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PubMed1993

Oat cell carcinoma of the gallbladder. A rare and highly lethal neoplasm.

Oat cell carcinomas arising in the gallbladder are an extremely rare and aggressive form of gallbladder cancer. These neoplasms are morphologically identical to their pulmonary counterparts, contain neurosecretory granules on ultramicroscopic examination, and demonstrate immunohistochemical staining for cytokeratin, neuron-specific enolase, and other neuroendocrine markers. Oat cell carcinomas typically occur in elderly women with cholelithiasis, and pursue a fulminant course with extensive metastases, especially to the liver. The mean survival is less than 7 months. We present a well-documented case of oat cell carcinoma of the gallbladder and review the literature on this unusual entity.

Aged↗
PubMed1999

Adenocarcinomas metastatic to the liver: the value of cytokeratins 20 and 7 in the search for unknown primary tumors.

BACKGROUND: Metastatic adenocarcinoma in the liver with an unidentified primary tumor site is a common clinical problem. Pathologists often are asked to identify the primary tumor site. The histologic picture itself usually is not helpful, because the histology may be similar in the metastases of tumors with different primary localizations. Immunohistochemistry can be helpful, but the previously recommended antibody panels are too complicated for everyday use. METHODS: A simple immunohistochemical algorithm with two monoclonal cytokeratin (CK) antibodies, CK20 and CK7, was tested on 93 autopsy cases of adenocarcinomas metastatic to the liver. Sections of the liver metastases were stained automatically and evaluated as negative (no staining), focally positive, or diffusely positive. Statistical comparison of the staining results for a single antibody was calculated as an odds ratio. RESULTS: Thirty-six of 93 (39%) metastases proved to be CK20 positive (+). In this group, the CK20+/CK7 negative (-) pattern was highly characteristic for colorectal localization of the primary tumor, having been observed 17 of 21 of the cases (81%). The CK20+/CK7+ pattern of the metastatic liver adenocarcinomas was highly suggestive of primary localization in the pancreas or biliary tract (11 of 14 cases; 79%). Exclusion of the tumors originating in the stomach raised these values to 94% and 92%, respectively. The statistically calculated predicted probability of primary tumor site being in the colon or rectum for CK20+/CK7- metastasis was 78,41%, the probability of a primary tumor being located in the pancreas or biliary tract was 74,85%, if calculated for the whole study group. CONCLUSIONS: The tested simple algorithm proved to be useful in CK20 positive (+) cases, predicting a primary tumor localization in the colon, rectum, pancreas, or biliary tract with high accuracy. The CK20- group was too heterogeneous to be classified adequately by these two antibodies.

Adenocarcinoma↗
PubMed1978

Radiographic evaluation of metastatic melanoma.

Malignant melanoma can potentially involve any organ system in the body once it metastasizes beyond the regional lymph nodes. A survey of the radiographic and associated clinical manifestations of metastatic melanoma is presented. The findings from 74 autopsies of patients who died of metastatic melanoma are included.

Adult↗
PubMed1994

Traditional and nontraditional histopathologic predictors of recurrence in uterine endometrioid adenocarcinoma.

Ninety-three consecutive operative cases of myometrial invasive endometrioid adenocarcinoma of the uterus without evidence of extrauterine spread at surgery were reviewed to determine whether any histopathologic features other than those traditionally reported might predict recurrence. Recurrence was associated with traditionally analyzed features of deep myometrial invasion, high FIGO grade, vascular space invasion, and cervical stromal invasion as well as patient age. In addition, a diffuse pattern of myometrial invasion was associated with an increased risk for recurrence. Contrary to results from previous studies, no increased risk was seen with high nuclear grade or the presence of perivascular lymphocytic infiltrates. When adjusted for traditional parameters, perivascular lymphocytes and a tumor-host inflammatory response were associated with prolonged time to recurrence. A desmoplastic host response or residual adenomyosis were unrelated to recurrence.

Abdominal Neoplasms↗
PubMed1991

[Surgical therapy of proximal bile duct cancer].

During the past 13 years a total of 60 patients (33 male, 27 female, median age 64.8 years) were operated upon and 21 of these patients underwent resection with a resectability rate of 35%. The remaining 39 patients had a palliative procedure. In 7 patients some form of bypass procedure was performed. 25 patients underwent some form of drainage procedure and in 7 patients only an explorative laparotomy was undertaken. Patients having resection surgery had a postoperative complication rate of 29% and there were 2 postoperative deaths (9.5%). The complication rate in the palliation group was 38%. The mean survival time in patients operated on with surgical resection was 34.1 months, palliative procedures 4.8 months and in patients with nonresectable tumors 3.6 months. In the resection group (n = 21) curative resection (= R0-resection) was performed in 14 patients, whereas in 7 patients there was a histologically invasion of the bile duct (= R1-resection). The mean survival time in the R0-group was 45.7 months and 11.8 months in the R1-group (Breslow p less than 0.0098, Mantel-Cox p less than 0.0070). We conclude that radical surgical resection offers the best possibility of prolonged survival with a good quality of life in patients with hilar cancer.

Aged↗
PubMed1989

Epithelial markers in synovial sarcoma. An immunohistochemical study on paraffin embedded tissues.

Immunohistochemical studies on synovial sarcomas have proved the potentiality of these neoplasm for epithelial and mesenchymal differentiation and antibodies detecting epithelial cells have been found to be helpful in determining the histological types. In this study different epithelial markers directed against various cytokeratins, HMFG-2 and EMA were investigated on paraffin embedded tissues of 13 cases of synovial sarcomas, with regard to their reliability in unmasking the epithelial components demonstrable in this type of neoplasm. The results lead to three conclusions: firstly, synovial sarcomas possess the capacity for generating different epithelial cell types with uncommon compositions of intermediate filaments as well as of membrane proteins, secondly, these features may be expressed in a heterogenous pattern even within the same tumour and finally, the use of wide range anti-cytokeratin antibodies covering the spectrum of basic as well as acidic type proteins seems to be necessary for the detection of all epithelial components demonstrable in synovial sarcomas.

Antibodies↗