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1.
Semin Urol Oncol ; 14(1 Suppl 1): 23-9, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8727807

ABSTRACT

Subtle cytologic and histologic nuances have a major impact on diagnosis and, consequently, on therapy for superficial bladder cancer. Therefore, the urologist and the pathologist must carefully assess all clinical findings before a course of treatment can be determined. The urologist must advise the pathologist of all the circumstances surrounding a biopsy--whether its purpose is for preliminary clinical impression or diagnosis, the patient's recent treatment history, the availability of previous biopsy specimens for comparison, a thorough history of treatments that may induce characteristic cytologic changes that might lead to misdiagnosis, and alternate diagnostic possibilities drawn from initial pathology and treatment history. Armed with this information, the task of the pathologist is to provide as much data as possible regarding tumor histopathology from the biopsy specimens. Thus, establishment of a close working relationship between the urologist and the pathologist is an important tool for (1) initially characterizing superficial bladder cancer, which is essential in determining an appropriate course of treatment, and (2) accurately evaluating follow-up biopsies to determine the effectiveness of that treatment.


Subject(s)
Carcinoma in Situ/pathology , Carcinoma, Transitional Cell/pathology , Urinary Bladder Neoplasms/pathology , Biopsy, Needle , Carcinoma in Situ/physiopathology , Carcinoma in Situ/therapy , Carcinoma, Transitional Cell/physiopathology , Carcinoma, Transitional Cell/therapy , Disease Progression , Humans , Neoplasm Staging , Prognosis , Urinary Bladder Neoplasms/physiopathology , Urinary Bladder Neoplasms/therapy , Urine/cytology
2.
Am J Clin Pathol ; 102(1): 109-14, 1994 Jul.
Article in English | MEDLINE | ID: mdl-8037155

ABSTRACT

Pathologic grade and stage, immunohistochemical analysis of eight cell and tumor markers, and DNA ploidy were studied in 36 cases of bladder cancer to determine the features of value in assessment of patients' survival. Tumors of high grade and advanced stage correlated with DNA aneuploidy, whereas low grade and early stage correlated with DNA diploidy when simultaneously evaluated with survival. In addition, blood group isoantigen A correlated with DNA ploidy in deceased patients, whereas blood group isoantigen H and oncogene-related protein p21 correlated with DNA ploidy in surviving patients. Despite the relatively small number of cases studied, these results suggest that pathologic grade and stage and immunohistochemical analysis of blood group isoantigens A and H and oncogene-related protein p21 hold additional value in the prediction of bladder cancer survival when evaluated simultaneously with DNA ploidy.


Subject(s)
Carcinoma, Transitional Cell/mortality , Carcinoma, Transitional Cell/pathology , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/pathology , ABO Blood-Group System/chemistry , Aged , Biomarkers, Tumor/analysis , Carcinoma, Transitional Cell/blood , Cell Cycle , DNA, Neoplasm/analysis , Female , Flow Cytometry , Humans , Immunoenzyme Techniques , Male , Middle Aged , Ploidies , Proto-Oncogene Proteins p21(ras)/analysis , Urinary Bladder Neoplasms/blood
3.
Med Pediatr Oncol ; 22(1): 1-10, 1994.
Article in English | MEDLINE | ID: mdl-8232073

ABSTRACT

Many pediatric and adolescent cancer patients are treated with carcinogenic chemotherapeutic agents and radiation therapy to achieve permanent control of their malignancy. These modalities may induce a new cancer in the successfully treated patient. To identify disease and treatment factors which increased the risk of occurrence of a second malignant tumor following modern treatment for cancer during childhood or adolescence, we reviewed the courses of 1,406 previously untreated patients who were less than 20 years of age at diagnosis and were treated at Roswell Park Cancer Institute between January 1, 1960 and December 31, 1989. Eighteen patients developed a second malignant tumor, including two meningiomas, 2.65-25.65 years after diagnosis of the first cancer. The actuarial risk of a second malignant tumor was 5.6% at 25 years after diagnosis. Using Cox proportional hazards modelling, we identified prior therapy with BCNU (P = 0.0055) and doxorubicin (P = 0.0254) as the only factors that were significantly associated with the risk of a second malignant tumor. Three second malignant tumors of the central nervous system occurred following treatment with a nitrosourea. Successfully treated patients must be carefully followed to identify treatment related malignant tumors at an early stage.


