Estrogen Receptor Analysis on Fine Needle Aspirates and Biopsies from Palpable Breast Carcinoma

The estrogen hormone receptor (ER) content of human breast cancer has assumed an important role as a predictor of hormone therapy response and as a prognostic indicator. The conventional technique is the dextran-coated charcoal (DCC) method or a ligand-binding assay (LBA) based on the measurement of radiolabeled steroids in cytosolic extracts of tissue homogenate. The recent introduction of monoclonal antibodies with high specificity for human ERs has allowed the application of immunocytochemical assays (ICA) in human cancer tissue. An extension of the ICA technique to cytologic specimens is also widely used. Our aim was to evaluate the reliability of ER-ICAs on fine needle aspirates(FNA) from breast cancer patients by comparing it with ER-ICAs and ER-LBAs performed on surgically removed tissues. During a recent 6-month period, ER-ICAs and ER-LBAs were performed in 83 cases. Among these 83 cases, only the 40 cases for which the ER-ICA and the ER-LBA were performed simultaneously ere included in this study. As positive cutoff values, we assumed 10 fmol/mg protein for the ER-LBAs and a semiquantitative score of 4 for the ER-ICAs. The results were as follows : 1) The ER positive rate was 55% (22/40) for ICAs and 47.5% (19/40) for LBAs. The concordance rate between the ER of ICAs and that of LBAs was 82.5% (33/40). 2) The Pearson correlation coefficient between ER-ICAs of fine needle aspirates and that of surgically removed tissue was good (r=0.94, p<0.005) 3) The Spearman correlation coefficient between ER-ICAs of fine needle aspirates and ER-LBAs of surgically removed tissue was good (r=0.57, p=0.0001) In conclusion, ER determination by using the fine needle aspirate is a reliable method in palpable breast cancer. FNA-ER may be a useful method when it is difficult to take sufficient breast cancer tissue, i.e., in cases of diffusely recurrent cancer, liver metastasis, malignant pleural effusion, etc.

Clustered microcalcifications on mammogram: Loss of microcalcifications during tissue processing? radiologic-pathologic correlation

Mammography is the only examination capable of depicting malignant calcifications in breast. In some instances calcifications evident in mammogram and specimen mammograms are not observed in the histologic specimen. Therefore, wer retrospectively analyzed 27 cases in which hook-guided wire localization and biopsy had been performed to determine if microcalcifications were lost during histopathologic processing. Calcium was apparently lost during preparation of the block in about 7% of the cases and after slide preparation in about 11%, for a total possible loss of 18%. The authors recommend a protocol for avoiding these loss that involves performance of a more comprehensive examination of histologic sections by the pathologist and radiographic reexamination of paraffin-embedded tissue blocks with subsequent step sectioning by the pathologist.

Expression of alpha-smooth muscle actin in liver diseases

To evaluate the distribution of alpha-smooth muscle actin (alpha-SMA) positive cells in various liver diseases, we undertook an immunohistochemical study of liver diseases including chronic persistent hepatitis, chronic active hepatitis, liver cirrhosis, intrahepatic cholelithiasis and hepatocellular carcinoma. As a control, fetal livers (gestational age: 22-26 weeks) showed alpha-SMA positive cells along the blood vessels of the portal area, terminal hepatic venules and at perisinusoidal spaces. Perisinusoidal alpha-SMA positive cells were bipolar shaped and had round nuclei. In chronic persistent hepatitis, a few alpha-SMA positive cells were admixed with the inflammatory infiltrates mostly along the intact limiting plate. They were also detected multifocally in a linear pattern along the dilated sinusoid. In chronic active hepatitis, very strong alpha-SMA staining was detected at the site of piecemeal necrosis and adjacent lobules. A-SMA expression was decreased in some cases after interferon treatment. In cases of transplanted liver biopsies, expression of intralobular alpha-SMA was diffusely increased but showed no correlation with degree of acute rejection. Cirrhotic livers revealed strong alpha-SMA positivity in fibrous septae as well as in the perisinusoidal space of intact hepatocytes at the leading edge of fibrosis. Interlobular bile ducts were concentrically circumscribed by alpha-SMA positive cells in cases of intrahepatic cholelithiasis. In trabecular type hepatocellular carcinomas, most sinusoidal lining cells were positive for alpha-SMA. Most intralobular alpha-SMA positive cells represent, if not all, perisinusoidal cells (PSCs) which are involved in intralobular fibrogenesis in various liver diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytogenetic analysis of meningiomas

