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PubMed2002

Acral myxoinflammatory fibroblastic sarcoma: a report of five cases and review of the literature.

Five cases of acral myxoinflammatory fibroblastic sarcoma that occurred in the distal extremities within the subcutaneous tissue are described. In one case, recurrence and metastases were recognized rather rapidly, only 3 months after the first excision. There have been no reports of early recurrence or metastases, especially the latter. The predominant type of constituent cells, cellularity of the neoplastic cells and density of inflammatory cells varied microscopically among cases. However, characteristic ganglion-like cells, Reed-Sternberg-like cells, round mononuclear cells and myxoid stroma, sometimes only seen focally, were found in all cases. Positive immunoreaction for vimentin was present in all cases. There was no correlation between positivity of MIB-1 or p53 for the primary tumor and presence of recurrence or metastases. In conclusion, we should be more cautious about the possibility of recurrence or metastases in earlier phases of acral myxoinflammatory fibroblastic sarcoma. Identification of the atypical bizarre fibroblastic component as the manifestation of the malignant nature of this lesion is vital to correct diagnosis, and it is important to attend to the myxoid and hyalinized zones, the inflammatory infiltrate, the presence of ganglion-like cells and acral location as features of acral myxoinflammatory fibroblastic sarcoma.

Adolescent↗
PubMed1987

Factors influencing the survival of patients with regional melanoma of the extremity treated by perfusion.

Patients with regional metastases of malignant melanoma (75 with Stage IIIA soft tissue metastases, 124 with Stage IIIB nodal metastases and 75 with Stage IIIAB soft tissue and nodal metastases) treated by regional perfusion between 1957 and 1982 were retrospectively studied to identify prognostic factors relating to survival. In patients with Stage IIIB disease, the melanoma specific cumulative survival rates at five years was 72 per cent for one, 33 per cent for two to three and 20 per cent for four or more positive lymph nodes. In patients with Stage IIIAB disease, those with one node had a better survival rate at five years than those with multiple nodes (45 versus 25 per cent). In patients with Stage IIIA melanoma, two groups were identified based upon the results of prior treatment--those with and without prophylactic lymph node dissection (PLND) at the time of primary therapy. The factors associated with decreased survival rates in patients with PLND were: 1, increasing age; 2, presence of subcutaneous or both subcutaneous and dermal metastases, and 3, treatment at normothermic temperatures or earlier date of treatment. No significant factors were found in the group without PLND; however, the survival time was similar to that for patients with Stage IIIAB and one positive node (45 per cent at five years). Knowledge of these factors is important in assessing the prognosis and establishing randomization criteria for prospective studies evaluating various forms of therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2007

Expression of epidermal growth factor receptor in esophageal and esophagogastric junction adenocarcinomas: association with poor outcome.

BACKGROUND: The prognosis for patients with esophageal and esophagogastric junction (EGJ) adenocarcinoma remains poor, even after surgical resection. Pathologic assessment of depth of invasion and lymph node status are the primary prognostic factors in these patients. In patients with esophageal squamous cell carcinoma, increased epidermal growth factor receptor (EGFR) expression has been associated with a worse prognosis. It is not known whether EGFR plays a similar role in esophageal and EGJ adenocarcinomas. METHODS: To address this issue, the authors studied tumor specimens from 103 patients with surgically resected esophageal and EGJ adenocarcinomas (9 patients with stage I disease, 23 patients with stage II disease, 57 patients with stage III disease, and 14 patients with stage IV disease). The expression of EGFR was assessed by immunohistochemical analysis of tissue microarrays. Tumors were considered positive for EGFR expression when >5% of tumor cells were stained and negative when <or=5% of tumor cells were stained. RESULTS: EGFR was expressed in 33 of 103 adenocarcinomas (32%) and was correlated with higher pathologic tumor (T) classification (P = .02), the presence of lymph node metastasis (P = .01), and higher pathologic tumor, lymph node, metastasis classification (P = .02). EGFR expression also was correlated with shorter disease-free and overall survival in univariate analyses (P = .001 and P = .004, respectively), and there was a trend toward a correlation between EGFR expression and shorter disease-free survival in multivariate analyses (P = .07 and P = .08). The results demonstrated that EGFR expression in esophageal adenocarcinomas was correlated with advanced pathologic tumor classification and lymph node metastasis. EGFR expression also was correlated with poor disease-free and overall survival, but that correlation was not independent of T classification. CONCLUSIONS: The current findings suggested that EGFR expression correlates with poor prognostic factors and may be used to predict patient outcomes.

