In an experimental study in growing rabbits an endolaryngeal injury to the subglottis resulted in the development of a stenosis due to the formation of scar tissue containing ectopic cartilage. For ...comparison, biopsies taken from the subglottic stenosis in 8 children were studied histologically. In 6 cases ectopic cartilage was observed; all patients had a history of endotracheal intubation. In 3 children the diagnosis hamartoma was made. In the remaining 3 cases the formation of ectopic cartilage might have been a direct reaction to the endolaryngeal intubation. The observations suggest that the formation of ectopic cartilage in acquired subglottic stenosis is not always due to a developmental aberration such as a hamartoma.
In young rabbits (4-week-old) the growth of the subglottis was studied after an endolaryngeal soft tissue trauma. The injury induced the formation of a subglottic stenosis. In contrast to earlier ...observations on endolaryngeal trauma extending into the cricoid cartilage, the cricoid developed normally to the adult size and shape at 24 weeks. Similar to the earlier findings, the subepithelial layer showed considerable thickening as the result of formation of scar tissue, ectopic cartilage and fatty tissue with interruption of the elastic tunica (= conus elasticus). It was concluded that after endolaryngeal trauma in rabbits two types of subglottic stenosis can develop, determined by the depth of the injury.
The prognostic accuracy of 5 histological grading systems (Broders, Anderson, Mostofi, Gleason and Mostofi-Schroeder) was compared. Grading was performed on 50 prostatectomy specimens by 5 ...pathologists. The results were averaged so as to reduce the impact of inter-observer variation. The Cox proportional hazards model was used to estimate the relationship between average grading scores and both time-to-recurrence and time-to-death by prostatic carcinoma. Age at surgery was considered to be a possible confounding factor and adjusted accordingly. The prognostic impact of the 5 grading systems (related to both recurrence and death caused by prostatic carcinoma) was judged by the likelihood ratio (LR) test score (chi 2 distributed with 1 df); for time-to-recurrence for the Mostofi-Schroeder score the LR was 6.54 and for the Gleason system it was 1.79. A stepwise procedure demonstrated that the best prognostic performance was reached with the Mostofi-Schroeder and Broders systems used together (with Mostofi-Schroeder weighted 1.5 times larger than Broders). For time-to-recurrence the median grading result was also used, giving results similar to the mean grading result. For time-to-death from prostatic carcinoma the LR test scores for all grading systems were relatively low. In this analysis the outcome of the Gleason system showed a minimum of prognostic ability, whereas the Broders and Mostofi-Schroeder systems had a reasonable predictive ability. Since the inter-observer variation of the Mostofi-Schroeder system was large, the Broders system is preferable. The restrictions and implications of this study are discussed and a brief review of the prognostic importance of grading of prostatic carcinoma is presented.
In young rabbits the growth of the subglottis was studied over a period of 20 weeks after interruption of the circularity of the cricoid on the ventral side. In all cases the cricoid developed into a ...U-like structure which did not cause an airway narrowing. However, a cricoid lesion combined with an injury to the soft tissue lining led up to a subglottic stenosis. It was concluded that when the soft tissue layer is undamaged, an intact circular structure of the cricoid is not compulsory for the normal development of the subglottis.
In a previous study in growing rabbits it was demonstrated that after resection of a ventral part of the cricoid the lumen of the subglottic airway developed normal size during further growth up to ...the adult stage. Histologic investigations of these cases suggest that a subepithelial network of elastic fibres, ventrally suspended to the thyroid and the tracheal rings, ensures the airway lumen and prevents the development of a subglottic stenosis. Resection of a ventral part of the cricoid including the adjacent soft tissue lining of the airway causes an irreversible loss of the supporting elastic layer and the formation of scar tissue resulting in a stenosis. It was concluded that the larynx and trachea can be considered as an inner, elastic tube (= conus elasticus) lined with epithelium, suspended to an outer, segmented cartilaginous tube. At the level of the subglottis an intact conus elasticus is of more importance for the normal development of the airway lumen in young rabbits than an intact ventral half of the cricoid ring.
