ABSTRACT
UNLABELLED: This study was undertaken to assess the relationship between the degree of 99mTc-MIBI uptake in breast lesions and the following histologic factors: neovascularity, desmoplastic reaction, cellular proliferation and mitochondrial density. METHODS: Forty-two patients who previously underwent MIBI breast imaging (4 false-negative, 12 false-positive, 15 true-negative, 11 true-positive) were studied. Immunohistochemical staining was performed for neovascularity (Factor VIII antigen), desmoplasia (alpha-actin antigen), mitochondrial density (mitochondrial antigen) and cellular proliferation (MIB-1 antigen). The degree of microscopic staining was correlated with region of interest measurements of MIBI uptake on scintigraphy. RESULTS: There was a poor correlation between MIBI uptake and the degrees of neovascularity (r = 0.08, p > 0.05) and intracellular mitochondrial density (r = 0.04, p > 0.05) while there was a moderate correlation with cellular proliferation (r = 0.4, p < 0.05) and desmoplasia (r = 0.55, p < 0.001). CONCLUSION: The degree of MIBI uptake in breast lesions is multifactorial, but it appears to be related more to the degree of desmoplastic activity and cellular proliferation than neovascularity and mitochondrial density.
Subject(s)
Breast Diseases/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Breast/diagnostic imaging , Breast/metabolism , Breast/pathology , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Female , Humans , Neovascularization, Pathologic/pathology , Radionuclide ImagingABSTRACT
In this study, we analyzed 69 plasma cell neoplasms, including 54 multiple myelomas (MMs), 3 cases of plasma cell leukemia, and 12 plasmacytomas, for expression of cyclin D1 protein using an immuno-histochemical method applied to routinely fixed, paraffin-embedded tissue sections. Cyclin D1 was expressed in 18 (26%) of 69 plasma cell neoplasms, including 16 (30%) of 54 MMs and 2 (17%) of 12 plasmacytomas. Three cases of plasma cell leukemia were negative. Cyclin D1 expression correlated with the cytologic differentiation and histologic stage of MM. Twelve (75%) of 16 MMs had intermediate or immature cytologic features and were histologic Stage III. With use of a polymerase chain reaction assay, we also analyzed six cases (three cyclin D1 positive, three cyclin D1 negative) for the t(11;14); one MM carried the t(11;14) and expressed cyclin D1 protein. We conclude that cyclin D1 expression occurs in approximately one-quarter of plasma cell neoplasms and correlates with the degree of cytologic differentiation and histologic stage. The relatively high frequency of cyclin D1 expression, compared with the less than 5% incidence of the t(11;14) detected by conventional cytogenetics reported in the literature, suggests that upregulation of cyclin D1 protein might be the result of mechanisms other than the t(11;14).
Subject(s)
Cyclin D1/metabolism , Multiple Myeloma/metabolism , Plasmacytoma/metabolism , Adult , Aged , Aged, 80 and over , Female , Humans , Immunoglobulin Heavy Chains/immunology , Immunoglobulin Light Chains/immunology , Immunohistochemistry , Leukemia, Plasma Cell/immunology , Leukemia, Plasma Cell/metabolism , Leukemia, Plasma Cell/mortality , Male , Middle Aged , Multiple Myeloma/immunology , Multiple Myeloma/mortality , Paraffin Embedding , Plasmacytoma/immunology , Plasmacytoma/mortality , Polymerase Chain Reaction , Survival RateABSTRACT
Immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP) have each been associated with HIV infection. Sequential occurrence of these two diseases with a disease-free interval has been occasionally reported in the literature, whereas simultaneous manifestations of these two diseases have not been described. Here, we report an AIDS patient who was initially diagnosed as having TTP and showed an apparent partial response to plasmapheresis but was found to have a clinical course similar to ITP. Although precise mechanisms for the development of TTP and ITP in these patients are unclear, we offer several hypotheses. It is important to recognize that these two processes may be seen concurrently.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Autoimmune Diseases/complications , Purpura, Thrombocytopenic, Idiopathic/complications , Purpura, Thrombotic Thrombocytopenic/complications , AIDS-Related Opportunistic Infections/complications , Acquired Immunodeficiency Syndrome/immunology , Adult , Anti-Bacterial Agents , Antiviral Agents/therapeutic use , Autoimmune Diseases/immunology , Autoimmune Diseases/therapy , Combined Modality Therapy , Drug Therapy, Combination/therapeutic use , Erythrocyte Transfusion , Fatal Outcome , Female , Humans , Immunosuppressive Agents/therapeutic use , Plasma , Plasmapheresis , Pneumonia, Pneumocystis/complications , Purpura, Thrombocytopenic, Idiopathic/immunology , Purpura, Thrombocytopenic, Idiopathic/therapy , Purpura, Thrombotic Thrombocytopenic/immunology , Purpura, Thrombotic Thrombocytopenic/physiopathology , Purpura, Thrombotic Thrombocytopenic/therapy , Sarcoma, Kaposi/complicationsABSTRACT
A case of previously undiagnosed cervical carcinoma metastatic to the right ventricular cavity and the central and peripheral pulmonary arteries is presented. The usefulness of ultrafast computed tomography in comparison with echocardiography for the evaluation of suspected metastatic diseases to the heart and pulmonary arteries is discussed.
