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The evaluation of trends in soft tissue sarcoma according to diagnostic criteria and consumption of phenoxy herbicides.

The possible association between exposure to phenoxy herbicides and development of soft tissue sarcomas has been studied in both case-control and cohort studies. In these studies soft tissue sarcoma cases have been identified from either deaths with malignant neoplasms of the connective tissue (ICD-8 171) as the underlying cause of death, from incident cancer cases with the same topography code, or from incident cases of extraskeletal sarcomas, excluding lympho and reticulosarcomas. The current study shows that the choice of source material has a considerable influence on the registered occurrence of soft tissue sarcomas in a well defined population. In 1978 to 1982 an annual number of 33 deaths from ICD-8 171 was registered in Denmark, whereas the annual number of diagnosed extraskeletal sarcomas was 231. The distribution over histologic types differed between tumours coded to the connective tissue and extraskeletal sarcomas coded to specific organs. Furthermore, during the period 1943 to 1982 the mortality from ICD-8 171 increased slightly, whereas the incidence from all extraskeletal sarcomas decreased slightly, except for males since 1970. Time trends based on any of the three source materials should, however, be interpreted with caution.

2,4,5-Trichlorophenoxyacetic Acid↗

T cell type immunoblastic sarcoma diagnosed primarily by CSF cell membrane features.

The case of a 65 year-old female with an immunoblastic sarcoma of T cell type (reticulosarcoma) is reported. Post mortem tumor cell infiltrations with the typically histomorphological criteria of an immunoblastic sarcoma were found in the uterus, bone marrow and leptomeninges. With the aid of immunological markers the T cell type of this malignant lymphoma was diagnosed intra vitam on the basis of CSF cells. Until now, only one case of an immunoblastic sarcoma of the T cell type has been described in the literature.

Aged↗

[Antibodies to Epstein-Barr virus in the sera of children with different neoplasms].

The presence of antibody to virus capsid antigen (VCA) of Epstein-Barr virus (EBV) was determined in sera from children with various forms of neoplasia by the indirect immunofluorescence procedure of Henle. Eighty-one sera from children with Wilms tumor, teratoblastoma, reticulosarcoma, neuroblastoma, soft tissue sarcoma, as well as from children with benign tumors were examined. The controls included sera from normal children of the same ages. The test cells synthesizing VCA were suspension cultures of P3HR-1 cells which are one of the clones of Burkitt lymphoma. The studies showed no increase in the content of antibody to EBV in any of the groups of children with tumors as compared with the controls. It was also found that the percentage of EBV infection in various groups of sick and normal children varied from 82 to 100.

Adolescent↗

[Arteriography, lymphography, gammagraphy and computer tomography in the diagnosis of musculoskeletal tumors].

The authors emphasize the importance of early and exact diagnosis of musculoskeletal tumours of the extremities and spine. This aim cannot be achieved by common biochemical, haematological and X-ray examinations. Therefore the authors recommend to use already during the initial examination of the patient a combination of classical roentgenography, arteriography, possibly lymphography, gammagraphy and computed tomography. The authors present a detailed account of experience with the application of the above diagnostic methods in 146 patients. On arteriograms of 37 patients dislocated main arteries were found 16 times, blood lakes 20 times. Lymphography revealed metastatic affection of regional lymph nodes in 21% of all patients, most frequently in bone reticulosarcoma and in synovial sarcoma. All-body gammagraphy helped to make the localization and assessment of size of the tumour more accurate, in two-thirds of the patients it was larger when visualized by this method than on native roentgenograms. In 3 of 14 Ewing sarcomas all-body gammagraphy revealed a polyostotic localization of the tumour. Computed tomography revealed the extent of infiltration and destruction of bone and soft tissues in pelvic and spinal tumours.

Adolescent↗

[Cytokinetics of lymph nodes in lymph nodes in lymphatic system diseases (author's transl)].

