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PubMed2006

Pelvic chemoradiotherapy after chemotherapy for metastatic bladder cancer.

OBJECTIVE: Consolidative radiotherapy has improved local control in other tumors with high local recurrence rates but has not been well studied in urothelial cancer. We hypothesized that pelvic chemoradiotherapy (PCRT) given after systemic chemotherapy for metastatic bladder cancer (MTCC) might alter the pattern of disease recurrence, and reduce the complications and morbidity of intrapelvic disease relapse. A 74% locoregional relapse rate has been observed in MTCC patients with intrapelvic nodal disease after response to chemotherapy. To explore this hypothesis further, we performed a retrospective analysis and report the efficacy, toxicity and pattern of failure with this approach. MATERIALS AND METHODS: Patients treated for MTCC who received consolidative PCRT following at least a partial response to systemic chemotherapy were identified and their charts reviewed for pelvic relapse, disease progression, survival, and toxicity. RESULTS: Twelve patients were identified and median follow-up was 15.6 months. Nine patients developed progressive disease and died, and median survival was 15.6 months. Three patients had pelvic progression (pelvic failure rate 25%). Median time to pelvic failure was 12.8 months. At last follow-up, three patients were alive and disease-free. No life-threatening toxicities were observed. The most common acute non-hematological toxicities were diarrhea and nausea. CONCLUSIONS: These data support a hypothesis that consolidative PCRT following chemotherapy in MTCC patients with systemic disease control may be feasible and efficacious for improving pelvic disease control. This intervention should be considered for further study in prospective controlled clinical trials.

Aged↗

PubMed1991

Computed tomography contrast enhancement of cervical lymphadenopathy.

In a prospective study of 51 cases of lymphadenopathy (44 with cervical metastatic nasopharyngeal carcinoma, NPC) using intravenous contrast and computed tomography (CT), a ring enhancement was observed. A retrospective review of 105 cervical carcinomatous lymph nodes (64 with metastatic NPC) showed a prominent peripheral hypervascular pattern not seen in 48 lymphomas and 60 normal controls. We conclude that in carcinomatous cervical lymphadenopathy, enhancement can be achieved by intravenous contrast and CT; and the peripheral hypervascularity is the anatomical basis for the ring appearances seen radiographically.

Adult↗

PubMed1990

Ultrastructural features of diethylnitrosamine-induced lesions in the mouse liver.

Mice were given a single dose of diethylnitrosamine (DEN). After 12 and 15 months, the ultrastructural features of simple hepatic nodules and defined hepatocellular carcinomas were compared. The main difference between these two lesions is the presence of highly convoluted membranes in the hepatocytes of the carcinomas. A third population of nodules was also found which could not be easily classified at the light microscope level into either simple hepatic nodules or carcinomas. Ultrastructural examination of these lesions showed them to have areas resembling both simple hepatic nodules and carcinomas. Within both these areas hepatocytes with convoluted plasma membranes were observed. Changes in membrane pattern may be indicative of an altered cell growth pattern and the acquisition of invasive or metastatic properties. This provides further evidence suggesting that a sub-population of cells can be identified which has the potential to develop into overt carcinoma.

Animals↗

PubMed1989

Observations and proposed mechanism of N,N',N''-triethylenethiophosphoramide (thiotepa)-induced hyperpigmentation.

After receiving N,N',N''-triethylenethiophosphoramide (thiotepa) and cyclophosphamide intravenously, five women with metastatic adenocarcinoma of the breast developed a patterned hyperpigmentation confined to skin occluded by adhesive-containing materials. Determinations of thiotepa concentrations in occluded and nonoccluded skin, plasma, bandage with adhesive, and gauze containing sweat were performed. The results suggest that this alkylating agent is excreted onto the skin surface in sweat, accumulates beneath adhesive-containing bandages and electrocardiogram pads, and exerts a local toxic effect resulting in hyperpigmentation.

Adult↗

PubMed1995

Diagnostic and biological determinants in undifferentiated and poorly differentiated ovarian carcinomas.

