Urokinase plasminogen activator is localized in stromal cells in ductal breast cancer.

Urokinase plasminogen activator (uPA) regulates a proteolytic cascade that facilitates cancer invasion through degradation of the extracellular matrix, and high levels of uPA in human breast cancer tissue correlate with poor prognosis. We previously found that, in ductal breast cancer, uPA mRNA is highly expressed by myofibroblasts surrounding invasively growing cancer cells. However, the localization of uPA protein has not been settled in the published literature. Because uPA is a secreted molecule, it could conceivably be localized differently from its mRNA. We have studied the localization of uPA immunoreactivity in detail. Twenty-five cases of invasive ductal carcinoma were analyzed with three different uPA antibody preparations, all of which gave an essentially identical stromal staining pattern. Using double immunofluorescence, we identified uPA immunoreactivity in myofibroblasts and macrophages in all cases examined. Additionally, in approximately half of the tumors, we saw uPA staining of endothelial cells. In 3 of the 25 cases, a small subpopulation of the cancer cells was uPA-positive. We conclude that uPA immunoreactivity is almost exclusively associated with stromal cells, which thus play a major role in generation of proteolytic activity in ductal breast cancer.

Paratesticular tumour: a metastasis from primary pancreas cancer.

This is a report of a rare case of metastatic paratesticular tumour from primary pancreas cancer, the second reported case in the literature. Metastatic paratesticular tumour can present clinically as a testicular tumour.

[Mammographic screening in the municipality of Copenhagen. Results of the first screening round]. / Mammografiscreening i Københavns Kommune. Resultater fra første screeningsrunde.

The aim of the study was to evaluate the results from the prevalence round of the mammography screening programme in the Municipality of Copenhagen. All women who by 1 April 1991 were 50-69 years old, and who lived in the Municipality of Copenhagen, were during the period 1 April 1991-24 April 1993 offered a mammography. Those with suspect findings were recalled for further examination and possible biopsy. Women with breast cancer were offered treatment according to the standard national protocols (DBCCG). The participation rate was 71% (30,416/43,087). Among these 2043 (6.7%) were re-examined and 592 (1.9%) underwent surgical biopsy. Breast cancer was revealed in 359 (1.2%) women, of whom 88% had an invasive breast cancer. Prevalence of breast cancer increased significantly with increasing age. The positive predictive value for breast cancer among those re-examined was 18% and for those who had a surgical biopsy 61%. Among women with an invasive breast cancer 41% had a tumour of 10 mm or less, 80% had negative lymph node status and 56% had breast conserving surgery. During the following 12 months 14 women with a normal mammogram at the screening round developed breast cancer giving a sensitivity of 96%. It is concluded that the first mammography screening in Denmark showed the highest breast cancer prevalence published so far. A possible explanation could be a high sensitivity of the screening method, indicated by a relatively high frequency of small cancers. The screening programme was fully comparable with international standards.

Nephrogenic metaplasia of the bladder in renal transplant recipients. Case report.

Nephrogenic metaplasia in two cases of renal transplant recipients, following immunosuppressive treatment is reported. The lesion is rare with unknown pathogenesis. Histologically the tumor consists of cystic and tubular structures resembling the distal parts of the nephron, but may occur in any part of the urothelium lined organs from calyxes to urethra. Watchful waiting is the treatment of choice in the absence of microscopically malignant changes.

Adenoid cystic carcinoma of Bartholin's gland--a review of the literature and report of a patient.

A case of adenoid cystic carcinoma of the Bartholin's gland, a rare vulval tumor, is reviewed with respect to clinical and pathological characteristics. Histological transition from normal Bartholin gland to adenoid cystic carcinoma was evident in this case. Local recurrences are common and often precede distant metastases. The recommended primary treatment is vulvectomy, obtaining clear margins and bilateral inguinofemoral node dissection.

Bilateral virilizing hilus (Leydig) cell tumors of the ovary.

A 72-year-old postmenopausal woman with high plasma testosterone levels and virilization, as demonstrated by hirsutism and balding, is presented. Urinary 17-ketosteroids and 17-hydroxycorticosteroids, as well as computed axial tomography scan of the adrenal glands were normal. Although no pelvic mass was detected by ultrasonography or pelvis examination, the patient was found to have small bilateral hilus cell tumors of the ovary. Following bilateral salpingo-oophorectomy the plasma testosterone dropped to normal level. This is the third case of bilateral hilus cell tumors of the ovary to be reported.

T-cell receptor v-alpha and v-Beta gene usage in interleukin-2-cultured tumor-infiltrating lymphocytes from patients with breast-cancer.

