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Biomedical subjects

V S Ghali

Publications and source records attributed to V S Ghali.

11 recordsLinked to original sources

Primitive neuroectodermal tumor of the myocardium: a case report, review of the literature, immunohistochemical, and ultrastructural study.

We report the case of a primitive neuroectodermal tumor (PNET) arising in the heart of a 63-year-old man. The neuroectodermal nature of this tumor was confirmed by the immunohistochemical positivity for O13 (CD99) (the P30/32MIC2 gene product) neuron specific enolase (monoclonal and polyclonal), synaptophysin and vimentin. Other markers, such as actin, desmin, myoglobin, chromogranin, keratin, and leukocyte common antigen were negative. The diagnosis was made on an endomyocardial biopsy and was confirmed in sections from the myocardial tumor found within the heart excised during cardiac transplant. Primitive neuroectodermal tumors have been reported in a variety of sites, most commonly in the extremities. No case has ever been reported within the myocardium, although one has been reported in the pericardium. In addition to morphological similarities, PNET and extraskeletal Ewing's sarcoma have been shown to possess the same chromosomal translocation, t11;22, and the same cell surface antigen, P 30/32. Separation of this case from extraskeletal Ewing's sarcoma was possible because of the absence of PAS positivity, as well as the immunohistochemical positivity for at least two neural markers, as extraskeletal Ewing's sarcoma is only positive for neuron specific enolase.

Biopsy↗

A comparative study of DNA ploidy in 115 fresh-frozen breast carcinomas by image analysis versus flow cytometry.

BACKGROUND: Qualitative and quantitative analysis of cellular DNA content may be clinically useful in the prognostic evaluation of certain types of malignant tumors, including breast carcinoma. Flow cytometric (FCM) analysis has been the most frequently used procedure for DNA analysis, but it requires a reasonably large tissue sample. Computer-based image analysis (IA) now allows imprint, cytospin, and needle aspiration smear preparations and other small tissue samples to be used. METHODS: To resolve concern about the diagnostic efficacy of small tissue samples in the use of IA, the authors performed a comparative study of FCM analysis and IA using 115 fresh-frozen breast carcinomas. Feulgen-stained imprint preparations for IA and single-cell suspensions from the same fresh-frozen tissue for FCM analysis were used, and the respective histograms were compared. RESULTS: The results were concordant in 90.4% (104 of 115) of the cases, but 11 specimens yielded discordant data. IA provided histograms with a somewhat lower resolution and a relatively high coefficient of variation for the G0/G1 peak, thus rendering occasional tumors, which were near-diploid aneuploid by FCM analysis (four cases), not amenable to diagnosis by aneuploid characterization. In three additional cases, FCM analysis showed aneuploid hyperdiploid (two cases) and multiploid (one case) histograms, but IA only demonstrated a diploid peak. Conversely, in four other cases, aneuploid peaks were recognized only by IA. CONCLUSIONS: Computerized IA has significant advantages over FCM analysis, including lower cost, the ability to analyze very small specimens, the capability of detecting rare high ploidy cells, the capacity to classify cellular populations according to specific morphologic type, and the fact that no destructive enzyme or chemical digestion is required for specimen preparation, thereby preserving the integrity of fragile cells.

Breast Neoplasms↗

Distribution of Leu-7 antigen (HNK-1) in thyroid tumors: its usefulness as a diagnostic marker for follicular and papillary carcinomas.

The reactivity of the anti-Leu-7 monoclonal antibody was tested in 39 neoplastic and nonneoplastic thyroid tissue specimens. These included eight colloid goiters, 14 follicular adenomas, nine papillary carcinomas, five follicular carcinomas, two medullary carcinomas, and one metastatic follicular carcinoma in bone. We observed strong cytoplasmic and/or cell membrane positivity in all follicular and papillary carcinomas, in both primary and metastatic tumors. However, the medullary thyroid carcinomas tested were negative. We also observed weak and only occasional staining with anti-Leu-7 antibody in colloid goiter and follicular adenomas. The staining in the benign thyroid lesions was usually focal, less than 10% of the cells; however, in cases of follicular and papillary carcinomas, both in primary and metastatic tumors, the staining was diffuse and strong. Some of the colloid material in colloid goiters and follicular adenomas showed faint homogenous staining with anti-Leu-7 antibody. Our findings suggest that anti-Leu-7 monoclonal antibody is a marker that may facilitate the differentiation between benign and malignant thyroid lesions, with the exception of medullary carcinoma. In addition, caution should be taken when using this antibody to diagnose metastatic lesions, as other metastatic carcinomas have also been reported to be positive. This antibody should be used in conjunction with a panel of antisera to complement a morphologic diagnosis.

Adenocarcinoma↗

Malignant peripheral nerve sheath tumor arising spontaneously from retroperitoneal ganglioneuroma: a case report, review of the literature, and immunohistochemical study.