Six ovarian undifferentiated carcinomas (UCs) and 19 poorly differentiated serous (14 cases) and endometrioid (5 cases) carcinomas with areas of solid diffuse carcinomas have been considered for the study. Pathological findings were analyzed in conjunction with molecular analysis concerning the structure and expression of nm23-H1 gene. Differences in the frequency of loss of heterozigosity (LOH) of this gene have been observed between the two groups, UCs displaying lower percentage of LOH (1/5) as compared to poorly differentiated tumors (17/17). The remaining 3 cases (1 UC and 2 poorly differentiated carcinomas) were homozygotes, i.e., noninformative. UCs might occur as a consequence of cellular dedifferentiation, being at the end of the differentiation spectrum of epithelial ovarian tumors. Nevertheless, this study suggests that, in a fraction of cases, UCs could represent a distinct entity not involved in the malignant progression, associated with peculiar DNA anomalies, one possibly being that of the nm23-H1 deletion. In other words, a noticeable subset of UCs, not harboring nm23-H1 alterations, may be histologically uncommitted "ab initio". Moreover, nm23-H1 LOHs could be considered early events in the ovarian carcinogenesis, because similar molecular patterns were found both in primary and metastatic sites of the same tumor.

Biomarkers, Tumor↗

PubMed1996

[Mass screening for prostate cancer in Japan].

Since 1975 mass screening for prostate cancer has been performed in Japan. The Prostate Research Foundation has analysed the data every year that collected from all institutes performing a mass screening. Up to 1993, 67, 225 subjects were examined. The detection rate of prostate cancer was 0.69%. Approximately half of the cancer were stage B, and the subjects who have metastatic stage were only 20% and the pattern of stage seemed to be different from that of patients who visited hospitals. In Chiba prefecture the subjects lived in a district of south Boso peninsula received a mass screening for prostate cancer with total of 1,964 men from 1985, and 17 cancers were diagnosed (0.87%). The distribution of prostate-specific antigen (PSA) assayed with Tandem-R kit was examined using the stocked sera (n = 976) of the screening for prostate cancer in Chiba prefecture. The percentage of 0.05-4.0 ng/ml, 4.1-9.9 ng/ml, over than 10.0 ng/ml of the PSA, were 89.6%, 7.0%, 3.4%, respectively. This distribution is approximately as same as the previous reports by the United States and Canada.

Age Factors↗

PubMed1997

Histologic classification and staging of gestational trophoblastic disease.

Gestational trophoblastic disease (GTD) forms a heterogeneous group of interrelated lesions which are characterized by an abnormal proliferation of the different types of trophoblastic epithelium. Complete hydatidiform moles represent a noninvasive placental disease that is characterized by hydropic swelling of the chorionic villi with marked trophoblastic proliferation. The partial mole contains two populations of villi: one of normal size, the other hydropic with less marked trophoblastic hyperplasia. The risk of developing persistent GTD is very low. Choriocarcinomas represent an avillous invasive proliferation of trophoblastic cells surrounded by necroses and hemorrhages displaying a dimorphic pattern with early vascular invasion and hematogeneous metastatic spread. Placental site trophoblastic tumor (PSTT) resembles the rarest form of GTD. In its cellular composition, PSTT preferentially contains intermediate trophoblastic cells with typically positive hPL-immunostaining. Mostly, PSTT's are benign tumors, but malignant cases are well known. Miscelleanous forms of GTD include the exaggerated placental site and the placental site nodule or plaque. Both lesions are proliferations of the intermediate trophoblast. Staging of GTD should only be applied in cases of persistent disease. All different staging systems, including the revised FIGO system, the classification of the National Institute of Health (NIH), the WHO scoring system and the currently adopted TNM-system are able to define high risk patients.

Adult↗

PubMed1999

Fine-needle aspiration cytology of hemangiopericytoma: A report of five cases.

BACKGROUND: Hemangiopericytoma (HPC) is a relatively rare neoplasm, accounting for approximately 2.5% of all soft tissue tumors. Its histopathology has been well documented but to the authors' knowledge reports regarding its fine-needle aspiration (FNA) cytology rarely are encountered. In the current study the authors report the cytologic findings in FNA specimens from nine confirmed cases of HPC and attempt to correlate the cytologic features with the biologic outcomes. METHODS: FNA was performed with or without radiologic guidance. Corresponding sections of tissue were reviewed in conjunction with the cytologic preparations. RESULTS: Nine FNAs were performed in 5 patients (3 men and 2 women) with an age range of 38-77 years (mean, 56 years). Two lesions were primary soft tissue lesions arising in the lower extremities; seven were recurrent or metastatic lesions from bone (one lesion), kidney (one lesion), pelvic fossa (one lesion), lower extremities (two lesions), trunk (one lesion), and breast (one lesion). All aspirates were cellular and were comprised of single and tightly packed clusters of oval to spindle-shaped cells aggregated around branched capillaries. Basement membrane material was observed in 6 cases (67%). The nuclei were uniform and oval, with finely granular chromatin and inconspicuous nucleoli in all cases except one. No mitotic figures or areas of necrosis were identified. A correct diagnosis of HPC was made on one primary lesion and all recurrent or metastatic lesions. CONCLUSIONS: HPCs show a spindle cell pattern in cytologic preparations and must be distinguished from more common spindle cell lesions. The presence of branched capillaries and abundant basement membrane material supports a diagnosis of HPC. Immunohistochemistry and electron microscopy performed on FNA samples may be helpful in the differential diagnosis. FNA is a useful and accurate tool with which to confirm recurrent or metastatic HPC; however, prediction of the biologic behavior of HPC based on cytologic features is not feasible. Cancer (Cancer Cytopathol)