Seventeen patients with nonneoplastic osseous tumors in the soft tissues of the hands and feet were retrospectively studied. Three of the patients had a reliable history of trauma. Ten patients ...showed periosteal reaction associated with gradual formation of an osseous soft-tissue tumor, sometimes with a peripheral zone of bone density. Histologically (also radiographically), the lesions may be mistaken for malignant neoplasms such as osteosarcoma or parosteal osteosarcoma, especially when the pathologist does not receive representative material. In this series, malignancy was suspected in eight patients. Radiologic and pathologic criteria that may be helpful in the differential diagnosis of this lesion are presented. It is important that this nonneoplastic, benign, and self-limiting process in the hands and feet be recognized and treated accordingly. Local excision is adequate therapy in most cases, with little risk of local recurrence.
Tumoral calcinosis Geirnaerdt, M J; Kroon, H M; van der Heul, R O ...
Skeletal radiology,
02/1995, Letnik:
24, Številka:
2
Journal Article
Recenzirano
A patient with tumoral calcinosis involving the buttock and ischial bone is presented. Bone marrow involvement and a pattern of septal enhancement on MR imaging after intravenous administration of ...Gd-DTPA were very suggestive of a diagnosis of a chondro(sarco) matous musculoskeletal tumor. The absence of an underlying metabolic disorder, the appreciation of fluid-calcium levels within the lesion and knowledge of the macroscopic and microscopic appearance of this disorder have led to the correct diagnosis in this case.
Tumours of bones and joints Misdorp, W; Van der Heul, R O
Bulletin of the World Health Organization,
1976, Letnik:
53, Številka:
2-3
Journal Article
Recenzirano
Tumours of bones and joints are not infrequent in dogs but are rare in other domestic animals. In the dog, most bone tumours are malignant; osteosarcomas are by far the most frequently encountered ...tumours, especially in giant breeds and boxers. The following main categories of bone tumour are described: bone-forming, cartilage-forming, giant cell, marrow, vascular, miscellaneous, metastatic, unclassified, and tumour-like lesions. The tumours of joints and related structures are classified as synovial sarcomas, fibroxanthomas, and malignant giant cell tumour of soft tissues.
Six thymomas were classified histologically and studied immunohistochemically with a panel of mouse and rat monoclonal antibodies directed against thymic epithelial and lymphoid components. The ...antibodies included monoclonal antibodies directed against cytokeratin, medullary epithelial cells (ER-TR5), and HLA-DR and HLA-ABC antigens, as well as antibodies with specificity for thymocytes. Histologically, one thymoma was characterized by epithelial predominance (EP type), two showed lymphoid predominance (LP type), and two showed mixed lymphoid/epithelial composition (MLE type); one thymoma was a malignant pure epithelial thymoma (PE type). In the thymomas of the MLE and EP types the major populations of cells consisted of HLA-DR-negative, cytokeratin-positive epithelial cells with large ER-TR5-positive subpopulations (i.e., the phenotype of medullary epithelium). In the thymomas of the LP type, the neoplastic population was composed of cytokeratin-positive, ER-TR5-negative cells that expressed the HLA-DR antigen (i.e., the phenotype of cortical epithelium). The thymoma of the PE type consisted of cytokeratin-positive cells, some of which were ER-TR5- and HLA-DR-positive. Double immunofluorescence studies revealed the presence of varying numbers of additional nonepithelial (nonlymphoid) HLA-DR-positive cells in thymomas of the LP, MLE, and EP types. The intervening lymphoid population in the thymomas of the LP, MLE, and EP types consisted largely of cortical thymocytes, as defined by immunologic characterization. These results suggest that thymomas can be classified as medullary or cortical epithelial neoplasms on the basis of their immunologic phenotypes.
Lymphomas occurring in renal transplant recipients are mostly large cell non‐Hodgkin's lymphomas (B‐cell‐derived). A sarcoma with all morphologic, immunohistochemical, and ultrastructural ...characteristics of a tumor of the mononuclear phagocytic system (MPS) developed in a 23‐year‐old woman 1 year after renal transplantation. Anti‐Epstein‐Barr‐virus antibody titers proved to be exceptionally high, even in pretransplant sera. Tumor‐derived cells proved to be positive for Epstein‐Barr nuclear antigen (EBNA), and hybridization showed multiple copies of Epstein‐Barr virus (EBV)‐DNA, suggesting a relationship between this tumor and EBV. More widespread use of immunochemical and histochemical diagnostic techniques might detect more cases, which, until now, have probably been diagnosed as B‐cell‐derived immunoblastic lymphomas.
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