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PubMed1991

Postresection autopsy findings in patients with cancer of the main hepatic duct junction.

Extensive resection of the bile ducts combined with hepatic resection is the procedure of choice for carcinoma of the main hepatic duct junction. Currently this procedure is done without great risk, and increasing long-term survival is now the issue. For this purpose, it is necessary to elucidate the biologic properties of the cancer to take reasonable measures. Autopsy findings of patients who died of recurrence may offer a reliable guide. Autopsy findings were studied in 14 patients: eight who had undergone curative resection and six who had received noncurative resection. Cancer recurred at the liver hilum with invasion into adjacent organs. Peritoneal dissemination and lymph node metastases were infrequent. These were common findings in both curative and noncurative resection groups. Cancer cells in the connective tissue of the hepatoduodenal ligament may play a major role in recurrence.

Adenocarcinoma↗
PubMed1982

Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma.

Epithelioid hemangioendothelioma is a unique tumor of adult life which is characterized by an "epithelioid" or "histiocytoid" endothelial cell. Forty-one cases of this rare tumor have been recognized at the Armed Forces Institute of Pathology. They may occur in either superficial or deep soft tissue, and in 26 cases appeared to arise from a vessel, usually a medium-sized or large vein. They are composed of rounded or slightly spindled eosinophilic endothelial cells with rounded nuclei and prominent cytoplasmic vacuolization. The latter feature probably represents primitive lumen formation by a single cell. The cells grown in small nests or cords and only focally line well-formed vascular channels. The pattern of solid growth and the epithelioid appearance of the endothelium frequently leads to the mistaken diagnosis of metastatic carcinoma. The tumor can be distinguished from a carcinoma by the lack of pleomorphism and mitotic activity in most instances and by the presence of focal vascular channels. Ultrastructural study in four cases confirmed the endothelial nature of the tumor in demonstrating cells surrounded by basal lamina, dotted with surface pinocytotic vesicles, and occasionally containing Weibel-Palade bodies. Follow-up information in 31 cases indicated that 20 patients were alive and well following therapy; three developed local recurrences and six metastases. It is suggested the term epithelioid hemangioendothelioma be used to designate these biologically "borderline" neoplasms. The significance of the epithelioid endothelial cell is not entirely clear. Since it may be observed in both benign and malignant vascular lesions, its presence alone does not define a clinicopathologic entity.

Adolescent↗
PubMed1982

Immunohistochemistry of soft tissue tumors. Myoglobin as a tumor marker for rhabdomyosarcoma.

Myoglobin, found exclusively in striated muscle, can be considered a fetal antigen. This study investigated its usefulness as a tumor marker for rhabdomyosarcoma (RMS) using an immunoperoxidase technique. Eight-nine percent (89%) or 27 rhabdomyosarcomas contained immunoreactive myoglobin. In contrast, all other soft tissue tumors (54), carcinomas (10), and numerous normal tissues including smooth muscle were negative. Among RMS, staining correlated directly with cytoplasmic differentiation regardless of histologic type. Importantly, six of nine small cell RMS with no initially appreciated cytoplasm were positive, although focally. Since the three negative RMS had only limited tissue available for study, it remains possible that all RMS would exhibit rare positivity if sizeable specimens were tested. Myoglobin should be considered an extremely sensitive and specific tissue tumor marker for rhabdomyosarcoma of considerable clinical importance.

Adult↗
PubMed1998

[Clinical significance of matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1 in peripheral blood of patients with gastric carcinoma].

Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in peripheral blood were measured in 54 patients with gastric carcinoma; 46 were primary and 8 were recurrent cases. There were no significant associations between MMP-9 concentrations and clinicopathological factors. TIMP-1 levels were significantly increased in advanced and recurrent cases, and in cases with peritoneal dissemination and lymph node metastasis, suggesting that TIMP-1 concentration in the peripheral blood could be a new tumor marker for the recurrence of gastric carcinoma.

Biomarkers, Tumor↗
PubMed1994

Casual discovery of Tc-99m MDP uptake for melanoma metastasis in soft tissue.

