Metastatic tumors mimicking gynecologic cancer.

Review of the admissions to the Gynecologic Oncology Service at the University of Alabama Medical Center over a 12-year period reveals that 1% of all referrals had nongynecologic malignancies. Duration of symptoms was short; of 40 patients with adequate follow-up, 31 (77%) were dead from their cancer, with a median survival of eight months. The value of diagnostic radiologic procedures was assessed and, while these procedures proved helpful, most patients required a surgical procedure (often a reoperation) to establish the diagnosis.

Immunohistochemistry of the blood group A,B,H isoantigens and Oxford Ca antigen as prognostic markers for stage IB squamous cell carcinoma of the cervix.

Currently, there is lack of a histologic classification of squamous cell carcinoma of the cervix that correlates significantly with patient survival. This study investigated the survival predictive value of two immunohistochemical markers, the blood group A,B,H isoantigens and the Oxford Ca antigen, on conventional histologic sections of tumor tissues from 85 surgically treated patients with Stage IB squamous cell cervical cancer. The results indicated that the two antigens are two distinct markers, neither of which correlates with tumor grade. The expression of the A,B,H isoantigens is significantly related to patient survival after adjustment for the depth of stromal invasion of the tumor, whereas the Oxford Ca antigen has no survival predictive value.

Diagnosis and management of prolactinomas.

Prolactin secreting tumors account for ten to twenty percent of all intracranial lesions. The patients harboring these tumors present with amenorrhea, galactorrhea, other ovulatory disorders, infertility, delays in puberty and mixed polyendocrinopathy. These tumors are diagnosed by the measurement of serum prolactin levels, Goldmann-Bowl perimetry, and either computed axial tomography or magnetic resonance imaging. Protein secreting tumors are usually benign lesions and historically have been treated by partial or total hypophysectomy or radiation therapy. Surgical resection of the lesion often is followed by recurrence and administration of proton beam radiation therapy results in the development of a panhypopituitary state. Growth of pituitary tumors is controlled with the administration of dopamine agonists such as bromocriptine and prospective studies have suggested that these drugs are now the preferred method of treatment for primary lesions and recurrences.

Postovulatory predecidual development in the baboon, chimpanzee, and human.

The development of predecidual tissue during the late postovulatory phase was evaluated by light microscopic study in the baboon, chimpanzee, and human being. While the predecidual cells of these species appeared to be similar morphologically, the degree of predecidual differentiation was greater in humans and chimpanzees than in baboons. The evidence indicated that the presence of a blastocyst was not required for decidualization to occur in these three primates. Further, decidualization was not dependent on coitus in chimpanzees and baboons, and was probably not essential in humans either.

Morphological and histochemical study of the endometrical effects of ovral in the baboon.

In an effort to better understand changes induced by hormonal contraceptives, a group of female baboons were administered Ovral for a period of 9 months. During this time the endometrium was sampled by transcervical uterine biopsy from both the treated animals and from a control group. The biopsies were all obtained between 10 and 14 days of the treatment cycle or the normal menstrual cycle. The endometrial glandular cells from the treated animals exhibited an accelerated maturation compared with the controls. Ultrastructurally this was reflected by increased cell size, numerous long, slender microvilli on the apical membranes, and increased development of the Golgi complex. Differences were also observed in the predominant type of granule seen in the apical cytoplasm. After 3 and 6 months of treatment with Ovral, no significant differences were noted between groups or between animals within a group. However, after 9 months of treatment, the endometrium displayed differences from the earlier experimental groups as well as individual variations. The functional correlates of these observations are discussed and compared to human endometrium.

The median eminence in normal, ovariectomized, and ovariectomized-estradiol-treated hamsters: an ultrastructural study.

In an effort to define more clearly the effect various plasma concentrations of estrogen have on the morphology and function of tanycytes, the present investigation examined the median eminence (ME) of normally cycling, ovariectomized, and ovariectomized-estradiol-treated hamsters. In normally-cycling animals, when endogenous estrogen was at its highest level (day 4 or proestrus), numerous microappendages arose from the luminal surfaces of tanycytes located in the ventrolateral region of the ME. Large blebs (1.0-5.0-micrometers diameter), miniblebs (1.0-micrometer diameter), and microvilli dominated the surfaces of these cells. Large blebs appeared to have been formed by the coalescence of several miniblebs and were composed of cytoplasmic ground substance devoid of organelles. The peduncular shape of many of these blebs suggested their involvement in an apocrinelike secretion by the tanycyte. When endogenous estrogen levels were low (day 1 of the estrous cycle), the tanycytes of normally cycling hamsters possessed slightly fewer microappendages. Following ovariectomy, large blebs were nearly absent from the luminal surfaces of tanycytes, and the number of miniblebs and microvilli were also greatly reduced. Subcutaneous injections of 17-beta estradiol benzoate restored the large blebs to the tanycyte surface. The number and variety of tanycytic microappendages in these animals resembled those in normally cycling hamsters on day 4 of the estrous cycle. The present study demonstrates that tanycytes of the hamster ME are sensitive to estrogen and vary in their morphology in relation to the animal's reproductive status. These changes in tanycyte morphology can be correlated directly to functions of absorption (microvilli) and secretion (blebs). The sensitivity of tanycytes to estrogen suggests that these cells may also play a role in the hypophyseal-ovarian feedback mechanism.

