alcian-blue and Neoplasm-Metastasis

The sensitivity of an intraoperative diagnosis of sentinel lymph node metastasis of invasive lobular carcinoma using conventional staining is low.. To develop a fast, modified, Alcian blue stain to decrease the intraoperative false-negative results in testing for metastatic invasive lobular carcinoma.. Modified Alcian blue was optimized. Patients who had invasive lobular carcinoma on needle biopsy were candidates for this study. Touch preparations from every sentinel lymph node were prospectively prepared in the same manner, one stained with modified Alcian blue and one with conventional staining. These slides were independently interpreted.. A total of 121 sentinel lymph nodes from 31 patients with invasive lobular carcinoma were studied. There were 11 patients (35.5%) who had at least one positive lymph node test result. There were a total of 18 positive lymph node results (14.9%). Although 10 sentinel lymph nodes with abnormalities were detected in 7 patients with conventional staining, modified Alcian blue detected 15 sentinel lymph node abnormalities in 10 patients. Modified Alcian blue increased the sensitivity compared with conventional staining from 63.6% to 90.9% (calculated based on the number of patients) and from 55.6% to 83.3% (calculated based on number of sentinel lymph nodes). The staining process takes approximately 11 minutes.. Modified Alcian blue stain is a relatively rapid, cheap, highly sensitive, and specific method of detecting metastatic invasive lobular carcinoma. This method can be used in conjunction with conventional staining methods used intraoperatively.

Topics: Adult; Aged; Aged, 80 and over; Alcian Blue; Breast Neoplasms; Carcinoma, Lobular; Coloring Agents; False Negative Reactions; Female; Humans; Immunohistochemistry; Middle Aged; Monitoring, Intraoperative; Neoplasm Metastasis; Prospective Studies; Sentinel Lymph Node Biopsy

A series of 30 myxofibrosarcomas is described. These malignant soft tissue tumours are characterized by a mucoid and nodular appearance, a coarse plexiform capillary pattern, and they are mostly seen subcutaneously (26 out of 30) in the extremities (24 out of 30) and trunk (4 out of 30) elderly people. Histochemical studies, comprising staining with Alcian blue and toluidine blue at different pH's with and without preceding digestion with testicular hyaluronidase and with the Scott technique, indicated the presence of hyaluronic acid but not sulphated glycosaminoglycans as chondroitinsulphates. Myxofibrosarcoma is believed to belong to the general category of fibroblastic and histiocytic malignant soft tissue tumours. The median diameter of the tumours was 7 cm. They were divided into 4 grades according to cellularity, cell atypia and mitotic activity. The grade III and IV tumours showed pronounced atypia, often with the bi- and multinucleated giant tumour cells and occasionally with giant cells of Touton's type, suggesting a relationship to malignant fibroxanthoma. All of the patients were treated surgically and one received also pre- and post-operative irradiation. None of the 2 grade I myxofibrosarcomas recurred, while 2 out of 7 grade II tumours, 6 out of 10 grade III tumours, and 7 out of 11 grade IV tumours recurred once and up to 9 times. Metastasis appeared in 7 out of 30 patients; grade I tumours were not seen in any of these cases. By the time of follow-up after intervals ranging from 1 month up to 27 years, 14 patients had died; 6 of these had died post-operatively or of intercurrent disease. The differential diagnosis between myxofibrosarcoma and other myxoid soft tissue tumours is discussed.

Topics: Adult; Age Factors; Aged; Alcian Blue; Female; Fibrosarcoma; Follow-Up Studies; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Prognosis; Sex Factors; Soft Tissue Neoplasms; Tolonium Chloride