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A R Frost

Publications and source records attributed to A R Frost.

At least 37 records · Page 2Linked to original sources

Changes in cyclin dependent kinase inhibitors p21 and p27 during the castration induced regression of the CWR22 model of prostatic adenocarcinoma.

PURPOSE: The expression of the cyclin dependent kinase inhibitors p21 and p27 was examined in prostatic adenocarcinomas following castration. MATERIALS AND METHODS: Male nude mice inoculated with the androgen dependent human prostatic tumor CWR22 were castrated when the tumors reached a volume of 0.8 to 1.1 cm.3 and were sacrificed at 3, 7, 21, 28 and 42 days post-castration. An additional group of mice received a subcutaneous testosterone pellet at 21 days post-castration and was sacrificed at 28 days post-castration. The expression of the Ki-67 antigen, p21 and p27 was examined by immunohistochemistry. RESULTS: The mitotic rate as well as the number of Ki-67 antigen positive cells decreased to 3% of intact control values by 7 days post-castration and were less than 0.01% of intact control values at 21, 28 and 42 days post-castration. The percentage of p21 expressing cells decreased from 15+/-2% in intact controls to less than 1% by 42 days post-castration. In contrast, the percentage of cells that expressed p27 increased from 25+/-3% in intact controls to 51+/-8% at 3 days post-castration and to 80 to 95% at days 7, 21, 28 and 42 days post-castration. Testosterone treatment from 21 to 28 days post-castration resulted in an increase in Ki-67 antigen positive cells to 200% of intact controls and a concomitant reduction in p27 expressing cells to about 50% of intact controls. Castration-induced changes in p27 expression were not observed in the CWR22R tumor, a transplantable relapsed derivative of the CWR22 tumor. CONCLUSION: These findings suggest that p27 expression is regulated negatively by androgens and that increased expression of p27 in CWR22 xenografts may be involved in the suppression of proliferation following castration.

Adenocarcinoma↗

The stability of estrogen and progesterone receptor expression on breast carcinoma cells stored as PreservCyt suspensions and as ThinPrep slides.

BACKGROUND: Analysis of estrogen receptor (ER) and progesterone receptor (PR) status is an important ancillary test in the evaluation of positive breast fine-needle aspirates. This study compares the detection of ER and PR in breast carcinoma cells suspended in PreservCyt with that achieved with stored ThinPrep slides (TP). METHODS: ER and PR positive mammary tumor cells (cell line ZR-75-1 spiked in PreservCyt by the American Type Culture Collection) were used to evaluate the stability of immunodetection of ER and PR under two conditions: 1) TP slides prepared immediately from PreservCyt and stored air-dried (stored TP) for up to 56 days, and 2) TP prepared from cells suspended in PreservCyt (newly prepared TP) on Days 1, 2, 5, 14, 21, 42, and 56. At each of the time periods, stored TP and newly prepared TP were analyzed for ER and PR using the same immunocytochemical staining protocol. The percentage of positive cells was calculated by counting 1000 cells/TP. RESULTS: Positivity for ER and PR was demonstrated in both stored TP and newly prepared TP on Days 1, 2, 5, 14, 21, 42, and 56. Over the 56-day period, the number of ER positive cells ranged from 41% to 57% in stored TP and from 38% to 58% in newly prepared TP. The number of PR positive cells ranged from 31% to 41% in stored TP and from 26% to 37% in newly prepared TP. Mild, nonspecific cytoplasmic and nuclear staining occurred in all newly prepared TP (PR > ER). CONCLUSIONS: ER and PR antigenicity was preserved in both stored TP and newly prepared TP of mammary tumor cells over a 56-day storage period. This demonstrates that ER and PR status can be evaluated in cytologic material from breast carcinoma using the ThinPrep technique.

Biopsy, Needle↗

Utility of thin-layer preparations in thyroid fine-needle aspiration: diagnostic accuracy, cytomorphology, and optimal sample preparation.

