[THE RESULTS OF IRRADIATION THERAPY ON MALIGNANT TUMOR. 3. ON MALIGNANT LYMPHOMA (LYMPHOSARCOMA AND RETICULOSARCOMA)].
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One hundred ninety patients who had advanced active Hodgkin's disease, lymphosarcoma, or reticulum cell sarcoma were treated with a combination of cyclophosphamide, vincristine, procarbazine, and prednisone (COPP) given in a cyclical fashion every month. Complete remission was produced in 91 of 138 (66%) patients with Hodgkin's disease and in 39 of 52 (75%) patients with non-Hodgkin's lymphoma (lymphosarcoma and reticulum cell sarcoma). The response rate was higher in patients who completed six cycles of therapy compared to those who completed only three to five cycles: 77% vs. 45%, respectively, in Hodgkin's disease, and 85% vs. 46%, respectively, in non-Hodgkin's lymphoma. The median duration of remission was longer for Hodgkin's disease patients who completed six cycles (30 months vs. 10 months). The median duration of complete remission of non-Hodgkin's lymphoma was 14 months. The response to treatment correlated positively with survival. The median survival time start of COPP treatment for patients with Hodgkin's disease was 7 months for nonresponders, 14 months for those who attained partial remission, and more than 48 months for those who attained complete remission. For patients with non-Hodgkin's lymphoma, the median survival time from start of COPP treatment was 24 months for nonresponders and those who had partial remission, and more than 32 months for those who attained complete remission. Of complete remission responders with Hodgkin's disease, 70% are still alive 84 months after diagnosis, and 63% of the patients witn non-Hodgkin's lymphoma are still alive 48 months after diagnosis.
The nude mouse bearing a human tumor heterotransplant is a useful model for studying the tumor localization of radiolabeled compounds. The biological tissue distribution of carbon 14-labeled alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid, was determined in nude mice bearing human malignant melanoma heterotransplants in order to investigate the feasibility of using carbon 11 (t 1/2, 20.4 min)-labeled AIB for the visualization of human melanoma in vivo with positron emission tomography (PET). Our laboratory has previously demonstrated the use of 11C-labeled AIB as a tumor-imaging agent in a number of animal tumor models. The mean relative concentration of 14C-labeled AIB in tumor tissue at 45 min was 1.95 in this melanoma model. Tumor/blood and tumor/muscle ratios at 45 min postinjection were 5.42 and 12.2, respectively. These values suggest that 11C-labeled AIB may be useful for the in vivo study of malignant melanoma in humans. Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid, is thought to be actively accumulated into viable cells primarily by the A-type, or "alanine-prefering", amino acid transport system. AIB has been labeled with the short-lived, positron-emitting radionuclide, carbon 11 (t 1/2, 20.4 min), using a modified Bucherer-Strecker synthesis for amino acids. 11C-labeled AIB has been used to visualize tumors in dogs bearing spontaneous cancers, such as adenocarcinoma, lymphosarcoma, and osteogenic sarcoma, by utilizing positron-emission tomography (PET) and high-energy gamma (HEG) scintigraphy at the Sloan-Kettering Institute.(ABSTRACT TRUNCATED AT 250 WORDS)
This survey comprised thirty-four patients who were suffering from malignant tumors of the oral cavity diagnosed in a 12-year period in the Department of Oral Surgery, Royal Dental College, Aarhus, Denmark. The categories of tumors were as follows: carcinomas (twenty-seven), osteosarcomas (four), reticulum-cell sarcomas (two), and lymphosarcomas (one). Special emphasis is placed upon the calculation of two time factors, i.e., the time that elapsed from when the symptoms were first noticed until the patient consulted a physician or dentist, and the period during which the patient was under professional care up to the time at which a final diagnosis was made. The first of these periods was found to be, on an average, 4.9 months; the second period averaged 5.6 months. The most common complaints were swelling and pain, two symptoms with which the physician or surgeon often are confronted. This may be a possible reason for a relatively late diagnosis in the case of several malignant tumors. A frequently very suspect symptom, such as a persistent ulceration, was found in only thirteen of twenty-seven cases of carcinoma, whereas another symptom in the same category, disturbances in sensibility, was noted in only three cases. Because of the short observation period in some cases, no correlation between the two time factors and the prognosis was attempted. Despite the inadequacy, it may be concluded that the period of 5.6 months which in this material was found to elapse between the first consultation and the actual time of diagnosis was far too long. All lesions that do not respond to adequate therapy in 14 days should be suspected of being malignant, and the patient should be referred to a specialist for proper diagnosis.
