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Non-Hodgkin's lymphoma with immunologic phenotype similar to non-T, non-B acute lymphocytic leukemia.

A diagnosis of diffuse poorly differentiated lymphocytic lymphoma was made from a biopsy of a scapular mass on a 24-month-old child. The bone marrow and peripheral blood were not involved in the neoplastic process. Neoplastic cells stained negatively for Sudan black B, myeloperoxidase, periodic acid-Schiff reagent, alpha-naphthyl acetate esterase, and acid phosphatase. In addition, neoplastic cells did not form nonimmune rosettes with sheep erythrocytes or contain surface membrane immunoglobulin. However, neoplastic cells were positive for terminal deoxynucleotidyl transferase and "Ia-like" antigen. We conclude that this non-Hodgkin's lymphoma has a cytochemical and immunologic phenotype similar to that of lymphoblasts from cases of non-T, non-B acute lymphocytic leukemia.

Bone Neoplasms

Immunohistochemical detection of tartrate-resistant acid phosphatase in non-hematopoietic human tissues.

Immunohistochemical studies were done on formalin-fixed, paraffin-embedded tissues to evaluate the specificity of a newly developed monoclonal antibody (9C5) against tartrate-resistant acid phosphatase. Sections from 195 specimens were examined, which included 33 types of tissues/organs. These tissues included normal, inflammatory, and neoplastic processes. Neoplastic tissues from 14 patients with hairy cell leukemia served as positive controls. Epitope enhancement was accomplished either by microwave irradiation in citrate buffer or by boiling in water followed by trypsin digestion. Tissues were reacted with monoclonal antibody 9C5 and stained with either the avidin-biotin peroxidase method or the alkaline phosphatase anti-alkaline phosphatase method. The hairy cells of all cases of hairy cell leukemia reacted positively with 9C5. Other positively stained cells included osteoclasts, activated macrophages and giant cells. Immunohistochemical studies with 9C5, when interpreted within the context of the specificity of this antibody, are useful for the diagnosis and assessment of treatment results for hairy cell leukemia. Monoclonal antibody 9C5 also may be useful as a marker for osteoclasts and the activated macrophages and for the diagnosis of disorders involved by these cells.

Acid Phosphatase

Enzymes in benign and malignant effusions.

A critical review of the work done in this area indicates that, of the available enzyme systems now used in clinical diagnosis, the LDH system is the only one of significant value in the examination of pleural and peritoneal effusions. In terms of differential diagnosis, estimation of pleural or peritoneal fluid LDH levels will enable the examiner to distinguish between poorly cellular vs. abundantly cellular effusions. In the abundantly cellular effusions, estimation of levels of LDH do not distinguish with any degree of accuracy between those effusions due to inflammatory processes vs. neoplastic processes. Results of studies of LDH isoenzymes are at variance and require more study.

Ascitic Fluid

Assay for beta-glucuronidase in cerebrospinal fluid: usefulness for the detection of neoplastic meningitis.

The specificity and sensitivity of the assay for beta-glucuronidase in cerebrospinal fluid were evaluated to determine the usefulness of this test for the detection of neoplastic meningitis. The enzyme activity was first measured in cerebrospinal fluid from 131 patients with various disorders and was then prospectively measured in cerebrospinal fluid from 30 patients with cytologic results that were positive for or suggestive of malignant disease. Within the first group, elevated levels of beta-glucuronidase were found only among patients with neoplastic processes in the central nervous system, including neoplastic meningitis. Among 26 patients with neoplastic processes in the central nervous system, including neoplastic meningitis. Among 26 patients with positive cytologic results, 13 had elevated beta-glucuronidase activities. Elevated values were more frequent among patients with adenocarcinoma (75%) and myelogenous leukemia (60%). The patients with these two disorders also had the highest enzyme activities. The correlation of th beta-glucuronidase level with other cerebrospinal fluid values, including total protein, glucose content, and cell count, was not significant. The findings of this study indicate that measurement of beta-glucuronidase in cerebrospinal fluid can be used as an adjunctive diagnostic test for neoplastic meningitis. The results should be interpreted with caution, however, because of the possibility that the elevated enzyme levels may be due to acute or subacute bacterial or fungal meningitis.