Adult↗

PubMed2003

The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases.

The gross and routine microscopic features of 25 stage I primary mucinous ovarian carcinomas without clinical evidence of recurrence and 25 mucinous carcinomas metastatic to the ovaries were compared. Findings that were frequent in the latter and strongly favored a metastasis were: 1) bilaterality, 2) microscopic surface involvement by epithelial cells (surface implants), and 3) an infiltrative pattern of stromal invasion. Findings that were less frequent but present exclusively or almost exclusively in metastatic carcinomas were: 1) a nodular invasive pattern, 2) ovarian hilar involvement, 3) single cell invasion, 4) signet-ring cells, 5) vascular invasion, and 6) microscopic surface mucin. Findings that were frequent in, and strongly favored, primary ovarian carcinoma were: 1) an "expansile" pattern of invasion and 2) a complex papillary pattern. Findings that were less frequent but also favored a primary tumor were: 1) size >10 cm, 2) a smooth external surface, 3) benign-appearing and borderline-appearing areas, 4) microscopic cystic glands, and 5) necrotic luminal debris. Findings that did not distinguish the tumors were: 1) a cystic gross appearance, 2) gross solid, papillary, necrotic, or hemorrhagic areas, 3) nature of cyst contents (mucinous vs nonmucinous), 4) stromal mucin (pseudomyxoma ovarii), 5) cribriform, villous, or solid growth patterns, 6) focal area resembling typical colonic carcinoma, 7) goblet cells, or 8) tumor grade. Primary and metastatic mucinous ovarian carcinomas can be distinguished from each other in the great majority of cases based solely on their conventional histopathologic findings. Careful gross evaluation is also important with special attention paid to the external surface of the ovarian tumor(s) to detect abnormalities that have the features of surface implants on microscopic evaluation.

Adenocarcinoma, Mucinous↗

PubMed1991

Isoelectric focusing and immunoblotting analysis of thyroglobulin from different thyroid diseases.

Thyroglobulins (Tgs) have been obtained from macro-microfollicular goiter, toxic adenomas, papillary carcinomas and metastatic lympho-node and chromatographed by gel filtration. The 19S Tgs so obtained have been characterized by isoelectric focusing (IEF) and immunoblotting. IEF showed microheterogeneity pattern of Tgs from normal tissue, macro-microfollicular goiter and toxic adenomas to be within pH range from 4.2 to 4.5, while that from papillary carcinomas and metastatic lympho-node showed a wider microheterogeneity. Passive blotting of focused Tgs and immunoreaction with rabbit anti-Tg peroxidase conjugated antibody have been carried out and a positive reaction for all examined samples have been evidenced. Also two bands, focused at more cathodic pH value (pH 4.7), observed in IEF patterns of Tgs from carcinomas and metastatic lympho-node, gave a positive reaction with anti-Tg conjugated antibody. These differences observed in IEF and immunoblotting patterns of Tgs from papillary carcinomas and metastatic lympho-node are discussed in this report.

Adenoma↗

PubMedDate not supplied

Comparison of fusion imaging using a combined SPECT/CT system and intra-arterial CT: assessment of drug distribution by an implantable port system in patients undergoing hepatic arterial infusion chemotherapy.