Adenocarcinoma↗
PubMed1987

Lipoplastic lymphadenopathy presenting as an ovarian mass: a case report.

Lipoplastic lymphadenopathy is a pathological condition wherein accumulations of intranodal fat result in lymph node enlargement and may mimic abdominal, pelvic, and retroperitoneal neoplasms, particularly lymphomas. The pathology appears to be different from lipomatosis in that benign, mature adipocytes and lipids are located within lymph nodes, rather than deposited in body cavities. The case of a 49-year-old woman presenting as an ovarian neoplasm is presented as an example of the pathology and its ability to masquerade as other neoplasms. The etiology of lipoplastic lymphadenopathy is unclear although associated causes are suggested. The difficulties of radiological examination of this case and others makes open lymph node biopsy important for the final diagnosis.

Abdomen↗
PubMed1990

Tumour-associated fibrinolysis: the prognostic relevance of plasminogen activators uPA and tPA in human breast cancer.

Prognostic variables in breast cancer are urgently needed to individualize adjuvant cytotoxic therapy, especially in those patients where metastases in the lymph nodes have not been detected (node-negative disease). So far histomorphological criteria, the determination of receptors for steroid hormones or EGF (epidermal growth factor), the protease cathepsin D or DNA-ploidy are used to distinguish between low- and high-risk patients. High-risk patients have a higher incidence of recurrences and/or shorter overall survival after surgery of the primary tumour than low-risk patients. High-risk patients (node-positive; hormone-receptor-negative) would receive adjuvant hormone therapy or chemotherapy. In the node-negative patient, adjuvant therapy is only recommended if a high content of cathepsin D and aneuploidy of the tumour (or high S-phase in diploid tumours) has been diagnosed. Determination of cathepsin D in tumour extracts as a variable in breast cancer patients is based on the fact that invasion and metastasis is correlated with elevated levels of tumour-associated proteases such as cathepsins B and D, collagenase IV and plasminogen activators. The urokinase-type plasminogen activator (uPA) which is secreted by tumour cells as an enzymatically inactive proenzyme (pro-uPA) seems to play a key role in mediating tumour cell invasion in cancer tissues. Receptor-bound uPA converts enzymatically inactive plasminogen into the serine protease plasmin which then degrades the extracellular matrix surrounding the tumour cells (tumour stroma). We localized pro-uPA/uPA immunohistochemically in paraffin-embedded formalin-fixed breast cancer tissue sections. Pro-uPA/uPA was detected in the cytoplasm and on the plasma membrane of the tumour cells reflecting receptor-bound pro-uPA/uPA.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneuploidy↗
PubMedDate not supplied

A prospective study of tissue polypeptide specific antigen (TPS) in breast cancer diagnosis.

The aim of the present study was to evaluate the clinical value of a new tumour marker TPS in sera from patients with breast cancer and patients with benign breast disease. The results for TPS were compared with those for TAG 12, CA 15-3 and MCA. The cutoff levels (90% specificity) determined for each test were 108.0 U/1 for TPS, 57.5 KU/1 for TAG 12, 24.8 KU/1 for CA 15-3 and 9.7 KU/1 for MCA. The diagnostic sensitivity of the TPS test was 0.21, for the TAG 12 test it was 0.2, 0.13 for the CA 15-3 test and 0.12 for the MCA test in detecting breast cancer. TPS, TAG 12, CA 15-3 and MCA tests were tested in a multivariate analysis to find the best combination of independent predictors of breast cancer. The most important predictor of breast cancer was TAG 12 followed by TPS. In order to calculate the contributions of tumour marker tests, a diagnostic score (DS) was developed. The diagnostic score (DS) was: DS = TPS x 0.0085 x TAG 12 x 0.0596 - CA 15-3 x 0.0866 - MCA x 0.2938 + 0.1738. The sensitivity of the DS in detecting breast cancer was 55% with a specificity of 90% and an efficiency of 64%. In conclusion, new tumour markers TPS and TAG 12 may have some value in breast cancer diagnosis. In particular, the results indicate the usefulness of computer assistance and a simple diagnostic score when tumour markers are used in breast cancer diagnosis.

Adult↗
PubMed2000

Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease.