Cerebrospinal Fluid

Studies of neoplastic development in respiratory tract epithelium.

The dynamics of neoplastic development in conducting airways were studied in an animal model using morphologic and tissue culture techniques. Evidence for the regression of many metaplastic-dysplastic lesions, including advanced "preneoplastic" lesions, was provided. This regression of lesions is not synonymous with reversion of the neoplastic process. The number of "carcinogen-altered" cells and the number of cells with neoplastic potential continued to increase as a function of time after carcinogen exposure. With the cell culture methods developed for these studies, it is possible to analyze qualitatively and quantitatively the progression of the neoplastic process as it takes place in vivo and to detect and enumerate the progenitor cells of later-appearing cancers. The investigations also provide strong evidence suggesting that carcinogen-exposed organs contain many more cells with neoplastic potential. This expression may, however, be sharply enhanced when permissive or promoting conditions prevail. The investigations open up new avenues to develop means for detection of preneoplastic cell populations and for therapeutic intervention during early phases of the neoplastic disease process.

9,10-Dimethyl-1,2-benzanthracene

Current state-of-the-art in human cell transformation in culture.

The immortalization and transformation of cultured human cells has far-reaching implications for both cell and cancer biology. Human cell transformation studies will increase our understanding of the mechanisms underlying carcinogenesis and differentiation. The neoplastic process can now be studied in a model human cell culture system. The accompanying biochemical and genetic changes, once identified, will help define the relationship between malignancy and differentiation. The present studies indeed demonstrate that the neoplastic process can now be studied in a human cell model system. Primary human cells treated with various carcinogens became immortalized in culture but were not tumorigenic. Additional exposure to either retroviruses, chemical carcinogenes or X-ŗay irradiation to these cells induced morphological alterations associated with the acquisition of neoplastic properties. These findings demonstrate the malignant transformation of human primary cells in culture by the combined action of either a DNA transforming virus and a retrovirus or a DNA virus and a chemical or X-ray irradiation, and support an multistep process for neoplastic conversion. It has been known that normal human cells in culture are remarkably resistant to experimentally induced tumorigenicity. However, as shown above, normal human cells could now be transformed into tumorigenic cells.

Cell Transformation, Neoplastic

Fibrous histiocytomas of the oral mucosa.

The oral lesions reported in this article fall into the first category of benign fibrous histiocytomas analogous to those which occur on sun-exposed skin surfaces of young objects. The ages of the patients, the histologic features and the history of traumatic episodes, as well as their biologic behaviors on follow-up, are all features compatible with those benign lesions which occur in the skin. According to the information presented in these cases, there is stronger evidence that the lesions of the oral mucosa, like their dermatologic counterparts, are representative of reactive inflammatory processes rather than neoplastic processes. It is of considerable interest that in both cases reported here the patients were children whose lesions developed following significantly severe traumatic episodes. Also of interest is the finding that the lesions healed with no recurrences or complications, even though in one of the cases it was not completely removed. These findings are in agreement with other reports of such lesions which have occurred in the head and neck regions of children and young adults. From the over-all information obtained in the literature review regarding the biologic behavior of benign fibro-histiocytic lesions, the collected data seem to indicate that lesions of the skin and superfacial mucosal surfaces which occur in children and young adults are proliferative, reactive lesions and infection, or irradiation. Systemic, visceral, or deep-seated lesions in the lower extremities appear to be true neoplasms and their prognoses must be considered as guarded.

Child

Paget's disease of the breast.

Criteria of the morphological diagnosis as well as the histogenesis of the lesions in Paget's disease are presented; the authors claim that the initial lesion occurs in the lactiferous ducts, the skin being secondarily involved. Likewise, the dyskeratotic lesions are considered as secondary to the neoplastic process, either by neoplastic induction or by mobilization and proliferation of cancerous cells from lactiferous ducts. The utility of biopsies in all cases of nipple eczema, and of the histologic investigation of the profound tissues is pointed out. In this way the canalicular starting point in the vicinity of the nipple can be noticed.

