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Biomedical subjects

J A Fletcher

Publications and source records attributed to J A Fletcher.

At least 73 records · Page 4Linked to original sources

Solid variants of papillary (chromophil) renal cell carcinoma: clinicopathologic and genetic features.

Papillary renal cell carcinomas (RCCs) traditionally have been defined histologically as tumors with at least 50% true papillae. However, these tumors also have characteristic immunohistochemical and genetic features that separate them from other RCCs. We identified six tumors composed of solid sheets of cells without true papillae but that otherwise resembled papillary RCCs, which we feel represent solid variants of papillary RCCs. All six tumors were primary lesions of the kidney, all were strongly reactive for epithelial membrane antigen, cytokeratin 7, and callus keratin, and all were negative for the high molecular weight keratin antibody 34BE12. Four of four tumors tested showed trisomies for chromosome 7, chromosome 17, or both by either cytogenetic analysis or fluorescence in situ hybridization. Four cases were composed of solid sheets of cells containing distinct micronodules that in some cases resembled abortive papillae. The cells composing the micronodules had abundant eosinophilic cytoplasm, open chromatin, and in some cases prominent nucleoli. The intervening cells had similar nuclei, but the amount of cytoplasm was variable. In three of these micronodular cases, multiple tumors diffusely replaced the kidney; in the fourth case two typical clear cell RCCs and a typical papillary RCC were also present in the same kidney, but the micronodular tumor was unifocal. The two remaining cases were solitary tumors consisting of solid sheets of cells forming ill-defined tubules. These cells had scant clear cytoplasm and small round to elongate nuclei with occasional nuclear grooves but only rare small nucleoli. Limited follow-up has shown no evidence of disease in any patient thus far. The differential diagnosis includes "renal adenoma," renal adenomatosis, metanephric adenoma, and clear/granular cell RCC. We conclude that solid variants of papillary RCCs lack true papillae but have characteristic histologic, immunohistochemical, and genetic features.

Adult↗

HMGI(Y) activation by chromosome 6p21 rearrangements in multilineage mesenchymal cells from pulmonary hamartoma.

The chromosome band 6p21 high-mobility group gene, HMGI(Y), encodes DNA-binding proteins with both chromatin structural and gene regulatory roles. Although HMGI(Y) expression is associated with neoplastic transformation, no oncogenic HMGI(Y) mutations have been identified. We report pulmonary chondroid hamartoma chromosome 6p21 aberrations targeting HMGI(Y). Several pulmonary chondroid hamartomas had chromosome rearrangements mapping within 100 kb of HMGI(Y), and one pulmonary chondroid hamartoma contained an intragenic fusion juxtaposing HMGI(Y) A.T book DNA-binding domains with a laminin alpha 4 chain epidermal-growth-factor-like/ zinc-finger-like motif. These findings demonstrate an oncogenic role for HMGI(Y) and for laminin chain transcriptional regulatory motifs.

Amino Acid Sequence↗

Trisomy 3 in renal cell carcinoma.

Particular chromosomal aberrations have been associated with specific histologic types of renal cell carcinoma (RCC). To date, trisomy 3 has rarely been described, and this aberration has not been associated with any specific pathologic features. Herein, we report the cytogenetic analysis of 16 primary RCCs, including 8 papillary and 8 clear-cell primary tumors and 1 recurrent papillary tumor. Trisomies of chromosome 7 (7 of 8 tumors), 17 (7 of 8), 16 (7 of 8), and 20 (4 of 8) were frequent in primary papillary RCC, and deletions of chromosome 3p were detected in 7 of 8 clear-cell RCCs. Trisomy 3 was detected in five of eight papillary RCCs and was commonly associated with other trisomies. Trisomy 3 was an isolated finding in one of eight clear-cell RCCs. Four of five papillary RCCs with trisomy 3 had abundant intracytoplasmic hemosiderin, four of five were low grade, and all 5 were organ confined. The single clear-cell tumor with trisomy 3 had no other cytogenetic aberrations, also had abundant intracytoplasmic hemosiderin, and was also low grade and low stage. The recurrent papillary RCC did not have trisomy 3. We conclude that trisomy 3 is present in some RCCs and might be associated with low-grade, low-stage, papillary tumors with intracytoplasmic hemosiderin.

