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PubMed1983

Tc-99m MDP and indium-111 chloride scintigraphy in skeletal tuberculosis.

A case of diffuse osseous tuberculosis with changes on skeletal Tc-99m methylene diphosphonate (MDP) and indium-111 chloride scintigraphy is presented. Only two other cases of bone scan findings in osseous tuberculosis (TB) were reported in the literature and both show patterns similar to diffuse metastatic disease. In addition, the demonstration of corresponding areas of decreased tracer activity on indium-111 bone marrow scintigraphy is a finding that has not been previously reported for skeletal tuberculosis.

Adult↗
PubMed2001

Thoracic imaging of pediatric lymphomas.

Lymphoma (Hodgkin and non-Hodgkin types) is the most common intra-thoracic neoplasm in the pediatric age group. Diagnostic strategies and treatment approaches for these tumors are largely determined by protocols established by one of the large, multi-institutional cooperative groups. In this paper, Hodgkin and non-Hodgkin lymphoma is discussed in the context of these cooperative group protocols. The basic biology, patterns of primary and metastatic disease distribution, treatment approaches, imaging follow-up, and areas of active research are discussed.

Child↗
PubMed2003

Immunohistochemical assessment of a testicular tumor in a 63-year-old patient: proposal for an integrated clinicopathologic approach.

A 63-year-old man was admitted to our hospital for complaints of a painless knot in his right testicle. The patient underwent orchiectomy for suspicion of malignancy. Pathologic examination detected a firm, circumscribed mass that consisted histologically of noncohesive, large, undifferentiated tumor cells diffusely infiltrating the testicular interstice. Because of the patient's advanced age and the structure of the neoplastic cells, the differential diagnosis favored a lymphoma over a malignant germ cell tumor but also included a dedifferentiated metastatic neoplasm. Immunohistochemistry was tailored accordingly and was completed using three successive panels of antibodies. Immunostaining with the first panel of antibodies directed against leukocyte epitopes (CD45, CD20, and CD3) remained negative and made a lymphoma unlikely. The subsequent panel (cytokeratin AE1/3, cytokeratin 18, and HMB-45) helped to rule out a malignant melanoma and aided to settle the diagnosis of a metastatic carcinoma. The reaction pattern of the last panel of antibodies pointed to a pulmonary origin of the putative primary tumor (PSA-negative, TTF-1-positive, and CK20-negative). The diagnosis of a metastasized poorly differentiated adenocarcinoma of the lung was confirmed by autopsy 5 months later. This case represents the extremely rare occurrence of a testicular metastasis as a primary manifestation of an occult neoplasm and shows the usefulness of an integrated site-specific clinicomorphologic approach that should precede and guide the choice of diagnostic immunoreagents.

Adenocarcinoma↗
PubMed1993

Patterns of bone metastasis and their prognostic significance in patients with carcinoma of the prostate.

The different patterns of bone metastasis, metastatic load and their prognostic significance were examined in a consecutive series of 169 men with prostatic cancer and bone metastasis at presentation. Patients with an isolated metastasis in the pelvis or dorsal vertebrae had a better prognosis than those whose metastases were either diffuse or involved more distal sites such as the skull or the sternum, although all of these patients were classified as having M1 disease. Bone metastasis involving an area equivalent to 1 vertebral body equalled a metastatic load of 2. Based on their total metastatic load, 3 prognostic groups were identified with significant differences in case-specific survival despite receiving the same hormonal treatment. When comparing the potential efficacy of various treatments one must stratify the metastatic load, which is a powerful prognostic indicator of the outcome in patients with metastatic carcinoma of the prostate.

Bone Neoplasms↗
PubMedDate not supplied

A clinically relevant orthotopic implantation nude mouse model of human epithelial ovarian cancer--based on consecutive observation.

