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Robboy, Stanley J.

Overview:

My research program, largely histopathological, concerns definitions of criteria, biological properties, differential diagnosis, and survival associated with pathological lesions in the female genital tract. With the gynecologic oncologists at Duke, we have reviewed the Institution's long term experience of endometrial cancer and with the International Collaborative Group on Endometrium, we have developed a new classification system for endometrial hyperplasia that better differentiates precancerous from benign lesions. In a nationwide NIH study in which I head the pathology review, long term complications in both sons and daughters from prenatal exposure to DES are being assessed. A major initiative is a study of vulvar dermatoses and unusual vulvar neoplasms. A final clinical pathologic correlation study, ongoing for over 40 years, has been the long term follow-up of a very rare tumor (malignant struma ovarii). Long term study has been required to identify those features that will ultimately prove to be of biologic significance for defining cases which will likely recur.

Positions:

Professor of Pathology

Pathology
School of Medicine

Professor of Obstetrics and Gynecology

Obstetrics and Gynecology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Vice-chair for Diagnostic Pathology in the Department of Pathology

Pathology
School of Medicine

Education:

M.D. 1965

M.D. — University of Michigan at Ann Arbor

Intern, Pathology

Mount Sinai School of Medicine

Chief Resident, Pathology

Massachusetts General Hospital

Instructor, Pathology

Tufts University

Assistant Professor, Pathology

Harvard University

Associate Professor, Pathology

Harvard University

Professor, Pathology

University of Medicine and Dentistry of New Jersey

Grants:

Molecular Epidemiology Of Epithelial Ovarian Cancer

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
June 17, 1994
End Date
May 31, 1996

Publications:

Prenatal diethylstilbestrol exposure and high-grade squamous cell neoplasia of the lower genital tract.

Prenatal diethylstilbestrol (DES) exposure is associated with an excess risk of clear-cell adenocarcinoma of the vagina and cervix, and of high-grade squamous neoplasia.We explored whether neoplasia risk remains elevated among DES-exposed women as they age.In all, 4062 DES-exposed and 1837 unexposed daughters were followed for approximately 30 years (1982 through 2013) for pathology-confirmed diagnoses of cervical intraepithelial neoplasia grade ≥2 (CIN2+) of the lower genital tract (n = 178). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated adjusting for birth year and individual study cohort.The cumulative incidence of CIN2+ in the DES-exposed group was 5.3% (95% CI, 4.1-6.5%) and in the unexposed group was 2.6% (95% CI, 1.5-3.7%). The HR for DES and CIN2+ was 1.98 (95% CI, 1.33-2.94), and was similar with further adjustment for frequency of cervical cancer screening (HR, 1.97; 95% CI, 1.33-2.93). The HR was 2.10 (95% CI, 1.41-3.13) with additional adjustment for other potential confounders. The HR for DES exposure was elevated through age 44 years (age <45 years HR, 2.47; 95% CI, 1.55-3.94), but not in women age ≥45 years (HR, 0.91; 95% CI, 0.39-2.10). In exposed women, HRs for DES were 1.74 (95% CI, 1.09-2.79) among those who had earlier evidence of vaginal epithelial changes (VEC), presumably reflecting glandular epithelium undergoing transformation to normal, adult-type squamous epithelium, and 1.24 (95% CI, 0.75-2.06) among those without VEC, compared with unexposed women. The HRs for DES and CIN2+ were higher among women with earlier intrauterine exposure (HR, 2.64; 95% CI, 1.64-4.25 for <8 weeks' gestation and HR, 1.41; 0.88-2.25 for ≥8 weeks' gestation), and lowest when exposure began >15th week (HR, 1.14; 95% CI, 0.59-2.20).CIN2+ incidence was higher among the DES exposed, particularly those with early gestational exposure and VEC. The HR for DES and CIN2+ remained positive and significant until the mid-40s, confirming that the recommendation of annual cytological screening among these women is appropriate. Whether those ≥45 years of age continue to require increased screening is unclear, and would require a careful weighing of possible risks and benefits.

Authors
Troisi, R; Hatch, EE; Palmer, JR; Titus, L; Robboy, SJ; Strohsnitter, WC; Herbst, AL; Adam, E; Hyer, M; Hoover, RN
MLA Citation
Troisi, R, Hatch, EE, Palmer, JR, Titus, L, Robboy, SJ, Strohsnitter, WC, Herbst, AL, Adam, E, Hyer, M, and Hoover, RN. "Prenatal diethylstilbestrol exposure and high-grade squamous cell neoplasia of the lower genital tract." American journal of obstetrics and gynecology 215.3 (September 2016): 322.e1-322.e8.
PMID
26979629
Source
epmc
Published In
American Journal of Obstetrics & Gynecology
Volume
215
Issue
3
Publish Date
2016
Start Page
322.e1
End Page
322.e8
DOI
10.1016/j.ajog.2016.03.007

Invasive hydatidiform mole of the lung with an implantation site intermediate trophoblast: Report of a case supporting the pathways of trophoblast differentiation.

Authors
Yoo, SH; Kim, K-R; Robboy, SJ
MLA Citation
Yoo, SH, Kim, K-R, and Robboy, SJ. "Invasive hydatidiform mole of the lung with an implantation site intermediate trophoblast: Report of a case supporting the pathways of trophoblast differentiation." Pathology international 66.7 (July 2016): 413-414.
Website
http://hdl.handle.net/10161/12056
PMID
27126877
Source
epmc
Published In
Pathology International
Volume
66
Issue
7
Publish Date
2016
Start Page
413
End Page
414
DOI
10.1111/pin.12415

Diagnostic Significance of Simple Nonatrophic Glands in the Interpretation of Endometrium after Progestin Treatment in Patients with Endometrial Intraepithelial Neoplasia and Endometrioid Adenocarcinoma in Young Women

Authors
Kim, K-R; Yoo, SH; Robboy, SJ
MLA Citation
Kim, K-R, Yoo, SH, and Robboy, SJ. "Diagnostic Significance of Simple Nonatrophic Glands in the Interpretation of Endometrium after Progestin Treatment in Patients with Endometrial Intraepithelial Neoplasia and Endometrioid Adenocarcinoma in Young Women." February 2016.
Source
wos-lite
Published In
Laboratory Investigation
Volume
96
Publish Date
2016
Start Page
292A
End Page
292A

Diagnostic Significance of Simple Nonatrophic Glands in the Interpretation of Endometrium after Progestin Treatment in Patients with Endometrial Intraepithelial Neoplasia and Endometrioid Adenocarcinoma in Young Women

Authors
Kim, K-R; Yoo, SH; Robboy, SJ
MLA Citation
Kim, K-R, Yoo, SH, and Robboy, SJ. "Diagnostic Significance of Simple Nonatrophic Glands in the Interpretation of Endometrium after Progestin Treatment in Patients with Endometrial Intraepithelial Neoplasia and Endometrioid Adenocarcinoma in Young Women." February 2016.
Source
wos-lite
Published In
Modern Pathology
Volume
29
Publish Date
2016
Start Page
292A
End Page
292A

The Pathologist Workforce in the United States: II. An Interactive Modeling Tool for Analyzing Future Qualitative and Quantitative Staffing Demands for Services.

Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams.To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services.Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts.Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value.Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.

Authors
Robboy, SJ; Gupta, S; Crawford, JM; Cohen, MB; Karcher, DS; Leonard, DGB; Magnani, B; Novis, DA; Prystowsky, MB; Powell, SZ; Gross, DJ; Black-Schaffer, WS
MLA Citation
Robboy, SJ, Gupta, S, Crawford, JM, Cohen, MB, Karcher, DS, Leonard, DGB, Magnani, B, Novis, DA, Prystowsky, MB, Powell, SZ, Gross, DJ, and Black-Schaffer, WS. "The Pathologist Workforce in the United States: II. An Interactive Modeling Tool for Analyzing Future Qualitative and Quantitative Staffing Demands for Services." Archives of pathology & laboratory medicine 139.11 (November 2015): 1413-1430.
PMID
26516939
Source
epmc
Published In
Archives of Pathology and Laboratory Medicine
Volume
139
Issue
11
Publish Date
2015
Start Page
1413
End Page
1430
DOI
10.5858/arpa.2014-0559-oa

Factors associated with a lack of pap smear utilization in women exposed in utero to diethylstilbestrol.

Women in the 1940s-1960s were prescribed diethylstilbestrol (DES), a nonsteroidal estrogen, to prevent miscarriages, but the practice was terminated after it was discovered that the daughters so exposed in utero were at increased risk for developing clear cell adenocarcinoma (CCA) of the vagina or cervix at early ages. Pap smear screening is one of the principal methods used to identify tumor development and is necessary in this group of women to maintain their health. Currently, little is known about the factors associated with nonutilization of this screening tool in this high-risk population of women.National cohort data from the National Cancer Institute (NCI) DES Combined Cohort Follow-up Study during 1994, 1997, 2001, and 2006 were used to determine which factors were associated with Pap smear screening nonutilization in 2006 among DES-exposed and unexposed women. Self-reported questionnaire data from 2,861 DES-exposed and 1,027 unexposed women were analyzed using binary logistic regression models.DES exposure, not having a previous gynecologic dysplasia diagnosis, lack of insurance, originating cohort, increasing age, and previous screening behavior were all factors associated with not reporting a Pap smear examination in the 2006 questionnaire, although college education reduced nonutilization.Understanding which factors are associated with not acquiring a screening exam can help clinicians better identify which DES-exposed women are at risk for nonutilization and possibly tailor their standard of care to aid in the early detection of cervical and vaginal adenocarcinomas in this high-risk group.

Authors
Camp, EA; Prehn, AW; Shen, J; Herbst, AL; Strohsnitter, WC; Hobday, CD; Robboy, SJ; Adam, E
MLA Citation
Camp, EA, Prehn, AW, Shen, J, Herbst, AL, Strohsnitter, WC, Hobday, CD, Robboy, SJ, and Adam, E. "Factors associated with a lack of pap smear utilization in women exposed in utero to diethylstilbestrol." Journal of women's health (2002) 24.4 (April 2015): 308-315.
PMID
25768943
Source
epmc
Published In
Journal of Women's Health
Volume
24
Issue
4
Publish Date
2015
Start Page
308
End Page
315
DOI
10.1089/jwh.2014.4930

Organizing disparate, seemingly chaotic data into a meaningful and useful order.

Authors
Robboy, S
MLA Citation
Robboy, S. "Organizing disparate, seemingly chaotic data into a meaningful and useful order." Archives of pathology & laboratory medicine 139.2 (February 2015): 159-.
PMID
25611096
Source
epmc
Published In
Archives of Pathology and Laboratory Medicine
Volume
139
Issue
2
Publish Date
2015
Start Page
159
DOI
10.5858/arpa.2013-0648-ed

Defective pericyte recruitment of villous stromal vessels as the possible etiologic cause of hydropic change in complete hydatidiform mole.

The pathogenetic mechanism underlying the hydropic change in complete hydatidiform moles (CHMs) is poorly understood. A growing body of data suggests that pericytes play a role in vascular maturation. Since maturation of villous stromal vessels in CHMs is markedly impaired at early stages, we postulated that a defect in pericytes around stromal vessels in chorionic villi might cause vascular immaturity and subsequent hydropic change. To investigate this, we examined several markers of pericytes, namely, α-smooth muscle actin (α-SMA), platelet-derived growth factor receptor-β (PDGFR-β), and desmin, in 61 normally developing placentas and 41 CHMs with gestational ages of 4-12 weeks. The ultrastructure of villous stromal vessels was also examined. Mature blood vessels from normal placentas show patent vascular lumens and formed hematopoietic components in the villous stroma. α-SMA and PDGFR-β expression in the villous stroma gradually increased and extended from the chorionic plate to peripheral villous branches. The labeled cells formed a reticular network in the villous stroma and, after week 7, encircled villous stromal vessels. In comparison, α-SMA and PDGFR-β expression in the villous stroma and stromal vessels of CHMs was significantly lower (p<0.05). Ultrastructurally, endothelial cells in villous stromal vessels in normal placentas were consistently attached by pericytes after week 7 when the vessels formed distinct lumen, whereas the villous stromal vessels in CHMs consisted of linear chains of endothelial cells, often disclosing primitive clefts without hematopoietic cells inside, and neither pericytes nor basal lamina surrounded the endothelial cells at any gestational age studied. This suggests that pericytes recruitment around villous stromal vessels is defective in CHMs and links to the persistent vascular immaturity of the villous stroma in CHMs, which in turns leads to hydropic villi.

Authors
Kim, KR; Sung, CO; Kwon, TJ; Lee, J; Robboy, SJ
MLA Citation
Kim, KR, Sung, CO, Kwon, TJ, Lee, J, and Robboy, SJ. "Defective pericyte recruitment of villous stromal vessels as the possible etiologic cause of hydropic change in complete hydatidiform mole." PloS one 10.4 (January 2015): e0122266-.
PMID
25849742
Source
epmc
Published In
PloS one
Volume
10
Issue
4
Publish Date
2015
Start Page
e0122266
DOI
10.1371/journal.pone.0122266

Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply.

CONTEXT: Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. OBJECTIVE: To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists' services through 2030. DESIGN: Data came from various sources, including the literature, College of American Pathologists' internal data, and primary research through custom-developed surveys for the membership and for pathology practice managers RESULTS: Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precipitously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents. CONCLUSIONS: This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging population, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions. We believe a pathologist shortage will negatively impact both patient access to laboratory services and health care providers' abilities to deliver more effective health care to their patient populations.

Authors
Robboy, SJ; Weintraub, S; Horvath, AE; Jensen, BW; Alexander, CB; Fody, EP; Crawford, JM; Clark, JR; Cantor-Weinberg, J; Joshi, MG; Cohen, MB; Prystowsky, MB; Bean, SM; Gupta, S; Powell, SZ; Speights, VO; Gross, DJ; Black-Schaffer, WS
MLA Citation
Robboy, SJ, Weintraub, S, Horvath, AE, Jensen, BW, Alexander, CB, Fody, EP, Crawford, JM, Clark, JR, Cantor-Weinberg, J, Joshi, MG, Cohen, MB, Prystowsky, MB, Bean, SM, Gupta, S, Powell, SZ, Speights, VO, Gross, DJ, and Black-Schaffer, WS. "Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply." Arch Pathol Lab Med 137.12 (December 2013): 1723-1732.
PMID
23738764
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
137
Issue
12
Publish Date
2013
Start Page
1723
End Page
1732
DOI
10.5858/arpa.2013-0200-OA

Prognostic value of the diagnostic criteria distinguishing endometrial stromal sarcoma, low grade from undifferentiated endometrial sarcoma, 2 entities within the invasive endometrial stromal neoplasia family.

The World Health Organization (WHO 2003) recognizes 3 endometrial stromal neoplasms: noninvasive endometrial stromal nodule and the 2 invasive neoplasms, endometrial stromal sarcoma (ESS), low grade and undifferentiated endometrial sarcoma (UES). It is important to note that the WHO 2003 does not define moderate atypia (an important differentiating diagnostic criterion for ESS, low grade and UES), nor does it discuss its significance. Moreover, studies on reproducibility and additional prognostic value of other diagnostic features in large are lacking. Using strict definitions, we analyzed the agreement between routine and expert-review necrosis and nuclear atypia in 91 invasive endometrial stromal neoplasias (IESN). The overall 5-year and 10-year recurrence-free survival rate estimates of the 91 IESN patients were 82% and 75%, respectively. Necrosis was well reproducible, and nuclear atypia was reasonably well reproducible. The 10-year recurrence-free survival rates for necrosis absent/inconspicuous versus prominent were 89% and 45% (P<0.001) and those for review-confirmed none/mild, moderate, severe atypia were 90%, 30%, and <20% (P<0.00001). Therefore, cases with moderate/severe atypia should be grouped together. Nuclear atypia and necrosis had independent prognostic values (Cox regression). Once these features were taken into account, no other feature had an independent additional prognostic value, including mitotic count. Using "none/mild atypia, necrosis absent/inconspicuous" as ESS, low grade versus "moderate/severe atypia present or necrosis present" as UES resulted in 68 ESS, low grade and 23 UES cases with disease-specific overall mortality-free survival of 99% versus 48% (P<0.00001, hazard ratio=45.4). When strictly defined microscopic criteria are used, the WHO 2003 diagnoses of ESS, low grade and UES are well reproducible and prognostically strong.

Authors
Feng, W; Malpica, A; Robboy, SJ; Gudlaugsson, E; Hua, K; Zhou, X; Baak, JPA
MLA Citation
Feng, W, Malpica, A, Robboy, SJ, Gudlaugsson, E, Hua, K, Zhou, X, and Baak, JPA. "Prognostic value of the diagnostic criteria distinguishing endometrial stromal sarcoma, low grade from undifferentiated endometrial sarcoma, 2 entities within the invasive endometrial stromal neoplasia family." Int J Gynecol Pathol 32.3 (May 2013): 299-306.
PMID
23545579
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
32
Issue
3
Publish Date
2013
Start Page
299
End Page
306
DOI
10.1097/PGP.0b013e318229adfb

Prognostic Value of the Diagnostic Criteria Distinguishing Endometrial Stromal Sarcoma, Low Grade From Undifferentiated Endometrial Sarcoma, 2 Entities Within the Invasive Endometrial Stromal Neoplasia Family

Authors
Feng, W; Malpica, A; Robboy, SJ; Gudlaugsson, E; Hua, K; Zhou, X; Baak, JPA
MLA Citation
Feng, W, Malpica, A, Robboy, SJ, Gudlaugsson, E, Hua, K, Zhou, X, and Baak, JPA. "Prognostic Value of the Diagnostic Criteria Distinguishing Endometrial Stromal Sarcoma, Low Grade From Undifferentiated Endometrial Sarcoma, 2 Entities Within the Invasive Endometrial Stromal Neoplasia Family." INTERNATIONAL JOURNAL OF GYNECOLOGICAL PATHOLOGY 32.3 (May 2013): 299-306.
Source
wos-lite
Published In
International Journal of Gynecological Pathology
Volume
32
Issue
3
Publish Date
2013
Start Page
299
End Page
306
DOI
10.1097/PGP.0b013e318229adfb

Vulvar vascular tumors: a clinicopathologic study of 85 patients.

The subepidermal hormonally sensitive tissue of the vulva is anatomically unique and may give rise to a wide variety of vascular tumors. As a consequence, classifying vulvar vascular lesions has been challenging due both to the wide variety of lesions that may be encountered and the heterogeneity in reporting across several disciplines. The purpose of this study is to present an institutional experience of vulvar vascular lesions. Overall, 85 patients were identified over a 26-year period. Vascular lesions belonging to the following classes included (n, %total) benign vascular tumors (32, 38%), dilatations of preexisting vessels (31, 36%), hyperplasia/reactive (7, 8%), tumors with significant vascular component (11, 13%), malformations (3, 4%), and malignant vascular tumors (1, 1%). Two reaction patterns based on vulvar lymphatic pathology were identified: one is a stromal dominant pattern and the other is a vascular dominant pattern. Vulvar vascular malformations and true vascular malignancies, although rare, may have associated high morbidity. To accurately classify vulvar lymphatic lesions, the pathologist must carefully consider the patient's clinical history taking into account features such as preexisting lymphedema.

Authors
Papalas, JA; Sangueza, OP; Puri, PK; Robboy, SJ; Selim, MA
MLA Citation
Papalas, JA, Sangueza, OP, Puri, PK, Robboy, SJ, and Selim, MA. "Vulvar vascular tumors: a clinicopathologic study of 85 patients." Am J Dermatopathol 35.1 (February 2013): 1-7.
PMID
23348141
Source
pubmed
Published In
American Journal of Dermatopathology
Volume
35
Issue
1
Publish Date
2013
Start Page
1
End Page
7
DOI
10.1097/DAD.0b013e31823135c5

The natural history of uterine leiomyomas: light and electron microscopic studies of fibroid phases, interstitial ischemia, inanosis, and reclamation.

We propose, and offer evidence to support, the concept that many uterine leiomyomas pursue a self-limited life cycle. This cycle can be arbitrarily divided on the basis of morphologic assessment of the collagen content into 4 phases: (1) proliferation, (2) proliferation and synthesis of collagen, (3) proliferation, synthesis of collagen, and early senescence, and (4) involution. Involution occurs as a result of both vascular and interstitial ischemia. Interstitial ischemia is the consequence of the excessive elaboration of collagen, resulting in reduced microvascular density, increased distance between myocytes and capillaries, nutritional deprivation, and myocyte atrophy. The end stage of this process is an involuted tumor with a predominance of collagen, little to no proliferative activity, myocyte atrophy, and myocyte cell death. Since many of the dying cells exhibit light microscopic and ultrastructural features that appear distinct from either necrosis or apoptosis, we refer to this process as inanosis, because it appears that nutritional deprivation, or inanition, is the underlying cause of cell death. The disposal of myocytes dying by inanosis also differs in that there is no phagocytic reaction, but rather an apparent dissolution of the cell, which might be viewed as a process of reclamation as the molecular contents are reclaimed and recycled.

Authors
Flake, GP; Moore, AB; Sutton, D; Kissling, GE; Horton, J; Wicker, B; Walmer, D; Robboy, SJ; Dixon, D
MLA Citation
Flake, GP, Moore, AB, Sutton, D, Kissling, GE, Horton, J, Wicker, B, Walmer, D, Robboy, SJ, and Dixon, D. "The natural history of uterine leiomyomas: light and electron microscopic studies of fibroid phases, interstitial ischemia, inanosis, and reclamation." Obstet Gynecol Int 2013 (2013): 528376-.
PMID
24348569
Source
pubmed
Published In
Obstetrics and Gynecology International
Volume
2013
Publish Date
2013
Start Page
528376
DOI
10.1155/2013/528376

Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade?

An estimated 1500-3000 invasive Endometrial Stromal Sarcomas (ESS) cases annually occur worldwide. Before 2003, ESS was divided as low and high grade ESS based on mitotic activity. In 2003 the WHO changed the names, excluded mitoses and made nuclear atypia and necrosis the essential diagnostic criteria to distinguish ESS, Low Grade (ESS-LG, recurrence-free survival >90%) and Undifferentiated Endometrial Sarcoma (UES, poor prognosis). We have evaluated in WHO2003 defined ESS-LG whether proliferation biomarkers predict recurrence. Using survival analysis, the prognostic value of classical mitosis counts (Mitotic Activity Index, MAI) in haematoxyllin-eosin (H&E) sections, and immunohistochemical proliferation biomarkers (Ki-67 and PhosphoHistone-3 (PPH3)) were examined in 24 invasive endometrial stromal sarcomas. Three of 24 (12.5%) ESS-LG recurred. The MAI, PPH3 and Ki-67 were all prognostic (P = 0.001, 0.002 and 0.03). MAI values were >3 in the recurrent cases, but never exceeded 10 (the classical threshold for low and high grade). Non-recurrent cases had 0 ≤ MAI ≤ 3. PPH3 and Ki67 counts can be easier to perform than MAI and therefore helpful in the diagnosis of ESS, Low Grade. In conclusion, in this small study of WHO2003 defined ESS-LG, high levels of proliferation as measured by MAI, PPH3 and Ki-67 are predictive of recurrence. Larger studies are required to confirm these results.

Authors
Feng, W; Malpica, A; Skaland, I; Gudlaugsson, E; Robboy, SJ; Dalen, I; Hua, K; Zhou, X; Baak, JPA
MLA Citation
Feng, W, Malpica, A, Skaland, I, Gudlaugsson, E, Robboy, SJ, Dalen, I, Hua, K, Zhou, X, and Baak, JPA. "Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade? (Published online)." PLoS One 8.10 (2013): e75899-.
PMID
24146786
Source
pubmed
Published In
PloS one
Volume
8
Issue
10
Publish Date
2013
Start Page
e75899
DOI
10.1371/journal.pone.0075899

The natural history of uterine leiomyomas: morphometric concordance with concepts of interstitial ischemia and inanosis.

Based upon our morphologic observations, we hypothesize and also provide morphometric evidence for the occurrence of progressive developmental changes in many uterine fibroids, which can be arbitrarily divided into 4 phases. These developmental phases are related to the ongoing production of extracellular collagenous matrix, which eventually exceeds the degree of angiogenesis, resulting in the progressive separation of myocytes from their blood supply and a condition of interstitial ischemia. The consequence of this process of slow ischemia with nutritional and oxygen deprivation is a progressive myocyte atrophy (or inanition), culminating in cell death, a process that we refer to as inanosis. The studies presented here provide quantitative and semiquantitative evidence to support the concept of the declining proliferative activity as the collagenous matrix increases and the microvascular density decreases.

Authors
Flake, GP; Moore, AB; Flagler, N; Wicker, B; Clayton, N; Kissling, GE; Robboy, SJ; Dixon, D
MLA Citation
Flake, GP, Moore, AB, Flagler, N, Wicker, B, Clayton, N, Kissling, GE, Robboy, SJ, and Dixon, D. "The natural history of uterine leiomyomas: morphometric concordance with concepts of interstitial ischemia and inanosis." Obstet Gynecol Int 2013 (2013): 285103-.
PMID
24198832
Source
pubmed
Published In
Obstetrics and Gynecology International
Volume
2013
Publish Date
2013
Start Page
285103
DOI
10.1155/2013/285103

Vagina

Authors
Bean, SM; Veras, E; Bentley, RC; Robboy, SJ
MLA Citation
Bean, SM, Veras, E, Bentley, RC, and Robboy, SJ. "Vagina." Histology for Pathologists: Fourth Edition. July 16, 2012.
Source
scopus
Publish Date
2012

Prognostic value of the diagnostic criteria distinguishing endometrial stromal sarcoma, low grade from undifferentiated endometrial sarcoma, 2 entities within the invasive endometrial stromal neoplasia family

The World Health Organization (WHO 2003) recognizes 3 endometrial stromal neoplasms: noninvasive endometrial stromal nodule and the 2 invasive neoplasms, endometrial stromal sarcoma (ESS), low grade and undifferentiated endometrial sarcoma (UES). It is important to note that the WHO 2003 does not define moderate atypia (an important differentiating diagnostic criterion for ESS, low grade and UES), nor does it discuss its significance. Moreover, studies on reproducibility and additional prognostic value of other diagnostic features in large are lacking. Using strict definitions, we analyzed the agreement between routine and expert-review necrosis and nuclear atypia in 91 invasive endometrial stromal neoplasias (IESN). The overall 5-year and 10-year recurrence-free survival rate estimates of the 91 IESN patients were 82% and 75%, respectively. Necrosis was well reproducible, and nuclear atypia was reasonably well reproducible. The 10-year recurrence-free survival rates for necrosis absent/inconspicuous versus prominent were 89% and 45% (P<0.001) and those for review-confirmed none/mild, moderate, severe atypia were 90%, 30%, and <20% (P<0.00001). Therefore, cases with moderate/severe atypia should be grouped together. Nuclear atypia and necrosis had independent prognostic values (Cox regression). Once these features were taken into account, no other feature had an independent additional prognostic value, including mitotic count. Using "none/mild atypia, necrosis absent/inconspicuous" as ESS, low grade versus "moderate/severe atypia present or necrosis present" as UES resulted in 68 ESS, low grade and 23 UES cases with disease-specific overall mortality-free survival of 99% versus 48% (P<0.00001, hazard ratio=45.4). When strictly defined microscopic criteria are used, the WHO 2003 diagnoses of ESS, low grade and UES are well reproducible and prognostically strong. © 2012 International Society of Gynecological Pathologists.

Authors
Feng, W; Malpica, A; Robboy, SJ; Gudlaugsson, E; Hua, K; Zhou, X; Baak, JPA
MLA Citation
Feng, W, Malpica, A, Robboy, SJ, Gudlaugsson, E, Hua, K, Zhou, X, and Baak, JPA. "Prognostic value of the diagnostic criteria distinguishing endometrial stromal sarcoma, low grade from undifferentiated endometrial sarcoma, 2 entities within the invasive endometrial stromal neoplasia family." International Journal of Gynecological Pathology 31.2 (March 1, 2012): 151-158. (Review)
Website
http://hdl.handle.net/10161/12058
Source
scopus
Published In
International Journal of Gynecological Pathology
Volume
31
Issue
2
Publish Date
2012
Start Page
151
End Page
158
DOI
10.1097/PGP.0b013e318229adfb

Malignant struma ovarii: a blinded study of 86 cases assessing which histologic features correlate with aggressive clinical behavior.

CONTEXT: Struma ovarii exhibiting malignant histology are uncommon, and an aggressive clinical course in the form of initial extraovarian spread or recurrence is even more exceptional for these tumors. OBJECTIVE: To determine whether specific histologic features have predictive value in distinguishing clinically benign from clinically malignant struma ovarii. DESIGN: Blinded analysis of 19 histologic characteristics of thyroid tumors was performed in 60 clinically benign and 26 clinically malignant struma ovarii cases, with long-term follow-up. RESULTS: Except for lack of fibrosis and macrofollicular pattern, which were more common in biologically malignant tumors (P  =  .04 and P  =  .008, respectively), and trabecular pattern, which was associated with a benign clinical course (P  =  .03), none of the other histologic features was found to be correlated with clinical behavior. The presence of the following features was similar in the biologically benign and malignant tumors: papillae, pseudo-papillae, psammoma bodies, nuclear grooves, nuclear overlap, "orphan Annie" nuclei, nuclear pseudo-inclusions, prominent nucleoli, hypercellularity, colloid scalloping, eosinophilic cytoplasm, mitoses, vascular invasion, cytologic atypia, nuclear pleomorphism, and cell size and type. Trabecular pattern and absence of fibrosis were uncommon, and there was considerable overlap of macrofollicular pattern ratio between benign and malignant cases. Thus, their practical usefulness is uncertain. CONCLUSIONS: The clinical outcome of struma ovarii cannot be predicted based on the microscopic diagnosis of the thyroid tissue or on specific histologic features. The lack of correlation between morphology and outcome in proliferative and histologically malignant struma ovarii is striking, making the behavior of these tumors particularly unpredictable.

Authors
Shaco-Levy, R; Peng, RY; Snyder, MJ; Osmond, GW; Veras, E; Bean, SM; Bentley, RC; Robboy, SJ
MLA Citation
Shaco-Levy, R, Peng, RY, Snyder, MJ, Osmond, GW, Veras, E, Bean, SM, Bentley, RC, and Robboy, SJ. "Malignant struma ovarii: a blinded study of 86 cases assessing which histologic features correlate with aggressive clinical behavior." Arch Pathol Lab Med 136.2 (February 2012): 172-178.
PMID
22288964
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
136
Issue
2
Publish Date
2012
Start Page
172
End Page
178
DOI
10.5858/arpa.2011-0092-OA

Mammography screening behaviors of women exposed prenatally to diethylstilbestrol.

BACKGROUND: In utero diethylstilbestrol (DES) exposure is a risk factor for rare development of vaginal and cervical cancer and may potentially be a risk factor for breast cancer. Mammography use in this population is relatively unknown; therefore, this study aims to determine if in utero DES exposure is associated with the frequency of mammography screening examinations while considering demographic and clinical factors. METHODS: Using combined DES cohort questionnaire data, self-reported mammography screening over the past 5 years (2001-2006) was analyzed in women aged ≥45 years. Binary logistic regression assessed if DES exposure was associated with mammography use after adjustment for benign breast disease (BBD), previous cancer diagnosis, and whether insurance access influenced screening use. RESULTS: Overall, the frequency of mammography examinations was similar for both DES-exposed and unexposed women. DES-exposed (n=2986) and unexposed women (n=1397) over the age of 44 reported receiving ≥3 mammography examinations in the past 5 years (73.8% and 74.0%, respectively). After adjustment, DES exposure was not associated with ≥3 mammograms in the past 5 years compared to ≤2 examinations (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.86-1.17), p=0.99). CONCLUSIONS: In utero DES exposure was not associated with mammography use, nor was health insurance status or a BBD or cancer diagnosis. Because of the potential elevated risk for breast cancer in women exposed prenatally to DES, continued monitoring of standard mammography recommendations is recommended for this group, which is predominantly over the age of 45.

Authors
Camp, EA; Robboy, SJ; Hatch, EE; Titus-Ernstoff, LT; Herbst, AL; Strohsnitter, W; Kaufman, RH; Adam, E
MLA Citation
Camp, EA, Robboy, SJ, Hatch, EE, Titus-Ernstoff, LT, Herbst, AL, Strohsnitter, W, Kaufman, RH, and Adam, E. "Mammography screening behaviors of women exposed prenatally to diethylstilbestrol." J Womens Health (Larchmt) 21.2 (February 2012): 209-214.
PMID
22150213
Source
pubmed
Published In
Journal of Women's Health
Volume
21
Issue
2
Publish Date
2012
Start Page
209
End Page
214
DOI
10.1089/jwh.2011.2741

Adverse Health Outcomes in Women Exposed In Utero to Diethylstilbestrol EDITORIAL COMMENT

Authors
Hoover, RH; Hyer, M; Pfeiffer, RM; Adam, E; Bond, B; Cheville, AL; Colton, T; Hartge, P; Hatch, EE; Herbst, AL; Karlan, BY; Kaufman, R; Noller, KL; Palmer, JR; Robboy, SJ; Saal, RC; Strohsnitter, W; Titus-Ernstoff, L; Troisi, R
MLA Citation
Hoover, RH, Hyer, M, Pfeiffer, RM, Adam, E, Bond, B, Cheville, AL, Colton, T, Hartge, P, Hatch, EE, Herbst, AL, Karlan, BY, Kaufman, R, Noller, KL, Palmer, JR, Robboy, SJ, Saal, RC, Strohsnitter, W, Titus-Ernstoff, L, and Troisi, R. "Adverse Health Outcomes in Women Exposed In Utero to Diethylstilbestrol EDITORIAL COMMENT." OBSTETRICAL & GYNECOLOGICAL SURVEY 67.2 (February 2012): 94-96.
Source
wos-lite
Published In
Obstetrical and Gynecological Survey
Volume
67
Issue
2
Publish Date
2012
Start Page
94
End Page
96
DOI
10.1097/OGX.0b013e318247c7e1

Quality and the college of american pathologists.

The College of American Pathologists (CAP) is dedicated to pathology and laboratory medicine quality. The CAP's Laboratory Accreditation Program, Proficiency Testing Program, Q-Probes and Q-Tracks, site-specific cancer checklists, webinars, annual meetings, and Advanced Practical Pathology series are all focused on providing superior patent quality. The CAP is synonymous with quality in pathology and laboratory medicine. As pathology practice becomes more sophisticated, the CAP's many programs will increasingly help pathologists provide appropriate, personalized patient care.

Authors
Allen, TC; Hammond, MEH; Robboy, SJ
MLA Citation
Allen, TC, Hammond, MEH, and Robboy, SJ. "Quality and the college of american pathologists." Arch Pathol Lab Med 135.11 (November 2011): 1441-.
PMID
22032571
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
135
Issue
11
Publish Date
2011
Start Page
1441
DOI
10.5858/arpa.2011-0287-SA

Adverse health outcomes in women exposed in utero to diethylstilbestrol.

BACKGROUND: Before 1971, several million women were exposed in utero to diethylstilbestrol (DES) given to their mothers to prevent pregnancy complications. Several adverse outcomes have been linked to such exposure, but their cumulative effects are not well understood. METHODS: We combined data from three studies initiated in the 1970s with continued long-term follow-up of 4653 women exposed in utero to DES and 1927 unexposed controls. We assessed the risks of 12 adverse outcomes linked to DES exposure, including cumulative risks to 45 years of age for reproductive outcomes and to 55 years of age for other outcomes, and their relationships to the baseline presence or absence of vaginal epithelial changes, which are correlated with a higher dose of, and earlier exposure to, DES in utero. RESULTS: Cumulative risks in women exposed to DES, as compared with those not exposed, were as follows: for infertility, 33.3% vs. 15.5% (hazard ratio, 2.37; 95% confidence interval [CI], 2.05 to 2.75); spontaneous abortion, 50.3% vs. 38.6% (hazard ratio, 1.64; 95% CI, 1.42 to 1.88); preterm delivery, 53.3% vs. 17.8% (hazard ratio, 4.68; 95% CI, 3.74 to 5.86); loss of second-trimester pregnancy, 16.4% vs. 1.7% (hazard ratio, 3.77; 95% CI, 2.56 to 5.54); ectopic pregnancy, 14.6% vs. 2.9% (hazard ratio, 3.72; 95% CI, 2.58 to 5.38); preeclampsia, 26.4% vs. 13.7% (hazard ratio 1.42; 95% CI, 1.07 to 1.89); stillbirth, 8.9% vs. 2.6% (hazard ratio, 2.45; 95% CI, 1.33 to 4.54); early menopause, 5.1% vs. 1.7% (hazard ratio, 2.35; 95% CI, 1.67 to 3.31); grade 2 or higher cervical intraepithelial neoplasia, 6.9% vs. 3.4% (hazard ratio, 2.28; 95% CI, 1.59 to 3.27); and breast cancer at 40 years of age or older, 3.9% vs. 2.2% (hazard ratio, 1.82; 95% CI, 1.04 to 3.18). For most outcomes, the risks among exposed women were higher for those with vaginal epithelial changes than for those without such changes. CONCLUSIONS: In utero exposure of women to DES is associated with a high lifetime risk of a broad spectrum of adverse health outcomes. (Funded by the National Cancer Institute.).

Authors
Hoover, RN; Hyer, M; Pfeiffer, RM; Adam, E; Bond, B; Cheville, AL; Colton, T; Hartge, P; Hatch, EE; Herbst, AL; Karlan, BY; Kaufman, R; Noller, KL; Palmer, JR; Robboy, SJ; Saal, RC; Strohsnitter, W; Titus-Ernstoff, L; Troisi, R
MLA Citation
Hoover, RN, Hyer, M, Pfeiffer, RM, Adam, E, Bond, B, Cheville, AL, Colton, T, Hartge, P, Hatch, EE, Herbst, AL, Karlan, BY, Kaufman, R, Noller, KL, Palmer, JR, Robboy, SJ, Saal, RC, Strohsnitter, W, Titus-Ernstoff, L, and Troisi, R. "Adverse health outcomes in women exposed in utero to diethylstilbestrol." N Engl J Med 365.14 (October 6, 2011): 1304-1314.
PMID
21991952
Source
pubmed
Published In
The New England journal of medicine
Volume
365
Issue
14
Publish Date
2011
Start Page
1304
End Page
1314
DOI
10.1056/NEJMoa1013961

Vulvar manifestations of Crohn's disease.

Crohn's disease is an inflammatory bowel disorder with several well-known extraintestinal manifestations, such as erythema nodosum, uveitis, and arthritis. Less commonly observed are vulvar manifestations, which have primarily been discussed in case reports or small case series. These cases generally highlight patients with histopathology limited to noncaseating granulomas. As these histological findings are identified in bowel biopsies from only approximately 50% of patients with gastrointestinal Crohn's disease, there is likely an under-recognition and underdiagnosis of vulvar lesions as Crohn's disease manifestations. We describe the largest case series to date involving patients with vulvar Crohn's disease, discuss the varied clinical presentations, and describe the histopathological findings, which include noncaseating granulomas, ulcerations, lymphatic lesions, and even dysplasia and carcinoma. Our findings underscore the importance of keeping vulvar Crohn's disease on the differential diagnosis when faced with a range of vulvar symptoms and suggest that regular gynecological surveillance in patients with Crohn's disease may be of benefit.

Authors
Foo, W-C; Papalas, JA; Robboy, SJ; Selim, MA
MLA Citation
Foo, W-C, Papalas, JA, Robboy, SJ, and Selim, MA. "Vulvar manifestations of Crohn's disease." Am J Dermatopathol 33.6 (August 2011): 588-593.
PMID
21697699
Source
pubmed
Published In
American Journal of Dermatopathology
Volume
33
Issue
6
Publish Date
2011
Start Page
588
End Page
593
DOI
10.1097/DAD.0b013e31820a2635

Preterm birth, fetal growth, and age at menarche among women exposed prenatally to diethylstilbestrol (DES).

Diethylstilbestrol (DES), a synthetic estrogen used in pregnancy during the 1950s and 1960s, provides a model for potential health effects of endocrine disrupting compounds in the environment. We evaluated prenatal exposure to DES, based on medical record review, in relation to gestational length, fetal growth, and age at menarche in 4429 exposed and 1427 unexposed daughters. DES exposure was associated with an increase in preterm birth (odds ratio (OR)=2.97; 95% CI=2.27, 3.87), and a higher risk of small for gestational age (SGA) (OR=1.61; 95% CI=1.31, 1.98). The association between DES exposure and early menarche was borderline, with stronger effects when early menarche was defined as ≤ 10 years (OR=1.41 95% CI=0.97, 2.03) than defined as ≤ 11 years (OR=1.16; 95% CI=0.97, 1.39). This study provides evidence that prenatal DES exposure was associated with fetal growth and gestational length, which may mediate associations between DES and health outcomes in later life.

Authors
Hatch, EE; Troisi, R; Wise, LA; Titus-Ernstoff, L; Hyer, M; Palmer, JR; Strohsnitter, WC; Robboy, SJ; Anderson, D; Kaufman, R; Adam, E; Hoover, RN
MLA Citation
Hatch, EE, Troisi, R, Wise, LA, Titus-Ernstoff, L, Hyer, M, Palmer, JR, Strohsnitter, WC, Robboy, SJ, Anderson, D, Kaufman, R, Adam, E, and Hoover, RN. "Preterm birth, fetal growth, and age at menarche among women exposed prenatally to diethylstilbestrol (DES)." Reprod Toxicol 31.2 (February 2011): 151-157.
PMID
21130156
Source
pubmed
Published In
Reproductive Toxicology
Volume
31
Issue
2
Publish Date
2011
Start Page
151
End Page
157
DOI
10.1016/j.reprotox.2010.11.006

Malignant Struma Ovarii: A Study of 86 Cases Demonstrating No Correlation between Pathological Features and Disease Course.

Authors
Shaco-Levy, R; Peng, R; Snyder, MM; Bean, SM; Robboy, SJ
MLA Citation
Shaco-Levy, R, Peng, R, Snyder, MM, Bean, SM, and Robboy, SJ. "Malignant Struma Ovarii: A Study of 86 Cases Demonstrating No Correlation between Pathological Features and Disease Course." February 2011.
Source
wos-lite
Published In
Modern Pathology
Volume
24
Publish Date
2011
Start Page
265A
End Page
265A

Malignant Struma Ovarii: A Study of 86 Cases Demonstrating No Correlation between Pathological Features and Disease Course.

Authors
Shaco-Levy, R; Peng, R; Snyder, MM; Bean, SM; Robboy, SJ
MLA Citation
Shaco-Levy, R, Peng, R, Snyder, MM, Bean, SM, and Robboy, SJ. "Malignant Struma Ovarii: A Study of 86 Cases Demonstrating No Correlation between Pathological Features and Disease Course." February 2011.
Source
wos-lite
Published In
Laboratory Investigation
Volume
91
Publish Date
2011
Start Page
265A
End Page
265A

Endocervical-like (Müllerian) mucinous borderline tumours of the ovary are frequently associated with the KRAS mutation.

AIMS:   Clinicopathological aspects of the endocervical-like mucinous borderline tumour of the ovary (EMBT), including higher frequencies of bilaterality, endometriosis and hormone receptor reactivity, and often admixtures of various Müllerian-type epithelia, closely resembles endometrioid tumour more than mucinous borderline tumour of the intestinal type (IMBT). Thus, the aims of this study were to determine whether EMBT is really a subtype of mucinous borderline tumours, as shown in the current classification system, and to determine the best classification for EMBT. METHODS AND RESULTS:   The clinicopathological and immunohistochemical features of 17 EMBTs were analysed, including oestrogen receptor (ER), progesterone receptor (PR), PTEN, cytokeratins (CK) 7 and 20, and β-catenin. Additionally, mutational analyses of the KRAS (exon 1) and PTEN genes (all nine exons) were performed in all cases, and the results were compared with literature findings for IMBT and endometrioid tumours. Twelve patients (71%) were confirmed histologically to have endometriosis in one or both ovaries. In seven cases, gradual transitions from endometriotic foci to the EMBT were identified. Immunohistochemically, all cases were reactive for ER and PR, with no nuclear expression of β-catenin. CK7 positivity was strong in all patients, whereas there was no reactivity for CK20. PTEN reactivity was diffuse in the nuclei of epithelial and underlying stromal cells. Sixty-nine per cent showed KRAS mutations in exon 1 and codon 12, but no PTEN mutation was identified in any of the nine exons. CONCLUSION:   Our study suggests that EMBT has features of both mucinous and endometrioid tumours and is an additional tumour type arising in endometriosis. While clinicopathological features of EMBTs are closer to endometrioid tumours, they still have molecular characteristics closer to IMBTs.

Authors
Kim, K-R; Choi, J; Hwang, J-E; Baik, Y-A; Shim, JY; Kim, YM; Robboy, SJ
MLA Citation
Kim, K-R, Choi, J, Hwang, J-E, Baik, Y-A, Shim, JY, Kim, YM, and Robboy, SJ. "Endocervical-like (Müllerian) mucinous borderline tumours of the ovary are frequently associated with the KRAS mutation." Histopathology 57.4 (October 2010): 587-596.
PMID
20955384
Source
pubmed
Published In
Histopathology
Volume
57
Issue
4
Publish Date
2010
Start Page
587
End Page
596
DOI
10.1111/j.1365-2559.2010.03673.x

Autoimmune disease incidence among women prenatally exposed to diethylstilbestrol.

OBJECTIVE: Animal studies have suggested that prenatal diethylstilbestrol (DES) exposure may alter immune system development and function including antigen self-recognition. A cohort study was conducted to investigate whether prenatal DES exposure might influence the incidence of at least some specific autoimmune diseases in women. METHODS: A group of women who were and were not prenatally exposed to DES have been followed for more than 25 years for numerous health outcomes including autoimmune disease. To verify diagnoses, medical records or physician abstracts were requested for all women who reported a diagnosis of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), optic neuritis (ON), and idiopathic thrombocytopenic purpura (ITP). Incidence rates of these autoimmune diseases were compared between women who were and who were not prenatally DES-exposed. RESULTS: Overall, there was no increase in verified autoimmune disease among DES-exposed women relative to those who were not exposed (RR 1.2; 95% CI 0.7, 2.1). There was, however, a positive association between prenatal DES exposure and RA among women younger than 45 years (RR 4.9; 95% CI 1.1, 21.6) and an inverse association among women who were 45 years and older (RR 0.1; 95% CI 0.01, 0.7). CONCLUSION: Overall, these data provide little support for an association between prenatal DES exposure and development of autoimmune disease. The implication that such exposure may be related to RA in an unusual age-related manner is based on small numbers of cases and warrants further study.

Authors
Strohsnitter, WC; Noller, KL; Troisi, R; Robboy, SJ; Hatch, EE; Titus-Ernstoff, L; Kaufman, RH; Palmer, JR; Anderson, D; Hoover, RN
MLA Citation
Strohsnitter, WC, Noller, KL, Troisi, R, Robboy, SJ, Hatch, EE, Titus-Ernstoff, L, Kaufman, RH, Palmer, JR, Anderson, D, and Hoover, RN. "Autoimmune disease incidence among women prenatally exposed to diethylstilbestrol." J Rheumatol 37.10 (October 2010): 2167-2173.
PMID
20634240
Source
pubmed
Published In
The Journal of rheumatology
Volume
37
Issue
10
Publish Date
2010
Start Page
2167
End Page
2173
DOI
10.3899/jrheum.091092

Acquired vulvar lymphangioma circumscriptum: a comparison of 12 cases with Crohn's associated lesions or radiation therapy induced tumors.

BACKGROUND: Lymphangioma circumscriptum (LC) is a benign lesion of lymphatic origin. Vulvar involvement occurs in various clinical settings. METHODS: We present 12 cases, and compare lesions in patients with Crohn's disease and those associated with pelvic radiation. RESULTS: The average age at presentation was 49 years. Thirty-three percent of the patients had Crohn's disease, 58% had radiation therapy and 9% had no significant medical history. Sixty-seven percent of the patients had multifocal lesions in anatomically distinct regions. Patients presented on average 16 years after onset of predisposing factors. Presenting complaints were pruritus, wetness and vulvar edema. Lesions were clinically heterogeneous, often found on the labia majora. Lesions consisted of dilated lymphatic channels at the junction of the reticular and papillary dermis. The cells lining these spaces lacked cytologic atypicality or mitotic activity. All lesions so examined were immunoreactive for D240. Patients were most often treated with surgical excision followed by laser ablation. Four of twelve patients, all with radiation-associated lesions, experienced disease progression necessitating additional surgery. CONCLUSIONS: Patients with LC secondary to radiation, when compared to those with Crohn's disease, were 10 years younger, more likely to have associated co-morbidities, and frequently experienced disease progression needing additional surgeries. Acquired vulvar LC has multiple causes with differing prognosis.