The clinical and pathological findings of 28 cases (27 horses, 1 donkey) of equid sinonasal tumours examined at the Edinburgh Veterinary School are presented and include: seven cases of squamous cell carcinoma (SCC); five adenocarcinomas; three undifferentiated carcinomas; two adenomas; five fibro-osseous and bone tumours; and single cases of ameloblastoma, fibroma, fibrosarcoma, undifferentiated sarcoma, melanoma and lymphosarcoma. The median ages of animals affected with epithelial, and fibro-osseous/bone tumours were 14 and 4 years, respectively. Unilateral purulent or mucopurulent nasal discharge (81% of cases) and gross facial swellings (82% of cases) were the most common presenting signs with sinonasal tumours, with epistaxis recorded in just 23% of cases. Radiology and endoscopy were the most useful ancillary diagnostic techniques. The maxillary area was the most common site of tumour origin, and only three cases were definitively identified as originating in the nasal cavity. Four of the maxillary SCC lesions originated within the nasal cavities or maxillary sinuses, while two originated in the oral cavity. Fourteen of 15 carcinomas, but only two of the 13 remaining tumours, spread to other sites in the head. Only three cases of sinonasal tumour had lymph node metastases, and none had distant metastases. In the long term, surgical treatment with seven malignant tumours was unsuccessful (6 months median survival post-operatively), but was successful with four out of five benign tumours (no regrowth at a median of 4 years post-operatively).
Sections of 47 skin biopsies diagnosed during 1960-1970 as suggestive of or diagnostic of malignant lymphoma were retrospectively analyzed. Thirteen with monomorphous cutaneous infiltrates of reticulum cells or poorly differentiated lymphocytes were encountered; all were from patients who had extracutaneous manifestations of reticulum-cell sarcoma, poorly differentiated lymphosarcoma, or leukemia at the time of biopsy or within a year after biopsy. Diagnosis of well-differentiated lymphosarcoma or leukemia cutis is more tenuous, since mature lymphocytic infiltrates were encountered in patients with or without evidence of extracutaneous lymphoma. These are designated "unclassified" lymphocytic infiltrates of skin, requiring careful clinical exclusion of these types of malignant lymphoma. Other purported histopathologic discriminants of malignant lymphoma and pseudolymphoma, the latter term utilized to designate banal disorders characterized by a polymorphous infiltrate with or without atypical reticulum cells, are of little value for their distinction. These diagnostic criteria for malignant lymphoma cutis should clarify much of the pathologic and clinical uncertainty attendant upon the so-called "lymphoreticular" infiltrates of the skin.
The most common locations of tumours in 22 sheep with malignant lymphoma were the lymph nodes (19 sheep), spleen (14), liver (13), kidney (10), small intestine (9) and heart (9). The distribution of the lesions could be classified as multicentric (14 sheep, alimentary (6), skin (1) and thymic (1). Histological examination of malignant lymphomas from 40 sheep showed there were three reticulum cell sarcomas, and 37 lymphosarcomas. The lymphosarcomas were further classified on the basis of cytological features as lymphoblastoid, lymphocytic/prolymphocytic, prolymphocytic and lymphocytic in 14, 6, 11 and six cases, respectively. Viruses were not detected by electron microscopy in tumourous tissue from 10 sheep with malignant lymphoma.
A dihydro derivative of karminomycin was prepared using chemical reduction with potassium boron hydride. When dihydrokarminomycin was administered intravenously to healthy albino mice in a single dose it practically showed the same toxicity as karminomycin. However, unlike the latter dihydrokarminomycin induced the death of the animals at later periods of time. Studies on mice with transplantable tumours showed high antitumor activity of dihydrokarminomycin against lymphosarcoma L10-1, sarcoma 180, Garding-Passy melanoma, lymphoid leukosis L-1210 and lymphocytal leukosis P-388. In treatment of the mice with leukosis L-1210 and Garding-Passy melanoma dihydrokapminomycin was much inferior by its efficiency than karminomycin.