BACKGROUND: The efficacy of preparing thyroid fine-needle aspirations (FNAs) as thin-layer slides has not been evaluated extensively. METHODS: To evaluate the efficacy of thin-layer cytology, the authors examined thyroid FNAs from 135 unselected palpable lesions that were aspirated using uniform procedures and prepared as air-dried, Diff-Quik-stained direct smears (DS) and Papanicolaou-stained thin-layer slides (TL). Diagnoses rendered independently on masked slides from each thyroid nodule were compared with the reported final cytologic or histologic diagnoses based on all available pathologic material. Slides were analyzed for diagnostically important cytologic features and the optimal number of TL slides per sample was assessed. RESULTS: TL diagnoses agreed with final diagnoses in 85% of cases compared with 96% for DS. All 11 neoplasms were recognized in both preparations. A final diagnosis of chronic lymphocytic thyroiditis (CLT) was missed in 10 of 26 TL (39%) compared with 2 of 26 DS (8%) (P = 0.013, McNemar's test). Cytologic features appreciated less often in TL than DS (McNemar's test) included diffuse colloid, spherules, tissue fragments, and lymphocytes. Multinucleated giant cells were identified more often in TL than DS. Two TL slides were sufficient for diagnosis in 83% of cases. CONCLUSIONS: The diagnostic accuracy of TL was 85% compared with 96% for DS. CLT was diagnosed accurately in 62% of TL compared with 92% of DS. Cytologic features in TL and DS may differ. Preparation of only two TL slides is adequate for definitive diagnosis in most cases.

Biopsy, Needle↗

Interobserver variability in the classification of proliferative breast lesions by fine-needle aspiration: results of the Papanicolaou Society of Cytopathology Study.

This study evaluates the applicability of the published cytologic criteria in the categorization of proliferative breast lesions by assessing the diagnostic accuracy and interobserver reproducibility of a panel of experts. Twelve breast fine-needle aspiration (FNA) specimens of biopsy-proven nonproliferative breast lesion (NPL) (1 case), proliferative lesions without atypia (PL) (7 cases), proliferative lesion with atypia (PLA) (1 case), and low-nuclear grade ductal carcinoma in situ (DCIS) (3 cases) were selected. Six FNAs were Papanicolaou (PAP) and 6 were Diff-Quik-stained (DQ). Six expert cytopathologists classified the smears using a summary of published criteria as a guideline. All 6 participants rendered the same cytologic diagnosis in 2/12 (16%) cases. The agreement among the 6 raters was low (Kappa = 0.35). Cytohistologic correlation was achieved in 26/72 (36%) FNA diagnoses. The correlation of the PAP-stained cases was better than the DQ: 17/36 (47%) PAP and 9/36 (25%) DQ correlated. Improving the correlation was achieved by amalgamation of NPL and PL into "low risk" and PLA and DCIS into "high risk" categories: 47/72 (65%) FNA diagnoses then correlated with histology [29/36 (81%) PAP and 18/36 (50%) DQ]. We conclude that the cytologic criteria of proliferative breast lesions need to be further defined and assessed. Consideration should be given to minimizing the number of diagnostic categories and adopting a terminology that has a direct effect on patient management.

Adult↗

Can nonproliferative breast disease and proliferative breast disease without atypia be distinguished by fine-needle aspiration cytology?

BACKGROUND: Cytologic criteria reported to be helpful in the distinction of proliferative breast disease without atypia (PBD) from nonproliferative breast disease (NPBD) have not been rigorously tested. METHODS: Fifty-one air-dried, Diff-Quik-stained fine-needle aspirates (FNA) of palpable breast lesions with biopsy-proven diagnoses of NPBD (34 cases) or PBD (17 cases) were reviewed. The smears were evaluated for the cellularity, size, and architectural arrangement of the epithelial groups; the presence of single epithelial cells and myoepithelial cells; and nuclear characteristics. RESULTS: The only cytologic feature found to be significantly different between PBD and NPBD was a swirling pattern of epithelial cells. A swirling pattern was noted in 13 of 17 PBD cases (76%) and 12 of 34 NPBD cases (35%) (P = 0.008). CONCLUSIONS: Because there is significant overlap in cytologic features between NPBD and PBD, the distinction between the two entities is difficult in cytologic sampling.

Biopsy, Needle↗

In situ hybridization studies of metalloproteinases 2 and 9 and TIMP-1 and TIMP-2 expression in human prostate cancer.

