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PubMed1997

Fine needle aspiration in the diagnosis of bone tumors.

Fine needle aspiration (FNA) is an important part of the preoperative diagnosis in bone tumors. The diagnosis must be based on clinical, radiologic and morphologic correlation. In palpable lesions, FNA is performed on the most accessible part of the tumor. Deep-seated and/or non-palpable lesions need radiologic guidance. Material from the FNA can be used for additional examinations, i.e. electron microscopy, immunocytochemistry, cytochemistry, DNA-ploidy analysis, chromosomal analysis and molecular genetics. Those examinations are of particular importance in the primary and differential diagnosis of Ewing sarcoma, osteosarcoma and chondrosarcoma. The majority of tumors in FNA aspirates can be classified as primary (benign or malignant) and metastatic tumors. Cellularity, pleomorphism, chromatin pattern, nucleolar structure, mitotic figures and necrosis are parameters of malignancy.

Biopsy, Needle↗

PubMed2005

In vitro characterization of 211 At-labeled antibody A33--a potential therapeutic agent against metastatic colorectal carcinoma.

The humanized antibody A33 binds to the A33 antigen, expressed in 95% of primary and metastatic colorectal carcinomas. The restricted pattern of expression in normal tissue makes this antigen a possible target for radioimmunotherapy of colorectal micrometastases. In this study, the A33 antibody was labeled with the therapeutic nuclide (211)At using N-succinimidyl para-(tri-methylstannyl)benzoate (SPMB). The in vitro characteristics of the (211)At-benzoate-A33 conjugate ((211)At-A33) were investigated and found to be similar to those of (125)I-benzoate-A33 ((125)I-A33) in different assays. Both conjugates bound with high affinity to SW1222 cells (K(d) = 1.7 +/- 0.2 nM, and 1.8 +/- 0.1 nM for (211)At-A33 and (125)I-A33, respectively), and both showed good intracellular retention (70% of the radioactivity was still cell associated after 20 hours). The cytotoxic effect of (211)At-A33 was also confirmed. After incubation with (211)At-A33, SW1222 cells had a survival of approximately 0.3% when exposed to some 150 decays per cell (DPC). The cytotoxic effect was found to be dose-dependent, as cells exposed to only 56 DPC had a survival of approximately 5%. The (211)At-A33 conjugate shows promise as a potential radioimmunotherapy agent for treatment of micrometastases originating from colorectal carcinoma.

Antibodies, Monoclonal↗

PubMed1998

Acute myelofibrosis mimicking multiple bone metastases on Tc-99m MDP bone imaging.

PURPOSE: Tc-99m bone scintigraphy is widely used for evaluation of osseous spread of malignant tumors. PATIENT: A 60-year-old man had multiple areas of increased uptake on a bone scan in a pattern considered characteristic for extensive metastatic disease. However, a primary neoplasm could not be identified. Finally, acute myelofibrosis--a rare, fatal myeloproliferative syndrome--was diagnosed. CONCLUSION: To avoid delays and extensive diagnostic procedures, acute myelofibrosis should be considered in the differential diagnosis of bone scans showing multiple hot spots. In such cases, a diagnosis can be made on an a tissue sample.

Acute Disease↗

PubMedDate not supplied

Brenner tumor of the ovary: CT and MR findings.

PURPOSE: The purpose of this study was to determine the CT and MR characteristics of Brenner tumors, rare epithelial neoplasms of the ovary. METHOD: CT and MR scans of eight pathologically proven Brenner tumors of the ovary (seven benign, one malignant, and one associated with mucinous cystadenoma) were retrospectively reviewed. The masses were analyzed for location, size, external configuration, internal architecture, enhancement pattern, presence of calcification, and metastatic spread. RESULTS: The patients' median age was 63 years (range 39-79 years), and the mean size of the tumors was 11.4 cm (7.5-17 cm). All tumors were unilateral and had a well-defined margin. The mass was mostly solid in three, mostly cystic in one, and "mixed" solid and cystic in four cases. The tumors with cystic components (n = 5) were mostly multilocular in appearance (n = 4). All the solid components showed mild homogeneous enhancement on postcontrast CT and MRI. Extensive amorphous calcification within the solid component on CT was seen in five of six cases (83%). No characteristic findings discriminating malignancy from benign Brenner tumor could be found. CONCLUSION: Extensive amorphous calcification in a solid mass or solid component in a multilocular cystic mass is a characteristic finding of Brenner tumor of the ovary on CT and MRI.