Cytogenetic analysis of 4 cases of meningiomas from 3 male and 1 female patients is reported. One of male patients suffered from neurofibromatosis type 2. Histologically, the meningiomas were meningotheliomatous (1), transitional (2), and psammomatous (1). Chromosomal abnormalities were found in all cases with a karyotype 45,XY,-22, 45,XY,-16, 45,XX,-2, and 45,XY,t (15p;22q), respectively. Monosomy of chromosome 22 was detected only in the patient with neurofibromatosis type 2. These cytogenetic analysis demonstrates that variable clonal karyotype aberrations exist in meningiomas.

Directional Coronary Atherectomy (Simpson AtheroCath) : Reasons for Device Selection, Angiographic and Histologic Findings, and Its Mechanisms

BACKGROUND: Despite improved operator technique and advanced equipment designs, acute closure and restenosis remain as serious limitations to both the short and long-term success of balloon angioplasty. Atherectomy is a new transluminal interventional technique for the treatment of coronary artery obstructive disease. We evaluate preliminary experience of directonal coronary atherectomy (DCA) for complex coronary artery lesions. METHODS: We tried DCA in the 16 lesions of 15 nonrandomized sequential patients(mean age 66 years, M/F : 12/3) with coronary artery lesions that were ostial lesion in 4, ulcerated and/or eccentric in 13, restenosis after PTCA in 2 and after stent implantation in 2. The target vessel was right coronary artery in 7 and left anterior descending artery in 9. RESULTS: Primary success was achieved in 14 of 16 lesions (88%) by atherectomy and in 5(36%) by additional use of balloon angioplasty. Atherectomy retrieved tissue in 15 out of 15 attempts(100%). One patients suffered acute closure due to large dissection during the DCA which was solved successfully after stent implantation. CONCLUSIONS: Atherectomy can predictably treat selected patients with eccentric, ostial bulky coronary lesions with overall safety comparable to that of conventional balloon angioplasty, although the procedure as currently performed does not appear to prevent restenosis.

The role of flow cytometry in urine cytology / 대한비뇨기과학회지

We evaluated the results of urine cytology and urine flow cytometry in 33 patients with transitional cell carcinoma of the bladder and 15 patients with other urologic diseases. The sensitivity of voided urine cytology, washed urine cytology, voided urine flow cytometry and washed urine flow cytometry was 39%, 54%, 57% and 66%, respectively. The specificity of voided urine cytology. washed urine cytology, voided urine flow cytometry and washed urine flow cytometry was 100%, 93%. 86% and 73%, respectively. Washed urine cytology or flow cytometry was more sensitive, but less specific than void urine cytology or flow cytometry. Flow cytometric measurement was superior to conventional cytology in sensitivity. Combination of voided urine cytology and flow cytometry significantly increased the sensitivity from 39% to 66% equal to that of washed urine flow cytometry. Combination of washed urine cytology and flow cytometry also increased the sensitivity from 54% to 75% but the difference was not significant. These results indicate that combination of voided urine cytology and flow cytometry is non-invasive and more sensitive method than conventional voided urine or washed urine cytology.

Cystic lymphangioma of the colon: case report

No abstract available.

