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At least 19 recordsLinked to original sources

PubMed1992

Small cell anaplastic carcinoma of the prostate: a clinical, pathological and immunohistological study of 27 patients.

Because small cell anaplastic carcinoma of the prostate is an uncommon tumor, it has remained a poorly defined entity. To elucidate further the clinical, pathological and immunohistochemical characteristics of this cancer the 27 patients who presented to the Mayo Clinic from 1960 to 1990 were reviewed. Of these patients 18 (67%) presented with pure small cell anaplastic carcinoma, and 9 (33%) were diagnosed with small cell anaplastic carcinoma and adenocarcinoma of the prostate. Twenty-six patients (96%) had either stage C or D disease at the time of diagnosis. Two patients presented with a paraneoplastic syndrome, including 1 man with inappropriate antidiuretic hormone secretion and 1 who suffered from thyroxine intoxication. Of 24 men with long-term followup 22 (92%) died of small cell anaplastic carcinoma of the prostate despite antiandrogen therapy and the remaining 2 are alive with active, progressive disease. The median survival time following diagnosis was 17.1 months (range 2 to 90 months). All tumors with tissue available for immunohistochemical staining reacted positive for neuron-specific enolase, indicating that small cell anaplastic carcinoma of the prostate is most likely a neuroendocrine neoplasm. No tumor stained positive for either prostatic acid phosphatase or prostate specific antigen. Pathologically, small cell anaplastic carcinoma of the prostate appears to be similar to oat cell carcinoma of the lung. This series of 27 patients emphasizes that small cell anaplastic carcinoma of the prostate is highly malignant, is frequently of advanced stage at presentation, responds poorly to antiandrogen therapy and has a poor prognosis.

Adenocarcinoma↗

PubMed1977

Fatal thyroid carcinoma. Anaplastic transformation of adenocarcinoma.

Prognosis of well-differentiated carcinoma of the thyroid gland is generally favorable, while that of anaplastic carcinoma, extremely poor. Well-differentiated carcinoma may sometimes be fatal; the most common underlying cause is considered to be due to anaplastic transformation of the original well-differentiated carcinoma to a less differentiated form. We studied 27 consecutive autopsy cases of fatal thyroid cancer treated at the Ito Hospital, Tokyo, during a five-year period, 1969-1973. We found uniform histological features of anaplastic carcinoma in 10 cases and of well differentiated carcinoma in four cases. In addition, co-existence of well-differentiated and anaplastic carcinomas was observed in nine cases and well differentiated and squamous cell carcinomas in four. Circumstantial evidence strongly suggests that malignant transformation is a part of the natural history of thyroid carcinoma, from well-differentiated carcinoma to less differentiated forms, either squamous cell or anaplastic carcinoma.

Adenocarcinoma↗

PubMed1979

Anaplastic carcinoma of the thyroid gland. An ultrastructural study on four cases.

Four cases of anaplastic carcinoma of the thyroid, composed of one small cell carcinoma and three giant cell carcinomas, were studied with electron microscope. In the case of small cell carcinoma, fine cytoplasmic interdigitations and junctional complex between apposing cytoplasmic membranes of neighbouring tumor cells and a few microlumina within tumor cell clusters surrounded by well-defined basal lamina were seen. In the cases of giant cell carcinoma, occasional cytoplasmic interdigitations as well as desmosomal structures were detected even in tumor cells markedly pleomorphic and anaplastic. Abundant cytoplasmic organelles including profiles of Golgi apparatus, rough endoplasmic reticulum and a few mitochondria were seen in the cytoplasm of tumor cell of all four cases. Of interest to note was that all giant cell carcinomas demonstrated evidences of fairly well differentiated tumor within anaplastic carcinoma, indicating probable pre-existing either benign or malignant epithelial neoplasm more differentiated, with its subsequent anaplastic transformation. Findings in the present study support an assumption that these anaplastic tumors are derived from the follicular epithelium of the thyroid gland. In addition, it can be said that tumor cells of the small cell carcinoma provide evidences suggesting functional differentiation of carcinoma cells to a certain extent, yet unable to produce thyroglobulin.