Authors
Papalas, JA; Robboy, SJ; Burchette, JL; Foo, W-C; Selim, MA
MLA Citation
Papalas, JA, Robboy, SJ, Burchette, JL, Foo, W-C, and Selim, MA. "Acquired vulvar lymphangioma circumscriptum: a comparison of 12 cases with Crohn's associated lesions or radiation therapy induced tumors." J Cutan Pathol 37.9 (September 2010): 958-965.
PMID
20653826
Source
pubmed
Published In
Journal of Cutaneous Pathology
Volume
37
Issue
9
Publish Date
2010
Start Page
958
End Page
965
DOI
10.1111/j.1600-0560.2010.01569.x

Pathogenesis of endometriosis.

Many theories have been proffered to explain the histogenesis of endometriosis (Robboy et al., 2009). Generally, they divide into those that favour transplantation of endometrial fragments to ectopic sites, metaplasia of the multipotential celomic peritoneum and induction of undifferentiated mesenchyme in ectopic sites to form endometriotic tissues after exposure to substances released from shed endometrium.

Authors
Robboy, SJ; Bean, SM
MLA Citation
Robboy, SJ, and Bean, SM. "Pathogenesis of endometriosis." Reprod Biomed Online 21.1 (July 2010): 4-5.
PMID
20627684
Source
pubmed
Published In
Reproductive BioMedicine Online
Volume
21
Issue
1
Publish Date
2010
Start Page
4
End Page
5
DOI
10.1016/j.rbmo.2010.03.031

Human uterine leiomyoma-derived fibroblasts stimulate uterine leiomyoma cell proliferation and collagen type I production, and activate RTKs and TGF beta receptor signaling in coculture.

BACKGROUND: Uterine leiomyomas (fibroids) are benign smooth muscle tumors that often contain an excessive extracellular matrix (ECM). In the present study, we investigated the interactions between human uterine leiomyoma (UtLM) cells and uterine leiomyoma-derived fibroblasts (FB), and their importance in cell growth and ECM protein production using a coculture system. RESULTS: We found enhanced cell proliferation, and elevated levels of ECM collagen type I and insulin-like growth factor-binding protein-3 after coculturing. There was also increased secretion of vascular endothelial growth factor, epidermal growth factor, fibroblast growth factor-2, and platelet derived growth factor A and B in the media of UtLM cells cocultured with FB. Protein arrays revealed increased phosphorylated receptor tyrosine kinases (RTKs) of the above growth factor ligands, and immunoblots showed elevated levels of the RTK downstream effector, phospho-mitogen activated protein kinase 44/42 in cocultured UtLM cells. There was also increased secretion of transforming growth factor-beta 1 and 3, and immunoprecipitated transforming growth factor-beta receptor I from cocultured UtLM cells showed elevated phosphoserine expression. The downstream effectors phospho-small mothers against decapentaplegic -2 and -3 protein (SMAD) levels were also increased in cocultured UtLM cells. However, none of the above effects were seen in normal myometrial cells cocultured with FB. The soluble factors released by tumor-derived fibroblasts and/or UtLM cells, and activation of the growth factor receptors and their pathways stimulated the proliferation of UtLM cells and enhanced the production of ECM proteins. CONCLUSIONS: These data support the importance of interactions between fibroid tumor cells and ECM fibroblasts in vivo, and the role of growth factors, and ECM proteins in the pathogenesis of uterine fibroids.

Authors
Moore, AB; Yu, L; Swartz, CD; Zheng, X; Wang, L; Castro, L; Kissling, GE; Walmer, DK; Robboy, SJ; Dixon, D
MLA Citation
Moore, AB, Yu, L, Swartz, CD, Zheng, X, Wang, L, Castro, L, Kissling, GE, Walmer, DK, Robboy, SJ, and Dixon, D. "Human uterine leiomyoma-derived fibroblasts stimulate uterine leiomyoma cell proliferation and collagen type I production, and activate RTKs and TGF beta receptor signaling in coculture. (Published online)" Cell Commun Signal 8 (June 10, 2010): 10-.
Website
http://hdl.handle.net/10161/4370
PMID
20537183
Source
pubmed
Published In
Cell Communication and Signaling
Volume
8
Publish Date
2010
Start Page
10
DOI
10.1186/1478-811X-8-10

Natural history of biologically malignant struma ovarii: analysis of 27 cases with extraovarian spread.

The natural history of 27 cases of biologically malignant struma ovarii from a series of 88 cases of histologically malignant or histologically proliferative struma ovarii is described. The extraovarian spread was evident at presentation in 17 patients. The malignant nature of the other 10 tumors became apparent only after they recurred. The tumors measured 5 to 24.5 cm and were more than 50% thyroid tissue in all but 2 cases. The microscopic diagnosis of the thyroid tissue was follicular adenoma in 17 cases (63%), papillary carcinoma in 7 (26%), unremarkable in 2 (7%), and follicular carcinoma in 1 case (4%). Generally, the clinical course was protracted, with long-term survival documented in most patients. Clinical features predictive of biologic malignancy were the presence of adhesions, peritoneal fluid (> or = 1 L), or a serosal rent in the struma ovarii (including cystectomy). In addition, pathologic factors predictive of a poorer prognosis were large size (> or = 10 cm), strumal component more than 80%, and extensive papillary carcinoma, especially with solid areas, necrosis, and > or = 5 mitoses per 10 high-power fields. Follow-up for all patients was 1.5 to 33 years (mean=13.5 yr). On last follow-up 3 patients (11%) had no evidence of disease, 9 (33%) were alive with disease, 5 (19%) died of other causes, and 10 patients (37%) died of the disease. Death from disease occurred 1.5 to 32 years after diagnosis (mean=14 yr). Recurrence was seen as early as 2 months and as late as 29 years after initial surgery (mean=7 yr). Long-term follow-up is indicated in patients with any of the above-mentioned adverse indicators.

Authors
Shaco-Levy, R; Bean, SM; Bentley, RC; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Bentley, RC, and Robboy, SJ. "Natural history of biologically malignant struma ovarii: analysis of 27 cases with extraovarian spread." Int J Gynecol Pathol 29.3 (May 2010): 212-227.
PMID
20407319
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
29
Issue
3
Publish Date
2010
Start Page
212
End Page
227
DOI
10.1097/PGP.0b013e3181bfb133

Isolated and synchronous vulvar granular cell tumors: a clinicopathologic study of 17 cases in 13 patients.

Granular cell tumors (GCTs) are benign Schwann cell-derived neoplasms occurring throughout the body. Vulvar GCTs are usually isolated, but occasionally multifocal. On account of their anatomic location, surgical interventions aiming for negative resection margins can result in significant morbidity. We describe the clinicopathologic features of 17 vulvar GCTs in 13 patients followed for an average of 7 years. The average age at presentation was 46 years, and 84% of the patients were black. The tumors were multifocal in 3 (23%) patients, and all, either at presentation or subsequently also developed extravulvar foci. Patients with multifocal vulvar GCTs were nearly 10 years younger at presentation than patients in whom the disease was isolated. The most common complaint was a slow-enlarging mass occasionally associated with pruritus or overlying hyperpigmentation. Clinically, the tumors were subcutaneous, mobile, and nodular (2.1 cm on average), without overlying ulceration, and most often were found in the labia majora (6/17). The neoplasms were histologically heterogeneous, but exhibited either a predominantly nodular (3/17) or infiltrative (13/17) pattern of invasion. Cytologically, the tumors displayed round to polygonal cells with a granular cytoplasm, small hyperchromatic nuclei with minimal pleomorphism, and less than 2 mitoses per 10 high power fields. One tumor (1/17) consisted of cells with predominantly vesicular nuclei and prominent nucleoli and was classified as an atypical vulvar GCT. All tumors so examined were reactive for S-100 protein. Eight of 17 tumor excision specimens had positive margins. Of these, 5 tumors remained stable whereas the other 2 with follow-up progressed to require reexcisions after periods of 14 and 8.0 years, respectively. All patients with excisions with negative margins remained stable. Patients with multifocal tumors did not have a higher risk of recurrence per tumor, compared with patients with isolated disease, regardless of the margin status. No patient died from her disease. As granular cell neoplasms have such a low risk or recurrence and behave generally in an indolent manner, aggressive therapy is usually unwarranted.

Authors
Papalas, JA; Shaco-Levy, R; Robboy, SJ; Selim, MA
MLA Citation
Papalas, JA, Shaco-Levy, R, Robboy, SJ, and Selim, MA. "Isolated and synchronous vulvar granular cell tumors: a clinicopathologic study of 17 cases in 13 patients." Int J Gynecol Pathol 29.2 (March 2010): 173-180.
PMID
20173503
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
29
Issue
2
Publish Date
2010
Start Page
173
End Page
180
DOI
10.1097/PGP.0b013e3181bb4f05

Paget disease of the vulva: a study of 56 cases.

OBJECTIVE: To resolve controversial issues regarding vulvar Paget disease through analysis of a substantial number of cases. STUDY DESIGN: The medical records and pathology slides of 56 patients with a diagnosis of vulvar Paget disease were reviewed. Possible correlation between clinical and pathological data was examined. RESULTS: Most patients were Caucasian and their mean age at diagnosis was 69 years. The average length of follow-up was 5.6 years. The most common symptom was pruritus, almost always accompanied by erythematous-white plaques. Substantial delay between appearance of symptoms and diagnosis was observed in many patients, and was significantly associated with larger lesions. Recurrence rate after surgical management was 32%, with disease involving the perineum being the only statistically significant risk factor. Patients with positive surgical margins had an increased recurrence rate, but this was not statistically significant. Intra-operative frozen section analysis of the margins as well as radical surgery as initial treatment did not reduce recurrence rate. In general, stromal invasion was not associated with worse prognosis, but the single patient who died of disease had the deepest stromal invasion. Radiation therapy given to five patients who either had multiple positive surgical margins or experienced disease recurrence and refused additional surgery resulted in complete response with no further recurrences. On the last day of follow-up 24 patients (43%) had no evidence of disease, 24 patients (43%) were dead of other causes, 5 patients (9%) were alive with disease, 2 patients (3%) were lost to follow-up, and 1 (2%) died due to vulvar Paget disease with invasive adenocarcinoma. CONCLUSIONS: Vulvar Paget disease only rarely results in a patient's death, but long term follow-up is required, as recurrences are common and can be noted many years after the initial treatment.

Authors
Shaco-Levy, R; Bean, SM; Vollmer, RT; Jewell, E; Jones, EL; Valdes, CL; Bentley, RC; Selim, MA; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Vollmer, RT, Jewell, E, Jones, EL, Valdes, CL, Bentley, RC, Selim, MA, and Robboy, SJ. "Paget disease of the vulva: a study of 56 cases." Eur J Obstet Gynecol Reprod Biol 149.1 (March 2010): 86-91.
PMID
19969410
Source
pubmed
Published In
European Journal of Obstetrics Gynecology and Reproductive Biology
Volume
149
Issue
1
Publish Date
2010
Start Page
86
End Page
91
DOI
10.1016/j.ejogrb.2009.11.003

Paget Disease of the Vulva - A Study of 56 Cases

Authors
Shaco-Levy, R; Bean, SM; Bentley, RC; Vollmer, RT; Papalas, JA; Selim, MA; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Bentley, RC, Vollmer, RT, Papalas, JA, Selim, MA, and Robboy, SJ. "Paget Disease of the Vulva - A Study of 56 Cases." February 2010.
Source
wos-lite
Published In
Modern Pathology
Volume
23
Publish Date
2010
Start Page
262A
End Page
262A

Paget Disease of the Vulva - A Study of 56 Cases

Authors
Shaco-Levy, R; Bean, SM; Bentley, RC; Vollmer, RT; Papalas, JA; Selim, MA; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Bentley, RC, Vollmer, RT, Papalas, JA, Selim, MA, and Robboy, SJ. "Paget Disease of the Vulva - A Study of 56 Cases." February 2010.
Source
wos-lite
Published In
Laboratory Investigation
Volume
90
Publish Date
2010
Start Page
262A
End Page
262A

Natural History of Biologically Malignant Struma Ovarii: Analysis of 27 Cases with Extra-Ovarian Spread

Authors
Shaco-Levy, R; Bean, SM; Bentley, RC; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Bentley, RC, and Robboy, SJ. "Natural History of Biologically Malignant Struma Ovarii: Analysis of 27 Cases with Extra-Ovarian Spread." February 2010.
Source
wos-lite
Published In
Laboratory Investigation
Volume
90
Publish Date
2010
Start Page
262A
End Page
262A

Natural History of Biologically Malignant Struma Ovarii: Analysis of 27 Cases with Extra-Ovarian Spread

Authors
Shaco-Levy, R; Bean, SM; Bentley, RC; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Bentley, RC, and Robboy, SJ. "Natural History of Biologically Malignant Struma Ovarii: Analysis of 27 Cases with Extra-Ovarian Spread." February 2010.
Source
wos-lite
Published In
Modern Pathology
Volume
23
Publish Date
2010
Start Page
262A
End Page
262A

Defect of Pericyte Recruitment Can Induce Villous Hydropic Change in Complete Hydatidiform Moles

Authors
Kim, K-R; Kwon, T-J; Song, JS; Kim, S-A; Robboy, SJ
MLA Citation
Kim, K-R, Kwon, T-J, Song, JS, Kim, S-A, and Robboy, SJ. "Defect of Pericyte Recruitment Can Induce Villous Hydropic Change in Complete Hydatidiform Moles." February 2010.
Source
wos-lite
Published In
Laboratory Investigation
Volume
90
Publish Date
2010
Start Page
249A
End Page
250A

Defect of Pericyte Recruitment Can Induce Villous Hydropic Change in Complete Hydatidiform Moles

Authors
Kim, K-R; Kwon, T-J; Song, JS; Kim, S-A; Robboy, SJ
MLA Citation
Kim, K-R, Kwon, T-J, Song, JS, Kim, S-A, and Robboy, SJ. "Defect of Pericyte Recruitment Can Induce Villous Hydropic Change in Complete Hydatidiform Moles." February 2010.
Source
wos-lite
Published In
Modern Pathology
Volume
23
Publish Date
2010
Start Page
249A
End Page
250A

Acquired Vulvar Lymphangioma Circumscriptum: A Comparison between Crohn's Associated and Radiation Therapy Induced Tumors

Authors
Papalas, JA; Robboy, SJ; Selim, MA
MLA Citation
Papalas, JA, Robboy, SJ, and Selim, MA. "Acquired Vulvar Lymphangioma Circumscriptum: A Comparison between Crohn's Associated and Radiation Therapy Induced Tumors." February 2010.
Source
wos-lite
Published In
Modern Pathology
Volume
23
Publish Date
2010
Start Page
258A
End Page
259A

Acquired Vulvar Lymphangioma Circumscriptum: A Comparison between Crohn's Associated and Radiation Therapy Induced Tumors

Authors
Papalas, JA; Robboy, SJ; Selim, MA
MLA Citation
Papalas, JA, Robboy, SJ, and Selim, MA. "Acquired Vulvar Lymphangioma Circumscriptum: A Comparison between Crohn's Associated and Radiation Therapy Induced Tumors." February 2010.
Source
wos-lite
Published In
Laboratory Investigation
Volume
90
Publish Date
2010
Start Page
258A
End Page
259A

Paget disease of the vulva: a histologic study of 56 cases correlating pathologic features and disease course.

The Duke experience with 56 vulvar Paget disease patients was analyzed emphasizing pathologic features and controversial issues. Nearly all patients were Caucasian, and their mean age was 69 years. The average length of follow-up was 5.6 years. For each case, the following histologic features were evaluated and their association with disease course was examined: pseudo-invasion, adnexal involvement, signet-ring cells, cytologic atypia, glands formation, epidermal acantholysis, parakeratosis, hyperkeratosis, and chronic inflammation. The recurrence rate after surgical management was 32%, with epidermal acantholysis being the only statistically significant risk factor. Stromal invasion occurred in 10 patients (18%), and was not a statistically significant adverse prognostic indicator, although the single patient who died of the disease had the deepest stromal invasion. Recurrence was more common after resections with positive surgical margins, but this correlation was not statistically significant. Intraoperative frozen section analysis of the margins did not reduce recurrence rate, nor was it useful in attaining permanent free margins. The Paget cells were consistently reactive with cytokeratin-7 and carcinoembryonic antigen and unreactive with S-100 protein, HMB-45, and Mart-1. In addition, the tumor cells were usually positive for mucin stains. This profile helps distinguish vulvar Paget disease from its mimics, Pagetoid squamous cell carcinoma and malignant melanoma.

Authors
Shaco-Levy, R; Bean, SM; Vollmer, RT; Papalas, JA; Bentley, RC; Selim, MA; Robboy, SJ
MLA Citation
Shaco-Levy, R, Bean, SM, Vollmer, RT, Papalas, JA, Bentley, RC, Selim, MA, and Robboy, SJ. "Paget disease of the vulva: a histologic study of 56 cases correlating pathologic features and disease course." Int J Gynecol Pathol 29.1 (January 2010): 69-78.
PMID
19952933
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
29
Issue
1
Publish Date
2010
Start Page
69
End Page
78
DOI
10.1097/PGP.0b013e3181b1cc5e

Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread.

Struma ovarii that display extraovarian spread or later recurrence is exceedingly rare. Among 88 patients with "malignant" struma ovarii followed for prolonged periods, several features helped to predict the adverse clinical course. Adhesions (graded 2 to 4+), peritoneal fluid (> or =1 L) or ovarian serosal rent were worrisome features, occurring in 74% of 27 biologically malignant tumors but only 10% of 61 clinically benign tumors. The size of the strumal component rather than the overall size of the ovarian teratoma also had some predictive value. Tumors with a strumal component < or =6 cm recurred rarely (7%), whereas 33% of the consult and 88% of the literature cases > or =12 cm were clinically malignant. Except for a papillary pattern or poorly differentiated cancer, no microscopic feature reliably predicted the clinical outcome, including those typically associated with malignancy in primary thyroid tumors. Among the consult cases, 7% with histologic follicular adenomas and 29% with papillary carcinomas were clinically malignant. Unequivocal vascular invasion was rare, precluding assessment of its effect. Optically clear nuclei, when extensive, were useful to diagnose papillary carcinoma, but were present nevertheless in smaller numbers in both macrofollicular and microfollicular adenomas. Eight tumors confined initially to the ovary (stage 1) recurred. Papillary carcinomas recurred earlier (average 4 y) than follicular adenomatous neoplasms (average 11 y, range: 1-29 y). Overall, the survival rate for all patients was 89% at 10 years and 84% at 25 years, indicating the need for routine long-term follow-up.

Authors
Robboy, SJ; Shaco-Levy, R; Peng, RY; Snyder, MJ; Donahue, J; Bentley, RC; Bean, S; Krigman, HR; Roth, LM; Young, RH
MLA Citation
Robboy, SJ, Shaco-Levy, R, Peng, RY, Snyder, MJ, Donahue, J, Bentley, RC, Bean, S, Krigman, HR, Roth, LM, and Young, RH. "Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread." Int J Gynecol Pathol 28.5 (September 2009): 405-422.
PMID
19696610
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
28
Issue
5
Publish Date
2009
Start Page
405
End Page
422
DOI
10.1097/PGP.0b013e3181a27777

Schistosomiasis and vesicovaginal fistula.

Schistosoma haematobium is presented as a cause of vesicovaginal fistula in a nulliparous adolescent. The possible role of S. haematobium in failure of fistula repair and the importance of screening and treatment in endemic areas prior to repair are discussed.

Authors
Dennis, N; Wilkinson, J; Robboy, S; Idrissa, A
MLA Citation
Dennis, N, Wilkinson, J, Robboy, S, and Idrissa, A. "Schistosomiasis and vesicovaginal fistula." African journal of reproductive health 13.3 (September 2009): 137-140.
PMID
20690269
Source
epmc
Published In
African Journal of Reproductive Health
Volume
13
Issue
3
Publish Date
2009
Start Page
137
End Page
140

p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.

OBJECTIVES: Evaluation of anal intraepithelial neoplasia (AIN) is subjective. Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade. Biomarkers like p16 and Ki-67 may improve interobserver agreement. The objectives were (1) to determine the extent of interobserver agreement in evaluating AIN on routine hematoxylin and eosin (H&E) sections and (2) to test whether p16 and/or Ki-67 staining improve interobserver diagnostic agreement. MATERIALS AND METHODS: Seventy-seven anal specimens were retrieved. Sections were stained with monoclonal antibodies against p16 and Ki-67. Blind to the original diagnoses, 4 pathologists assessed H&E alone, p16 alone, Ki-67 alone, and all 3 simultaneously. Diagnoses were normal/reactive, AIN I/HPV, AIN II, and AIN III. Agreement was calculated using kappa and S statistics. RESULTS: Pathologists were board certified and had 2 to 25 years (mean = 13.6 years) of experience. Fair agreement was observed using H&E diagnosis alone (kappa = 0.38, S = 0.56). The p16 diagnostic evaluation demonstrated the highest agreement (kappa = 0.57, S = 0.73). Interobserver agreement for Ki-67 alone and for H&E/p16/Ki-67 combined were comparable to that of H&E alone (kappa = 0.4, S = 0.54 and kappa = 0.44, S = 0.62, respectively). When the pathologists' diagnoses for all diagnostic evaluations were compared with consensus diagnoses, the lowest average magnitude of disagreement was seen with Ki-67 alone, followed by p16 alone, H&E/p16/Ki-67 combined, and H&E alone. CONCLUSIONS: Interobserver agreement for diagnosis of AIN was fair when based solely on H&E preparation. p16 alone improved interobserver agreement and demonstrated superior agreement when compared with H&E, Ki-67, and H&E/p16/Ki-67 combined.

Authors
Bean, SM; Meara, RS; Vollmer, RT; Conner, MG; Crowe, DR; Novak, L; Eltoum, IA; Robboy, SJ; Chhieng, DC
MLA Citation
Bean, SM, Meara, RS, Vollmer, RT, Conner, MG, Crowe, DR, Novak, L, Eltoum, IA, Robboy, SJ, and Chhieng, DC. "p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia." J Low Genit Tract Dis 13.3 (July 2009): 145-153.
PMID
19550211
Source
pubmed
Published In
Journal of Lower Genital Tract Disease
Volume
13
Issue
3
Publish Date
2009
Start Page
145
End Page
153
DOI
10.1097/LGT.0b013e3181934486

Breast cancer screening in women exposed in utero to diethylstilbestrol.

PURPOSE: To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations. METHODS: 1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990-1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms. RESULTS: DES-exposed women exceeded annual recommendations for CBEs (aOR 2.20, 95% CI, 1.04-4.67) among women without a history of benign breast disease (BBD) compared with unexposed women. There were no other statistically significant differences between exposed and unexposed women who reported performing BSEs, CBEs (<40 years of age), and mammographies, regardless of BBD history. CONCLUSIONS: The majority of DES-exposed women receive breast cancer screenings at least at recommended intervals, but over two thirds do not perform monthly BSEs. Future efforts should be focused on further educating this and other at-risk populations through mailed reminders and during patient consultations on the benefits of screening examinations.

Authors
Camp, EA; Coker, AL; Robboy, SJ; Noller, KL; Goodman, KJ; Titus-Ernstoff, LT; Hatch, EE; Herbst, AL; Troisi, R; Kaufman, RH; Adam, E
MLA Citation
Camp, EA, Coker, AL, Robboy, SJ, Noller, KL, Goodman, KJ, Titus-Ernstoff, LT, Hatch, EE, Herbst, AL, Troisi, R, Kaufman, RH, and Adam, E. "Breast cancer screening in women exposed in utero to diethylstilbestrol." J Womens Health (Larchmt) 18.4 (April 2009): 547-552.
PMID
19361323
Source
pubmed
Published In
Journal of Women's Health
Volume
18
Issue
4
Publish Date
2009
Start Page
547
End Page
552
DOI
10.1089/jwh.2007.0580

The villous stromal constituents of complete hydatidiform mole differ histologically in very early pregnancy from the normally developing placenta.

Histologic distinction between complete hydatidiform moles and nonmolar abortuses in early pregnancy is often extremely difficult. This study details the chronologic changes that occur in normal placenta, especially in the villous stroma during gestational weeks 4 to 12 and compares the findings in 63 normal placentas and 73 early complete moles. Over time, the chorionic villi in normal placenta showed gradual but recognizable alterations, from basophilic/hypocellular and nonvascular stroma to basophilic/cellular stroma containing angiogenic cell cords (immature blood vessels), and then to loose, edematous/reticular stroma with mature blood vessels containing vascular lumina and hematopoietic components. A basophilic stroma, which was frequently seen in early complete moles, was a constant feature of chorionic villi younger than week 7 in normal placenta, but had disappeared after week 8, except in the newly branched sprouts. Trophoblastic proliferation was virtually unrecognizable in 59% of early complete moles, whereas circumferential trophoblastic sprouts during weeks 4 to 6 of normal placenta can be mistaken as that of complete moles. Few or no mature blood vessels and excessive stromal karyorrhexis are characteristic features of early complete moles, even in the absence of trophoblastic proliferation, but they are occasionally found in normal placenta younger than week 7. Although many features of normal and molar placenta were similar during the earliest weeks (5 to 6) including basophilic stroma, angiogenic cell cords (immature blood vessels), and often circumferential trophoblastic sprouts and proliferation, already by that time early moles showed significantly greater percentages of stromal cells undergoing karyorrhexis and apoptosis compared with normal placenta (37.6% vs. 5.4%). These results indicate the histologic features do exist early on in pregnancy to differentiate normal from molar pregnancy. Further, it points out that complete hydatidiform mole in addition to being disease of trophoblastic proliferation is also associated with defects in vasculogenesis and maturation of villous stromal constituents.

Authors
Kim, K-R; Park, B-H; Hong, Y-O; Kwon, H-C; Robboy, SJ
MLA Citation
Kim, K-R, Park, B-H, Hong, Y-O, Kwon, H-C, and Robboy, SJ. "The villous stromal constituents of complete hydatidiform mole differ histologically in very early pregnancy from the normally developing placenta." Am J Surg Pathol 33.2 (February 2009): 176-185.
PMID
18936691
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
33
Issue
2
Publish Date
2009
Start Page
176
End Page
185
DOI
10.1097/PAS.0b013e31817fada1

Differential expression of receptor tyrosine kinases (RTKs) and IGF-I pathway activation in human uterine leiomyomas.

Uterine leiomyomas (fibroids) are benign tumors that are prevalent in women of reproductive age. Research suggests that activated receptor tyrosine kinases (RTKs) play an important role in the enhanced proliferation observed in fibroids. In this study, a phospho-RTK array technique was used to detect RTK activity in leiomyomas compared with myometrial tissue. We found that fifteen out of seventeen RTKs evaluated in this study were highly expressed (P < 0.02-0.03) in the leiomyomas, and included the IGF-I/IGF-IR, EGF/EGFR, FGF/FGF-R, HGF/HGF-R, and PDGF/PDGF-R gene families. Due to the higher protein levels of IGF-IR observed in leiomyomas by us in earlier studies, we decided to focus on the activation of the IGF-IR, its downstream effectors, and MAPKp44/42 to confirm our earlier findings; and validate the significance of the increased IGF-IR phosphorylation observed by RTK array analysis in this study. We used immunolocalization, western blot, or immunoprecipitation studies and confirmed that leiomyomas overexpressed IGF-IRbeta and phosphorylated IGF-IRbeta. Additionally, we showed that the downstream effectors, Shc, Grb2, and MAPKp44/42 (P < 0.02-0.001) were also overexpressed and involved in IGF-IR signaling in these tumors, while IRS-I, PI3K, and AKT were not. In vitro studies showed that IGF-I (100 ng/mL) increased the proliferation of uterine leiomyoma cells (UtLM) (P < 0.0001), and that phosphorylated IGF-IRbeta, Shc, and MAPKp44/42 were also overexpressed in IGF-I-treated UtLM cells (P < 0.05), similar to the tissue findings. A neutralizing antibody against the IGF-IRbeta blocked these effects. These data indicate that overexpression of RTKs and, in particular, activation of the IGF-IR signaling pathway through Shc/Grb2/MAPK are important in mediating uterine leiomyoma growth. These data may provide new anti-tumor targets for noninvasive treatment of fibroids.

Authors
Yu, L; Saile, K; Swartz, CD; He, H; Zheng, X; Kissling, GE; Di, X; Lucas, S; Robboy, SJ; Dixon, D
MLA Citation
Yu, L, Saile, K, Swartz, CD, He, H, Zheng, X, Kissling, GE, Di, X, Lucas, S, Robboy, SJ, and Dixon, D. "Differential expression of receptor tyrosine kinases (RTKs) and IGF-I pathway activation in human uterine leiomyomas." Mol Med 14.5-6 (May 2008): 264-275.
PMID
18231572
Source
pubmed
Published In
Molecular medicine (Cambridge, Mass.)
Volume
14
Issue
5-6
Publish Date
2008
Start Page
264
End Page
275
DOI
10.2119/2007-00101.Yu

Cervical screening and general physical examination behaviors of women exposed in utero to diethylstilbestrol.

OBJECTIVE: To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women. MATERIALS AND METHODS: 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations. RESULTS: Diethylstilbestrol-exposed women exceeded the recommended frequency of Papanicolaou smear screenings [adjusted odds ratio (aOR) = 2.15, 95% CI (confidence interval) = 1.60-2.88] compared to the unexposed. This association held among those without a history of cervical intraepithelial neoplasia (aOR = 1.88, 95% CI = 1.35-2.62). Diethylstilbestrol-exposed women exceeded annual recommendations for physical examinations (aOR = 2.27, 95% CI = 1.16-4.43) among women without a history of chronic disease when compared to unexposed women. CONCLUSIONS: Most DES-exposed women are receiving cervical cancer screening at least at recommended intervals, but one third of the women are not receiving annual Papanicolaou smear examinations.

Authors
Camp, EA; Coker, AL; Troisi, R; Robboy, SJ; Noller, KL; Goodman, KJ; Titus-Ernstoff, LT; Hatch, EE; Herbst, AL; Kaufman, RH; Adam, E
MLA Citation
Camp, EA, Coker, AL, Troisi, R, Robboy, SJ, Noller, KL, Goodman, KJ, Titus-Ernstoff, LT, Hatch, EE, Herbst, AL, Kaufman, RH, and Adam, E. "Cervical screening and general physical examination behaviors of women exposed in utero to diethylstilbestrol." J Low Genit Tract Dis 12.2 (April 2008): 111-117.
PMID
18369304
Source
pubmed
Published In
Journal of Lower Genital Tract Disease
Volume
12
Issue
2
Publish Date
2008
Start Page
111
End Page
117
DOI
10.1097/LGT.0b013e31815ae980

The association between in utero cigarette smoke exposure and age at menopause.

Menopause onset, on average, occurs earlier among women who smoke cigarettes than among women who do not smoke. Prenatal smoke exposure may also influence age at menopause through possible effects on follicle production in utero. Smoking information was obtained from the mothers of 4,025 participants in the National Cooperative Diethylstilbestrol Adenosis (DESAD) Project, a US study begun in 1975 to examine the health effects of prenatal diethylstilbestrol exposure. Between 1994 and 2001, participants provided information on menopausal status. Cox proportional hazards modeling compared the probability of menopause among participants who were and were not prenatally exposed to maternal cigarette smoke. Participants prenatally exposed to maternal cigarette smoke were more likely than those unexposed to be postmenopause (hazard ratio = 1.21, 95% confidence interval: 1.02, 1.43). The association was present among only those participants who themselves had never smoked cigarettes (hazard ratio = 1.38, 95% confidence interval: 1.10, 1.74) and was absent among active smokers (hazard ratio = 1.03, 95% confidence interval: 0.81, 1.31). In this cohort of participants predominantly exposed to diethylstilbestrol, results suggest that prenatal exposure to maternal cigarette smoke may play a role in programming age at menopause. The possibility that active cigarette smoking modifies this effect is also suggested.

Authors
Strohsnitter, WC; Hatch, EE; Hyer, M; Troisi, R; Kaufman, RH; Robboy, SJ; Palmer, JR; Titus-Ernstoff, L; Anderson, D; Hoover, RN; Noller, KL
MLA Citation
Strohsnitter, WC, Hatch, EE, Hyer, M, Troisi, R, Kaufman, RH, Robboy, SJ, Palmer, JR, Titus-Ernstoff, L, Anderson, D, Hoover, RN, and Noller, KL. "The association between in utero cigarette smoke exposure and age at menopause." Am J Epidemiol 167.6 (March 15, 2008): 727-733.
PMID
18192675
Source
pubmed
Published In
American Journal of Epidemiology
Volume
167
Issue
6
Publish Date
2008
Start Page
727
End Page
733
DOI
10.1093/aje/kwm351

A clinicopathologic analysis of primary mucinous adenocarcinoma of the ovary in south Korea

Authors
Choi, G; Lee, HI; Kim, K-R; Robboy, SJ
MLA Citation
Choi, G, Lee, HI, Kim, K-R, and Robboy, SJ. "A clinicopathologic analysis of primary mucinous adenocarcinoma of the ovary in south Korea." January 2008.
Source
wos-lite
Published In
Laboratory Investigation
Volume
88
Publish Date
2008
Start Page
200A
End Page
200A

A clinicopathologic analysis of primary mucinous adenocarcinoma of the ovary in south Korea

Authors
Choi, G; Lee, HI; Kim, K-R; Robboy, SJ
MLA Citation
Choi, G, Lee, HI, Kim, K-R, and Robboy, SJ. "A clinicopathologic analysis of primary mucinous adenocarcinoma of the ovary in south Korea." January 2008.
Source
wos-lite
Published In
Modern Pathology
Volume
21
Publish Date
2008
Start Page
200A
End Page
200A

Maturation delayed in villous stromal components in complete hydatidiform mole in early pregnancy

Authors
Kim, K-R; Park, B-H; Hong, Y-O; Robboy, SJ
MLA Citation
Kim, K-R, Park, B-H, Hong, Y-O, and Robboy, SJ. "Maturation delayed in villous stromal components in complete hydatidiform mole in early pregnancy." January 2008.
Source
wos-lite
Published In
Modern Pathology
Volume
21
Publish Date
2008
Start Page
210A
End Page
210A

Maturation delayed in villous stromal components in complete hydatidiform mole in early pregnancy

Authors
Kim, K-R; Park, B-H; Hong, Y-O; Robboy, SJ
MLA Citation
Kim, K-R, Park, B-H, Hong, Y-O, and Robboy, SJ. "Maturation delayed in villous stromal components in complete hydatidiform mole in early pregnancy." January 2008.
Source
wos-lite
Published In
Laboratory Investigation
Volume
88
Publish Date
2008
Start Page
210A
End Page
210A

Differential expression of Receptor Tyrosine Kinases (RTKs) and IGF-I pathway activation in human uterine leiomyomas (Molecular Medicine (2008) 14: 5-6 (264-275))

Authors
Yu, L; Saile, K; Swartz, CD; He, H; Zheng, X; Kissling, GE; Di, X; Lucas, S; Robboy, SJ; Dixon, D
MLA Citation
Yu, L, Saile, K, Swartz, CD, He, H, Zheng, X, Kissling, GE, Di, X, Lucas, S, Robboy, SJ, and Dixon, D. "Differential expression of Receptor Tyrosine Kinases (RTKs) and IGF-I pathway activation in human uterine leiomyomas (Molecular Medicine (2008) 14: 5-6 (264-275))." Molecular Medicine 14.7-8 (2008): 538--.
Source
scival
Published In
Molecular medicine (Cambridge, Mass.)
Volume
14
Issue
7-8
Publish Date
2008
Start Page
538-
DOI
10.2119/2007-00101.Erratum.Yu

A primer of endometrial cytology with histological correlation.

Cytology is an effective method for assessing benign endometrium and for discovering premalignant and malignant endometrial states. In addition, it is useful for diagnosing non-neoplastic abnormalities of the endometrium. This overview compares endometrial cytology to endometrial histology for a variety of benign, abnormal non-neoplastic, and neoplastic conditions; and, discusses both diagnostic criteria and pitfalls in the assessment of endometrial brushings specimens. It also makes an attempt to estimate levels of confidence in endometrial cytodiagnosis. When endometrial brushing is used in conjunction with other diagnostic techniques such as ultrasonography/sonohysterography or hysteroscopy, cytology becomes a sensitive case finding technique that shows good patient acceptance (because of a significant decrease in procedure-associated pain) and high diagnostic yield.

Authors
Maksem, JA; Meiers, I; Robboy, SJ
MLA Citation
Maksem, JA, Meiers, I, and Robboy, SJ. "A primer of endometrial cytology with histological correlation." Diagn Cytopathol 35.12 (December 2007): 817-844. (Review)
PMID
18008351
Source
pubmed
Published In
Diagnostic Cytopathology
Volume
35
Issue
12
Publish Date
2007
Start Page
817
End Page
844
DOI
10.1002/dc.20745

Cancer risk in women prenatally exposed to diethylstilbestrol.

Prenatal diethylstilbestrol (DES) exposure is associated with excess risks of clear cell adenocarcinoma (CCA), and breast cancer in older women. Whether overall cancer risk is also elevated is unclear. Total and site-specific cancer risks were evaluated in the DES Combined Cohort Follow-up Study using age- and calendar-year specific standardized incidence rate ratios (SIR), and age-adjusted incidence rate ratios (RR) comparing DES exposed and unexposed women. A total of 143 and 49 cancer cases occurred in 97,831 and 34,810 person-years among the exposed and unexposed, respectively. There was no overall excess risk among exposed women when compared with external rates (SIR 1.01; 95% confidence interval [CI] 0.86-1.2). The overall RR comparing exposed with unexposed women was 1.32 (95% CI 0.94-1.8). Breast cancer risk was elevated only among women over 40 years (RR 1.83; 95% CI 1.1-3.2). The CCA SIR among exposed women was nearly 40, and the estimated attack rate through age 39 was 1.6/1,000 women. CCA incidence decreased by over 80% after age 25 when compared with 20-24 years. Excluding CCA and breast cancer, the overall RR was 1.21 (95% CI 0.74-2.0). DES was not associated with excess risks of either endometrial or ovarian cancer. These data suggest that the DES associated increase in CCA incidence remains elevated through the reproductive years. There was no consistent evidence of risk excesses for cancers other than CCA, and breast cancer in older women. Given that the population is still young, continued follow-up is necessary to assess the overall carcinogenic impact of prenatal DES exposure.

Authors
Troisi, R; Hatch, EE; Titus-Ernstoff, L; Hyer, M; Palmer, JR; Robboy, SJ; Strohsnitter, WC; Kaufman, R; Herbst, AL; Hoover, RN
MLA Citation
Troisi, R, Hatch, EE, Titus-Ernstoff, L, Hyer, M, Palmer, JR, Robboy, SJ, Strohsnitter, WC, Kaufman, R, Herbst, AL, and Hoover, RN. "Cancer risk in women prenatally exposed to diethylstilbestrol." Int J Cancer 121.2 (July 15, 2007): 356-360.
PMID
17390375
Source
pubmed
Published In
International Journal of Cancer
Volume
121
Issue
2
Publish Date
2007
Start Page
356
End Page
360
DOI
10.1002/ijc.22631

Preeclampsia risk in women exposed in utero to diethylstilbestrol.

OBJECTIVE: To assess whether preeclampsia risk is elevated in pregnancies of diethylstilbestrol (DES)-exposed daughters. METHODS: This study used data from the National Cancer Institute DES Combined Cohorts Follow-up Study. A total of 285 preeclampsia cases (210 exposed and 75 unexposed) occurred in 7,313 live births (4,759 DES exposed and 2,554 unexposed). Poisson regression analysis estimated relative risks and 95% confidence intervals (CI) for preeclampsia adjusted for age at the index pregnancy, parity, education, smoking, body mass index, year of diagnosis, and cohort. RESULTS: In utero DES exposure was associated with nearly a 50% elevation in preeclampsia risk. Adjustment for preeclampsia risk factors attenuated the relative risk slightly (1.42, 95% CI 1.04-1.94). The excess risk with DES was concentrated among women who developed preeclampsia in their first pregnancies (relative risk 1.81, 95% CI 1.17-2.79), who were exposed before 15 weeks of gestation (relative risk 1.57, 95% CI 1.11-2.23), and who were treated with magnesium sulfate (relative risk 2.10, 95% CI 0.82-5.42). Among DES-exposed women who had a prior hysterosalpingogram, preeclampsia prevalence was higher in those with uterine abnormalities (12.4%) than in those without (7.7%). CONCLUSION: These data suggest that in utero exposure to DES is associated with a slightly elevated risk of preeclampsia, and that one possible biological mechanism involves uterine abnormalities.

Authors
Troisi, R; Titus-Ernstoff, L; Hyer, M; Hatch, EE; Robboy, SJ; Strohsnitter, W; Palmer, JR; Øglaend, B; Adam, E; Kaufman, R; Herbst, AL; Hoover, RN
MLA Citation
Troisi, R, Titus-Ernstoff, L, Hyer, M, Hatch, EE, Robboy, SJ, Strohsnitter, W, Palmer, JR, Øglaend, B, Adam, E, Kaufman, R, Herbst, AL, and Hoover, RN. "Preeclampsia risk in women exposed in utero to diethylstilbestrol." Obstet Gynecol 110.1 (July 2007): 113-120.
PMID
17601905
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
110
Issue
1
Publish Date
2007
Start Page
113
End Page
120
DOI
10.1097/01.AOG.0000268796.75591.02

Is stromal microinvasion in primary mucinous ovarian tumors with "mucin granuloma" true invasion?

Stromal microinvasion has been recently described in ovarian mucinous borderline tumors (MBTs), leading to proposals for new classifications, including a category of MBTs with stromal microinvasion. This study was conducted to test the validity of this belief. To determine whether stromal microinvasion can be distinguishable from extruded neoplastic epithelium from an adjacent ruptured gland, particularly if accompanied by a mucin granuloma (MG) on hematoxylin and eosin (H&E)-stained sections, we compared the histopathologic features of 138 primary ovarian mucinous tumors, consisting of 81 MBTs, 37 MBTs with stromal microinvasion, 11 intraglandular carcinomas, 2 with microinvasive foci, and 7 mucinous adenocarcinomas with extensive stromal invasion. Immunohistochemical analysis for cytokeratin was performed in 72 cases. Of 77 cases containing MGs, 52% contained "microinvasive foci," consisting of individually scattered epithelial or irregular glandular components in the intervening stroma, as determined by H&E staining. Of the 37 negative cases on H&E, cytokeratin reactivity was detected in 15 additional cases with epithelial/glandular components. Therefore, "stromal microinvasion" can be missed on H&E. All patients with MBT with or without microinvasive foci and localized intraglandular carcinoma with or without microinvasive foci had stage I tumors; none died of tumor-related causes during the follow-up period. Tumor-related deaths were identified only in 5 patients with extensive stromal invasion. This study suggests that some cases of stromal microinvasion in stage I MBTs not accompanied by high grade nuclear atypia represent mucocele-like stromal reaction to ruptured mucinous glands rather than true stromal invasion because isolated tumor cells were exclusively confined to the boundary of MGs and devoid of obvious cellular atypia, and no patient with stromal microinvasion died of tumor-related causes.

Authors
Kim, K-R; Lee, H-I; Lee, S-K; Ro, JY; Robboy, SJ
MLA Citation
Kim, K-R, Lee, H-I, Lee, S-K, Ro, JY, and Robboy, SJ. "Is stromal microinvasion in primary mucinous ovarian tumors with "mucin granuloma" true invasion?." Am J Surg Pathol 31.4 (April 2007): 546-554.
PMID
17414101
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
31
Issue
4
Publish Date
2007
Start Page
546
End Page
554
DOI
10.1097/01.pas.0000213430.68998.2c

Benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia.

Endometrial "hyperplasia," as currently diagnosed, includes the changes caused by an abnormal hormonal state and those caused by a separate category of monoclonal premalignant disease. The appearance of the disease in these 2 functional categories is discontinuous, permitting more specific diagnosis of the condition using the terms "benign endometrial hyperplasia" and "endometrial intraepithelial neoplasia" (EIN), respectively. Benign endometrial hyperplasia involves the entire endometrial compartment and, with protracted estrogen exposure, shows the progressive development of cysts, remodeled glands, vascular thrombi, and stromal microinfarcts. They are best construed as a sequence of changes whereby the appearance at any single time point is uniquely dependent on the preceding combination and the duration of hormonal exposures. In contrast, the premalignant clone of an EIN lesion is characteristically offset from the background endometrium by its altered cytology and crowded architecture. The use of an internal standard for cytology assessment, combined with the distinctive topography of a clonal process, enables the diagnosis of EIN lesions with a long-term cancer risk 45-fold greater than that of their benign endometrial hyperplasia counterparts. The resolution of hormonal and premalignant subsets of traditional "endometrial hyperplasias" is possible using redefined diagnostic criteria, enabling patient therapy to be appropriately matched with the underlying disease mechanisms.

Authors
Mutter, GL; Zaino, RJ; Baak, JPA; Bentley, RC; Robboy, SJ
MLA Citation
Mutter, GL, Zaino, RJ, Baak, JPA, Bentley, RC, and Robboy, SJ. "Benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia." Int J Gynecol Pathol 26.2 (April 2007): 103-114. (Review)
PMID
17413975
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
26
Issue
2
Publish Date
2007
Start Page
103
End Page
114
DOI
10.1097/PGP.0b013e31802e4696

Neoplasms and pathology of sexual developmental disorders (intersex).

Continuing new insights into the biology of sexual development and advances in chromosome analysis have led to early identification and prompt treatment of the intersexual patient, the results of which facilitate a more normal life for affected individuals. Based on these advances, a classification of abnormal sexual development has been developed and refined that correlates the gonadal and genital anatomy with the chromosomal findings and specific genetic or metabolic defects. In a shift from a classification anchored on whether the intersex revolves about a specific gene or whole chromosomal abnormality, the current classification is organised by broader categories into which the intersexual disorders are divided into 'abnormalities of genital differentiation', due largely to the abnormal production or sensitivity of a single hormone, or 'abnormalities in sex determination', due to abnormal gonadal differentiation, usually testicular, with or without chromosomal aberration. The current classification is an integrated approach to this complex group of disorders and is organised according to the manner by which patients present as well as on the pathophysiological basis of the defect. The classification also groups patients who are at high risk for development of gonadal neoplasia.

Authors
Robboy, SJ; Jaubert, F
MLA Citation
Robboy, SJ, and Jaubert, F. "Neoplasms and pathology of sexual developmental disorders (intersex)." Pathology 39.1 (February 2007): 147-163. (Review)
PMID
17365831
Source
pubmed
Published In
Pathology
Volume
39
Issue
1
Publish Date
2007
Start Page
147
End Page
163
DOI
10.1080/00313020601137359

Silent corticotroph cell pituitary adenoma in a struma ovarii.

This is the first report of a silent corticotroph cell pituitary adenoma arising in a struma ovarii. The patient, a 79-year-old woman, was found to have an asymptomatic left-sided adnexal mass confirmed by vaginal sonography to be a complex cystic and solid tumor. Pathological analysis demonstrated an 8-cm partially cystic struma ovarii in which there was a focus of predominantly basophilic adenohypophyseal cells arranged in a diffuse pattern, adjacent to mature neural tissue containing numerous Herring bodies. The epithelial lining cells of the colloid-filled small and cystic follicles were immunoreactive for thyroglobulin. The pituitary cells were predominantly immunoreactive for adrenocorticotropic hormone, in addition to synaptophysin.

Authors
Waugh, MS; Soler, AP; Robboy, SJ
MLA Citation
Waugh, MS, Soler, AP, and Robboy, SJ. "Silent corticotroph cell pituitary adenoma in a struma ovarii." Int J Gynecol Pathol 26.1 (January 2007): 26-29.
PMID
17197893
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
26
Issue
1
Publish Date
2007
Start Page
26
End Page
29
DOI
10.1097/01.pgp.0000228139.94339.e0

Designing the "next generation" of medical information systems

A new breed of medical information systems is required to more effectively address unresolved and newly emerging needs in the healthcare environment. This paper attempts to define those needs and describe the design and implementation of a solution. In order to rapidly develop a prototype solution that is both sustainable with minimal resources and adaptable to future (perhaps unforeseen) needs, certain design principles are proposed. A prototype application was developed using a high level ("abstract") object oriented approach that permits ongoing modification and adaptation at minimal cost. Standards for user interaction, data modeling, and data coding and retrieval were utilized to create a robust web-based application. Production uses as an autopsy information system, biospecimen management system, and clinical trial management system have ensued. © 2006 IEEE.

