancer remains a valuable tool for early detection of bilateral testicular tumors.-cal distribution of TIN in testes removed for this lesion. Their results suggested that after puberty TIN is usually randomly dispersed throughout the testicle. Support for this concept was recently given by Mumperow et al. (1992). These authors examined tumor-bearing testes and they did not find differences in the presence of TIN in biopsies taken from a location close to the tumor and taken from a location distant from the tumor. Thus, one single biopsy is regard to be representative for the entire testis and one biopsy taken after puberty is also assumed to be reliable for predicting whether the testis will ever develop cancer (Berthelsen and Skakkebaek 1981 a). Conversely, if the biopsy is negative for TIN, a future tumor manifestation in the testicle examined is not expected according to this theory (Skakkebaek et al. 1987). Taken together, the concept of TIN would constitute an ideal avenue for the early detection of testis cancer in high-risk populations with the biopsy being a safe means of discriminating between individuals who will or who will not develop testis cancer.

Adult↗
PubMed1992

Prostate cancer in nonurological patients with normal prostates on digital rectal examination.

Random systematic ultrasonographically guided transrectal core biopsies of the prostate were performed in 73 patients with pulmonary malignancies to exclude prostate cancer as a primary malignant neoplasm. Of the patients 41 had normal prostates as judged by digital rectal examination, 27 had firm prostates and 5 had clinical stage B nodules. Hypoechoic areas were seen on transrectal ultrasonography in 14 of the 41 patients (34%) with normal prostates. Biopsy of the hypoechoic areas in this subgroup detected only 1 grade II prostate cancer. In another patient with normal transrectal ultrasound grade I cancer was detected by mapping of the prostate with 6 systematic ultrasonographically guided transrectal core biopsies. Of the remaining 39 patients with normal prostates transrectal ultrasound detected no hypoechoic defect in 26, a specificity for the detection of prostate cancer of 67%. Multiple core biopsies revealed prostate cancer in 15 of the 32 cases of palpably abnormal prostates, including 12 that were hypoechoic. Prostate cancer is a rare histopathological finding in men with normal prostates on rectal examination. Transrectal ultrasound detected only 1 of 2 low volume prostate cancers in our study group. Thus, ultrasound seems to have little use in patients with prostates that appear normal on digital examination, and its specificity is low.

Aged↗
PubMed1992

Unusual differential diagnosis of testis tumor: intrascrotal sarcoidosis.

We report 2 cases of sarcoidosis with extrapulmonary manifestations in the testis, epididymis and spermatic cord. Each patient presented with an intrascrotal mass of unknown origin that suggested a testicular tumor. Sarcoidosis was confirmed in case 1 by radical orchiectomy and further small sarcoid foci were detected in 1 of the lacrimal glands. In case 2 sarcoidosis was confirmed by biopsy and there were no further extrapulmonary indications. Both cases were stage II disease so no specific therapy was applied. The patients were without signs of progression at 2 and 10 years, respectively, after initial diagnosis.

Adult↗
PubMed1991

Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder.

When a second transurethral resection was routinely performed 8 to 14 days after the initial transurethral resection in 46 patients for stage T1 bladder tumors residual disease was found in 20 despite the surgical report of complete resection in 40. In only 13 patients was residual tumor noted at repeat resection by the senior urologist performing the operation and residual tumor was confirmed histologically in 10 of them. The extent of the lesion is easily misjudged even by experienced surgeons. Early cystoscopy cannot exclude residual tumor. Residual tumor is an important cause of early recurrence and repeat resection of stage T1 lesions is recommended.

Carcinoma, Transitional Cell↗
PubMed1991

Persistent testicular intraepithelial neoplasia after chemotherapy.

A 33-year-old man with a beta HCG-positive seminoma was found to have testicular intraepithelial neoplasia (TIN; carcinoma in situ) in the contralateral testis. Because of retroperitoneal bulky disease (stage IIc), the patient received single agent carboplatin therapy. Complete remission, as judged radiologically and serologically, was achieved after three cycles, but the control biopsy of the testis revealed persistent TIN. Only after local radiotherapy with 20 Gy to the afflicted testis did TIN disappear. Chemotherapy is not safe for the treatment of TIN, and it usually cannot prevent contralateral testicular tumors.