Aged↗

PubMed1979

Anaplastic seminoma: an analysis of 77 patients.

Over a 28 year period, 77 patients with early stage anaplastic seminoma of the testis were treated by orchiectomy and lymphatic irradiation at three Army medical centers. With a median follow-up of 97 months, the 10 year actuarial survival is 96% of Stage I patients and 87% for Stage II patients. For patients with Stage I anaplastic seminoma no survival advantage can be demonstrated for adding mediastinal and supraclavicular irradiation versus para-aortic and pelvic irradiation alone. The addition of retroperitoneal lymphadenectomy to lymphatic irradiation increased the frequency of major gastrointestinal complications without significantly improving survival. Patients with anaplastic seminoma and elevated serum beta-subunit human chorionic gonadotrophin levels have a poor prognosis and should be considered for adjuvant combination chemotherapy. Anaplastic seminoma of the testis has a similar clinical presentation, response to therapy and prognosis compared to typical seminoma and should be managed in the same way.

Adolescent↗

PubMed1992

Anaplastic Paget's disease.

Six cases of a distinct, histologically anaplastic variant of mammary Paget's disease are described. Patients ranged in age from 40 to 85 years. All patients had scaling erythematous lesions confined to the nipple; none had palpable breast masses. Histologically, the lesions had features resembling Bowen's disease, including full-thickness epidermal atypia, loss of nuclear polarity, and marked cytologic anaplasia. Intraepidermal acantholysis was a distinctive feature in all cases. In some biopsies, small groups and single typical Pagetoid cells were seen within the areas of confluent Bowen-like change. Immunohistochemically, carcinoembryonic antigen (CEA) was positive in three of six patients; epithelial membrane antigen (EMA) in five of six patients, and cytokeratin AE1/AE3 in three of six patients. Mucicarmine stains were uniformly negative. In our series, anaplastic Paget's disease was associated with concomitant invasive ductal carcinoma in three of six patients (50%). This percentage is significantly higher than that previously reported for patients with Paget's disease and without palpable breast mass. Histologic features that are helpful in distinguishing between anaplastic Paget's disease and Bowen's include cleft-like acantholysis, absence of dyskeratotic cells, and persistence of basal cell layer. More rarely, but very helpful when present, are underlying ductal carcinoma, intracellular lumina, and associated conventional Paget's disease. Immunohistochemistry results were variable and of relative value. Our study suggests that a nipple lesion histologically resembling Bowen's disease is likely to represent anaplastic Paget's disease.

Adult↗

PubMed1992

p53 gene mutations associated with anaplastic transformation of human thyroid carcinomas.

Anaplastic carcinoma of the thyroid gland, which is one of the most aggressive, malignant tumors in humans, is considered to originate from preexisting differentiated thyroid cancer. To define the genetic alterations associated with such progression, we examined nine cases of anaplastic thyroid carcinoma for mutation in exons 4-9 of the p53 tumor suppressor gene. Preliminary screening for mutation by RNase protection analysis demonstrated that two out of nine anaplastic carcinomas contained sequence alterations in the p53 gene. Subsequent DNA sequencing identified the mutated nucleotides in these two cases; one was a nonsense mutation at codon 165, and the other was a single-base deletion at codon 176 resulting in the creation of a stop codon downstream due to frameshift. The fact that no mutations were detected in coexisting foci of papillary carcinomas from the same patients shows that these mutations of the p53 gene occurred after development of papillary carcinomas. These results suggest that p53 gene mutation triggers the progression from differentiated into anaplastic carcinoma in the human thyroid gland.

Base Sequence↗

PubMed1979

Giant-cell carcinoma of the lung. Clinical and pathological assessment. Comparison with other large-cell anaplastic bronchogenic carcinomas.