Untreated malignant lymphatic system diseases are characterized by a preponderance of cell new formation (proliferation) against the destruction of lymphatic cells. If the lymph nodes are enlarged during these diseases, then cell new formation occurs largely or mostly in these lymph nodes. The proliferating cells of the lymph node are bigger than small lyphocytes and have, in general, a mean diameter of the nucleus of 10 mu and more. In normal lymph nodes they belong morphologically to the big lymphocytes, immunoblasts and plasmoblasts. In pathological lymph nodes they have to be looked for among the bigger cells of the disease-specific cell population. Whereas in healthy lymph nodes and in chronic lymphatic leukemia only about 1% of lymph node cells was found to proliferate, they amount on the average to 5% in lymphomas of lymphogranulomatosis and mostly to 30--50% in the lympho-reticulosarcoma (lymphoblast and immunoblast sarcoma, corresponding to large-cell, poorly differentiated lymphomas). The proliferating cells often appear as foci in the lymphomas. The generation times of the proliferating cells both in normal and pathological lymph nodes are about 24 hrs. or slightly longer. In lymphatic proliferation, apart from plasma cells big and smallymphocytes are produced in the normal lymph node; in CLL, big and small lymphocytes, in lymphogranulomatosis, big and small lymphocytes and Hodgkin-cells, and in poorly differentiated lymphomas, the corresponding lymphoma cells are produced. The clinicist is at the beginning of drawing conclusions from prevalent kinetic disturbances.

Cell Division↗

[Cerebral metastasis in Blacks in Senegal].

Twenty-six brain-metastases in black patients, appearing for most of them as primitive, were observed during a period of 11 years in the Neurological Clinic of the Fann U.H.C. in Dakar. They represent 13.9% of brain-tumours and 11.81% of intracranial space occupying lesions. Their etiology is very diversified: lung cancer (4, 15.4%); breast (0); liver (3, 11.5%); digestive tract (3, 11.5%); prostate gland (1); ovaries (1); parotid gland (1); thyroid gland (2); lympho-reticulosarcoma (2); melano-sarcoma (1); chorio carcinoma (3); undetermined (5, 11.5%). This series enables us to appreciate differences with African statistics, which are not numerous and with other foreign statistics. The difference of division of cancer in Africa, particularly in Senegal, explains some results such as the relative high frequency of liver-cancer in the etiology of this metastasis. But it is surprising to learn that lung-cancer is frequent and breast-cancer absent. Also to be marked is the non-negligible influence of the choriocarcinoma metastasis. Progress in approaching diagnosis, by developing scintigraphy, might facilitate extraction of solitary metastasis more often.

Adult↗

Cancer in renal transplant recipients.

The incidence of cutaneous malignancies and non-Hodgkin lymphomas is higher in transplant recipients than in the general population. From 1968 to 1984, 200 kidney grafts were transplanted to 180 patients with end-stage renal disease. All patients were on azathioprine (Aza) and prednisolone. In selected cases ALG and/or small doses of CsA were added. Six patients developed malignant tumors (two Kaposi sarcoma, one squamous cell and one squamous plus basal cell skin cancers, one reticulosarcoma, and one glioma). Mean age of patients was 43 years (range 35-53 years), and mean time of appearance of the tumor after transplantation was 62 months (range 24-98 months). Treatment consisted of reduction of the dosage of Aza, surgical removal or local irradiation of the tumor, and chemotherapy in case of systemic involvement (two cases). Three patients died (one Kaposi sarcoma, one reticulosarcoma, and one glioma) 3 to 6 months after diagnosis, and all three had previously been on high doses of Aza. The remaining three cases (one Kaposi) were cured by stopping or decreasing Aza, by excision, and/or local irradiation of the tumor. It seems that late diagnosis and Aza in high dosage are the main factors leading to the rapid dissemination of the initially localized tumor.

Adult↗

[The diagnosis and surgical treatment of isolated lymphomas of the stomach].

The study group included 18 patients with isolated malignant lymphoma of the stomach (lymphosarcoma--15, reticulosarcoma--2 and Hodgkin's sarcoma--1). Correct diagnosis was made or suspected on the basis of clinical, X-ray and endoscopic data before surgery in 12 cases. Out of the 18 patients operated on, radical surgery was performed in 16 cases, and two patients died in postoperative period. Longterm results were studied in 11 cases; one of them (female) died 18 months after the operation. Four patients have survived 5 years, two--5-10 years and longer. Extirpation of the stomach has proved to be most effective in surgical treatment for isolated lymphosarcoma.