Adult↗

Comparison between the in vitro intrinsic radiation sensitivity of human soft tissue sarcoma and breast cancer cell lines.

The purpose of this study is to evaluate the radiation sensitivity of human soft tissue sarcoma cell lines in vitro and to compare with that of human breast carcinoma and glioblastoma cell lines. The intrinsic radiation sensitivity parameters of seven human soft tissue sarcomas and eight breast carcinoma cell lines were investigated in vitro by clonogenic assays for single-dose irradiation under aerobic conditions on cells in exponential phase of growth. The results for sarcoma cell lines showed that the mean surviving fraction at 2 Gy (SF2) was 0.39 (SD +/- 0.09) with a range of 0.24 to 0.53, and the average mean inactivation dose (MID) was 1.92 (SD +/- 0.35) range from 1.36 Gy to 2.49 Gy. These values were not different from that of breast cell lines examined concurrently and using the same experimental methods (mean SF2 0.38, SD +/- 0.09; MID 1.9 Gy, SD +/- 0.37). However radiobiological parameters of nine karyotyped human malignant glioma cell lines determined earlier in this laboratory were significantly higher (mean SF2 0.50 +/- 0.14; mean MID 2.61 +/- 0.60). In conclusion, the data presented here do not support the view that cells of sarcomas show unusual radiation resistance. To the extent that the in vitro determined cellular radiation sensitivity reflects the tumor response in vivo, the success rate for radiation applied against sarcoma and breast carcinoma of comparable size could be similar.

Breast Neoplasms↗

Isochromosome 7q in adult Wilms' tumor.

We describe cytogenetic and histologic findings in a Wilms' tumor resected from a 37-year-old man. The tumor karyotype was 45,X,-Y,i(7)(q10). These findings are notable because overrepresentation of chromosome 7 long arm material, i(7)(q10) in particular, has been described recently as a nonrandom event in pediatric Wilms' tumors. The present case suggests a shared genetic pathway in the initiation or progression of some pediatric and adult Wilms' tumors.

Adult↗

Cytology of typical and atypical Ewing's sarcoma/PNET.

The cytologic appearance of both typical and atypical Ewing's sarcoma (ES)/PNET has been described, but predominantly in small series. The authors reviewed the cytology of 22 cases (5 fine-needle aspirates, 17 intraoperative smears) of confirmed ES/PNET. Fifteen cases had typical cytologic features, including small round cells, scant cytoplasm, round nuclei, fine chromatin, and inconspicuous, but distinct basophilic nucleoli. Two cases were atypical (large cell) variants, with abundant eosinophilic cytoplasm, large irregular nuclei, vesicular chromatin, and prominent eosinophilic nucleoli. Both cases had the immunophenotype of ES/PNET, including reactivity for CD99. Five cases had features intermediate between typical and atypical ES/PNET, including abundant cytoplasm, intranuclear grooves, and pale vesicular nuclei. All cases had the characteristic immunophenotype of ES/PNET, including reactivity for CD99 or demonstrated a t(11;22)(q24;q12) cytogenetically. The authors conclude that although atypical ES/PNET is rare, a significant proportion of cases may exhibit unusual cytologic features. Ancillary studies are recommended to establish the correct diagnosis.

Adolescent↗

Papillary renal cell carcinoma: quantitation of chromosomes 7 and 17 by FISH, analysis of chromosome 3p for LOH, and DNA ploidy.

Papillary renal cell carcinoma (papillary RCC) is an uncommon histologic variant of RCC with distinct gross, microscopic, and immunohistochemical features. Recent karyotypic analyses suggest that papillary RCC differs from other types of RCC at the genetic level as well. Whereas nonpapillary (clear cell, granular cell) RCC is characterized by deletions in chromosome 3p, papillary tumors reportedly exhibit a pattern of chromosomal trisomies, typically including chromosomes 7 and 17. To further examine the relationship between overrepresentation of these chromosomes and papillary histology, archival material from 36 papillary tumors was subjected to fluorescence in situ hybridization (FISH) analysis using alpha-satellite repeat probes specific to 7 and 17. Excess signals for chromosome 17 were detected in 22 of 28 (78%) low-grade papillary tumors (Fuhrman nuclear grades 1 and 2), and in seven of eight (87%) high-grade tumors (grades 3 and 4). Correlation of chromosome 17 FISH signals with karyotypes performed on two low-grade and three high-grade tumors was excellent. Among the cases without evidence of excess chromosome 17 were three unusual papillary tumors with sclerotic and hyalinized fibrovascular cores. In two cases, comparison was made of FISH signals from multiple, separate gross nodules of tumor; concordance for trisomic 17 signals was observed in one case, but not in the other. Chromosome 7 signals were overrepresented in all seven papillary tumors examined. DNA ploidy was determined in 19 of the 36 tumors; a relationship between DNA ploidy and polysomy 7 or 17 was not apparent. To examine the possible role of chromosome 3p deletions in the development of papillary RCC, 11 cases were studied for loss of heterozygosity (LOH) at one or more loci in the region of 3p13-21. Only three of the 11 cases had LOH at these loci. The findings are discussed with respect to the development and progression of papillary RCC.