Subject(s)
Neoplasms, Second Primary/etiology , Neoplasms/therapy , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Child , Child, Preschool , Combined Modality Therapy/adverse effects , Female , Humans , Incidence , Infant , Male , Neoplasms/drug therapy , Neoplasms/radiotherapy , Neoplasms, Second Primary/chemically induced , Proportional Hazards Models , Radiotherapy/adverse effects , Risk Factors
4.
Urol Int ; 50(2): 61-4, 1993.
Article in English | MEDLINE | ID: mdl-8460449

ABSTRACT

A wide range of cell and tumor markers including the blood group-related isoantigens A, B, O(H) and T-Ag, the cell markers DCA(F36/22) and epithelial membrane antigen (EMA), and the oncogene-related proteins RAP-5p21 and ORP-p21 were investigated by means of immunohistochemistry in selected biopsies from 36 bladder cancer patients with the aim of ascertaining which are of value in patients' survival. A heterogeneous distribution of positivity was found for each marker. In addition, EMA immunostaining correlated significantly (p < 0.05) with patient survival. We conclude that immunohistochemical detection of EMA may provide additional prognostic information in bladder cancer patients.


Subject(s)
Biomarkers, Tumor/analysis , Carcinoma, Transitional Cell/chemistry , Urinary Bladder Neoplasms/chemistry , Antigens, Differentiation/analysis , Antigens, Neoplasm/analysis , Antigens, Viral, Tumor/analysis , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/mortality , Humans , Immunohistochemistry , Isoantigens/analysis , Membrane Glycoproteins/analysis , Mucin-1 , Proto-Oncogene Proteins/analysis , Survival Rate , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/mortality
5.
Cancer ; 70(4): 799-807, 1992 Aug 15.
Article in English | MEDLINE | ID: mdl-1643611

ABSTRACT

Clinical and pathologic data of 36 patients with transitional cell carcinoma of the bladder were investigated to determine the significance on patient survival of these factors: pathologic grade and stage; the immunohistochemistry of eight cell and tumor markers; nuclear DNA flow cytometric parameters; and patient smoking status. The bivariate and multivariate statistical analysis significantly correlated patient survival rates with the immunohistochemical expression of blood group, isoantigens A (P less than 0.05), O(H) (P = 0.001), the oncogene-related protein ORP-p21 (P less than 0.05), the pathologic grade and stage (P = 0.002), and the tumor DNA ploidy (P less than 0.05). Smoking status correlated aneuploidy (P less than 0.05) and tumor expression of ORP-p21 (P less than 0.05) with the patient survival rate. Despite the relatively small number of patients in this study, the results suggest that the clinicopathologic variables are significant factors in survival of bladder cancer.


Subject(s)
Antigens, Tumor-Associated, Carbohydrate , Urinary Bladder Neoplasms/mortality , ABO Blood-Group System , Aged , Antigens, Neoplasm/analysis , Biomarkers, Tumor/analysis , DNA, Neoplasm/genetics , Female , Humans , Immunohistochemistry , Isoantigens/analysis , Male , Membrane Glycoproteins/analysis , Middle Aged , Mucin-1 , Neoplasm Staging , Oncogene Protein p21(ras)/analysis , Ploidies , Predictive Value of Tests , Prognosis , Smoking/adverse effects , Urinary Bladder Neoplasms/chemistry , Urinary Bladder Neoplasms/pathology
6.
J Urol ; 145(2): 373-5, 1991 Feb.
Article in English | MEDLINE | ID: mdl-1988736

ABSTRACT

Endometrioid carcinoma of the prostate is considered a variant of classical prostatic ductal carcinoma. Endometrioid carcinoma variant often has the unique clinical presentation of gross hematuria. The propensity of this tumor to spread within the urothelium makes local failure of curative therapy commonplace. We present 2 representative cases with a review of followup surveillance procedures and treatment options for the local recurrence once identified.


Subject(s)
Adenocarcinoma/surgery , Endometriosis/surgery , Neoplasm Recurrence, Local , Prostatic Neoplasms/surgery , Adenocarcinoma/pathology , Aged , Endometriosis/pathology , Humans , Male , Middle Aged , Prostate/pathology , Prostatectomy , Prostatic Neoplasms/pathology
7.
Urology ; 35(2): 164-7, 1990 Feb.
Article in English | MEDLINE | ID: mdl-2154876

ABSTRACT

A case of malignant phyllodes tumor of the prostate, with clinical course of recurrence and pulmonary metastasis is described in a thirty-eight-year-old man. Histologically the tumor was characterized by a fibrosarcoma-like pattern with adjacent changes of fibroadenoma and phyllodes type of prostatic atypical hyperplasia. The pathology, histogenesis, differential diagnosis, and the role of immunohistochemistry in the diagnosis and demonstration of its components is reviewed.