The expression of MMP-2, MMP-9, TIMP-1, TIMP-2, and the urokinase receptor were examined in fetal and normal prostate tissues, benign prostatic hyperplasia and prostate cancer (n = 117). In situ hybridization with digoxigenin-labeled oligonucleotide probes demonstrated that TIMP-1 and TIMP-2 were expressed at elevated levels in the stroma of Gleason sum 5 tissues, whereas MMP-2 and MMP-9 were expressed at relatively low levels. In higher Gleason sum tissues (GS 8-10), TIMP-1 and TIMP-2 were not expressed, whereas MMP-2 and MMP-9 were intensely expressed. Furthermore, TIMP-1 and TIMP-2 expression was high in organ-confined specimens (OC, n = 43), somewhat lower in specimens with capsular penetration (CP, n = 29), and low or negative in samples with surgical margin/seminal vesicle (M/SV, n = 17) and lymph node (LN, n = 13) involvement. In contrast, MMP-2 and MMP-9 expression was low in the OC tissues; and noticeably higher in CP, M/SV, and LN specimens. Finally, correlation of TIMP and MMP expression with GS and pathological stage versus cure rate further revealed that a high percentage of organ-confined, GS 5 specimens expressing TIMP and little MMP were cured. In comparison, few of the GS 7-10 patients with capsular penetration and expressing MMP and little TIMP were cured. The data suggest that TIMP-1 (and TIMP-2) and MMP-2 (and MMP-9) are independent predictors of outcome.

Collagenases↗

Cytomorphology of cystic parathyroid lesions: report of four cases evaluated preoperatively by fine-needle aspiration.

Cystic parathyroid lesions (CPL) account for 1-5% of neck cysts. They are seldom palpable; however, they may present as neck swellings that are mistaken both clinically and cytologically for thyroid nodules and subsequently referred for evaluation by fine-needle aspiration. We present 4 cases of histologically confirmed CPL (one simple cyst, one hyperplasia, and two adenomas), 2 of which were misdiagnosed as adenomatoid thyroid nodules by fine-needle aspiration. Aspirated fluid from one patient was clear and colorless, a classic finding for parathyroid cysts, and contained high levels of C-terminal/midmolecule parathyroid hormone (CMPH). Fluids obtained from the remaining 3 patients were bloody to brown, resembling thyroid cyst fluid. In only 1 of the 3 patients, the fluid was analyzed and contained high levels of CMPH. Though cytologic features of parathyroid epithelium overlap with those of thyroid epithelium, distinguishing features such as unusual cytoplasmic vacuolization and granularity, and the absence of colloid, should raise suspicions of a parathyroid lesion. Fluid from CPL may not possess the classic appearance; however, identification of the subtler cytologic features with knowledge of relevant clinical data should prompt analysis of cyst fluid for CMPH, thus confirming the diagnosis and avoiding inappropriate therapy.

Adenoma↗

Aromatase and 17 beta-hydroxysteroid dehydrogenase type 1 in human breast carcinoma.

The in situ formation of estradiol plays an important role in the development and biological behavior of human breast cancer Aromatase and 17 beta-hydroxysteroid dehydrogenase type 1 (17 beta-HSD type 1) are two principal enzymes involved in in situ estradiol production. We evaluated the expression of aromatase and 17 beta-HSD type 1 by immunohistochemistry in 41 cases of invasive breast carcinoma (19 lobular and 22 ductal). We then examined the correlation among the expression of these enzymes, estrogen (ER) and progesterone (PR) receptor status, Ki67 labeling index of carcinoma cells, age, and the clinical stage of the patients. Marked aromatase immunoreactivity was observed in stromal cells around carcinomatous glands in 32 of 41 cases (78%), and 17 beta-HSD type 1 immunoreactivity was detected in carcinoma cells in 23 of 41 cases (56%). There was a significant correlation observed between expression of 17 beta-HSD type 1 and aromatase in invasive lobular carcinoma (P = 0.0119), but not in invasive ductal carcinoma. There was an inverse correlation between aromatase and ER status in invasive ductal carcinoma (P = 0.0213), but not in invasive lobular carcinoma. No other correlations were observed among 17 beta-HSD type 1, aromatase, PR, ER, clinical stage, age, and Ki67 labeling indexes. Aromatase and 17 beta-HSD are not always expressed simultaneously in human breast carcinoma, but their simultaneous expression is more frequent in invasive lobular carcinoma than invasive ductal carcinoma. Consequently, different mechanisms may be involved in the regulation of expression of these two enzymes in human breast carcinoma.