The authors report the casual discovery in 1991 of a metastasis during Tc-99m MDP imaging of a 57-year-old woman who underwent surgery in 1983 for cutaneous melanoma on the right calf. The scan did not show bone alterations but did reveal an area of hyperactive uptake in the soft tissue of the medial surface of the thigh, where slightly altered pigmentation was also apparent. A subsequent immunoscan with Tc-99m-F(ab')2 225.28S confirmed increased uptake at this site. The lesion was removed and was histologically diagnosed as a skin metastasis from melanoma. Inguinal adenopathy appeared 6 months later. The uptake of Tc-99m MDP by both primary and metastases tumors has been described, although this may be the first report concerning melanoma. The uptake mechanism is not known.

Antibodies, Monoclonal↗
PubMed2000

Radioimmunoguided surgery in colorectal cancer using a genetically engineered anti-CEA single-chain Fv antibody.

In radioimmunoguided surgery (RIGS), a radiolabeled antibody is given i.v. before surgery and a hand-held gamma-detecting probe is used to locate tumor in the operative field. The rapid blood clearance and good tumor penetration of single-chain Fv antibodies (scFv) offer potential advantages over larger antibody molecules used previously for RIGS. A Phase I clinical trial is reported on RIGS with scFv (MFE-23-his) to carcinoembryonic antigen (CEA). Thirty-four patients undergoing surgery for colorectal carcinoma (17 primary tumors, 16 liver metastases, and 1 anastomotic recurrence) and 1 patient with liver metastases of pancreatic carcinoma received 125I-labeled MFE-23-his scFv (125I-MFE-23-his) 24, 48, 72, or 96 h before operation. 125I-MFE-23-his showed biexponential blood clearance with alpha and beta half-lives of 0.32 and 10.95 h, respectively. The abdomen was scanned during surgery with a hand-held gamma detecting probe (Neoprobe Corp.). 125I-MFE-23-his showed good tumor localization; comparison with histology showed overall accuracy of 84%. Highest median ratios for tumor:normal tissue and tumor:blood were recorded 72 or 96 h after scFv injection for patients undergoing resection of liver metastases. High levels of radioactivity were found in the kidneys. Five patients had grade 1 fever, and three had a grade 1 rise in blood pressure according to the Common Toxicity Criteria. There was a significant correlation between these ratios and those measured in excised tissues using a laboratory gamma counter (P < 0.001). MFE-23-his scFv antibody localizes in CEA-producing carcinomas. The short interval between injection and operation, the lack of significant toxicity, and the relatively simple production in bacteria make MFE-23-his scFv suitable for RIGS.

Adult↗
PubMed1979

Comparison of the distribution of diagnostic and thyroablative I-131 in the evaluation of differentiated thyroid cancers.

In 206 patients with differentiated thyroid cancer, the distribution of iodine-131 were compared after diagnostic (200-500 microCi) and thyroblative (approximately 100 mCi) doses. In the diagnostic scans, only normal thyroid tissue could be seen, whereas in one-fourth of the patients the therapeutic scans showed tumor tissue as well, usually in lymphnode metastases. In 16% of patients, the therapeutic scan was the only way to demonstrate the presence of tumor tissue, since no further uptake was achievable. In patients in whom all tumor was believed to have been removed by surgery alone, a "preventive" I-131 ablation was used, and in 16 of these 97 patients tumor was revealed in the therapeutic scan. In ten more, tumor was found in subsequent followup scans, its functioning having been induced by destruction of postsurgical remnants of normal thyroid. Some possible explanations for the differences in scans are proposed, and the importance of therapeutic scans for correct staging of thyroid cancer is stressed.

Adult↗
PubMed1987

Cause-specific mortality among male chemical workers.