Adult↗

PubMed2004

Small cell carcinoma of the major salivary glands: clinicopathologic study with emphasis on cytokeratin 20 immunoreactivity and clinical outcome.

Small cell carcinomas arising in salivary glands, extremely rare high-grade malignant tumors, are subclassified into neuroendocrine and ductal types. The neuroendocrine type may be segregated further into Merkel cell and pulmonary varieties according to cytokeratin 20 immunoreactivity. Whether subclassification of this tumor group has any biologic or clinical significance is not known. We examined 15 cases (11 men, 4 women; mean age, 66.5 years) of small cell carcinoma of major salivary glands from a single institution and analyzed their clinicopathologic profiles, including immunohistochemical features and prognostic factors. Three fourths of small cell carcinomas showed cytokeratin 20-positive immunostaining, often with a paranuclear dotlike pattern of reactivity. All tumors were immunoreactive for at least 2 of 6 neuroendocrine markers examined, and 6 tumors were also positive for neurofilament, with a paranuclear dotlike pattern. Postoperatively, 9 patients developed metastatic disease, and 10 patients died of disease 2 to 45 months (mean, 15.9 months) after diagnosis. By log-rank analysis, overall survival was reduced significantly for patients with a primary tumor larger than 3 cm in diameter (P = 0.032), negative immunostain reaction for cytokeratin 20 (P = 0.012), and decreased immunoreactivity for neuroendocrine markers (P = 0.034). These results indicate that small cell carcinoma of major salivary glands is a highly aggressive tumor, although the prognosis may be better than for extrasalivary neoplasms. Our data also suggest that most salivary gland small cell carcinomas exhibit neuroendocrine differentiation. Immunohistochemical expression of cytokeratin 20 can be used to classify salivary small cell carcinomas into Merkel cell and pulmonary types and may have prognostic significance.

Aged↗

PubMed1999

Differential expression of facilitative glucose transporter (GLUT) genes in primary lung cancers and their liver metastases.

Glucose uptake is mediated by members of the facilitative glucose transporter (GLUT) family. Malignant cells take up more glucose than their normal counterparts. The aim of this study was to investigate the gene expression levels of the GLUT family, especially GLUT1, GLUT3, and GLUT5 in primary lung cancer, metastatic liver tumors, and normal lung tissues, and to compare the expression levels of primary and metastatic tumors with those of normal tissues. We analyzed 105 autopsy samples (35 primary lung tumors, 35 corresponding normal lung tissues, 25 normal liver tissues, and 10 metastatic liver tumors) from 35 patients using the quantitative reverse transcription polymerase chain reaction. The GLUT1 gene expression levels in primary lung tumors were significantly higher than those in normal lung tissues. In liver metastatic lesions, the GLUT3 and GLUT5 gene expression levels were significantly higher than those in primary lung tumors, but there were no differences in GLUT1 expression levels between primary and metastatic liver tumors. Our results show that the gene expression pattern of the GLUT family is different between primary and metastatic liver tumors and suggest that the energy transporters in metastatic tumors may be different from those in primary tumors.

Actins↗

PubMed1982

Hepatocellular carcinoma combined with hepatic mesenchymal cell tumor and sarcoma.

An autopsy case of hepatocellular carcinoma combined with sarcoma and mesenchymal cell tumor or cholangiole cell carcinoma is presented. The main tumor nodes in the liver consisted of hepatocellular carcinoma and sarcoma. Extrahepatic metastases showed characteristics of monocytic or reticulum cells and hemangioendothelial sarcomas. In this report, some problems concerning hepatocellular carcinoma and sarcomatous representation of the liver tumor are proposed. Differentiation to the monocyte-macrophage-like cells and a reticulum cell pattern were present in the metastatic locations. Thus strongly suggesting that the sarcoma may have arisen from mesenchymal cells, particularly from the Kupffer cells or endothelia consisted of the sinusoid. However, mesenchymal tumor from cholangiole cells might be associated in a part of the sarcomatous cells.