Authors
Dash, RC; Hubbard, C; Robboy, SJ; Proia, AD
MLA Citation
Dash, RC, Hubbard, C, Robboy, SJ, and Proia, AD. "Designing the "next generation" of medical information systems." Proceedings - 9th International Conference on Information Technology, ICIT 2006 (2007): 249-250.
Source
scival
Published In
Proceedings - 9th International Conference on Information Technology, ICIT 2006
Publish Date
2007
Start Page
249
End Page
250
DOI
10.1109/ICIT.2006.45

Dynamic behavioural interpretation of cervical intraepithelial neoplasia with molecular biomarkers.

The microscopic phenotype of cervical intraepithelial neoplasia (CIN) reflects a fine balance between factors that promote or reduce CIN development. A shortcoming of the current grading system is its reliance on static morphology and microscopic haematoxylin-eosin features of the epithelium alone. In reality, CIN is a dynamic process, and the epithelium may exhibit differing results over time. Functional biomarkers p16, Ki-67, p53, retinoblastoma protein cytokeratin (CK)14 and CK13, help in the assessment of an individual CIN's lesion's potential for progression and regression. The aggregate information provided by these biomarkers exceeds the value of the classic grading system. Consequently, many more CINs that will either regress or progress can be accurately identified. These findings agree with known molecular interactions between HPV and the host. For accurate interpretation of a CIN, it is essential that these biomarkers be determined quantitatively and separately in the superficial, middle and deep layers of the epithelium. Such geography-specific epithelial evaluations of quantitative biomarkers emphasise the dynamic nature of a particular CIN lesion, thereby changing the art of static morphology grading into dynamic interpretation of the diseased tissue, with a strong prognostic effect.

Authors
Baak, JPA; Kruse, A-J; Robboy, SJ; Janssen, EAM; van Diermen, B; Skaland, I
MLA Citation
Baak, JPA, Kruse, A-J, Robboy, SJ, Janssen, EAM, van Diermen, B, and Skaland, I. "Dynamic behavioural interpretation of cervical intraepithelial neoplasia with molecular biomarkers." J Clin Pathol 59.10 (October 2006): 1017-1028. (Review)
PMID
16679355
Source
pubmed
Published In
Journal of Clinical Pathology
Volume
59
Issue
10
Publish Date
2006
Start Page
1017
End Page
1028
DOI
10.1136/jcp.2005.027839

Birth weight and breast cancer risk.

Exploring whether the positive association between birth weight and breast cancer risk differs by other breast cancer risk factors may help inform speculation about biological mechanism. In these data, high birth weight was associated with breast cancer risk in younger and in more educated women, but was not associated overall.

Authors
Troisi, R; Hatch, EE; Titus-Ernstoff, L; Palmer, JR; Hyer, M; Strohsnitter, WC; Robboy, SJ; Kaufman, R; Herbst, A; Adam, E; Hoover, RN
MLA Citation
Troisi, R, Hatch, EE, Titus-Ernstoff, L, Palmer, JR, Hyer, M, Strohsnitter, WC, Robboy, SJ, Kaufman, R, Herbst, A, Adam, E, and Hoover, RN. "Birth weight and breast cancer risk." Br J Cancer 94.11 (June 5, 2006): 1734-1737.
PMID
16641898
Source
pubmed
Published In
British Journal of Cancer
Volume
94
Issue
11
Publish Date
2006
Start Page
1734
End Page
1737
DOI
10.1038/sj.bjc.6603122

Transtubal spread of serous adenocarcinoma of the endometrium: an underrecognized mechanism of metastasis.

Most endometrial carcinomas metastasize by invading myometrial lymphatics and spreading to regional lymph nodes. However, uterine serous carcinomas (USCs) metastasize frequently to peritoneal surfaces even when only minimally invasive. This study examines the methods of spread and the role of retrograde transtubal spread. Eighty-seven USCs treated by hysterectomy were identified. Primary peritoneal cases and cases with significant ovarian involvement were excluded. Eighty (92%) cases were pure serous, and the remainder had at least 25% serous histology. Fifty-four of 87 (62%) had extrauterine spread at hysterectomy, most commonly to peritoneal surfaces and sometimes to the pelvic lymph nodes. Twenty-six of 54 (48%) cases had no lymphatic/vascular (LV) invasion and 18/54 (33%) had no myometrial invasion. Eleven of these 54 (20%) patients with metastases lacked both myometrial and LV invasion, and the metastases involved the peritoneal surface more often than the lymph nodes (p<0.001). Three of the 11 cases had tumor clusters in the fallopian tube lumen. Another 13 cases also had clusters of tumor within the fallopian tube lumen, and all 16 cases had peritoneal spread (p<0.001). Extrauterine spread correlated highly with LV invasion (p<0.001) but not with the presence or depth of myometrial invasion. Retrograde transtubal implantation as well LV invasion are two important mechanisms by which USC spreads; all cases with tumor clusters in the fallopian tube lumen had peritoneal spread. This explains the phenomenon whereby patients with serous carcinomas confined to the endometrium and lacking LV invasion have widespread metastases to the peritoneum.

Authors
Snyder, MJ; Bentley, R; Robboy, SJ
MLA Citation
Snyder, MJ, Bentley, R, and Robboy, SJ. "Transtubal spread of serous adenocarcinoma of the endometrium: an underrecognized mechanism of metastasis." Int J Gynecol Pathol 25.2 (April 2006): 155-160.
PMID
16633065
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
25
Issue
2
Publish Date
2006
Start Page
155
End Page
160
DOI
10.1097/01.pgp.0000179614.47838.82

Lymphoma of the female genital tract: current status.

SUMMARY: : Primary lymphomas affecting the female reproductive system are uncommon but often pose a diagnostic challenge if their existence is not suspected. This article reviews the pathological and clinical features of lymphomas occurring in various sites in the female genital tract including the vulva, vagina, cervix, endometrium, fallopian tubes, and ovaries. Using the recent World Health Organization classification, the various types of lymphomas are identified as separate diseases and not as morphological variations of the same disease. The immunophenotypic and cytogenetics features of the major lymphomas are summarized. The incidence, presenting symptoms, gross and microscopic features, major differential diagnostic considerations, response to therapy, and expected outcome are discussed. Using published data on patient outcome, the International Federation of Obstetricians and Gynecologists and Ann Arbor staging systems are compared for their predictive value, and the difficulty in assigning primary and secondary status in extranodal lymphomas is emphasized. The observed differences in the behavior of some lymphomas in gynecological sites compared with their usual nodal location are presented. Finally, the possible etiology of these conditions is discussed in light of the emerging paradigm of mucosa-associated lymphoid tissue lymphomas.

Authors
Lagoo, AS; Robboy, SJ
MLA Citation
Lagoo, AS, and Robboy, SJ. "Lymphoma of the female genital tract: current status." Int J Gynecol Pathol 25.1 (January 2006): 1-21. (Review)
PMID
16306779
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
25
Issue
1
Publish Date
2006
Start Page
1
End Page
21

Age at natural menopause in women exposed to diethylstilbestrol in utero

Age at natural menopause is related to several health outcomes, including cardiovascular disease and overall mortality. Age at menopause may be influenced by the number of follicles formed during gestation, suggesting that prenatal factors could influence menopausal age. Diethylstilbestrol (DES), a nonsteroidal estrogen widely prescribed during the 1950s and 1960s, is related to reproductive tract abnormalities, infertility, and vaginal cancer in prenatally exposed daughters but has not been studied in relation to age at menopause. The authors used survival analyses to estimate the risk of natural menopause in 4,210 DES-exposed versus 1,829 unexposed US women based on responses to questionnaires mailed in 1994, 1997, and 2001. DES-exposed women were 50% more likely to experience natural menopause at any given age (hazard ratio = 1.49, 95% confidence interval: 1.28, 1.74). Among women for whom dose information was complete, there were dose-response effects, with a greater than twofold risk for those exposed to >10,000 mg. The causal mechanism for earlier menopause may be related to a smaller follicle pool, more rapid follicle depletion, or changes in hormone synthesis and metabolism in DES-exposed daughters. Age at menopause has been related, albeit inconsistently, to several exposures, but, to the authors' knowledge, this is the first study to suggest that a prenatal exposure may influence reproductive lifespan. Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved.

Authors
Hatch, EE; Troisi, R; Wise, LA; Hyer, M; Palmer, JR; Titus-Ernstoff, L; Strohsnitter, W; Kaufman, R; Adam, E; Noller, KL; Herbst, AL; Robboy, S; Hartge, P; Hoover, RN
MLA Citation
Hatch, EE, Troisi, R, Wise, LA, Hyer, M, Palmer, JR, Titus-Ernstoff, L, Strohsnitter, W, Kaufman, R, Adam, E, Noller, KL, Herbst, AL, Robboy, S, Hartge, P, and Hoover, RN. "Age at natural menopause in women exposed to diethylstilbestrol in utero." American Journal of Epidemiology 164.7 (2006): 682-688.
PMID
16887893
Source
scival
Published In
American Journal of Epidemiology
Volume
164
Issue
7
Publish Date
2006
Start Page
682
End Page
688
DOI
10.1093/aje/kwj257

Differential expression of p63 isoforms in female reproductive organs.

p63 is the identity switch for uterine/vaginal epithelial cell fate, and disruption of p63 expression by diethylstilbestrol (DES) induces cervical/vaginal adenosis in mice. In this article, we report the expression patterns of p63 isoforms (TA, DeltaN, alpha, beta and gamma) in mice, focusing on the reproductive tract. We also present the reproductive tract phenotype of female p63-/- mice. Finally, to better evaluate the potential role of p63 in human development of DES-induced cervical/vaginal adenosis, we describe the ontogeny of p63 in human female fetuses. In adult mice, the DeltaN isoforms of p63 were expressed only in squamous/basal/myoepithelial cells of epithelial tissues, while TA isoforms of p63 were highly expressed in germ cells of the ovary and testis. In fetal mice, the DeltaN and alpha forms of p63 were expressed in the cloacal and urogenital sinus epithelia. In the female p63-/- mice, the sinus vagina developed, but p63-/- sinus vaginal epithelium failed to undergo squamous differentiation confirming an essential role of p63 in squamous epithelial differentiation. Although TAp63 was highly expressed in developing primordial germ cells/oocytes, p63-/- ovaries and oocytes developed normally. The ontogeny of p63 in female reproductive organs was essentially identical in mouse and human. In the human fetus at the susceptible stage for DES-induced cervical/vaginal adenosis, most cervical/vaginal epithelial cells were columnar and negative for p63. Therefore, inhibition of p63 expression by DES should change the cell fate of human Müllerian duct epithelial cells and cause cervical/vaginal adenosis as previously demonstrated in mouse.

Authors
Kurita, T; Cunha, GR; Robboy, SJ; Mills, AA; Medina, RT
MLA Citation
Kurita, T, Cunha, GR, Robboy, SJ, Mills, AA, and Medina, RT. "Differential expression of p63 isoforms in female reproductive organs." Mech Dev 122.9 (September 2005): 1043-1055.
PMID
15922574
Source
pubmed
Published In
Mechanisms of Development
Volume
122
Issue
9
Publish Date
2005
Start Page
1043
End Page
1055
DOI
10.1016/j.mod.2005.04.008

Hypospadias in sons of women exposed to diethylstilbestrol in utero.

BACKGROUND: Diethylstilbestrol (DES) is a synthetic estrogen that was widely prescribed to pregnant women before 1971. DES increases the risk of breast cancer in women who took the drug and the risk of reproductive tract abnormalities in their offspring. Dutch investigators have reported a 20-fold increase in risk of hypospadias among sons of women who were exposed to DES in utero. We assessed this relation in data from an ongoing study of DES-exposed persons. METHODS: Several U.S. cohorts of women with documented exposure in utero to DES have been followed by mailed questionnaires since the 1970s. Comparison subjects are unexposed women of the same ages. In 1997, participants were asked about congenital abnormalities in their children. We calculated prevalence odds ratios for the risk of hypospadias in sons of exposed mothers relative to sons of unexposed mothers using generalized estimating equations to adjust for multiple sons per mother and controlling for maternal age at the son's birth. RESULTS: We obtained data from 3916 exposed and 1746 unexposed women. These women reported a total of 13 liveborn sons with hypospadias (10 exposed, 3 unexposed). The prevalence odds ratio for risk of hypospadias among the exposed was 1.7 (95% confidence interval = 0.4-6.8). CONCLUSIONS: Our findings do not support a greatly increased risk of hypospadias among the sons of women exposed to DES in utero, as has been previously reported.

Authors
Palmer, JR; Wise, LA; Robboy, SJ; Titus-Ernstoff, L; Noller, KL; Herbst, AL; Troisi, R; Hoover, RN
MLA Citation
Palmer, JR, Wise, LA, Robboy, SJ, Titus-Ernstoff, L, Noller, KL, Herbst, AL, Troisi, R, and Hoover, RN. "Hypospadias in sons of women exposed to diethylstilbestrol in utero." Epidemiology 16.4 (July 2005): 583-586.
PMID
15951681
Source
pubmed
Published In
Epidemiology
Volume
16
Issue
4
Publish Date
2005
Start Page
583
End Page
586

Synchronous endometrial and ovarian tumors: metastatic disease or independent primaries?

Authors
Robboy, SJ; Datto, MB
MLA Citation
Robboy, SJ, and Datto, MB. "Synchronous endometrial and ovarian tumors: metastatic disease or independent primaries?." Hum Pathol 36.6 (June 2005): 597-599.
PMID
16021564
Source
pubmed
Published In
Human Pathology
Volume
36
Issue
6
Publish Date
2005
Start Page
597
End Page
599
DOI
10.1016/j.humpath.2005.05.012

Risk of benign gynecologic tumors in relation to prenatal diethylstilbestrol exposure.

OBJECTIVE: To investigate the association between prenatal diethylstilbestrol (DES) exposure and risk of benign gynecologic tumors. METHODS: We conducted a collaborative follow-up study of women with and without documented intrauterine exposure to DES. We compared the incidence of self-reported ovarian cysts, paraovarian cysts, and uterine leiomyomata confirmed by medical record in DES-exposed and unexposed women. RESULTS: A total of 85 cases of uterine leiomyomata and 168 cases of ovarian or paraovarian cysts were confirmed histologically. After adjustment for age, no association was found between prenatal DES exposure and ovarian cysts or uterine leiomyomata. Prenatal DES exposure was positively associated with paraovarian cysts. CONCLUSION: The present results do not support the hypothesis that prenatal DES exposure increases risk of uterine leiomyomata or ovarian cysts. Prenatal DES exposure was associated with an increased risk of paraovarian cysts, but detection bias cannot be ruled out as an explanation of this finding.

Authors
Wise, LA; Palmer, JR; Rowlings, K; Kaufman, RH; Herbst, AL; Noller, KL; Titus-Ernstoff, L; Troisi, R; Hatch, EE; Robboy, SJ
MLA Citation
Wise, LA, Palmer, JR, Rowlings, K, Kaufman, RH, Herbst, AL, Noller, KL, Titus-Ernstoff, L, Troisi, R, Hatch, EE, and Robboy, SJ. "Risk of benign gynecologic tumors in relation to prenatal diethylstilbestrol exposure." Obstet Gynecol 105.1 (January 2005): 167-173.
PMID
15625159
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
105
Issue
1
Publish Date
2005
Start Page
167
End Page
173
DOI
10.1097/01.AOG.0000147839.74848.7c

Retrograde transtubal spread in extra-uterine metastasis of uterine serous carcinoma

Authors
Snyder, MJ; Bentley, RC; Lutman, C; Robboy, SJ
MLA Citation
Snyder, MJ, Bentley, RC, Lutman, C, and Robboy, SJ. "Retrograde transtubal spread in extra-uterine metastasis of uterine serous carcinoma." January 2005.
Source
wos-lite
Published In
Laboratory Investigation
Volume
85
Publish Date
2005
Start Page
204A
End Page
205A

Retrograde transtubal spread in extra-uterine metastasis of uterine serous carcinoma

Authors
Snyder, MJ; Bentley, RC; Lutman, C; Robboy, SJ
MLA Citation
Snyder, MJ, Bentley, RC, Lutman, C, and Robboy, SJ. "Retrograde transtubal spread in extra-uterine metastasis of uterine serous carcinoma." January 2005.
Source
wos-lite
Published In
Modern Pathology
Volume
18
Publish Date
2005
Start Page
204A
End Page
205A

Combined p53 and retinoblastoma protein detection identifies persistent and regressive cervical high-grade squamous intraepithelial lesions

Most cervical high-grade squamous intraepithelial lesions (HSILs) persist, but approximately one third regress (ie, no HSIL in follow-up biopsies). To identify factors related to histologic proven persistence or regression. Twenty-eight small histologic (marker) biopsies with adequate follow-up were analyzed for human papillomavirus (HPV) genotypes and different immunoquantitative proliferation, cell cycle regulation, and differentiation markers. All cases had a biopsy-interval between the marker and first follow-up biopsy of at least 100 days (median, 8.2 months; range, 3.4-22.5 months). Follow-up was classified as regression or persistence. All lesions were high-risk (hr) HPV and p16 positive, 63% for HPV-16 or HPV-16 mixed with other hr genotypes, while 37% had other hrHPV types. The marker biopsies of the persistent HSILs had lower p53 and retinoblastoma protein (pRb) detected in the deep half of the epithelium (P = 0.001 and 0.02, respectively) than nonpersistent HSILs. The degree of positivity of p16, Ki-67, cyclin D1, lesion extent, positivity of the resection margins, and patient age were all unrelated to persistence or regression. Lesions with HPV-16 or mixed-16 genotypes had a significantly lower percentage of pRb (P = 0.02), p53 (P = 0.02), and cyclin D (P = 0.04) positive nuclei in the deep epithelial layers. In agreement with this, type-16 positive HSILs had a lower regression percentage than those with other HPV types, but the difference was not significant. HSILs with combined negativity/low positivity for p53 and pRb protein in small histologic biopsies are highly likely to persist, contrasting those in which one of these cell cycle regulators is strongly positive (p53 > 15%; pRb > 40%). Copyright © 2005 by Lippincott Williams & Wilkins.

Authors
Baak, JPA; Kruse, A-J; Garland, SM; Skaland, I; Janssen, EAM; Tabrizi, S; Fagerheim, S; Robboy, S; Nilsen, S-T
MLA Citation
Baak, JPA, Kruse, A-J, Garland, SM, Skaland, I, Janssen, EAM, Tabrizi, S, Fagerheim, S, Robboy, S, and Nilsen, S-T. "Combined p53 and retinoblastoma protein detection identifies persistent and regressive cervical high-grade squamous intraepithelial lesions." American Journal of Surgical Pathology 29.8 (2005): 1062-1066.
PMID
16006801
Source
scival
Published In
American Journal of Surgical Pathology
Volume
29
Issue
8
Publish Date
2005
Start Page
1062
End Page
1066

The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 world health organization classification system

BACKGROUND. The objective of this study was to compare the accuracy of disease progression prediction of the molecular genetics and morphometry-based Endometrial Intraepithelial Neoplasia (EIN) and World Health Organization 1994 (WHO94) classification systems in patients with endometrial hyperplasias. METHODS. A multicenter, multivariate analysis was conducted on 477 patients with endometrial hyperplasia who were required to have a 1-year minimum disease-free interval from the time of the index biopsy (1-18 years of follow-up). The results from that analysis were compared with the results from 197 patients who had < 1 year of follow-up. RESULTS. Twenty-four of 477 hyperplasias (5.0%) progressed to malignant disease over an average of 4 years (maximum, 10 years). According to the WHO94 classification, 16 of 123 atypical hyperplasias (13%) and 8 of 354 nonatypical hyperplasias (2.3%) progressed (hazard ratio [HR] = 7). Twenty-two of 118 EINs (19%) and 2 of 359 non-EINs (0.6%) progressed (HR = 45). EIN was prognostic within each WHO94 subcategory. Progression rates were 3% in simple hyperplasias, 22% in complex hyperplasias, 17% in simple atypical hyperplasias, and 38% in complex atypical hyperplasias with EIN, compared with progression rates of 0.0-2.0% in all hyperplasias if EIN was absent. EIN detected precancerous lesions (sensitivity, 92%) better than WHO94 atypical hyperplasias collectively (67%) or complex atypical hyperplasias alone (46%). In a Cox regression analysis, EIN was the strongest prognostic index of future endometrial carcinoma. The same was true for patients with < 1 year of follow-up (HR for EIN, atypical hyperplasia, and complex atypical hyperplasia: 58, 7, and 8, respectively). CONCLUSIONS. The EIN classification system predicted disease progression more accurately than the WHO94 classification and identified many women with benign changes that would have been regarded as high risk according to the WHO94 classification system. © 2005 American Cancer Society.

Authors
Baak, JP; Mutter, GL; Robboy, S; Diest, PJV; Uyterlinde, AM; Ørbo, A; Palazzo, J; Fiane, B; Løvslett, K; Burger, C; Voorhorst, F; Verheijen, RH
MLA Citation
Baak, JP, Mutter, GL, Robboy, S, Diest, PJV, Uyterlinde, AM, Ørbo, A, Palazzo, J, Fiane, B, Løvslett, K, Burger, C, Voorhorst, F, and Verheijen, RH. "The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 world health organization classification system." Cancer 103.11 (2005): 2304-2312.
PMID
15856484
Source
scival
Published In
Cancer
Volume
103
Issue
11
Publish Date
2005
Start Page
2304
End Page
2312
DOI
10.1002/cncr.21058

Interobserver and intraobserver variability in the histological dating of the endometrium in fertile and infertile women.

OBJECTIVE: To assess effects of biopsy timing and fertility status on inter- and intraobserver variability in dating of the endometrium. DESIGN: Endometrial biopsy slides randomly selected from a multicenter study testing the utility of biopsy in the diagnosis of infertility were distributed to three gynecologic pathologists, who estimated cycle day using standard criteria. Readers were blinded to the purpose of the study, patient age, fertility status, or timing of biopsy relative to LH surge or next menses. SETTING: Multicenter academic research programs in reproductive medicine. PATIENT(S): Eighty-two women with proven fertility, 83 infertile patients. INTERVENTION(S): Endometrial biopsy during midluteal (days 21-22) or late (days 26-27) luteal phase. MAIN OUTCOME MEASURE(S): Intraclass correlation coefficient (ICC), kappa. RESULT(S): Overall agreement was excellent (ICC 0.88); addition of readings by local pathologists decreased ICC only slightly. In subgroup analyses, ICCs were lowest for infertile women during the midluteal phase (0.65 vs. 0.71 for fertile women in the midluteal phase, and 0.88-0.90 for both groups in the late luteal phase). Intraobserver reliability was excellent (0.9-0.99). Agreement for diagnoses of "out-of-phase" was only moderate, with kappa values between 0.4 and 0.6. CONCLUSION(S): Observer variability in dating the endometrium was greatest in infertile women during the window of implantation.

Authors
Myers, ER; Silva, S; Barnhart, K; Groben, PA; Richardson, MS; Robboy, SJ; Leppert, P; Coutifaris, C; NICHD National Cooperative Reproductive Medicine Network,
MLA Citation
Myers, ER, Silva, S, Barnhart, K, Groben, PA, Richardson, MS, Robboy, SJ, Leppert, P, Coutifaris, C, and NICHD National Cooperative Reproductive Medicine Network, . "Interobserver and intraobserver variability in the histological dating of the endometrium in fertile and infertile women." Fertil Steril 82.5 (November 2004): 1278-1282.
PMID
15533342
Source
pubmed
Published In
Fertility and Sterility
Volume
82
Issue
5
Publish Date
2004
Start Page
1278
End Page
1282
DOI
10.1016/j.fertnstert.2004.04.058

An abnormal cervicovaginal cytology smear in uterine carcinosarcoma is an adverse prognostic sign: analysis of 25 cases.

Carcinosarcoma of the uterus has been poorly characterized on cervicovaginal (Pap) smears, and we examine whether they effectively screen for carcinosarcoma and whether an abnormal Pap smear result has any clinical importance. Twenty-five patients with histologically confirmed carcinosarcoma had a conventional Pap smear shortly before diagnosis. Eleven smears (44%) originally were read as abnormal (malignant or atypical), and 4 additional cases were read as abnormal on retrospective review (15/25 [60%]). All malignant elements were epithelial, and 2 cases (8%) had atypical spindle cells, but no diagnostic sarcoma. Cervical involvement was the only histologic parameter correlating with an abnormal Pap smear result (P = .04). Univariate analysis found stage III or IV disease was an adverse prognostic sign compared with stage I or II disease (mean survival, 8 vs 36 months, respectively; P = .001), and multivariate analysis indicated that an abnormal Pap smear result correlated with worse survival (P = .023). The conventional Pap smear is insensitive (60%) for detecting carcinosarcoma, but when the result is abnormal, the Pap is an important stage-independent adverse prognosticator.

Authors
Snyder, MJ; Robboy, SJ; Vollmer, RT; Dodd, LG
MLA Citation
Snyder, MJ, Robboy, SJ, Vollmer, RT, and Dodd, LG. "An abnormal cervicovaginal cytology smear in uterine carcinosarcoma is an adverse prognostic sign: analysis of 25 cases." Am J Clin Pathol 122.3 (September 2004): 434-439.
PMID
15362375
Source
pubmed
Published In
American Journal of Clinical Pathology
Volume
122
Issue
3
Publish Date
2004
Start Page
434
End Page
439
DOI
10.1309/KUA1-FQ3B-QRC8-YG4V

A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium.

We describe a histologic feature useful in the diagnosis of endometrial polyps, namely, the parallel arrangement of the endometrial glands' long axis to the surface epithelium (PGE). Polyps that are removed intact are usually easy to diagnose because of the polypoid appearance plus surface epithelium on all sides. In addition, there are thick-walled blood vessels and irregularly shaped glands. Rarely are all or even some of the characteristic features easy to identify in biopsies and curettage specimens. We evaluated 76 cases of grossly identifiable polyps from hysterectomy or polypectomy (working group) for various histologic features and tested the validity of those findings with another 75 specimens (test group), which had been diagnosed as polyps in another institute by separate investigators. The frequency of the various histologic features in the polyps varied depending on the menstrual state, shape, and histologic types of the polyps. PGE was found in 80% (40 of 50 polyps) of premenopausal women as the most common histologic feature, but it was less common in postmenopausal women (42%, 11 of 26) (P = 0.001). All functional polyps (100%, 19 of 19), many of hyperplastic polyp (65%, 20 of 31), and some fibrous polyps (38%, 8 of 21) showed the change. In premenopausal women, incidence of PGE was significantly different by the polyp's shape or histologic types (P < 0.05), but not in postmenopausal women. PGE was not identified in any of the 56 normal background endometria, even though the surface was often undulated. Almost identical findings were observed in the series from the test group, confirming the validity of this new finding. In summary, PGE, if present, is a useful histologic finding in facilitating the diagnosis of endometrial polyp in curettage specimens.

Authors
Kim, K-R; Peng, R; Ro, JY; Robboy, SJ
MLA Citation
Kim, K-R, Peng, R, Ro, JY, and Robboy, SJ. "A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium." Am J Surg Pathol 28.8 (August 2004): 1057-1062.
PMID
15252313
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
28
Issue
8
Publish Date
2004
Start Page
1057
End Page
1062

Mucinous adenocarcinoma arising in rectovaginal fistulas associated with Crohn's disease.

BACKGROUND: Crohn's disease is a chronic inflammatory disorder characterized by focal, transmural inflammation of the intestine. Gynecologic involvement, including rectovaginal fistula formation, is frequent. Case #1. A 53-year-old female with a 30-year history of Crohn's disease and numerous perirectal fistulas developed a foul smelling, purulent drainage from her rectum and a mucopurulent, bloody discharge from her vagina. A lower vaginal lesion biopsy demonstrated a low-grade mucinous adenocarcinoma. Case #2. A 42-year-old female with a 15-year history of Crohn's disease developed drainage from her vagina. Physical examination revealed an enlarging mass involving the posterior wall of the vaginal vault that connected to the anus by a fistula tract. A biopsy revealed mucinous adenocarcinoma. CONCLUSIONS: Malignant transformation of persistent rectovaginal fistulas is a potential complication of Crohn's disease.

Authors
Moore-Maxwell, CA; Robboy, SJ
MLA Citation
Moore-Maxwell, CA, and Robboy, SJ. "Mucinous adenocarcinoma arising in rectovaginal fistulas associated with Crohn's disease." Gynecol Oncol 93.1 (April 2004): 266-268.
PMID
15047250
Source
pubmed
Published In
Gynecologic Oncology
Volume
93
Issue
1
Publish Date
2004
Start Page
266
End Page
268
DOI
10.1016/j.ygyno.2003.11.056

Placental site trophoblastic tumor arising from antecedent molar pregnancy.

OBJECTIVE: Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease. Little is known about its pathogenesis and natural history. METHODS: This report describes two cases that arose in patients with documented complete hydatidiform moles and summarizes the antecedent prenatal histories of PSTTs based on a detailed Medline literature analysis. CASES: A 28-year-old, G(2)P(2) female had a live, 12-week gestation fetus and a coexisting molar pregnancy. Her hCG levels dropped promptly from 1.5 million to 23,273 IU/ml after termination, but rose shortly thereafter together with the onset of recurrent vaginal bleeding. Curettage revealed persistent mole. Persistently elevated hCG led to hysterectomy disclosing a fundal PSTT. The second case was that of a 48-year-old, G(2) woman who presented with symptoms of preeclampsia, hyperthyroidism, and elevated hCG. Curettage yielded a complete hydatidiform mole. Although the hCG level decreased for a short period, it soon increased despite treatment with methotrexate. A second curettage revealed a PSTT. DISCUSSION: A Medline literature analysis of PSTT, which consists almost entirely of individual cases and several small series, disclosed that PSTT is preceded in 61% of cases by normal term pregnancy, 12% molar pregnancy, 9% spontaneous abortion, 8% therapeutic abortion, and 3% with ectopic pregnancy, stillbirths or preterm delivery. No information is known in 7%. This report describes two additional cases of PSTT preceded by complete molar pregnancy. CONCLUSIONS: PSTT is a well recognized, but uncommon form of gestational trophoblastic disease. Although little is known about its pathogenesis, it is preceded not uncommonly by an abnormal pregnancy, including a molar pregnancy.

Authors
Moore-Maxwell, CA; Robboy, SJ
MLA Citation
Moore-Maxwell, CA, and Robboy, SJ. "Placental site trophoblastic tumor arising from antecedent molar pregnancy." Gynecol Oncol 92.2 (February 2004): 708-712. (Review)
PMID
14766272
Source
pubmed
Published In
Gynecologic Oncology
Volume
92
Issue
2
Publish Date
2004
Start Page
708
End Page
712
DOI
10.1016/j.ygyno.2003.10.048

Ki67 predicts progression in early CIN: Validation of a multivariate progression-risk model

This study of early CIN biopsies (25 CIN1 and 65 CIN2) with long follow-up was done to validate, in a new group of patients, the value of Ki67 immuno-quantitative features to predict high CIN grade in a follow-up biopsy (often denoted to as "progression"), as described in a previous study. Each biopsy in the present study was classified with the previously described Ki67-model (consisting of the stratification index and the % positive nuclei in the middle third layer of the epithelium) as "low-risk" or "high-risk", and matched with the follow-up outcome (progression-or-not). Furthermore, it was studied whether subjective evaluation of the Ki67 sections by experienced pathologists, who were aware of the prognostic quantitative Ki67 features, could also predict the outcome. Thirdly, the reproducibility of routine use of the quantitative Ki67-model was assessed. Fifteen cases progressed (17%) to CIN3, 2/25 CIN1 (8%) and 13/65 CIN2 (20%), indicating that CIN grade (as CIN1 or CIN2) is prognostic and that the percentage of CIN1 and CIN2 cases with progression in the present study is comparable to many previous studies. However, the quantitative Ki67 model had stronger prognostic value than CIN grade as none of the 40 "Ki67-model low-risk" patients progressed, in contrast to 15 (30%) of the 50 "Ki67-model high-risk" patients (p < 0.001). In multivariate analysis, neither CIN grade nor any of the other quantitative Ki67 features added to the abovementioned prognostic Ki67-model. Subjective analysis of the Ki67 features was also prognostic, although quantitative assessments gave better results. Routine application of the quantitative Ki67-model in CIN1 and CIN2 was well reproducible. In conclusion, the results confirm that quantitative Ki67 features have strong prognostic value for progression in early CIN lesions.

Authors
Kruse, A-J; Baak, JPA; Janssen, EA; Kjellevold, K-H; Fiane, B; Lovslett, K; Bergh, J; Robboy, S
MLA Citation
Kruse, A-J, Baak, JPA, Janssen, EA, Kjellevold, K-H, Fiane, B, Lovslett, K, Bergh, J, and Robboy, S. "Ki67 predicts progression in early CIN: Validation of a multivariate progression-risk model." Cellular Oncology 26.1-2 (2004): 13-20.
PMID
15371653
Source
scival
Published In
Cellular Oncology
Volume
26
Issue
1-2
Publish Date
2004
Start Page
13
End Page
20

Prognostic value and reproducibility of koilocytosis in cervical intraepithelial neoplasia.

The purpose of this study was to evaluate the influence of koilocytosis on the progression of cervical intraepithelial neoplasia (CIN) to a higher grade during follow-up in cervical biopsy specimens with CIN 1 and 2. In adequate, consecutive, biopsy specimens of 103 CIN 1 and 2 patients, CIN grade and presence or absence of koilocytosis were assessed. Patients were followed by colposcopy and cytology according to protocol. When recurrent CIN was suspected with either of the techniques, a re-biopsy was taken. Progression of the CIN was defined as an increase of grade by at least 1. Univariate analysis was applied to all patients and in the CIN 1 and 2 subgroups separately. An experienced gynecological pathologist using strict criteria reviewed koilocytosis. The Kappa test was used to assess interobserver reproducibility of koilocytosis. Koilocytosis was found in 70 (68%) of the specimens (18 of 29=62% of the CIN 1 and 52 of 74=70% of the CIN 2 cases). Twenty-one of 103 (20%) dysplasias progressed and 10 of these (48%) showed koilocytosis. Koilocytosis was found more frequently (73%, 60 of 82) in the cases that showed no progression. Follow-up showed that patients with koilocytosis had a significantly lower likelihood of progression (log-rank=5.5, p=0.02). In CIN 1, progression without and with koilocytosis was 27% and 0%, respectively, log-rank=4.9, p=0.03. In CIN 2, a similar trend was found: only 10 of 52 (19%) CIN 2 cases with koilocytosis progressed, whereas 8 of 22 (36%) lesions lacking koilocytosis progressed, a difference just below significance (p=0.06). In agreement with other studies, interobserver diagnosis of koilocytosis was poorly reproducible. In conclusion, the presence of koilocytosis is associated with a lack of progression in CIN 1 lesions, but reproducibility of koilocytosis assessment is not optimal. Therefore, other more objective and better reproducible criteria are required to extract the potentially important prognostic information contained in the microscopic image of CIN 1 and 2 lesions.

Authors
Kruse, A-J; Baak, JPA; Helliesen, T; Kjellevold, K-H; Robboy, SJ
MLA Citation
Kruse, A-J, Baak, JPA, Helliesen, T, Kjellevold, K-H, and Robboy, SJ. "Prognostic value and reproducibility of koilocytosis in cervical intraepithelial neoplasia." Int J Gynecol Pathol 22.3 (July 2003): 236-239.
PMID
12819389
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
22
Issue
3
Publish Date
2003
Start Page
236
End Page
239
DOI
10.1097/01.PGP.0000071045.12278.0A

Embolic microspheres within ovarian arterial vasculature after uterine artery embolization.

BACKGROUND: Adverse events after uterine artery embolization, including hysterectomy and premature ovarian failure, are concerning for women who desire future fertility. CASE: A 39-year-old woman underwent emergency hysterectomy after uterine artery embolization embolic microspheres found within the ovarian arterial vasculature. CONCLUSION: Uterine artery embolization for the treatment of uterine fibroids has been associated with loss of ovarian function in up to 14% of patients. This case report demonstrates that embolic microspheres injected into the uterine artery can unintentionally migrate through anastomotic channels into the ovarian arterial vasculature and potentially compromise ovarian blood flow. Hypoxic tissue injury may be the mechanism of premature ovarian failure observed after uterine artery embolization. Understanding the etiology of premature ovarian failure after uterine artery embolization might allow better patient selection.

Authors
Payne, JF; Robboy, SJ; Haney, AF
MLA Citation
Payne, JF, Robboy, SJ, and Haney, AF. "Embolic microspheres within ovarian arterial vasculature after uterine artery embolization." Obstet Gynecol 100.5 Pt 1 (November 2002): 883-886.
PMID
12423846
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
100
Issue
5 Pt 1
Publish Date
2002
Start Page
883
End Page
886

Mosaicism and endometrial adenocarcinoma in an adult Turner syndrome patient.

Authors
Goodman, BK; Golembiewski-Ruiz, V; Tirado, CA; Kishnani, PS; Stenzel, TT; Lancaster, JM; Robboy, SJ
MLA Citation
Goodman, BK, Golembiewski-Ruiz, V, Tirado, CA, Kishnani, PS, Stenzel, TT, Lancaster, JM, and Robboy, SJ. "Mosaicism and endometrial adenocarcinoma in an adult Turner syndrome patient." October 2002.
Source
wos-lite
Published In
The American Journal of Human Genetics
Volume
71
Issue
4
Publish Date
2002
Start Page
304
End Page
304

Cell proliferation and apoptosis in human uterine leiomyomas and myometria.

To determine the role of cell proliferation and apoptosis in uterine leiomyoma growth, we studied protein expression of two major regulatory proteins of apoptosis -- Bcl-2 (anti-apoptotic) and Bax (pro-apoptotic) -- and two endogenous markers of cell replication - proliferating cell nuclear antigen (PCNA) and Ki-67 - in tumors and matched myometrium from premenopausal women. Conventional mitotic indices also were determined, and all proliferation data were correlated to tumor size. In situ end-labeling of fragmented DNA and routine histology were used to assess apoptosis. Our results showed that the apoptosis-regulating proteins (Bcl-2 and Bax) were expressed in the cytoplasm of the leiomyoma and myometrial smooth muscle cells throughout the menstrual cycle. Bax expression differed from Bcl-2 in that it also was found in the cytoplasm of vascular smooth muscle cells of the myometria and tumors. Both tumors and myometrial samples expressed 26-kDa and 21-kDa proteins that reacted with antibodies directed towards Bcl-2 and Bax, respectively. Apoptosis was not a prominent feature of uterine leiomyomas or myometrium. PCNA- and Ki-67-labeling and mitotic counts were significantly ( P<0.05) higher in leiomyomas than in matched myometrial samples. Proliferative activity was variable for individual tumors of the same patient and independent of tumor size. Our results suggest that altered apoptosis by overexpression of Bcl-2 or by decreased expression of Bax does not appear to be a major factor in uterine leiomyoma growth. We conclude that increased cell proliferation is the most significant contributor to growth and that the proliferative state is autonomous for each tumor in a given patient and is independent of tumor size.

Authors
Dixon, D; Flake, GP; Moore, AB; He, H; Haseman, JK; Risinger, JI; Lancaster, JM; Berchuck, A; Barrett, JC; Robboy, SJ
MLA Citation
Dixon, D, Flake, GP, Moore, AB, He, H, Haseman, JK, Risinger, JI, Lancaster, JM, Berchuck, A, Barrett, JC, and Robboy, SJ. "Cell proliferation and apoptosis in human uterine leiomyomas and myometria." Virchows Arch 441.1 (July 2002): 53-62.
PMID
12111201
Source
pubmed
Published In
Virchows Archiv
Volume
441
Issue
1
Publish Date
2002
Start Page
53
End Page
62
DOI
10.1007/s00428-001-0568-7

Embolic microspheres within ovarian arterial vasculature after uterine artery embolization

BACKGROUND: Adverse events after uterine artery embolization, including hysterectomy and premature ovarian failure, are concerning for women who desire future fertility. CASE: A 39-year-old woman underwent emergency hysterectomy after uterine artery embolization embolic microspheres found within the ovarian arterial vasculature. CONCLUSION: Uterine artery embolization for the treatment of uterine fibroids has been associated with loss of ovarian function in up to 14% of patients. This case report demonstrates that embolic microspheres injected into the uterine artery can unintentionally migrate through anastomotic channels into the ovarian arterial vasculature and potentially compromise ovarian blood flow. Hypoxic tissue injury may be the mechanism of premature ovarian failure observed after uterine artery embolization. Understanding the etiology of premature ovarian failure after uterine artery embolization might allow better patient selection. © 2002 by The American College of Obstetricians and Gynecologists.

Authors
Payne, JF; Robboy, SJ; Haney, AF
MLA Citation
Payne, JF, Robboy, SJ, and Haney, AF. "Embolic microspheres within ovarian arterial vasculature after uterine artery embolization." Obstetrics and Gynecology 100.5 (2002): 883-886.
Source
scival
Published In
Obstetrics & Gynecology (Elsevier)
Volume
100
Issue
5
Publish Date
2002
Start Page
883
End Page
886
DOI
10.1016/S0029-7844(02)02270-6

Incidence of squamous neoplasia of the cervix and vagina in women exposed prenatally to diethylstilbestrol (United States).

OBJECTIVES: Women exposed prenatally to diethylstibestrol (DES) have an excess risk of clear-cell adenocarcinoma of the vagina and cervix, but the effect on the incidence of squamous neoplasia is uncertain. The purpose of the current study was to evaluate the long-term risk of developing high-grade squamous neoplasia of the genital tract among women exposed prenatally to DES. METHODS: A cohort comprising 3,899 DES-exposed and 1,374 unexposed daughters was followed for 13 years (1982 1995) for pathology-confirmed diagnoses of high-grade squamous intraepithelial neoplasia (HSIL) of the genital tract. Poisson regression analysis was used to compute relative risks (RR) and 95% confidence intervals (95% CI), adjusting for age, calendar year, and other covariates. RESULTS: The RR (95% CI) among DES-exposed versus unexposed, based on 111 cases of high-grade disease, was 2.1 (1.2-3.8). Adjustment for screening history estimated by the number of years since the last Pap smear had little effect. Risk estimates were higher with earlier intrauterine exposure; the RR (95% CI) for exposure within 7 weeks of the last menstrual period was 2.8 (1.4-5.5). Only two cases of invasive squamous cervical cancer occurred in total, precluding separate analysis. CONCLUSIONS: The findings support an association between in-utero DES exposure and high-grade squamous neoplasia, although a role for more intensive screening among DES-exposed women in the production of this excess could not be completely ruled out.

Authors
Hatch, EE; Herbst, AL; Hoover, RN; Noller, KL; Adam, E; Kaufman, RH; Palmer, JR; Titus-Ernstoff, L; Hyer, M; Hartge, P; Robboy, SJ
MLA Citation
Hatch, EE, Herbst, AL, Hoover, RN, Noller, KL, Adam, E, Kaufman, RH, Palmer, JR, Titus-Ernstoff, L, Hyer, M, Hartge, P, and Robboy, SJ. "Incidence of squamous neoplasia of the cervix and vagina in women exposed prenatally to diethylstilbestrol (United States)." Cancer Causes Control 12.9 (November 2001): 837-845.
PMID
11714112
Source
pubmed
Published In
Cancer Causes & Control
Volume
12
Issue
9
Publish Date
2001
Start Page
837
End Page
845

A double-blind randomized study on the effects of red clover isoflavones on the endometrium.

OBJECTIVE: To assess the effects of a red clover-derived isoflavone extract on the Ki-67 proliferative marker of endometrial biopsies in 45-to 50-year-old perimenopausal women. We hypothesized that we would be able to detect a decrease in the Ki-67 proliferative index during the late follicular phase after a 3-month course of approximately 50 mg red clover isoflavones. Isoflavones have been found to have some antiestrogenic effects, and an antiproliferative effect during the perimenopausal period may be especially useful owing to the excessive endometrial proliferation often characteristic of this period. DESIGN: In a double-blind, randomized, controlled study, 30 women between the ages of 45 and 50 years consented to an endometrial biopsy before and after a 3-month course of either placebo or active isoflavone extract. The biopsies were timed as close as possible to days 7-11 of the menstrual cycle, and simultaneous measurements of transvaginal endometrial thickness, uterine artery Doppler, hormone profiles, lipids, and bone markers were performed. RESULTS: Of 30 women, 2 did not return for a second biopsy, and a third had an unsuccessful second biopsy. Four subjects were excluded from the Intention to Treat analysis because they did not have a menstrual bleed within the time frame of the study (3 subjects) or were tested on day 13 instead of between days 7 and 11 of the cycle (1 subject). There was no change in the Ki-67 proliferation index after treatment in either group. Eight subjects in the placebo group and eight in the P-07 group had proliferative endometrial biopsies that were synchronized with estradiol levels at baseline and post-treatment, and analysis of these subjects revealed no detectable change in the relationship between estradiol levels and Ki-67 with treatment in either group. There was no change in fasting lipids, bone markers, uterine Doppler resistance, or pulsatility index. CONCLUSION: In this small pilot study, we did not find, using immunohistochemical quantification of the Ki-67 antigen, that red clover isoflavones had an antiproliferative effect in the endometrium. Small sample size, examination of a relatively short interval in the menstrual cycle, and isoflavone formulation may have contributed to our lack of findings; however, we believe that the issue of isoflavones and their possible antiproliferative effect is deserving of further study. A simpler physiological model with less hormonal variability, such as healthy, recently menopausal women on predetermined doses of estrogen, may prove to be more informative.

Authors
Hale, GE; Hughes, CL; Robboy, SJ; Agarwal, SK; Bievre, M
MLA Citation
Hale, GE, Hughes, CL, Robboy, SJ, Agarwal, SK, and Bievre, M. "A double-blind randomized study on the effects of red clover isoflavones on the endometrium." Menopause 8.5 (September 2001): 338-346.
PMID
11528360
Source
pubmed
Published In
Menopause
Volume
8
Issue
5
Publish Date
2001
Start Page
338
End Page
346

Cancer risk in men exposed in utero to diethylstilbestrol.

BACKGROUND: An association between prenatal diethylstilbestrol (DES) exposure and cancer in men, especially testicular cancer, has been suspected, but findings from case-control studies have been inconsistent. This study was conducted to investigate the association between prenatal DES exposure and cancer risk in men via prospective follow-up. METHODS: A total of 3613 men whose prenatal DES exposure status was known were followed from 1978 through 1994. The overall and site-specific cancer incidence rates among the DES-exposed men were compared with those of the unexposed men in the study and with population-based rates. The relative rate (RR) was used to assess the strength of the association between prenatal DES exposure and cancer development. All statistical tests were two-sided. RESULTS: Overall cancer rates among DES-exposed men were similar to those among unexposed men (RR = 1.07; 95% confidence interval [CI] = 0.58 to 1.96) and to national rates (RR = 0.99; 95% CI = 0.65 to 1.44). Testicular cancer may be elevated among DES-exposed men, since the RRs for testicular cancer were 3.05 (95% CI = 0.65 to 22.0) times those of unexposed men in the study and 2.04 (95% CI = 0.82 to 4.20) times those of males in the population-based rates. The higher rate of testicular cancer in the DES-exposed men is, however, also compatible with a chance observation. CONCLUSIONS: To date, men exposed to DES in utero do not appear to have an increased risk of most cancers. It remains uncertain, however, whether prenatal DES exposure is associated with testicular cancer.

Authors
Strohsnitter, WC; Noller, KL; Hoover, RN; Robboy, SJ; Palmer, JR; Titus-Ernstoff, L; Kaufman, RH; Adam, E; Herbst, AL; Hatch, EE
MLA Citation
Strohsnitter, WC, Noller, KL, Hoover, RN, Robboy, SJ, Palmer, JR, Titus-Ernstoff, L, Kaufman, RH, Adam, E, Herbst, AL, and Hatch, EE. "Cancer risk in men exposed in utero to diethylstilbestrol." J Natl Cancer Inst 93.7 (April 4, 2001): 545-551.
PMID
11287449
Source
pubmed
Published In
Journal of the National Cancer Institute
Volume
93
Issue
7
Publish Date
2001
Start Page
545
End Page
551

Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types.