We report a case of a malignant peripheral nerve sheath tumor arising from a retroperitoneal ganglioneuroma in an adult male. There was no known previous history of a childhood neuroblastoma or of radiation therapy. In addition, the patient had no stigmata or family history of von Recklinghausen's neurofibromatosis. This case provides evidence that, although rare, spontaneous malignant transformation of ganglioneuroma can occur. Immunohistochemical studies supported that the spindle cell component was of nerve sheath origin.

Adult↗

IgA nephritis in HIV-positive patients: a new HIV-associated nephropathy?

Four HIV-positive patients were shown to have IgA-associated nephritis on biopsy, including one with anaphylactoid purpura. Three were homosexuals, while the fourth acquired the infection from his mother. All had hematuria, a variable degree of proteinuria and renal disease with a benign course. Serologic studies showed elevated levels of IgA as well as IgA immune complexes and rheumatoid factor. IgA antibodies to multiple HIV antigens were detected by Western blot. Pathologic studies showed tubuloreticular inclusions in endothelial cells and nuclear bodies in interstitial cells in all cases. HIV antigens were not detected in kidney biopsies by monoclonal antibodies nor was HIV viral genome demonstrated by in situ hybridization. The possibility that this represents a unique type of IgA-associated HIV nephropathy is discussed.

AIDS-Associated Nephropathy↗

Angiostrongyliasis: a rare cause of gastrointestinal hemorrhage.

Angiostrongylus costaricensis is an intestinal nematode, endemic to Central and South America. Affecting mostly children, it causes an eosinophilic gastroenteritis with involvement of the appendix, distal small bowel, and right colon. We report a case of a 41-yr-old man, from a non-endemic area, with the unique presentation of recurrent gastrointestinal bleeding. The diagnosis was made after surgical exploration.

Adult↗

Isolated leukemia cutis--a case report.

A 67-year-old woman with acute myelomonocytic leukemia had a clinical course characterized by the initial appearance of leukemia cutis without bone marrow involvement. When marrow involvement subsequently occurred, induction chemotherapy cleared all manifestations of the illness. Shortly thereafter, while blood and bone marrow remained in remission, the skin lesions reappeared. The introduction of 6-thioguanine, as part of the maintenance treatment protocol, resulted in the rapid and permanent disappearance of the leukemic skin infiltrates.

Aged↗

Gastric choriocarcinoma and yolk sac tumor in a man: observations about its possible origin.

The case of a 65-year-old man who had a gastric tumor with components of choriocarcinoma and yolk sac tumor is presented. The presence of a small component of adenocarcinoma in the primary tumor and the absence of any gonadal or other primary tumor at autopsy confirm its origin. Despite the common association of embryonal and trophoblastic elements in gonadal tumors, this is the first case in which such an association was clearly depicted in the stomach. This and the usual coexistence of adenocarcinoma with choriocarcinoma in the stomach suggest the possibility of a different mode of development of these tumors in the two sites: forward differentiation of neoplastic germ cells in the gonads and retrodifferentiation (opisthoplasia) of neoplastic mucosal epithelial cells in the stomach.

Aged↗

Prostatic adenocarcinoma with carcinoidal features producing adrenocorticotropic syndrome. Immunohistochemical study and review of the literature.

An autopsy case of disseminated, military-type, composite adenocarcinoma and carcinoid tumor associated with adrenocorticotropic syndrome is discussed. Prostatic origin and functional activity were demonstrated by immunohistochemical techniques. Of interest in this case is that the tumor had the characteristics of amine precursor uptake and decarboxylation (APUD) cells and also kept the antigenicity of its prostatic origin. The APUD system perhaps should be considered as one form of functional differentiation of cells of different origin rather than an exclusive derivative of the neural crest.

ACTH Syndrome, Ectopic↗

Fluorescence of Pneumocystis carinii in Papanicolaou smears.

Pneumocystis carinii organisms can be identified in routine cytologic smears stained by the Papanicolaou method and viewed under ultraviolet light in a fluorescence microscope. The organisms can be identified easily in thin, well-preserved cytologic smears. No false-positive results were obtained when 55 Papanicolaou smears of bronchial washings were observed by this method. Twenty-three of these smears were from patients with Pneumocystic carinii pneumonia in whom the acquired immunodeficiency syndrome (AIDS) had been well documented with Gomori's methenamine silver stain. With this method no additional special stains are required, no time delay for special stains is involved, and no additional material for the preparation of extra smears for special stains is needed. An additional advantage is the possibility of the retrospective analysis of smears already stained by the Papanicolaou method.

Animals↗

Intracerebral arterial aneurysm in a newborn.

Angiographic diagnosis of an intracerebral aneurysm in a neonate was made on the 13th day of life following persistent neurological symptoms that began at birth. Rupture of the aneurysm probably occurred within the first day of life. This unusual condition should be considered in newborn infants with unexplained neurological signs or intracranial hemorrhage.

Female↗