Biopsy↗

[Reticulosarcoma: diagnostic problems].

Diagnostic problems connected with reticulum cell sarcoma are analyzed. Clinical, radiological, biochemical and hematological investigations combined with an accurate pathologic study are essential in order to arrive at a precise diagnosis. Ewing's sarcoma and other osteolytic sarcomas are discussed in the differential diagnosis.

Adolescent↗

[Classification of vascular neoplasms].

Neoplasms of blood and lymph vessels differ from angiectatic and angiokeratotic nevi by real proliferating growth. According to their features of growth and their wall structures, they are classified into three main groups: angiomas, glomangiomas and malignant vascular tumors. Within the angiomas on the one hand, capillary angiomas are classified into: planotuberous and tuberonodous angiomas of childhood and Kasabach-Merritt syndrome, multilocular hemangiomatosis, progressive multiple angiomas, tardive ("senile") angiomas, eruptive angiomas (granulomata pediculata), papular angioplasia, gemmangioma, and benign juvenile hemangioendothelioma. On the other hand, cavernous angiomas, i.e. arterial and venous cavernomas, as well as blue rubberbleb nevus, Mafucci's syndrome, angioleiomyoma, benign juvenile hemangiopericytoma and cavernous lymphangioma, form thick walled structures without involution. Glomangiomas occur as solitary, multiple systematized, and multiple disseminated and familiar forms. Within the group of malignant vascular tumors--Kaposi sarcoma, lymphangiosarcoma in lymphedema, hemangioendothelioma and angioplastic reticulosarcoma, hemangio- or lymphangiosarcoma, angioendotheliomastosis proliferans, rarity and increasing loss of characteristic differentiated structures give rise to difficulties in nosologic classification.

Diagnosis, Differential↗

Primary rib tumours in children (report of 27 cases with short literature review).

27 cases of primary malignant and benign rib tumours are reported. The most common malignant rib tumour in childhood is Ewing sarcoma (20 cases). Some other rare bone tumours and tumorous conditions (reticulosarcoma, aneurysmal bone cyst, monostotic rib eosinophilic granuloma, osteoid osteoma and lymphangioma) are also described. In the authors' opinion Ewing sarcoma presents with characteristic clinico-radiographic findings in most of the cases. Other monostotic, primary rib tumours and tumorous conditions in childhood--with the exception of exchondroma and enchondroma--rarely show diagnostic radiographic features.

Adolescent↗

[Tumoral pathology of the jejunum. Apropos of 5 cases].

1654 cases of tumour of the digestive tube operated on in the Department of General Clinical Surgery and Surgical Therapy of the University of Pavia, during the period 2nd half 1964--1st half 1977, have been considered. Four primary tumours (1 leiomyoma, 2 adenocarcinomas, 1 reticulosarcoma) and one secondary tumour (metastases of retroperitoneal sarcoma) occurred in the jejunum and their pathology is examined from the etiopathogenetic and anatomoclinical viewpoints.

Adenocarcinoma↗

Study of malignant lymphomas from the aspect of immunoglobulin production.

Intracytoplasmic localization of immunoglobulins in neoplastic cells of malignant lymphomas was studied by both light and electron microscopic immunoperoxidase methods. This was demonstrated in 17 out of 71 cases submitted to light or electron microscopic immunoperoxidase methods. Out of 19 cases examined by the electron microscopic immunoperoxidase method, immunoglobulins were intracellularly identified in 10 cases; 3 out of 6 cases which were diagnosed as follicular lymphoma, 3 out of 5 cases of reticulosarcoma, 2 out of 6 cases of lymphosarcoma and 2 cases of immunoblastic sarcoma. Out of the above 10 cases, IgM was demonstrated in 9 cases except one of immunoblastic sarcoma in which IgA, IgG and IgM were identified intracellularly. In addition to these findings, our ultracytological and pathological studies have indicated that immunoglobulin-producing tumors can be classified into the following three major groups according to their cellular origin; germinal centers (group 1), primary follicles (group 2) and extrafollicular (group 3). Group 1 is comprised of follicular lymphoma and reticulosarcoma, group 2 lymphosarcoma, and group 3 immunoblastic sarcoma.

Adolescent↗