One thousand consecutive cases of surgically proven endometriosis were reviewed to evaluate the frequency and types of pelvic cancers that were associated with ovarian and extraovarian endometriosis. The frequency and types of histologic abnormalities present in the eutopic endometrium when cancers were noted in endometriosis were also evaluated. In the large subset of cases for which the authors were the primary pathologists and all foci of endometriosis were recorded, the frequency of malignancy was 10.8%. In contrast, the frequency was only 3.2% in cases diagnosed by others previously in our institution. Cancers were more commonly found in ovaries when endometriosis was present in that ovary (5%) compared to when endometriosis was present at other sites (1%). Clear cell and endometrioid carcinomas were the malignancies most commonly seen in ovaries containing endometriosis, while clear cell adenocarcinoma and adenosarcoma were most commonly seen in conjunction with extraovarian endometriosis. The association of endometriosis with endometrioid and clear cell carcinoma was much stronger than that of serous and mucinous tumors (p < .01). Concurrent endometrial pathology was commonly seen in cases of malignant transformation of endometriosis (32% of cases).

Authors
Stern, RC; Dash, R; Bentley, RC; Snyder, MJ; Haney, AF; Robboy, SJ
MLA Citation
Stern, RC, Dash, R, Bentley, RC, Snyder, MJ, Haney, AF, and Robboy, SJ. "Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types." Int J Gynecol Pathol 20.2 (April 2001): 133-139.
PMID
11293158
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
20
Issue
2
Publish Date
2001
Start Page
133
End Page
139

K-ras mutations in Müllerian inclusion cysts associated with serous borderline tumors of the ovary.

OBJECTIVE: Müllerian inclusion cysts (MIC) are small benign appearing glands that are occasionally noted in lymph nodes and peritoneal biopsies. They occur most frequently in women with serous ovarian tumors, with borderline tumors (SBOT) having a higher incidence than invasive cancers. The aim of this study was to examine whether MIC and SBOT have identical K-ras mutations, which would suggest that they are related. Methods. Six patients in whom adequate tissue was available from SBOT, MIC, and normal tissue were identified from a consecutive series of patients with SBOT who underwent lymph node sampling from 1992 to 1997 at Duke University Medical Center. DNA extraction was performed using laser capture microdissection. Exon 1 of the K-ras gene was amplified using PCR and subjected to single-strand conformation analysis to screen for mutations. Shifted bands were sequenced to confirm the presence of mutations. RESULTS: Mutations in codon 12 of K-ras were found in three of six (50%) SBOT. In two of these three cases, the identical mutation was found in the SBOT and the MIC (gly to val in both cases), but not in the corresponding normal DNA. In one case, a mutation was seen in the ovarian tumor (gly to asp), but not in the corresponding MIC. CONCLUSIONS: Mutations in codon 12 of the K-ras gene are a hallmark of serous borderline tumors. The presence of identical K-ras mutations in some SBOT and their associated MIC suggests that they are related processes. Both may arise due to a field effect, or alternatively some MIC may represent metastases from the primary ovarian tumor.

Authors
Alvarez, AA; Moore, WF; Robboy, SJ; Bentley, RC; Gumbs, C; Futreal, PA; Berchuck, A
MLA Citation
Alvarez, AA, Moore, WF, Robboy, SJ, Bentley, RC, Gumbs, C, Futreal, PA, and Berchuck, A. "K-ras mutations in Müllerian inclusion cysts associated with serous borderline tumors of the ovary." Gynecol Oncol 80.2 (February 2001): 201-206.
PMID
11161860
Source
pubmed
Published In
Gynecologic Oncology
Volume
80
Issue
2
Publish Date
2001
Start Page
201
End Page
206
DOI
10.1006/gyno.2000.6066

BOOK REVIEWS.

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "BOOK REVIEWS." Int J Gynecol Pathol 20.1 (January 2001): 102-.
PMID
11773748
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
20
Issue
1
Publish Date
2001
Start Page
102

Pathology and pathophysiology of uterine smooth-muscle tumors.

Smooth-muscle tumors of uterine origin encompass a broad family of neoplasms. The leiomyoma, by far the most common of all the neoplasms, generally is hormone sensitive, with rates of growth semiquantitatively related to estrogen and progesterone receptor levels. Several forms of degenerative change can occur in the leiomyoma. The most common is hyaline degeneration, which is important in that it should not be mistaken for the coagulative tumor cell necrosis seen in leiomyosarcoma. Red degeneration (necrobiosis) is a form of degeneration that occurs characteristically but not exclusively in pregnancy, and the process is often the cause of pain and fever. Several forms of treatment have been used medically in the treatment of leiomyoma. Gonadotropin-releasing hormone analogs or agonists or selective arterial embolization with polyvinylformaldehyde particles may lead to substantial degeneration or infarction of the leiomyoma, respectively. Several variants of leiomyoma, the cellular and symplastic leiomyomas, are important to recognize, as they can be misinterpreted as sarcoma. In addition, there are two unusual growth patterns of leiomyoma that are important to recognize. Both the benign metastasizing leiomyoma and disseminated peritoneal leiomyomatosis are found outside the uterus, and neither is malignant. Recent studies offer insights into their origin and hormonal influences. From a diagnostic and therapeutic point of view, the leiomyosarcoma, while rare, is clinically of great import. Coagulative necrosis, cytologic atypia, and mitotic counts are all important in diagnosing the condition.

Authors
Robboy, SJ; Bentley, RC; Butnor, K; Anderson, MC
MLA Citation
Robboy, SJ, Bentley, RC, Butnor, K, and Anderson, MC. "Pathology and pathophysiology of uterine smooth-muscle tumors." Environ Health Perspect 108 Suppl 5 (October 2000): 779-784. (Review)
PMID
11035982
Source
pubmed
Published In
Environmental health perspectives
Volume
108 Suppl 5
Publish Date
2000
Start Page
779
End Page
784

Bladder cancer: race differences in extent of disease at diagnosis.

BACKGROUND: Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS: A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77% of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS: Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS: While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved.

Authors
Prout, GR; Wesley, MN; Greenberg, RS; Chen, VW; Brown, CC; Miller, AW; Weinstein, RS; Robboy, SJ; Haynes, MA; Blacklow, RS; Edwards, BK
MLA Citation
Prout, GR, Wesley, MN, Greenberg, RS, Chen, VW, Brown, CC, Miller, AW, Weinstein, RS, Robboy, SJ, Haynes, MA, Blacklow, RS, and Edwards, BK. "Bladder cancer: race differences in extent of disease at diagnosis." Cancer 89.6 (September 15, 2000): 1349-1358.
PMID
11002231
Source
pubmed
Published In
Cancer
Volume
89
Issue
6
Publish Date
2000
Start Page
1349
End Page
1358

Some mullerian inclusion cysts in lymph nodes may sometimes be metastases from serous borderline tumors of the ovary.

Glandular inclusions that appear morphologically benign are occasionally found in lymph nodes as well as in peritoneal and omental biopsies. In patients with gynecologic malignancies, the nature and significance of these mullerian inclusion cysts (MIC) present a diagnostic challenge with regard to whether they are benign and incidental or are related to the coincident tumor for which surgery is being performed. Sixty-two cases of MIC were prospectively identified during a 6-year period. The frequencies were calculated and stratified by lymph node chain distribution, primary tumor site, and primary tumor type. MIC appeared as small cysts lined by a serous (mullerian)-type, cytologically bland, cuboidal to columnar epithelium with a simple architecture. Among 62 women, MIC was found in lymph nodes (27 cases), pelvic peritoneum (19 cases), omentum (16 cases), bowel serosa (9 cases), uterine serosa (8 cases), and parametrial connective tissues (4 cases). Among a set of 417 consecutive cases in which lymphadenectomy was performed, 46 (11%) women had MIC. The MIC involved multiple sites (26 cases in the peritoneum/omentum and 27 in lymph nodes). The primary tumor was in the ovary in 32 of the 46 women with MIC (70%) and of these, 17 were borderline serous (53%). Sixty-two of 6,154 lymph nodes examined contained MIC (1.0%). 3.2% of nodes contained MIC in which the primary tumor arose in the ovary, but only 0.1% with either endometrial or cervical tumors (chi2, p <0.00001). The lymph nodes most often involved by MIC were from para-aortic sites (40%), which reflect the primary drainage route from the ovary. Not uncommonly, neighboring areas in the same lymph node group with MIC disclosed separate foci of obvious metastatic borderline tumor (4 of 10; 40%). In summary, the increased frequency of MIC in lymph nodes sampled for primary ovarian malignancies suggests that MIC in some cases, rather than being benign, incidental inclusions, are more likely bland-appearing forms of metastatic tumor. The preponderance of inclusions occurs with serous ovarian tumors of borderline malignancy, and the inclusions are overrepresented in the lymph nodes that primarily receive drainage from the ovary.

Authors
Moore, WF; Bentley, RC; Berchuck, A; Robboy, SJ
MLA Citation
Moore, WF, Bentley, RC, Berchuck, A, and Robboy, SJ. "Some mullerian inclusion cysts in lymph nodes may sometimes be metastases from serous borderline tumors of the ovary." Am J Surg Pathol 24.5 (May 2000): 710-718.
PMID
10800990
Source
pubmed
Published In
American Journal of Surgical Pathology
Volume
24
Issue
5
Publish Date
2000
Start Page
710
End Page
718

The outcome of stage I-II clinically and surgically staged papillary serous and clear cell endometrial cancers when compared with endometrioid carcinoma.

PURPOSE: The aim of this study was to compare survival and recurrence in clinical and surgical stage I-II papillary serous (PS), clear cell (CC), and endometrioid (EM) cancers of the endometrium and examine the prognostic utility of myometrial invasion. METHODS: Clinical, surgicopathologic, and survival data were retrospectively collected on 574 clinical stage I-II endometrial cancer patients, including 53 PS and 18 CC (based on postoperative histology), undergoing hysterectomy at Duke University Medical Center between 1967 and 1990. All staging material was available and reexamined prior to this analysis, and FIGO surgical staging was retrospectively assigned. Prognostic variables examined included age, stage, grade, myometrial invasion, lymph-vascular space invasion (LVSI), and histology. PS and CC histologic subtypes were compared as both common category and discrete categories versus EM, EM grade 1 (EM1), EM grade 2 (EM2), and EM grade 3 (EM3). Statistical analyses were performed using chi(2), Fisher's exact, and Wilcoxon rank sum tests, Cox regression analysis, and Kaplan-Meier survival analysis. RESULTS: PS tumors accounted for 9%, CC for 3%, and EM for 88% of cases. Recurrences were more frequent among PS (38%) and CC (22%) compared with EM (9%) (P < 0.001 and 0.08, respectively), and PS recurred more frequently than EM3 alone (20%) (P = 0.06). Among PS, CC, and EM3 patients with recurrences there were no statistical differences in the proportion that received preoperative or postoperative radiotherapy or chemotherapy. Prognostic factors for shorter survival included age >=60, surgical stage III+IV, presence of LVSI, histology (PS, CC, or EM3), and >=50% myometrial invasion. The estimated 5-year survival of PS+CC patients with <2 mm myometrial invasion is 0.56 compared to 0.93 for EM patients (P < 0. 001). PS + CC tumors confined to the endometrium had a 5-year survival of 0.60 compared to 0.98 and 1.00 for EM and EM3, respectively. The 5-year survival for surgically staged IA patients (0.57) was not different from stages IB and IC combined (0.53) (P = 0.72). The 5-year survival for surgical stage I + II PS + CC patients (0.56) was comparable to that for clinical stage I + II PS + CC patients (0.46) and remained significantly smaller than that for EM patients (0.86) (P < 0.001). CONCLUSION: Recurrences are more frequent among PS and CC tumors compared with EM and among PS compared with EM3. When controlled for surgical stage I-II tumors, 5-year survival for PS + CC patients remains comparable to that of clinical stage I-II patients and below that of EM. Prognostic factors for survival in PS and CC patients include age, stage, and LVSI. PS, CC, and EM3 subtypes together are predictors of poor survival. Thorough extended surgical staging is indicated in PS and CC tumors, and prospective trials of aggressive adjuvant therapies for surgical stage I-II tumors are needed to improve outcome in PS and CC patients.

Authors
Cirisano, FD; Robboy, SJ; Dodge, RK; Bentley, RC; Krigman, HR; Synan, IS; Soper, JT; Clarke-Pearson, DL
MLA Citation
Cirisano, FD, Robboy, SJ, Dodge, RK, Bentley, RC, Krigman, HR, Synan, IS, Soper, JT, and Clarke-Pearson, DL. "The outcome of stage I-II clinically and surgically staged papillary serous and clear cell endometrial cancers when compared with endometrioid carcinoma." Gynecol Oncol 77.1 (April 2000): 55-65.
PMID
10739691
Source
pubmed
Published In
Gynecologic Oncology
Volume
77
Issue
1
Publish Date
2000
Start Page
55
End Page
65
DOI
10.1006/gyno.2000.5737

Epidemiologic and surgicopathologic findings of papillary serous and clear cell endometrial cancers when compared to endometrioid carcinoma.

PURPOSE: The aim of this study was to identify similarities and differences in epidemiologic and surgicopathologic staging results for papillary serous (PS) and clear cell (CC) endometrial cancers compared with endometrioid (EM) carcinoma of the endometrium. METHODS: Clinical and surgicopathologic data were retrospectively collected on 574 clinical stage I-II endometrial cancer patients, including 53 PS and 18 CC (based on postoperative histology), undergoing hysterectomy at Duke University Medical Center between 1967 and 1990. All staging material was available and reexamined prior to this analysis, and FIGO surgical staging was retrospectively assigned. PS and CC histologic subtypes were compared both as a common category and as discrete categories versus EM, EM grade 1 (EM1), EM grade 2 (EM2), and EM grade 3 (EM3). Fisher's exact test was used to compare proportions with unordered categories (2x2 tables), while the chi(2) test for trend was used to compare proportions in 3x2 tables with ordered categories. Differences in medians were compared with the Wilcoxon rank-sum test. RESULTS: PS tumors accounted for 8%, CC for 2%, and EM for 90% of cases. Overall, 14% of tumors were changed to a different postoperative histology including 64% of PS, 50% of CC, and 8% of EM. Postoperative histology changes were 4% for EM1 and 21% for EM3. PS, CC, and EM3 had more surgical sampling performed than for other EM. Rates for lymph node dissections were similar for EM3 (81%), PS (72%), and CC (67%) tumors, although metastases were more frequent for PS and CC compared with EM3. When PS tumors were confined to the endometrium, paraaortic metastases occurred in 13%. LVSI increased with EM grade and was highest for PS and CC. Upstaging to surgical stage III-IV occurred in 47% of PS, 39% of CC, and 12% of EM. The majority of PS and CC tumors were confined to the inner one-third of the myometrium, compared with EM tumors, where grade correlated with depth of myometrial invasion. Extrauterine metastases occurred in 55% of PS and 45% of CC tumors confined to the inner one-half, compared with 17% of EM3. CONCLUSION: Frequent changes from preoperative to postoperative histology and grade may contribute to misassignment of preoperative and intraoperative risk as determined by depth of myometrial invasion for PS and CC patients. The higher frequency of extrauterine metastases in PS and CC tumors compared with EM3, despite similar surgical sampling rates, supports a more virulent behavior. The poor correlation between depth of myometrial invasion and risk for extrauterine metastases helps to explain poorer survival in PS and CC patients, in addition to more frequent upstaging. These results support routine extended surgical staging for women with preoperative or intraoperative diagnosis of PS and CC tumors. Intraoperative assessment of tumor grade and histology may be indicated and warrants further investigation.

Authors
Cirisano, FD; Robboy, SJ; Dodge, RK; Bentley, RC; Krigman, HR; Synan, IS; Soper, JT; Clarke-Pearson, DL
MLA Citation
Cirisano, FD, Robboy, SJ, Dodge, RK, Bentley, RC, Krigman, HR, Synan, IS, Soper, JT, and Clarke-Pearson, DL. "Epidemiologic and surgicopathologic findings of papillary serous and clear cell endometrial cancers when compared to endometrioid carcinoma." Gynecol Oncol 74.3 (September 1999): 385-394.
PMID
10479498
Source
pubmed
Published In
Gynecologic Oncology
Volume
74
Issue
3
Publish Date
1999
Start Page
385
End Page
394
DOI
10.1006/gyno.1999.5505

Progesterone receptor activity in leiomyomatosis peritonealis disseminata.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition that primarily affects women of reproductive age. Immunohistochemical studies were performed in four cases: LPD from a premenopausal woman on oral contraceptives (one case); LPD associated with postpartum massive ectopic decidual reaction (one case); and LPD from a perimenopausal and a postmenopausal woman. Progesterone receptor activity was present in nine of nine cases, and eight of eight cases were strongly positive for vimentin; reactivity for cytokeratin was uniformly negative. Most cases had a pattern of staining typical of smooth muscle tumors with expression of desmin, smooth muscle actin, and muscle-specific actin. Although estrogen receptor was detected in most cases, reactivity was notably absent (one case) or weak (one case) in nodules with a prominent decidual reaction. Expression of CD 34, a marker for which LPD staining characteristics have not been previously reported, varied from absent to weak. Peritoneal nodules from the postmenopausal woman lacked staining for both estrogen receptor and desmin, smooth muscle actin and muscle-specific actin were only focally expressed, whereas staining for CD 34 was focally intense. Uterine myometrium and leiomyomata were positive for progesterone and estrogen receptor, vimentin, desmin, smooth muscle actin, and muscle-specific actin. Cytokeratin expression was absent. CD 34 exhibited weak staining in leiomyomata, but was absent from myometrium. Progesterone receptor appears to be uniformly expressed in LPD nodules from premenopausal and postmenopausal women, a finding supporting the contention that hormones influence the development of LPD in all cases, regardless of menopausal status.

Authors
Butnor, KJ; Burchette, JL; Robboy, SJ
MLA Citation
Butnor, KJ, Burchette, JL, and Robboy, SJ. "Progesterone receptor activity in leiomyomatosis peritonealis disseminata." Int J Gynecol Pathol 18.3 (July 1999): 259-264. (Review)
PMID
12090595
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
18
Issue
3
Publish Date
1999
Start Page
259
End Page
264

Mullerian inclusion cysts - Possible metastases of serous borderline tumors of the ovary.

Authors
Moore, WF; Berchuck, A; Robboy, SJ
MLA Citation
Moore, WF, Berchuck, A, and Robboy, SJ. "Mullerian inclusion cysts - Possible metastases of serous borderline tumors of the ovary." LABORATORY INVESTIGATION 79.1 (January 1999): 120A-120A.
Source
wos-lite
Published In
Laboratory Investigation
Volume
79
Issue
1
Publish Date
1999
Start Page
120A
End Page
120A

Evaluation of an automated technique for identification of extraneous tissue in formalin-fixed surgical specimens

Authors
Morphew, E; Nuckols, JD; Mann, KP; Howell, DN; Robboy, SJ; Stenzel, TT
MLA Citation
Morphew, E, Nuckols, JD, Mann, KP, Howell, DN, Robboy, SJ, and Stenzel, TT. "Evaluation of an automated technique for identification of extraneous tissue in formalin-fixed surgical specimens." LABORATORY INVESTIGATION 79.1 (January 1999): 193A-193A.
Source
wos-lite
Published In
Laboratory Investigation
Volume
79
Issue
1
Publish Date
1999
Start Page
193A
End Page
193A

Critical commentary to Cotyledonoid dissecting leiomyoma (Sternberg tumor): An unusual form of leiomyoma

Authors
Bentley, RC; Robboy, SJ
MLA Citation
Bentley, RC, and Robboy, SJ. "Critical commentary to Cotyledonoid dissecting leiomyoma (Sternberg tumor): An unusual form of leiomyoma." Pathology Research and Practice 195.6 (1999): 439--.
Source
scival
Published In
Pathology Research and Practice
Volume
195
Issue
6
Publish Date
1999
Start Page
439-

Goblet-cell mucinous epithelium lining the endometrium and endocervix: evidence of metastasis from an appendiceal primary tumor through the use of cytokeratin-7 and -20 immunostains.

Differential staining with cytokeratin (CK)-7 and CK-20, two members of a complex family of proteins in human epithelial cells, proved critical in showing that the extremely well-differentiated goblet-cell (intestinal) mucinous epithelium lining the surface of the endometrium and endocervix in two patients and the fallopian tube in one was identical to that of the coincident appendiceal neoplasms. One of these patients also had a large ovarian tumor that grossly and microscopically resembled a mucinous cystadenoma of borderline malignancy and would have been considered primary except for the CK stains (CK-20 positive and CK-7 negative), which suggested metastasis from the appendix, presumably by a transtubal route.

Authors
Moore, WF; Bentley, RC; Kim, KR; Olatidoye, B; Gray, SR; Robboy, SJ
MLA Citation
Moore, WF, Bentley, RC, Kim, KR, Olatidoye, B, Gray, SR, and Robboy, SJ. "Goblet-cell mucinous epithelium lining the endometrium and endocervix: evidence of metastasis from an appendiceal primary tumor through the use of cytokeratin-7 and -20 immunostains." Int J Gynecol Pathol 17.4 (October 1998): 363-367.
PMID
9785138
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
17
Issue
4
Publish Date
1998
Start Page
363
End Page
367

Cancer risk in women exposed to diethylstilbestrol in utero.

CONTEXT: The association between in utero exposure to diethylstilbestrol (DES) and clear cell adenocarcinoma (CCA) of the vagina and cervix is well known, yet there has been no systematic study of DES-exposed daughters to determine whether they have an increased risk of other cancers. As many as 3 million women in the United States may have been exposed to DES in utero. OBJECTIVE: To determine whether women exposed to DES in utero have a higher risk of cancer after an average of 16 years of follow-up. DESIGN: A cohort study with mailed questionnaires and medical record review of reported cancer outcomes. PARTICIPANTS: A cohort of 4536 DES-exposed daughters (of whom 81% responded) and 1544 unexposed daughters (of whom 79% responded) who were first identified in the mid-1970s. MAIN OUTCOME MEASURES: Cancer incidence in DES-exposed daughters compared with population-based rates and compared with cancer incidence in unexposed daughters. RESULTS: To date, DES-exposed daughters have not experienced an increased risk for all cancers (rate ratio, 0.96; 95% confidence interval [CI], 0.58-1.56) or for individual cancer sites, except for CCA. Three cases of vaginal CCA occurred among the exposed daughters, resulting in a standardized incidence ratio of 40.7 (95% CI, 13.1-126.2) in comparison with population-based incidence rates. The rate ratio for breast cancer was 1.18 (95% CI, 0.56-2.49); adjustment for known risk factors did not alter this result. CONCLUSIONS: Thus far, DES-exposed daughters show no increased cancer risk, except for CCA. Nevertheless, because exposed daughters included in our study were, on average, only 38 years old at last follow-up, continued surveillance is warranted to determine whether any increases in cancer risk occur during the menopausal years.

Authors
Hatch, EE; Palmer, JR; Titus-Ernstoff, L; Noller, KL; Kaufman, RH; Mittendorf, R; Robboy, SJ; Hyer, M; Cowan, CM; Adam, E; Colton, T; Hartge, P; Hoover, RN
MLA Citation
Hatch, EE, Palmer, JR, Titus-Ernstoff, L, Noller, KL, Kaufman, RH, Mittendorf, R, Robboy, SJ, Hyer, M, Cowan, CM, Adam, E, Colton, T, Hartge, P, and Hoover, RN. "Cancer risk in women exposed to diethylstilbestrol in utero." JAMA 280.7 (August 19, 1998): 630-634.
PMID
9718055
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
280
Issue
7
Publish Date
1998
Start Page
630
End Page
634

Signet-ring cell carcinoma of the endometrium: a primary tumor masquerading as a metastasis.

Extragenital metastases to the endometrium are unusual, but several histologic features have been suggested as highly suggestive or even pathognomonic for this diagnosis. We report an endometrial carcinoma with a prominent signet-ring cell morphology and a diffusely permeative pattern of infiltration, features that have been reported as indicating an extragenital metastasis. To the best of our knowledge, this is the first reported case of a signet-ring cell carcinoma of the endometrium. Gynecological pathologists should be aware of this entity because of its potential primary of metastatic signet-ring carcinoma to be endometrium.

Authors
Mooney, EE; Robboy, SJ; Hammond, CB; Berchuck, A; Bentley, RC
MLA Citation
Mooney, EE, Robboy, SJ, Hammond, CB, Berchuck, A, and Bentley, RC. "Signet-ring cell carcinoma of the endometrium: a primary tumor masquerading as a metastasis." Int J Gynecol Pathol 16.2 (April 1997): 169-172.
PMID
9100072
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
16
Issue
2
Publish Date
1997
Start Page
169
End Page
172

Aetiology and histopathology of endometrial hyperplasia and carcinoma

Endometrial hyperplasias and many endometrial carcinomas are the result of over-stimulation of the endometrium by oestrogens. Hyperplasias are classified as simple, complex or atypical, the terms 'simple' and 'complex' referring to the glandular architectural pattern as assessed under low magnification and 'atypical' taking account of nuclear features under high power. Atypical hyperplasia may be difficult to distinguish from well-differentiated adenocarcinoma. The commonest type of adenocarcinoma, the typical endometrioid carcinoma, needs to be distinguished from the less frequently encountered serous and clear cell carcinomas because of the much worse prognosis associated with the latter two types of tumour. Squamous elements may be found in endometrial carcinomas; the importance of this finding and the value of assessing the malignancy of the squamous component is controversial.

Authors
Anderson, MC; Robboy, SJ
MLA Citation
Anderson, MC, and Robboy, SJ. "Aetiology and histopathology of endometrial hyperplasia and carcinoma." Current Obstetrics and Gynaecology 7.1 (1997): 2-7.
Source
scival
Published In
Current Obstetrics & Gynaecology
Volume
7
Issue
1
Publish Date
1997
Start Page
2
End Page
7
DOI
10.1016/S0957-5847(97)80003-0

Epithelial repair of the uterine cervix: assessment of morphologic features and correlations with cytologic diagnosis.

This study evaluates the morphologic features of squamous epithelial repair of the uterine cervix, a condition describing a state of regeneration, and compares them with the features of its two histologic mimics, squamous metaplasia and mild dysplasia. The materials examined were from 20 patients with a histologic diagnosis of repair, 42 with cervical biopsy specimens of acceptable quality obtained within 3 weeks of a cervical smear showing repair, and 20 each with squamous metaplasia or mild dysplasia. Specimens with repair disclosed distinctive morphologic characteristics. On low-power magnification, the stroma was chronically inflamed (100%), often floridly (55%). The nuclei were uniform with absent or minimal pleomorphism (90%). The chromatin was bland and evenly distributed (70%). Nucleoli of a bull's eye or macronucleolar appearance (45%) were easily found. Mildly dysplastic epithelium, unlike reparative epithelium, was infrequently associated with an intensely inflamed stroma (20%); its nuclei were pleomorphic (100%) and commonly displayed coarse chromatin (75%) and mitoses (60%). Metaplastic epithelium ws also infrequently associated with an intensely inflamed stroma (10%). Nuclear pleomorphism (10%) and mitotic figures were infrequent (10%), never atypical (0%), and always basally located. Most nuclei had nucleoli, but the majority were small (80%). This study indicates that most cases of repair, mild dysplasia, and metaplasia can be readily distinguished, although due to overlapping features, some cases are difficult to classify as shown by interobserver variability.

Authors
Yelverton, CL; Bentley, RC; Olenick, S; Krigman, HR; Johnston, WW; Robboy, SJ
MLA Citation
Yelverton, CL, Bentley, RC, Olenick, S, Krigman, HR, Johnston, WW, and Robboy, SJ. "Epithelial repair of the uterine cervix: assessment of morphologic features and correlations with cytologic diagnosis." Int J Gynecol Pathol 15.4 (October 1996): 338-344.
PMID
8886881
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
15
Issue
4
Publish Date
1996
Start Page
338
End Page
344

Prospective correlation of cervicovaginal cytologic and histologic specimens.

An effective, prospective, computer-guided method of correlation is reported. The mechanism for identification of cases, comparison of diagnoses, and reconciliation of discrepancies are explained. The results are similar to prior, retrospective, correlation studies. The benefits specific to this unique prospective approach include optimal capture of cases for correlation, minimization of errors before diagnoses are released to clinicians and patients, and internal standardization of diagnostic criteria. Three thousand four hundred and four consecutive paired cervicovaginal cytologies and biopsies were accessioned at the Pathology Department of Duke University Medical Center over a 43-month period. Of these, 481 paired cases (14%) had discordant diagnoses, defined as differing more than one degree of dysplasia or as dysplasia or carcinoma identified by only one modality. Additional evaluation reconciled the diagnostic differences in 35 cases. Eighteen initial diagnostic differences arose from cytologic screening errors, 16 from interpretive errors by staff pathologists, and one from superficial initial histologic sections. The remaining 446 discordances were attributed to sampling differences. The cytologic smear contained the diagnostic lesion in 40% of the cases and the biopsy the remainder, emphasizing the utility of pairing these sampling techniques in patients at risk for dysplasia.

Authors
Ibrahim, SN; Krigman, HR; Coogan, AC; Wax, TD; Dodd, LG; Bentley, RC; Robboy, SJ; Johnston, WW
MLA Citation
Ibrahim, SN, Krigman, HR, Coogan, AC, Wax, TD, Dodd, LG, Bentley, RC, Robboy, SJ, and Johnston, WW. "Prospective correlation of cervicovaginal cytologic and histologic specimens." Am J Clin Pathol 106.3 (September 1996): 319-324.
PMID
8816588
Source
pubmed
Published In
American Journal of Clinical Pathology
Volume
106
Issue
3
Publish Date
1996
Start Page
319
End Page
324

Differences between black and white patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United States).

To determine whether Black women with symptoms of uterine corpus cancer had longer times from symptom recognition to initial medical consultation than did White women in the United States, 331 newly diagnosed patients living in Atlanta (GA), New Orleans (LA), and San Francisco/Oakland (CA) during 1985-87 were interviewed to collect information on symptoms, dates of recognition and consultation, and other factors that might affect the interval. Data were analyzed to estimate medical consultation rates and rate ratios following symptom recognition. Median recalled times between symptom recognition and consultation were 16 days for Black women and 14 days for White women. Although poverty, having no usual source of healthcare, and other factors were associated with lower consultation rates, the adjusted rate among Black women was only somewhat lower (0.87) than among White women, and the 95 percent confidence interval (CI = 0.58-1.31) was consistent with no true difference between the races. In addition, the median time to consultation for women with stage IV cancer was only 15 days longer than the time (14 days) for the women with stage I cancer. These results suggest that time from symptom recognition to initial medical consultation does not contribute importantly to the more advanced stage cancer of the uterine corpus commonly found among Black women.

Authors
Coates, RJ; Click, LA; Harlan, LC; Robboy, S; Barrett, RJ; Eley, JW; Reynolds, P; Chen, VW; Darity, WA; Blacklow, RS; Edwards, BK
MLA Citation
Coates, RJ, Click, LA, Harlan, LC, Robboy, S, Barrett, RJ, Eley, JW, Reynolds, P, Chen, VW, Darity, WA, Blacklow, RS, and Edwards, BK. "Differences between black and white patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United States)." Cancer Causes Control 7.3 (May 1996): 328-336.
PMID
8734826
Source
pubmed
Published In
Cancer Causes & Control
Volume
7
Issue
3
Publish Date
1996
Start Page
328
End Page
336

Postsurgical surveillance of patients with FIGO stage I/II endometrial adenocarcinoma.

OBJECTIVE: To examine the effect of postsurgical surveillance on survival of patients with FIGO stage I/II endometrial adenocarcinoma. METHODS: We examined the records of 354 patients who underwent primary surgical therapy for FIGO stage I/II endometrial adenocarcinoma. In patients who developed recurrent disease, we determined whether symptoms or signs of disease were present at recurrence and whether there was evidence of disease on Pap smear or chest radiograph. RESULTS: Among the 354 patients in this study, 44 (12%) developed recurrent disease. Sites of recurrence included 12 (27%) isolated vaginal, 12 (27%) pelvic with vagina or abdomen, 4 (10%) isolated lung, 13 (29%) pelvic/abdominal with other distant sites, and 3 (7%) other distant sites. At diagnosis of recurrence 61% of patients had symptoms related to their cancer, 68% had physical exam findings suggestive of recurrence, and 84% had symptoms and/or signs. Findings consistent with recurrent cancer were detected by Pap smear in 25% and on chest radiograph in 20%. Among the 44 patients who developed recurrent disease, 8 (18%) remain alive without evidence of disease, including 6/12 (50%) with isolated vaginal disease and 2/34 (6%) with other patterns of recurrent disease (P = 0.01). Among the 12 patients with isolated vaginal recurrence, 1/3 (33%) in whom recurrent disease was diagnosed by Pap smear alone was salvaged compared to 5/9 (56%) who had symptoms or signs of vaginal recurrence. None of the three patients in whom an abnormal chest radiograph was the only evidence of recurrence survived. CONCLUSIONS: Because of the low recurrence rate of FIGO stage I/II endometrial cancer and the paucity of effective second-line treatment, surveillance Pap smears and chest radiographs appear to have little impact on survival. Although few asymptomatic potentially curable recurrences were detected due to surveillance examinations, the value of psychological reassurance associated with a normal examination is difficult to quantitate.

Authors
Berchuck, A; Anspach, C; Evans, AC; Soper, JT; Rodriguez, GC; Dodge, R; Robboy, S; Clarke-Pearson, DL
MLA Citation
Berchuck, A, Anspach, C, Evans, AC, Soper, JT, Rodriguez, GC, Dodge, R, Robboy, S, and Clarke-Pearson, DL. "Postsurgical surveillance of patients with FIGO stage I/II endometrial adenocarcinoma." Gynecol Oncol 59.1 (October 1995): 20-24.
PMID
7557610
Source
pubmed
Published In
Gynecologic Oncology
Volume
59
Issue
1
Publish Date
1995
Start Page
20
End Page
24
DOI
10.1006/gyno.1995.1262

Endometrial cancer: stage at diagnosis and associated factors in black and white patients.

OBJECTIVE: This study examined the relationship of clinicopathologic, health status, medical system, and socioeconomic factors to differences in stage at diagnosis of endometrial cancer in black and white patients. STUDY DESIGN: A population-based study of 130 black and 329 white patients with invasive endometrial cancer was conducted as part of the National Cancer Institute's Black/White Cancer Survival Study. Logistic regression was used to determine the relative importance of factors thought to be related to stage at diagnosis after age and geographic location were adjusted for. RESULTS: High-grade (poorly differentiated) lesions increased the risk for stage III or IV disease (odds ratio 8.3, 95% confidence interval 3.4 to 20.3), as did serous histologic subtype (odds ratio 3.5, 95% confidence interval 1.4 to 8.8) and no usual source of care (odds ratio 5.5, 95% confidence interval 1.4 to 20.9). In the final statistical model these three factors also accounted for the majority of the excess risk of advanced stage for blacks. CONCLUSIONS: Black-white racial disparities in stage at diagnosis appear to be related to higher-grade lesions and more aggressive histologic subtypes occurring more frequently in black patients with endometrial cancer.

Authors
Barrett, RJ; Harlan, LC; Wesley, MN; Hill, HA; Chen, VW; Clayton, LA; Kotz, HL; Eley, JW; Robboy, SJ; Edwards, BK
MLA Citation
Barrett, RJ, Harlan, LC, Wesley, MN, Hill, HA, Chen, VW, Clayton, LA, Kotz, HL, Eley, JW, Robboy, SJ, and Edwards, BK. "Endometrial cancer: stage at diagnosis and associated factors in black and white patients." Am J Obstet Gynecol 173.2 (August 1995): 414-422.
PMID
7645616
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
173
Issue
2
Publish Date
1995
Start Page
414
End Page
422

Racial differences in tumor grade among women with endometrial cancer.

Black women with endometrial cancer have more advanced disease and less favorable tumor grade than do white women. This study evaluated whether racial differences in tumor grade could be explained by hormone-related factors and other putative determinants of grade. Subjects included 207 white and 81 black postmenopausal women diagnosed with primary cancer of the uterine corpus between 1985 and 1987. Blacks had poorer tumor grade than whites (odds ratio for FIGO grade 2 versus grade 1 is 1.8; odds ratio for grade 3 versus grade 1 is 2.8). Over 75% of the excess of poorly differentiated tumors versus well-differentiated tumors among blacks could be explained by racial differences in use of replacement estrogens, age at first pregnancy, history of oophorectomy, poverty, stage of disease, use of screening, and access to health care. The most prominent factor was estrogen therapy, which was associated with favorable tumor grade and was used much less frequently by blacks. Although not statistically significant, a moderate racial difference in tumor grade remained after control of the potential explanatory explanatory variables. This may reflect true biologic variation between blacks and whites and may explain, in part, the observation that blacks with endometrial cancer have a worse prognosis.

Authors
Hill, HA; Coates, RJ; Austin, H; Correa, P; Robboy, SJ; Chen, V; Click, LA; Barrett, RJ; Boyce, JG; Kotz, HL
MLA Citation
Hill, HA, Coates, RJ, Austin, H, Correa, P, Robboy, SJ, Chen, V, Click, LA, Barrett, RJ, Boyce, JG, and Kotz, HL. "Racial differences in tumor grade among women with endometrial cancer." Gynecol Oncol 56.2 (February 1995): 154-163.
PMID
7896178
Source
pubmed
Published In
Gynecologic Oncology
Volume
56
Issue
2
Publish Date
1995
Start Page
154
End Page
163

Borderline and malignant serous tumor arising in pelvic lymph nodes: evidence of origin in benign glandular inclusions.

This report describes two cases of malignant serous cancers with areas of borderline malignancy, which appear to have arisen within benign glandular inclusions of coelomic origin in pelvic or para-aortic lymph nodes. The patients were 44 and 62 years of age. In both cases the nodes contained benign glandular inclusions lined by a single layer of epithelium which resembled that of tubal epithelium. The location of the glandular epithelium varied from within the fat near the node to intracapsular, subcapsular, or interfollicular positions. The number of glands ranged from few to extensive. In both cases the glandular inclusions disclosed epithelial proliferations, ranging from minor degrees of stratification with formation of small papillae of atypical cells (borderline serous tumor) to almost solid tumor typical of serous cancer. In both cases, the borderline and cancerous tumors exhibited areas of transition which appeared to arise from benign glands. Although benign glandular inclusions of coelomic origin are well documented to occur in pelvic or para-aortic lymph nodes of 5-20% of women and have been considered to be of significance only because of the possibility of the misdiagnosis of cancer, it should now be recognized that the glandular inclusion cysts themselves can become neoplastic.

Authors
Prade, M; Spatz, A; Bentley, R; Duvillard, P; Bognel, C; Robboy, SJ
MLA Citation
Prade, M, Spatz, A, Bentley, R, Duvillard, P, Bognel, C, and Robboy, SJ. "Borderline and malignant serous tumor arising in pelvic lymph nodes: evidence of origin in benign glandular inclusions." Int J Gynecol Pathol 14.1 (January 1995): 87-91.
PMID
7883433
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
14
Issue
1
Publish Date
1995
Start Page
87
End Page
91

PROGNOSTIC INDEXES IN MALIGNANT STRUMA OVARII (MSO) - CLINICOPATHOLOGICAL ANALYSIS OF 36 PATIENTS WITH 20+-YEAR FOLLOW-UP

Authors
ROBBOY, SJ; KRIGMAN, HR; DONOHUE, J; SCULLY, RE
MLA Citation
ROBBOY, SJ, KRIGMAN, HR, DONOHUE, J, and SCULLY, RE. "PROGNOSTIC INDEXES IN MALIGNANT STRUMA OVARII (MSO) - CLINICOPATHOLOGICAL ANALYSIS OF 36 PATIENTS WITH 20+-YEAR FOLLOW-UP." LABORATORY INVESTIGATION 72.1 (January 1995): A95-A95.
Source
wos-lite
Published In
Laboratory Investigation
Volume
72
Issue
1
Publish Date
1995
Start Page
A95
End Page
A95

Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium

Authors
Handa, VL; Bachus, KE; Johnston, WW; Robboy, SJ; Hammond, CB
MLA Citation
Handa, VL, Bachus, KE, Johnston, WW, Robboy, SJ, and Hammond, CB. "Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium." ACOG Current Journal Review 8.1 (1995): 48--.
Source
scival
Published In
ACOG Current Journal Review
Volume
8
Issue
1
Publish Date
1995
Start Page
48-

Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium.

OBJECTIVE: To test the hypothesis tha a very-low-dose regimen of vaginal estrogen would provide effective relief from atrophic vaginitis without endometrial proliferation. METHODS: Twenty postmenopausal women with symptoms, signs, and cytologic evidence of atrophic vaginitis were enrolled. Each subject was treated with 0.3 mg of conjugated estrogens, administered vaginally 3 nights per week for 6 months. We examined the following outcomes: symptoms, vaginal cellular (cytologic) maturity, endometrial histology, sonographic evaluation of endometrial thickness, Doppler measures of uterine artery blood flow, and serum levels of estrone and estradiol. Pre- and post-treatment data were compared for each subject. RESULTS: Satisfactory relief of symptoms occurred in 19 of 20 cases. Vaginal cellular maturation improved significantly with therapy (P < .01). There were no significant changes in endometrial thickness, uterine artery blood flow, or serum estrogen levels. Endometrial proliferation was observed in one case. CONCLUSIONS: Relief from atrophic vaginitis can be achieved with 0.3 mg of conjugated estrogens administered vaginally three times per week. Endometrial proliferation may occur at this low dose, albeit rarely.

Authors
Handa, VL; Bachus, KE; Johnston, WW; Robboy, SJ; Hammond, CB
MLA Citation
Handa, VL, Bachus, KE, Johnston, WW, Robboy, SJ, and Hammond, CB. "Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium." Obstet Gynecol 84.2 (August 1994): 215-218.
PMID
8041532
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
84
Issue
2
Publish Date
1994
Start Page
215
End Page
218

Pathology of epithelial ovarian tumors.

Authors
Krigman, H; Bentley, R; Robboy, SJ
MLA Citation
Krigman, H, Bentley, R, and Robboy, SJ. "Pathology of epithelial ovarian tumors." Clin Obstet Gynecol 37.2 (June 1994): 475-491. (Review)
PMID
8033455
Source
pubmed
Published In
Clinical Obstetrics and Gynecology
Volume
37
Issue
2
Publish Date
1994
Start Page
475
End Page
491

Synoptic reports in gynecologic pathology.

Authors
Robboy, SJ; Bentley, RC; Krigman, H; Silverberg, SG; Norris, HJ; Zaino, RJ
MLA Citation
Robboy, SJ, Bentley, RC, Krigman, H, Silverberg, SG, Norris, HJ, and Zaino, RJ. "Synoptic reports in gynecologic pathology." Int J Gynecol Pathol 13.2 (April 1994): 161-174.
PMID
8005738
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
13
Issue
2
Publish Date
1994
Start Page
161
End Page
174

Overexpression of p53 is not a feature of benign and early-stage borderline epithelial ovarian tumors.

Since overexpression of mutant p53 protein is a common feature of invasive epithelial ovarian cancers, we investigated whether overexpression of the p53 tumor suppressor gene product occurs in benign and borderline epithelial ovarian tumors. Immunohistochemical staining for p53 was performed in frozen samples of 17 benign tumors and in 49 borderline tumors (4 frozen, 45 paraffin embedded). Overexpression of p53 was observed in 0/17 (0%) benign ovarian tumors and 2/49 (4%) borderline tumors. Overexpression of p53 in borderline tumors was only seen in advanced stage cases; overexpression was seen in 2/8 (25%) stage III cases, but not in any of 41 stage I/II cases. In conclusion, overexpression of p53 is not a feature of benign epithelial ovarian tumors or early-stage borderline ovarian tumors. Similar to invasive epithelial ovarian cancers, however, a fraction of metastatic borderline tumors also overexpress p53.

Authors
Berchuck, A; Kohler, MF; Hopkins, MP; Humphrey, PA; Robboy, SJ; Rodriguez, GC; Soper, JT; Clarke-Pearson, DL; Bast, RC
MLA Citation
Berchuck, A, Kohler, MF, Hopkins, MP, Humphrey, PA, Robboy, SJ, Rodriguez, GC, Soper, JT, Clarke-Pearson, DL, and Bast, RC. "Overexpression of p53 is not a feature of benign and early-stage borderline epithelial ovarian tumors." Gynecol Oncol 52.2 (February 1994): 232-236.
PMID
7508877
Source
pubmed
Published In
Gynecologic Oncology
Volume
52
Issue
2
Publish Date
1994
Start Page
232
End Page
236
DOI
10.1006/gyno.1994.1037

Special report. Synoptic reports in gynecologic pathology

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Special report. Synoptic reports in gynecologic pathology." Inter J Gynecol Pathol 13 (1994): 161-174.
Source
cinii-english
Published In
Inter J Gynecol Pathol
Volume
13
Publish Date
1994
Start Page
161
End Page
174
DOI
10.1097/00004347-199404000-00010

An ultrastructural study of the developing urogenital tract in early human fetuses.

OBJECTIVES: This study examines the gonoducts during the ambisexual stage of human fetal development to define their ultrastructural characteristics, including the origin and antomic relationship of the mesonephric and paramesonephric ducts during gonoductal development. STUDY DESIGN: The reproductive tracts from five fetuses ranging in gestational age from 35 to 45 days were processed for ultrastructural examination. The developing mesonephric ducts, paramesonephric ducts, and their surrounding mesenchyme were studied with a Phillips 300 transmission electron microscope. RESULTS: The mesonephric ducts and paramesonephric ducts have distinctive cytoplasmic and cell surface ultrastructural characteristics, as well as different morphologic patterns of epithelial-mesenchymal interaction. Cephalad portions of mesonephric ducts and paramesonephric ducts are separated by mesenchyme, but more caudal aspects move progressively closer until they are juxtaposed but separate. CONCLUSIONS: Early mesonephric ducts and paramesonephric ducts may be distinguished because of their distinctive ultrastructural features; epithelial-mesenchymal interaction may be important in their differentiation and maintenance; both gonoducts retain their morphologic identity throughout, supporting their separate origins.

Authors
Lawrence, WD; Whitaker, D; Sugimura, H; Cunha, GR; Dickersin, GR; Robboy, SJ
MLA Citation
Lawrence, WD, Whitaker, D, Sugimura, H, Cunha, GR, Dickersin, GR, and Robboy, SJ. "An ultrastructural study of the developing urogenital tract in early human fetuses." Am J Obstet Gynecol 167.1 (July 1992): 185-193.
PMID
1442924
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
167
Issue
1
Publish Date
1992
Start Page
185
End Page
193

The gelatinous bone marrow (serous atrophy) in patients with acquired immunodeficiency syndrome: Evidence of excess sulfated glycosaminoglycan

Patients with the acquired immunodeficiency syndrome uniformly exhibit hematologic abnormalities characterized by anemia and/or pancytopenia. In a study of 75 consecutive bone marrow biopsy specimens from patients with acquired immunodeficiency syndrome, 29% exhibited serous atrophy, characterized by marrow hypoplasia, fat atrophy, and deposition of extracellular 'gelatinous' material (gelatinous transformation). The latter material was composed exclusively of glycosaminoglycans (alcian blue positive at pHs of 2.5 and 1.0, and sensitive to testicular hyaluronidase digestion). Excess glycosaminoglycan, which significantly alters the bone marrow microenvironment, is detrimental to erythropoiesis. The present findings support the concept that the damaged hematopoietic inductive microenvironment in patients with acquired immunodeficiency syndrome leads to failure of hematopoiesis, and, hence, to peripheral hematologic abnormalities.

Authors
Mehta, K; Gascon, P; Robboy, S
MLA Citation
Mehta, K, Gascon, P, and Robboy, S. "The gelatinous bone marrow (serous atrophy) in patients with acquired immunodeficiency syndrome: Evidence of excess sulfated glycosaminoglycan." Archives of Pathology and Laboratory Medicine 116.5 (1992): 504-508.
PMID
1580754
Source
scival
Published In
Archives of Pathology and Laboratory Medicine
Volume
116
Issue
5
Publish Date
1992
Start Page
504
End Page
508

Selected topics in the pathology of the vagina.

Authors
Robboy, SJ; Welch, WR
MLA Citation
Robboy, SJ, and Welch, WR. "Selected topics in the pathology of the vagina." Hum Pathol 22.9 (September 1991): 868-876. (Review)
PMID
1916747
Source
pubmed
Published In
Human Pathology
Volume
22
Issue
9
Publish Date
1991
Start Page
868
End Page
876

The diagnosis of ovarian cancer by pathologists: how often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?

The Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study of ovarian, breast, and endometrial cancer in women 20 to 54 years of age, permitted the diagnoses of contributing pathologists to be compared with those of a panel of three gynecologic pathologists. A diagnosis of ovarian cancer was made by contributing pathologists on 477 subjects. Agreement between the two groups of pathologists was 97% for primary epithelial ovarian cancer and 89% for primary nonepithelial ovarian malignancies. Agreement on diagnosis of major cellular subtypes of ovarian malignancy ranged between 73% for endometrioid cancer and 100% for clear cell carcinomas. We conclude that the diagnosis of pathologic features of primary ovarian cancer is highly predictable. Nonetheless, diagnosis by histologic type varies sufficiently that a review process should be considered for clinical or investigative decisions involving specific histologic diagnoses of ovarian cancer.

Authors
Tyler, CW; Lee, NC; Robboy, SJ; Kurman, RJ; Paris, AL; Wingo, PA; Williamson, GD
MLA Citation
Tyler, CW, Lee, NC, Robboy, SJ, Kurman, RJ, Paris, AL, Wingo, PA, and Williamson, GD. "The diagnosis of ovarian cancer by pathologists: how often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?." Am J Obstet Gynecol 164.1 Pt 1 (January 1991): 65-70.
PMID
1986629
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
164
Issue
1 Pt 1
Publish Date
1991
Start Page
65
End Page
70

THE DIAGNOSIS OF OVARIAN-CANCER BY PATHOLOGISTS - HOW OFTEN DO DIAGNOSES BY CONTRIBUTING PATHOLOGISTS AGREE WITH A PANEL OF GYNECOLOGIC PATHOLOGISTS

Authors
TYLER, CW; LEE, NC; ROBBOY, SJ; KURMAN, RJ; PARIS, AL; WINGO, PA; WILLIAMSON, GD
MLA Citation
TYLER, CW, LEE, NC, ROBBOY, SJ, KURMAN, RJ, PARIS, AL, WINGO, PA, and WILLIAMSON, GD. "THE DIAGNOSIS OF OVARIAN-CANCER BY PATHOLOGISTS - HOW OFTEN DO DIAGNOSES BY CONTRIBUTING PATHOLOGISTS AGREE WITH A PANEL OF GYNECOLOGIC PATHOLOGISTS." AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 164.1 (January 1991): 65-70.
Source
wos-lite
Published In
American Journal of Obstetrics & Gynecology
Volume
164
Issue
1
Publish Date
1991
Start Page
65
End Page
70

The diagnosis of ovarian cancer by pathologists: How often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?

The Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study of ovarian, breast, and endometrial cancer in women 20 to 54 years of age, permitted the diagnoses of contributing pathologists to be compared with those of a panel of three gynecologic pathologists. A diagnosis of ovarian cancer was made by contributing pathologists on 477 subjects. Agreement between the two groups of pathologists was 97% for primary epithelial ovarian cancer and 89% for primary nonepithelial ovarian malignancies. Agreement on diagnosis of major cellular subtypes of ovarian malignancy ranged between 73% for endometrioid cancer and 100% for clear cell carcinomas. We conclude that the diagnosis of pathologic features of primary ovarian cancer is highly predictable. Nonetheless, diagnosis by histologic type varies sufficiently that a review process should be considered for clinical or investigative decisions involving specific histologic diagnoses of ovarian cancer. © 1991.

Authors
Jr, CWT; Lee, NC; Robboy, SJ; Kurman, RJ; Paris, AL; Wingo, PA; Williamson, GD
MLA Citation
Jr, CWT, Lee, NC, Robboy, SJ, Kurman, RJ, Paris, AL, Wingo, PA, and Williamson, GD. "The diagnosis of ovarian cancer by pathologists: How often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?." American Journal of Obstetrics and Gynecology 164.1 PART 1 (1991): 65-70.
Source
scival
Published In
American Journal of Obstetrics & Gynecology
Volume
164
Issue
1 PART 1
Publish Date
1991
Start Page
65
End Page
70

Sarcoidosis of the uterus.

The present case of sarcoidosis of the uterus and the previously reported cases are reviewed. Uterine sarcoidosis is usually detected during the investigation of abnormal uterine bleeding in patients with prior evidence of sarcoidosis in another site. However, in several of the reviewed cases, either the uterus was the site of the initial diagnosis of sarcoidosis or its involvement was detected soon afterward. When hysterectomies were performed on patients with endometrial involvement, the myometrium was usually found to contain nonnecrotizing epithelioid granulomas. By contrast, uterine tuberculosis usually spares the myometrium. The differential diagnosis between uterine sarcoidosis and uterine tuberculosis is discussed.

Authors
DiCarlo, FJ; DiCarlo, JP; Robboy, SJ; Lyons, MM
MLA Citation
DiCarlo, FJ, DiCarlo, JP, Robboy, SJ, and Lyons, MM. "Sarcoidosis of the uterus." Arch Pathol Lab Med 113.8 (August 1989): 941-943. (Review)
PMID
2667499
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
113
Issue
8
Publish Date
1989
Start Page
941
End Page
943

Impaired bone marrow in AIDS.

Fifty bone marrows from patients with AIDS were studied to identify the abnormalities related to marrow failure. Prominent reticulin fibrosis and increased atypical megakaryocytes were the major changes associated with the aberrant hematopoietic microenvironment.

Authors
Mehta, KU; Gascon, P; Tannir, N; Lombardo, J; Robboy, SJ
MLA Citation
Mehta, KU, Gascon, P, Tannir, N, Lombardo, J, and Robboy, SJ. "Impaired bone marrow in AIDS." N J Med 86.8 (August 1989): 623-627. (Review)
PMID
2685666
Source
pubmed
Published In
New Jersey medicine : the journal of the Medical Society of New Jersey
Volume
86
Issue
8
Publish Date
1989
Start Page
623
End Page
627

Human papillomavirus infection. Frequency and association with cervical neoplasia in a young population.

One million, six hundred thirty-two thousand, eight hundred forty-seven women from two independent populations in the United States received cytologic screening during a two-year period. Condylomatous lesions (human papillomavirus [HPV] infections) were the most frequent cytologic abnormality in women in both the Planned Parenthood and private sector groups (prevalence rates of 18.6 to 19.0 in women between ages 15 to 19). The prevalence rates of mild-to-moderate dysplasia were also similar in both populations, with the highest frequencies being between ages 25 to 29. Severe dysplasia and carcinoma in situ were most frequent between ages 35 to 39. In both populations, women with condylomatous changes coexisting with dysplastic changes were about ten years younger, grade-for-grade of severity of the lesion, than women without evidence of HPV infection. Since HPV infection is believed to represent the soil from which neoplasm develops, both the frequency of condyloma and the occurrence of dysplasia and cancer in young women suggest that women should begin regular screening programs while in their teens or after they become sexually active.

Authors
Sadeghi, SB; Sadeghi, A; Cosby, M; Olincy, A; Robboy, SJ
MLA Citation
Sadeghi, SB, Sadeghi, A, Cosby, M, Olincy, A, and Robboy, SJ. "Human papillomavirus infection. Frequency and association with cervical neoplasia in a young population." Acta Cytol 33.3 (May 1989): 319-323.
PMID
2543171
Source
pubmed
Published In
Acta cytologica
Volume
33
Issue
3
Publish Date
1989
Start Page
319
End Page
323

Chlamydia trachomatis.

The frequency of positive serological tests for Chlamydia trachomatis, the most common sexually transmitted pathogen in the United States, was assessed in 18,622 specimens derived from New Jersey clinics. From the results, 13 percent female patients and 17 percent male patients were reactive for chlamydial antigen.

Authors
Lombardo, JM; Smith, CA; Siddiqui, LL; Robboy, SJ
MLA Citation
Lombardo, JM, Smith, CA, Siddiqui, LL, and Robboy, SJ. "Chlamydia trachomatis." N J Med 86.4 (April 1989): 289-292.
PMID
2725974
Source
pubmed
Published In
New Jersey medicine : the journal of the Medical Society of New Jersey
Volume
86
Issue
4
Publish Date
1989
Start Page
289
End Page
292

Information in the clinical laboratory: computer-assisted organization and management.

Authors
Robboy, SJ; Trost, R
MLA Citation
Robboy, SJ, and Trost, R. "Information in the clinical laboratory: computer-assisted organization and management." Adv Clin Chem 27 (1989): 269-301.
PMID
2756854
Source
pubmed
Published In
Advances in clinical chemistry
Volume
27
Publish Date
1989
Start Page
269
End Page
301

Absence of teratogenic effects of progesterone on the developing genital tract of the human female fetus.

It has been questioned whether prenatal exposure to progesterone, like exposure to diethylstilbestrol (DES), results in teratogenic abnormalities of the upper and lower genital tract in human females. Through the use of a recently described model in which human fetal reproductive tracts can be transplanted and grown in vivo for extended periods in athymic nude mice, genital tracts from human female fetuses, ages 7 to 18 weeks postovulation, were grafted into castrated murine hosts and grown for 4 to 10 weeks in the presence or absence of continuous exposure to progesterone. Substantial growth was observed. For all specimens, the morphogenetic process proceeded normally, resulting in the harmonious organization of a complete, well differentiated genital tract composed of fallopian tubes, uterine corpus, and cervix and vagina. The fallopian tubes were highly convoluted and disclosed fimbria. The uterine corpus was lined by a simple columnar epithelium; two layers of stroma in the wall were distinctly separated from each other. In the older specimens, the outer layer of stroma had assumed microscopic properties diagnostic of smooth muscle (myometrium). In the majority of specimens the region of the cervix/vagina disclosed the development of a fornix-like evagination at which point or slightly cranially there was a gradual but defined transition from columnar epithelium to squamous epithelium. The inner layer of endometrial stroma tapered and disappeared at or close to the squamocolumnar junction. The vaginal stroma was a single homogeneous layer and was continuous with the myometrium of the uterine corpus. In the context of this model system, prenatal exposure of the developing human female genital tract of progesterone was not associated with any obvious teratogenic effects.

Authors
Cunha, GR; Taguchi, O; Sugimura, Y; Lawrence, WD; Mahmood, F; Robboy, SJ
MLA Citation
Cunha, GR, Taguchi, O, Sugimura, Y, Lawrence, WD, Mahmood, F, and Robboy, SJ. "Absence of teratogenic effects of progesterone on the developing genital tract of the human female fetus." Hum Pathol 19.7 (July 1988): 777-783.
PMID
3402971
Source
pubmed
Published In
Human Pathology
Volume
19
Issue
7
Publish Date
1988
Start Page
777
End Page
783

Prevalence of dysplasia and cancer of the cervix in a nationwide, planned parenthood population.

Two and three-tenths percent of cervical smears disclosed abnormalities from among 1,045,059 submitted for processing and examination by the Cancer Screening Service. The smears came from 198 Planned Parenthood Family Planning Clinics in 23 States during a 3-year period. Mild to moderate dysplasia was most frequent in women 25 to 29 years of age (prevalence rate, 25.7/1000), severe dysplasia and carcinoma in situ in women 35 to 39 years of age (prevalence rate, 4.6/1000), and invasive carcinoma in women older than 50 years of age (prevalence rate, 0.47/1000). All lesions also were encountered in younger women. Mild dysplasia was found in girls as young as 10 years of age, severe dysplasia in girls as young as 15 years, and invasive carcinoma in women as young as 20 years. The large number of young women with abnormalities suggests that availability of screening programs for sexually active women is important.

Authors
Sadeghi, SB; Sadeghi, A; Robboy, SJ
MLA Citation
Sadeghi, SB, Sadeghi, A, and Robboy, SJ. "Prevalence of dysplasia and cancer of the cervix in a nationwide, planned parenthood population." Cancer 61.11 (June 1, 1988): 2359-2361.
PMID
3365664
Source
pubmed
Published In
Cancer
Volume
61
Issue
11
Publish Date
1988
Start Page
2359
End Page
2361

Clear cell adenocarcinoma of the vagina and cervix: incidence, undetected disease, and diethylstilbestrol.

We conducted an incidence study to determine the occurrence rates of clear cell adenocarcinoma (CCAC) of the vagina and cervix in young women (born in 1940 and thereafter), and a case-series analysis, focusing on the maternal history of pregnancy and delivery and in-utero exposure to diethylstilbestrol (DES). Overall, 10 cases of CCAC had been listed in the files of the Connecticut State Tumor Registry prior to the study, and each of the 10 cases were confirmed as valid. In addition, another 10 cases, all previously undetected, were found after the tissue slides of young women listed as having other cancers of the vagina and cervix were reviewed by expert pathologists, suggesting that prior estimates of the incidence rate for CCAC must be misleading unless special efforts are taken to identify undetected cases. The incidence rates of vaginal CCAC (11 cases total) were highest in 1975-1979, and decreased slightly during 1980-1982. In the cervix (nine cases total), the rate increased consistently since 1970. History of in-utero exposure to diethylstilbestrol was obtained for five of eight vaginal cases and four of eight cervical cases of CCAC. In all nine cases, exposure to diethylstilbestrol was associated with a history of bleeding during the pregnancy or prior miscarriage. We conclude that the finding of stable (or rising) incidence rates for CCAC occurring nearly 30 years after the marked decrease in diethylstilbestrol sales emphasizes the need for continued clinical and epidemiologic studies of the etiology and clinical course of CCAC.

Authors
Horwitz, RI; Viscoli, CM; Merino, M; Brennan, TA; Flannery, JT; Robboy, SJ
MLA Citation
Horwitz, RI, Viscoli, CM, Merino, M, Brennan, TA, Flannery, JT, and Robboy, SJ. "Clear cell adenocarcinoma of the vagina and cervix: incidence, undetected disease, and diethylstilbestrol." J Clin Epidemiol 41.6 (1988): 593-597.
PMID
3385459
Source
pubmed
Published In
Journal of Clinical Epidemiology
Volume
41
Issue
6
Publish Date
1988
Start Page
593
End Page
597

Statistical methods for morphometric analysis

Statistical procedures and software packages appropriate for the analysis of morphometric data are discussed. In a typical situation, morphometry is used to provide an objective system of measures, which along with various demographic data can be used to project the probability of recurrence of disease. Morphometric methods are compared to subjective grading systems, which have been used to predict survival, but at best semiquantify architectural and cytologic features.

Authors
Trost, RC; Ambros, RA; Robboy, SJ
MLA Citation
Trost, RC, Ambros, RA, and Robboy, SJ. "Statistical methods for morphometric analysis." IEEE/Engineering in Medicine and Biology Society Annual Conference 10.pt 1 (1988): 293-294.
Source
scival
Published In
IEEE/Engineering in Medicine and Biology Society Annual Conference
Volume
10
Issue
pt 1
Publish Date
1988
Start Page
293
End Page
294

Computer-aided morphometric applications (image analysis) in gynecologic pathology

The female genital tract gives rise to a wide spectrum of disease entities that are borderline abnormal on the one hand or borderline cancer on the other. While traditional criteria have been developed for the diagnosis of these lesions, based on cytological characteristics of cells and their architectural arrangements, the emerging area of morphometry (image analysis) has shown in some cases a greater degree of diagnostic precision than the eye. A description is given of the current status of such morphometric applications in gynecologic pathology.

Authors
Robboy, SJ; Mehta, K; Trost, R; Lambert, WC
MLA Citation
Robboy, SJ, Mehta, K, Trost, R, and Lambert, WC. "Computer-aided morphometric applications (image analysis) in gynecologic pathology." IEEE/Engineering in Medicine and Biology Society Annual Conference 10.pt 1 (1988): 297-298.
Source
scival
Published In
IEEE/Engineering in Medicine and Biology Society Annual Conference
Volume
10
Issue
pt 1
Publish Date
1988
Start Page
297
End Page
298

Hysterectomy, tubal sterilization, and the risk of breast cancer

Studies suggest that hysterectomy and tubal sterilization may alter the function of the remaining ovaries. Conceivably, this effect could alter breast cancer risk. To investigate whether these surgeries affect breast cancer risk, the authors analyzed data collected between December 1, 1980, and April 30, 1983, in a population-based, case-control study of women aged 20-54 years, the Cancer and Steroid Hormone Study. Compared with never-sterilized women, women with hysterectomy and no remaining ovaries had a decreased risk of breast cancer (relative risk (RR) = 0.7, 95% confidence interval (CI) = 0.6-0.8). Risk was lowest in women who had their surgery before age 40 years or 15 or more years in the past; surgery at an early age provided greater protection than surgery in the distant past. Hysterectomy with one or two remaining ovaries was also inversely associated with breast cancer risk (RR = 0.8, 95% CI = 0.7-0.9), but no relation was found with age at surgery or time since surgery. Women with tubal sterilization had a slightly increased risk of breast cancer, which was of borderline statistical significance (RR = 1.2, 95% CI = 1.0-1.3). However, no relation was found with age at surgery or time since surgery. The data suggest that hysterectomy with bilateral oophorectomy decreases the breast cancer risk in women aged less than 55 years, possibly by curtailing ovarian function at a critical period. However, neither hysterectomy without bilateral oophorectomy nor tubal sterilization appears to substantially alter breast cancer risk in women of this age.

Authors
Irwin, KL; Lee, NC; Peterson, HB; Rubin, GL; Wingo, PA; Mandel, MG; Greenberg, R; Meigs, JW; Thompson, WD; Swanson, GM; Smith, E; Key, C; Pathak, D; Ausing, D; Thomas, D; Lyon, J; West, D; Gorstein, F; McDivitt, R; Robboy, SJ
MLA Citation
Irwin, KL, Lee, NC, Peterson, HB, Rubin, GL, Wingo, PA, Mandel, MG, Greenberg, R, Meigs, JW, Thompson, WD, Swanson, GM, Smith, E, Key, C, Pathak, D, Ausing, D, Thomas, D, Lyon, J, West, D, Gorstein, F, McDivitt, R, and Robboy, SJ. "Hysterectomy, tubal sterilization, and the risk of breast cancer." American Journal of Epidemiology 127.6 (1988): 1192-1201.
PMID
3369418
Source
scival
Published In
American Journal of Epidemiology
Volume
127
Issue
6
Publish Date
1988
Start Page
1192
End Page
1201

Teratogenic effects of clomiphene, tamoxifen, and diethylstilbestrol on the developing human female genital tract.

The potential estrogenicity and teratogenicity of triphenylethylene antiestrogens were examined in 54 genital tracts isolated from 4- to 19-week-old human female fetuses and grown for 1 to 2 months in untreated athymic nude mice or host mice treated by subcutaneous pellet with the antiestrogens clomiphene and tamoxifen or the synthetic estrogen diethylstilbestrol (DES). In specimens grown to a gestational age equivalent of 15 weeks or less, the vagina and urogenital sinus were lined by an immature squamous epithelium, which were similar in both drug-treated and untreated specimens. Proliferation and maturation of the squamous vaginal epithelium were observed in specimens treated with clomiphene, tamoxifen, or DES only when grown to a gestational age equivalent of 16 weeks or more. Formation of endometrial and cervical glands proceeded in 87 per cent (13 of 15) of control specimens grown to a gestational age equivalent of 13 weeks or more in untreated hosts. By contrast, age-matched drug-treated specimens contained glands in only 44 per cent (12 of 27) of specimens. In the developing uterine corpus of untreated controls, the uterine mesenchyme segregated into inner (endometrial stroma) and outer (myometrial) layers; whereas in drug-treated specimens, condensation and segregation of the mesenchyme were greatly impaired. The fallopian tube was also affected by clomiphene and tamoxifen (and to a lesser extent by DES) in that its epithelium was hyperplastic and disorganized. The complex mucosal plications characteristic of the fallopian tube were also distorted in drug-treated specimens. These results emphasize the heretofore unrecognized estrogenicity and potential teratogenicity of triphenylethylene antiestrogens on the developing human genital tract and emphasize the need for caution to prevent inadvertent exposure of the developing fetus to these compounds.

Authors
Cunha, GR; Taguchi, O; Namikawa, R; Nishizuka, Y; Robboy, SJ
MLA Citation
Cunha, GR, Taguchi, O, Namikawa, R, Nishizuka, Y, and Robboy, SJ. "Teratogenic effects of clomiphene, tamoxifen, and diethylstilbestrol on the developing human female genital tract." Hum Pathol 18.11 (November 1987): 1132-1143.
PMID
3679188
Source
pubmed
Published In
Human Pathology
Volume
18
Issue
11
Publish Date
1987
Start Page
1132
End Page
1143

The acquired immunodeficiency syndrome in intravenous drug abusers and patients with a sexual risk: clinical and postmortem comparisons.

Clinical and necropsy findings in 13 intravenous drug abusers who died of the acquired immunodeficiency syndrome (AIDS) were reviewed and compared with findings in eight patients who acquired the infection through sexual exposure, the most common mode of transmission in AIDS. No differences were found in lymphocyte counts or duration of survival, despite reports that the degree of immunosuppression in intravenous drug abusers with AIDS differs from that in homosexuals. Neoplasms were found in 25 per cent of patients with sexual risks, but not in any drug abusers (0 per cent). Two opportunistic infections (toxoplasmosis and cytomegalovirus pneumonia and esophagitis) were more common in the intravenous drug abuser group. Although cytomegalovirus has been associated with Kaposi's sarcoma, this association was not found in this study. The postmortem findings in both groups were otherwise similar.

Authors
Ambros, RA; Lee, EY; Sharer, LR; Khan, MY; Robboy, SJ
MLA Citation
Ambros, RA, Lee, EY, Sharer, LR, Khan, MY, and Robboy, SJ. "The acquired immunodeficiency syndrome in intravenous drug abusers and patients with a sexual risk: clinical and postmortem comparisons." Hum Pathol 18.11 (November 1987): 1109-1114.
PMID
2824321
Source
pubmed
Published In
Human Pathology
Volume
18
Issue
11
Publish Date
1987
Start Page
1109
End Page
1114

Coital risk factors for cervical cancer. Sexual activity among white middle class women.

This study reports the sexual history of a group of young women participating in an epidemiologic project. The methods used to recruit and interview the participants minimized self-selection bias. Results of over 11,000 interviews with 1,892 participants showed that 72.3% should be considered at high risk for developing cervical cancer and its precursors and should be screened regularly for this disease.

Authors
Noller, KL; O'Brien, PC; Melton, LJ; Offord, JR; Richart, RM; Robboy, SJ; Kaufman, RH
MLA Citation
Noller, KL, O'Brien, PC, Melton, LJ, Offord, JR, Richart, RM, Robboy, SJ, and Kaufman, RH. "Coital risk factors for cervical cancer. Sexual activity among white middle class women." Am J Clin Oncol 10.3 (June 1987): 222-226.
PMID
3591742
Source
pubmed
Published In
American Journal of Clinical Oncology: Cancer Clinical Trials
Volume
10
Issue
3
Publish Date
1987
Start Page
222
End Page
226

ULTRASTRUCTURAL-STUDY OF DEVELOPING UROGENITAL TRACT IN EARLY HUMAN FETUSES

Authors
LAWRENCE, WD; WHITAKER, D; SUGIMURA, Y; CUNHA, G; DICKERSON, GR; ROBBOY, SJ
MLA Citation
LAWRENCE, WD, WHITAKER, D, SUGIMURA, Y, CUNHA, G, DICKERSON, GR, and ROBBOY, SJ. "ULTRASTRUCTURAL-STUDY OF DEVELOPING UROGENITAL TRACT IN EARLY HUMAN FETUSES." LABORATORY INVESTIGATION 56.1 (January 1987): A42-A42.
Source
wos-lite
Published In
Laboratory Investigation
Volume
56
Issue
1
Publish Date
1987
Start Page
A42
End Page
A42

Neural and neuroendocrine tumors of the larynx

Benign and malignant neural and neuroendocrine tumors of the larynx are uncommon enough that knowledge about them is sparse, coming from single case reports and literature reviews. We have reviewed the clinical behavior, pathologic findings, treatment, and outcome in 42 patients seen at one institution from 1907 to 1986. In some cases, electron microscopy or immunocytochemistry, or both, may be needed to reach the correct diagnosis. Treatment is largely determined by the histopathologic features, size, and location of the tumor. The most common sites are the supraglottic region and posterior larynx. Most tumors are treated by conservation surgery, including transoral excision; however, some are aggressive and require larger surgical procedures, including wide-field laryngectomy and complete neck dissection.

Authors
Stanley, RJ; Weiland, LH; Scheithauer, BW; III, HBN
MLA Citation
Stanley, RJ, Weiland, LH, Scheithauer, BW, and III, HBN. "Neural and neuroendocrine tumors of the larynx." Annals of Otology, Rhinology and Laryngology 96.6 (1987): 630-638.
Source
scival
Published In
Annals of Otology, Rhinology and Laryngology
Volume
96
Issue
6
Publish Date
1987
Start Page
630
End Page
638

Endodermal sinus tumor (yolk sac tumor) of the ear

Endodermal sinus tumors (yolk sac tumors) are malignant germ cell tumors that usually arise in the gonads. We report what is, to our knowledge, the first known case of endodermal sinus tumor of the ear. The tumor was present in in a developmentally delayed child with an abnormal temporal bone and exhibited histopathologic and immunocytochemical features identical to those of endodermal sinus tumors of gonadal origin. The tumor resolved after chemotherapy, and the patient remained alive without evidence of disease at the time of this writing. The purpose of this report is to add a rare tumor to the differential diagnosis of neoplasms of the ear in children and to familiarize otorhinolaryngologists and head and neck surgeons with its pathologic features and clinical management.

Authors
Stanley, RJ; Scheithauer, BW; Thompson, EI; Kispert, DB; Weiland, LH; Pearson, BW
MLA Citation
Stanley, RJ, Scheithauer, BW, Thompson, EI, Kispert, DB, Weiland, LH, and Pearson, BW. "Endodermal sinus tumor (yolk sac tumor) of the ear." Archives of Otolaryngology - Head and Neck Surgery 113.2 (1987): 200-203.
Source
scival
Published In
Archives of Otolaryngology - Head and Neck Surgery
Volume
113
Issue
2
Publish Date
1987
Start Page
200
End Page
203

Expression of nuclear estrogen-binding sites within developing human fetal vagina and urogenital sinus.

An autoradiographic study of nuclear estrogen binding was performed in developing human urogenital sinuses and vaginas derived from first and second trimester specimens. Nuclear estrogen binding was detected in all specimens greater than or equal to 10 weeks of gestation within mesenchymal cells. Nuclear labelling within epithelium was observed only in those specimens whose development and differentiation was advanced. Thus, mesenchyme appears to be the initial estrogen target tissue within the developing human vagina and may play a fundamental role in estrogen-induced teratogenesis of the human genital tract.

Authors
Taguchi, O; Cunha, GR; Robboy, SJ
MLA Citation
Taguchi, O, Cunha, GR, and Robboy, SJ. "Expression of nuclear estrogen-binding sites within developing human fetal vagina and urogenital sinus." Am J Anat 177.4 (December 1986): 473-480.
PMID
3812331
Source
pubmed
Published In
American Journal of Anatomy
Volume
177
Issue
4
Publish Date
1986
Start Page
473
End Page
480
DOI
10.1002/aja.1001770405

Pulmonary cytology of the acquired immune deficiency syndrome: an analysis of 36 cases.

The infectious pathogens and associated cellular reactions in 75 pulmonary cytological specimens obtained largely by fiberoptic bronchoscopy from 36 patients with the acquired immune deficiency syndrome are described and correlated with the biopsy specimens. An opportunistic pathogen was diagnosed in 33% of cytological preparations. Pneumocystis carinii was encountered most frequently; Cryptococcus neoformans and cytomegalovirus were also seen. The polymorphonuclear neutrophil was the predominant inflammatory cell. Cells of secondary import were bronchial cells and type II pneumocytes with atypia and hyperplasia. Bronchoalveolar lavage had the highest yield, positive predictive value, and sensitivity for all pathogens and for P. carinii. An opportunistic pathogen was diagnosed in 69% of patients utilizing histological material and in 33% using cytological samples; the rate of diagnosis increased to 72% when the samples were combined.

Authors
Duggan, MA; Pomponi, C; Robboy, SJ
MLA Citation
Duggan, MA, Pomponi, C, and Robboy, SJ. "Pulmonary cytology of the acquired immune deficiency syndrome: an analysis of 36 cases." Diagn Cytopathol 2.3 (September 1986): 181-186.
PMID
3021408
Source
pubmed
Published In
Diagnostic Cytopathology
Volume
2
Issue
3
Publish Date
1986
Start Page
181
End Page
186

Infantile chlamydial conjunctivitis. A comparison of Papanicolaou, Giemsa and immunoperoxidase staining methods.

The use of conjunctival smears to diagnose infantile Chlamydia trachomatis infection increased sixteen-fold in our hospital between the years 1979 and 1984. The present study was conducted to compare Papanicolaou and Giemsa staining methods with the avidin-biotin technique of immunostaining utilizing a highly specific antichlamydial monoclonal antibody. On retrospective review of 33 patients, chlamydial infection was diagnosed in 61% of the Papanicolaou-stained and 64% of the Giemsa-stained slides. After the Papanicolaou-stained slides were destained and immunostained with the antichlamydial antibody, round particles corresponding in size to elementary and reticulate bodies were readily seen in 79% of the cases. In comparison with the immunoperoxidase method, the sensitivity and specificity of Papanicolaou staining were 73% and 86%, respectively, while the corresponding figures for Giemsa staining were 77% and 100%, respectively. The study established the applicability of the immunoperoxidase method to this clinical condition, confirmed the accuracy of diagnoses with routine stains and highlighted the increasing incidence of chlamydial conjunctivitis in our hospital population.

Authors
Duggan, MA; Pomponi, C; Kay, D; Robboy, SJ
MLA Citation
Duggan, MA, Pomponi, C, Kay, D, and Robboy, SJ. "Infantile chlamydial conjunctivitis. A comparison of Papanicolaou, Giemsa and immunoperoxidase staining methods." Acta Cytol 30.4 (July 1986): 341-346.
PMID
2426891
Source
pubmed
Published In
Acta cytologica
Volume
30
Issue
4
Publish Date
1986
Start Page
341
End Page
346

Vaginal adenosis in women born prior to the diethylstilbestrol era.

Vaginal adenosis was evaluated in 41 women, all of whom had been born prior to the diethylstilbestrol (DES) era, and compared with the adenosis commonly encountered in DES-exposed progeny. The patients were 24 to 88 years of age (median, 44 years). Six of the women were symptomatic, and in four of these six the glands were enmeshed in a marked inflammatory infiltrate. In an additional 26 women the adenosis was discovered as incidental, nonsymptomatic macroscopic nodules or cysts. The remaining nine cases of adenosis were discovered by pathologists. Three types of epithelia characterized the glands: mucinous, tuboendometrial, and embryonic. Mucinous columnar cells resembling the lining of the normal endocervix and tuboendometrial cells resembling the lining of the normal fallopian tube or endometrium constituted the glands exclusively in 22 and eight specimens, respectively, and as a mixture in seven. The glands lined by mucinous cells most often presented clinically as cysts or nodules. The specimens composed of tuboendometrial cells were most often discovered on microscopic examination. The third type of epithelium, composed of embryonic columnar cells, was encountered in four specimens. These glands, less than 30 micron in greatest diameter, were located at the junction between the lamina propria and the squamous epithelium, and were incidental microscopic findings. It is concluded that the microscopic appearances of adenosis in women born prior to the DES era are identical to those encountered in young women exposed in utero to DES.

Authors
Robboy, SJ; Hill, EC; Sandberg, EC; Czernobilsky, B
MLA Citation
Robboy, SJ, Hill, EC, Sandberg, EC, and Czernobilsky, B. "Vaginal adenosis in women born prior to the diethylstilbestrol era." Hum Pathol 17.5 (May 1986): 488-492.
PMID
3699812
Source
pubmed
Published In
Human Pathology
Volume
17
Issue
5
Publish Date
1986
Start Page
488
End Page
492

The Incidence of Cervical and Vaginal Dysplasia After Exposure to DES-Reply

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "The Incidence of Cervical and Vaginal Dysplasia After Exposure to DES-Reply." JAMA: The Journal of the American Medical Association 255.1 (January 3, 1986): 37-37.
Source
crossref
Published In
JAMA : the journal of the American Medical Association
Volume
255
Issue
1
Publish Date
1986
Start Page
37
End Page
37
DOI
10.1001/jama.1986.03370010038014

THE INCIDENCE OF CERVICAL AND VAGINAL DYSPLASIA AFTER EXPOSURE TO DES - REPLY

Authors
ROBBOY, SJ; LAWRENCE, WD; NOLLER, KL; OBRIEN, P; BERGSTRAHL, E; MCGORRAY, S; TILLEY, BC; KAUFMAN, RH
MLA Citation
ROBBOY, SJ, LAWRENCE, WD, NOLLER, KL, OBRIEN, P, BERGSTRAHL, E, MCGORRAY, S, TILLEY, BC, and KAUFMAN, RH. "THE INCIDENCE OF CERVICAL AND VAGINAL DYSPLASIA AFTER EXPOSURE TO DES - REPLY." JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 255.1 (January 3, 1986): 37-37.
Source
wos-lite
Published In
JAMA : the journal of the American Medical Association
Volume
255
Issue
1
Publish Date
1986
Start Page
37
End Page
37

The incidence of cervical and vaginal dysplasia after exposure to DES

Authors
Richart, RM; Robboy, SJ; Lawrence, WD
MLA Citation
Richart, RM, Robboy, SJ, and Lawrence, WD. "The incidence of cervical and vaginal dysplasia after exposure to DES." Journal of the American Medical Association 255.1 (1986): 36-37.
Source
scival
Published In
Journal of the American Medical Association
Volume
255
Issue
1
Publish Date
1986
Start Page
36
End Page
37

Female adnexal tumor of probable Wolffian origin with multiple recurrences over 16 years.

The case history of a woman with a "female adnexal tumor of probable Wolffian origin" is described in which the neoplasm recurred three times during a 16-year interval and responded with prolonged remission after repeated surgical excision and radiotherapy. Ultrastructural data are given to support the Wolffian nature of the tumor. Although the tumor was considered in the past to be a benign neoplasm, the current report, as well as six others in which the tumor recurred or metastasized, indicates that the female adnexal tumor of probable Wolffian origin should be classified within the International Classification of Disease-Oncology and the Systematized Nomenclature of Medicine nomenclatures as "of low malignant potential."

Authors
Brescia, RJ; Cardoso de Almeida, PC; Fuller, AF; Dickersin, GR; Robboy, SJ
MLA Citation
Brescia, RJ, Cardoso de Almeida, PC, Fuller, AF, Dickersin, GR, and Robboy, SJ. "Female adnexal tumor of probable Wolffian origin with multiple recurrences over 16 years." Cancer 56.6 (September 15, 1985): 1456-1461.
PMID
4027880
Source
pubmed
Published In
Cancer
Volume
56
Issue
6
Publish Date
1985
Start Page
1456
End Page
1461

Pathology of colposcopic findings in 2635 diethylstilbestrol exposed young women

An analysis of 6055 colposcopically directed biopsy specimens from 2635 diethylstilbestrol (DES)-exposed women and 445 biopsy specimens from 277 nonexposed women was undertaken to correlate microscopic findings with colposcopic patterns. All examinations were performed using a standardized protocol which required that each participant have colposcopy, cytologic smears, and biopsy of abnormal colposcopic lesions. The findings of colposcopic 'columnar epithelium, gland openings, and Nabothian cysts' correlated most often with glandular epithelium in the biopsy specimen. 'White epithelium', which includes three related colposcopic patterns, mosaicism, punctation, and white epithelium, was associated most frequently (82-93% of cases) with squamous metaplasia, but occasionally with dysplasia and carcinoma in situ (CIS)(0-6%). The presence of dysplasia or CIS in any individual biopsy specimen occurred most frequently with the observation of higher graded lesions by colposcopy or a prior diagnosis of dysplasia.

Authors
Welch, WR; Robboy, SJ; Kaufman, RH; Townsend, D; Noller, KL; Gundersen, J; Lawrence, WD; Richart, RM; O'Brien, P; McGorray, S; Tilley, BC; Chazen, G
MLA Citation
Welch, WR, Robboy, SJ, Kaufman, RH, Townsend, D, Noller, KL, Gundersen, J, Lawrence, WD, Richart, RM, O'Brien, P, McGorray, S, Tilley, BC, and Chazen, G. "Pathology of colposcopic findings in 2635 diethylstilbestrol exposed young women." Gynecologic Oncology 21.3 (August 28, 1985): 277-286.
Source
scopus
Published In
Gynecologic Oncology
Volume
21
Issue
3
Publish Date
1985
Start Page
277
End Page
286
DOI
10.1016/0002-9149(85)90958-0

Pathology of colposcopic findings in 2635 diethylstilbestrol-exposed young women.

An analysis of 6055 colposcopically directed biopsy specimens from 2635 diethylstilbestrol (DES)-exposed women and 445 biopsy specimens from 277 nonexposed women was undertaken to correlate microscopic findings with colposcopic patterns. All examinations were performed using a standardized protocol which required that each participant have colposcopy, cytologic smears, and biopsy of abnormal colposcopic lesions. The findings of colposcopic "columnar epithelium, gland openings, and Nabothian cysts" correlated most often with glandular epithelium in the biopsy specimen. "White epithelium," which includes three related colposcopic patterns, mosaicism, punctation, and white epithelium, was associated most frequently (82-93% of cases) with squamous metaplasia, but occasionally with dysplasia and carcinoma in situ (CIS)(0-6%). The presence of dysplasia or CIS in any individual biopsy specimen occurred most frequently with the observation of higher graded lesions by colposcopy or a prior diagnosis of dysplasia.

Authors
Welch, WR; Robboy, SJ; Kaufman, RH; Townsend, D; Noller, KL; Gundersen, J; Lawrence, WD; Richart, RM; O'Brien, P; McGorray, S
MLA Citation
Welch, WR, Robboy, SJ, Kaufman, RH, Townsend, D, Noller, KL, Gundersen, J, Lawrence, WD, Richart, RM, O'Brien, P, and McGorray, S. "Pathology of colposcopic findings in 2635 diethylstilbestrol-exposed young women." Gynecol Oncol 21.3 (July 1985): 277-286.
PMID
4007608
Source
pubmed
Published In
Gynecologic Oncology
Volume
21
Issue
3
Publish Date
1985
Start Page
277
End Page
286

Increased incidence of cervical and vaginal dysplasia in 3980 diethylstilbestrol-exposed young women: Experience of the national collaborative diethylstilbestrol adenosis project

The purpose of this article is to report the incident cases of intraepithelial neoplasia of the cervix and vagina among patients in the National Collaborative Diethylstilbestrol Ad-enosis Project. Incidence rates for dysplasia/carcinoma in situ have been calculated and analyses have been performed in an attempt to determine whether intrauterine diethylstilbestrol exposure is associated with increased rates of dysplasia/carcinoma in situ and, if so, to identify any other factors associated with its occurrence. The categories included diethylstilbestrol-exposed daughters identified through review of obstetric records ("prenatal record review"), nonexposed daughters identified through review of the same records ("controls"), exposed daughters who were referred to the project by other physicians ("referral"), and exposed daughters who themselves requested entry into the project ("walk-in"). Within the first two groups, exposed and unexposed offspring were paired for cohort control studies; the 744 pairs were either sisters (197 pairs) or were matched by date of birth (within 6 months), age of mother (within 5 years), race, and center (547 pairs). Comparison of the exposed and unexposed matched cohorts revealed that both groups were remarkably similar with regard to many variables, including number of sexual partners. Although both groups exhibited similar frequencies of several sexually transmitted diseases (syphilis, gonorrhea, and venereal "warts"), the exposed patients reported increased rates for genital herpes (11.8 vs. 6.3 per cent). Changes observable by colposcopy that extended into the vagina (vaginal epithelial changes) were identified more often in exposed women (44.2 vs. 8.0 per cent). In the pairs of record review exposed and control participants (matched cohorts), the incidence rates for dysplasia by either biopsy or cytological testing were significantly increased in exposed women: 15.7 cases per 1000 patient-years of follow-up were found in exposed women in contrast to 7.9 cases per 1000 in the controls (P < 0.01). The statistical association was considered significant only if the participants with biopsy-documented dysplasia or cytolog-ically detected dysplasia were tested alone. If cases of mild dysplasia were eliminated to adjust for the possibility that not all mild dysplasia may represent neoplasia (some cases are thought to reflect a papilloma-virus infection), the incidence rates were still higher in exposed females. In this case, however, the increase was statistically significant only in those participants with dysplasia detected by biopsy. These increases were also noted in the unmatched participant categories. The incidence rate of dysplasia and carcinoma in situ rose as the area of squamous metaplasia increased and extended to the outer half of the cervix or onto the vagina. The rates were similar in both the exposed and unexposed groups when the squamous metaplasia (defined as benign squamous epithelium with glycogen-poor cytoplasm) was confined to the os or the inner half of the cervix. The incidence rates of dysplasia in the three unmatched diethylstilbestrol-exposed cohorts (record review, self-referral (walk-in), and physician referral) were similar. All three cohorts had some cases of the more severe degrees of intraepithelial neoplasia (severe dysplasia and carcinoma in situ). Because of the marked differences between the incidence rates of dysplasia in the matched cohorts, additional features were examined in the larger number of participants in all three exposed cohorts to help identify factors that might explain the apparent association between diethylstilbestrol exposure and dysplasia. © Williams and Wilkins 1985.

Authors
Robboy, SJ; Noller, KL; O Brien, P; Kaufman, RH; Townsend, D; Barnes, AB; Gundersen, J; Lawrence, D; Bergstrahl, E; McGorray, S; Tilley, BC; Anton, J; Chazen, G
MLA Citation
Robboy, SJ, Noller, KL, O Brien, P, Kaufman, RH, Townsend, D, Barnes, AB, Gundersen, J, Lawrence, D, Bergstrahl, E, McGorray, S, Tilley, BC, Anton, J, and Chazen, G. "Increased incidence of cervical and vaginal dysplasia in 3980 diethylstilbestrol-exposed young women: Experience of the national collaborative diethylstilbestrol adenosis project." Obstetrical and Gynecological Survey 40.6 (January 1, 1985): 379-380.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
40
Issue
6
Publish Date
1985
Start Page
379
End Page
380

Diethylstilbestrol and its consequences: Status in 1985

Authors
Robboy, SJ; Sugimura, Y; Plapinger, L; Cunha, G
MLA Citation
Robboy, SJ, Sugimura, Y, Plapinger, L, and Cunha, G. "Diethylstilbestrol and its consequences: Status in 1985." Cervix and the Lower Female Genital Tract 3.3 (1985): 289-296.
Source
scival
Published In
Cervix and the Lower Female Genital Tract
Volume
3
Issue
3
Publish Date
1985
Start Page
289
End Page
296

INFANTILE CHLAMYDIAL CONJUNCTIVITIS - A COMPARISON OF PAPANICOLAOU, GIEMSA AND IMMUNOPEROXIDASE METHODS OF STAINING

Authors
DUGGAN, MA; POMPONI, C; ROBBOY, SJ
MLA Citation
DUGGAN, MA, POMPONI, C, and ROBBOY, SJ. "INFANTILE CHLAMYDIAL CONJUNCTIVITIS - A COMPARISON OF PAPANICOLAOU, GIEMSA AND IMMUNOPEROXIDASE METHODS OF STAINING." ACTA CYTOLOGICA 29.5 (1985): 926-927.
Source
wos-lite
Published In
Acta cytologica
Volume
29
Issue
5
Publish Date
1985
Start Page
926
End Page
927

Increased Incidence of Cervical and Vaginal Dysplasia in 3,980 Diethylstilbestrol-Exposed Young Women: Experience of the National Collaborative Diethylstilbestrol Adenosis Project

The incidence rates of dysplasia and carcinoma in situ (CIS) of the cervix and vagina were determined in 3,980 young women exposed prenatally to diethylstilbestrol. Strict criteria were developed to minimize selection bias among the subset of 744 pairs of matched exposed and unexposed (control) cohort participants, all of whom were identified through review of prenatal obstetrical records. A high degree of compliance was achieved throughout the seven-year study period since in each group about 90% of the women remained as active participants, kept 77% of the annual anniversary examinations, and had separate Papanicolaou smears of the cervix and vagina performed in 99% of the anniversary examinations. The incidence rate for dysplasia and CIS was significantly higher in the women exposed to diethylstilbestrol than in those not exposed in the matched cohort (15.7 v 7.9 cases per 1,000 person-years of follow-up). The rates were higher in the exposed women if squamous metaplasia extended to the outer half of the cervix or onto the vagina. In other respects, the matched cohorts were strikingly similar. © 1984, American Medical Association. All rights reserved.

Authors
Robboy, SJ; Noller, KL; O'Brien, P; Kaufman, RH; Townsend, D; Barnes, AB; Gundersen, J; Lawrence, WD; Bergstrahl, E; McGorray, S; Tilley, BC; Anton, J; Chazen, G
MLA Citation
Robboy, SJ, Noller, KL, O'Brien, P, Kaufman, RH, Townsend, D, Barnes, AB, Gundersen, J, Lawrence, WD, Bergstrahl, E, McGorray, S, Tilley, BC, Anton, J, and Chazen, G. "Increased Incidence of Cervical and Vaginal Dysplasia in 3,980 Diethylstilbestrol-Exposed Young Women: Experience of the National Collaborative Diethylstilbestrol Adenosis Project." JAMA: The Journal of the American Medical Association 252.21 (December 7, 1984): 2979-2983.
Source
scopus
Published In
JAMA : the journal of the American Medical Association
Volume
252
Issue
21
Publish Date
1984
Start Page
2979
End Page
2983
DOI
10.1001/jama.1984.03350210027024

Increased incidence of cervical and vaginal dysplasia in 3,980 diethylstilbestrol-exposed young women. Experience of the National Collaborative Diethylstilbestrol Adenosis Project.

The incidence rates of dysplasia and carcinoma in situ (CIS) of the cervix and vagina were determined in 3,980 young women exposed prenatally to diethylstilbestrol. Strict criteria were developed to minimize selection bias among the subset of 744 pairs of matched exposed and unexposed (control) cohort participants, all of whom were identified through review of prenatal obstetrical records. A high degree of compliance was achieved throughout the seven-year study period since in each group about 90% of the women remained as active participants, kept 77% of the annual anniversary examinations, and had separate Papanicolaou smears of the cervix and vagina performed in 99% of the anniversary examinations. The incidence rate for dysplasia and CIS was significantly higher in the women exposed to diethylstilbestrol than in those not exposed in the matched cohort (15.7 v 7.9 cases per 1,000 person-years of follow-up). The rates were higher in the exposed women if squamous metaplasia extended to the outer half of the cervix or onto the vagina. In other respects, the matched cohorts were strikingly similar.

Authors
Robboy, SJ; Noller, KL; O'Brien, P; Kaufman, RH; Townsend, D; Barnes, AB; Gundersen, J; Lawrence, WD; Bergstrahl, E; McGorray, S
MLA Citation
Robboy, SJ, Noller, KL, O'Brien, P, Kaufman, RH, Townsend, D, Barnes, AB, Gundersen, J, Lawrence, WD, Bergstrahl, E, and McGorray, S. "Increased incidence of cervical and vaginal dysplasia in 3,980 diethylstilbestrol-exposed young women. Experience of the National Collaborative Diethylstilbestrol Adenosis Project." JAMA 252.21 (December 7, 1984): 2979-2983.
PMID
6502858
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
252
Issue
21
Publish Date
1984
Start Page
2979
End Page
2983

Timing and irreversibility of Müllerian duct inhibition in the embryonic reproductive tract of the human male.

A study was undertaken to determine (1) the effects of endogenous Müllerian inhibiting substance (MIS) on the developing human fetal genital tract; (2) the time in fetal life when MIS is first capable of inhibiting the growth of the embryonic Müllerian ducts; and (3) the reversibility of the effects of MIS on the developing male Müllerian ducts. Human fetal reproductive tracts were transplanted and grown for sustained periods in vivo in athymic nude mice. The genital tracts from 12 male human fetuses, ages 51 to 68 days postovulation, were grafted without their associated gonads into castrated murine hosts and grown for 30 to 70 days. Controls consisted of genital tracts from 8 female human fetuses, ages day 53 to 70 that were grown under identical conditions. Male specimens grew to approximately one-half the size of female specimens and disclosed varying degrees of inhibition of the Müllerian duct system from absence of the Müllerian ducts in older specimens (after Day 63) to poorly segregated segments of stroma as the mildest defect (less than Day 61). It is concluded that (1) MIS secretion by the embryonic testes probably begins before Day 51 of gestation; (2) the effects of MIS are progressive during the so-called critical window; (3) the effects of MIS are permanent; and (4) the mesenchyme is an important target of MIS.

Authors
Taguchi, O; Cunha, GR; Lawrence, WD; Robboy, SJ
MLA Citation
Taguchi, O, Cunha, GR, Lawrence, WD, and Robboy, SJ. "Timing and irreversibility of Müllerian duct inhibition in the embryonic reproductive tract of the human male." Dev Biol 106.2 (December 1984): 394-398.
PMID
6548718
Source
pubmed
Published In
Developmental Biology
Volume
106
Issue
2
Publish Date
1984
Start Page
394
End Page
398

Insular carcinoid of ovary associated with malignant mucinous tumors.