Subject(s)
Phyllodes Tumor/pathology , Prostate/pathology , Prostatic Neoplasms/pathology , Adult , Humans , Immunohistochemistry , Lung Neoplasms/secondary , Male , Neoplasm Recurrence, Local/pathology , Phyllodes Tumor/diagnosis , Phyllodes Tumor/secondary , Prostatic Neoplasms/diagnosis
8.
J Urol ; 142(6): 1589-93, 1989 Dec.
Article in English | MEDLINE | ID: mdl-2511340

ABSTRACT

This study was designed to determine the role of immediate intravesical instillation of single dose thiotepa post transurethral resection of bladder tumor in the prevention of recurrence by tumor implantation, using murine bladder tumor line 2 and 201 C3H/He mice. Previous studies have suggested implantation may take place as early as the first hour and reach its maximum in 24 hours after resection of bladder tumor. An in vitro dose response curve of MBT2 to thiotepa was established by treatment with various concentrations of thiotepa of 0.00, 0.01, 0.21, 0.44, and 1.91 mg./ml. In a group of 201 mice, the bladder was catheterized with a 24G angiocatheter, and a fine copper wire was inserted through the lumen. The bladder was cauterized by touching the wire with a Bovie coagulator for four seconds at the lowest setting. All bladders were instilled with 1 x 10(6) cells of murine bladder tumor line 2, followed by instillation of 1.91 mg./ml. of thiotepa with various time delays per treatment group. The bladder implantation rates were 30.4% (17/56), 3.4% (2/59), 6.5% (2/31) and 26.9% (7/26) in the control, immediate, one-hour delay and 24-hour delay groups, respectively. The urethral implantation rates were 21.4% (12/56), 0% (0/59), 6.5% (2/31) and 0% (2/26), respectively. The overall implantation rates (bladder, urethra, or both) were 42.9% (24/56), 3.4% (2/59), 6.5% (2/31) and 25.9% (7/27), respectively. Implantation rates were significantly higher in the control and 24-hour delay groups than in the immediate and one-hour instillation groups (p less than 0.05, Fisher Exact Test). We conclude from this animal model that intravesical instillation of single dose thiotepa, to be effective, should be initiated within the first hour after tumor resection, since it dramatically decreased the incidence of bladder and urethral implantation.


Subject(s)
Carcinoma, Transitional Cell/prevention & control , Cautery , Neoplasm Recurrence, Local/prevention & control , Thiotepa/administration & dosage , Urinary Bladder Neoplasms/prevention & control , Urinary Bladder/surgery , Administration, Intravesical , Animals , Carcinoma, Transitional Cell/surgery , Cautery/instrumentation , Cautery/methods , Disease Models, Animal , Dose-Response Relationship, Drug , Drug Evaluation, Preclinical , Female , Mice , Mice, Inbred C3H , Postoperative Care , Prospective Studies , Random Allocation , Time Factors , Urinary Bladder Neoplasms/surgery
9.
Am J Clin Pathol ; 92(4): 408-14, 1989 Oct.
Article in English | MEDLINE | ID: mdl-2801608

ABSTRACT

The authors examined three cortical tumors (adenomas) of the kidney and found a consistent chromosome pattern. A combination of chromosome abnormalities (+7, +7, +17, -Y) was shared by these tumors. In contrast, none of them showed alterations of chromosome 3p and 5q, the most common changes in renal cell carcinomas. The chromosome abnormalities in these patients may define a subgroup of renal tumors, so-called adenomas, that cannot be distinguished easily from adenocarcinomas in histopathologic examination.


Subject(s)
Adenoma/genetics , Chromosome Deletion , Chromosomes, Human, Pair 12 , Chromosomes, Human, Pair 17 , Chromosomes, Human, Pair 1 , Chromosomes, Human, Pair 21 , Chromosomes, Human, Pair 7 , Kidney Cortex/pathology , Kidney Neoplasms/genetics , Monosomy , Trisomy , Y Chromosome , Adenoma/pathology , Aged , Diagnosis, Differential , Giant Cell Tumors/genetics , Giant Cell Tumors/pathology , Humans , Karyotyping , Kidney Neoplasms/pathology , Male , Middle Aged
10.
Pediatr Ann ; 17(4): 285-300, 1988 Apr.
Article in English | MEDLINE | ID: mdl-3290815