Tumor-infiltrating lymphocytes (TIL) are often found in malignant breast tumors, and have been claimed to be of prognostic value. It has been proposed that TIL may represent an enriched population of tumor-specific cytotoxic lymphocytes, reacting with antigenic determinants on the tumor cell surface through the T cell receptor (TCR) complex. We have studied the phenotype, cytotoxicity, and expression of TCR variable (V) alpha and beta chain on in vitro IL-2-cultured TIL isolated from primary malignant breast tumors from 11 patients. 10/11 cultures were dominated by CD4(+) (T-helper) cells. The different TIL cultures exhibited varying levels of cytotoxicity against the natural killer (NK)-sensitive cell line K562 and breast cancer cell line T47D. The level of clonality, as measured by PCR-based analyses of usage of the different V segments was low, as only a few tumors showed patterns of restricted V gene expression. The mean number of V alpha segments per TIL culture was higher than the number of V beta segments per culture. A significant negative correlation was observed between the number of CD4+ cells and the number of V beta segments per culture, and no other correlations between phenotypes and expression of any particular V segments were found. Neither was there any correlation between the expression of specific V alpha/V beta segments and cytotoxicity against allogeneic tumor cells.

Management of prelabor rupture of membranes at term. A randomized study.

OBJECTIVE: To compare the rate of obstetric interventions, length of labor, and maternal morbidity in pregnancies with prelabor rupture of membranes at term after either early or late induction of labor in both primiparous and pluriparous women. DESIGN: Prospective, randomized study. SUBJECTS: 362 women with singleton pregnancies, cephalic presentations, gestational age of 36 completed weeks or more were allocated at random to induction with oxytocin either 6 hours after PROM (n = 62) (early) or 24 hours (n = 62) (late). Those eligible, but not participating in the study, totalled 238 women. MAIN OBSTETRIC MEASURES: Time of spontaneous labor in the late induction group, length of labor, obstetric intervention rate, maternal morbidity, and the degree of histologic chorioamnionitis. RESULTS: The length of labor was longer in the late induction group than in the early induction group in both primiparous and pluriparous (p < 0.05). There were no overall differences in the rate of obstetric interventions or maternal morbidity, but there were marked differences between primiparous and pluriparous women. Increasing time span between the period from rupture of membranes to delivery increased the degree of histologic chorioamnionitis. CONCLUSION: If a woman wants a short labor, she will benefit from early induction. We did not find statistical differences in the rate of obstetric intervention or in the maternal morbidity, but there was a tendency towards adverse effects of late induction.

Endometrioid carcinoma arising from endometriosis of the sigmoid colon during estrogenic treatment.

A case of endometrioid carcinoma arising from endometriosis of the sigmoid colon is reported. The patient had been treated with unopposed continuous estrogen injection for twenty years after bilateral salpingo-oophorectomy because of severe endometriosis. The pathology, pertinent literature and implications of the present case are discussed.

The prevalence of human papillomavirus in cervical lesions with koilocytosis and/or CIN I.

Thirty-one patients with koilocytosis and/or concomitant CIN I were analysed for the presence of HPV types 11, 16 and 18 by in situ hybridization and Southern blot analysis. The prevalence of HPV was 48% and 55%, respectively, when measured by the two methods and among the HPV positive, HPV 11 and 16 were present in 47% and 60%, respectively, whereas HPV 18 was not found.

[Epidermoid cyst of the testis]. / Epidermoidcyste i testis.

We report a case of epidermoid cyst of the testis. The condition is rare and benign. Conservative surgical treatment is advocated when the diagnosis is confirmed by histological frozen sections.

Carcinosarcoma of the urinary bladder. Case report.

A case of carcinosarcoma in the urinary bladder is presented. On basis of a review of the most recent literature and referring to our own case, radical cystectomy appears to be the most effective treatment of this tumour.

Early arteriolopathy following "high-dose" cyclosporine in kidney transplantation.

Thirty-seven consecutive kidney graft biopsies from 37 patients immunosuppressed with "high-dose" cyclosporine (CsA) were mixed with 37 random biopsies obtained from 37 patients given azathioprine and prednisone (Aza/P) and reexamined by light microscopy, without knowledge of the therapy, for occurrence of early arteriolopathy. All biopsies were taken within 35 days after transplantation. Arteriolopathy was demonstrated in 12 biopsies from 37 patients given CsA but in none of those from 37 patients on Aza/P. The specific alteration found in those 12 biopsies was glycogen storage in the muscular layer of the arterioles. The average donor was significantly older in those grafts in which arteriolopathy was shown than in those without arteriolopathy but also given CsA (p less than 0.001). All kidneys from donors more than 53 yr old had arteriolopathy. The occurrence of arteriolopathy was independent of the average CsA level from transplantation to biopsy, but the CsA level had never been below 380 ng/ml in those patients with arteriolopathy. The clinical course in grafts with arteriolopathy was characterized by poorer graft function as judged from the renograms, delayed onset of function and a high proportion of "never-functioning" grafts (50%). We concluded that patients receiving a cadaver graft from a donor older than 50 yr should not be treated with "high-dose" CsA. If the arteriolopathy is demonstrated in kidney graft biopsies within the first 5 weeks after transplantation in patients treated with CsA, one should consider a change or modification of the treatment strategy.