Transcervical endometrial biopsy in the baboon: Effects on the menstrual cycle and relations to protein and dry matter content and histology.

The baboon has been used increasingly for reproductive studies. While hormonal regulation of the menstrual cycle and ovulation as well as the endocrinology of gestation have been reported, little information is available describing endometrial parameters. It is the purpose of this paper to describe the ease with which repeated transcervical biopsies can be performed, to describe baseline endometrial protein and dry weight data and to demonstrate that the biopsy procedure itself does not significantly affect the baboons' ability to continue normal menstrual cycle function. Endometrial biopsy samples were taken throughout the menstrual cycle under light ketamine anesthesia. Protein and dry weight contents were determined. Endometrial biopsies Protein and dry weight contents were determined. Endometrial biopsies averaged 25 mg (wet weight) and contained 7.54% protein and 16.3% dry matter. The formulas (Y = a + bx) which expressed the linear relationships between wet weight (mg), protein (µg) and dry matter (µg) content and the correlation coefficients (r) were as follows: between wet weight and protein content - wet weight = 5.58 + 10.0 (protein), Sxy = 4.83, r = 0.883; between wet weight and dry weight - wet weight = 1.99 + 7.94 (dry weight), Sxy = 4.52, r = 0.904; between protein and dry weight - protein = 0.446 + 0.446 (dry weight), Sxy = 4.82, r = 0.870. All three linear regression coefficients were statistically significant (P < 0.001). No significant cyclical patterns in either protein or dry matter content were demonstrable throughout the menstrual cycles. The average length of all nonbiopsy cycles was 32.4 ± 2.7 days and 32.8 ± 3.6 days for those in which biopsies were taken. Similarly, follicular and luteal phase lengths for nonbiopsy and biopsy cycles were 15.4 ± 2.3 and 15.5 ± 2.8 days and 16.9 ± 2.2 and 17.2 ± 3.2 days, respectively. The time required for sex-skin swelling to decrease from maximum to minimum during the luteal phase was shorter, but the quiescent stage was equally lengthened. It was concluded that the endometrium of the baboon was easily accessible for study without causing serious alterations in menstrual cycle function. These studies further demonstrate the potential of the baboon as a model o reproductive studies. In fact, the baboon may well the only practical primate model available for endometrial studies.

The baboon as a primate model for the study of endometrium.

A series of transcervical uterine biopsy specimens were obtained at various stages of the menstrual cycle from a colony of 11 normally cycling female baboons, Papio anubis and Papio cynocephalus. Morphologically, baboon endometrium appeared to be similar to human endometrium. Alkaline phosphatase activity was maximal throughout the preovulatory phase and during the late postovulatory period. During the preovulatory phase acid phosphatase was not demonstrable but increased after ovulation to reach maximal activity prior to menstruation. While differences exist between human and baboon endometria, the overall morphologic and histochemical changes are similar. In addition, the baboon's endometrium is readily accessible by transcervical uterine biopsy, thus making these animals valuable primate models for study of human reproductive problems.

Histochemical and ultrastructural effects of enovid E on the endometrium of the baboon.

Endometrium from a group of baboons treated with the oral contraceptive, Enovid E, was studied histologically, histochemically and ultrastructurally, and compared to endometrium from normally cycling animals. All endometria were obtained by transcervical uterine biopsy between 10 and 14 days of the treatment cycle or the normal menstrual cycle. Histologically, no discernible differences between the control and experimental endometria were apparent. While observable differences were not evident between the endometrial alkaline phosphatase and succinate dehydrogenase activities of control and experimental animals, there was an increased acid phosphatase activity in the Enovid E-treated baboon endometrium. Ultrastructurally, the glandular cells of treated animals appeared to be more physiologically advanced than did those from the control endometria. These advances were evident from the prominent Golgi complex, increased development of the endoplasmic reticulum and increases in the size, number and complexity of mitochondria. The functional correlates of these morphological and histochemical observations are discussed and compared to human endometrial studies.