The clinical and pathologic features of 50 cases of diffuse-type tenosynovial giant cell tumor (D-TGCT), also known as extraarticular pigmented villonodular tenosynovitis (PVNTS), are presented. Patients' ages ranged from 4 to 76 years (median, 41 yrs), with a slight female predominance (28 women, 22 men). By definition, all lesions presented as predominant soft tissue masses, with or without an associated articular component. Tumor sites included the wrist (9 cases), knee (8 cases), thigh and foot (6 cases each), finger (5 cases), ankle (3 cases), hand, elbow, toes, buttock, paravertebral region (2 cases each), lower leg, sacrococcygeal area, and retroperitoneum; 27 cases were described as entirely extraarticular. Tumors showed infiltrative margins and, in most cases, a sheet-like growth pattern. Striking variation in the number of osteoclast-like giant cells, foamy cells, amount of hemosiderin, and in the degree of stromal hyalinization were responsible for a wide morphologic spectrum. In addition to the predominant histiocyte-like cells, we identified in most cases a subpopulation of large dendritic, desmin-positive cells showing characteristic, but potentially misleading, cytologic features, including abundant eosinophilic cytoplasm, large vesicular nuclei, paranuclear eosinophilic inclusions, and occasional nuclear inclusions. Follow-up information was available for 24 patients, with a duration ranging from 6 months to 30 years (mean, 55 mos). Local recurrence occurred in eight cases (33%), between 4 months and 6 months after surgery (median, 15 mos) and was repeated in five cases; recurrence did not appear to correlate with morphologic parameters. Six cases showed atypical histologic features and four of these contained areas of sarcomatous change. Among the latter, one of three cases with available follow up developed pulmonary metastases and died after 35 months. In addition, one histologically benign lesion gave rise, after two local recurrences, to inguinal and iliac lymph node metastases. Despite this exceedingly uncommon event, we think most cases of D-TGCT are best regarded as benign but locally aggressive neoplasms with significant recurrent potential and should be treated, when possible, by wide excision. Atypical features such as increased mitotic activity, necrosis, spindling of the mononucleate cells, and cytologic atypia are not indicative of malignancy when present individually. This study also confirms the existence of malignant tenosynovial giant cell tumors, some of which are characterized by aggressive behavior.

Adolescent↗
PubMed1981

[Characteristics of gastric lymph outflow in the presence of an adhesive process].

Under study were some regularities in the formation of gastric adhesions lymph vessels taking into account the pretumor background lesions and age. The study was undertaken on 103 complexes of abdominal organs from person died at the age of 50-94 and from 74 patients operated upon for cancer arising from ulcers and due to chronic gastritis. In cancers caused by ulcers gastric adhesions with adjacent organs were found to be well developed, these occurred prior to ulcer malignant transformation and had an extensive network of lymph vessels being the routes for proliferation of neoplastic cells beyond the boundaries of the organ under unfavourable conditions of their growth in gastric walls due to the presence of scarring tissue in the periphery of ulcer. In cancers arising due to chronic gastritis adhesions would develop at late stages of the disease as a compensatory mechanism in significantly impaired lymphodynamics by the lesion. These were of no practical importance for tumor metastasizing, since a submucous gastric layer, loose and rich in lymph vessels, contributed to prompt tumor invasion of the stomach walls. In aged and senile patients a considerable deformation and reduction of lymph vessels in adhesions and in the stomach walls do not contribute to rapid growth and proliferation of a neoplasm.

Aged↗
PubMedDate not supplied

Fine needle aspiration cytology: utilization in pediatric pathology.

Fine needle aspiration can serve as the initial diagnostic modality for a wide variety of lesions within the pediatric age group. The utility of the technique depends on the clinical setting and histologic type of tumor under study. FNA is most valuable for staging and conformation of metastatic spread in small round cell malignancies. The use of aspiration cytology as the initial diagnostic procedure for these neoplasms is more controversial since this technique may deprive the clinician of valuable information (histologic subtype, oncogene status) now available only by examination of large tissue biopsies. Similarly, FNA can serve as a triage technique for the separation of patients harboring thyroid nodules or enlarged lymph nodes into operative candidates and non-operative candidates. As cytopathologists become more familiar with the appearance of pediatric neoplasms, this diagnostic technique will become more widely used, reducing the need for operative intervention in the diagnosis of many benign and reactive lesions.

