Primary Ki-1 lymphoma of the skin: expression of growth hormone receptors.

The biological significance of growth hormone (GH) in the physiology and pathophysiology of the immune system is not established. To address the site and mode of action through which GH exerts its effects on lymphocyte tumors, we applied a well-characterized monoclonal antibody directed against the hormone binding site of the receptor and were able to further characterize the tumor by immunohistochemical localization of GH receptors. Cutaneous T cell lymphomas were identified by histologic and immunomorphologic diagnosis according to the updated Kiel classification, with the application of monoclonal antibodies. Nodular tumors of the skin, identified as highly malignant Ki-1 lymphomas of large anaplastic cells, had intense GH receptor immunoreactivity. The presence of GH receptors in these proliferating tumor cells supports the hypothesis that GH is involved in paracrine-autocrine mechanisms acting locally in regulating peripheral T cell lymphoma tumor growth.

Potential usefulness of biotinylated neoglycoproteins as tumor markers.

We used several biotinylated neoglycoproteins as tumor markers to detect and localize endogenous carbohydrate-binding proteins in cultured hepatoblastoma, melanoma, and bladder carcinoma tumor cells. The neoglycoproteins used consisted of cellobiose, fucose, N-acetyl-galactosamine, N-acetyl-glucosamine, lactose, maltose, mannose, melibiose, and xylose. In addition, naturally occurring asialofetuin that was chemically disialylated was also used. Binding to the cultured tumor cells was made visible with the avidin-peroxidase technique. Depending on the type of neoglycoprotein used, markedly different expression of cytoplasmic and nuclear receptors for sugars (endogenous lectins) was obtained from rat hepatoblastoma, human melanoma, and bladder carcinoma tumor cells. The most pronounced staining differences were documented for asialofetuin and the neoglycoproteins containing fucose, N-acetyl-galactosamine, and lactose.

Papillary carcinoma of the thyroid with numerous spindle-shaped tumor cells in fine needle aspiration smears. A case report.

A papillary carcinoma of the thyroid characterized by numerous spindle-shaped tumor cells in fine needle aspiration (FNA) smears is reported. The oval nuclei of the spindle cells, arranged in monolayered sheets, occasionally showed "rhythmic," palisaded patterns. Comparative study of cytology and histology of this tumor revealed that the spindle cells observed in FNA smears originated in the epithelium covering the edematous neoplastic papillae.

Management of thymoma. A retrospective study.

Thymoma is a relatively rare tumour. Twelve cases seen in Kuwait Cancer Control Centre over a period of 10 years were analyzed. Two patients had Myasthenia gravis at presentation, and one developed it after the treatment, during remission. Six patients had total resection and four had subtotal resection of the tumour; the remaining had only diagnostic biopsy. All the six patients who had total resection were alive, disease-free with three of them Stage III, whereas, of the four cases who had subtotal resection two are dead, one with local disease and the other with pulmonary metastases. Eight patients were given postoperative radiotherapy and none of them relapsed at the primary site. Of the three patients who had chemotherapy, two had partial remission, and the remaining one failed to show any response. Patients with predominantly epithelial type histology fared worse compared to predominantly lymphocytic type and mixed cell type. Histological subtypes, invasiveness of the tumour and completeness of resection and association of Myasthenia gravis as prognostic features are discussed. The role of radiotherapy and chemotherapy as adjunctive treatment to surgery is reviewed.

Serum CA-15.3 and CEA patterns in postsurgical follow-up, and in monitoring clinical course of metastatic cancer in patients with breast carcinoma.

Serum CA-15.3 and CEA levels were longitudinally determined in 307 patients with breast carcinoma during postsurgical follow-up and/or therapy. Of 120 patients with no apparent disease, the specificity of marker levels fluctuating within the normal range (true-negative) was 98% for CA-15.3 alone (P = 0.004) and about 88% for CEA alone or for the tests combined. However, the false-negative levels in patients with progressive cancer reduced the predictive value of the tandem to around 76%, i.e. normal levels of both markers correctly predicted uneventful postsurgical course in only three fourths of the patients. Of 187 patients with active disease, the sensitivity of raised or increasing marker levels was around 70% for CA-15.3 alone or CEA alone, and 82% for the tests combined (P = 0.006). The 11% false-positive rate of CEA in patients with no apparent disease decreased the predictive value of a positive test from 98% for CA-15.3 alone (P = 0.006) to 91% for CEA alone or the tandem. Serum CA-15.3 or CEA paralleled the site of relapse: at least one marker was found elevated in 60% of patients with locoregional disease or with metastases to the lungs or bones exclusively, and in 90% of those with metastases to the lungs and bones or to the liver. A concurrent decrease of both marker levels reflected response to therapy while an increase of at least one marker level reflected treatment failure. It may be concluded that the marker tandem was better than either marker alone for follow-up aimed at detection of relapse, and that the tests were approximately 80% accurate for follow-up and/or monitoring therapy.

Effectiveness of moderate dose combination chemotherapy in Burkitt's lymphoma.

Twenty-five evaluable pediatric patients with histologically proven Burkitt's lymphoma were treated with moderate dose combination chemotherapy consisting of cyclophosphamide, vincristine, methotrexate and cytosine arabinoside (COMA regime) without central nervous system prophylaxis. Complete remission was achieved in 94.1% (16/17) of patients with Stage I, I R, II and III A disease, with disease-free survival of more than 3 years. This protocol was attended by minimal chemotherapeutic toxicity. This combination chemotherapy was ineffective in more advanced disease (Stages III B, IV), major cause of failure being progressive disease with central nervous system involvement. This study showed the effectiveness of moderate dose chemotherapy without CNS prophylaxis in early stage Burkitt's lymphoma including Stage III A and needs for aggressive chemotherapy with CNS prophylaxis in more advanced disease.