17-Hydroxysteroid Dehydrogenases↗

DNA analysis and S-phase fraction determination by flow cytometric analysis of infiltrating lobular carcinoma of the breast.

Flow cytometric analysis was performed on 50 infiltrating labular carcinomas (ILCs) of the breast from 50 patients with clinical follow-up (average duration, 4.1 yr) who had been treated between 1976 and 1991. The patients were classified as alive with no evidence of disease, alive with disease, or dead of disease. Ploidy and S-phase fraction (SPF) were compared with clinical outcome, histologic pattern (classical versus variant patterns), nuclear grade 1 or 2, axillary lymph node status, tumor size, percentage of signet ring cells, and estrogen receptor status. There was no association between aneuploid or diploid ILC and disease recurrence (of those patients classified as alive with no evidence of disease plus dead of disease, 4 (40%) of 10 were aneuploid and 15 (38%) of 40 were diploid), survival (of those classified as alive with no evidence of disease plus alive with disease, 9 (90%) of 10 were aneuploid and 36 (90%) of 40 were diploid), or any of the other factors evaluated. However, ILCs with a high SPF were more likely to recur than those with a low SPF (a high SPF was found in 9 [56%] of 16; a low SPF was found in 9 [30%] of 30), but this relationship was not statistically significant (P = 0.08). When only diploid ILCs were considered, there was a statistically significant association between high SPF and recurrence (a high SPF was found in 9 [64%] of 14, a low SPF was found in 6 [24%] of 25, P = 0.033). After the stratification of the diploid ILCs by the stage of disease, this relationship persisted only in Stage 1 (recurrence: a high SPF was found in 3 [75%] of 4; a low SPF was found in 1 [9%] of 11, P = 0.033). There was no association between SPF and any of the other factors evaluated. Our study indicates that ILC is usually diploid and that SPF may be a prognostic indicator that is limited to Stage 1 disease.

Breast Neoplasms↗

The significance of signet ring cells in infiltrating lobular carcinoma of the breast.

To determine the prognostic significance of signet ring cells in infiltrating lobular carcinomas, the percentage of signet ring cells in 99 infiltrating lobular carcinomas was correlated with the patients' clinical outcomes (mean follow-up interval of 4.8 years). When the carcinomas were divided into those with 0%, 1-9%, and 10% or more signet ring cells, 57% (26/46) of patients with 10% or more signet ring cells had experienced recurrences or metastases compared with 40% (2/5) and 31% (15/48) with 0% and 1-9%, respectively. A similar analysis performed with breakpoints at 20% or 30% failed to yield any statistically significant associations. When patients were stratified by pathologic stage, patients with stage I disease and 10% or more signet ring cells were more likely to have recurrences or metastases than those patients with stage I tumors and fewer than 10% signet ring cells. There was no relationship between signet ring cells and disease progression in stages II, III, and IV. These results indicate that the presence of 10% or more signet ring cells represents a poor individual prognostic factor in stage I infiltrating lobular carcinomas.

Breast Neoplasms↗

ACTH-producing pituitary carcinoma presenting as the cauda equina syndrome.

A 43-year-old woman presented with incontinence, weakness, and paresthesia, consistent with the cauda equina syndrome, 10 years after having a pituitary tumor surgically removed and 4 years after excision of two "meningiomas" of the cervical cord. The patient was also hypertensive and had a cushingoid habitus. Emergent surgical decompression of the spinal cord revealed intradural metastatic adrenocorticotropic hormone-producing pituitary carcinoma. Pituitary carcinomas are rare. The majority of reported cases of adrenocorticotropic hormone-producing carcinoma have exhibited metastases outside the central nervous system. To our knowledge, this represents the first case of an adrenocorticotropic hormone-producing pituitary carcinoma presenting with the cauda equina syndrome. A review of all reported cases of pituitary carcinoma indicated that central nervous system metastases were more common than metastases to distant sites, and patients with distant metastases experienced a shorter duration of disease than did those with central nervous system metastases.