Aneuploidy↗
PubMed1994

Apoptosis of T lymphoma cells and its inhibition by monoclonal antibodies against cell surface adhesion molecules.

We previously established the malignant T lymphoma CS-21 cell line from a spontaneously developed lymphoma in a BALB/c mouse. CS-21 cells produce lymph node metastasis with a high incidence following s.c. injection. CS-21 lymphoma cells grew continuously when the cells were co-cultured under the cell-cell attached conditions with stromal cells prepared from lymph nodes. However, they were unable to proliferate by themselves and underwent apoptosis when separated from the lymph node stromal cells. To identify the cell adhesion molecules of CS-21, we developed monoclonal antibodies (mAbs) directed against CS-21 cell-surface proteins. Fourteen mAbs partially inhibited the binding of CS-21 cells to a CA-12 stromal cell monolayer. MCS-5 (mAb against CS-21 No. 5) directed against a 168-kDa cell-membrane protein and MCS-19 against a 23-kDa protein were found to suppress apoptosis and stimulate CS-21 cell growth. Soluble factors secreted from CA-12 stromal cells enhanced CS-21 cell growth but were not sufficient to prevent apoptosis. In the presence of both stromal cell-secreted factors and mAbs MCS-5 or MCS-19, CS-21 lymphoma cells resisted apoptosis and grew as quickly as in the co-culture with CA-12 stromal cells. Based on these results, we conclude that CA-12 lymph node stromal cells support CS-21 lymphoma cell growth by secreting paracrine growth factors and presenting receptors for the 168-kDa and 23-kDa cell surface adhesion molecules of CS-21 cells that transmit signals to prevent CS-21 cell apoptosis.

Animals↗
PubMed1988

[Usefulness of gallium 67 in research into the need for radical cervical lymph node dissection in patients with head and neck carcinomas].

Fifty-nine patients with head and neck carcinoma were examined with 67Ga scintigraphy. All patients had undergone lymph node dissection of the neck. They were followed for a minimum of 2 years after the examination. The primary tumor, treated prior/contemporaneously to the lymph node dissection, did not evolve in this interval. Metastatic involvement of the lymph node capsule was observed in all 44 cases with metastatic lymph nodes; macroscopic radicality was surgically obtained since involvement of the capsule was only microscopic. Nevertheless, complementary radiotherapy was given. The whole of 17 recurrences in the soft tissues of the neck were found, within 2 years, in the group of 26 patients who had undergone dissection of lymph nodes with metastatic capsular involvement and whose postoperative 67Ga scintigraphy was positive. On the contrary, no recurrences in the soft tissues of the neck were observed in the group of 18 patients who had undergone dissection of lymph nodes with metastatic capsular involvement and whose scintigraphy was negative. This result proves (P less than 0.001) 67Ga capable of evidencing eventual microscopic diffusion. Such a possibility has not yet been realized in vivo with any other investigation technique. Scintigraphy was negative in a control group of 15 patients who had undergone lymph node dissection, and with nonmetastatic lymph nodes. This finding leads us to exclude that the use of 67Ga might result in misinterpreted findings in the exploration of relatively superficial tissues. In fact, the eventual accumulation of radioisotope in nonneoplastic pathologies is quite easily recognizable in the neck. We can therefore conclude that in those 9 cases with positive scintigraphy and in whom no recurrence was found, microscopic diffusion was probably present, but local recurrence of the disease was prevented by complementary radiotherapy.

Carcinoma↗
PubMed2002

[Trends in the mortality from malignancies in the population of the city of Poznan].

In the view of epidemiological data Poland is a country with higher risk factors for malignant disease than European Union States. In the population of Poland neoplasms are the second cause of death after cardiovascular diseases while mortality and morbidity in this group continue to show growing tendency. The tendencies in the mortality from neoplasms in the population of the city of Poznań were analyzed with respect to gender and type of neoplasm. The underlying causes of deaths in death certificates of permanent residents of Poznań in years 1981-2000 were analyzed. The higher mortality from neoplasms in the 90's was caused by the rise in mortality from malignancies in both sexes. Throughout the period monitored mortality rates for men were higher than for women, with highest values in 1998 and 1999. In the years 1996-2000 the highest mortality rates for men were from prostate cancer, whereas in 1997-1999 they were highest for bowel cancer. Amongst women in the 90's an increased mortality from bowel, breast, lungs, bladder cancers and lymphatic and erythropoetic tissue malignancies was observed.

Adult↗