Adult↗

Percutaneous biopsy for prognostic testing of neuroblastoma.

PURPOSE: To determine whether percutaneous biopsy can provide the diagnostic and prognostic information necessary to treat children with advanced neuroblastoma. MATERIALS AND METHODS: From 1991 through 1995, 21 percutaneous biopsies were performed in 20 children with advanced neuroblastoma by using 15- or 16-gauge core biopsy needles. An average of six samples were obtained. Since September 1994, fresh tissue was sent to the reference laboratory, where touch preparations were prepared for N-myc evaluation. RESULTS: Histologic confirmation and prognostic information (Shimada classification) were obtained in all cases. Genetic prognostic information was obtained in 19 patients (95%), DNA index (ploidy) in 18 (90%), N-myc gene expression in 14 (70%), and cytogenetic analysis in 10 (50%). N-myc and ploidy determinations were successful in all five biopsy specimens obtained since September 1994. CONCLUSION: Percutaneous biopsy of advanced neuroblastoma is a feasible alternative to open biopsy.

Adolescent↗

Synovial sarcoma: prognostic significance of tumor size, margin of resection, and mitotic activity for survival.

PURPOSE: The present study serves to describe outcomes-based prognostic variables characteristic of synovial cell sarcoma. PATIENTS AND METHODS: An analysis was performed of a prospectively compiled data base of 48 consecutive patients with extremity and truncal synovial sarcomas seen between 1966 and 1994. RESULTS: No local recurrences were observed among 27 patients who presented with localized primary disease. Patients with synovial sarcoma less than 5 cm in size has a cancer-specific survival rate at 10 years of 100%, compared with a 10-year survival rate of 32% and 0% for those with sarcoma 5 to 10 cm and greater than 10 cm, respectively (P = .002). Patients with synovial sarcoma with less than 10 mitoses per 10 high-power fields (hpf) had a 10-year cancer-specific survival rate of 46%, compared with a 10-year survival rate of 14% for those with sarcomas with greater than 10 mitoses per hpf (P = .04). Patients with a clean margin of excision were found to have a 10-year cancer-specific survival rate of 43%, compared with 0% for those with microscopic positive margins (P = .03). Among 14 patients treated with neoadjuvant chemotherapy, seven (50%) had objective responses. CONCLUSION: Local control for patients with nonmetastatic disease was excellent. The overall cancer-specific survival rate for patients with localized synovial sarcoma was 34% at 10 years. Primary tumor size, margin of resection, and mean mitotic activity were prognostic factors for survival in synovial sarcoma. There was a high objective response rate to treatment with neoadjuvant chemotherapy; however, there was no detectable beneficial effects on survival in the subset of patients treated with chemotherapy versus nonrandomized patients who received no chemotherapy. Patients with synovial sarcoma > or = 5 cm in size, microscopic positive margins, and/or mean mitotic activity greater than 10 mitoses per 10 hpf should be targeted for new therapeutic studies.

Adult↗

Cytogenetics and molecular biology of soft tissue tumors.