Hepatic arterial infusion (HAI) chemotherapy is effective for treating primary and metastatic carcinoma of the liver. We compared the perfusion patterns of HAI chemotherapy on intra-arterial port-catheter computed tomography (iapc-CT) and fused images obtained with a combined single-photon emission computed tomography/computed tomography (SPECT/CT) system. We studied 28 patients with primary or metastatic carcinoma of the liver who bore an implantable HAI port system. All underwent abdominal SPECT using Tc-99m-MAA (185 Mbq); the injection rate was 1 mL/min, identical to the chemotherapy infusion rate, and 0.5 mL/sec for iapc-CT. Delivery was through an implantable port. We compared the intrahepatic perfusion (IHP) and extrahepatic perfusion (EHP) patterns of HAI chemotherapy on iapc-CT images and fused images obtained with a combined SPECT/CT system. In 23 of 28 patients (82%), IHP patterns on iapc-CT images and fused images were identical. In 5 of the 28 patients (18%), IHP on fusion images was different from IHP on iapc-CT images. EHP was seen on fused images in 12 of the 28 patients (43%) and on iapc-CT images in 8 patients (29%). In 17 patients (61%), upper gastrointestinal endoscopy revealed gastroduodenal mucosal lesions. EHP was revealed on fused images in 10 of these patients; 9 of them manifested gastroduodenal toxicity at the time of subsequent HAI chemotherapy. Fusion imaging using the combined SPECT/CT system reflects the actual distribution of the infused anticancer agent. This information is valuable not only for monitoring adequate drug distribution but also for avoiding potential extrahepatic complications.

Adult↗

PubMed1989

An autopsy case of breast carcinoma with prominent lipid-secretions in the metastatic foci.

A 70-year-old woman was treated with a simple mastectomy followed by a course of 5000 rad to the breast and chemotherapy with 5-fluorouracil for breast cancer. About 15 months later, the patient died of widespread metastases. An autopsy revealed no recurrent cancer in the breast. The metastases were seen in bones (sternum, ribs and spine), pleura, spleen, uterus, ovaries, small intestine, adrenal glands, and lymph nodes (hilar, periaortic and mesenteric). Histologically, the resected tumor was a solid-tubular carcinoma with an infiltrative growth pattern. At autopsy, the tumor cells in the metastatic foci contained an abundance of lipids in the cytoplasm, while the tumor cells in the primary tumor contained small amounts of lipids.

Adenocarcinoma↗

PubMed1986

Deceptive patterns of uremic pulmonary edema.

Three uremic patients had chest x-ray changes due to pulmonary edema, but mimicking lobar pneumonia and fungal or metastatic disease. It is important to be aware of these deceptive radiographic patterns. Otherwise, a potentially disastrous delay in fluid removal, the mainstay of therapy, may result.

Adult↗

PubMed1994

Expression of interleukin 8 correlates with the metastatic potential of human melanoma cells in nude mice.

We correlated the steady state transcription and protein secretion of interleukin 8 (IL-8) in 13 different human melanoma cell lines with their ability to grow and produce metastasis in nude mice. Highly metastatic cells expressed higher steady state levels of IL-8 mRNA transcripts than did low metastatic cells. In situ mRNA hybridization analyses confirmed the pattern of mRNA expression on a cellular level. Increased mRNA expression directly correlated with secretion of IL-8 protein as determined by enzyme-linked immunosorbent assay. Recombinant IL-8 stimulated the proliferation of low metastatic A375P cells in a dose-dependent manner, a stimulation that was abrogated by the use of a polyclonal antibody against IL-8. The data suggest that IL-8 can be an autocrine growth factor for human melanoma cells and that IL-8 is involved in melanoma metastasis.

Animals↗

PubMed1987

[An immunohistochemical study on esophageal carcinomas with various kinds of antikeratin antibodies].

Fifty five formalin-fixed, paraffin-embedded, pronase-pretreated esophageal carcinomas and their metastatic nodes were studied immunohistochemically with peroxidase-antiperoxidase technique for keratins using polyclonal antibody (DAKO), antibody against keratins of keratinocyte (KL1), against high molecular weight-keratin (EY904), and against low molecular weight-keratins (EY902, PKK1). The suprabasal layer of the esophageal epithelium was stained diffusely with DAKO, KL1 and EY902 and faintly or locally with EY904 and PKK1. Esophageal ducts were positive with any antibodies. We classified staining pattern of the esophageal carcinoma according to the localization and proportion of the positive cells in the cancer nests. No significant correlation of the staining pattern was found between the primary lesions and metastatic nodes. The proportion of the EY904-positive cells correlated significantly with the degree of lymph node metastasis, histologic stage, and prognosis by rank correlation method and generalized Wilcoxon test, but not with the depth of invasion nor histologic degree of differentiation. The proportion of DAKO-positive cells correlated significantly only with histologic degree of differentiation. It was supposed that esophageal carcinomas with high molecular weight-keratin had less tendency to metastasize to nodes.

Antibodies↗

PubMed1986

Oncocytic tumours of the salivary gland, kidney, and thyroid: nuclear DNA patterns studied by flow cytometry.

