1/5. Conjunctival intraepithelial neoplasia presenting as corneal ulcer.PURPOSE: To report a case of conjunctival intraepithelial neoplasia presenting as corneal ulcer. METHOD: Case report of a 28-year-old man who presented with sudden onset of pain, redness, and watering in the right eye. Examination of right cornea revealed deep stromal infiltrate inferonasally. Adjacent to the infiltrate and straddling the inferonasal limbus, a reddish well-defined sessible lesion with prominent blood vessels was seen. After corneal scraping for microbiological evaluation, the patient was treated with frequent instillation of ciprofloxacin hydrochloride 0.3% eyedrops. RESULTS: Corneal scraping revealed no microorganisms. Infiltrate resolved promptly after excision of the lesion. Histopathologic evaluation of the excised lesion revealed conjunctival intraepithelial neoplasia. CONCLUSIONS: This case highlights the fact that conjunctival intraepithelial neoplasia at the limbus may present as corneal ulcer. This ulcer could have occurred secondary to a dellen formation and epithelial breakdown predisposing to a corneal ulcer.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. Multinucleated spermatogonia in cryptorchid boys: a possible association with an increased risk of testicular malignancy later in life?At birth, undescended testes contain germ cells, but after 1 year of life, a reduced number of germ cells is generally found. Microlithiasis and carcinoma-in-situ-testis occur in cryptorchid boys. Multinucleated germ cells, including at least 3 nuclei in the cell, exist in impaired spermatogenesis and in the senescent testis. AIM OF THE STUDY: We investigated whether multinucleated spermatogonia were present in undescended testes of cryptorchid boys, and if such a pattern is associated with special clinical features. RESULTS: Multinucleated spermatogonia occurred in 13/168 (8%) of 163 consecutive cryptorchid boys, who underwent surgery for cryptorchidism with simultaneous testicular biopsy showing seminiferous tubules. The patients with multinucleated spermatogonia more often exhibited a normal germ cell number (Fisher's exact test, p<0.0005), and were younger at surgery (Mann Whitney, p<0.005) than the rest of the patients. Before surgery, 3 patients underwent treatment with erythropoietin because of renal failure. An intra-abdominal testis underwent clipping and division of the spermatic vessels, and a biopsy at final surgery 7 months later, exhibited multinucleated spermatogonia. In 1 case the undescended testicular position, a fixed retraction, was acquired after surgery for an inguinal hernia. Multinucleated spermatogonia were found in cases of carcinoma-in situ-testis in 2 cryptorchid boys. No case of multinucleated germ cells appeared in our normal material. CONCLUSION: Multinucleated spermatogonia are a further abnormality present in cryptorchidism. The cryptorchid boys with multinucleated spermatogonia in general exhibited rather many germ cells. This feature may be associated with an increased risk of testicular malignancy later in life, and we propose a careful follow up regime in these cases including ultrasound examination and a testicular biopsy in cases of symptoms or clinical findings.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. The significance of atypical vessels and neovascularization in cervical neoplasia.The relationship between atypical vessels seen colposcopically and dysplasia, carcinoma in situ (CIS), microinvasion, and frank invasion was studied quantitatively. No atypical vessels were found with dysplasia, but 2.8% of patients with CIS had atypical vessels. Half of the patients with microinvasion and all of the patients with frank invasion, in whom the entire zone of transformation was viewed, had atypical vessels. Eight-two percent of the patients with atypical vessels had invasion. The conclusions are: (1) Atypical vessels are not present with dysplasia and rarely present with CIS. (2) Atypical vessels may be associated with microinvasion, but are required for frank invasion to occur. (3) Because atypical vessels are usually associated with invasion, which can be in or near the field of atypical vessels, diagnosis cone biopsy should be performed if atypical vessels are seen and colposcopic biopsies do not show frank invasion. (4) Microinvasion without atypical vessels may be a localized disease.- - - - - - - - - - ranking = 15keywords = vessel (Clic here for more details about this article) |
4/5. Carcinoma of the larynx. growth, p-classification and grading of squamous cell carcinoma of the vocal cords.For this investigation on growth, p-classification and grading of squamous cell carcinomas of the vocal cord serial sectioning was applied to 108 specimens (58 partially and 50 totally extirpated larynges) of vocal cord cancers that had not previously been treated otherwise. The evaluation of these serial sections showed that frequently recurring patterns of the spread of carcinomas can be recognized which may be subdivided as follows: (1) carcinoma in situ and early carcinomas of the vocal cord (microinvasive or minimal invasive carcinomas) originate from the strip of squamous cell epithelium covering the vocal cord mostly on its subglottic part. There are circumscribed as well as diffuse types, the latter mostly spreading subglottically, too. (2) Similar to the early vocal cord carcinomas the larger ones mostly expand in the subglottic direction. These glotto-subglottic tumours also follow the metaplastic areas of squamous cell epithelium caudally; they often infiltrate deeply, affect the cricoid and the thyroid cartilage and leave finally the larynx dorsolaterally. They metastasize to the deep cervical and paratracheal lymph nodes. (3) Less frequently larger carcinomas develop in the upper half of the vocal cord epithelium at the floor of the ventricle and extend cranially. These 'ventricle carcinomas' do not spread widely on the surface, but at once infiltrate deeply lateralcaudally into the paraglottic space and - in extreme cases - grow intramurally circularly. They often penetrate the laryngeal framework and metastasize mainly to the deep cervical lymph nodes. (4) Transglottic tumours ('multiregional' vocal cord carcinomas) represent a kind of 'pool' for advanced vocal cord carcinomas having expanded in different directions (sub- and supraglottically). In extensive cancerized fields they can also arise multicentrically. They frequently penetrate the laryngeal framework and metastasize to the deep cervical and paratracheal lymph nodes. The investigation of the growth of vocal cord carcinomas proved different modes of invasion of the various anatomical structures of the larynx. The submucosa or the so-called compartments do not resist the tumour growth, muscles are destroyed with increasing infiltration; tumours quickly spread in the relatively loose tissue and use vessels and nerves as pathways. The ossified parts of the hyaline laryngeal framework are infiltrated comparatively easily whereas non-ossified parts, together with ciliated epithelium, and mucous glands represent a kind of barrier against tumour growth.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/5. Superficial carcinoma of the esophagus coexisting with esophageal leiomyoma: a case report and review of the Japanese literature.A case of superficial spreading squamous cell carcinoma located just over a leiomyoma is presented. The patient complained of slight dysphagia and an esophagogram showed an elevated tumor in the middle thoracic esophagus. esophagoscopy revealed an ulcerative mucosal lesion over the elevated lesion and biopsy showed that the lesion was a squamous cell carcinoma. Blunt dissection of the esophagus with esophago-gastro-anastomosis was performed. There was neither lymph vessel invasion nor lymph node metastasis. His post-operative recovery was satisfactory and he is doing well two years after the operation. A review of the Japanese and English literature revealed that a few cases of esophageal carcinoma coexisting with esophageal leiomyoma have been reported. There was no report of superficial esophageal carcinoma coexisting with esophageal leiomyoma. This is the first report of the coexistence of these two lesions, and esophagoscopy is necessary to find a superficial esophageal carcinoma coexisting with esophageal leiomyoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |