bromochloroacetic-acid and Anaplasia

A case of mucinous cystic ovarian tumor with mural nodules of anaplastic carcinoma in a 30-year-old woman is described. The carcinomatous components within the nodules showed strong immunopositivity for cytokeratin and carcinoembryonic antigen, and ultrastructurally they displayed epithelial and glandular differentiation. Omental metastasis had already developed in the patient, and she received postoperative adjuvant chemotherapy consisting of cyclophosphamide and cis-platinum. No sign of recurrence was evident 4 months after the operation. The literature is reviewed and the importance of adjuvant chemotherapy in the postoperative management of such patients highlighted. The salient pathologic features differentiating mural nodules of anaplastic carcinoma and true sarcoma from prognostically favorable sarcoma-like nodules are presented.

Topics: Adenocarcinoma, Mucinous; Adult; Anaplasia; Carcinoembryonic Antigen; Cell Membrane; Cytoplasm; Female; Humans; Keratins; Ovarian Neoplasms

To analyse the cytomorphologic spectrum of Wilms tumour (WT) on aspirates, the largest series reported to date.. Adequate aspirates from paediatric renal tumours over a period of 17 years were reviewed and selected if subsequent excision showed WT or aspirates were diagnostic for WT and clinical/radiological evidence consistent with that diagnosis. Smears were re-examined for the proportion of components, degree of pleomorphism and mitosis.. Of 110 aspirates, smears were triphasic in 44 (40.0%), biphasic (blastema and tubules) in 36 (32.7%) and monophasic (blastema alone) in 30 (27.3%). Stromal predominance was seen in 11 aspirates (10.0%) and five showed rhabdomyoblastic differentiation; all 11 were triphasic. Mean mitotic rate was 9.3/5000 cells (range 4-39/5000). Nuclear atypia not amounting to anaplasia and without atypical mitoses was seen in 15 (13.6%); these presented diagnostic problems. Two aspirates (1.8%) were considered anaplastic (unfavourable), both having atypical mitoses. Criteria similar to histology (i.e. 3-fold or more variation in nuclear size, marked hyperchromasia with bizarre nuclei and atypical mitoses in a biphasic or triphasic aspirate) helped in distinguishing anaplastic WT. Histopathological correlation in 67 cases showed good correlation of blastemal predominance, stromal predominance and anaplastic histology with the corresponding cytology. However, 9/27 (33.3%) triphasic tumours had only blastemal cells on corresponding aspiration because of sampling error. Cytokeratin was positive in 4 of 20 aspirates with blastema alone.. Aspirates from WT were triphasic or biphasic in the majority (72.7%), permitting cytological diagnosis, which was improved by cytokeratin immunocytochemistry. Blastemal and stromal predominance on histology correlated well with cytology, but many triphasic tumours showed only blastema on aspiration. Anaplastic WT can be detected on aspirates using criteria similar to histology.

Topics: 12E7 Antigen; Adolescent; Anaplasia; Antigens, CD; Biopsy, Fine-Needle; Carcinoma, Renal Cell; Cell Adhesion Molecules; Cell Differentiation; Child; Child, Preschool; Chromosomal Proteins, Non-Histone; Diagnosis, Differential; DNA-Binding Proteins; Female; Follow-Up Studies; Humans; Infant; Keratins; Kidney; Kidney Neoplasms; Male; Peptide Fragments; Rhabdoid Tumor; SMARCB1 Protein; Staining and Labeling; Synaptophysin; Transcription Factors; Wilms Tumor; WT1 Proteins

An autopsied case of an 80-year-old man with spindle cell carcinoma of the gingiva is reported. The tumor was polypoid and mostly composed of a sarcomatous proliferation of spindle cells with a small focus of squamous cell carcinoma at the stalk portion. The carcinoma metastasized to a cervical lymph node, lungs and pleura with extension to the diaphragm. In the metastatic lymph node, the squamous cell component was more prominent than the spindle cell one, while only anaplastic pleomorphic carcinoma cells were found in the lungs. The spindle or anaplastic cells were immunohistochemically positive for vimentin and carcinoembryonic antigen (CEA) but not for other epithelial antigens. We have concluded that the sarcomatoid component arose from the oral squamous cell carcinoma by a metaplastic process. This is the first case report of an oral spindle cell carcinoma examined by autopsy.