Fewer than 40 cases of giant-cell carcinoma of the lung have been described in the world literature. Fourteen new cases are now presented. This is a special type of large-cell anaplastic carcinoma characterized by tumour giant cells with one or more nuclei and by a very pleomorphic appearance. A number of previous authors have emphasized the following special features of this type of tumour. Occurrence in a younger age group, a more rapid course from initial symptoms until death, more extensive metastasization, and a more peripheral location of the primary tumour than in other large-cell anaplastic carcinomas. It has also been stated that the tumour differs from other large-cell anaplastic carcinomas in its shorter duration (average 4 1/2 months) and more peripheral distribution (c/p ratio 1:2.2). In the present material only the survival period was significantly shorter (average 7 months), while in other respects the tumour did not differ from other large-cell anaplastic carcinomas.

Aged↗

PubMed1992

Loss of keratin expression in anaplastic carcinoma cells due to posttranscriptional down-regulation acting in trans.

Rat keratin K5 and vimentin complementary DNAs have been isolated, identified, and used to study keratin and vimentin expression as markers for cell differentiation. Isologous rat neoplastic epithelial cell lines used were based on a clonal benign epithelial line (A5P/B10) and a clonal anaplastic malignant derivative line (T952/F7). Stable cytoplasmic mRNA was detected for keratin but not vimentin in the benign cells. The anaplastic derivative cells expressed vimentin but showed a 1000-fold reduction in the keratin message, which nuclear run-on assays identified as being due to posttranscriptional down-regulation. An identical pattern of posttranscriptional down-regulation was found in independent malignant somatic cell hybrids of the benign and anaplastic cells. trans-acting regulatory mechanisms implicated in posttranscriptional (pretranslational) keratin down-regulation in these anaplastic malignant cells may play a role in the apparent loss of differentiation evident in tumor progression.

Animals↗

PubMed2026

Spindle Cell Predominant Anaplastic Pleomorphic Xanthoastrocytoma (WHO Grade 3) With Focal Piloid Features: A Rare Case Study With Comprehensive Molecular Profiling.

Pleomorphic xanthoastrocytoma (PXA) is a rare astrocytic tumor of the central nervous system. The typical form demonstrates relatively low-grade histologic features, whereas an anaplastic variant shows more aggressive behavior, including increased mitotic activity and necrotic changes. These tumors are often associated with alterations involving key growth signaling pathways and cell cycle regulatory genes, with molecular features that may resemble those seen in other high-grade astrocytic neoplasms. We describe an unusual example of an anaplastic pleomorphic xanthoastrocytoma showing focal piloid differentiation. The patient presented with acute neurologic symptoms, and imaging demonstrated a large, enhancing, well-circumscribed cerebral lesion with limited surrounding edema. Histologic evaluation revealed a highly cellular astrocytic neoplasm composed of spindle-shaped cells with marked pleomorphism, including scattered multinucleated forms, brisk mitotic activity, and necrotic areas. At the periphery, regions with elongated bipolar glial cells and occasional cytoplasmic inclusions suggestive of piloid morphology were identified. Molecular analysis demonstrated an activating alteration in the mitogen-activated protein kinase (MAPK) pathway along with additional genomic abnormalities, while mutations commonly associated with diffuse gliomas were not detected. The presence of piloid features within an otherwise anaplastic tumor is rare and may be relevant to the relatively favorable outcome observed during extended follow-up.

anaplastic↗

PubMed1975

Ultrastructure of anaplastic (spindle and giant cell) carcinoma of the thyroid.

Three anaplastic (spindle and giant cell) carcinomas of the thyroid were studied by light and electron microscopy; two of the tumors also included foci of recognizable follicular carcinoma. The follicular carcinoma cells desplayed prominent mitochondria and rough endoplasmic reticulum, and showed evidence of secretory activity. Desmosomes and complex cellular interdigitations were evident. Basal laminae were present, with conspicuous reduplication in the well-differentiated foci. However, some epithelial clusters were surrounded by basal lamina, showing focal discontinuities through which epithelial cells protruded into the stroma. The pleomorphic spindle and giant cells showed cytoplasmic and nuclear characteristics similar to the better differentiated carcinomatous follicular elements, but showed rare desmosomes and no basal laminae. The basic ultrastructural similarity between follicular and anaplastic tumor cells confirms their common epithelial origin. However, while partially retaining their secretory capability, the anaplastic cells progressively lose their capacity to synthetize basal lamina and develop complex cellular attachments.

Aged↗

PubMed1977

Morphological changes in anaplastic gliomas treated with radiation and chemotherapy.

The effects of antineoplastic treatment on gliomas are related to tumour cell cycle and proliferation kinetics, glioma tissue architecture, and the surrounding environment. Morphological changes induced by radiation and chemotherapy are characterized by cell necrosis and severe alterations in cell and nuclear morphology caused by changes in the cell kinetic parameters which, however, may also occur spontaneously in untreated anaplastic gliomas. Comparative studies of cytological imprints and routine histological preparations of biopsy and autopsy specimens were performed in four groups of anaplastic astrocytomas and glioblastomas (78 cases) with postsurgical irradiation, combination chemotherapy, and CCNU treatment, and without specific postsurgical treatment (control group). Following radiation and chemotherapy, in addition to increased necrosis and vascular response, a variety of characteristic but nonspecific changes were observed in cell and nuclear morphology with prominent formation of multinucleated giant and monstrous cells, irregular and hyperchromatic nuclei, and severe cytoplasmic degeneration indicating both inhibition of cell division and cell damage. Statistically significant findings were a posttreatment increase in the number of multinucleated giant and monstrous cells and a decrease in the number of mitoses. These changes were more pronounced after chemotherapy than after radiation, while no significant dissimilarities were found between combination chemotherapy and CCNU. The implications of these changes on the mechanisms of antitumour treatment in anaplastic gliomas are discussed.

Brain Neoplasms↗

PubMed1978

Combination chemotherapy in the management of superior vena caval obstruction in small-cell anaplastic carcinoma of the lung.

Among 225 consecutive patients with small-cell anaplastic bronchogenic carcinoma, 26 (11.5%) had superior vena caval obstruction when the malignancy was diagnosed. Of these 26 patients, a consecutive series of 22 were treated initially with combination chemotherapy (cyclophosphamide, methotrexate and CCNU, in some cases combined with vincristine) alone, and in all these cases resolution of the syndrome was prompt within a median of 7 days. In no case were symptoms increased transiently by the treatment. No difference in response rate was observed between the histologic subtypes of small-cell anaplastic bronchogenic carcinoma according to the WHO classification. Combination chemotherapy alone is an effective treatment of superior vena caval obstruction in patients with small-cell anaplastic bronchogenic carcinoma.

Aged↗

PubMed1992

CD30-positive, anaplastic large-cell lymphomas that express CD15 but lack CD45. A possible diagnostic pitfall.

We report the immunohistochemical and clinical features of two cases of morphologically typical anaplastic large-cell lymphoma. One patient had lymph node and focal visceral involvement, and the other patient had multiple-organ involvement by lymphoma. In both cases, the lymphoma cells were CD30 (Ber-H2) and CD15 (Leu-M1) positive and CD45 (common leukocyte antigen) negative--a phenotype that is commonly seen in Hodgkin's disease. This unusual phenotype in large-cell anaplastic lymphoma led to an initial misinterpretation in one of the cases. Large-cell anaplastic lymphomas are highly variable, both in immunophenotype and clinical presentation. Because of this variability, a broad immunophenotypic panel, in conjunction with morphological features, should be used to establish the correct diagnosis.

Adult↗

PubMed1992

Expression of the novel intermediate filament-associated protein restin in Hodgkin's disease and anaplastic large-cell lymphoma.

In this study, the expression of the novel intermediate filament protein Restin in human tissues was analyzed. Restin expression was studied by immunohistochemistry using polyclonal and monoclonal antibodies. Restin was not detected in normal tissues, a range of B- and T-cell non-Hodgkin's lymphomas, and nonlymphoid tumors. However, Restin was present in Reed-Sternberg cells and variants thereof in Hodgkin's disease, with the exception of the lymphocyte-predominant, paragranuloma subtype. Restin was also highly expressed in anaplastic large-cell lymphoma (so-called Ki-1 lymphoma). As expected, Restin was also expressed in Hodgkin cell lines L428, L428KSA, Co, and KM-H2 and the anaplastic large-cell lymphoma cell line Karpas 299, which was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting, as well as Northern blotting. The presence of Restin in both Hodgkin's disease and anaplastic large-cell lymphoma is intriguing and might indicate a role of this structural protein in the pathogenesis of both conditions.