Ovarian carcinoids are frequently encountered in association with mucinous cysts and occasionally with mucinous cystadenomas. From a series of more than 200 ovarian carcinoids, this report describes 2 cases of insular carcinoid, 1 of which arose in a cystadenoma of borderline malignancy and the other in a mucinous adenocarcinoma. Histogenesis, histologic patterns, and natural history of carcinoid are discussed.

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "Insular carcinoid of ovary associated with malignant mucinous tumors." Cancer 54.10 (November 15, 1984): 2273-2276.
PMID
6091862
Source
pubmed
Published In
Cancer
Volume
54
Issue
10
Publish Date
1984
Start Page
2273
End Page
2276

Low-dose preoperative radiation therapy for adenocarcinoma of the endometrium. A pilot study.

A pilot study using low-dose preoperative radiation therapy, i.e., 10 Gy in 3 to 4 days as an adjuvant preoperative procedure for grade 2 or 3 (FIGO classification) endometrial carcinoma, was done. The concept of low-dose preoperative radiation therapy is to administer treatment, either surgical or radiotherapeutic, postoperatively according to the surgical and pathologic findings, allowing identification of those patients with previously undiagnosed extensive metastatic disease outside the pelvis found at laparotomy in whom routine pelvic radiation therapy is futile, as well as those patients with relatively low risk of recurrence who may not require further radiotherapy. Forty-four patients with clinical Stage I, grade 2 or 3 with adenocarcinoma of the endometrium were entered into the pilot study. Following surgery, 68% remained Stage I by pathologic examination, and in the remaining patients the stages were changed to II in seven, III in three, and IV in four. Postoperative treatment was administered according to extent of the disease found at surgery. The 4-year actuarial probability of survival rate for the entire group of patients with clinical Stage I disease was 80%; corresponding disease-free rate was 77%. For the Stage I disease confirmed by pathologic examination, the corresponding rate was 96%. The rates for Stages II through IV, as shown by pathologic findings at laparotomy, were 53% and 42%, respectively. In this pilot stud, a treatment policy for clinical Stage I, grade 2 or 3 adenocarcinoma of the endometrium using low-dose preoperative radiation therapy is recommended.

Authors
Wang, CC; Shimm, DS; Dosoretz, DE; Nelson, JH; Ingersoll, FM; Fuller, AF; Nikrui, N; Scully, RE; Robboy, SJ; Young, RH
MLA Citation
Wang, CC, Shimm, DS, Dosoretz, DE, Nelson, JH, Ingersoll, FM, Fuller, AF, Nikrui, N, Scully, RE, Robboy, SJ, and Young, RH. "Low-dose preoperative radiation therapy for adenocarcinoma of the endometrium. A pilot study." Cancer 54.6 (September 15, 1984): 1002-1006.
PMID
6467126
Source
pubmed
Published In
Cancer
Volume
54
Issue
6
Publish Date
1984
Start Page
1002
End Page
1006

Atypical vaginal adenosis and cervical ectropion. Association with clear cell adenocarcinoma in diethylstilbestrol-exposed offspring.

Knowledge of the evolution of clear cell adenocarcinomas of the vagina and cervix in diethylstilbestrol-exposed progeny has remained elusive despite the known topographical association of these tumors with the tuboendometrial form of vaginal adenosis and cervical ectropion. Twenty radical hysterectomy or radical hysterectomy and vaginectomy specimens of clear cell adenocarcinoma of the vagina or cervix were serially blocked in toto; tuboendometrial epithelium was found in the vagina in 19 (95%) of the cases, usually in greatest concentration at the margin of the tumor, particularly inferiorly. Foci of atypical tuboendometrial epithelium were identified in 16 (80%) of the cases, almost always immediately adjacent to the tumor. Twenty-five of a second group of 47 specimens in which only substantial portions of the vagina or cervix adjacent to a clear cell adenocarcinoma were available for examination also had foci of atypical tuboendometrial epithelium. The frequency with which atypical tuboendometrial glands in the vagina and cervix were associated with the carcinomas and the proximity of the former to the latter provide strong evidence that atypical vaginal adenosis and atypical cervical ectropion of the tuboendometrial type are precursors of clear cell adenocarcinoma.

Authors
Robboy, SJ; Young, RH; Welch, WR; Truslow, GY; Prat, J; Herbst, AL; Scully, RE
MLA Citation
Robboy, SJ, Young, RH, Welch, WR, Truslow, GY, Prat, J, Herbst, AL, and Scully, RE. "Atypical vaginal adenosis and cervical ectropion. Association with clear cell adenocarcinoma in diethylstilbestrol-exposed offspring." Cancer 54.5 (September 1, 1984): 869-875.
PMID
6537153
Source
pubmed
Published In
Cancer
Volume
54
Issue
5
Publish Date
1984
Start Page
869
End Page
875

Are metaplasias in colorectal adenomas truly metaplasias?

Five thousand seven hundred seventy-eight adenomas or adenomas containing carcinoma from 3215 patients were examined by routine histologic methods for the presence of epithelial metaplasias. Three forms of epithelial metaplasia were encountered: squamous cell metaplasia (0.44%), Paneth cell metaplasia (0.20%), and melanocytic metaplasia (0.017%). In several instances multiple forms of metaplasia were encountered in the same polyp. In those cases in which the paraffin blocks were available, a Grimelius stain was performed. Grimelius-positive cells were present in 63% of the adenomas containing a metaplastic cell type. All cases with Paneth cell differentiation were immunoreactive for lysozyme; all lesions containing areas of squamous differentiation were immunoreactive for keratin except 2. The histopathologic features of these cases are discussed, and it is concluded that rather than representing a true metaplastic process, Paneth cell, squamous cell, and melanocyte differentiation represent the full range of cellular differentiation that endodermally derived tissues can exhibit, particularly when they undergo neoplastic alterations.

Authors
Bansal, M; Fenoglio, CM; Robboy, SJ; King, DW
MLA Citation
Bansal, M, Fenoglio, CM, Robboy, SJ, and King, DW. "Are metaplasias in colorectal adenomas truly metaplasias?." Am J Pathol 115.2 (May 1984): 253-265.
PMID
6202148
Source
pubmed
Published In
The American journal of pathology
Volume
115
Issue
2
Publish Date
1984
Start Page
253
End Page
265

Structural anomalies of the cervix and vagina in women enrolled in the Diethylstilbestrol Adenosis (DESAD) Project.

Among women exposed in utero to diethylstilbestrol (DES) and enrolled in the Diethylstilbestrol Adenosis (DESAD) Project, structural anomalies of the cervix or vagina were found in 25% of the 1,655 subjects identified by review of prenatal records, 43% of the 800 who themselves requested entry into the project, and 49% of the 1,089 referred by physicians but in only 2% of the 963 control subjects. Among the 367 cases found by record review to have complete information on the DES exposure, multivariate analysis indicated close association of the anomalies with the gestational week of first exposure and the total dose. Also, the prevalence rate of the anomalies was lower among subjects who had been pregnant and higher among those with later age at menarche.

Authors
Jefferies, JA; Robboy, SJ; O'Brien, PC; Bergstralh, EJ; Labarthe, DR; Barnes, AB; Noller, KL; Hatab, PA; Kaufman, RH; Townsend, DE
MLA Citation
Jefferies, JA, Robboy, SJ, O'Brien, PC, Bergstralh, EJ, Labarthe, DR, Barnes, AB, Noller, KL, Hatab, PA, Kaufman, RH, and Townsend, DE. "Structural anomalies of the cervix and vagina in women enrolled in the Diethylstilbestrol Adenosis (DESAD) Project." Am J Obstet Gynecol 148.1 (January 1, 1984): 59-66.
PMID
6691382
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
148
Issue
1
Publish Date
1984
Start Page
59
End Page
66

Benign prostatic hypertrophy and uterine leiomyomas: analogous or dissimilar diseases?

Authors
Robboy, SJ; Lawrence, WD; Cunha, GR
MLA Citation
Robboy, SJ, Lawrence, WD, and Cunha, GR. "Benign prostatic hypertrophy and uterine leiomyomas: analogous or dissimilar diseases?." Prog Clin Biol Res 145 (1984): 67-79. (Review)
PMID
6201884
Source
pubmed
Published In
Progress in Clinical and Biological Research
Volume
145
Publish Date
1984
Start Page
67
End Page
79

Evaluation of squamous epithelium in adenoacanthoma and adenosquamous carcinoma of the endometrium: immunoperoxidase analysis of involucrin and keratin localization.

A study was undertaken to determine whether immunoperoxidase stains for keratin and involucrin, the latter a protein present in cells of stratified squamous epithelium that have differentiated beyond the basal stage, distinguish any differences in squamous cells present in the adenoacanthoma from those in the adenosquamous carcinoma of the uterine corpus. Forty-eight tumors were studied, of which 33 were adenoacanthomas and 15 adenosquamous carcinomas. The patients with adenoacanthomas were slightly younger (mean 61.5 vs. 64.5 years) and had tumors that were generally better differentiated than the adenosquamous carcinomas. The squamous epithelium in every tumor, regardless of histologic type, stained positively for keratin. There were no obvious differences in staining when tumors were stratified for histologic type, grade, or location within the tumor. The glandular portion of both tumor types stained irregularly, but nonetheless positively, for keratin in 71% of the cases. Involucrin was detected in 57% of adenoacanthomas and 87% of adenosquamous carcinomas. The deeper or more central portion of the squamous morules stained only if the more superficial or peripheral areas were positive. The extent of the involucrin staining was less in the adenosquamous carcinomas than in the adenoacanthomas. The glandular component of the tumors did not stain for involucrin. It is concluded that no qualitative differences in the staining reactions with respect to keratin and involucrin distinguish the adenoacanthomas from the adenoaquamous carcinoma. These findings support the argument that the adenoacanthoma and adenosquamous carcinoma represent a spectrum of squamous differentiation in a single tumor type.

Authors
Warhol, MJ; Rice, RH; Pinkus, GS; Robboy, SJ
MLA Citation
Warhol, MJ, Rice, RH, Pinkus, GS, and Robboy, SJ. "Evaluation of squamous epithelium in adenoacanthoma and adenosquamous carcinoma of the endometrium: immunoperoxidase analysis of involucrin and keratin localization." Int J Gynecol Pathol 3.1 (1984): 82-91.
PMID
6203856
Source
pubmed
Published In
International Journal of Gynecological Pathology
Volume
3
Issue
1
Publish Date
1984
Start Page
82
End Page
91

Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases.

Forty cases of ovarian lymphoma and two of extramedullary leukemia were examined with emphasis on histologic types correlated with age, modes of presentation, operative findings, including frequency of bilaterality and omental spread, clinical course following therapy, and problems in differential diagnosis. Although most cases were referred with diagnoses other than lymphoma (granulosa cell tumor or dysgerminoma, occasionally anaplastic tumor, Krukenberg tumor, or metastatic breast carcinoma), utilization of sections cut at 4 mu and stained with hematoxylin and eosin, or sections stained by the methyl green pyronine (MGP), naphthol-ASD esterase (NASD) or periodic acid-Schiff (PAS) methods helped bring out the lymphoid or hematopoietic nature of the cells. Sixteen patients were under 20 years of age. They had small noncleaved cell lymphoma (undifferentiated Burkitt's and non-Burkitt's, 10 cases), diffuse immunoblastic large cell lymphoma (4 cases), or acute granulocytic leukemia (2 cases). Twenty-six patients were 29 to 74 years of age and had diffuse large cell lymphoma (10 cases), diffuse immunoblastic large cell lymphoma (9 cases), follicular (nodular) lymphoma (6 cases) or small noncleaved cell lymphoma (1 case). Pain with an abdominal or pelvic mass was the most common presentation. Nine tumors were discovered during investigation of other gynecologic complaints. At laparotomy, the tumors in 55% of cases involved both ovaries, and in 64% also involved extragonadal sites (usually omentum, fallopian tubes, or lymph nodes). Seventeen patients had tumor affecting one ovary, seven of these without any evidence of extragonadal spread. Forty-two percent (15) of 37 patients with follow-up were alive after 2 years. Only nine patients survived more than 5 years; two subsequently died of lymphoma. Favorable prognostic features included: (1) FIGO stage IA; (2) unilateral ovarian involvement; (3) focal involvement of one ovary; and (4) follicular (nodular) lymphoma.

Authors
Osborne, BM; Robboy, SJ
MLA Citation
Osborne, BM, and Robboy, SJ. "Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases." Cancer 52.10 (November 15, 1983): 1933-1943.
PMID
6627208
Source
pubmed
Published In
Cancer
Volume
52
Issue
10
Publish Date
1983
Start Page
1933
End Page
1943

Histologic, nuclear DNA, and human papillomavirus studies of cervical condylomas.

Fifty-four cervical condylomatous lesions, with and without nuclear atypia, from 42 women, were studied with the Feulgen microspectrophotometric technique for nuclear DNA quantitation and an immunoperoxidase technique for human papillomavirus (HPV) antigen. All ordinary cervical condylomas (without atypia/dysplasia) had a diploid or polyploid nuclear DNA distribution; 61% had detectable HPV antigen. Among the cervical condylomas with atypia/dysplasia, 55% (17/31) had diploid or polyploid nuclear DNA pattern, and, of these, 59% (10/17) had demonstrable papillomavirus antigen. Fourteen (45%) were aneuploid lesions, 2 of which had a small number of cells with papillomavirus antigen (14%). These findings suggest that the majority of cervical condylomas are related to papillomavirus infection. That lesions with dysplasia, including high degrees of dysplasia, may also exhibit coexistence of papillomavirus infection suggests the possibility of an infectious etiology in the genesis of cervical squamous neoplasia.

Authors
Fu, YS; Braun, L; Shah, KV; Lawrence, WD; Robboy, SJ
MLA Citation
Fu, YS, Braun, L, Shah, KV, Lawrence, WD, and Robboy, SJ. "Histologic, nuclear DNA, and human papillomavirus studies of cervical condylomas." Cancer 52.9 (November 1, 1983): 1705-1711.
PMID
6193864
Source
pubmed
Published In
Cancer
Volume
52
Issue
9
Publish Date
1983
Start Page
1705
End Page
1711

A hypothetic mechanism of diethylstilbestrol(DES)-induced anomalies in exposed progeny.

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "A hypothetic mechanism of diethylstilbestrol(DES)-induced anomalies in exposed progeny." Hum Pathol 14.10 (October 1983): 831-833.
PMID
6618482
Source
pubmed
Published In
Human Pathology
Volume
14
Issue
10
Publish Date
1983
Start Page
831
End Page
833

Maturation of vaginal and cervical epithelium in women exposed in utero to diethylstilbestrol (DESAD Project).

A total of 452 women with documented exposure in utero to diethylstilbestrol (DES) with epithelial findings present at the time of their initial examination have been evaluated prospectively to determine whether these findings changed over a period of 3 years. The examinations were all performed according to a strict protocol. Findings present at the time of the third annual examination were verified at a fourth examination. A verified decrease in the extent of epithelial findings occurred in 29.2% of these women and a verified increase in 6.6%; 53.1% had no change in the extent of epithelial findings, and 11.1% had a change that could not be verified at the time of the fourth visit. Analysis of many variables failed to identify a strong association between any variable and a decrease in the extent of the findings. It appears that the most important factor in the occurrence of changes in DES-associated findings is the passage of time.

Authors
Noller, KL; Townsend, DE; Kaufman, RH; Barnes, AB; Robboy, SJ; Fish, CR; Jefferies, JA; Bergstralh, EJ; O'Brien, PC; McGorray, SP; Scully, R
MLA Citation
Noller, KL, Townsend, DE, Kaufman, RH, Barnes, AB, Robboy, SJ, Fish, CR, Jefferies, JA, Bergstralh, EJ, O'Brien, PC, McGorray, SP, and Scully, R. "Maturation of vaginal and cervical epithelium in women exposed in utero to diethylstilbestrol (DESAD Project)." Am J Obstet Gynecol 146.3 (June 1, 1983): 279-285.
PMID
6859137
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
146
Issue
3
Publish Date
1983
Start Page
279
End Page
285

Nuclear DNA content of clear cell adenocarcinoma of the vagina and cervix and its relationship to prognosis.

A study was performed to determine if ploidy levels of nuclear DNA content could be used as a prognostic index of the biologic behavior of clear cell adenocarcinoma of the vagina and cervix in young females. Forty tumors were examined. Four patterns of nuclear DNA distribution were identified: (1) peridiploid stem cell lines (2N to 3N); (2) peritetraploid stem cell lines (3N to 5N); (3) hypertetraploid stem cell lines (greater than 5N); and (4) highly aneuploid without detectable stem cell lines. Tumors having peridiploid and peritetraploid stem cell lines (low ploidy group) were most often clinical Stage I or II (87%) and were in general associated with a favorable prognosis. Tumors having hypertetraploid stem cell lines and highly aneuploid distribution (high ploidy group) were usually clinical Stage III or IV (65%). Clinically advanced tumors (Stage III or IV) had poor prognosis irrespective of ploidy level. Among the clinical Stage I and II tumors, the low ploidy group had a slightly better prognosis than the high ploidy group. This difference, however, was not statistically significant.

Authors
Welch, WR; Fu, YS; Robboy, SJ; Herbst, AL
MLA Citation
Welch, WR, Fu, YS, Robboy, SJ, and Herbst, AL. "Nuclear DNA content of clear cell adenocarcinoma of the vagina and cervix and its relationship to prognosis." Gynecol Oncol 15.2 (April 1983): 230-238.
PMID
6832636
Source
pubmed
Published In
Gynecologic Oncology
Volume
15
Issue
2
Publish Date
1983
Start Page
230
End Page
238

Experimental study of the effect of diethylstilbestrol on the development of the human female reproductive tract.

Female genital tracts from human embryos and fetuses 5-17 weeks post fertilization were grown for 1-3 months in vivo as grafts to athymic female nude mice. The nude mice were either untreated or treated with diethylstilbestrol (DES). In control (untreated) hosts, anticipated normal development occurred with a high degree of precision. Müllerian ducts fused and proliferated, forming a solid uterovaginal canal that later canalized and formed a normal vaginal mucosa. Uterine glands appeared, and the uterine tube developed its highly plicated mucosa. Under the influence of DES, many of these normal developmental processes were adversely affected. Müllerian epithelium was largely obliterated in the fallopian tube and uterine corpus, mesenchymal stratification into endometrial stroma and myometrium was suppressed, plical development in the fallopian tube was inhibited, cervicovaginal epithelial development was abnormal, and vaginal adenosis was observed in several specimens. This in vivo model of human development is discussed in terms of its potential for resolving the mechanisms of normal human genital development and understanding the teratogenic action of DES on the developing human genital tract.

Authors
Taguchi, O; Cunha, GR; Robboy, SJ
MLA Citation
Taguchi, O, Cunha, GR, and Robboy, SJ. "Experimental study of the effect of diethylstilbestrol on the development of the human female reproductive tract." Biol Res Pregnancy Perinatol 4.2 (1983): 56-70.
PMID
6882849
Source
pubmed
Published In
Biological Research in Pregnancy and Perinatology
Volume
4
Issue
2
Publish Date
1983
Start Page
56
End Page
70

ATYPICAL TUBOENDOMETRIAL ADENOSIS AND ECTROPION - FORERUNNER OF CLEAR CELL ADENOCARCINOMA IN DES-EXPOSED OFFSPRING

Authors
ROBBOY, SJ; YOUNG, RH; WELCH, WR; TRUSLOW, GY; PRAT, J; HERBST, AL; SCULLY, RE
MLA Citation
ROBBOY, SJ, YOUNG, RH, WELCH, WR, TRUSLOW, GY, PRAT, J, HERBST, AL, and SCULLY, RE. "ATYPICAL TUBOENDOMETRIAL ADENOSIS AND ECTROPION - FORERUNNER OF CLEAR CELL ADENOCARCINOMA IN DES-EXPOSED OFFSPRING." LABORATORY INVESTIGATION 48.1 (1983): A71-A72.
Source
wos-lite
Published In
Laboratory Investigation
Volume
48
Issue
1
Publish Date
1983
Start Page
A71
End Page
A72

Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation): a light microscopic, ultrastructural and immunohistochemical study of seven cases.

Seven cases of ovarian yolk sac tumor (endodermal sinus tumor) with patterns resembling those of hepatocellular carcinoma were encountered in patients 7-43 years of age. Two of the patients had gonadal dysgenesis with a 46XY karyotype. At operation three tumors were confined to the ovary and four were associated with intra-abdominal metastases. Two of the Stage I tumors recurred within one year. The hepatoid pattern was a prominent feature of all the tumors and was exclusive in four of them. In one specimen it merged almost imperceptibly with a polyvesicular vitelline pattern. The hepatoid component of the tumors was characterized by discrete masses, nests and/or broad bands of large polyhedral cells with central nuclei and prominent nucleoli; gland-like spaces, some of which contained mucin, were occasionally evident. Each tumor contained numerous PAS-positive, diastase-resistant intracytoplasmic and extracytoplasmic hyaline bodies. Alpha-fetoprotein and alpha-1-antitrypsin were identified by immunoperoxidase and immunofluorescence techniques in four tumors and albumin in two. Immunoperoxidase stains for chorionic gonadotropin were negative in four cases. Ultrastructural analysis of two specimens disclosed features similar to those of hepatocellular carcinoma.

Authors
Prat, J; Bhan, AK; Dickersin, GR; Robboy, SJ; Scully, RE
MLA Citation
Prat, J, Bhan, AK, Dickersin, GR, Robboy, SJ, and Scully, RE. "Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation): a light microscopic, ultrastructural and immunohistochemical study of seven cases." Cancer 50.11 (December 1, 1982): 2355-2368.
PMID
7139531
Source
pubmed
Published In
Cancer
Volume
50
Issue
11
Publish Date
1982
Start Page
2355
End Page
2368

Topographic relation of cervical ectropion and vaginal adenosis to clear cell adenocarcinoma.

Twenty specimens of uterus and vagina removed because of clear cell adenocarcinoma of the cervix or vagina in women exposed prenatally to diethylstilbestrol were serially blocked and sectioned to study the topographic relation between the carcinoma and the cervical ectropion and vaginal adenosis. Three tumors were cervical; 17 were vaginal. Iodine staining performed on 8 specimens indicated that the carcinoma developed consistently just above the distal limit of the cervical or vaginal surface that failed to stain with iodine, a location that usually corresponds to the distal limit of abnormality visible by colposcopic examination. Microscopic examination disclosed the presence of both cervical ectropion and vaginal adenosis in all the specimens. Mucinous glands were abundant above the tumor. In 18 of the 20 cases, tuboendometrial glands were intimately related to the carcinoma, either surrounding it or abutting its inferior border. These data, in addition to other evidence, suggest that tuboendometrial epithelium, whether in the ectocervix or vagina, provides the bed from which clear cell adenocarcinoma develops.

Authors
Robboy, SJ; Welch, WR; Young, RH; Truslow, GY; Herbst, AL; Scully, RE
MLA Citation
Robboy, SJ, Welch, WR, Young, RH, Truslow, GY, Herbst, AL, and Scully, RE. "Topographic relation of cervical ectropion and vaginal adenosis to clear cell adenocarcinoma." Obstet Gynecol 60.5 (November 1982): 546-551.
PMID
6890656
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
60
Issue
5
Publish Date
1982
Start Page
546
End Page
551

The clinical pathologist: physician, not administrator.

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "The clinical pathologist: physician, not administrator." Hum Pathol 13.9 (September 1982): 788-789.
PMID
7049897
Source
pubmed
Published In
Human Pathology
Volume
13
Issue
9
Publish Date
1982
Start Page
788
End Page
789

Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice.

Autoradiographic analysis of [3H]-estrogen nuclear binding sites was performed on developing genital tracts (uterus, cervix and vagina) of mice 1 to 90 days postpartum. During days 1 to 15 postpartum, nuclear estrogen binding sites were observed exclusively within mesenchymal cells; epithelial cells did not exhibit nuclear labelling. At 18 days postpartum vaginal and cervical epithelial cells exhibited nuclear estrogen binding sites for the first time, whereas the initial appearance of estrogen receptor activity in the epithelium of the uterus was detected at 20 days postpartum. Thereafter, nuclear estrogen binding sites were maintained in both epithelial and stromal cells into adulthood. The acquisition of nuclear binding sites within epithelium of female genital organs at 18 days is discussed in terms of epithelial-mesenchymal interactions and the acquisition of growth responsiveness.

Authors
Cunha, GR; Shannon, JM; Vanderslice, KD; Sekkingstad, M; Robboy, SJ
MLA Citation
Cunha, GR, Shannon, JM, Vanderslice, KD, Sekkingstad, M, and Robboy, SJ. "Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice." J Steroid Biochem 17.3 (September 1982): 281-286.
PMID
7132346
Source
pubmed
Published In
Journal of Steroid Biochemistry
Volume
17
Issue
3
Publish Date
1982
Start Page
281
End Page
286

Dysgenesis of testicular and streak gonads in the syndrome of mixed gonadal dysgenesis: perspective derived from a clinicopathologic analysis of twenty-one cases.

The clinical and pathologic aspects of 21 cases of mixed gonadal dysgenesis (MGD) were studied. The gonads in 15 patients consisted of a macroscopic testis and a streak gonad; six patients had variants, including two with bilateral testes and four with bilateral streak gonads or tumors. Functionally, the gonads were incompetent. Testes 1) failed to completely inhibit müllerian development, 2) failed to support full differentiation of mesonephric duct structures, 3) failed to adequately masculinize development of the external genitalia, or 4) often failed to mediate their own descent, resulting in asymmetry of the internal and external genitalia. None of the streak gonads mediated normal female adolescent development or fertility. Microscopic examination revealed that every gonad, regardless of its gross appearance, was morphologically abnormal. Although gonads with seminiferous tubules usually developed to a moderately advanced state, macroscopically resembling testes, the hilar zone remained architecturally disorganized; the cortex invariably lacked more than a rudimentary tunica albuginea or exhibited partial ovarian differentiation, sometimes even with a rare primordial follicle. Over time, the seminiferous tubules atrophied and hyalinized. Gonads that grossly resembled streak gonads were observed microscopically to be composed of a stroma resembling that of normal ovarian cortex. In patients more than several years of age, the entire complement of germ cells in streak gonads disappeared. It is suggested that patients with MGD be raised as females. Early removal of gonads will prevent the development of gonadoblastoma and dysgerminoma. If the uterus is retained and the patient is subsequently given exogenous estrogen, care should be taken to detect early any signs of the development of endometrial carcinoma or its precursor, to which these patients may be prone.

Authors
Robboy, SJ; Miller, T; Donahoe, PK; Jahre, C; Welch, WR; Haseltine, FP; Miller, WA; Atkins, L; Crawford, JD
MLA Citation
Robboy, SJ, Miller, T, Donahoe, PK, Jahre, C, Welch, WR, Haseltine, FP, Miller, WA, Atkins, L, and Crawford, JD. "Dysgenesis of testicular and streak gonads in the syndrome of mixed gonadal dysgenesis: perspective derived from a clinicopathologic analysis of twenty-one cases." Hum Pathol 13.8 (August 1982): 700-716.
PMID
7106733
Source
pubmed
Published In
Human Pathology
Volume
13
Issue
8
Publish Date
1982
Start Page
700
End Page
716

The pathologic features and behavior of endometrial carcinoma associated with exogenous estrogen administration.

Authors
Robboy, SJ; Miller, AW; Kurman, RJ
MLA Citation
Robboy, SJ, Miller, AW, and Kurman, RJ. "The pathologic features and behavior of endometrial carcinoma associated with exogenous estrogen administration." Pathol Res Pract 174.3 (August 1982): 237-256.
PMID
7145769
Source
pubmed
Published In
Pathology - Research and Practice
Volume
174
Issue
3
Publish Date
1982
Start Page
237
End Page
256
DOI
10.1016/S0344-0338(82)80069-1

Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethylstilbestrol.

An in vivo model is described for the study of human uterovaginal development in the presence and absence of the teratogenic drug diethylstilbestrol (DES). Intact reproductive tracts from fragments of 29 human embryos and fetuses 5.0 to 17.7 weeks of age obtained after dilatation and curettage were grown for four weeks in vivo in athymic (nude) mice that were either untreated (control) or implanted subcutaneously with a DES pellet. Control specimens grown in vivo continued their anticipated morphogenesis for equivalent in-utero ages; the normal processes observed included fusion of the paired embryonic müllerian ducts into a single uterovaginal canal, stratification of endometrial and tubal mesenchyma into inner (presumptive endometrial stroma) and outer (presumptive myometrium) layers; plication of tubal and endometrial mucosa; uterine gland formation; and stratification (transformation) of the simple columnar epithelium of the vagina and cervix into a stratified squamous plate. Specimens exposed in vivo to DES exhibited anomalies, many of which mimicked those observed clinically in young women exposed prenatally to DES. Glandular epithelium (adenosis) was found in the vagina. The upper genital tract was malformed; its growth was stunted, and the inner and outer stromal layers of the uterine corpus and fallopian tubes failed to segregate. The authors conclude that the in vivo model that they describe, with its built-in controls, provides a valid approach for examining the dynamics of morphogenesis and cytodifferentiation in developing human genital tracts under experimentally regulated conditions.

Authors
Robboy, SJ; Taguchi, O; Cunha, GR
MLA Citation
Robboy, SJ, Taguchi, O, and Cunha, GR. "Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethylstilbestrol." Hum Pathol 13.3 (March 1982): 190-198.
PMID
7076207
Source
pubmed
Published In
Human Pathology
Volume
13
Issue
3
Publish Date
1982
Start Page
190
End Page
198

Detection bias in endometrial cancer.

Authors
Horwitz, RI; Feinstein, AR; Robboy, SJ
MLA Citation
Horwitz, RI, Feinstein, AR, and Robboy, SJ. "Detection bias in endometrial cancer." Lancet 1.8264 (January 16, 1982): 164-. (Letter)
PMID
6119534
Source
pubmed
Published In
The Lancet
Volume
1
Issue
8264
Publish Date
1982
Start Page
164

Neurohormonal peptides in ovarian carcinoids: an immunohistochemical study of 81 primary carcinoids and of intraovarian metastases from six mid-gut carcinoids.

Eighty-one primary ovarian carcinoids and intraovarian metastases from six mid-gut carcinoids were examined for the presence of tumor cells immunoreactive with antisera raised against various neurohormonal peptides, mostly of gastroenteropancreatic (GEP) origin. Twenty of the primary and two of the metastatic carcinoids contained such tumor cells. The incidence of tumors with any kind of neurohormonal peptide immunoreactive tumor cells was 53% in the trabecular carcinoids, and 42% in the strumal carcinoids, whereas the incidence was much lower (7%) in the insular type. Immunoreactive pancreatic polypeptide (PP), glucagon, enkephalin, and somatostatin were those neurohormonal peptides most commonly observed in the tumor cells of the primary carcinoids. Those less commonly found were substance P, calcitonin, VIP, neurotensin, beta-endorphin, and ACTH. Four metastatic carcinoids were nonreactive with all the antisera used. Cells storing immunoreactive insulin, glucagon, PP, VIP, gastrin, substance P, or enkephalin were found in one of the two remaining metastatic carcinoids; in the other only gastrin-immunoreactive tumor cells were observed. The occurrence and distribution of tumor cells storing the neurohormonal peptides in ovarian carcinoids are discussed in relation to their possible origin in the ovary and to carcinoids in the gut.

Authors
Sporrong, B; Falkmer, S; Robboy, SJ; Alumets, J; Håkanson, R; Ljungberg, O; Sundler, F
MLA Citation
Sporrong, B, Falkmer, S, Robboy, SJ, Alumets, J, Håkanson, R, Ljungberg, O, and Sundler, F. "Neurohormonal peptides in ovarian carcinoids: an immunohistochemical study of 81 primary carcinoids and of intraovarian metastases from six mid-gut carcinoids." Cancer 49.1 (January 1, 1982): 68-74.
PMID
6119150
Source
pubmed
Published In
Cancer
Volume
49
Issue
1
Publish Date
1982
Start Page
68
End Page
74

Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice

Autoradiographic analysis of [3H]-estrogen nuclear binding sites was performed on developing genital tracts (uterus, cervix and vagina) of mice 1 to 90 days postpartum. During days 1 to 15 postpartum, nuclear estrogen binding sites were observed exclusively within mesenchymal cells; epithelial cells did not exhibit nuclear labelling. At 18 days postpartum vaginal and cervical epithelial cells exhibited nuclear estrogen binding sites for the first time, whereas the initial appearance of estrogen receptor activity in the epithelium of the uterus was detected at 20 days postpartum. Thereafter, nuclear estrogen binding sites were maintained in both epithelial and stromal cells into adulthood. The acquisition of nuclear binding sites within epithelium of female genital organs at 18 days is discussed in terms of epithelial-mesenchymal interactions and the acquisition of growth responsiveness. © 1982.

Authors
Cunha, GR; Shannon, JM; Vanderslice, KD; Sekkingstad, M; Robboy, SJ
MLA Citation
Cunha, GR, Shannon, JM, Vanderslice, KD, Sekkingstad, M, and Robboy, SJ. "Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice." Journal of Steroid Biochemistry 17.3 (1982): 277-280.
Source
scival
Published In
Journal of Steroid Biochemistry
Volume
17
Issue
3
Publish Date
1982
Start Page
277
End Page
280

Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethylstilbestrol

Authors
Robboy, SJ; Taguchi, O; Cunha, GR
MLA Citation
Robboy, SJ, Taguchi, O, and Cunha, GR. "Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethylstilbestrol." Laboratory Investigation 46.1 (1982): 69A-70A.
Source
scival
Published In
Laboratory Investigation
Volume
46
Issue
1
Publish Date
1982
Start Page
69A
End Page
70A

Epidermoid hidradenoma. A clinicopathologic study

Clinical and histopathologic data in 8 cases of epidermoid hidradenoma are presented. Most of the tumors were in the head and neck, and most of the patients were middle-aged and older adults. Generally, the lesions were asymptomatic nodules that sometimes showed ulceration or rapid growth. Despite having some histologic atypia or focal mitotic activity, the tumors were found to be benign on long-term evaluation. This epidermoid variant should not be otherwise differentiated from the benign group of solid-cystic hidradenomas, because cytologic variability did not predict a significant change in prognosis.

Authors
Stanley, RJ; Sanchez, NP; Massa, MC; Cooper, AJ; Crotty, CP; Winkelmann, RK
MLA Citation
Stanley, RJ, Sanchez, NP, Massa, MC, Cooper, AJ, Crotty, CP, and Winkelmann, RK. "Epidermoid hidradenoma. A clinicopathologic study." Journal of Cutaneous Pathology 9.5 (1982): 293-302.
Source
scival
Published In
Journal of Cutaneous Pathology
Volume
9
Issue
5
Publish Date
1982
Start Page
293
End Page
302
DOI
10.1111/j.1600-0560.1982.tb01066.x

ESTROGEN-DEPENDENT LESIONS

Authors
ROBBOY, SJ
MLA Citation
ROBBOY, SJ. "ESTROGEN-DEPENDENT LESIONS." INTERNATIONAL JOURNAL OF GYNECOLOGICAL PATHOLOGY 1.3 (1982): 317-318.
Source
wos-lite
Published In
International Journal of Gynecological Pathology
Volume
1
Issue
3
Publish Date
1982
Start Page
317
End Page
318
DOI
10.1097/00004347-198203000-00013

PRIMARY OVARIAN INVOLVEMENT BY LYMPHOMA OR LEUKEMIA

Authors
OSBORNE, BM; ROBBOY, SJ
MLA Citation
OSBORNE, BM, and ROBBOY, SJ. "PRIMARY OVARIAN INVOLVEMENT BY LYMPHOMA OR LEUKEMIA." LABORATORY INVESTIGATION 46.1 (1982): A64-A64.
Source
wos-lite
Published In
Laboratory Investigation
Volume
46
Issue
1
Publish Date
1982
Start Page
A64
End Page
A64

DYSGENESIS OF TESTICULAR AND STREAK GONADS IN THE SYNDROME OF MIXED GONADAL-DYSGENESIS - PERSPECTIVE DERIVED FROM A CLINICOPATHOLOGIC ANALYSIS OF 21 CASES

Authors
WELCH, WR; ROBBOY, SJ; MILLER, T; DONAHOE, PK; JAHRE, C; HASELTINE, FP; MILLER, WA; ATKINS, L; CRAWFORD, JD
MLA Citation
WELCH, WR, ROBBOY, SJ, MILLER, T, DONAHOE, PK, JAHRE, C, HASELTINE, FP, MILLER, WA, ATKINS, L, and CRAWFORD, JD. "DYSGENESIS OF TESTICULAR AND STREAK GONADS IN THE SYNDROME OF MIXED GONADAL-DYSGENESIS - PERSPECTIVE DERIVED FROM A CLINICOPATHOLOGIC ANALYSIS OF 21 CASES." LABORATORY INVESTIGATION 46.1 (1982): A89-A89.
Source
wos-lite
Published In
Laboratory Investigation
Volume
46
Issue
1
Publish Date
1982
Start Page
A89
End Page
A89

Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice

Autoradiographic analysis of [3H]-estrogen nuclear binding sites was performed on developing genital tracts (uterus, cervix and vagina) of mice 1 to 90 days postpartum. During days 1 to 15 postpartum, nuclear estrogen binding sites were observed exclusively within mesenchymal cells; epithelial cells did not exhibit nuclear labelling. At 18 days postpartum vaginal and cervical epithelial cells exhibited nuclear estrogen binding sites for the first time, whereas the initial appearance of estrogen receptor activity in the epithelium of the uterus was detected at 20 days postpartum. Thereafter, nuclear estrogen binding sites were maintained in both epithelial and stromal cells into adulthood. The acquisition of nuclear binding sites with epithelium of female genital organs at 18 days is discussed in terms of epithelial-mesenchymal interactions and the acquisition of growth responsiveness.

Authors
Cunha, GR; Shannon, JM; Vanderslice, KD; Sekkingstad, M; Robboy, SJ
MLA Citation
Cunha, GR, Shannon, JM, Vanderslice, KD, Sekkingstad, M, and Robboy, SJ. "Autoradiographic analysis of nuclear estrogen binding sites during postnatal development of the genital tract of female mice." Journal of Steroid Biochemistry 17.3 (1982): 281-286.
Source
scival
Published In
Journal of Steroid Biochemistry
Volume
17
Issue
3
Publish Date
1982
Start Page
281
End Page
286
DOI
10.1016/0022-4731(82)90201-1

Hypothesis: when is a seminoma not a seminoma?

Authors
Prat, J; Bhan, AK; Dickersin, GR; Robboy, SJ; Scully, RE
MLA Citation
Prat, J, Bhan, AK, Dickersin, GR, Robboy, SJ, and Scully, RE. "Hypothesis: when is a seminoma not a seminoma?." J Clin Pathol 34.11 (November 1981): 1308-1309. (Letter)
PMID
7320227
Source
pubmed
Published In
Journal of Clinical Pathology
Volume
34
Issue
11
Publish Date
1981
Start Page
1308
End Page
1309

Role of hormones including diethylstibestrol (DES) in the pathogenesis of cervical and vaginal intraepithelial neoplasia.

Authors
Robboy, SJ; Truslow, GY; Anton, J; Richart, RM
MLA Citation
Robboy, SJ, Truslow, GY, Anton, J, and Richart, RM. "Role of hormones including diethylstibestrol (DES) in the pathogenesis of cervical and vaginal intraepithelial neoplasia." Gynecol Oncol 12.2 Pt 2 (October 1981): S98-110. (Review)
PMID
7030882
Source
pubmed
Published In
Gynecologic Oncology
Volume
12
Issue
2 Pt 2
Publish Date
1981
Start Page
S98
End Page
110

Histopathologic Distinctions in the Relationship of Estrogens and Endometrial Cancer

The slides of 233 patients included in a case-control study of estrogens and endometrial cancer were reviewed to determine how often endometrial cancer was misdiagnosed and whether patients with uterine cancer had other coexistent endometrial diseases. Reasonably close agreements were found among the original diagnoses and those of three additional reviewers (the total range of disagreements among all pathologists was from 2% to 16%). Proliferative and hyperplastic endometrium coexisted in many specimens from patients with endometrial cancer, and especially in those who had used estrogen replacement therapy. In contrast, estrogen therapy had seldom been used by patients whose cancers were not accompanied by these proliferative and hyperplastic lesions. In addition, these changes were found significantly more often in women with grade 1 cancers than grade 2 or 3 cancers. We conclude from these data that diagnostic misclassification is uncommon and that coexistent proliferative and hyperplastic lesions occur frequently, especially among women with grade 1 cancers. The data also suggest that the frequent finding of grade 1 cancer in estrogen users is due to bleeding that results from the stimulated coexistent benign proliferating endometrium. (JAMA 1981;246:1425-1427). © 1981, American Medical Association. All rights reserved.

Authors
Horwitz, RI; Feinstein, AR; Vidone, RA; Sommers, SC; Robboy, SJ
MLA Citation
Horwitz, RI, Feinstein, AR, Vidone, RA, Sommers, SC, and Robboy, SJ. "Histopathologic Distinctions in the Relationship of Estrogens and Endometrial Cancer." JAMA: The Journal of the American Medical Association 246.13 (September 25, 1981): 1425-1427.
Source
scopus
Published In
JAMA : the journal of the American Medical Association
Volume
246
Issue
13
Publish Date
1981
Start Page
1425
End Page
1427
DOI
10.1001/jama.1981.03320130031019

Histopathologic distinctions in the relationship of estrogens and endometrial cancer.

The slides of 233 patients included in a case-control study of estrogens and endometrial cancer were reviewed to determine how often endometrial cancer was misdiagnosed and whether patients with uterine cancer had other coexistent endometrial diseases. Reasonably close agreements were found among the original diagnoses and those of three additional reviewers (the total range of disagreements among all pathologists was from 2% to 16%). Proliferative and hyperplastic endometrium coexisted in many specimens from patients with endometrial cancer, and especially in those who had used estrogen replacement therapy. In contrast, estrogen therapy had seldom been used by patients whose cancers were not accompanied by these proliferative and hyperplastic lesions. In addition, these changes were found significantly more often in women with grade 1 cancers than grade 2 or 3 cancers. We conclude from these data that diagnostic misclassification is uncommon and that coexistent proliferative and hyperplastic lesions occur frequently, especially among women with grade 1 cancers. The data also suggest that the frequent finding of grade 1 cancer in estrogen users is due to bleeding that results from the stimulated coexistent benign proliferating endometrium.

Authors
Horwitz, RI; Feinstein, AR; Vidone, RA; Sommers, SC; Robboy, SJ
MLA Citation
Horwitz, RI, Feinstein, AR, Vidone, RA, Sommers, SC, and Robboy, SJ. "Histopathologic distinctions in the relationship of estrogens and endometrial cancer." JAMA 246.13 (September 25, 1981): 1425-1427.
PMID
7265446
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
246
Issue
13
Publish Date
1981
Start Page
1425
End Page
1427

Necropsy diagnosis of endometrial cancer and detection-bias in case/control studies.

Authors
Horwitz, RI; Feinstein, AR; Horwitz, SM; Robboy, SJ
MLA Citation
Horwitz, RI, Feinstein, AR, Horwitz, SM, and Robboy, SJ. "Necropsy diagnosis of endometrial cancer and detection-bias in case/control studies." Lancet 2.8237 (July 11, 1981): 66-68.
PMID
6113441
Source
pubmed
Published In
The Lancet
Volume
2
Issue
8237
Publish Date
1981
Start Page
66
End Page
68

Breast carcinoma masquerading as primary ovarian neoplasm.

Metastases which present as palpable masses in the pelvis occasionally masquerade as primary neoplasms of the ovary. Although most such cancers originate in the stomach and large intestine, the histories of two patients are presented in whom the ovarian tumors were discovered prior to the detection of the breast primary. Three similar cases were found in the literature and are reviewed.

Authors
Young, RH; Carey, RW; Robboy, SJ
MLA Citation
Young, RH, Carey, RW, and Robboy, SJ. "Breast carcinoma masquerading as primary ovarian neoplasm." Cancer 48.1 (July 1, 1981): 210-212.
PMID
7237387
Source
pubmed
Published In
Cancer
Volume
48
Issue
1
Publish Date
1981
Start Page
210
End Page
212

Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project.

This report presents the cytologic findings and the rates of dysplasia for 4,589 young women enrolled in the National Cooperative Diethylstilbestrol-Adenosis (DESAD) Project. Mucinous columnar cells and/or metaplastic squamous cells with or without mucinous droplets were encountered in 22% of vaginal scrape smears from all diethylstilbestrol (DES)-exposed participants identified by review of prenatal records and in 43% of women in whom vaginal epithelial changes (VEC) were observed by colposcopy or by iodine staining. The frequency of cellular findings in the vaginal scrape smears was closely related to the timing of the administration of the DES to the mother. With increasing age of the daughters, the overall frequencies of both the mucinous and metaplastic cells decreased; relative to each other, an increasing proportion was metaplastic squamous cells. These data suggest that, as the women grow older, vaginal adenosis regresses by the process of squamous metaplasia. Endometrial type cells were found in 2% of vaginal scrape smears. Their cyclical occurrence during the menstrual cycle and lack of correlation with the presence of VEC indicated an origin from the uterine corpus rather than the tuboendometrial type of adenosis. Squamous cell dysplasia of the vagina and cervix was detected by biopsy or scrape smear specimens in 1.8% of DES-exposed women in the record review group. The rate of unexposed women was twice as high. In general, the rates of dysplasia were higher in the cervix than vagina, and the more severe degrees of dysplasia were encountered only in those women who were referred to the DESAD Project or who themselves requested entry. Four patients who were referred or who themselves requested entry were found to have clear cell adenocarcinoma of the vagina. The vaginal smear provided the first clue to the presence of an abnormality in three of them.

Authors
Robboy, SJ; Szyfelbein, WM; Goellner, JR; Kaufman, RH; Taft, PD; Richard, RM; Gaffey, TA; Prat, J; Virata, R; Hatab, PA; McGorray, SP; Noller, KL; Townsend, D; Labarthe, D; Barnes, AB
MLA Citation
Robboy, SJ, Szyfelbein, WM, Goellner, JR, Kaufman, RH, Taft, PD, Richard, RM, Gaffey, TA, Prat, J, Virata, R, Hatab, PA, McGorray, SP, Noller, KL, Townsend, D, Labarthe, D, and Barnes, AB. "Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project." Am J Obstet Gynecol 140.5 (July 1, 1981): 579-586.
PMID
7195652
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
140
Issue
5
Publish Date
1981
Start Page
579
End Page
586

Retrieval in a Computer-assisted Pathology Encoding and Reporting System (CAPER).

A previous report described an online computer-assisted pathology encoding and reporting system (CAPER) developed at the Massachusetts General Hospital that accessions specimens, monitors their state of completion, produces all log books, and permits instantaneous display of all diagnoses rendered within a three-year period. The present report updates the functions currently available and describes a new function that enables the pathologist, independent of computer programmer support, to request complex, in-depth searches of the entire accumulated pathology data base, which at present contains in excess of 150,000 cases and 5,000,000 pieces of information. The pathologist can instruct the system to compare more than 30 types of data items through the development of Boolean expressions. The report also describes the test codes that were developed to reflect the work product of the surgical pathology division, form the basis for automated billing and compilation of monthly and yearly statistics, and are an integral part of the long-term data base for in-depth searches.

Authors
Robboy, SJ; Altshuler, BS; Chen, HY
MLA Citation
Robboy, SJ, Altshuler, BS, and Chen, HY. "Retrieval in a Computer-assisted Pathology Encoding and Reporting System (CAPER)." Am J Clin Pathol 75.5 (May 1981): 654-661.
PMID
6786087
Source
pubmed
Published In
American Journal of Clinical Pathology
Volume
75
Issue
5
Publish Date
1981
Start Page
654
End Page
661

Role of hormones including diethylstilbestrol (DES) in the pathogenesis of cervical and vaginal intraepithelial neoplasia

The preponderance of evidence suggests that a venereal component plays a role in the pathogenesis of cervical neoplasia. While prenatal exposure to diethylstilbestrol may result in some intrinsic alterations of the metaplastic and dysplastic cells, preliminary data indicate that the rates of cervical dysplasia may not yet be appreciably different in exposed and unexposed women. The results of epidemiologic investigations about oral contraceptives are conflicting. © 1981.