ABSTRACT

Osteosarcoma is the most common bone tumor of children and adolescents. The peak incidence of the disease is in the 15 to 19 year age group. The disease is more commonly seen in males than females. While several factors, including exposure to radiation, genetic disorders such as retinoblastoma, and high rate of bone growth, have been associated with osteosarcoma, in most cases no definite etiology can be established. Osteosarcoma usually originates in the metaphyseal region of long bones and extends through the cortex, causing varying degrees of bone destruction and expansion of periosteum. The radiographic appearance caused by this process is often referred to as "sun burst" sign. Positive diagnosis of osteosarcoma is made by histopathology. The histopathological classification of osteosarcoma can also predict the degree of aggressive behavior of this tumor and thus has prognostic significance. Surgery, including amputation or limb-salvage procedure, is the mainstay of treatment of osteosarcoma. It is now unequivocally established that adjuvant chemotherapy will prolong the survival of patients with this disease. Chemotherapy agents often used include platinum derivates, methotrexate, vincristine, cyclophosphamide, adriamycin, actinomycin D, bleomycin and DTIC. Depending on surgical decision, these agents can be used prior to or after the operation. Immediate fitting with prosthesis and provision of appropriate medical and psychological support in the care of these patients is essential.


Subject(s)
Bone Neoplasms/therapy , Osteosarcoma/therapy , Adolescent , Adult , Animals , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Humans , Osteosarcoma/diagnosis , Osteosarcoma/pathology
11.
Cancer Genet Cytogenet ; 28(2): 343-8, 1987 Oct.
Article in English | MEDLINE | ID: mdl-3476190

ABSTRACT

Chromosome studies were performed on an adrenocortical carcinoma extending into the kidney. The following karyotype was present in all metaphases: 46,XX,t(4;11)(q35;p13). Two metaphases with an additional del(1)(q23) were found. The results are briefly discussed in relation to specific karyotypic changes in cancer, in general, and to those of adrenocortical tumors, in particular.


Subject(s)
Adrenal Cortex Neoplasms/genetics , Carcinoma/genetics , Chromosomes, Human, Pair 11 , Chromosomes, Human, Pair 4 , Translocation, Genetic , Adrenal Cortex Neoplasms/pathology , Adult , Carcinoma/pathology , Chromosome Banding , Female , Genetic Markers , Humans , Karyotyping
12.
Urology ; 29(3): 258-61, 1987 Mar.
Article in English | MEDLINE | ID: mdl-3824720

ABSTRACT

In 1981, the National Prostatic Cancer Treatment Group began an open survey of available A1, B1 prostatic adenocarcinomas to determine outcome and clinical characteristics. Their report as of September, 1985, summarizes the outcome and important features of the survey. The majority of A1 cases had a low tumor grade I and were followed. Stage B1 received surgery or radiation generally. The B1 tumor grade was approximately one-third grade I, II, or III-IV. Presently, symptoms differ, as would be expected. Follow-up data to date have indicated no major changes. In some of the special study cases (12/52), the stage was changed as a result of the central laboratory review.


Subject(s)
Adenocarcinoma/therapy , Prostatic Neoplasms/therapy , Adenocarcinoma/pathology , Follow-Up Studies , Humans , Male , Neoplasm Staging , Prostatic Neoplasms/pathology , Registries , United States
13.
Urology ; 27(4): 306-8, 1986 Apr.
Article in English | MEDLINE | ID: mdl-3962053

ABSTRACT

Multivariable analysis was used to investigate the relationship between risk of disease progression or death in patients who were treated with adjuvant therapy after definitive treatment for prostatic adenocarcinoma and the components of the National Prostatic Cancer Treatment Group (NPCTG) and Gleason systems for pathologic grading of prostatic cancer. Data were available for 203 patients who were treated on NPCTG Protocols 900 and 1,000, which involve surgical and radiation therapy as definitive treatment. Since less than 10 per cent of these patients have died, analysis of survival was not attempted. The study focus was progression-free survival, which is the minimum of time to progression or death. The analysis demonstrates that a new measure, the NPCTG score (the sum of the glandular and nuclear grades) is superior to the previously reported NPCTG grade (the maximum of the two grades). In addition, the Gleason score is somewhat superior to the new NPCTG score. All of this, however, applies only to the primary tumor and not the nature of any present or future metastatic lesions.


Subject(s)
Prostatic Neoplasms/pathology , Evaluation Studies as Topic , Humans , Male , Methods , Models, Biological , Prostatic Neoplasms/mortality
15.
Prostate ; 9(1): 9-14, 1986.
Article in English | MEDLINE | ID: mdl-3737488

ABSTRACT

Six patients with papillary adenoma of the prostatic urethra are described. Their ages ranged from 39 to 70 years old. Two of them showed evidence of clinical recurrence 1 year after treatment. The pathological features as well as the immunohistochemical demonstration of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) are illustrated. A brief review of the literature is discussed with special emphasis on the histogenesis and nature of this lesion.


