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Biomedical subjects

A H Tulusan

Publications and source records attributed to A H Tulusan.

At least 55 records · Page 3Linked to original sources

[The role of mammography in the diagnosis of simultaneous second cancers in the contralateral breast].

In 1048 breast cancer patients, operated in the period 1969-1985 at the University of Erlangen Clinic of Obstetrics and Gynecology, estimations were made to determine the relative contribution of mammography and meticulous histology to the diagnosis of simultaneous contralateral cancer. The incidence of a bilateral simultaneous disease was 17% (6.1% invasive forms, 10.6% in situ). Complete histological examination of the extirpated tissue as well as the occurrence of discrete radiological signs could account for the detection of 41% of all invasive and 39% of all in situ forms respectively. Those contralateral breast cancer cases detected just by means of mammography, but without any presence of clinical signs, recorded an average diameter of 9 mm and in 20% had metastacised to the axillary lymph nodes. Comparatively, clinically and radiologically diagnosed cases were 17 mm on average and the occurrence of axillary lymph node involvement was 41%. The conclusion is drawn, that a meticulous diagnostic effort is necessary in view of the high incidence of occurrence of simultaneous cancer on the other breast and the prognostic importance of an early diagnosis for many patients. Every minute radiologically detected sign in the other breast of patients with mammary carcinoma requires careful diagnostic clarification. However, it should be considered that the data presented were gathered in a situation in which the radiologist performed the X-ray examination, knowing that an excision would have been carried out in 85 percent of all cases even without his specific localisation. The presence of additional risk factors (lobular cancer, multicentricity and family history of breast cancer) make such an effort justified and obligatory as well.

Biopsy↗

A contribution to the natural history of breast cancer. V. Bilateral primary breast cancer: incidence, risks and diagnosis of simultaneous primary cancer in the opposite breast.

Tissue from contralateral breast was taken from 505 patients with invasive breast cancer. Every 5th patient had simultaneous carcinoma in the opposite breast, 7.7% (39/505) had invasive cancer, and 13.1% (66/505) had carcinoma in situ. Invasive cancers in the opposite breast were diagnosed at an earlier stage as compared with the neoplasm of the primary breast. However, 26% of the patients already had positive axillary nodes. The following risk indicators of the bilateral disease were found: age at time of diagnosis, histologic type of tumours, familial breast cancer, suspicious mammography, P2/DY-breast parenchymal pattern (Wolfe) and multicentric cancer of primary breast. Our findings support the proposal to consider bilaterality of breast cancer as a sign of systemic disease of the breasts, involving the ductal and lobular system within eight quadrants of a paired organ (Ober).

Age Factors↗

Incidence of double minutes, cytogenetic equivalents of gene amplification, in human carcinoma cells.

Screening of the occurrence of double minutes (DM) was performed in more than 1,000 metaphases obtained from a total of 22 solid human breast tumours and more than 3,600 metaphases from a total of 55 malignant effusions (45 patients with different types of carcinomas). DM were observed in 15 of these breast tumor cases and in 34 of the effusions (obtained from 29 cancer patients). The percentage of cells exhibiting DM as well as the number of DM per respective cell varied widely. It could be seen that metastatic cells from malignant effusions exhibited on the average more DM per cell than did cells of primary breast carcinomas. Differences in the incidence of DM could be observed between different carcinomas as well as between different age groups. In addition, it did not appear that DM could be induced by mutagenic tumor therapy. DM are thus not a rare finding in human solid tumors but, as cytogenetic equivalents of gene amplification, they rather represent a fundamental biological characteristic of tumor development.

Breast Neoplasms↗

[How 67 carcinomas of the breast with a maximal microscopic diameter of 10 mm were recognized].