Breast

[The association of myasthenia gravis and hairy-cell leukemia].

Myasthenia gravis (MG) and tricholeucemia (TL) produce an important immune alteration favoring the appearance of neoplastic and autoimmune disorders. The case of a 53 years old patient who developed type B TL 5 years after the diagnosis of MG is reported. Upon revision of the literature, 37 cases of association of MG and malignant hemopathies, fundamentally lymphoproliferative were found. In general, MG precedes the appearance of the neoplastic process. The autoimmunity and immunodeficiency characteristic of MG probably constitute the pathogenic mechanism leading to the appearance of the neoplastic process.

Bone Marrow

Free-radical processes in multistage carcinogenesis.

Rodent and human cells in culture, transformed in vitro by radiation or chemicals into malignant cells, afford us the opportunity to probe into early and late events in the neoplastic process at a cellular and molecular level. Transformation can be regarded as an abnormal expression of cellular genes. The initiating agents disrupt the integrity of the genetic apparatus altering DNA in ways that result in the activation of cellular transforming genes (oncogenes) during some stage of the neoplastic process. Events associated with initiation and promotion may overlap to some degree, but in order for them to occur, cellular permissive conditions prevail. Permissive and potentiating factors include free radicals, and thyroid hormone, and inadequate antioxidants. Protective factors which suppress the carcinogenic process include enzymatic and dietary antioxidants. These are constitutive under normal circumstances and can be induced under conditions of oxidative stress produced by a wide range of carcinogens.

Animals

Nuclear medicine techniques in the evaluation of pulmonary neoplasia.

Many noninvasive imaging techniques are available for evaluating patients with pulmonary neoplastic processes. Computed tomography, magnetic resonance imaging, and gallium scintigraphy, while having made major contributions to the noninvasive workup of patients with pulmonary neoplastic processes, are inadequate for purposes of accurate pathologic staging. A more complete understanding of the potential for existing techniques utilizing gallium 67 and thallium 201 along with the development of new radiopharmaceuticals coupled with recent advances in detection equipment will further expand the role of nuclear medicine in the noninvasive assessment of pulmonary neoplasias.

Carcinoma, Bronchogenic

[Needle aspiration cytology in euthyroid uninodular goiter].

Fine needle aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totaling 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadequate for diagnosis. In 39 of the 41 patients with a benign (negative) cytology result, the histopathological diagnosis confirmed the absence of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected malignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of erythroid goiter and could help reduce significantly the number of patients who need to be surgically intervened.

Adolescent

Thymic lymphosarcoma of T cell lineage in a koala (Phascolarctos cinereus).

OBJECTIVE: To diagnose and characterise thymic lymphosarcoma in a koala. DESIGN: A pathological case. ANIMAL: Seven-year-old female koala. PROCEDURE: The neoplastic process was investigated macroscopically, haematologically, histologically and immunohistologically. RESULTS: The koala had difficulty swallowing because of a medial swelling in the lower neck. Biopsy of this mass and blood examination revealed lymphosarcoma with a leukaemic manifestation; necropsy and histopathological examination showed the mass to be thymus. Palatine tonsils, cervical, axillary and mesenteric lymph nodes, spleen, liver, gut, bronchi, genitalia and bone marrow were infiltrated by neoplastic cells. Immunohistological staining of the thymic mass, cervical and mesenteric lymph nodes, bone marrow, spleen and gut revealed the neoplastic cells to be of T lymphocyte origin (positive for both anti-human CD3 and CD5). CONCLUSIONS: It is speculated that the neoplastic process originated in the thymus and was disseminated by bloodborne neoplastic cells. This first report of thymic lymphosarcoma in a marsupial confirms that antibodies raised originally to investigate human lymphoid neoplasia can cross-react with neoplastic lymphocytes in koalas.