The aim of this study is to establish an orthotopic implantation nude mouse model of epithelial ovarian cancer (EOC) and observe its biologic features. A human ovarian tumor line SKOV3ipl previously grown subcutaneously was implanted orthotopically as intact tissue into the ovarian capsule of 64 nude mice. Every week eight mice were taken randomly, and the tumor growth pattern and extent of metastatic disease were monitored continuously. Those mice that died of disease were necropsied and the end date was recorded. The orthotopic implanted tumors demonstrated a 100% take rate. Three weeks after implantation the tumors grew fast and weighed 1149 +/- 152 mg, and 5 weeks after implantation the tumors reached a flat stage. The tumors metastasized more often to peritoneum (32/56) and diaphragm (18/56), then to pelvic lymph nodes (11/56) and lung (10/56), and then to the seldom invaded organs including the pancreas, the liver, the contralateral ovary, and the para-aortic lymph node. Eight nude mice became exhausted 7 weeks after implantation and died within 68 days after implantation. Our study, utilizing the SKOV3ipl cell, is the first model of consecutive observation of the process of invasion and metastasis of EOC. It should be useful in understanding the molecular biology of EOC and in the development of therapeutic modalities against metastasis.

Animals↗
PubMed1998

[Evaluation of body surface ultrasonography in the diagnosis of diseases of abdominal segment esophagus and early-stage carcinoma].

OBJECTIVE: To investigate the possibility of detecting esophageal carcinoma and other lesions by body surface ultrasound (BSUS). METHODS: BSUS examinations of the abdominal segment of the esophagus in 797 subjects were undertaken. Wall thickness more than or equal to 6 mm, wall echo abnormality, and lumen morphologic changes were referred as the criteria of the disease. RESULTS: A visualization rate of 92% (n = 729) was obtained. 716 subjects without any esophageal diseases had a wall thickness of 4 mm or less; Of other 13, one patient had a wall thickness of 5 mm, 11 had 6 mm or more, and one had luminal cystic dilatation without wall thickening. In the 13 cases, the final pathological examination showed 5 cases of esophageal carcinoma (intramucosal, mucosal muscle, submucosal, proper musculature, and serosal patterns, respectively), 2 of metastatic lesion, one of leimyoma, 2 of edematous benign ulcer, one of diverticulum with polyp, and 2 of normal result. CONCLUSION: BSUS can not only detect the early-stage carcinoma, but also further demonstrate wall echo and pathologic changes inside and outside the wall. In the visualization of the submucosal tumor, it is advantage ous to barium examination and endoscopy. With its high sensitivity, simplicity, and non-intervention, BSUS can become a better screening method in everyday practice and in the area with high incidence of esophageal carcinoma.

Adult↗
PubMedDate not supplied

Differential diagnosis of small round cervical lymph nodes: comparison of power Doppler US with contrast-enhanced CT and pathologic results.

PURPOSE: The purpose of this study was to differentiate reactive small round lymph nodes (SRLNs) from metastases by power Doppler ultrasonography (PD-US) and contrast-enhanced CT (CE-CT). MATERIALS AND METHODS: Both PD-US and CE-CT were performed in 99 cervical lymph nodes (LNs) with a maximum diameter of 1.5 cm or smaller and maximum longitudinal/transverse ratio of 1.5 or smaller in 76 patients with head and neck cancer. At pathologic examinations, 45 were reactive and 54 were metastatic LNs. The vascular patterns on PD-US were classified as hilar, avascular, peripheral, and miscellaneous vascular patterns. The enhancement patterns on CE-CT were classified as homogeneous, heterogeneous, and ring enhancement. RESULTS: On PD-US, the hilar pattern was more frequently associated with benignancy (91%) and the peripheral, miscellaneous vascular pattern with malignancy (91%). The avascular pattern included both benign (58%) and malignant (42%) LNs. On PD-US, accuracy was 85%. On CE-CT, ring enhancement showed metastasis (100%), and these LNs showed avascular or peripheral patterns on PD-US. On CE-CT, accuracy was 77%. When information on CE-CT results was added to PD-US results, the accuracy rate increased significantly, to 94% (p=0.01). CONCLUSION: Vascular patterns evaluated with PD-US and enhancement patterns on CE-CT can characterize SRLNs. For an avascular pattern on PD-US, information on CE-CT results can significantly increase the accuracy of characterization.