Adult↗
PubMed1990

Incidence and distribution of carcinoma in situ in testes removed for germ cell tumour: possible inadequacy of random testicular biopsy in detecting the condition.

A total of 127 testicular specimens with germ cell tumours were stained immunohistologically for placental alkaline phosphatase to investigate the presence and topographic distribution of carcinoma in situ cells adjacent to the invasive tumours. Carcinoma in situ was detected in 72% of the cases. In 60% of the cases positive for placental alkaline phosphatase the distribution of carcinoma in situ was not diffuse, as claimed in the literature, but focal. Clinicians screening for carcinoma in situ by only one random biopsy have, therefore, to be aware of possible false negative results.

Carcinoma↗
PubMed1990

Testicular sex cord stromal tumour with granulosa cell differentiation: detection of steroid hormone receptors as a possible basis for tumour development and therapeutic management.

A testicular sex cord stromal tumour with granulosa cell differentiation, typical of granulosa cell tumours of the adult type, was investigated immunohistologically on snap frozen and paraffin wax embedded material. The predominance of vimentin and the additional expression of cytokeratin subtypes 8 and 18, as well as the negative staining for epithelial membrane antigen, accorded with results previously reported, for ovarian granulosa cell tumours; the lack of expression of desmoplakin, however, was a distinctive feature. Together with negative staining for leucocyte common antigen, the antigen pattern facilitates the differential diagnosis between granulosa cell tumour and undifferentiated carcinoma or gonadal lymphoma, although its suitability for differentiating within the group of gonadal stromal tumours seems to be limited. The small growth fraction, shown by the monoclonal antibody Ki-67, is typical of the clinical behaviour of granulosa cell tumours. The expression of oestrogen and progesterone receptors, also recently found in testicular Leydig cell tumours, may provoke new approaches to the management of testicular granulosa cell tumours, as well as a new hypothesis on the development of these tumours.

Aged↗
PubMed1990

[Wilms' tumor in adults].

A rare case of metastatic nephroblastoma on the right side in a 28-year-old female patient is presented. Complete remission was achieved by inductive chemotherapy with vincristine, Adriamycin, actinomycin D and cyclophosphamide and subsequent radical nephrectomy. There was no evidence of disease 24 months after the initial diagnosis had been made. The problems specific to the diagnosis and treatment of adult Wilms tumor are discussed. A chemotherapy regimen known to be successful in childhood Wilms tumor was shown to be equally effective in our adult patient.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Oncogenic hypophosphatemic osteomalacia].

In the courses of six years a severe hypophosphataemic osteomalacia, painful motor impairment and multiple rib fractures developed in a 51-year-old man. The symptoms gradually improved within one year under treatment with 3 micrograms daily of 1,25-dihydroxycholecalciferol, 3 g phosphorus and 3 g calcium, and biochemical parameters and the bone scintigram became normal. Ultimately, computed tomography, scintigraphy and digital subtraction angiography revealed a highly vascularized tumour in the condylar aspect of the right femur, and it was chiselled out. Histologically it was a mesenchymal phosphaturic tumour of haemangiopericytoma type of questionable benignity. After the operation the patient was symptom-free for some weeks without any drug treatment, but the latter was then resumed because of renewed bone pain. By now, two years later, he is essentially without pain and has full mobility. However, repeat scintigraphy and angiography revealed renewed tumour growth in the right femoral condyle.

Calcitriol↗
PubMed1989

Immunohistological determination of oestrogen receptor, progesterone receptor, and intermediate filaments in Leydig cell tumours, Leydig cell hyperplasia, and normal Leydig cells of the human testis.

Testicular Leydig cell tumours are able to produce oestrogens and can be induced by exogeneous oestrogen administration. Oestrogen and progesterone receptors, cytokeratin, vimentin, and proliferative activity were determined immunohistologically in human testes in six Leydig cell tumours, 14 cases of Leydig cell hyperplasia, and 13 cases with normal Leydig cells. While both steroid receptors were detected in about 70 per cent of the tumour cells in cryostat sections, no reaction was observed in normal Leydig cells. This supports the hypothesis of an enhanced receptor state in a Leydig cell subpopulation as a basic pathophysiological factor in the development of Leydig cell tumours. On cryostat sections, all tumours co-express cytokeratin and vimentin. Neither the receptors nor the intermediate filaments could be detected reliably in paraffin sections. The low proliferative activity of Leydig cell tumours corresponds to their benign clinical course.