The classification of lymphoreticular tissue tumours is still confused. The tumours themselves take many forms and tissue reaction may be such as to preclude a clear distinction between neoplastic and inflammatory processes. This has led to what Willis called a chaos of definitions. The grouping proposed by Gall and Mallory in 1942 is still valid and includes Hodgkin's disease, lymphosarcoma, reticulum cell sarcoma, and follicular lymphoma. Its basis is both clinical and histological, particularly the latter; vary slight differences between the respective histological pictures and the possibility of transition forms. True leukaemias, however, must be excluded.
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Three-week-old to 12-month-old male Syrian hamsters were inoculated iv with 10(8.5) median tissue culture infective dose of simian virus 40 (SV40). Three-week-old hamsters were similarly inoculated with aliquots of SV40 of progressively decreasing titers. The tumor incidence and, to a lesser extent, the tumor latency were directly dependent on the age of the animals at the time of virus exposure and on the dose of the virus. However, this age-dose dependence was not of the magnitude usually observed in hamsters inoculated with SV40 sc or im. Moreover, the wide morphologic spectrum of neoplasms induced, i.e., lymphosarcoma, reticulum cell sarcoma, and osteogenic sarcoma, by iv route of inoculation, contrasted sharply with the anaplastic and spindle-cell sarcomas which were the only types of malignant tumors resulting when other routes were used.
Review of the pathology of benign and malignant tumors of the adrenal gland. Generally, all neoplasms of the adrenal gland may show endocrine activity with respective clinical syndromes. Such syndromes may give first clues for the important differential diagnosis between hyperplasia and neoplasia. There is no correlation between morphology and function of the various tumors. Cancers of the adrenal cortex are extremely rare. They occur at any age. At infancy, neoplasms of the adrenal cortex are almost always hormonally active and malignant. Adenomas and carcinomas of the adrenal cortex are discussed with special reference to the difficulty of differential diagnosis. The prognosis of carcinomas of the adrenal cortex is poor. The five years' survival rate amounts to 10--25%. The dignity of phaeochromocytoma can hardly be established by morphology alone. Most of them are benign. Metastases of these tumors are the only certain criterion of malignancy. Neuroblastoma metastasizes very early and--in case of bone marrow involvement--must be separated from lymphosarcoma, Ewing's sarcoma, and from undifferentiated leukemias. Cysts of the adrenal gland are very rare but they are important in the differential diagnosis of adrenal masses. Finally, tumors like myelolipoma are briefly discussed.
Antitumor activity of karminomycin used perorally was studied with respect to 3 strains of mouse transplantable tumors, i. e. one ascitic strain of lymphadenosis NK/LI and two solid strains of lymphosarcoma L10-1 and sarcoma 180. Karminomycin was shown to have a high antitumor activity against the above tumors on its oral administration. In the experiments with lymphadenosis NK/LI the efficiency of karminomycin was higher when it was used perorally as compared to its intravenous administration. It was found that karminomycin had practically the same inhibitory effect on growth of lymphosarcoma L10-1 and sarcoma 180 on its peroral and intravenous administration in doses equivalent by their toxicity.
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The total concentrations of alpha(2) globulin and two of its components, haptoglobin and caeruloplasmin, have been determined in the sera from 78 patients with primary malignant diseases of lympho-reticular tissue (reticuloses). The total alpha(2) globulin fraction was significantly raised only in Hodgkin's disease. The serum haptoglobin was also significantly increased in Hodgkin's disease and some other reticuloses, including acute leukaemia, lymphosarcoma, and reticulum cell sarcoma. The serum level of caeruloplasmin was raised in all reticuloses. There was possibly some correlation between the rise in haptoglobin and caeruloplasmin concentrations and the total alpha(2) globulin in Hodgkin's disease but this was not statistically significant. The significance of these results is discussed, and it is concluded that the increase in alpha(2) globulin which occurs in Hodgkin's disease is due to an increase in several of its components and not to a single component.