Subject(s)
Cystadenoma/secondary , Prostatic Neoplasms/pathology , Urethral Neoplasms/secondary , Adult , Aged , Cystadenoma/pathology , Humans , Male , Middle Aged , Polyps/pathology , Prostate/pathology , Urethra/pathology , Urethral Neoplasms/pathology
16.
Urology ; 27(1): 18-23, 1986 Jan.
Article in English | MEDLINE | ID: mdl-3942017

ABSTRACT

Endometrial carcinoma of the prostate is a unique lesion which contrasts markedly to the more ubiquitous prostatic acinar carcinoma with regard to morphology, clinical manifestations, localization stage at diagnosis, and possibly prognosis. Although endometrial carcinoma of the prostate may occur more commonly than previously recognized, wider recognition and study are essential for further delineation of this lesion. Finally, the inherent limits of endoscopic or of enucleative surgery and the propensity of endometrial carcinoma to present at a low stage suggest in appropriately selected cases that radical prostatectomy or possible external radiotherapy may offer the best opportunity for cure.


Subject(s)
Adenocarcinoma/diagnosis , Endometriosis/diagnosis , Prostatic Neoplasms/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Aged , Endometriosis/pathology , Endometriosis/therapy , Humans , Male , Prognosis , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy
17.
Am J Pathol ; 121(3): 451-4, 1985 Dec.
Article in English | MEDLINE | ID: mdl-2416221

ABSTRACT

With the use of a murine monoclonal antibody (F5), a panel of metastatic tumors was evaluated for the expression of prostate-specific antigen (PA) under immunoperoxidase staining procedures. Specimens studied included 25 of prostatic origin and 73 originating from nonprostatic primary sites. Regardless of the site of dissemination or the malignancy grade, all metastases from the prostate were antibody-reactive. In contrast, nonprostatic metastases were negative in each case, including those originating from other genitourinary neoplasms. Thus, PA expression as detected with monoclonal antibody F5 is a stable characteristic of disseminated prostatic tumors.


Subject(s)
Antibodies, Monoclonal , Antigens, Neoplasm/analysis , Prostatic Neoplasms/pathology , Humans , Immunoenzyme Techniques , Male , Neoplasm Metastasis , Prostate-Specific Antigen , Prostatic Neoplasms/diagnosis
18.
J Nucl Med ; 26(12): 1394-401, 1985 Dec.
Article in English | MEDLINE | ID: mdl-4067642

ABSTRACT

A nongeometric, attenuation-corrected technique to quantitate left ventricular volumes using equilibrium radionuclide angiography was validated in vitro and in vivo. In vitro experiments were performed to derive a linear attenuation coefficient, which was then employed in the volume determinations using balloons in a water bath. Good in vitro correlation was found between radionuclide and actual volumes (r = 0.99, p less than 0.0001), over a wide range (5 to 400 ml). In vivo validation was done by comparing the nuclear technique to contrast angiography in 29 patients: Good correlations were found for end-diastolic volume (r = 0.98), end-systolic volume (r = 0.95), stroke volume (r = 0.96), and ejection fraction (r = 0.85). When the conventional linear attenuation coefficient was used, the radionuclide technique consistently overestimated volumes in vitro and in vivo. Although high intraobserver and interobserver correlation coefficients were found (r from 0.88 to 0.93), significant individual variability existed, particularly in the interobserver data. Our data provide unique validation of radionuclide volume determinations, using an experimentally determined attenuation coefficient, which results in improved accuracy.


Subject(s)
Cardiac Volume , Heart/diagnostic imaging , Stroke Volume , Adult , Aged , Cardiac Catheterization , Cineangiography , Humans , Middle Aged , Models, Structural , Radionuclide Imaging , Technetium , Technology, Radiologic
20.
An Esp Pediatr ; 20(9): 842-6, 1984 Jun.
Article in Spanish | MEDLINE | ID: mdl-6486578

ABSTRACT

We report the results of a Municipal Immunisation Program in a industrial community. These results were evaluated through the School Health Program. Our immunisation policies resulted in a substantial increase of immunity covering with particular impact on the less wealthy social layers. Immunity rats rose from 32% to 71% of the population. We conclude that our program is an adequate policy for control of infection diseases.


Subject(s)
Preventive Health Services/organization & administration , Vaccination , Adolescent , Child , Evaluation Studies as Topic , Humans , School Health Services/organization & administration , Socioeconomic Factors , Spain
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