Characteristic genetic aberrations have been identified in many soft tissue tumors, and it is likely that several of these aberrations, e.g., the translocation of chromosomes X and 18 in synovial sarcoma, will play an increasing diagnostic role. It is fascinating that most of the consistent soft tissue tumor translocations result in fusion genes, and these fusion genes encode proteins, which in turn regulate the expression of other genes. Thus, many soft tissue tumor translocations represent the first steps in complicated cascades of events contributing to deregulated tumor cell growth. Although a number of translocations appear to be useful in diagnosis, it should be emphasized that cytogenetic and molecular detection of chromosome translocations and gene fusions is not always straightforward. Cytogenetic and molecular analyses are perhaps best reserved for the subgroup of undifferentiated small round cell or spindle cell sarcomas, which remain unclassified after histological, immunohistochemical, and ultrastructural studies. Tumor specimens frozen at -70 degrees C can be used subsequently for FISH and PCR studies, although the opportunity to karyotype such specimens is lost upon freezing.

Chromosome Aberrations↗

Fluorescence in situ hybridization evaluation of chromosome deletion patterns in prostate cancer.

Various nonrandom chromosomal aberrations have been identified in prostate carcinoma. These aberrations include deletions of several chromosome regions, particularly the chromosome 8 short arm. Large-scale numerical aberrations, reflected in aberrant DNA ploidy, are also found in a minority of cases. However, it is unclear whether prostate carcinomas contain aberrations of certain chromosome regions that are deleted frequently in other common types of cancer. In this study, we performed dual-color fluorescence in situ hybridization on intact nuclei from touch preparations of 16 prostate cancers. Chromosome copy number was determined using pericentromeric probes, whereas potential chromosome arm deletions were evaluated using yeast artificial chromosome (YAC) and P1 probes. Two YAC probes targeted chromosome 8 short arm regions known to be deleted frequently in prostate cancer. Other YACs and P1s were for chromosome regions, including 1p22, 3p14, 6q21, 9p21, and 22q12, that are deletion targets in a variety of cancers although not extensively studied in prostate cancer. Hybridization efficiencies and signal intensities were excellent for both repeat sequence (alpha-satellite) and single, copy (YAC and P1) fluorescence in situ hybridization probes. Of 16 prostate cancers, 11 had clonal aberrations of 1 or more of the 13 chromosome regions evaluated, and 10 cases (62.5%) had 8p deletions, including 4 cases with 8p deletion in virtually all cells and aneuploidy in only a subset of those deleted cells. Deletions at 3p14, 6q21, and 22q12 were identified in 2, 1, and 1 case, respectively, and each of those cases had a similarly sized cell population with 8p deletion. These studies confirm 8p deletion in the majority of prostate carcinomas. 8p deletions appear to be early events in prostate tumorigenesis, often antedating aneuploidy. Fluorescence in situ hybridization strategies incorporating pericentromeric and single-copy regional chromosome probes offer a powerful and efficient means for determining frequency and progression of oncogenetic events in prostate cancer.

Carcinoma↗

Detection of chromosome 18 rearrangement in synovial sarcoma by fluorescence in situ hybridization.

Fluorescence in situ hybridization (FISH) evaluations of chromosome 18 were performed in synovial sarcoma, hemangiopericytoma, and mesothelioma. Each case was evaluated with centromeric and whole chromosome paint probes. The synovial sarcomas had t(X;18) cytogenetically, but the FISH evaluator was blinded to the cytogenetic results and to the histopathologic diagnosis. The FISH analyses were consistent with chromosome 18 translocation in 6 of 7 synovial sarcomas, 0 of 3 hemangiopericytomas, and 0 of 1 mesothelioma. These findings support the use of FISH in the diagnosis of synovial sarcoma.

Chromosomes, Human, Pair 18↗

Codeletion of p15 and p16 in primary malignant mesothelioma.

The p15 and p16 CDK4 inhibitor genes map within the chromosome band 9p21 region deleted frequently in malignant mesothelioma and other cancers. p16 has been implicated recently as a potential target of 9p21 deletions in mesothelioma, but the role of this gene is uncertain because deletions have been detected more often in established cell lines than in primary tumor specimens. We determined p15 and p16 copy number by fluorescence in situ hybridization with a P1 contig in 50 primary mesotheliomas. Codeletion of p15 and p16 was found in 72% of mesotheliomas, including all cases with spindle-cell components (n = 21) and total deletion of p15 and p16 was found in several mesotheliomas that lacked cytogenetic deletion of the chromosome 9 short arm. Point mutations were not found, however, in exon 2 of retained p15 and p16 alleles from seven mesotheliomas. These findings demonstrate that p15, p16 and/or a closely neighboring gene, are the targets of frequent chromosome 9p deletion in primary malignant mesothelioma.