Adenocarcinoma↗

PubMed1975

Malignant meningioma metastasizing through the cerebrospinal pathways.

A 53-year old man presented with a malignant meningioma which was incompletely removed. The tumour subsequently metastasized through the cerebrospinal pathways causing clinical signs through invasion of the cranial nerve roots. Microscopically, the metastatic deposits displayed a papillary pattern and increased anaplastic cytological features.

Brain Neoplasms↗

PubMedDate not supplied

Spectrum of thymic uptake at 18F-FDG PET.

Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as a strong diagnostic tool for the diagnosis and staging of neoplasms. Uptake in the thymus at (18)F-FDG PET complicates the assessment of mediastinal involvement by tumor in children and young adults. Increased thymic (18)F-FDG uptake may represent normal physiologic uptake but may also indicate the presence of thymic hyperplasia, lymphomatous infiltration, primary thymic neoplasm, or metastatic disease. Familiarity with the patterns of (18)F-FDG uptake that characterize these pathologic conditions is crucial to the interpretation of PET findings in the thymus. In addition, awareness of the subsets of patients in whom physiologic uptake may be seen and of the normal morphologic features and (18)F-FDG PET appearance of the thymus, along with a general sense of the upper limits of metabolic activity for physiologic thymic uptake, will aid in differentiating between physiologic thymic uptake and mediastinal disease. In equivocal cases, correlation with morphologic data from computed tomography or magnetic resonance imaging will likely continue to play a key role in diagnosis and will aid in differentiating benign thymic uptake from malignancy.

Fluorodeoxyglucose F18↗

PubMed2002

Prognostic factors for patients with microsurgically resected brain metastases.

BACKGROUND: With the advent of new therapies for metastatic carcinoma to the brain, patterns of intracranial disease and factors influencing survival become important considerations when examining treatment options. This study was conducted at a single institution to determine prognostic factors for tumor response and patient survival after microsurgical resection of brain metastases. PATIENTS AND METHODS: 187 consecutive patients who underwent microsurgical resection of brain metastases between July 1989 and September 1996 were retrospectively reviewed and statistically analyzed. The primary cancers included lung cancer (85), gastrointestinal cancer (20), renal cell cancer (19), breast cancer (17), malignant melanoma (8) and 38 cases of various other carcinomas or of unknown primary site. 111 patients received whole-brain radiation therapy (WBRT) with a mean dose of 32 Gy after tumor resection. The influence of number, size, and localization of brain metastases as well as histology of the primary tumor, preoperative performance status, presence of extracranial systemic disease, time course and adjuvant radiation therapy were statistically evaluated (uni- and multivariate) as prognostic factors for survival. RESULTS: Early postoperative Karnofsky score was improved in 59%, unchanged in 32% and worse in 9% of patients. Median survival time (MST) was 9.8 months (range 1 day-5.3 years). The most important parameter showing a significant influence on survival time was the histology of the primary tumor, with prediction of a bad outcome especially for patients with metastases from renal-cell cancer and malignant melanomas. Patients with breast cancer showed longer survival than patients with other primary cancers. Furthermore, survival varied significantly depending on location of brain metastases, performance status at time of craniotomy and duration of symptoms. None of the other studied variables gained prognostic significance. CONCLUSION: Microsurgical resection of one or more brain metastases followed by WBRT still is a useful and efficient treatment in a carefully selected patient group to prolong median survival and improve or stabilize the performance status. Among the factors determining the survival times in this patient group, histology of the primary tumor is most important, together with preoperative Karnofsky score, location of metastasis and preoperative duration of symptoms.

Adult↗

PubMed1996

Pulmonary and mediastinal metastases of a vaccination-site sarcoma in a cat.