Cause specific mortality was surveyed among 37,682 male employees with three or more days of service between 1940 and 1982 at the Midland or Bay City, Michigan, locations of Dow Chemical USA. Vital status was ascertained through 1982 for 97.5% of the cohort members, and death certificates were obtained for 97.1% of the 7,751 decedents. Comparisons of observed mortality with expected levels based on any of three general population groups (US, Michigan, or seven local counties) consistently demonstrated lower mortality in the cohort from each of the major causes of death, including total malignant neoplasms. Unique among hourly employees was significant excess mortality in the categories of cancer of other lymphatic tissue, and motor vehicle accidents, and both hourly and salaried nonexempt employees experienced significantly higher mortality from other and ill-defined cancers. The influence of duration of employment and age at and period of hire were explored with the Mantel-Haenszel method as adapted for a cohort study. Results were evaluated both including and excluding the mortality experience of subsets of employees with past exposure to known human carcinogens (arsenic, asbestos, bis-chloromethyl ether, benzene, organic dyes, and vinyl chloride). The use of the general mortality survey in monitoring whether or not there are major health problems among the employees and in setting research priorities is emphasized.

Accidents, Occupational↗
PubMedDate not supplied

Immunocytochemistry applied to aspiration biopsy cytology. Diagnostic contribution in 100 cases of previously stained, routine specimens.

OBJECTIVE: To assess the contribution of immunocytochemistry (ICC) to aspiration biopsy cytology (ABC), in a diagnostic context, on routine, previously stained cytologic specimens. STUDY DESIGN: Among 5,221 consecutive cases of ABC, 5.3% were subjected to ICC in the clinical-morphologic context. One hundred of these cases, with a final clinical and histopathologic diagnosis, were studied to determine the contribution of this ancillary technique to the final cytologic diagnosis. All cases had histopathologic study and prospective ICC, performed on usual smears, alcohol fixed and previously stained by the Papanicolaou technique, and were subjected to an avidinbiotin-peroxidase complex method. RESULTS: ICC was contributory in 82% of cases. The contribution of ICC to ABC of lymphoid tissue, thyroid and related organs, soft tissue and miscellaneous cases was, respectively, 84% (39 cases), 88% (26), 72% (18) and 76% (17). ICC was noncontributory in 18 cases, due mainly to misleading interpretation (6%), uncharacteristic profile (5%) and inconclusive immunostain (7%). CONCLUSION: ICC could be successfully applied in routine ABC specimens since the usually investigated antigenic determinants are preserved, allowing previous morphologic study and screening of the smears. The principal contribution of ICC applied to lymph nodes, thyroid and soft tissue aspirates was, respectively, confirmation of metastatic neoplasms, differential of follicular versus C-cell proliferation and assessment of mesenchymal lineages.

Adenocarcinoma↗
PubMed1983

Carrier activity of sonicated small liposomes containing melphalan to regional lymph nodes of rats.

Tissue distribution following subcutaneous injection of liposomes containing melphalan (MPL) was studied in rats using 14C-MPL and 3H-phosphatidylcholine. Two types of liposomes, prepared by either a brief or a prolonged sonication, were compared. Brief sonication formed large liposomes of various sizes, while liposomes obtained after a prolonged sonication were small and relatively uniform in size (34 nm in mean diameter). Subcutaneous injection of small liposomes produced a strikingly high and sustained concentration of MPL equivalents in regional lymph nodes. In contrast, most liposomes prepared by a brief sonication appeared to remain at the injection site, and there was only a slight increase in the lymph node concentration of MPL equivalents over the plasma level during the 24-hour experiments.

Animals↗
PubMedDate not supplied

Imaging findings of extrapulmonary metastases of osteosarcoma.