Adrenocorticotropic Hormone↗

An analysis of prognostic features in infiltrating lobular carcinoma of the breast.

To establish prognostically useful pathologic features for infiltrating lobular carcinoma, histologic pattern, nuclear Grade 1 or 2, lymphatic invasion, the presence and extent of lobular carcinoma in situ, estrogen and progesterone receptor status, axillary lymph node status, tumor size, and pathologic stage were assessed as prognostic variables in 92 cases of infiltrating lobular carcinoma. Clinical follow-up was obtained (mean duration, 5.2 yr), and patients were classified as alive with no evidence of disease, alive with disease, or dead of disease. Recurrence (alive with disease and dead of disease) was associated with axillary lymph node metastases (P = 0.04), tumors measuring > 1.0 cm (P = 0.008), and pathologic Stage III/IV disease (P = 0.033). Survival (no evidence of disease and alive with disease) was associated with Stage I/II disease (P = 0.003). Statistically insignificant associations with disease recurrence or survival follow: infiltrative pattern (classical, alveolar, solid, mixed), nuclear grade, lymphatic vessel invasion, presence of lobular carcinoma in situ, extent of lobular carcinoma in situ (< 25% or > or = 25%), and hormone receptor status. Many of the prognostic features used in ductal carcinoma do not appear to be applicable to infiltrating lobular carcinoma. However, tumor size, axillary node status, and pathologic stage are prognostically useful in infiltrating lobular carcinoma.

Axilla↗

Retrospective analysis of non-correlating cervical smears and colposcopically directed biopsies.

The purpose of this study is to evaluate the cause of discrepancies between non-correlating cytologic and histologic cervical samples. The biopsy results of 433 women examined colposcopically were compared to their referral cervical smears (RS). There was a discrepancy between the RS and the subsequent biopsy in 120 women (28%). One hundred of these 120 RS were available for review; and in each case, a reason for the discrepancy was established and classified as RS overcall, RS undercall, RS sampling error, or biopsy sampling error. Fifty-one discrepant RS were overcalled. They were reported initially as condyloma (19), mild dysplasia (22), and moderate dysplasia (10). One RS was undercalled. Nine RS were not diagnostic of the biopsy-proven lesion due to smear sampling error. The discrepancies in the remaining 39 cases were due to biopsy sampling error. Twenty-one of these 39 cases had additional biopsies or smears that confirmed the presence of condyloma/dysplasia, and 18 had negative follow-up. In summary, discrepancies were a result of pathologists' interpretative error, predominantly overcalls, in 52% of non-correlating cases, and smear or biopsy sampling error in the remaining 48%.

Biopsy↗

A comparison of the usefulness of electron microscopy and immunohistochemistry. One laboratory's experience.

As a quality assurance measure, the usefulness of transmission electron microscopy (EM) and immunohistochemistry (IHC) in our surgical pathology laboratory was compared. The surgical pathology reports from 150 consecutive neoplasms that were examined by both EM and IHC were reviewed. Based on the reported clinical histories, final diagnoses, light microscopy results, and the findings by EM or IHC, the contributions of EM and IHC were classified as "helpful" or "not helpful" for each specimen. Electron microscopy was helpful (92%) more often than was IHC (73%). Electron microscopy was most useful in further classifying poorly differentiated carcinomas, while IHC was particularly useful in classifying poorly differentiated neoplasms. Electron microscopy and IHC were of limited value in identifying the origin of metastatic carcinomas of an uncertain primary. All cases determined to be "not helpful" by either modality were further analyzed to establish a reason for the lack of information provided in each case. This analysis demonstrated a need for improved technical quality and ordering patterns of immunohistochemical stains in our laboratory.

Humans↗

"Signet Ring" sinus histiocytosis mimicking metastatic adenocarcinoma: report of two cases with immunohistochemical and ultrastructural study.