Sarcomas at vaccination sites in cats were first reported in 1992. Recent retrospective studies have confirmed an association between these vaccination-site sarcomas (VSS) and feline leukemia virus (FeLV) and/ or rabies vaccines. In most cases, VSS are locally invasive fibrosarcomas that tend to recur but rarely metastasize. We report the mediastinal and pulmonary metastases of a VSS in a FeLV-and feline immunodeficiency virus-negative, 8-year-old, domestic short-haired cat. The primary sarcoma was removed from an interscapular vaccination site and diagnosed as a VSS 3 months prior to radiographic lesions suggestive of pulmonary and mediastinal metastases. At necropsy, there were multiple pulmonary and mediastinal nodules that histologically and ultrastructurally were fibrosarcomas, cytomorphologically similar to the VSS. In addition, immunohistochemical staining patterns of the VSS and metastatic sites were consistent with that described for VSS. Recent reports of pulmonary and mediastinal metastases of interscapular VSS emphasize the importance of early diagnosis and treatment of these tumors.

Animals↗

PubMed1986

Two cases of spontaneous malignant fibrous histiocytoma in Wistar rats.

Spontaneous malignant fibrous histiocytoma (MFH) of subcutaneous tissues was found in 2 Wistar rats of a 18-month-old male and a 21-month-old female. These tumors consisted of spindle, oval, myxoid and giant cells. In the female rat, a similar histological pattern was found in the metastatic tumor nodules in the lung and liver. In the electron microscopy, four differentiated cells of fibroblast-like, histiocyte-like, giant and undifferentiated cells were identified in these tumors. Spontaneous MFH of Wistar rats in the present study was quite similar to those reported in rats of other strains.

Animals↗

PubMed1996

Clinical significance of diffuse dural enhancement detected by magnetic resonance imaging.

This study was performed to determine the clinical significance of diffuse dural enhancement (DDE) detected by magnetic resonance (MR) imaging and to typify enhancing patterns related to inflammatory or metastatic causes. The authors retrospectively evaluated the clinical, imaging, and laboratory characteristics of 20 consecutive patients with DDE. Those with DDE and an underlying neoplastic disease (13 patients) were compared to 11 consecutive patients with cytological evidence of neoplastic leptomeningeal metastasis evaluated by MR imaging. The DDE was often associated with an underlying malignancy (13 (65%) of 20 patients) but it coexisted with leptomeningeal metastasis in only one patient. Skull metastases were evident in 10 (77%) of 13 patients and cranial nerve palsies in six (46%) of 13. Other causes of DDE were related to cerebrospinal fluid (CSF) leak or shunting (five (25%) of 20), with or without symptoms of intracranial hypotension, and to dural sinus thrombosis and pachymeningitis. Dural biopsies obtained in two patients with DDE showed a narrow rim of granulation-like tissue adherent to the dural surface facing the inner skull table. Magnetic resonance subtraction, diffusion, and perfusion studies revealed unique characteristics in patients with metastatic causes as compared to those with DDE secondary to CSF leak. None of the patients with proven leptomeningeal metastasis had DDE, but four of them presented with focal dural enhancement and two displayed apparent leptomeningeal enhancement. The findings indicate that DDE is not a radiographic hallmark of leptomeningeal metastasis in spite of the similarities in clinical manifestations (for example, headache and cranial polyneuropathy). Nonetheless, DDE is most frequently associated with metastatic malignancies and particularly with skull metastases and CSF leak. Special MR techniques can discern the underlying cause and elucidate the disparity in the pathophysiological mechanisms leading to DDE.

Aged↗

PubMed2002

Rhabdomyosarcomatous (myoblastic?) phenotype of metastatic malignant melanoma. A case report.

Melanoma may present a great variety of cell morphology and mimic virtually almost all other neoplasms, and metastatic lesions pose major diagnostic difficulties. A typical immunoreactive profile of melanoma is: S-100p- and HMB-45-positivity, but these markers are not always present. Other new antigens for melanoma are NKIC3 and Anti-Melan-A (MART-1). This tumor may also present expression of unspecific markers, as cytokeratin, CEA, EMA, desmin, NFP, GFAP, CD68 and actins. We present here unusual features of two metastatic melanomas, showing the anaplastic pattern, immunopositive for desmin.

