Malignant fibrous histiocytoma of the larynx after radiotherapy for squamous cell carcinoma.

A few cases of malignant fibrous histiocytoma (MFH) of the larynx have been reported to date. All ages may be affected, but the tumor is more prevalent in the sixth and seventh decade of life. We describe a case of MFH in a 71-year-old Italian man who 8 years before underwent a right cordectomy and radiotherapy for squamous cell carcinoma. Recurrent tumor was found to be MFH. The clinico-pathological features of this tumor are presented and the possible relationship between radiotherapy and MFH discussed. The neoplasm was characterized by spindle-shaped atypical cells arranged in a diffuse storiform pattern. Mitoses were prominent, numerous, and often atypical. Immunohistochemically, neoplastic cells were strongly positive for vimentin and alpha1-antichymotrypsin but were negative for cytokeratins and S-100 protein. These findings confirmed the diagnosis and excluded possible sarcomatoid carcinoma, inflammatory pseudotumor, and a new carcinosarcoma. The risk of sarcoma after radiotherapy for squamous cell carcinoma in the larynx is very low when considering the frequent use of radiotherapy, but long follow-ups are required.

[Fetal uropathies: anatomo-pathologic background]. / Uropatie in età fetale: inquadramento anatomo-patologico.

The kidney malformations are complex anatomo-clinical entities that can be described with different classification approaches, based on morphological or etiopathogenetic criteria. The most serious fetal uropathies can be associated with the oligohydramnios sequence, due to insufficient urine escretion, related, for example to bilateral renal agenesis. A second malformation sequence can also be present, the so-called prune belly syndrome, in which an early urethral obstruction can produce abnormal bladder distension and finally renal dysplasia and globous dilation of the abdomen. The anatomo-pathological experience of the last ten years in the Institute of Pathological Anatomy of the University of Bari is based upon 154 cases of congenital uropathies in second trimester fetuses. Almost 80% of these cases presented also other associated anomalies, both chromosomal and non chromosomal syndromic or in casual combination. The possible echographic recognition of these pathologies, together with genetic and anatomopathological studies allow to categorize the fetal uropathies in two groups: the first characterized by an early or late obstruction of the urinary tract, in "sensu strictu" the true obstructive uropathies, and the second, formed by different morphologies all genetically determined.

Expression of ER-D5 and EGFr in laryngeal carcinoma and pre-malignant epithelium.

The expression of estrogen receptors was biochemically assessed in a series of 46 cases of consecutive laryngeal carcinomas. ER-D5 and EGFr were also immunohistochemically detected in 44 and 46 cases respectively. There was no correlation between the expression of these molecules and the typical anatomo-clinical prognostic parameters of laryngeal tumors. The concomitant expression of estrogen receptors, ER-D5 and EGFr was also investigated in normal, hyperplastic and dysplastic epithelium. An increasing expression of ER-D5 and EGFr from normal to hyperplastic and dysplastic epithelium was noted. These data suggest a possible role of hormone receptors in the laryngeal carcinogenesis.

Cathepsin D in laryngeal carcinoma. preliminary report.

The biological activity of tumor cells seems to be related to some peptides produced in the same neoplastic cytoplasms. Cathepsin D is considered one of these proteins, which is able to promote mitosis and tumor invasion. The effects of cathepsin D have been studied in tumors of the breast, ovary and endometrium, and in few cases of laryngeal cancer. Using an immunohistochemical method, we have attempted to evaluate cathepsin D expression in 17 cases of laryngeal squamous cell carcinoma in comparison with the presence of the same protein in the adjacent normal laryngeal mucosa and in inflammatory cells surrounding the tumor. In 11 cases, cathepsin D was present in more than 50% of neoplastic cells, in 4 cases positive cells were 30-50% of all neoplastic cells, in the last 2 cases less than 30% of neoplastic cells expressed the antigen. In normal respiratory epithelium the expression of cathepsin D was limited to the apex of cells. In flat metaplastic epithelium, we observed a positive reaction of basal and parabasal cells. Such positivity became diffuse to all cellular layers in dysplastic foci. A minimal positivity was also detected in salivary glands and ducts. A strong positivity was present in macrophages around and among tumor cells. Our findings suggest that cathepsin D plays a role in cancerogenesis and growth of laryngeal squamous cell carcinoma. The expression of cathepsin D also in normal and inflammatory cells may influence the quantitation of this antigen in studies in which cytosolic levels of cathepsin D are measured after protein extraction.

[The status of receptors in laryngeal carcinoma: a study of receptors for estrogen, progesterone, androgens and glucocorticoids]. / Stato recettoriale del carcinoma laringeo: studio dei recettori per estrogeni, progesterone, androgeni e glucocorticoidi.

In order to verify the hypothesized hormone sensibility of the laryngeal carcinoma, we evaluated the level of steroid receptors in this type of neoplasm and correlated this datum with common pathological and clinical prognostic indices. Estrogen and progesterone receptors were evaluated in 105 patients with a squamous cell carcinoma and 2 patients with a mucoepidermoid laryngeal carcinoma. Receptors for androgens and glucocorticoids were evaluated in 35 patients (all with a squamous cell carcinoma). Dosage was performed on fresh neoplastic tissue using the DCC (Dextran Coated Charcoal) method. Estrogen receptors were present in 26 cases (24.3%); progesterone receptors were present in 18 cases (16.8%); both receptors were revealed in 8 patients (7.5%). Androgen receptors were evident in 4 patients (4/35, 11.4%); glucocorticoid receptors were evident in 7 patients (7/35, 20%); both receptors were revealed in 4 (11.4%) cases. No statistical difference with regard to grading, site and extension of the cancer, extralaryngeal tissue involvement or node metastasis was noted in the groups of patients with or without steroid receptors.

Lipomatous tumors of the uterus. Clinico-pathological features of 10 cases with immunocytochemical study of histogenesis.

The clinico-pathological and immunocytochemical findings of 10 uterine fatty tumors (1 pure lipoma and 9 lipoleiomyomas) are referred. This kind of tumor is more frequent in older postmenopausal women, treated for a preoperative diagnosis of uterine leiomyoma. Macroscopically the tumor may show different consistence and colour as a consequence of the amount of lipomatous component. The microscopical detection of areas of perivascular immature mesenchymal cells with differentiation into adipocytes supports the hypothesis of "neometaplasia" of the lipomatous component derived from immature perivascular cells. On the contrary, the evidence of multivacuolation in smooth muscular cells and the presence of muscle markers in typical mature adipocytes in lipoleiomyomas, as revealed by immunocytochemistry, suggests the hypothesis of direct transformation of smooth muscle cells into adipocytes.

Expression of AgNORs in serous ovarian tumors.

The nosological nature of the borderline ovarian tumor has been investigated by several methodological approaches. The aim of our research was to verify how the study of the nucleolar organizer regions (AgNOR) may offer its contribution on this subject. We studied 18 cases of ovarian serous tumours, respectively 6 benign, 6 borderline and 6 malignant. A separate calculation for clusters (> 1 mu) and total NORs was performed on fifty neoplastic cells chosen at random from every tumour. The findings recorded were the following: 1) the quantity and shape of clusters, dots and total NORs were significantly increasing from benign to borderline to malignant tumours; 2) the number of the dots and total NORs was higher in the case of borderline tumour stage III than in other cases limited to the ovary; 3) the clusters of the poorly differentiated carcinomas were much less numerous than the clusters of those well differentiated; instead the dots and the total NORs were more numerous. These data suggest a correlation between the number of the NORs and the biological activity of the tumours. The borderline serous tumours of the ovary showed a median position between benign and malignant tumours.