Nuclear DNA ploidy studies were performed by flow cytometry on extracted nuclei from 12 oncocytic tumours of the salivary gland, 65 oncocytic tumours of the kidney, and 37 oncocytic tumours of the thyroid gland from the pathology archives of the Mayo Clinic. In order to provide an interesting clinical spectrum, three different classes of well-differentiated oncocytic tumours were selected for examination. Salivary gland oncocytic tumours were chosen for their generally benign behaviour. Oncocytic thyroid cancers exhibiting malignant potential because of local invasion, were thought to represent the opposite extreme of aggressiveness. Renal oncocytic tumours were known to demonstrate an intermediate degree of malignancy. All of the oncocytic salivary gland tumours showed a 'normal' DNA histogram and had a benign clinical course. For the oncocytic tumours of the kidney, 45% of DNA histograms were normal, 40% exhibited a significant increase in the DNA tetraploid/polyploid (4C) peak, and 15% showed a DNA aneuploid peak. Three patients with a DNA tetraploid pattern developed tumour metastasis and two have died from metastatic renal cancer. Among the oncocytic thyroid cancers, 27% were normal, 22% exhibited an increased DNA tetraploid peak, and 51% had a distinct DNA aneuploid peak. None of the thyroid tumour patients with a normal DNA pattern or with an increased DNA tetraploid peak died as a result of thyroid malignancy. In contrast, 58% of patients whose thyroid tumours showed a DNA aneuploid peak subsequently died from thyroid cancer.

Adenoma↗

PubMed2001

Loss of beta-catenin expression associated with disease progression in malignant melanoma.

BACKGROUND: beta-catenin plays a crucial role in the function of cell adhesion molecules and also participates in growth regulatory signalling pathways that may be involved in malignant transformation. OBJECTIVES: To examine beta-catenin expression in lesions of melanocytic origin for associations with clinicopathological markers of disease progression and for its significance as a predictor of disease recurrence and prognosis. METHODS: beta-catenin expression was examined by immunoperoxidase staining in 50 melanocytic naevi and 91 primary and 50 metastatic melanomas. RESULTS: beta-catenin was expressed in 96% of melanocytic naevi, in 94% and 65%, respectively, of radial and vertical growth phase primary melanomas, and in 38% of metastatic melanomas. Benign and malignant melanocytic lesions had distinct patterns of beta-catenin localization. Most lesions expressing beta-catenin exhibited cytoplasmic staining; however, over 40% of benign lesions also displayed nuclear staining, which was present only in 10% of primary and 15% of metastatic melanomas. Absent or weak expression of beta-catenin in primary melanomas was associated with several markers of disease progression, including tumour thickness and presence of lymph node metastases. A similar but not statistically significant trend was observed for the association of beta-catenin expression with disease recurrence and prognosis. CONCLUSIONS: These results suggest that loss or downregulation of beta-catenin expression in melanoma cells plays a significant role in progression of the disease.

Adolescent↗

PubMedDate not supplied

Patterns of internal echoes in lymph nodes in the diagnosis of lung cancer metastasis.

In 1989-90, all 37 lung cancer patients scheduled for surgery underwent transesophageal endoscopic ultrasonography (EUS) for pre-operative detection of hilar and mediastinal lymph node metastases. An electronic ultrasonic fiberscope with a linear array (EPB-503-FS, Machida-Toshiba) was used. Of 380 nodes surgically removed and that could have been detected by EUS, the detection rates for histologically metastatic and non-metastatic nodes were 65% (33 of 51) and 44% (144 of 329), respectively (p less than 0.01). Metastatic nodes were detected readily in every lymph node site, especially subaortic and subcarinal. Non-metastatic nodes were detected at low rates, especially in the superior mediastinum, paratracheal, and tracheobronchial locations. For greater long or short axes of the detected nodes, or for rounder nodes, the metastasis rate was higher. Detected nodes were classified into six types by their internal echo patterns; three were rarely metastatic (called "negative") and the other three were often metastatic (called "positive"). Of the "negative" nodes histologically proved to be metastatic, metastasis was often diffuse. The "positive" nodes found to be metastatic tended to have one of two patterns of internal echoes when invasion was diffuse and a third pattern when it was localized. In an examination of the diagnostic usefulness of EUS, we made more correct diagnoses from the internal echo pattern than by reference to either the long or short axis alone. The short axes, node shape, and internal echoes were examined by Hayashi's second method of quantification. The sensitivity, specificity, and accuracy of the diagnoses were 85%, 84%, and 84%, respectively, superior to those by computed tomography done of the same patients.

Adenocarcinoma↗