67 breast cancers with a maximum diameter of up to 10 mm on the histological section were retrospectively analysed according to the primary situation for medical consultation and the way to cancer diagnosis. 46 women presented themselves with clinical signs. 19 women had an anamnestical risk, whereas only two women were without any risks or symptoms. 34 tumourspecific clinical signs are followed by 25 tumourspecific mammograms. Eight small invasive carcinomas were detected only under the microscope, two of them in mastectomy specimens. Even small cancers, therefore, are mostly diagnosed from the patients themselves. The contribution of mammography is tremendous. Intensified systematic histological examination of biopsies and mastectomy specimens is mandatory especially in high risk patients.

Breast Neoplasms↗

Correlations of the receptor content and ultrastructure of breast cancer cells.

Receptor assay results were compared with the ultrastructure of 127 breast cancers (112 primary tumors, six recurrent lesions, nine metastases). Tumors were considered to be receptor positive if the receptor levels were greater than or equal to 15 fmol/mg of soluble tissue protein. Most breast cancer had heterogenous cells with different grades of ultrastructural differentiation. a prevalence of well-differentiated cancer cells and an abundance of intracytoplasmic vacuoles had a significant correlation with a positive estrogen receptor status. The correlation was better than between malignancy grades and receptor content. The type of breast cancer and the menopausal status bore no relation to receptor content. Progesterone receptors were found in well-differentiated tumors of low malignancy.

Breast Neoplasms↗

A contribution to the natural history of breast cancer. III. Changes in the basement membranes in breast cancers with stromal microinvasion.

Twenty-eight small breast cancers and 17 other breast cancer specimens from which appropriate semi-thin sections had been prepared were examined by electron microscopy and special staining techniques for alterations in the basement membranes and the basal lamina. In each case disruptions of the basement membranes were invariably observed at the point of initial invasion. Two types of invasion were noted: (1) bud-like protrusions of intraduct cancer with disruption of the basement membranes at the point of invasion; (2) extensive basement membrane defects with single cancer cell invasion. Our study confirms that invasive breast cancer originates in intraductal or lobular carcinoma in situ.

Basement Membrane↗

A contribution to the natural history of breast cancer. IV. Lobular carcinoma in situ and its relation to breast cancer.

We studied 52 patients with lobular carcinoma in situ (LCIS) of the breast, tissue being available from both breasts in 46 patients. Detailed histological examination of the tissue was combined with specimen radiography. By this technique, six invasive cancers were detected within 2 years of the primary diagnosis. five of these six carcinomas were clinically occult and were not suspected at specimen radiography. Three other invasive cancers were discovered 4 years, 7 years, and 10 years after diagnosing LCIS. The extent of the LCIS in the primary biopsy was the only feature which gave a guide to the possible presence and location of an occult invasive lesion.

Biopsy↗

Histological features of "pagetoid reticulosis" (Woringer-Kolopp) in pre-mycosis fungoides.

The case of a 66-year-old female with chronic skin lesions is described, which clinically resembled parakeratosis variegata but histologically showed the pattern of "pagetoid reticulosis" (Woringer-Kolopp). The intraepidermal pagetoid cells were lymphoid cells which, by electron microscopy, could be identified as small Sézary cells. The intraepidermal presence of numerous atypical reticulum cells does not support the theory of "pagetoid reticulosis" as a separate nosological entity, but rather stresses the epidermotropic character of (pre-)mycosis fungoides just known from intraepidermal Pautrier microabscesses.

Aged↗

Morphologic differential diagnosis of idiopathic cardiomyopathies.

Scanning electron microscopic examination of the myocardium in cardiomyopathies is a valuable complementary method beside light and transmissionelectron microscopy for the differential diagnosis of this rare disease. In two cases of congestive cardiomyopathy no marked alterations of the myocardial architecture could be found whereas in one case of nonobstructive hypertrophic cardiomyopathy myocardial cell alterations and structure disorders could be demonstrated in an almost stereologic view. The pathogenesis of heart failure in this disease was clearly shown. Similar changes were not observed in hearts without cardiomyopathy or in other forms of cardiac hypertrophy.

Autopsy↗