Adult↗
PubMed1989

Nesidioblastosis of the pancreas in an adult with persistent hyperinsulinemic hypoglycemia.

The rare finding of pancreatic nesidioblastosis in an adult is described. A 43-year-old woman presented with a two-year history of hypoglycemic hyperinsulinism. Extensive diagnostic procedures revealed no insulinoma. Subtotal (75%) pancreatectomy relieved her symptoms; she has normal insulin levels 2.5 years after surgery. The pancreatic specimen revealed only discrete islet cell abnormalities, namely B-cells budding off ductular epithelium, islets in apposition to ducts, slight islet cell hypertrophy, and islet enlargement. Immunohistochemistry showed normal total endocrine cell content as well as normal proportions of islet cell subpopulations. Review of 20 cases in the literature and the authors' experience led to subtotal (75-90%) pancreatectomy as the treatment of choice. The authors conclude that the pediatric disease of nesidioblastosis may rarely occur in adults and that the paucity of histologic findings makes the exclusion of an insulinoma mandatory.

Adult↗
PubMed1989

Leiomyosarcoma of the kidney. Immunohistological and ultrastructural findings with special emphasis on the growth fraction.

This report deals with a case of renal smooth muscle tumour. Considering the low mitotic rate, this neoplasm would have been classified as leiomyoma. However, it displayed a relatively large growth fraction by immunostaining with the monoclonal antibody Ki-67. This led us to the diagnosis "leiomyosarcoma", which is in line with the unfavourable clinical course. We suggest that assessment of the growth fraction with Ki-67 seems to be more objective than the conventional criteria for determining the malignant potential of smooth muscle tumours.

Aged↗
PubMed1989

Characterisation of adenoid cystic carcinoma of the breast by immunohistology.

An adenoid cystic carcinoma of the breast in a 78 year old woman was analysed immunohistologically for the production of type IV collagen, the expression of vimentin, epithelial membrane antigen (EMA) and steroid receptors, and the proliferative activity of the tumour cells. The data were compared with those obtained in eight adenoid cystic carcinomas of salivary glands and in ductal carcinomas of the breast with a cribriform growth pattern. The patients' ages were as follows: 45-80 years (mean 63.2) for the salivary gland carcinomas; 37-69 years (mean 50.6) for the ductal breast carcinomas. In contrast to the cribriform spaces of ductal carcinomas, the pseudocysts in adenoid cystic carcinomas were lined by type IV collagen. The opposite pattern was observed for EMA. Like the myoepithelium of normal breast, the myoepithelium-like cells of adenoid cystic carcinoma stained positive for vimentin while the ductular epithelium-like ones did not. All adenoid cystic carcinomas, including that of the breast, were negative for the oestrogen and progesterone receptors, unlike the ductal carcinomas. Proliferative activity of the adenoid cystic carcinoma of the breast was relatively low. These data broaden the range of antibodies suitable for differential diagnosis of both tumour types. They may explain the differences in prognosis, and they explain why hormonal treatment or radiotherapy of adenoid cystic carcinoma of the breast are often ineffectual.

Antigens, Neoplasm↗
PubMed1989

[Carcinoma in situ of the testis: clinical significance, diagnosis and therapy].

The term "carcinoma in situ (CIS) of the testis" is used to mean the presence of atypical neoplastic spermatogonia exhibiting distinct morphological and immunohistological characteristics that differentiate them from normal germ cells. The lesion is considered to be the uniform precursor cell of all germ cell tumors, and it can usually be detected many years before manifestation of the tumor by surgical biopsy and subsequent immunohistological staining for placental alkaline phosphatase (PIAP). This paper gives a review of the theoretical and clinical features of CIS. The description is based on data in the literature and on the authors' experience with two recently detected cases of CIS in the contralateral testis of patients with germ cell tumors. In view of the observation of intraepithelial spread inside the seminiferous tubules, the term "testicular intraepithelial neoplasia" (TIN) is suggested instead of carcinoma in situ.

Biopsy↗