Antibodies, Monoclonal↗

PubMed1978

Anaplastic transformation of medullary thyroid cancer.

The paper presents a detailed microscopic study of a case of medullary thyroid carcinoma with the loss of amyloid production and of argyrophilic cellular granules combined with the prevalence of giant multinucleated cells in a part of the primary tumor and namely in metastatic deposits. These changes are believed to give evidence of anaplastic dedifferentiation. Similar cases to that reported are reviewed with the conclusion that not only differentiated thyroid cancers but medullary thyroid cancers as well are capable of anaplastic transformation. However rare the medullary thyroid cancers are, they should be diagnosed and radically treated so as to prevent their fatal anaplastic transformation.

Aged↗

PubMed1976

Small cell anaplastic carcinoma of lung. Reappraisal of current management.

The relative roles of radiotherapy, intensive chemotherapy, and a combination of both were evaluated by an analysis of 157 of 188 patients who were registered at Tumor Registry and the Department of Radiation Medicine at Massachusetts General Hospital with a diagnosis of small cell anaplastic carcinoma of the lung between 1968 and 1974. Stage of the tumor was the single most important prognostic factor. Bone marrow involvement was found in 29% of patients studied. For extensive tumor, better survival was obtained by a combination of intensive chemotherapy and radiotherapy than with radiotherapy alone. However, no improvement of survival was noted with combination of concomitant or sequential intensive COPP or COP chemotherapy and radiotherapy over that obtained with radiotherapy followed by subsequent chemotherapy for progressive disease in patients with localized tumor. For localized tumor, primary radiotherapy should be given with an intention of local control or cure. Conclusions regarding the proper timing of chemotherapy and radiotherapy in apparently localized small cell anaplastic carcinoma require further prospective evaluation.

Adult↗

PubMed1976

Anaplastic neuronal tumors of brain.

A multicentric neuronal tumor of brain with unique morphologic features is described. It is compared with four other markedly anaplastic brain tumors containing neoplastic neurons. Demonstration of axon processes, which must be carefully distinguished from other similarly stained structures, is essential for the recognition of such tumors. Recent experience suggests that anaplastic neuronal tumors are more frequent than is generally realized. It is suggested that axon stains should be more widely employed in the investigation of atypical or highly pleomorphic gliomas.

Adult↗

PubMed1977

Treatment of small cell anaplastic carcinoma of the lung with the oral solution of VP-16-213 (NSC 141540, 4'-demethylepipodophyllotoxin 9-(4,6-O-ethylidene-beta-D-glucopyranoside).

The semisynthetic podophyllotoxin derivative VP-16-213 (NSC 141540) has been evaluated in a phase II study in patients with small cell anaplastic carcinoma of the lung. The drug was administered as an oral solution, the drinking ampoule, in doses of 100 mg twice a day for 4 days in 30 patients previously treated with intensive combination chemotherapy and for 5 days in 10 untreated patients. The courses were repeated every third week with dose modifications according to individual tolerance. All patients had measurable disease and objective responses were obtained in 20 patients (50%), 15 previously treated (50%) and 5 untreated patients (50%). The median time for response after the start of treatment was 15 days (range 6-42) and the median duration of response was 56 days (range 16-147). Dose-limiting toxicity was principally hematologic, consisting of leukopenia, but gastrointestinal toxicity and alopecia were also observed. The study demonstrated that VP-16-213 administered as an oral solution is highly effective against small cell anaplastic carcinoma of the lung without clinical cross-resistance to CCNU, cyclophosphamide, methotrexate, or vincristine.

Administration, Oral↗