The axillary lymph nodes from two patients with invasive breast carcinoma showed "signet ring" histiocytosis with sinusoidal distribution of cells having prominent cytoplasmic vacuolization which simulated metastatic adenocarcinoma. Immunohistochemical studies confirmed the histiocytic nature of the signet ring cells and eliminated the possibility of metastatic adenocarcinoma. Electron microscopy in one case revealed lipid within the cytoplasmic vacuoles. The etiology of this reactive change is unknown; however, a history of previous surgery involving the chest wall may be causally related with disruption of adipose tissue. Prior to ipsilateral mastectomy both patients had undergone a contralateral mastectomy for mammary carcinoma. Signet ring sinus histiocytosis is a reactive sinusoidal proliferation that can mimic metastatic carcinoma, but close inspection will usually reveal the histiocytic nature of the cells.

Adult↗

The bone marrow in human immunodeficiency virus (HIV)-related disease. Morphology and clinical correlation.

To determine the true incidence of abnormalities in bone marrow specimens from patients infected with human immunodeficiency virus (HIV) and the clinical significance of these abnormalities regarding their cause and their role in the production of hematologic complications, 216 bone marrow biopsies, aspirates, and/or imprint preparations from 178 patients who either were seropositive for HIV infection or met the Centers for Disease Control (CDC) criteria for acquired immunodeficiency syndrome (AIDS) were studied. Detailed morphologic review was performed in a blind fashion as to clinical status. Extensive clinical, therapeutic, and laboratory data were collected for each patient. Statistical analysis was performed to detect significant correlations between morphologic findings and clinical/therapeutic/laboratory features. Among the most common bone marrow findings were hypercellularity (53% of specimens), myelodysplasia (69%), evidence of reticuloendothelial (RE) iron blockade (65%), megaloblastic hematopoiesis (38%), fibrosis (20%), plasmacytosis (25%), lymphocytic aggregates (36%), and granulomas (13%). A number of statistically significant correlations between morphologic findings and clinical features were noted. No significant association was detected between any morphologic finding and therapy with a variety of drugs. In 7 of 14 (50%) patients found to have marrow involvement by malignant neoplasm, the bone marrow represented the initial site of diagnosis of the neoplasm. Most of the bone marrow abnormalities associated with HIV infection appear to be related directly to the infection or its complications and not to therapeutic intervention. In certain clinical situations, bone marrow examination continues to be useful in the management of patients infected with HIV.

Adolescent↗

Cytologic features of ductal and lobular carcinoma in fine needle aspirates of the breast.

OBJECTIVE: To define cytologic criteria that reliably distinguish lobular (LC) and ductal (DC) carcinoma and classical LC from its variants-alveolar, solid and mixed infiltrative patterns. STUDY DESIGN: Fine needle aspiration (FNA) specimens from 29 cases each of histologically proven LC and DC were reviewed without knowledge of their histologic diagnoses. Malignant cells were seen and evaluated in 23 cases each of DC and LC (13 classic and 10 variant) for cellularity; cell size, pleomorphism and arrangement (group size, Indian filing, single cells); nuclear features (molding, nucleoli, intranuclear inclusions); and cytoplasmic features (vacuoles, signet-ring cells, granules). RESULTS: Features associated with LC included low cellularity (DC: 26%, LC: 70%), low pleomorphism (DC: 26%, LC: 61%), vacuoles (DC: 22%, LC: 61%), small nucleoli (DC: 43%, LC: 78%), and signet-ring cells (DC: 4%, LC: 48%). Features associated with DC included granular cytoplasm (DC: 39%, LC: 0%), high cellularity (DC: 57%, LC: 13%), high pleomorphism (DC: 48%, LC: 0%), medium to large nucleoli (DC: 35%, LC: 0%) and large sheets of cells (DC: 48%, LC: 17%). The range of cell size was larger in DC (1-20 times the size of RBCs) than in LC (1-8 times). Few cytologic differences were seen between the classic and variant patterns of LC. Variant patterns were slightly more likely to have intranuclear inclusions than classic LC; that was the only statistically significant difference seen. CONCLUSION: Most features studied were seen in at least a few examples of both DC and LC and in both classic and variant patterns of LC. However, some features were more characteristic of one entity than others.

Biopsy, Needle↗