The beginnings of pathology in America: a contemporary analysis of William E. Horner's A Treatise on Pathological Anatomy.

CONTEXT: A Treatise on Pathological Anatomy, published in 1829 by William E. Horner, is the first American textbook on pathology. Several articles have been written on Horner, but they do not evaluate the role that the knowledge he recorded played on the intellectual origin of the discipline of pathology in America. Only one article, published in 1930, deals in some detail with the content of the Treatise. Because of new historiographic standards, this is an opportunity to expand on, and update, that article. Furthermore, Horner's book is now available free online, and print-on-demand paperback copies can be ordered for a modest cost from online booksellers. OBJECTIVE: To describe the organization and structure of the scientific knowledge found in the Treatise with the intent of demonstrating how this material created the intellectual basis for the origin of pathology as a discipline in America. DESIGN: Using current historiographic standards, the knowledge included in the book is examined and contextualized within the social, professional, and educational conditions existing at the time of publication. The essay also includes biographic data on the author. RESULTS: The Treatise contains important information on the principles, ideas, and practice of pathology in the nineteenth century and illustrates the influence of French literature on the author. CONCLUSION: The contribution of the Treatise as the first formal textbook on the subject in America is seminal and should be the basis for further historic studies on the organization and structure of scientific knowledge in pathology in America.

Dedifferentiated liposarcoma with a paraganglioma-like histologic pattern: a case report and review of the literature.

A 53-year-old man presented with a 4-month history of increasing abdominal discomfort and distension. A large retroperitoneal mass was found on imaging. Image-guided needle core biopsy demonstrated a poorly differentiated malignant neoplasm. A 30 x 32 x 33-cm soft tissue mass was removed. Microscopically, the tumor consisted of predominantly epithelioid malignant cells arranged in a paraganglioma-like growth pattern. Immunohistochemically, these cells were strongly positive for neuron-specific enolase. Stains for synaptophysin and chromogranin, however, were negative. There was no ultrastructural evidence of neuroendocrine differentiation. Adjacent sarcomatous areas were composed of spindled cells arranged in storiform and fibrosarcoma-like growth patterns. A small area of well-differentiated liposarcoma was identified, and a diagnosis of dedifferentiated liposarcoma was established. To the best of our knowledge, this represents the first reported case of dedifferentiated liposarcoma with a paraganglioma-like histologic pattern. A brief review focusing on the morphologic variations of dedifferentiated liposarcoma is also presented.

Transmission electron microscopy of fine needle aspiration biopsies of metastases. Accuracy of both techniques as established by biopsy diagnoses.

OBJECTIVE: To determine the accuracy of fine needle aspiration biopsy in establishing the primary on cytology and on cytologic and electron microscopy examinations using tissue biopsy as the gold standard. STUDY DESIGN: A retrospective study of 96 nonrandomly selected cases of metastases with an unknown primary was carried out. Tissue biopsy was performed subsequently for confirmation. Proper clinical correlation was part of the analysis. RESULTS: The accuracy of cytology in identifying the tumor category (e.g., carcinoma, sarcoma) and tumor type (e.g., adenocarcinoma, leiomyosarcoma) was 76% and 78%, respectively, while that of electron microscopy was 95% and 91%, respectively. The primary site was correctly identified by cytology in 59% and by electron microscopy in 88% of cases, provided that clinical parameters were also considered. CONCLUSION: Electron microscopy is an ancillary technique useful in increasing the accuracy of tumor classification of metastatic neoplasms identified by fine needle aspiration biopsy.