Adult↗
PubMedDate not supplied

Modulation of IgG and complement receptor expression of phagocytes in kidney cancer patients during treatment with interferon-alpha.

BACKGROUND: The mode of action of interferon involves both direct cytotoxic and antiproliferative effects on the tumour cell and indirect effects that facilitate immune detection by the host. Among the immunological effects of interferon-alpha is the activation of monocytes. As opsonin receptors are crucial in the function of phagocytes, e.g. monocytes and neutrophils, their modulation by interferon-alpha (INF-alpha) merit to be further clarified. We hypothesised that the role of phagocytes in defence against cancer is reflected in the expression of opsonin receptors for IgG and complement, which further could be modified by INF-alpha. PATIENTS AND METHODS: The expression of the receptors for IgG and complement was studied in neutrophils and monocytes from blood samples of 18 kidney cancer patients treated with INF-alpha and from 39 healthy individuals. Blood samples were collected prior/to and during treatment with INF-alpha, 4.5 to 13.5 MU t.d.w., subcutaneously. After lysing the red blood cells, the samples were incubated with fluorochrome conjugated monoclonal antibodies specific for IgG (Fc gammaRI, -RII and -RIII) and complement (CR1, CR3) receptors and then analysed in flow cytometry. The results were given as the mean log fluorescence intensity (a measure of receptor number) and as the proportion of receptor-positive cells. In the in vitro experiments, the direct effect of interferon-alpha on the receptors of neutrophils and monocytes was studied. RESULTS: In patients before any treatment, the expression of CR3 and Fc gammaRI receptors in neutrophils and all receptors except Fc gammaRIII in monocytes was significantly raised when compared to the controls. Treatment with INF-alpha, induced statistically significant; transient changes in CR1-receptor expression in neutrophils and Fc gammaRI expression in monocytes. Incubation of blood cells with INF-alpha in vitro confirmed the induction of CR1 receptors in neutrophils. CONCLUSION: Changes in receptor expression reflect the inflammatory activation of phagocytes in metastatic kidney cancer. The pattern of receptor expression differs from that observed in infectious diseases. Interferon-alpha both in vivo and in vitro modulates the expression of phagocytic receptors.

Aged↗
PubMed1998

[Different integrin-induced adhesion of highly liver metastatic and little metastatic colon carcinoma cells in an extracellular matrix].

Poorly and highly liver metastatic colon carcinoma cell lines have different integrin-mediated adhesion to extracellular matrix. Specific integrin-mediated interactions between tumor cells and extracellular matrix (ECM) in the host organs are important for organ-specific metastasis. In colon carcinoma integrin expression differs depending on the metastatic potential of the tumor. Integrin-mediated adhesion of poorly (HT-29P) and highly liver-metastatic (HT-29LMM) colon carcinoma to extracellular matrix (ECM; Collagen I-C I, Collagen IV-C IV, Laminin LN, Fibronectin FN, Vitronectin VN) was investigated. HT-29LMM showed significant better adhesion to LN (45% vs. 26%; p < 0.001) and FN 20% vs. 1%; p < 0.001). No adhesion was found to VN. RGD-oligopeptides completely inhibited adhesion to FN. Using inhibition with anti-integrin-mAB it was shown, that adhesion to C I and C IV is mediated by alpha 2 beta 1-integrin, adhesion to LN by alpha 6 beta 1 and adhesion to FN by alpha v beta 1. These results have shown that adhesion of HT-29 cells is mediated by different integrins depending on ECM components. Poorly and highly metastatic cells possessed different patterns of adhesion to various substrates.

Cell Adhesion↗
PubMed2004

Lymphadenopathic form of alveolar rhabdomyosarcoma: A case report.