Adult↗

PubMed1975

[Mesentery capillary barrier in rats injected intravascularly with ascitic Zajdela hepatoma. III. Effect of serotonin and histamine on the extravasation of the tumor].

The addition of serotonin or of histamin with tumoral cells of ascitic Zajdela's hepatoma and their injection in aorta induce plain hemodynamic changes and increase the tumoral extravasation. So only cells blocked in thrombi are observed in blood vessels. Therefore, serotonin and histamin do facilitate tumoral cells extravasation, allowing so a better metastatic diffusion in this experimental pattern.

Animals↗

PubMed1990

Chordoma metastatic to the ovary.

We report a case of sacral chordoma that metastasized to the ovary 31/2 years after initial excision. The ovarian metastasis was the initial evidence of recurrent disease and had to be differentiated from several primary ovarian neoplasms whose appearance was simulated to some extent, particularly a juvenile granulosa cell tumor and an epithelioid smooth-muscle tumor. This case illustrates a heretofore unreported (to our knowledge) metastatic site of chordoma, whose patterns of spread are briefly reviewed.

Bone Neoplasms↗

PubMed1989

State of hepatitis B viral genomes in cirrhotic and hepatocellular carcinoma nodules.

DNA of individual cirrhotic nodules (CN) and hepatocellular carcinoma nodules (HCN) of three hepatitis B surface antigen positive autopsy cases with macronodular cirrhosis were analyzed by Southern blot and slot blot hybridization with a hepatitis B virus (HBV) DNA probe. Evidence of episomal or replicating viral DNA, viral DNA integration at the same cellular DNA site in many cells (clonal integration) and viral integration in different cellular DNA sites in many different cells (non-clonal integration) was found in different cirrhotic nodules of the same liver, indicating heterogeneity in the state of HBV in different cells and in different cirrhotic nodules within each infected liver. Episomal or replicating viral DNA forms were found in all cirrhotic nodules of one liver, in less than 10% of examined nodules of a second liver and in none of the third. Evidence of clonal viral integration was found in CN of all three livers and non-clonal integration in CN of the latter two. Cirrhotic nodules with apparent different integrations in many different cells (non-clonal integration) outnumbered those with the same integration site in many cells (clonal integration), and many cirrhotic nodules in those two livers had no detectable viral DNA. Cirrhotic nodules with a viral integration in the same cellular DNA site in many cells would appear to have been formed by clonal expansion of an original cell containing the viral integration, and cirrhotic nodules with different integrations in many different cells (non-clonal integration) may have been formed by recruitment of many different cells with different viral integrations or by clonal expansion of cells without HBV integrations and subsequent viral integrations occurring integration. In one liver, three different hepatocellular carcinoma nodules appeared to represent metastatic lesions because the clonal pattern of HBV integration was identical in each, and in another liver different HCN appeared to be of different clonal origin, i.e. to have arisen from different cells, because multiple viral integrations (i.e. multiple individual restriction fragments with HBV sequences) were each different in different HCN of that liver.

Blotting, Southern↗

PubMed1988

[A case of small cell carcinoma of the prostate].

A case of a small cell carcinoma of the prostate that occurred in a 68-year-old man is reported. Needle biopsy of the prostate showed an adenocarcinoma. A second biopsy revealed both an adenocarcinoma and a small cell carcinoma. A subsequent third biopsy revealed only a small cell carcinoma, and the patient died of respiratory failure 26 months after the initial presentation. An autopsy revealed the tumor that had replaced the prostate extended into the bladder and rectum. Widespread metastatic foci, showing a histologic pattern of solely a small cell carcinoma, were present in various organs. The adenocarcinoma component was seen restricted to the prostatic region. Immunoperoxidase staining for prostate-specific antigen, prostate-specific acid phosphatase, gamma-seminoprotein, and leu-7 showed positivity only in the adenocarcinoma, whereas neuron-specific enolase was positive only in the small cell carcinoma.

Adenocarcinoma↗