Authors
Robboy, SJ; Truslow, GY; Anton, J; Richart, RM
MLA Citation
Robboy, SJ, Truslow, GY, Anton, J, and Richart, RM. "Role of hormones including diethylstilbestrol (DES) in the pathogenesis of cervical and vaginal intraepithelial neoplasia." Gynecologic Oncology 12.2 PART 1 (1981): S98-S110.
Source
scival
Published In
Gynecologic Oncology
Volume
12
Issue
2 PART 1
Publish Date
1981
Start Page
S98
End Page
S110

DYSPLASIA AND CYTOLOGIC FINDINGS IN 4589 YOUNG-WOMEN ENROLLED IN DIETHYLSTILBESTROL-ADENOSIS (DESAD) PROJECT

Authors
ROBBOY, SJ; SZYFELBEIN, WM; GOELLNER, JR; KAUFMAN, RH; TAFT, PD; RICHARD, RM; GAFFEY, TA; PRAT, J; VIRATA, R; HATAB, PA; MCGORRAY, SP; NOLLER, KL; TOWNSEND, D; LABARTHE, D; BARNES, AB
MLA Citation
ROBBOY, SJ, SZYFELBEIN, WM, GOELLNER, JR, KAUFMAN, RH, TAFT, PD, RICHARD, RM, GAFFEY, TA, PRAT, J, VIRATA, R, HATAB, PA, MCGORRAY, SP, NOLLER, KL, TOWNSEND, D, LABARTHE, D, and BARNES, AB. "DYSPLASIA AND CYTOLOGIC FINDINGS IN 4589 YOUNG-WOMEN ENROLLED IN DIETHYLSTILBESTROL-ADENOSIS (DESAD) PROJECT." LABORATORY INVESTIGATION 44.1 (1981): A55-A56.
Source
wos-lite
Published In
Laboratory Investigation
Volume
44
Issue
1
Publish Date
1981
Start Page
A55
End Page
A56

YOLK-SAC TUMOR OF OVARY WITH HEPATOID DIFFERENTIATION

Authors
PRAT, J; BHAN, AK; DICKERSIN, GR; ROBBOY, SJ; SCULLY, RE
MLA Citation
PRAT, J, BHAN, AK, DICKERSIN, GR, ROBBOY, SJ, and SCULLY, RE. "YOLK-SAC TUMOR OF OVARY WITH HEPATOID DIFFERENTIATION." LABORATORY INVESTIGATION 44.1 (1981): A53-A53.
Source
wos-lite
Published In
Laboratory Investigation
Volume
44
Issue
1
Publish Date
1981
Start Page
A53
End Page
A53

ROLE OF HORMONES INCLUDING DIETHYLSTILBESTROL (DES) IN THE PATHOGENESIS OF CERVICAL AND VAGINAL INTRA-EPITHELIAL NEOPLASIA

Authors
ROBBOY, SJ; TRUSLOW, GY; ANTON, J; RICHART, RM
MLA Citation
ROBBOY, SJ, TRUSLOW, GY, ANTON, J, and RICHART, RM. "ROLE OF HORMONES INCLUDING DIETHYLSTILBESTROL (DES) IN THE PATHOGENESIS OF CERVICAL AND VAGINAL INTRA-EPITHELIAL NEOPLASIA." GYNECOLOGIC ONCOLOGY 12.2 (1981): S98-S110.
Source
wos-lite
Published In
Gynecologic Oncology
Volume
12
Issue
2
Publish Date
1981
Start Page
S98
End Page
S110
DOI
10.1016/0090-8258(81)90065-2

Strumal carcinoid of the ovary: an analysis of 50 cases of a distinctive tumor composed of thyroid tissue and carcinoid.

Strumal carcinoid of the ovary is a type of germ-cell tumor characterized by an intimate mixture of thyroid tissue and carcinoid. Fifty patients with this type of tumor ranged in age from 21 to 77 years. The tumors measured up to 26 cm in diameter and were always unilateral. In 10% of the cases, the contralateral ovary contained another type of neoplasm, usually a dermoid cyst. Three-fifths of the strumal carcinoids arose in dermoid cysts or in mature solid teratomas. Birefringent calcium oxalate monohydrate crystals were commonly identified in the thyroid colloid, and argentaffin granules, in the carcinoid cells, thus substantiating the identity of the neoplastic components. Although 31% of the tumors were accompanied by focal stromal luteinization, only 8% of the cases exhibited clinical signs of steroid hormone production (endometrial hyperplasia, hirsutism, or virilism). In 8% of the cases, there was evidence suggesting functioning of the thyroid component, but no patient had the carcinoid syndrome. Only one woman died of tumour; five others died of unrelated causes. The remaining patients remained alive and well; 23, for at least five years, and 15, for at least ten years postoperatively. Although the carcinoid component of the strumal carcinoid has been considered a malignant transformation of struma ovarii, it is almost always benign, and treatment with a simple oophorectomy or salpingo-oophorectomy is effective.

Authors
Robboy, SJ; Scully, RE
MLA Citation
Robboy, SJ, and Scully, RE. "Strumal carcinoid of the ovary: an analysis of 50 cases of a distinctive tumor composed of thyroid tissue and carcinoid." Cancer 46.9 (November 1, 1980): 2019-2034.
PMID
7427909
Source
pubmed
Published In
Cancer
Volume
46
Issue
9
Publish Date
1980
Start Page
2019
End Page
2034

Risk factors for cancer of the testis.

Authors
Loughlin, JE; Robboy, SJ; Morrison, AS
MLA Citation
Loughlin, JE, Robboy, SJ, and Morrison, AS. "Risk factors for cancer of the testis." N Engl J Med 303.2 (July 10, 1980): 112-113. (Letter)
PMID
6104291
Source
pubmed
Published In
The New England journal of medicine
Volume
303
Issue
2
Publish Date
1980
Start Page
112
End Page
113
DOI
10.1056/NEJM198007103030218

Endodermal sinus tumor of the pineal region.

Two cases of endodermal sinus tumor of the pineal region are reported and compared with 16 others in the literature. The preponderance of neoplasms occurs in boys, usually in their second decade. The diagnosis is usually established within three months of the onset of non-specific symptoms of an intracranial mass. Treatment with operation or radiotherapy alone is inadequate. Most patients have died within two years, some with widespread intradural metastases. The one individual who has survived five years was treated with both operation and radiotherapy.

Authors
Tavcar, D; Robboy, SJ; Chapman, P
MLA Citation
Tavcar, D, Robboy, SJ, and Chapman, P. "Endodermal sinus tumor of the pineal region." Cancer 45.10 (May 15, 1980): 2646-2651.
PMID
7378998
Source
pubmed
Published In
Cancer
Volume
45
Issue
10
Publish Date
1980
Start Page
2646
End Page
2651

Ultrastructure of 16 cases of clear cell adenocarcinoma of the vagina and cervix in young women.

Sixteen cases of clear cell adenocarcinoma of the cervix and vagina in young women were studied by electron microscopy and the observations were compared with the light microscopic appearance. Ultrastructurally, the neoplastic cells were found to be of the same basic type, regardless of whether light microscopy disclosed a solid or tubulocystic tumor pattern, and whether the cells were clear, hobnail, flat or of a nonspecific müllerian appearance. Cytoplasmic glycogen and short, blunt, surface villi were the outstanding features. Less consistent findings included prominent Golgi apparatuses and numerous mitochondria. The fine structural characteristics were similar to those reported for clear cell adenocarcinoma of the endometrium and ovary in older women. This study disclosed no difference between 14 tumors that arose in patients with confirmed histories of prenatal exposure to diethylstilbestrol (DES) or dienestrol, and reported cases of clear cell carcinoma in which there were no histories of such exposure. No specific ultrastructural features could be identified as prognostic indices for the neoplasms.

Authors
Dickersin, GR; Welch, WR; Erlandson, R; Robboy, SJ
MLA Citation
Dickersin, GR, Welch, WR, Erlandson, R, and Robboy, SJ. "Ultrastructure of 16 cases of clear cell adenocarcinoma of the vagina and cervix in young women." Cancer 45.7 (April 1, 1980): 1615-1624.
PMID
7370920
Source
pubmed
Published In
Cancer
Volume
45
Issue
7
Publish Date
1980
Start Page
1615
End Page
1624

Progress in medical information management. Systematized nomenclature of medicine (SNOMED).

Authors
Côté, RA; Robboy, S
MLA Citation
Côté, RA, and Robboy, S. "Progress in medical information management. Systematized nomenclature of medicine (SNOMED)." JAMA 243.8 (February 1980): 756-762.
PMID
6986000
Source
epmc
Published In
JAMA : the journal of the American Medical Association
Volume
243
Issue
8
Publish Date
1980
Start Page
756
End Page
762
DOI
10.1001/jama.1980.03300340032015

A 34-year-old woman with pelvic pain not relieved by hysterectomy and salpingo-oophorectomy for endometriosis

Authors
Ingersoll, FM; Robboy, SJ
MLA Citation
Ingersoll, FM, and Robboy, SJ. "A 34-year-old woman with pelvic pain not relieved by hysterectomy and salpingo-oophorectomy for endometriosis." New England Journal of Medicine 302.24 (1980): 1354-1358.
Source
scival
Published In
New England Journal of Medicine
Volume
302
Issue
24
Publish Date
1980
Start Page
1354
End Page
1358

Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project

Authors
Robboy, SJ; Szyfelbein, WM; Goellner, JR
MLA Citation
Robboy, SJ, Szyfelbein, WM, and Goellner, JR. "Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project." Gynecologic Oncology 10.3 (1980): 361--.
Source
scival
Published In
Gynecologic Oncology
Volume
10
Issue
3
Publish Date
1980
Start Page
361-
DOI
10.1016/0090-8258(80)90117-1

Neurohormonal peptides in primary ovarian carcinoids. An immunohistochemical study

Although the primary ovarian carcinoid does not give rise to symptoms characteristic of an endocrine tumor (except the one-third with the classical carcinoid syndrome), they still have the capacity to produce one or several peptide hormones. The spectrum of the peptide hormones demonstrated is about the same as for carcinoids of the 'hind gut' type, indicating a common origin of the two tumors.

Authors
Sporrong, B; Falkmer, S; Robboy, SJ
MLA Citation
Sporrong, B, Falkmer, S, and Robboy, SJ. "Neurohormonal peptides in primary ovarian carcinoids. An immunohistochemical study." Acta Obstetricia et Gynecologica Scandinavica 59.Suppl. 93 (1980): No.-150.
Source
scival
Published In
Acta Obstetricia et Gynecologica Scandinavica
Volume
59
Issue
Suppl. 93
Publish Date
1980
Start Page
No.
End Page
150

Progress in medical information management: the systematized nomenclature of medicine (SNOMED)

In the article we describe the birth and development of classification of diseases for statistical purposes. Because of needs that have become more specific, especially in relation to the medical record, there has been an evolution of classification towards nomenclature. We then describe the ideal system for medical information management, which requires a harmonious working alliance between a statistical classification and a detailed and specific nomenclature. An important feature of the article is the description of the role played by the different organisations in the elaboration of these concepts, especially the World Health Organization and the College of American Pathologists. Finally, we propose the adoption of SNOMED, a classification-nomenclature system, as the information management tool which to date is the closest to the ideal tool.

Authors
Cote, RA; Robboy, S
MLA Citation
Cote, RA, and Robboy, S. "Progress in medical information management: the systematized nomenclature of medicine (SNOMED)." Union Medicale du Canada 109.9 (1980): 1243-1252.
PMID
7008313
Source
scival
Published In
Union Medicale du Canada
Volume
109
Issue
9
Publish Date
1980
Start Page
1243
End Page
1252

Progress in medical information management. Systematized nomenclature of medicine (SNOMED)

Authors
Cote, RA; Robboy, S
MLA Citation
Cote, RA, and Robboy, S. "Progress in medical information management. Systematized nomenclature of medicine (SNOMED)." Journal of the American Medical Association 243.8 (1980): 756-762.
Source
scival
Published In
Journal of the American Medical Association
Volume
243
Issue
8
Publish Date
1980
Start Page
756
End Page
762
DOI
10.1001/jama.243.8.756

Strumal carcinoid of the ovary. An Analysis of 50 cases of a distinctive tumor composed of thyroid tissue and carcinoid

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Strumal carcinoid of the ovary. An Analysis of 50 cases of a distinctive tumor composed of thyroid tissue and carcinoid." Cancer 46 (1980): 2019-2034.
Source
cinii-english
Published In
Cancer
Volume
46
Publish Date
1980
Start Page
2019
End Page
2034

EVIDENCE FOR DETECTION BIAS IN STUDIES OF ESTROGENS AND ENDOMETRIAL CANCER

Authors
HORWITZ, RI; FEINSTEIN, AR; ROBBOY, SJ
MLA Citation
HORWITZ, RI, FEINSTEIN, AR, and ROBBOY, SJ. "EVIDENCE FOR DETECTION BIAS IN STUDIES OF ESTROGENS AND ENDOMETRIAL CANCER." CLINICAL RESEARCH 28.2 (1980): A226-A226.
Source
wos-lite
Published In
Clinical Research
Volume
28
Issue
2
Publish Date
1980
Start Page
A226
End Page
A226

A 34-YEAR-OLD WOMAN WITH PELVIC PAIN NOT RELIEVED BY HYSTERECTOMY AND SALPINGO-OOPHORECTOMY FOR ENDOMETRIOSIS - OVARIAN-REMNANT SYNDROME - ENDOMETRIOSIS

Authors
INGERSOLL, FM; ROBBOY, SJ; FERRUCCI, JT; SCULLY, RE; NELSON, JH
MLA Citation
INGERSOLL, FM, ROBBOY, SJ, FERRUCCI, JT, SCULLY, RE, and NELSON, JH. "A 34-YEAR-OLD WOMAN WITH PELVIC PAIN NOT RELIEVED BY HYSTERECTOMY AND SALPINGO-OOPHORECTOMY FOR ENDOMETRIOSIS - OVARIAN-REMNANT SYNDROME - ENDOMETRIOSIS." NEW ENGLAND JOURNAL OF MEDICINE 302.24 (1980): 1354-1358.
Source
wos-lite
Published In
The New England journal of medicine
Volume
302
Issue
24
Publish Date
1980
Start Page
1354
End Page
1358

29-YEAR-OLD WOMAN WITH AMENORRHEA AND HIRSUTISM - THECOMA OF OVARY, WITH VIRILIZATION

Authors
LONGCOPE, C; FERRUCCI, JT; SCULLY, RE; CROWLEY, WF; RICHARDSON, GS; CALDERWOOD, S; ROBBOY, SJ
MLA Citation
LONGCOPE, C, FERRUCCI, JT, SCULLY, RE, CROWLEY, WF, RICHARDSON, GS, CALDERWOOD, S, and ROBBOY, SJ. "29-YEAR-OLD WOMAN WITH AMENORRHEA AND HIRSUTISM - THECOMA OF OVARY, WITH VIRILIZATION." NEW ENGLAND JOURNAL OF MEDICINE 302.11 (1980): 621-626.
Source
wos-lite
Published In
The New England journal of medicine
Volume
302
Issue
11
Publish Date
1980
Start Page
621
End Page
626

Torulopsis glabrata fungemia--a clinical pathological study.

The clinical findings, pathologic features, and outcome were investigated in 46 patients in whom Torulopsis glabrata was isolated in 131 specimens of blood. Nineteen of the patients had only a single positive blood culture and no evidence of systemic yeast infection, while 27 patients had a clinically significant fungemia based upon the occurrence of 2 or more positive blood cultures, or the combination of a positive blood culture and isolation of the organism from a closed body cavity or demonstration of the yeast in tissue sections. The predisposing factors to the development of fungemia included the presence of intravenous lines, indwelling Foley catheters, antibiotics and surgery, especially when the gastrointestinal tract was involved. Only 22% of patients received either steroids or cytostatic agents. Possible portals of entry were suggested by the prior isolation of the organism from urine, sputum, wounds, and central venous catheter tips in most of the patients. Twelve of 27 patients with clinically significant fungemia were treated. The initial mode of therapy in nine patients was removal of intravenous lines because of the clinical suspicion of catheter related sepsis. Seven of the patients improved rapidly and one more after amphotericin B was subsequently administered. Amphotericin B was the initial therapy in three cases. One patient was cured while another died of an unrelated infection. Five patients were not treated although the isolation of T. glabrata had been reported; the fact that the presence of the organism was felt to be unimportant was considered to be a factor in the delay of treatment. In the remaining 10 patients the organism was isolated only after the patient had died. Division of the patients into four groups based upon whether the individuals survived, died of unrelated disease, died with potentially lethal infection, or died with T. glabrata infection significantly contributing to death, revealed a spectrum of disease, certain signs of which appeared to be of predictive value as prognostic indices of survival and severity of the infection. Seven patients with transient fungemia experienced an acute episode of high spiking fever (greater than 102.5 degrees F), rigors and/or hypotension, six of whom improved after the intravenous catheter was removed, suggesting a catheter-related sepsis. In contrast, persistent low grade fever (less than 102.5 degrees F) characterized eight of the nine patients in whom T. glabrata infection was considered either potentially lethal, or contributing significantly to death. A deteriorating clinical course with organ failure was also associated with this latter category of patients. Catheter-induced specticemia was considered in only two patients in this category. The autopsy and clinical findings in this investigation as well as reported experimental studies suggest that T. glabrata is an organism of low virulence. The patients' underlying disease (e.g., neoplasia) and coexisting bacterial infection are the most important factors responsible for death.

Authors
Berkowitz, ID; Robboy, SJ; Karchmer, AW; Kunz, LJ
MLA Citation
Berkowitz, ID, Robboy, SJ, Karchmer, AW, and Kunz, LJ. "Torulopsis glabrata fungemia--a clinical pathological study." Medicine (Baltimore) 58.6 (November 1979): 430-440.
PMID
574609
Source
pubmed
Published In
Medicine
Volume
58
Issue
6
Publish Date
1979
Start Page
430
End Page
440

Changing trends and prognostic features in endometrial cancer associated with exogenous estrogen therapy.

A study was undertaken to investigate changing trends in the microscopic patterns of endometrial carcinoma and to compare the biologic characteristics of those cases associated with and without estrogen usage. After each case was reviewed independently and in a random order by at least 2 pathologists, a diagnosis of cancer was agreed on in 274 patients who had been treated by 5 gynecologists at the Masachusetts General Hospital between 1940 and 1971. Six microscopic patterns were identified (adenocarcinoma, adenoacanthoma, atypical adenoacanthoma, adenosquamous carcinoma, clear-cell adenocarcinoma, and undifferentiated carcinoma). The frequency of each pattern relative to the other 5 changed only slightly during the 30-year interval. The tumors that developed in estrogen users were more highly differentiated than those that developed in nonusers (P less than 0.005) and were found at an earlier average age (P less than 0.02). That the adenoacanthoma was associated with estrogen usage more frequently (51%) than any other tumor type (P less than 0.02) may reflect, in part, a similar and lower mean age of estrogen users (56 years) and patients with adenoacanthoma (55 years) compared with that of nonusers with the other forms of tumors (60--67 years). Although the overall 5- and 10-year survival rates of the estrogen users were higher than those of the nonusers, the differences between the 2 groups disappeared when the grade of the neoplasm was considered.

Authors
Robboy, SJ; Bradley, R
MLA Citation
Robboy, SJ, and Bradley, R. "Changing trends and prognostic features in endometrial cancer associated with exogenous estrogen therapy." Obstet Gynecol 54.3 (September 1979): 269-277.
PMID
471366
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
54
Issue
3
Publish Date
1979
Start Page
269
End Page
277

Prenatal diethylstilbestrol exposure and human genital tract abnormalities.

The incidence of clear cell adenocarcinoma of the vagina and cervix associated with intrauterine exposure to DES and similar compounds during the first half of pregnancy has increased. Ninety percent of these cancers have occurred in patients 14 years of age or older. Although these carcinomas are exceedingly rare, nonneoplastic abnormalities including vaginal adenosis, cervical eversion (ectropion), and transverse cervical and vaginal ridges are frequent in the exposed population, particularly if the drug was administered early in pregnancy. Current evidence favors a disturbance in development of the müllerian duct as the explanation of these changes. Whether DES is only a teratogen or also a carcinogen is unknown, as is the possible role of other factors in the development of cancer. An increased incidence of cancer among exposed males has not been documented.

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "Prenatal diethylstilbestrol exposure and human genital tract abnormalities." Natl Cancer Inst Monogr 51 (May 1979): 25-35.
PMID
481577
Source
pubmed
Published In
National Cancer Institute monograph
Issue
51
Publish Date
1979
Start Page
25
End Page
35

Comparison of Histologic and Colposcopic Findings in Des-Exposed Females

Authors
WELCH, WILLIAMR; ROBBOY, STANLEYJ; TOWNSEND, DUANEE; BARNES, ANNB; SCULLY, ROBERTE; HERBST, ARTHURL
MLA Citation
WELCH, WILLIAMR, ROBBOY, STANLEYJ, TOWNSEND, DUANEE, BARNES, ANNB, SCULLY, ROBERTE, and HERBST, ARTHURL. "Comparison of Histologic and Colposcopic Findings in Des-Exposed Females." Obstetrical & Gynecological Survey 34.4 (April 1979): 332-334.
Source
crossref
Published In
Obstetrical and Gynecological Survey
Volume
34
Issue
4
Publish Date
1979
Start Page
332
End Page
334
DOI
10.1097/00006254-197904000-00027

Pathologic findings in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project.

Authors
Robboy, SJ; Kaufman, RH; Prat, J; Welch, WR; Gaffey, T; Scully, RE; Richart, R; Fenoglio, CM; Virata, R; Tilley, BC
MLA Citation
Robboy, SJ, Kaufman, RH, Prat, J, Welch, WR, Gaffey, T, Scully, RE, Richart, R, Fenoglio, CM, Virata, R, and Tilley, BC. "Pathologic findings in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project." Obstet Gynecol 53.3 (March 1979): 309-317.
PMID
424102
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
53
Issue
3
Publish Date
1979
Start Page
309
End Page
317

Vaginal epithelial changes in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project.

Initial clinical findings are reported for the 3339 young women enrolled in the Diethylstilbestrol Adenosis (DESAD) project. Changes in the vaginal mucosa (VEC--vaginal epithelial changes), which were detected by colposcopy or iodine staining, occurred in 34% of 1275 participants identified by review of prenatal records 59% of participants who themselves requested entry into the project, and 65% of participants referred by a physician. Analysis of data on the 298 women who were identified by record review and whose prenatal records contained complete information about drug exposure indicated that VEC is most closely associated with the timing of the onset of intrauterine exposure to diethylstilbestrol (DES), total dose, and length of exposure. Frequency of VEC was also found to decrease with age. No instances of severe dysplasia, carcinoma in situ, invasive squamous cell adenocarcinoma, or clear cell carcinoma were observed among the women identified by record review.

Authors
O'Brien, PC; Noller, KL; Robboy, SJ; Barnes, AB; Kaufman, RH; Tilley, BC; Townsend, DE
MLA Citation
O'Brien, PC, Noller, KL, Robboy, SJ, Barnes, AB, Kaufman, RH, Tilley, BC, and Townsend, DE. "Vaginal epithelial changes in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project." Obstet Gynecol 53.3 (March 1979): 300-308.
PMID
424101
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
53
Issue
3
Publish Date
1979
Start Page
300
End Page
308

Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol

Authors
Robboy, SJ; Keh, PC; Nickerson, RJ; Helmanis, EK; Prat, J; Szyfelbein, WM; Taft, PD; Barnes, AB; Scully, RE; Welch, WR
MLA Citation
Robboy, SJ, Keh, PC, Nickerson, RJ, Helmanis, EK, Prat, J, Szyfelbein, WM, Taft, PD, Barnes, AB, Scully, RE, and Welch, WR. "Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol." Obstetrical and Gynecological Survey 34.1 (January 1, 1979): 60-63.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
34
Issue
1
Publish Date
1979
Start Page
60
End Page
63

Pathologic findings in young women enrolled in the national cooperative diethylstilbestrol adenosis (DESAD) project

Authors
Robboy, SJ; Kaufman, RH; Prat, J; Welch, WR; Gaffey, T; Scully, RE; Richart, R; Fenoglio, C; Virata, R; Tilley, BC
MLA Citation
Robboy, SJ, Kaufman, RH, Prat, J, Welch, WR, Gaffey, T, Scully, RE, Richart, R, Fenoglio, C, Virata, R, and Tilley, BC. "Pathologic findings in young women enrolled in the national cooperative diethylstilbestrol adenosis (DESAD) project." Obstetrical and Gynecological Survey 34.8 (January 1, 1979): 612-616.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
34
Issue
8
Publish Date
1979
Start Page
612
End Page
616

Vaginal epithelial changes in young women enrolled in the national cooperative diethylstilbestrol adenosis (Desad) project

Authors
O Brien, PC; Noller, KL; Robboy, SJ; Barnes, AB; Kaufman, RH; Tilley, BC; Townsend, DE
MLA Citation
O Brien, PC, Noller, KL, Robboy, SJ, Barnes, AB, Kaufman, RH, Tilley, BC, and Townsend, DE. "Vaginal epithelial changes in young women enrolled in the national cooperative diethylstilbestrol adenosis (Desad) project." Obstetrical and Gynecological Survey 34.8 (January 1, 1979): 611-612.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
34
Issue
8
Publish Date
1979
Start Page
611
End Page
612

Disseminated intravascular coagulation: a reappraisal.

Authors
Colman, RW; Robboy, SJ; Minna, JD
MLA Citation
Colman, RW, Robboy, SJ, and Minna, JD. "Disseminated intravascular coagulation: a reappraisal." Annu Rev Med 30 (1979): 359-374. (Review)
PMID
400501
Source
pubmed
Published In
Annual Review of Medicine
Volume
30
Publish Date
1979
Start Page
359
End Page
374
DOI
10.1146/annurev.me.30.020179.002043

Pathologic findings in young women enrolled in national cooperative diethylstilbestrol adenosis (DESAD) project

Authors
Robboy, SJ; Kaufman, RH; Prat, J
MLA Citation
Robboy, SJ, Kaufman, RH, and Prat, J. "Pathologic findings in young women enrolled in national cooperative diethylstilbestrol adenosis (DESAD) project." Laboratory Investigation 40.2 (1979): 280-281.
Source
scival
Published In
Laboratory Investigation
Volume
40
Issue
2
Publish Date
1979
Start Page
280
End Page
281

ULTRASTRUCTURE OF CLEAR CELL ADENOCARCINOMA OF THE VAGINA AND CERVIX IN DES-EXPOSED PROGENY - ANALYSIS OF 16 CASES

Authors
DICKERSIN, GR; WELCH, WR; ERLANDSON, RA; ROBBOY, SJ
MLA Citation
DICKERSIN, GR, WELCH, WR, ERLANDSON, RA, and ROBBOY, SJ. "ULTRASTRUCTURE OF CLEAR CELL ADENOCARCINOMA OF THE VAGINA AND CERVIX IN DES-EXPOSED PROGENY - ANALYSIS OF 16 CASES." LABORATORY INVESTIGATION 40.2 (1979): 252-252.
Source
wos-lite
Published In
Laboratory Investigation
Volume
40
Issue
2
Publish Date
1979
Start Page
252
End Page
252

Complications of prenatal therapy with diethylstilbestrol.

Authors
Herbst, AL; Scully, RE; Robboy, SJ; Welch, WR
MLA Citation
Herbst, AL, Scully, RE, Robboy, SJ, and Welch, WR. "Complications of prenatal therapy with diethylstilbestrol." Pediatrics 62.6 Pt 2 (December 1978): 1151-1159.
PMID
724352
Source
pubmed
Published In
Pediatrics
Volume
62
Issue
6 Pt 2
Publish Date
1978
Start Page
1151
End Page
1159

Comparison of histologic and colposcopic findings in DES-exposed females.

A study was undertaken to evaluate the histologic alterations associated with two of the most abnormal colposcopic findings, mosaicism and punctation, that are commonly found in the vaginas and cervices of young women who have been exposed prenatally to diethylstilbestrol (DES). Four-fifths of 215 biopsy specimens from 171 exposed subjects with mosaicism or punctation disclosed metaplastic squamous epithelium, the presence of which is thought to reflect the repair of vaginal adenosis and cervical ectropion. Hyperkeratosis was observed in one-fifth of the specimens and was more frequent in lesions colposcopically graded I than II. Mild dysplasia was encountered in only one specimen. The findings indicate that the presence of squamous cell dysplasia cannot be predicted by the finding of Grade I or II mosaicism or punctation in the DES-exposed female despite the fact that these abnormal colposcopic patterns are associated with dysplasia in about 10% of cases when encountered in the cervix of the unexposed woman.

Authors
Welch, WR; Robboy, SJ; Townsend, DE; Barnes, AB; Scully, RE; Herbst, AL
MLA Citation
Welch, WR, Robboy, SJ, Townsend, DE, Barnes, AB, Scully, RE, and Herbst, AL. "Comparison of histologic and colposcopic findings in DES-exposed females." Obstet Gynecol 52.4 (October 1978): 457-461.
PMID
714329
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
52
Issue
4
Publish Date
1978
Start Page
457
End Page
461

Nuclear DNA study of vaginal and cervical squamous cell abnormalities in DES exposed progeny.

Authors
Fu, YS; Robboy, SJ; Prat, J
MLA Citation
Fu, YS, Robboy, SJ, and Prat, J. "Nuclear DNA study of vaginal and cervical squamous cell abnormalities in DES exposed progeny." Obstet Gynecol 52.2 (August 1978): 129-137.
PMID
683651
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
52
Issue
2
Publish Date
1978
Start Page
129
End Page
137

Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol.

Squamous cell abnormalities of the vagina and cervix were evaluated in 1424 women exposed to diethylstilbestrol (DES) in utero. The prevalence of dysplasia was 2.1% and the incidence 0.85/100 person-years of followup. The dysplastic epithelial changes were almost always mild in women with no prior history of dysplasia and was slightly more frequent in the cervix than the vagina. Severe dysplasia and carcinoma in situ (CIS) were encountered only in those subjects specifically referred because of those abnormalities. The most common problem in the diagnosis of these squamous cell changes was the misinterpretation of mature and immature metaplastic cells for dysplastic squamous cells. Discordance between biopsy and cytology was common-place in the detection and followup of dysplasia, especially when it was mild. There were no instances in the study where cytology and biopsy samples from the vagina were both abnormal concurrently. Colposcopically directed biopsies did not increase the frequency of confirmation of cytologic findings. These data suggest that both cytology and biopsy of abnormal segments of the vagina and cervix remain an integral part of the examination of the DES-exposed female during long-term follow-up studies.

Authors
Robboy, SJ; Keh, PC; Nickerson, RJ; Helmanis, EK; Prat, J; Szyfelbein, WM; Taft, PD; Barnes, AB; Scully, RE; Welch, WR
MLA Citation
Robboy, SJ, Keh, PC, Nickerson, RJ, Helmanis, EK, Prat, J, Szyfelbein, WM, Taft, PD, Barnes, AB, Scully, RE, and Welch, WR. "Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol." Obstet Gynecol 51.5 (May 1978): 528-535.
PMID
652199
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
51
Issue
5
Publish Date
1978
Start Page
528
End Page
535

Immediate pathologic confirmation of radiologic interpretations by computer feedback.

A computer system is used to provide automatic pathology diagnostic feedback to radiologists. This feedback occurs on a daily basis whenever surgical specimens are obtained for which pertinent radiologic examinations have been performed. On-line inquiry capability is also provided. The implementation relies on linkage between two operational computer systems at Massachusetts General Hospital, for pathology specimen accession management and radiology examination scheduling.

Authors
Greenes, RA; Bauman, RA; Robboy, SJ; Wieder, JF; Mercier, BA; Altshuler, BS
MLA Citation
Greenes, RA, Bauman, RA, Robboy, SJ, Wieder, JF, Mercier, BA, and Altshuler, BS. "Immediate pathologic confirmation of radiologic interpretations by computer feedback." Radiology 127.2 (May 1978): 381-383.
PMID
347495
Source
pubmed
Published In
Radiology
Volume
127
Issue
2
Publish Date
1978
Start Page
381
End Page
383
DOI
10.1148/127.2.381

Design and preliminary observations of National Cooperative Diethylstilbestrol Adenosis (DESAD) Project.

The National Cooperative Diethylstilbestrol Adenosis (DESAD) Project has completed the major portion of its enrollment phase with the examination of more than 3000 daughters of women taking synthetic nonsteroidal estrogens (denoted DES) during pregnancies occurring from the early 1940s to the mid-1960s. The aims of the Project are to fill urgent needs for information on the prevalence and incidence of structural and epithelial abnormalities or neoplastic changes and their complications in these young women. Participants are grouped by mode of entry as identified by prenatal record review (40.1%), documented as DES-exposed but walking in (25.1%), or referred (22.8%) to the DESAD Project for examination, and not documented as exposed but having gynecologic abnormalities typical of those associated with DES exposure (12.0%). This study cohort, in part having paired controls, will be examined annually for at least 5 years. Details of the design and selected preliminary findings are reported.

Authors
Labarthe, D; Adam, E; Noller, KL; O'Brien, PC; Robboy, SJ; Tilley, BC; Townsend, D; Barnes, AB; Kaufman, RH; Decker, DG; Fish, CR; Herbst, AL; Gundersen, J; Kurland, LT
MLA Citation
Labarthe, D, Adam, E, Noller, KL, O'Brien, PC, Robboy, SJ, Tilley, BC, Townsend, D, Barnes, AB, Kaufman, RH, Decker, DG, Fish, CR, Herbst, AL, Gundersen, J, and Kurland, LT. "Design and preliminary observations of National Cooperative Diethylstilbestrol Adenosis (DESAD) Project." Obstet Gynecol 51.4 (April 1978): 453-458.
PMID
662228
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
51
Issue
4
Publish Date
1978
Start Page
453
End Page
458

Urogenital sinus origin of mucinous and ciliated cysts of the vulva.

The origin of mucinous and ciliated cells in the vulva and the pathogenesis of cysts lined by these epithelia were investigated. Small mucinous glands numbering from one to more than a hundred were encountered in 9 of 19 vulvas (53%) that were consecutively examined at autopsy. Eleven other cysts were encountered clinically. Six were lined by mucinous epithelium, three by pseudostratified cells with cilia plus small foci of mucinous epithelium, and two by ciliated epithelium only. Four of the cysts with ciliated epithelium were otherwise typical Bartholin's gland cysts. It is concluded that glands lined by either mucinous or ciliated epithelia are normal constituents of the vulvar vestibule, are derived from urogenital sinus, and develop into cysts when the neck leading to the vulvar surface becomes inflamed and obstructed.

Authors
Robboy, SJ; Ross, JS; Prat, J; Keh, PC; Welch, WR
MLA Citation
Robboy, SJ, Ross, JS, Prat, J, Keh, PC, and Welch, WR. "Urogenital sinus origin of mucinous and ciliated cysts of the vulva." Obstet Gynecol 51.3 (March 1978): 347-351.
PMID
628540
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
51
Issue
3
Publish Date
1978
Start Page
347
End Page
351

Blue nevus of the cervix.

Authors
Carinelli, SG; Prat, J; Robboy, SJ
MLA Citation
Carinelli, SG, Prat, J, and Robboy, SJ. "Blue nevus of the cervix." Tumori 64.1 (February 28, 1978): 95-98.
PMID
653834
Source
pubmed
Published In
Tumori
Volume
64
Issue
1
Publish Date
1978
Start Page
95
End Page
98

Pathology of prenatal diethylstilbestrol exposure.

Authors
Welch, WR; Prat, J; Robboy, SJ; Herbst, AL
MLA Citation
Welch, WR, Prat, J, Robboy, SJ, and Herbst, AL. "Pathology of prenatal diethylstilbestrol exposure." Pathol Annu 13 Pt 1 (1978): 201-216. (Review)
PMID
364384
Source
pubmed
Published In
Pathology Annual
Volume
13 Pt 1
Publish Date
1978
Start Page
201
End Page
216

Complications of prenatal therapy with diethylstilbestrol

The possibility that adenosis of the vagina is a premalignant lesion was discussed. Vaginal adenosis had been recorded prior to the availability of diethylstilbestrol. Transverse vaginal ridges, which occur as a consequence of prenatal diethylstilbestrol exposure, may occur even without exposure. Although vaginal adenosis and squamous metaplasia occur in diethylstilbestrol-treated females with vaginal carcinoma and are the source of the ultimate cancer, they are not truly premalignant. Untreated, they will not invariably progress to carcinoma. Adenosis is usually a consequence of exposure to diethylstilbestrol prior to the 17th week of gestation, in those those girls who develop carcinoma, exposure has occurred prior to the 20th week. Radical surgical treatment of adenosis is unwarranted. Contraceptive techniques in these women should be mechanical rather than hormonal. Estrogens increase mucous discharge from the glands and thus increase vaginal discharge in girls with adenosis. Adenosis has been observed by 13 years of age, but carcinoma of the vagina has been reported in a 7-year-old girl exposed to diethylstilbestrol prenatally. After surgery of early vaginal (stage I) carcinoma, preliminary data suggest a 75% overall survival rate.

Authors
Herbst, AL; Scully, RE; Robboy, SJ; Welch, WR
MLA Citation
Herbst, AL, Scully, RE, Robboy, SJ, and Welch, WR. "Complications of prenatal therapy with diethylstilbestrol." Pediatrics 62.6 II SUPPL. (1978): 1151-1159.
Source
scival
Published In
Pediatrics
Volume
62
Issue
6 II SUPPL.
Publish Date
1978
Start Page
1151
End Page
1159

DISSEMINATED INTRA-VASCULAR COAGULATION, PLEURAL EFFUSIONS AND ASCITES IN A 53-YEAR-OLD WOMAN

Authors
GRIFFITHS, CT; ROBBOY, SJ; SCULLY, RE; FERRUCCI, JT; BARNES, AB; RICHARDSON, GS
MLA Citation
GRIFFITHS, CT, ROBBOY, SJ, SCULLY, RE, FERRUCCI, JT, BARNES, AB, and RICHARDSON, GS. "DISSEMINATED INTRA-VASCULAR COAGULATION, PLEURAL EFFUSIONS AND ASCITES IN A 53-YEAR-OLD WOMAN." NEW ENGLAND JOURNAL OF MEDICINE 298.14 (1978): 786-792.
Source
wos-lite
Published In
The New England journal of medicine
Volume
298
Issue
14
Publish Date
1978
Start Page
786
End Page
792

COMPLICATIONS OF PRENATAL THERAPY WITH DIETHYLSTILBESTROL

Authors
HERBST, AL; SCULLY, RE; ROBBOY, SJ; WELCH, WR
MLA Citation
HERBST, AL, SCULLY, RE, ROBBOY, SJ, and WELCH, WR. "COMPLICATIONS OF PRENATAL THERAPY WITH DIETHYLSTILBESTROL." PEDIATRICS 62.6 (1978): 1151-1159.
Source
wos-lite
Published In
Pediatrics
Volume
62
Issue
6
Publish Date
1978
Start Page
1151
End Page
1159

SQUAMOUS-CELL DYSPLASIA AND CARCINOMA INSITU AFTER PRENATAL EXPOSURE TO DIETHYLSTILBESTROL - EXAMINATION AND FOLLOW-UP OF 1,424 WOMEN

Authors
PRAT, J; ROBBOY, SJ; BARNES, AB; SCULLY, RE; WELCH, WR
MLA Citation
PRAT, J, ROBBOY, SJ, BARNES, AB, SCULLY, RE, and WELCH, WR. "SQUAMOUS-CELL DYSPLASIA AND CARCINOMA INSITU AFTER PRENATAL EXPOSURE TO DIETHYLSTILBESTROL - EXAMINATION AND FOLLOW-UP OF 1,424 WOMEN." LABORATORY INVESTIGATION 38.3 (1978): 360-361.
Source
wos-lite
Published In
Laboratory Investigation
Volume
38
Issue
3
Publish Date
1978
Start Page
360
End Page
361

Computer-assisted pathology encoding and reporting system (CAPER).

An on-line computer-assisted pathology encoding and reportying system (CAPER) has been developed by the Department of Pathology and Laboratory of Computer Science of the Massachusetts General Hospital for a department of surgical pathology that processes more than 25,000 specimens yearly. CAPER performs clerical functions, including the accessioning of specimens, monitoring their state of completion, production of log books, billing, statistics, and transfer of diagnoses to other hospital departments. It also permits instantaneous display of all diagnoses rendered within two years, printout within 24 hours of all older diagnoses for any patient, and retrieval of all specimens with any given diagnosis, further defined by any data item (e.g., age) stored in the computer file.

Authors
Aller, RD; Robboy, SJ; Poitras, JW; Altshuler, BS; Cameron, M; Prior, MC; Miao, S; Barnett, GO
MLA Citation
Aller, RD, Robboy, SJ, Poitras, JW, Altshuler, BS, Cameron, M, Prior, MC, Miao, S, and Barnett, GO. "Computer-assisted pathology encoding and reporting system (CAPER)." Am J Clin Pathol 68.6 (December 1977): 715-720.
PMID
602910
Source
pubmed
Published In
American Journal of Clinical Pathology
Volume
68
Issue
6
Publish Date
1977
Start Page
715
End Page
720

Squamous cell neoplasia controversy in the female exposed to diethylstilbestrol.

Authors
Robboy, SJ; Prat, J; Welch, WR; Barnes, AB
MLA Citation
Robboy, SJ, Prat, J, Welch, WR, and Barnes, AB. "Squamous cell neoplasia controversy in the female exposed to diethylstilbestrol." Hum Pathol 8.5 (September 1977): 483-485.
PMID
903141
Source
pubmed
Published In
Human Pathology
Volume
8
Issue
5
Publish Date
1977
Start Page
483
End Page
485

PRIMARY TRABECULAR CARCINOID OF THE OVARY

Authors
ROBBOY, STANLEYJ; SCULLY, ROBERTE; NORRIS, HENRYJ
MLA Citation
ROBBOY, STANLEYJ, SCULLY, ROBERTE, and NORRIS, HENRYJ. "PRIMARY TRABECULAR CARCINOID OF THE OVARY." OBSTETRICAL & GYNECOLOGICAL SURVEY 32.7 (July 1977): 487-488.
Source
crossref
Published In
Obstetrical and Gynecological Survey
Volume
32
Issue
7
Publish Date
1977
Start Page
487
End Page
488
DOI
10.1097/00006254-197707000-00023

Age-incidence and risk of diethylstilbestrol-related clear cell adenocarcinoma of the vagina and cervix.

This study was based on cases accessioned in the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females to ascertain the incidence of diethylstilbestrol (DES)-related cancers by age and year of birth. For accuracy in estimating the size of the reference population for the incidence rates, calculations were restricted to 127 white residents of the United States who were exposed prenatally to DES or other nonsteroidal synthetic estrogens. The disease is exceedingly rare prior to age 14 when the incidence rate begins to rise rapidly. The incidence peaks at age 19 (median 19.2 years) and then drops precipitately. Thus, DES-related clear cell adenocarcinoma is unusual in that nearly all cancers have been diagnosed in a narrow age range of 10 years (14 to 23 years). Women born in 1951 to 1953 have higher incidence rates than those born in the previous or subsequent three-year period. This suggests that the prevalence of pregnancy-related use of DES was at a peak in the early 1950's. The cumulative risk of this type of genital cancer, through age 24, for DES-exposed female subjects is estimated to be in the range of 0.14 to 1.4 per thousand. The wide limits are due to the fact that the number of young women exposed is not known precisly. The low risk of disease and the narrow age range of the cases, relative to the long latency period, suggest that DES is an incomplete carcinogen. Other factors, possibly related to puberty, may be involved in the causation of this disease.

Authors
Herbst, AL; Cole, P; Colton, T; Robboy, SJ; Scully, RE
MLA Citation
Herbst, AL, Cole, P, Colton, T, Robboy, SJ, and Scully, RE. "Age-incidence and risk of diethylstilbestrol-related clear cell adenocarcinoma of the vagina and cervix." Am J Obstet Gynecol 128.1 (May 1, 1977): 43-50.
PMID
851158
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
128
Issue
1
Publish Date
1977
Start Page
43
End Page
50

Microglandular hyperplasia in vaginal adenosis associated with oral contraceptives and prenatal diethylstilbestrol exposure.

Eight cases of microglandular hyperplasia arising in vaginal adenosis are presented. Five of the patients were known to have taken oral contraceptives and a sixth was pregnant at the time the lesion was discovered; a history of prenatal exposure to diethylstilbestrol (DES) was present in 5 cases. It is important to differentiate microglandular hyperplasia, which is benign, from clear cell adenocarcinoma, which also arises in a background of vaginal adenosis.

Authors
Robboy, SJ; Welch, WR
MLA Citation
Robboy, SJ, and Welch, WR. "Microglandular hyperplasia in vaginal adenosis associated with oral contraceptives and prenatal diethylstilbestrol exposure." Obstet Gynecol 49.4 (April 1977): 430-434.
PMID
857207
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
49
Issue
4
Publish Date
1977
Start Page
430
End Page
434

Primary trabecular carcinoid of the ovary.

Eighteen cases of primary trabecular carcinoid of the ovary were analyzed from a clinicopathologic viewpoint. The patients ranged in age from 24 to 74 years and presented with symptoms of an ovarian mass; none had the carcinoid syndrome. Although the carcinoid always proved to be unilateral, the contralateral ovary was sometimes enlarged by a dermoid cyst. The carcinoid usually formed a small mass in an otherwise obvious dermoid cyst, but in six instances it formed a large, solid mass, and in 2 of these cases no other teratomatous elements could be demonstrated. The prognosis was nearly always favorable after removal of the neoplasm, although 1 patient had a recurrence after 2 years and died after 51/2 years. Primary trabecular carcinoids are characterized by a distinctive pattern of ribbons of argentaffin cells and should not be confused with a Sertoli-Leydig cell tumor, a strumal carcinoid, or a metastatic trabecular carcinoid.

Authors
Robboy, SJ; Scully, RE; Norris, HJ
MLA Citation
Robboy, SJ, Scully, RE, and Norris, HJ. "Primary trabecular carcinoid of the ovary." Obstet Gynecol 49.2 (February 1977): 202-207.
PMID
834404
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
49
Issue
2
Publish Date
1977
Start Page
202
End Page
207

Intrauterine diethylstilbestrol exposure and its consequences: pathologic characteristics of vaginal adenosis, clear cell adenocarcinoma, and related lesions.

In 1971, the development of clear cell adenocarcinoma of the vagina in young females was first linked to a history of intrauterine exposure to diethylstilbestrol (DES). This communication reviews data on cases accessioned in the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females, findings in exposed female and male subjects without cancer, and discusses current concepts of the pathogenesis of the DES-related anomalies of the lower genital tract.

Authors
Robboy, SJ; Scully, RE; Welch, WR; Herbst, AL
MLA Citation
Robboy, SJ, Scully, RE, Welch, WR, and Herbst, AL. "Intrauterine diethylstilbestrol exposure and its consequences: pathologic characteristics of vaginal adenosis, clear cell adenocarcinoma, and related lesions." Arch Pathol Lab Med 101.1 (January 1977): 1-5.
PMID
576195
Source
pubmed
Published In
Archives of Pathology and Laboratory Medicine
Volume
101
Issue
1
Publish Date
1977
Start Page
1
End Page
5

Disseminated intravascular coagulation: a dermatologic disease.

Authors
Colman, RW; Minna, JD; Robboy, SJ
MLA Citation
Colman, RW, Minna, JD, and Robboy, SJ. "Disseminated intravascular coagulation: a dermatologic disease." Int J Dermatol 16.1 (January 1977): 47-51.
PMID
832942
Source
pubmed
Published In
International Journal of Dermatology
Volume
16
Issue
1
Publish Date
1977
Start Page
47
End Page
51

Aspergillus-induced small bowel obstruction in a leukemic newborn.

An infant with congenital acute myelocytic leukemia, who was being treated with chemotherapeutic agents, developed obstruction and infarction of the ileum due to occlusion of mesenteric arteries by Aspergillus hyphae. This case demonstrates how blood vessel occlusion by occult aspergillosis can present clinically as a surgical emergency.