Metastatic Renal Cell Carcinoma in Maxillary Sinus: A case report

Metastases to the sinonasal tract are infrequent occurrences from primaries below the clavicles. The total number of reported cases to date is less than 100. There is, however, complete unanimity concerning the histologic type of metastatic neoplasm most often encountered. An interesting phenomenon, generally attributable only to breast and renal cell carcinoma, is the late recurrence of the malignant tumor, even 10 or more years after operation. A 61 year-old-male was admitted to ENT due to frequent epistaxis and right facial swelling. CT scan revealed a huge soft tissue density mass I right maxillary sinus with extension into nasopharynx and deviation of nasal septum. The histologic diagnosis was metastatic renal cell carcinoma. He had left nephrectomy because of renal cell carcinoma, 14 years ago. We report a case of metastatic renal cell carcinoma of maxillary sinus in view of rarity, and a brief review of the literature related to this type of tumor is presented.

Merkel Cell Carcinoma: A case report associated with squamous cell carcinoma

Merkel cell carcinoma is a relatively uncommon, cutaneous, neuroendocrine neoplasm that was first recognized by Toker in 1972. Occasionally it is found concurrent with squamous cell carcinoma or basal cell carcinoma and in them cases, the coexistence of them is suggesive of presenting the effect of a common carcinogenic influence on two distinct precursor cells. Now the authors report a case of Merkel cell carcinoma associated with squamous cell carcinoma arising in the overlying epidermis, and a brief review of literatures is introduced. The patient was a 75-year-old female, who had noticed a reddish brown, ulcerated mass on the right buttock. It had progressively enlarged to become lemon-size during last 4 months. The right buttock mass excised measured 10x8x3 cm and was gray white, solid, with an ill-defined marigin. Histologically the tumor was located in the dermis and was lacking in connection with the epidermis in which invasive squamous cell carcinoma developed. The neoplastic cells were arranged in a diffuse, lymphoma-like pattern or trabecular arrangement and their cytologic details were reminiscent of small cell carcinoma of the lung, On electron microscopy the cells displayed many neurosecretory granules averaging about 100nm in diameter, intermediate filaments and desmosomes. Immunohistochemically a ball-like immunostaining for keratin, resembling an inclusion body, was seen, but other markers, including neuron-specific enolase, vimentin, S-100 protein and leukocyte common antigen, were unrewarded.

Clear Cell Adenocarcinoma of the Bladder: Report of a Case / 대한비뇨기과학회지

No abstract available.

Plasma prostaglandin E2 Levels in Patients wth Gastric Carcinoma

This study was performed for the purpose of evaluation of plasma PGE2, levels in patients with gastric carcinomas. To carry out this study twenty-one gastrectomy patients with gastric carcinoma were selected. Serial plasma PGE2 levels were measured before and after operation by radioimmunoassay. Plasma PGE2 was also measured in five normal healthy volunteers or of patients with gastric ulcer. The conclusion drawn therefrom were as followed: 1) In normal healthy volunteers, plasma PGE2 level was 50.2+/-16.5 pg/ml which ws higher than that of parients with gastric ulcer, 20.7+/-15.4 pg/ml, (p<0.001). 2) In patients with diffuse type of gastric carcinoma, preoperative and postoperative plasma PGE2 levels were 25.7+/-12.1 pg/ml, and 23.1+/-8.7 pg/ml, rewpectively. In parients with intestinal type of gastric carcinoma, preoperative and postoperastive plasma PGE2 levels were 26.2+/-8.9 pg/ml and 24.1+/-11.2 pg/ml, respectively. In both types of gastric carcinoma, plasma PGE2 levels were lower than that of normal healthy volunteers and there was no significant difference compaired with the levels in patients with gastric ulcer. 3) In diffuse and intestinal types of gastric carcinoma, postoperative PGE2 levels were lower that those of preoperative state but it was not significant. 4) In early and advanced gastric carcinoma, preoperative PGE2 levels were 29.0+/-11.7 pg/ml and 24.8+/-9.9 pg/ml, respectively. There was no significant difference by the depth of invasion. From the result as mentioned above, it is concluded that plasma PGE2 levels of patients with gastric carcinoma and it is presumable that there is a factor decreasing plasma PGE2 levels in patients with gastric carcinoma or ulcer.