PURPOSE: To review imaging findings of extrapulmonary metastasis from osteosarcoma and to evaluate them for any consistent pattern and correlation between imaging findings. MATERIALS AND METHODS: This study was retrospectively conducted in 13 patients with extrapulmonary metastasis of pathologically confirmed osteosarcoma. We evaluated the radioisotope (RI) scans (n=16), ultrasonography (USG) (n=4), computed tomography (CT) scans (n=10), MRIs (n=6), clinical records, and pathological reports for assessment of imaging findings and correlation between radiologic findings and RI uptake of the lesions. Points evaluated were the following: uptake on RI scans, presence of mineralization on CT, and MRI, size, enhancement pattern, attenuation on CT, signal intensity (SI) on MRI, and echogenicity on USG. RESULTS: Extrapulmonary metastatic sites were diverse, including another bone other than the primary site (n=6), lymph node (n=4), pleura (n=2), liver (n=2), pancreas (n=1), kidney (n=1), peritoneum (n=1), muscle (n=1), and subcutaneous fat layer (n=1). One patient had tumor growth within the pulmonary artery and jejunum. Among 21 metastatic sites in 13 patients, bone scan was performed in 16 cases and RI uptake was detected in 10 lesions. Calcification was detected in eight lesions on radiologic imaging, including plain radiography, USG, CT, and MRI. Two lesions showed RI uptake without definite calcification or ossification on MRI and plain radiography, respectively. We analyzed the enhancement pattern and mass size in 18 metastatic sites and these factors had poor correlation with uptake on RI scans. CONCLUSION: The sites and imaging findings of extrapulmonary metastasis of osteosarcoma were variable. All the lesions with mineralization were detectable on RI scans prior to radiologic imaging. RI scan has a limited role in the evaluation of metastatic lesions without mineralization.

Adipose Tissue↗
PubMed1996

Synovial cyst formation complicating total hip arthroplasty: a case report.

The most frequent causes of unilateral limb swelling unrelated to trauma or surgery are deep venous thrombosis, chronic venous insufficiency, and primary lymphedema. Other important but less frequent causes include infection and neoplasm. Neoplasms may cause limb swelling, either by soft tissue enlargement or incidental compression of venous or lymphatic structures. Reported here is an unusual case of a patient with unilateral leg swelling and an inguinal mass presenting years after total hip arthroplasty. The unilateral leg swelling was caused by compression of the right common femoral vein by a synovial cyst arising from the hip joint. Although only 2 cases have been described in the literature, such cyst formation is not uncommon with loose acetabular components. The most apparent cause of cyst formation was polyethylene debris. Treatment efforts should be directed at the source of the debris intraarticularly.

Female↗
PubMed2000

Increased expression of tissue inhibitor of metalloproteinases type 1 (TIMP-1) in a more tumourigenic colon cancer cell line.

Genetic changes occurring in the late stages of colonic tumour progression have received much less attention than those occurring in the early stages. As described in the accompanying paper, SW480 and SW620 cell lines provide a useful model for studying the advanced stages of progression for colon cancer. Comparison of the two cell lines by differential display reveals that SW620 cells express lower levels of the CC3 tumour suppressor gene and also lower levels of the tissue inhibitor of metalloproteinases-3 (TIMP-3) gene. Northern blot analysis for TIMP-3 confirms this finding and shows a similar difference in the expression of TIMP-2, which seems logical since TIMPs inhibit enzymes that play a role in tumour invasion. For this reason, it was surprising to find that TIMP-1 messenger RNA expression is markedly increased in SW620 cells. Consistent with this finding, western blot analysis shows a ten-fold increase in TIMP-1 protein secretion by SW620 cells. It is noteworthy that high TIMP-1 expression is associated with poor prognosis in colorectal cancer. This association between TIMP-1 expression and tumour progression may be related to additional growth factor-like effects described for TIMP-1 in some systems.

Blotting, Northern↗
PubMed1991

Childhood Ki-1 lymphoma: presentation as a buttock mass.

Ki-1 lymphoma is a rare, large-cell anaplastic non-Hodgkin's lymphoma that most commonly affects older children and young adults. Presentation usually occurs as a localized infiltration of the skin and lymph nodes. We report an unusual case of childhood Ki-1 lymphoma that presented as a buttock mass in an eight-year-old girl, Pathologic evaluation revealed the characteristic lymphoma cells expressing Ki-1 antigen (CD-30), HLA-DR, interleukin 2 (CD-25), T-cell gene rearrangement, and the cytogenetic karyotype t(2;5). The patient is in complete remission following treatment with combination chemotherapy. This report broadens the clinical spectrum associated with Ki-1 lymphomas and illustrates the importance of combining routine pathologic examination with other specialized diagnostic techniques in the evaluation of childhood soft-tissue masses.

Aneuploidy↗