Base Sequence↗

Codeletion of p15 and p16 genes in primary non-small cell lung carcinoma.

Chromosome band 9p21 is deleted frequently in non-small cell lung carcinoma (NSCLC), and the p15 and p16 cyclin-dependent kinase-4 inhibitor genes map within this deletion region. Recent studies demonstrated deletion of p15 and p16 in NSCLC metastases and cell lines, suggesting a role for these genes in NSCLC progression. We now report p15 and p16 copy number, as determined by fluorescence in situ hybridization with a P1 contig, in 18 primary NSCLCs. Codeletion of p15 and p16 was found in 15 of 18 NSCLCs, and 1 of the 3 tumors with normal p15 and p16 copy number had a nonsense mutation in exon 2 of p16. We conclude that p15 and p16 are deleted and/or mutated in most primary NSCLCs. Two observations, however, support the involvement of at least one additional tumor suppressor gene on chromosome 9. These observations are: (a) the large size (> 100 kb) of most NSCLC p15/p16 deletions; and (b) the absence of exon 2 mutations in most retained NSCLC p15 and p16 alleles.

Adult↗

Disruption of the architectural factor HMGI-C: DNA-binding AT hook motifs fused in lipomas to distinct transcriptional regulatory domains.

Lipomas are one of the most common mesenchymal neoplasms in humans. They are characterized by consistent cytogenetic aberrations involving chromosome 12 in bands q14-15. Interestingly, this region is also the site of rearrangement for other mesenchymally derived tumors. This study demonstrates that HMGI-C, an architectural factor that functions in transcriptional regulation, has been disrupted by rearrangement at the 12q14-15 chromosomal breakpoint in lipomas. Chimeric transcripts were isolated from two lipomas in which HMGI-C DNA-binding domains (AT hook motifs) are fused to either a LIM or an acidic transactivation domain. These results, identifying a gene rearranged in a benign neoplastic process that does not proceed to a malignancy, suggest a role for HMGI-C in adipogenesis and mesenchyme differentiation.

Amino Acid Sequence↗

Identification of a YAC spanning the translocation breakpoints in uterine leiomyomata, pulmonary chondroid hamartoma, and lipoma: physical mapping of the 12q14-q15 breakpoint region in uterine leiomyomata.

Uterine leiomyomata are the most common tumors in women and can cause abnormal uterine bleeding, pelvic pain, and infertility. Approximately 200,000 hysterectomies are performed annually in the U.S. to relieve patients of the medical sequelae of these benign neoplasms. Our efforts have focused on cloning the t(12;14)(q14-q15;q23-q24) breakpoint in uterine leiomyoma to further our understanding of the biology of these tumors. Thirty-nine YACs and six cosmids mapping to 12q14-q15 have been mapped by fluorescence in situ hybridization to tumor metaphase chromosomes containing a t(12;14). One YAC spanned the translocation breakpoint and was mapped to tumor metaphases from a pulmonary chondroid hamartoma containing a t(12;14)(q14-q15;q23-q24) and a lipoma containing a t(12;15)(q15;q24); this YAC also spanned the breakpoint in these two tumors, suggesting that the same gene on chromosome 12 may be involved in the pathobiology of these distinct benign neoplasms.

Base Sequence↗

Translocation t(8;13)(p11;q11-12) in stem cell leukemia/lymphoma of T-cell and myeloid lineages.

An unusual hematologic neoplasia has been described recently in which the predominant clinical features include T-cell lymphoma, myeloid hyperplasia, and eosinophilia. The multilineage involvement in this disorder suggests transformation of a primitive stem cell. Abnormal karyotypes have been described in three such cases, including one case with t(8;13)(p11.2;q12) and a second case with t(8;13)(p23;q14). We report translocation of chromosomes 8 and 13 in lymph node karyotypes from two patients with this syndrome. Fluorescence in situ hybridization confirmed an identical translocation, t(8;13)(p11;q11-12), in lymphoma cells from each patient. The translocation breakpoints are of particular interest because the FLT3 receptor tyrosine kinase gene has been mapped 13q12. FLT3 is expressed highly in hematopoietic progenitor cells and in myeloid and lymphoid acute leukemias.

Adolescent↗