Authors
Raaf, JH; Donahoe, PK; Truman, JT; Robboy, SJ
MLA Citation
Raaf, JH, Donahoe, PK, Truman, JT, and Robboy, SJ. "Aspergillus-induced small bowel obstruction in a leukemic newborn." Surgery 81.1 (January 1977): 111-113.
PMID
16977756
Source
pubmed
Published In
Surgery
Volume
81
Issue
1
Publish Date
1977
Start Page
111
End Page
113

Introduction

Authors
Scully, RE; Robboy, SJ
MLA Citation
Scully, RE, and Robboy, SJ. "Introduction." Human Pathology 8.5 (1977): 487--.
Source
scival
Published In
Human Pathology
Volume
8
Issue
5
Publish Date
1977
Start Page
487-

Computer assisted pathology encoding and reporting system (CAPER). An on-line computer system developed at the Massachusetts General Hospital

An on-line computer-assisted pathology encoding and reporting system (CAPER) has been developed by the Department of Pathology and Laboratory of Computer Science of the Massachusetts General Hospital for a department of surgical pathology that processes more than 25,000 specimens yearly. CAPER performs clerical functions, including the accessioning of specimens, monitoring their state of completion, production of log books, billing, statistics, and transfer of diagnoses to other hospital departments. It also permits instantaneous display of all diagnoses rendered within two years, printout within 24 hours of all older diagnoses for any patient, and retrieval of all specimens with any given diagnosis, further defined by any data item (e.g. age), stored in the computer file.

Authors
Aller, RD; Robboy, SJ; Poitras, JW; Altshuler, BS; Cameron, M; Prior, MC; Miao, S; Barnett, GO
MLA Citation
Aller, RD, Robboy, SJ, Poitras, JW, Altshuler, BS, Cameron, M, Prior, MC, Miao, S, and Barnett, GO. "Computer assisted pathology encoding and reporting system (CAPER). An on-line computer system developed at the Massachusetts General Hospital." American Journal of Clinical Pathology 68.6 (1977): 715-720.
Source
scival
Published In
American Journal of Clinical Pathology
Volume
68
Issue
6
Publish Date
1977
Start Page
715
End Page
720

Pelvic mass in a 53 year old woman with primary amenorrhea

Authors
Richardson, GS; Robboy, SJ
MLA Citation
Richardson, GS, and Robboy, SJ. "Pelvic mass in a 53 year old woman with primary amenorrhea." New England Journal of Medicine 296.8 (1977): 439-444.
Source
scival
Published In
New England Journal of Medicine
Volume
296
Issue
8
Publish Date
1977
Start Page
439
End Page
444

Primary trabecular carcinoid of the ovary

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Primary trabecular carcinoid of the ovary." Obstet Gynecol 49 (1977): 202-207.
Source
cinii-english
Published In
Obstet Gynecol
Volume
49
Publish Date
1977
Start Page
202
End Page
207

SYMPOSIUM ON GYNECOLOGIC PATHOLOGY

Authors
SCULLY, RE; ROBBOY, SJ
MLA Citation
SCULLY, RE, and ROBBOY, SJ. "SYMPOSIUM ON GYNECOLOGIC PATHOLOGY." HUMAN PATHOLOGY 8.5 (1977): 487-487.
Source
wos-lite
Published In
Human Pathology
Volume
8
Issue
5
Publish Date
1977
Start Page
487
End Page
487
DOI
10.1016/S0046-8177(77)80109-3

The embryologic development of the human vagina.

Our present understanding of the sequence and mechanisms of human genital organogenesis is reviewed. Current theories about the derivation of the vaginal epithelium are examined and tested against two anomalous circumstances, congenital androgen insensitivity and agenesis of the lower vagina, which are presented as examples demonstrating the respective participation of the urogenital sinus or of the Müllerian ducts alone in the developmental process. The abnormalities recently described in the vagina and cervix of girls exposed in utero to diethylstilbestrol (DES) correspond remarkably with those encountered in lower vaginal agenesis, particularly with regard to the presence of vaginal adenosis, the deficiency of glycogen in the squamous cells (squamous metaplasia), and the abnormal response of the squamous epithelium to Schiller's iodine test. It is concluded that the development of the human vagina is best explained by the theory which holds that the Müllerian ducts in fetal life extend caudally to the level of the future hymen. After fusion of these ducts, squamous cells arising in the epithelium of the urogenital sinus invade from below, advance, and replace completely the Müllerian mucosa up to the level of the external os of the cervical canal.

Authors
Ulfelder, H; Robboy, SJ
MLA Citation
Ulfelder, H, and Robboy, SJ. "The embryologic development of the human vagina." Am J Obstet Gynecol 126.7 (December 1, 1976): 769-776.
PMID
1033667
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
126
Issue
7
Publish Date
1976
Start Page
769
End Page
776

Cytology of 575 young women with prenatal exposure to diethylstilbestrol.

The vaginal and cervical cellular changes encountered in 575 postpubertal females exposed prenatally to diethylstilbestrol (DES) were compared with those of an unexposed population with particular reference to the role of cytology in the detection of vaginal adenosis and cervical ectropion (erosion). Several methods of obtaining specimens were utilized, the most effcacious of which was scraping of the vagina, especially the fornices, and the portio vaginalis of the cervix. With this technic, columnar cells of the mucinous type and metaplastic squamous cells were observed in 34% of the vaginal scrapes and 54% of the scrapes of the cervical portio. A higher incidence was apparent among those patients in whom iodine staining of the vaginal mucosa was abnormal or vaginal adenosis was proven by biopsy. Moderate to severe dysplasia of the squamous cells or atypical glandular cells were found in 1% of the exposed subjects. This study indicates that the presence of mucinous columnar or metaplastic squamous cells in vaginal scrapes is suggestive of vaginal adenosis but that vaginal cytology cannot be considered a uniformly reliable screening technic for detecting the presence of this disorder.

Authors
Robboy, SJ; Friedlander, LM; Welch, WR; Keh, PC; Taft, PD; Barnes, AB; Scully, RE; Herbst, AL
MLA Citation
Robboy, SJ, Friedlander, LM, Welch, WR, Keh, PC, Taft, PD, Barnes, AB, Scully, RE, and Herbst, AL. "Cytology of 575 young women with prenatal exposure to diethylstilbestrol." Obstet Gynecol 48.5 (November 1976): 511-515.
PMID
980279
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
48
Issue
5
Publish Date
1976
Start Page
511
End Page
515

Postoperative disseminated intravascular coagulation and fibrinolysis.

Authors
Colman, RW; Robboy, SJ
MLA Citation
Colman, RW, and Robboy, SJ. "Postoperative disseminated intravascular coagulation and fibrinolysis." Urol Clin North Am 3.2 (June 1976): 379-392.
PMID
960315
Source
pubmed
Published In
Urologic Clinics of North America
Volume
3
Issue
2
Publish Date
1976
Start Page
379
End Page
392

Glassy cell carcinoma of the cervix.

A clinicopathologic analysis of 13 cases of glassy cell carcinoma of the uterine cervix is presented. The glassy cell carcinoma is considered to be a poorly differentiated mixed adenosquamous carcinoma. Its histologic appearance is distinctive, being characterized by cells with a moderate amount of cytoplasm having a ground glass or finely granular appearance, a distinct cell wall that stains with eosin and PAS, and enlarged nuclei with prominent nucleoli. In the present study this tumor was associated with extrapelvic spread in 6/13 cases at diagnosis. Results were poor with either surgery and/or radiotherapy. Only four of 13 patients survived 5 years. The glassy cell carcinoma appears to be a distinct clinicopathologic entity which warrants a place in the classification of carcinoma of the cervix.

Authors
Littman, P; Clement, PB; Henriksen, B; Wang, CC; Robboy, SJ; Taft, PD; Ulfelder, H; Scully, RE
MLA Citation
Littman, P, Clement, PB, Henriksen, B, Wang, CC, Robboy, SJ, Taft, PD, Ulfelder, H, and Scully, RE. "Glassy cell carcinoma of the cervix." Cancer 37.5 (May 1976): 2238-2246.
PMID
1260713
Source
pubmed
Published In
Cancer
Volume
37
Issue
5
Publish Date
1976
Start Page
2238
End Page
2246

Nuclear chromatin determination in amniotic fluid cells for prenatal sex prediction in the macaque.

Amniotic fluid cells obtained after the ninetieth day of gestation in the macaque were analyzed for nuclear chromatin. The technique proved reliable for the prediction of fetal sex.

Authors
Herbst, A; Taft, PD; Robboy, SJ
MLA Citation
Herbst, A, Taft, PD, and Robboy, SJ. "Nuclear chromatin determination in amniotic fluid cells for prenatal sex prediction in the macaque." Am J Obstet Gynecol 124.7 (April 1, 1976): 761-763.
PMID
816201
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
124
Issue
7
Publish Date
1976
Start Page
761
End Page
763

Recurrent venous thrombosis and hepatic enlargement

Authors
Salzman, EW; Robboy, SJ
MLA Citation
Salzman, EW, and Robboy, SJ. "Recurrent venous thrombosis and hepatic enlargement." New England Journal of Medicine 295.18 (1976): 1003-1010.
Source
scival
Published In
New England Journal of Medicine
Volume
295
Issue
18
Publish Date
1976
Start Page
1003
End Page
1010

Fever cardiac arrhythmias and pericarditis after aortic valve replacement

Authors
Wheeler, EO; Robboy, SJ
MLA Citation
Wheeler, EO, and Robboy, SJ. "Fever cardiac arrhythmias and pericarditis after aortic valve replacement." New England Journal of Medicine 295.13 (1976): 718-724.
Source
scival
Published In
New England Journal of Medicine
Volume
295
Issue
13
Publish Date
1976
Start Page
718
End Page
724

Intestinal obstruction in an infant with congenital leukemia

Authors
Toch, R; Robboy, SJ
MLA Citation
Toch, R, and Robboy, SJ. "Intestinal obstruction in an infant with congenital leukemia." New England Journal of Medicine 295.11 (1976): 608-614.
Source
scival
Published In
New England Journal of Medicine
Volume
295
Issue
11
Publish Date
1976
Start Page
608
End Page
614

SPINAL-CORD DISORDER IN A WOMAN WITH CARCINOMA

Authors
YOUNG, RR; RICHARDSON, EP; ROBBOY, SJ; MCKUSICK, KA; ROBERSON, GH
MLA Citation
YOUNG, RR, RICHARDSON, EP, ROBBOY, SJ, MCKUSICK, KA, and ROBERSON, GH. "SPINAL-CORD DISORDER IN A WOMAN WITH CARCINOMA." NEW ENGLAND JOURNAL OF MEDICINE 294.26 (1976): 1447-1454.
Source
wos-lite
Published In
The New England journal of medicine
Volume
294
Issue
26
Publish Date
1976
Start Page
1447
End Page
1454

Clinical and epidemiological characteristics of young females developing cancer after intrauterine exposure to diethylstilbestrol and related drugs

A case control epidemiologic investigation associated the occurrence of 7 of 8 cases of clear cell adenocarcinoma of the vagina and cervix with maternal ingestion of diethylstilbestrol (DES) administered for the treatment of high risk pregnancy.

Authors
Herbst, AL; Robboy, SJ; Scully, RE
MLA Citation
Herbst, AL, Robboy, SJ, and Scully, RE. "Clinical and epidemiological characteristics of young females developing cancer after intrauterine exposure to diethylstilbestrol and related drugs." EXCERPTA MEDICA, ICS NO. 350 Vol.2 (December 1, 1975): 139-145.
Source
scopus
Published In
EXCERPTA MEDICA, ICS NO. 350
Volume
Vol.2
Publish Date
1975
Start Page
139
End Page
145

Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy.

The sexual precocity of polyostotic fibrous dysplasia is occasionally accompanied by other endocrine disorders, but in only two previous instances has Cushing syndrome been reported. The history of a 6-month-old girl is presented, in whom this syndrome was complicated by congenital Cushings syndrome. Although endocrinopathies of polyostotic fibrous dysplasia have usually been ascribed to a central (hypothalamic) origin, the findings in this patient suggest autonomous hyperfunction of the peripheral endocrine glands, with the Cushing syndrome caused by hyperplastic nodules in the adrenal glands and the precocity by luteinized follicular cysts of the ovary.

Authors
Danon, M; Robboy, SJ; Kim, S; Scully, R; Crawford, JD
MLA Citation
Danon, M, Robboy, SJ, Kim, S, Scully, R, and Crawford, JD. "Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy." J Pediatr 87.6 Pt 1 (December 1975): 917-921.
PMID
171361
Source
pubmed
Published In
The Journal of Pediatrics
Volume
87
Issue
6 Pt 1
Publish Date
1975
Start Page
917
End Page
921

Pathogenesis of fungal infection on heart valve prosthesis.

Four patients with heart valve prostheses developed Candidate endocarditis. At autopsy the foci of infection were confined to patches of neoendocardium that appeared to have developed as ingrowths of host endocardium onto the sewing cloth of the artificial valve. This suggested that one mechanism of fungal infection is related to the presence of the neoendocardium rather than to the cloth or metallic substances of the valve itself. Future studies might be directed toward inhibiting the development of the neoendocardium or to agents preventing its susceptibility to infection.

Authors
Robboy, SJ; Kaiser, J
MLA Citation
Robboy, SJ, and Kaiser, J. "Pathogenesis of fungal infection on heart valve prosthesis." Hum Pathol 6.6 (November 1975): 711-715.
PMID
1183994
Source
pubmed
Published In
Human Pathology
Volume
6
Issue
6
Publish Date
1975
Start Page
711
End Page
715

Vaginal adenosis and other diethylstilbestrol-related abnormalities.

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "Vaginal adenosis and other diethylstilbestrol-related abnormalities." Clin Obstet Gynecol 18.3 (September 1975): 185-194.
PMID
1157359
Source
pubmed
Published In
Clinical Obstetrics and Gynecology
Volume
18
Issue
3
Publish Date
1975
Start Page
185
End Page
194

Editorial: Problems in the examination of the DES-exposed female.

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "Editorial: Problems in the examination of the DES-exposed female." Obstet Gynecol 46.3 (September 1975): 353-355.
PMID
1161241
Source
pubmed
Published In
Obstetrics & Gynecology (Elsevier)
Volume
46
Issue
3
Publish Date
1975
Start Page
353
End Page
355

Insular carcinoid primary in the ovary. A clinicopathologic analysis of 48 cases.

Forty-eight cases of primary insular carcinoid of the ovary were analyzed from a clinicopathologic viewpoint. Sixteen (33%) were associated with preoperative clinical evidence of the carcinoid syndrome. At operation only one ovary was usually enlarged, but in 16% the contralateral ovary was also enlarged by either a dermoid cyst or a mucinous cystadenoma or cystadenocarcinoma. The volume of the carcinoid was the most important determinant of whether the carcinoid syndrome was present. No patient had the syndrome whose carcinoid formed only a small portion of a teratoma. Pure tumors or components of teratomas between 4 and 7 cm in diameter were associated with the syndrome in one-half, and larger carcinoids in two-third of the cases. Prominent acinar differentiation also correlated with the presence of the syndrome. Although the prognosis was nearly always favorable after the removal of the tumor, tricuspid valve damage continued to progress and led to cardiac decompensation in one patient; fatal recurrences developed in two others. The primary insular carcinoid should be distinguished from carcinoid metastatic to the ovary, which is nearly always bilateral, is usually associated with the presence of peritoneal metastases, and has a poor prognosis.

Authors
Robboy, SJ; Norris, HJ; Scully, RE
MLA Citation
Robboy, SJ, Norris, HJ, and Scully, RE. "Insular carcinoid primary in the ovary. A clinicopathologic analysis of 48 cases." Cancer 36.2 (August 1975): 404-418.
PMID
1157010
Source
pubmed
Published In
Cancer
Volume
36
Issue
2
Publish Date
1975
Start Page
404
End Page
418

Pathology of vaginal and cervical abnormalities associated with prenatal exposure to diethylstilbestrol (des).

Authors
Robboy, SJ; Scully, RE; Herbst, AL
MLA Citation
Robboy, SJ, Scully, RE, and Herbst, AL. "Pathology of vaginal and cervical abnormalities associated with prenatal exposure to diethylstilbestrol (des)." J Reprod Med 15.1 (July 1975): 13-18.
PMID
1151939
Source
pubmed
Published In
The Journal of reproductive medicine
Volume
15
Issue
1
Publish Date
1975
Start Page
13
End Page
18

The significance of adenosis and clear-cell adenocarcinoma of the genital tract in young females.

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "The significance of adenosis and clear-cell adenocarcinoma of the genital tract in young females." J Reprod Med 15.1 (July 1975): 5-11.
PMID
1151941
Source
pubmed
Published In
The Journal of reproductive medicine
Volume
15
Issue
1
Publish Date
1975
Start Page
5
End Page
11

Ultrastructure of primary and metastatic ovarian carcinoids: analysis of 11 cases.

The ultrastructure of 11 ovarian carcinoids was investigated. The 6 carcinoids with an insular pattern primary in the ovary or metastatic to it from the ileum displayed granules that were pleomorphic (dumbbell and reniform shaped) and varied from 90 to 410 mum, with an average diameter of 210 mum. Five trabecular carcinoids primary in the ovary or metastatic to if from the pancreas contained uniformly round granules with an average diameter of 185 mum and a range of 150-210 mum. These data confirm other reports that pleomorphic granules are typically associated with insular carcinoids of the midgut, and round granules with trabecular carcinoids of the foregut and hindgut.

Authors
Serratoni, FT; Robboy, SJ
MLA Citation
Serratoni, FT, and Robboy, SJ. "Ultrastructure of primary and metastatic ovarian carcinoids: analysis of 11 cases." Cancer 36.1 (July 1975): 157-160.
PMID
1203843
Source
pubmed
Published In
Cancer
Volume
36
Issue
1
Publish Date
1975
Start Page
157
End Page
160

Prenatal exposure to stilbestrol. A prospective comparison of exposed female offspring with unexposed controls.

Authors
Herbst, AL; Poskanzer, DC; Robboy, SJ; Friedlander, L; Scully, RE
MLA Citation
Herbst, AL, Poskanzer, DC, Robboy, SJ, Friedlander, L, and Scully, RE. "Prenatal exposure to stilbestrol. A prospective comparison of exposed female offspring with unexposed controls." N Engl J Med 292.7 (February 13, 1975): 334-339.
PMID
1117962
Source
pubmed
Published In
The New England journal of medicine
Volume
292
Issue
7
Publish Date
1975
Start Page
334
End Page
339
DOI
10.1056/NEJM197502132920704

Cytology of clear-cell adenocarcinoma of genital tract in young females: Review of 95 cases from the registry

Authors
Taft, PD; Robboy, SJ; Herbst, AL; Scully, RE
MLA Citation
Taft, PD, Robboy, SJ, Herbst, AL, and Scully, RE. "Cytology of clear-cell adenocarcinoma of genital tract in young females: Review of 95 cases from the registry." Obstetrical and Gynecological Survey 30.5 (January 1, 1975): 346-349.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
30
Issue
5
Publish Date
1975
Start Page
346
End Page
349

Clear cell adenocarcinoma of the vagina and cervix in young females: Analysis of 37 tumors that persisted or recurred after primary therapy

Authors
Robboy, SJ; Herbst, AL; Scully, RE
MLA Citation
Robboy, SJ, Herbst, AL, and Scully, RE. "Clear cell adenocarcinoma of the vagina and cervix in young females: Analysis of 37 tumors that persisted or recurred after primary therapy." Obstetrical and Gynecological Survey 30.4 (January 1, 1975): 283-285.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
30
Issue
4
Publish Date
1975
Start Page
283
End Page
285

Carcinoid metastatic to the ovary. A clinicopathologic analysis of 35 cases

Authors
Robboy, SJ; Scully, RE; Norris, HJ
MLA Citation
Robboy, SJ, Scully, RE, and Norris, HJ. "Carcinoid metastatic to the ovary. A clinicopathologic analysis of 35 cases." Obstetrical and Gynecological Survey 30.1 (January 1, 1975): 61-65.
Source
scopus
Published In
Obstetrical and Gynecological Survey
Volume
30
Issue
1
Publish Date
1975
Start Page
61
End Page
65

Effects of maternal DES ingestion on the female genital tract

More than 250 cases of vaginal or cervical carcinoma among young females (age 7 to 29 yr) have been entered in a registry established after the association between these rare cancers and maternal stilbestrol ingestion became apparent. The number may increase as girls within the exposed group mature. More cases are now being discovered before symptoms develop and all patients identified while asymptomatic are well after treatment. The registry mentioned was established shortly after the discovery of the initial cases. It is called the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females, and is supported by the National Cancer Institute and the American Cancer Society. Pathologists from all countries can refer their cases to the registry: Dr. R.E. Scully, Professor of Pathology, Massachusetts General Hospital.

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "Effects of maternal DES ingestion on the female genital tract." Hospital Practice 10.10 (1975): 51-57.
Source
scival
Published In
Hospital Practice
Volume
10
Issue
10
Publish Date
1975
Start Page
51
End Page
57

Problems in the examination of the DES exposed female

Authors
Herbst, AL; Scully, RE; Robboy, SJ
MLA Citation
Herbst, AL, Scully, RE, and Robboy, SJ. "Problems in the examination of the DES exposed female." Obstetrics and Gynecology 46.3 (1975): 353-355.
Source
scival
Published In
Obstetrics and Gynecology
Volume
46
Issue
3
Publish Date
1975
Start Page
353
End Page
355

Case records of the Massachusetts General Hospital. Mass in the region of the third ventricle in an eight year old girl

Authors
Locke, S; Robboy, SJ
MLA Citation
Locke, S, and Robboy, SJ. "Case records of the Massachusetts General Hospital. Mass in the region of the third ventricle in an eight year old girl." New England Journal of Medicine 293.13 (1975): 653-660.
PMID
1152912
Source
scival
Published In
New England Journal of Medicine
Volume
293
Issue
13
Publish Date
1975
Start Page
653
End Page
660

Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy

The sexual precocity of polyostotic fibrous dysplasia is occasionally accompanied by other endocrine disorders, but in only tww previous instances has Cushing syndrome been reported. The history of a 6-month-old girl is presented, in whom this syndrome was complicated by congenital Cushing syndrome. Although the endocrinopathies of polyostotic fibrous dysplasia have usually been ascribed to a central (hypothalamic) origin, the findings in this patient suggest autonomous hyperfunction of the peripheral endocrine glands, with the Cushing syndrome caused by hyperplastic nodules in the adrenal glands and the precocity by luteinized follicular cysts of the ovary. © 1975 The C. V. Mosby Company.

Authors
Danon, M; Robboy, SJ; Kim, S; Scully, R; Crawford, JD
MLA Citation
Danon, M, Robboy, SJ, Kim, S, Scully, R, and Crawford, JD. "Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy." The Journal of Pediatrics 87.6 PART 1 (1975): 917-921.
Source
scival
Published In
The Journal of Pediatrics
Volume
87
Issue
6 PART 1
Publish Date
1975
Start Page
917
End Page
921
DOI
10.1016/S0022-3476(75)80905-X

Clinical and epidemiological characteristics of young females developing cancer after intrauterine exposure to diethylstilbestrol and related drugs

A case control epidemiologic investigation associated the occurrence of 7 of 8 cases of clear cell adenocarcinoma of the vagina and cervix with maternal ingestion of diethylstilbestrol (DES) administered for the treatment of high risk pregnancy.

Authors
Herbst, AL; Robboy, SJ; Scully, RE
MLA Citation
Herbst, AL, Robboy, SJ, and Scully, RE. "Clinical and epidemiological characteristics of young females developing cancer after intrauterine exposure to diethylstilbestrol and related drugs." EXCERPTA MEDICA, ICS NO. 350 Vol.2 (1975): 139-145.
Source
scival
Published In
EXCERPTA MEDICA, ICS NO. 350
Volume
Vol.2
Publish Date
1975
Start Page
139
End Page
145

Prenatal exposure to stilbestrol: a prospective comparison of exposed female offspring with unexposed controls

The effects of prenatal exposure to diethylstilbestrol were studied by a prospective cohort investigation of 110 exposed and 82 unexposed females whose mothers had been treated between 1947 and 1958. The general health characteristics of mothers and daughters in both groups were similar. Among the exposed, there were striking benign alterations of the genital tract, which included transverse ridges (22%), abnormal vaginal mucosa (56%), and biopsy proven adenosis (35%). Among the unexposed, there were no ridges and one case of vaginal mucosal abnormality including adenosis (p<0.0001). Abnormal cervical epithelium occurred in almost all exposed subjects, but in only half the unexposed (p<0.0001). The incidence of vaginal adenosis was highest when diethylstilbestrol was begun in early pregnancy. It was not detected when treatment was initiated in the 18th wk or later. Oral contraceptive use and prior pregnancy were associated with less adenosis and erosion, respectively (p<0.05). No cases of cancer were observed.

Authors
Herbst, AL; Poskanzer, DC; Robboy, SJ; Friedlander, L; Scully, RE
MLA Citation
Herbst, AL, Poskanzer, DC, Robboy, SJ, Friedlander, L, and Scully, RE. "Prenatal exposure to stilbestrol: a prospective comparison of exposed female offspring with unexposed controls." New England Journal of Medicine 292.8 (1975): 334-339.
Source
scival
Published In
The New England journal of medicine
Volume
292
Issue
8
Publish Date
1975
Start Page
334
End Page
339

Prenatal exposure to stilbestrol (DES): A comparative study of vaginal and cervical abnormalities in exposed and unexposed (control) female subjects

Authors
Robboy, SJ; Herbst, AL; Friedlander, L; Scully, RE
MLA Citation
Robboy, SJ, Herbst, AL, Friedlander, L, and Scully, RE. "Prenatal exposure to stilbestrol (DES): A comparative study of vaginal and cervical abnormalities in exposed and unexposed (control) female subjects." Laboratory Investigation 33.3 (1975): 432-433.
Source
scival
Published In
Laboratory Investigation
Volume
33
Issue
3
Publish Date
1975
Start Page
432
End Page
433

Sexual precocity with polyostotic fibrous dysplasia

The case of a 2 1/2 yr old girl is described, concerning a granulosa cell tumor of the ovary. Luteinized follicular cysts of the ovaries were found. A survey on the etiology and pathophysiology of the syndrome is given.

Authors
Senior, B; Robboy, SJ
MLA Citation
Senior, B, and Robboy, SJ. "Sexual precocity with polyostotic fibrous dysplasia." New England Journal of Medicine 292.4 (1975): 199-203.
Source
scival
Published In
New England Journal of Medicine
Volume
292
Issue
4
Publish Date
1975
Start Page
199
End Page
203

Insular carcinoid primary in the ovary. A clinicopathologic analysis of 48 cases

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Insular carcinoid primary in the ovary. A clinicopathologic analysis of 48 cases." Cancer 36 (1975): 404-418.
Source
cinii-english
Published In
Cancer
Volume
36
Publish Date
1975
Start Page
404
End Page
418

ADENOSIS AND CLEAR-CELL ADENOCARCINOMA OF VAGINA - INVITATIONAL SYMPOSIUM - INTRODUCTION

Authors
REAGAN, JW; HERBST, AL; MORROW, CP; ROBBOY, SJ; STAFL, A
MLA Citation
REAGAN, JW, HERBST, AL, MORROW, CP, ROBBOY, SJ, and STAFL, A. "ADENOSIS AND CLEAR-CELL ADENOCARCINOMA OF VAGINA - INVITATIONAL SYMPOSIUM - INTRODUCTION." JOURNAL OF REPRODUCTIVE MEDICINE 15.1 (1975): 2-4.
Source
wos-lite
Published In
The Journal of reproductive medicine
Volume
15
Issue
1
Publish Date
1975
Start Page
2
End Page
4

MASS IN REGION OF 3RD VENTRICLE IN AN 8-YEAR-OLD GIRL

Authors
LOCKE, S; ROBBOY, SJ; RICHARDSON, EP; TAVERAS, JM; CHAPMAN, PH; BODE, HH; TRUMAN, JT
MLA Citation
LOCKE, S, ROBBOY, SJ, RICHARDSON, EP, TAVERAS, JM, CHAPMAN, PH, BODE, HH, and TRUMAN, JT. "MASS IN REGION OF 3RD VENTRICLE IN AN 8-YEAR-OLD GIRL." NEW ENGLAND JOURNAL OF MEDICINE 293.13 (1975): 653-660.
Source
wos-lite
Published In
The New England journal of medicine
Volume
293
Issue
13
Publish Date
1975
Start Page
653
End Page
660

PRENATAL EXPOSURE TO STILBESTROL (DES) - COMPARATIVE STUDY OF VAGINAL AND CERVICAL ABNORMALITIES IN EXPOSED AND UNEXPOSED (CONTROL) FEMALE SUBJECTS

Authors
ROBBOY, SJ; HERBST, AL; FRIEDLANDER, L; SCULLY, RE
MLA Citation
ROBBOY, SJ, HERBST, AL, FRIEDLANDER, L, and SCULLY, RE. "PRENATAL EXPOSURE TO STILBESTROL (DES) - COMPARATIVE STUDY OF VAGINAL AND CERVICAL ABNORMALITIES IN EXPOSED AND UNEXPOSED (CONTROL) FEMALE SUBJECTS." LABORATORY INVESTIGATION 32.3 (1975): 432-433.
Source
wos-lite
Published In
Laboratory Investigation
Volume
32
Issue
3
Publish Date
1975
Start Page
432
End Page
433

THE EFFECTS OF LOCAL PROGESTERONE ON STILBESTROL-ASSOCIATED VAGINAL ADENOSIS

Authors
HERBST, ARTHURL; ROBBOY, STANLEYJ; MacDONALD, GORDONJ; SCULLY, ROBERTE
MLA Citation
HERBST, ARTHURL, ROBBOY, STANLEYJ, MacDONALD, GORDONJ, and SCULLY, ROBERTE. "THE EFFECTS OF LOCAL PROGESTERONE ON STILBESTROL-ASSOCIATED VAGINAL ADENOSIS." Obstetrical & Gynecological Survey 29.11 (November 1974): 824-826.
Source
crossref
Published In
Obstetrical and Gynecological Survey
Volume
29
Issue
11
Publish Date
1974
Start Page
824
End Page
826
DOI
10.1097/00006254-197411000-00022

Clear-cell adenocarcinoma of the vagina and cervix in young females: analysis of 37 tumors that persisted or recurred after primary therapy.

Authors
Robboy, SJ; Herbst, AL; Scully, RE
MLA Citation
Robboy, SJ, Herbst, AL, and Scully, RE. "Clear-cell adenocarcinoma of the vagina and cervix in young females: analysis of 37 tumors that persisted or recurred after primary therapy." Cancer 34.3 (September 1974): 606-614.
PMID
4859252
Source
pubmed
Published In
Cancer
Volume
34
Issue
3
Publish Date
1974
Start Page
606
End Page
614

Disseminated intravascular coagulation: a problem in critical-care medicine.

Authors
Colman, RW; Minna, JD; Robboy, SJ
MLA Citation
Colman, RW, Minna, JD, and Robboy, SJ. "Disseminated intravascular coagulation: a problem in critical-care medicine." Heart Lung 3.5 (September 1974): 789-796.
PMID
4497501
Source
pubmed
Published In
Heart & Lung - The Journal of Acute and Critical Care
Volume
3
Issue
5
Publish Date
1974
Start Page
789
End Page
796

Clear-cell adenocarcinoma of the vagina and cervix in girls: analysis of 170 registry cases.

Authors
Herbst, AL; Robboy, SJ; Scully, RE; Poskanzer, DC
MLA Citation
Herbst, AL, Robboy, SJ, Scully, RE, and Poskanzer, DC. "Clear-cell adenocarcinoma of the vagina and cervix in girls: analysis of 170 registry cases." Am J Obstet Gynecol 119.5 (July 1, 1974): 713-724.
PMID
4857957
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
119
Issue
5
Publish Date
1974
Start Page
713
End Page
724

Vaginal and cervical abnormalities, including clear-cell adenocarcinoma, related to prenatal exposure to stilbestrol.

A variety of vaginal and cervical abnormalities have been encountered in the offspring of women who have taken stilbestrol or chemically related nonsteroidal estrogens during pregnancy. Cervical erosion has been noted most often, but vaginal adenosis has been proven by biopsy in over 30 percent, and transverse vaginal and cervical ridges have been seen in approximately 10 percent of the exposed population. Although the use of these drugs had been widespread during the last two decades, the Registry of Clear-Cell Adenocarcinoma of the Genital Tract in Young Females has been able to collect only 170 cases of vaginal and cervical cancers of this type from all over the world. It is important that cytologists and pathologists become familiar with the various non-enoplastic and neoplastic disorders related to these hormones in order that additional epidemiologic, clinical and pathological information be acquired without delay.

Authors
Scully, RE; Robboy, SJ; Herbst, AL
MLA Citation
Scully, RE, Robboy, SJ, and Herbst, AL. "Vaginal and cervical abnormalities, including clear-cell adenocarcinoma, related to prenatal exposure to stilbestrol." Ann Clin Lab Sci 4.4 (July 1974): 222-233.
PMID
4460850
Source
pubmed
Published In
Annals of Clinical and Laboratory Science
Volume
4
Issue
4
Publish Date
1974
Start Page
222
End Page
233

Cytology of clear-cell adenocarcinoma of genital tract in young females: review of 95 cases from the registry.

Authors
Taft, PD; Robboy, SJ; Herbst, AL; Scully, RE
MLA Citation
Taft, PD, Robboy, SJ, Herbst, AL, and Scully, RE. "Cytology of clear-cell adenocarcinoma of genital tract in young females: review of 95 cases from the registry." Acta Cytol 18.4 (July 1974): 279-290.
PMID
4526247
Source
pubmed
Published In
Acta cytologica
Volume
18
Issue
4
Publish Date
1974
Start Page
279
End Page
290

The effects of local progesterone on stilbestrol-associated vaginal adenosis.

Authors
Herbst, AL; Robboy, SJ; Macdonald, GJ; Scully, E
MLA Citation
Herbst, AL, Robboy, SJ, Macdonald, GJ, and Scully, E. "The effects of local progesterone on stilbestrol-associated vaginal adenosis." Am J Obstet Gynecol 118.5 (March 1, 1974): 607-615.
PMID
4130676
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
118
Issue
5
Publish Date
1974
Start Page
607
End Page
615

Carcinoid metastatic to the ovary. A clinocopathologic analysis of 35 cases.

Authors
Robboy, SJ; Scully, RE; Norris, HJ
MLA Citation
Robboy, SJ, Scully, RE, and Norris, HJ. "Carcinoid metastatic to the ovary. A clinocopathologic analysis of 35 cases." Cancer 33.3 (March 1974): 798-811.
PMID
4815582
Source
pubmed
Published In
Cancer
Volume
33
Issue
3
Publish Date
1974
Start Page
798
End Page
811

Clear-cell adenocarcinoma of the vagina and cervix in girls: Analysis of 170 Registry cases

One hundred cases of vaginal and 70 cervical adenocarcinomas from the Registry of Clear-Cell Adenocarcinoma of the Genital Tract in Young Females have been analyzed. The age range of the patients was 7 to 29 years, and the frequent association with prenatal exposure to diethylstilbestrol and similar nonsteroidal estrogens was confirmed. The hormone administration began prior to the eighteenth week of pregnancy and was continued for periods ranging from 1 week to almost the entire length of the pregnancy. The total dosages ranged from 300 to 18,200 mg. Although most patients had vaginal bleeding or discharge, 16 per cent were asymptomatic. Abnormal cytology was the first clue to the diagnosis of cancer in 11 patients, but 21 per cent of the smears were negative. The larger and more deeply invasive tumors were often complicated by lymph node metastases, but these were also encountered in 1 case in which the tumor had an area of only 3 sq. cm. and with another tumor that invaded less than 3 mm. These findings suggest that local treatment of the primary tumor alone may be inadequate in some cases. Recurrences developed in 37 of the patients and 24 of them died, although the follow-up in one third of the cases has been less than 2 years. The recurrences frequently involved the lungs and supraclavicular lymph nodes as well as the pelvis. The very common association of vaginal adenosis and the occasional coexistence of transverse vaginal or cervical ridges provide morphologic evidence of a stilbestrol-related disturbance in the development of the lower Müllerian tract. The results of intravenous pyelography suggest that the development of the urinary tract is not affected. The fact that all the asymptomatic patients with carcinoma have been successfully treated thus far underscores the importance of screening exposed asymptomatic patients in search of early cases. The rarity (9 per cent) of these cancers prior to the age of 12 years suggests that the inclusion of a large population of girls in this age group in a screening program would uncover very few cases. However, such individuals should certainly be examined at any time abnormal vaginal bleeding or discharge develops. © 1974.

Authors
Herbst, AL; Robboy, SJ; Scully, RE; Poskanzer, DC
MLA Citation
Herbst, AL, Robboy, SJ, Scully, RE, and Poskanzer, DC. "Clear-cell adenocarcinoma of the vagina and cervix in girls: Analysis of 170 Registry cases." American Journal of Obstetrics and Gynecology 119.5 (1974): 712--.
Source
scival
Published In
American Journal of Obstetrics & Gynecology
Volume
119
Issue
5
Publish Date
1974
Start Page
712-

Candida septicemia after double valve replacements

Authors
Karchmer, AW; Robboy, SJ
MLA Citation
Karchmer, AW, and Robboy, SJ. "Candida septicemia after double valve replacements." New England Journal of Medicine 291.19 (1974): 1021-1027.
Source
scival
Published In
New England Journal of Medicine
Volume
291
Issue
19
Publish Date
1974
Start Page
1021
End Page
1027

Immune hemolytic transfusion reactions in monkeys: activation of the kallikrein system.

Authors
Lopas, H; Birndorf, NI; Bell, CE; Robboy, SJ; Colman, RW
MLA Citation
Lopas, H, Birndorf, NI, Bell, CE, Robboy, SJ, and Colman, RW. "Immune hemolytic transfusion reactions in monkeys: activation of the kallikrein system." Am J Physiol 225.2 (August 1973): 372-379.
PMID
4198615
Source
pubmed
Published In
The American journal of physiology
Volume
225
Issue
2
Publish Date
1973
Start Page
372
End Page
379

Pulmonary hemorrhage syndrome as a manifestation of disseminated intravascular coagulation: analysis of ten cases.

Authors
Robboy, SJ; Minna, JD; Colman, RW; Birndorf, NI; Lopas, H
MLA Citation
Robboy, SJ, Minna, JD, Colman, RW, Birndorf, NI, and Lopas, H. "Pulmonary hemorrhage syndrome as a manifestation of disseminated intravascular coagulation: analysis of ten cases." Chest 63.5 (May 1973): 718-721.
PMID
4634077
Source
pubmed
Published In
Chest
Volume
63
Issue
5
Publish Date
1973
Start Page
718
End Page
721

The skin in disseminated intravascular coagulation. Prospective analysis of thirty-six cases.

Authors
Robboy, SJ; Mihm, MC; Colman, RW; Minna, JD
MLA Citation
Robboy, SJ, Mihm, MC, Colman, RW, and Minna, JD. "The skin in disseminated intravascular coagulation. Prospective analysis of thirty-six cases." Br J Dermatol 88.3 (March 1973): 221-229.
PMID
4197291
Source
pubmed
Published In
British Journal of Dermatology
Volume
88
Issue
3
Publish Date
1973
Start Page
221
End Page
229

Experimental transfusion reactions in monkeys: haemolytic, coagulant and renal effects of transfused isoimmune IgG and IgM.

Authors
Lopas, H; Birndorf, NI; Bell, CE; Robboy, SJ; Fortwengler, HP; Biddison, WE
MLA Citation
Lopas, H, Birndorf, NI, Bell, CE, Robboy, SJ, Fortwengler, HP, and Biddison, WE. "Experimental transfusion reactions in monkeys: haemolytic, coagulant and renal effects of transfused isoimmune IgG and IgM." Br J Haematol 23.6 (December 1972): 765-776.
PMID
4630454
Source
pubmed
Published In
British Journal of Haematology
Volume
23
Issue
6
Publish Date
1972
Start Page
765
End Page
776

Pathology of disseminated intravascular coagulation (DIC). Analysis of 26 cases.

Authors
Robboy, SJ; Major, MC; Colman, RW; Minna, JD
MLA Citation
Robboy, SJ, Major, MC, Colman, RW, and Minna, JD. "Pathology of disseminated intravascular coagulation (DIC). Analysis of 26 cases." Hum Pathol 3.3 (September 1972): 327-343.
PMID
5065327
Source
pubmed
Published In
Human Pathology
Volume
3
Issue
3
Publish Date
1972
Start Page
327
End Page
343

Atrioventricular-node inflammation--mechanism of sudden death in protracted meningococcemia.

Authors
Robboy, SJ
MLA Citation
Robboy, SJ. "Atrioventricular-node inflammation--mechanism of sudden death in protracted meningococcemia." N Engl J Med 286.20 (May 18, 1972): 1091-1093.
PMID
4623015
Source
pubmed
Published In
The New England journal of medicine
Volume
286
Issue
20
Publish Date
1972
Start Page
1091
End Page
1093
DOI
10.1056/NEJM197205182862008

Disseminated intravascular coagulation (DIC): an approach.

Authors
Colman, RW; Robboy, SJ; Minna, JD
MLA Citation
Colman, RW, Robboy, SJ, and Minna, JD. "Disseminated intravascular coagulation (DIC): an approach." Am J Med 52.5 (May 1972): 679-689. (Review)
PMID
4554877
Source
pubmed
Published In
The American Journal of Medicine
Volume
52
Issue
5
Publish Date
1972
Start Page
679
End Page
689

Embolic stroke from mural thrombi, a fatal complication of axillary artery catheterization.

Authors
Head, RM; Robboy, SJ
MLA Citation
Head, RM, and Robboy, SJ. "Embolic stroke from mural thrombi, a fatal complication of axillary artery catheterization." Radiology 102.2 (February 1972): 307-.
PMID
5009929
Source
pubmed
Published In
Radiology
Volume
102
Issue
2
Publish Date
1972
Start Page
307
DOI
10.1148/102.2.307

A new stain for systemic fungi in tissue.

Authors
Swartz, JH; Medrek, TF; Robboy, SJ
MLA Citation
Swartz, JH, Medrek, TF, and Robboy, SJ. "A new stain for systemic fungi in tissue." Am J Clin Pathol 57.1 (January 1972): 27-29.
PMID
4109487
Source
pubmed
Published In
American Journal of Clinical Pathology
Volume
57
Issue
1
Publish Date
1972
Start Page
27
End Page
29

Mechanism of Aspergillus-induced microangiopathic hemolytic anemia.

Authors
Robboy, SJ; Salisbury, K; Ragsdale, B; Bobroff, LM; Jacobson, BM; Colman, RW
MLA Citation
Robboy, SJ, Salisbury, K, Ragsdale, B, Bobroff, LM, Jacobson, BM, and Colman, RW. "Mechanism of Aspergillus-induced microangiopathic hemolytic anemia." Arch Intern Med 128.5 (November 1971): 790-793.
PMID
5119227
Source
pubmed
Published In
Archives of internal medicine
Volume
128
Issue
5
Publish Date
1971
Start Page
790
End Page
793

Disseminated intravascular coagulation and renal failure: Production in the monkey with autologous red blood cell stroma.

Authors
Birndorf, NI; Lopas, H; Robboy, SJ
MLA Citation
Birndorf, NI, Lopas, H, and Robboy, SJ. "Disseminated intravascular coagulation and renal failure: Production in the monkey with autologous red blood cell stroma." Lab Invest 25.4 (October 1971): 314-319.
PMID
5000483
Source
pubmed
Published In
Laboratory Investigation
Volume
25
Issue
4
Publish Date
1971
Start Page
314
End Page
319

Experimental transfusion reactions and disseminated intravascular coagulation produced by incompatible plasma in monkeys.

Authors
Lopas, H; Birndorf, NI; Robboy, SJ
MLA Citation
Lopas, H, Birndorf, NI, and Robboy, SJ. "Experimental transfusion reactions and disseminated intravascular coagulation produced by incompatible plasma in monkeys." Transfusion 11.4 (July 1971): 196-203.
PMID
4998710
Source
pubmed
Published In
Transfusion
Volume
11
Issue
4
Publish Date
1971
Start Page
196
End Page
203

Ovarian teratoma with glial implants on the peritoneum. An analysis of 12 cases.

Authors
Robboy, SJ; Scully, RE
MLA Citation
Robboy, SJ, and Scully, RE. "Ovarian teratoma with glial implants on the peritoneum. An analysis of 12 cases." Hum Pathol 1.4 (December 1970): 643-653.
PMID
5521737
Source
pubmed
Published In
Human Pathology
Volume
1
Issue
4
Publish Date
1970
Start Page
643
End Page
653

Circulating anticoagulants to factor VIII. Immunochemical studies and clinical response to factor VIII concentrates.

Authors
Robboy, SJ; Lewis, EJ; Schur, PH; Colman, RW
MLA Citation
Robboy, SJ, Lewis, EJ, Schur, PH, and Colman, RW. "Circulating anticoagulants to factor VIII. Immunochemical studies and clinical response to factor VIII concentrates." Am J Med 49.6 (December 1970): 742-752.
PMID
5006795
Source
pubmed
Published In
The American Journal of Medicine
Volume
49
Issue
6
Publish Date
1970
Start Page
742
End Page
752

Tinctorial and morphologic properties distinguishing actinomycosis and nocardiosis.

Authors
Robboy, SJ; Vickery, AL
MLA Citation
Robboy, SJ, and Vickery, AL. "Tinctorial and morphologic properties distinguishing actinomycosis and nocardiosis." N Engl J Med 282.11 (March 12, 1970): 593-596.
PMID
4189913
Source
pubmed
Published In
The New England journal of medicine
Volume
282
Issue
11
Publish Date
1970
Start Page
593
End Page
596
DOI
10.1056/NEJM197003122821104

Circulating anticoagulants to factor VIII

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Circulating anticoagulants to factor VIII." Am J Med 49 (1970): 742-752.
Source
cinii-english
Published In
Am J Med
Volume
49
Publish Date
1970
Start Page
742
End Page
752
DOI
10.1016/S0002-9343(70)80056-0

Ovarian teratoma with glial implants on the peritoneum : An analysis of twelve cases

Authors
ROBBOY, S
MLA Citation
ROBBOY, S. "Ovarian teratoma with glial implants on the peritoneum : An analysis of twelve cases." Hum Pathol 1 (1970): 643-653.
Source
cinii-english
Published In
Hum Pathol
Volume
1
Publish Date
1970
Start Page
643
End Page
653
DOI
10.1016/S0046-8177(70)80062-4

Autopsy findings with permanent pervenous pacemakers.

Authors
Robboy, SJ; Harthorne, JW; Leinbach, RC; Sanders, CA; Austen, WG
MLA Citation
Robboy, SJ, Harthorne, JW, Leinbach, RC, Sanders, CA, and Austen, WG. "Autopsy findings with permanent pervenous pacemakers." Circulation 39.4 (April 1969): 495-501.
PMID
5778250
Source
pubmed
Published In
Circulation
Volume
39
Issue
4
Publish Date
1969
Start Page
495
End Page
501

Fibrinolysis vs disseminated intravascular coagulation.

Authors
Robboy, S; Colman, R; Minna, J
MLA Citation
Robboy, S, Colman, R, and Minna, J. "Fibrinolysis vs disseminated intravascular coagulation." New England Journal of Medicine 281.4 (1969): 222--.
PMID
5790514
Source
scival
Published In
New England Journal of Medicine
Volume
281
Issue
4
Publish Date
1969
Start Page
222-

Zone electrophoresis and prolactin activity of rat adenohypophysis cultivated in vitro.

Authors
Robboy, SJ; Kahn, RH
MLA Citation
Robboy, SJ, and Kahn, RH. "Zone electrophoresis and prolactin activity of rat adenohypophysis cultivated in vitro." Endocrinology 78.3 (March 1966): 440-444.
PMID
5931628
Source
pubmed
Published In
Endocrinology
Volume
78
Issue
3
Publish Date
1966
Start Page
440
End Page
444
DOI
10.1210/endo-78-3-440

ELECTROPHORETIC SEPARATION OF HYDROLYTIC ENZYMES OF THE FEMALE RAT REPRODUCTIVE TRACT.

Authors
ROBBOY, SJ; KAHN, RH
MLA Citation
ROBBOY, SJ, and KAHN, RH. "ELECTROPHORETIC SEPARATION OF HYDROLYTIC ENZYMES OF THE FEMALE RAT REPRODUCTIVE TRACT." Endocrinology 75 (July 1964): 97-103.
PMID
14198302
Source
pubmed
Published In
Endocrinology
Volume
75
Publish Date
1964
Start Page
97
End Page
103
DOI
10.1210/endo-75-1-97

ELECTROPHORETIC SEPARATION OF HYDROLYTIC ENZYMES OF THE FEMALE RAT

Authors
ROBBOY, SJ; KAHN, RH
MLA Citation
ROBBOY, SJ, and KAHN, RH. "ELECTROPHORETIC SEPARATION OF HYDROLYTIC ENZYMES OF THE FEMALE RAT." Endocrinology 75 (1964): 97-103.
Source
scival
Published In
Endocrinology
Volume
75
Publish Date
1964
Start Page
97
End Page
103
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