We report the case of a special form of rhabdomyosarcoma called "lymphadenopathic" which was reported only two times in the literature. This lymphadenopathic alveolar RMS shows lymph nodes as clinical manifestation mimicking lymphoma with an unknown primary neoplasm. In the case we report, clinical examination, and radiological studies revealed superficial and deep located lymph nodes in association with bilateral pleural effusion. Conventional histological examination showed lymph node infiltration by a metastatic tumour having alveolar pattern. Some of tumour cells were round with multilobed off-centred nucleus and eosinophilic cytoplasm containing fibril material with longitudinal and transverse striation indicating a muscle nature of the tumour proliferation. The immunohistochemical study showed intense and diffuse immunoreactivity of tumour cells for vimentin and a discreet immunostaining by desmin. These findings were compatible with the diagnosis of lymph node metastasis by alveolar rhabdomyosarcoma.

Adolescent↗
PubMed2006

Hypoxia-induced up-regulation of angiopoietin-2 in colorectal cancer.

Angiogenesis is a compensatory mechanism that enables malignant tumors to survive in an oxygen-deficient environment. To test our hypothesis that hypoxia stimulates the production of angiopoietin-2 (Ang-2) in colorectal cancer (CRC), we investigated the expression of Ang-2 in three cultured CRC cell lines, and in specimens from 11 CRC metastatic liver tumors. Hypoxia-induced Ang-2 mRNA expression was clearly evident in HCT116 cells that did not express Ang-2 under normoxic conditions. Ang-2 mRNA was detected only after 48 h in hypoxic serum-deprived cultures in a LoVo cell line, and under both normoxic and hypoxic conditions without any noticeable difference in the HT29 cells. There was a stepwise increase in Ang-2 expression from the periphery to the central part of the liver metastatic foci, whereas an inverse result was noted in tumor blood vessels, with a gradual decrease in CD31-positive ECs from the edge to the central region of the metastatic lesion. An expression pattern similar to Ang-2 was found in glucose transporter 1 (Glut-1), a known hypoxia-induced factor. These findings suggest that hypoxia plays an important role in inducing the expression of Ang-2 in CRC.

Angiopoietin-2↗
PubMedDate not supplied

[Characteristics of osteosarcomas and morphological changes in the rat thymus during the combined action of gamma-radiation and 239Pu].

Under the combined effect of external gamma-irradiation and 239Pu, osteosarcomas occur more frequently and at earlier times, and have more pronounced multicentric pattern of growth and metastatic spreading than occurs with the two agents delivered separately. The difference is in the increased development of tumors and the decreased osteogenesis. Tumor carriers develop atrophy of thymus lymphoid tissue more frequently than normal ones.

Animals↗
PubMed1989

Strategy for lymphadenectomy of gastric cancer.

To determine the extent of lymphadenectomy necessary to cure early gastric cancer, the relationship between the frequency of nodal involvements and the extent of the primary invasion was examined in 274 patients with primary cancer of the stomach. We also evaluated the relationship between the number of metastatic lymph nodes, the pattern of metastases to the nodes, and the histologic type of the primary tumor. In early gastric cancer, lymph node metastasis was more frequent in protruded-type cancer with invasion into the submucosa more than 3 cm in diameter and located in the lower third of the stomach, but was limited to the group 1 lymph nodes, which were defined as being anatomically located nearest to the cancer. In cancer invading into the muscularis propria, metastasis to the group 2 or 3 lymph nodes, which were defined as being anatomically located farther from the cancer than group 1, was found. The number of lymph nodes involved and extent of cancer metastasis in these lymph nodes metastasis, differentiated early gastric cancer had more lymph node involvement and wider extent of metastases than undifferentiated cancers. The cancer cells sometimes replaced most of the node and invaded the perinodal fatty tissue, even in early gastric cancer. In addition, it is occasionally difficult to distinguish macroscopically early gastric cancer with submucosal invasion from cancer invaded into the muscle layer. In conclusion, group 1 and 2 lymph nodes, including perinodal fatty tissue, should be removed completely, even in early gastric cancer, except for carcinoma in situ, particularly when the cancer is of the differentiated type.