Animal Diseases

[Polyneuropathy in the course of Hodgkin's disease: case report].

Polyneuropathy in neoplastic process practically may occur in every stage, before clinical signs, together with clinical signs and in the last period. In some percent of patients polyneuropathy may outstrip manifestation of neoplastic process even for many years. We present a 61-year-old patient in whom signs of polyneuropathy appeared before the signs of essential disease - Hodgkin's disease. Our case confirms the necessity of very careful and precise diagnostics of polyneuropathy with unclear aetiology.

Demyelinating Diseases

Cancer of mamma virilis.

The authors describe a patient who, because of false shame, reported for treatment in the course of an advanced neoplastic process of the mamma. Combined treatment consisting of surgical castration, hormonotherapy and irradiation was applied. In about 30 per cent of patients thus treated a temporary remission or inhibition of the neoplastic process has been observed.

Breast Neoplasms

Disseminated meningeal tumor in a dog.

A 6-year-old Golden Retriever was referred for evaluation of hind limb paresis and generalized weakness. Neurologic examination revealed multifocal cervical and lumbosacral spinal disease. Radiography and myelography failed to identify a lesion. Cerebrospinal fluid was markedly cellular and had a high protein concentration, consistent with myelitis or a neoplastic process. The dog did not improve with medical management. Gross and histologic examination of the brain and spinal cord revealed a thick meningeal surface characterized by polymorphic histiocytic-like cells to multinucleate giant cells. The neoplastic process was considered to be a disseminated meningeal polymorphic cell sarcoma.

Animals

Cervical carcinoid ("argyrophil cell" carcinoma) associated with an endocervical adenocarcinoma: a light and ultrastructural study.

On microscopic examination of a cervical carcinoid removed from a 29-year-old woman, foci of endocervical adenocarcinoma in situ (AIS) and severe squamous dysplasia were present immediately adjacent to the invasive carcinoid tumor. Cells of the carcinoid tumor contained abundant intracytoplasmic argyrophilic granules and numerous neurosecretory granules (NSG) on ultrastructural study. Neoplastic cells of the endocervical AIS were devoid of argyrophilic granules and contained no NSGs. The present neoplastic process appeared similar to cases of a "mixed" type neoplasm composed of a carcinoid tumor and an adenocarcinoma, which have been reported from several areas of the body but only once previously from the cervix. The possible mechanisms accounting for such an unusual neoplastic process are discussed.

Adenocarcinoma

Poly(A+)RNA levels of growth-, differentiation- and transformation-associated genes in the progressive development of hepatocellular carcinoma in the rat.

The development of chemically induced hepatocellular carcinoma in the rat proceeds through a series of premalignant changes that may ultimately progress to a primary malignant tumor. Using the selection technique based on diminished binding of preneoplastic hepatocytes to tissue culture plates precoated with asialofetuin, we have isolated poly(A+)RNA from early preneoplastic foci as well as preneoplastic persistent nodules and primary hepatocellular carcinoma induced by the Solt-Farber protocol in the Fischer rat. The steady-state poly(A+)RNA levels of genes traditionally associated with growth, differentiation and/or transformation were then determined to address the question of their temporal expression in the multistep nature of cancer development. Ornithine decarboxylase- and P53-specific transcripts did not significantly change in preneoplastic foci but were increased in later-stage preneoplastic nodules and hepatocellular carcinoma. Albumin-specific transcripts were decreased in all hepatocellular carcinoma but there was no consistent coordinated increase in alpha-fetoprotein-specific transcripts. c-myc and raf transcripts increased at the very early preneoplastic foci stage and continued to increase throughout the neoplastic process. No L-myc or N-myc transcripts could be detected in any RNA sample. c-Ha-ras-specific transcripts were essentially unaltered in all RNA samples whereas no c-Ki-ras or N-ras transcripts could be detected throughout the neoplastic process. In addition, no dominant-acting transforming mutations in the ras gene family were detected by DNA transfection experiments using NIH/3T3 cells.

Animals