Topics: Aged; Aged, 80 and over; Anaplasia; Autopsy; Carcinoembryonic Antigen; Carcinoma; Carcinoma, Squamous Cell; Diaphragm; Gingival Neoplasms; Humans; Keratins; Lung Neoplasms; Lymphatic Metastasis; Male; Metaplasia; Mucin-1; Neoplasms, Multiple Primary; Pleural Neoplasms; Vimentin

In order to clarify the histogenesis and the direction of differentiation of spindle-cell and sarcomatous components of esophageal carcinosarcoma, 20 cases of the disease were reviewed histologically and immunohistochemically using the avidin-biotin-peroxidase complex method with monoclonal and polyclonal antibodies to various keratins, vimentin, desmin, muscle specific actin and S-100 protein. A gradual transition between carcinomatous and spindle cell sarcomatous components was present histologically in all 20 cases. Positive immunoreactivity for keratins was found in carcinomatous areas in all cases. Spindle cells in the transitional areas were positive for keratins in nine cases and for vimentin in five. Two cases demonstrated trace positive reactions to both keratin and vimentin in the same areas of transitional spindle cells between carcinomatous and sarcomatous components. The sarcomatous component showed an immunohistochemically positive reaction for vimentin in ten cases and for desmin in two. In one of the 20 cases, chondrosarcomatous cells were seen which showed a positive reaction to S-100 protein but were negative to keratin. The findings strongly suggested that neoplastic epithelial cells may show dedifferentiation to transforming spindle cells and also disdifferentiation to non-epithelial sarcoma like chondrosarcoma and leiomyosarcoma.

Topics: Actins; Adult; Aged; Anaplasia; Carcinoma, Squamous Cell; Carcinosarcoma; Cell Nucleus; Cytoplasm; Desmin; Esophageal Neoplasms; Female; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Male; Middle Aged; Neoplasm Invasiveness; S100 Proteins; Sarcoma; Vimentin

200 cases of thymoma operated on at the surgical centre of Marie-Lannelongue between 1955 and 1982 were reviewed and analysed statistically; their histology was compared and their evolutionary potential. Based on their degree of differentiation of the epithelial tumour component and on the proportion of non tumour associated lymphocytes, 4 histological types were defined: 1) Spindle-or-oval-cell thymomas where tumour cells reminiscent of normal involutive thymic cells were of small size with a tendency to form clusters, whorls or a glandular appearance; 2) Lymphocyte-rich thymomas where normal epithelial cells, few in number, reproduce the appearance of normal thymic cells; 3) Differentiated epithelial thymomas, comprised of large epithelial cells with abundant cytoplasm and clearly demarcated and often less numerous lymphocytes; 4) Undifferentiated epithelial thymomas, characterised by a poverty of lymphocytes and anaplastic epithelial cells with a raised nuclear cytoplasmic ratio, nuclear irregularity and mitosis. Statistically, there was a significant correlation between the degree of differentiation of the tumor and prognosis. Spindle-or-oval cell thymomas (type 1) and lymphocyte-rich thymomas (type 2) have an 80% survival at 5 years and a 75% survival at 10 years. Well differentiated epithelial thymomas of type 3 have a 75% survival at 5 years and a 50% survival at 10 years, finally undifferentiated epithelial thymomas (type 4); the survival rate was nil at 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anaplasia; Epithelium; Humans; Keratins; Lymphocytes; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Prognosis; Thymoma; Thymus Neoplasms

Dedifferentiated chondrosarcoma is a biphasic tumour, comprising well-differentiated chondrosarcoma and an anaplastic non-cartilaginous sarcoma juxtaposed but distinct from each other. Two cases of dedifferentiated chondrosarcoma, one primary and one recurrent, demonstrated muscle differentiation when studied with monoclonal antibodies to muscle specific actin, desmin and myoglobin. One of the tumours was also positive for cytokeratin, identified by AE1/AE3 and CAM 5.2 antibodies. Our findings are consistent with the concept that these tumours are capable of diverse patterns of morphological and immunophenotypic differentiation.

Topics: Adult; Anaplasia; Bone Neoplasms; Cell Transformation, Neoplastic; Chondrosarcoma; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Muscles; Pelvic Bones; Ribs

Using an avidin-biotin immunoperoxidase technic, the authors studied 29 anaplastic thyroid tumors (ATTs) to determine the frequency of hormonal (thyroglobulin--TG; calcitonin--CT), epithelial (epithelial membrane antigen, monoclonal keratin), or sarcoma (desmin; alpha-1-antichymotrypsin--ACT; vimentin) markers. Their results indicate that 27% of ATTs stain for TG and none for CT. Fifty-five percent showed epithelial markers, 48% marked for ACT, and 47% for vimentin. Coexpression of keratin and vimentin was found in 39% of cases tested. The expression of the tested antigens did not correlate significantly with histologic pattern (epithelial vs. "sarcomatous"). Of note is the fact that 30% of the ATTs the authors tested expressed none of the markers they examined, indicating total lack of differentiation.

Topics: Adult; Aged; Aged, 80 and over; Anaplasia; Calcitonin; Carcinoma; Chymotrypsin; Epithelium; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Membrane Proteins; Middle Aged; Mucin-1; Sarcoma; Thyroglobulin; Thyroid Neoplasms; Vimentin