Adenocarcinoma↗
PubMed1986

Mucinous carcinoid tumor of the appendix presenting as bilateral ovarian tumors.

Mucinous carcinoid tumor of the vermiform appendix, an uncommon variant of appendiceal carcinoid, may present clinically with ovarian metastases. We studied a tumor by immunohistochemistry and electron microscopy and reviewed eight similar cases from the literature. The primary and metastatic tumors in our case were composed of mucin-producing cells and small argyrophilic cells arranged in cords and acini. Tumor cells in both primary and metastatic sites exhibited identical patterns of immunoreactivity for epithelial antigens (epithelial membrane antigen, carcinoembryonic antigen) and neuroendocrine antigens (serotonin, vasoactive intestinal polypeptide, adrenocorticotropic hormone). Ultrastructurally, the cells contained either mucin vacuoles or dense-core neurosecretory granules; rare individual cells contained both types of inclusions. When bilateral solid mucinous ovarian tumors are discovered at laparotomy, diagnostic appendectomy is indicated if no obvious extraovarian primary tumor can be found.

Adrenocorticotropic Hormone↗
PubMed1984

[Effect of the morphological structure of lung cancer on the incidence and type of regional metastases].

A correlation between the frequency, nature of metastatic spreading and histological pattern of lung cancer was established on the basis of a study of 2,107 cases of morphologically confirmed cancer, 1,251 specimens of resected lung tissue and 145 exploratory thoracotomies. Poorly-differentiated cancer of the lung was found to involve frequent formation of metastases at all stages. Metastases generally occur as multiple lesions of lymph nodes.

Adenocarcinoma↗
PubMed1994

[Are video-assisted thoracoscopic resections in oncological surgery defensible?].

Video-assisted thoracoscopic surgery (VATS) is not to be accepted in oncologic patients at present. Up till now, the technical facilities are not as advanced as to compete with the established procedures of conventional surgery. The thoracoscopic, more indirect surgical methods are not able to adequately adjust to the specific growth pattern and paths of metastatic spread of bronchial carcinoma. Surgery for pulmonary metastasis has to be considered under the same aspects. Preoperative staging of lung cancer and the location and number of pulmonary metastases cannot be sufficiently assessed by computed tomography. Consequently, palpation of both the inflated and deflated lung is mandatory. Oncologic surgery includes complete lymph node dissection in all compartments, which cannot be achieved by VATS at present. It is irresponsible to risk the internationally quite homogenous stage-related results obtained in bronchial carcinoma for the sake of some new technical equipment. In surgery for lung metastasis, curative treatment demands to completely remove all lesions and the corresponding lymph nodes. This management alone promises benefit for the patient. VATS is established in 1) removal of coin lesions (change to open surgery in case of malignancy; 2) diagnostic resection in metastasis surgery. Results after VATS have to be assessed for quality control in VATS in the same way as it is done for open surgery.

Carcinoma, Bronchogenic↗
PubMedDate not supplied

Multivariate analysis of prognostic features in malignant pleural effusions from breast cancer patients.

To identify prognostic indicators in breast cancer patients with malignant pleural effusions, we analyzed the cytopathologic features of 57 fluids representing the first pathologic diagnosis of a distant metastasis in these women. The specimens were analyzed prior to reviewing the clinical records. The median survival of 55 patients who died of the disease was five months following the effusion diagnosis (range, 1-114). Univariate analysis identified three cytopathologic features that correlated with relatively prolonged survival: arrangement of tumor cells in spheroids, slight nuclear atypia and low mitotic rate. Women whose tumor cells formed spheroids survived a median of 24.5 months as compared to 4 months for women with all other architectural patterns (P = .004). Multivariate analysis revealed that slight nuclear atypia and low mitotic rate strongly correlated with spheroid formation. Since breast cancers that form spheroids in effusions portend a relatively favorable prognosis, we recommend that cytopathologists comment on this pattern when reporting on metastatic breast carcinoma in pleural fluids.

Adult↗