Search PubMed⌕ Search

Biomedical subjects

L Skoog

Publications and source records attributed to L Skoog.

At least 109 records · Page 6Linked to original sources
PubMed1991

Fine needle aspiration cytology and immunocytochemistry of metastatic melanoma.

The cytological and immunological findings of 81 metastatic melanomas are described. Fine needle aspiration was performed from secondary deposits in lymph nodes (38), subcutaneous and soft tissue (36), abdomen (5), lung (1) from 67 patients with histologically verified malignant melanoma. One patient had disease which had spread into the cerebrospinal fluid. Cytomorphologically the cases were classified as classical (47%), carcinoma-like (22%), spindle cell type (14%), lymphoma like (6%), undifferentiated (6%), myxoid type (3%), and clear cell type (2%). All cases were immunologically characterized using antibodies to S-100, vimentin and cytokeratin. All cases were S-100 positive and the majority (96%) reacted with antibodies to vimentin. A weak heterogenous reactivity to cytokeratin antibody was detected in only eight cases. The HMB45 antibody was applied to 20 cases and 16 (80%) of these tumours were positive. In summary, we found that an immunological characterization was necessary to conclusively diagnose over 50% of metastatic melanomas which presented with an equivocal cytological picture.

Biopsy, Needle↗
PubMed1991

Adjuvant tamoxifen in early-stage breast cancer: effects on intercurrent morbidity and mortality.

Intercurrent mortality and the pattern of inpatient hospital care was studied among 1,846 postmenopausal patients included in the Stockholm randomized trial of adjuvant tamoxifen (40 mg daily for 2 years) versus no adjuvant endocrine therapy. The median follow-up time was 54 months (range, 2 to 123 months). The patients were matched to the Swedish National Registry of Causes of Death and a computerized register covering about 95% of all hospital admissions in Stockholm County. There was no significant difference in the pattern of intercurrent mortality among the tamoxifen and control patients. The total number of hospital admissions was similar in both groups, but the tamoxifen patients were admitted significantly less frequently because of immunologic diseases (relative risk [RR] = 0.4; 95% confidence interval [CI], 0.2 to 0.9). Admissions because of thrombotic diseases were slightly, but not significantly, more frequent among the tamoxifen patients (RR = 1.2; 95% [CI], 0.6 to 2.3). The risk of hospital stay for benign gynecologic diseases other than prolapse or uterine bleeding was increased in the tamoxifen group (RR = 3.2; 95% CI, 1.2 to 8.6). No significant differences were found for diseases related to arteriosclerosis or osteoporosis. The study confirms and extends previous reports, which have shown that tamoxifen has few and usually mild side effects. However, the current results should be judged cautiously because of the relatively short median follow-up time (4.5 years) and the limitation of data in detecting morbidity that does not necessarily result in hospitalization.

Aged↗
PubMed1990

Randomized trial of adjuvant tamoxifen combined with postoperative radiation therapy or adjuvant chemotherapy in postmenopausal breast cancer.

From 1976 to 1984, 427 postmenopausal women with high-risk breast cancer (pN + or pT greater than 30 mm) were randomized between postoperative radiation therapy (RT), radiation therapy plus tamoxifen (RT-TAM), adjuvant chemotherapy (CT), or chemotherapy plus tamoxifen (CT-TAM). Surgery was a modified radical mastectomy in all cases. The radiation therapy was given with high-voltage techniques and included the chest wall and regional nodes. The dose was 4600 cGy/4 1/2 weeks. Tamoxifen was given at a dose of 40 mg daily for 2 years. The adjuvant chemotherapy consisted of 12 cycles of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (or chlorambucil, methotrexate, and 5-fluorouracil [LMF] for patients entered before 1978). At a median follow-up time of 6 1/2 years the recurrence-free survival was significantly better for patients allocated to radiation therapy compared to chemotherapy and for patients allocated to tamoxifen compared to no adjuvant endocrine treatment (P less than 0.01). At 10 years the recurrence-free survival for patients in the RT-TAM, RT, CT-TAM, and CT groups was 63%, 57%, 47%, and 31%, respectively. A significant reduction of treatment failures with tamoxifen was only observed among patients with estrogen receptor-positive tumors. The overall survival difference in favor of patients allocated to radiation therapy or tamoxifen was not significant: the respective survival percentage at 10 years in the RT-TAM, RT, CT-TAM, and CT group was 65%, 62%, 52%, and 50%. The results indicate that postoperative radiation therapy continues to play an important role in the primary management of postmenopausal women with high-risk breast cancer and that the addition of tamoxifen may further improve the results among ER-positive patients.

Aged↗
PubMed1990

Neuroendocrine (Merkel-cell) carcinoma of the skin: immunocytochemical and cytomorphologic analysis on fine-needle aspirates.

Cytomorphologic and immunocytochemical characteristics of tumor cells from fine-needle aspirates of four neuroendocrine (Merkel-cell) carcinomas of the skin are described. All aspirates were cellular with dispersed small to medium sized tumor cells with scanty cytoplasm. Many mitoses were observed. Careful scrutiny revealed a tendency of the tumor cells to form microacinar and pseudorosette formations as well as small clusters of molding cells. Immunocytochemical analysis of cytospin preparations showed a peculiar dot-like cytokeratin positivity, while neuron-specific enolase staining was more diffuse. A weak S-100 positivity was observed. This staining pattern is highly suggestive of Merkel-cell tumor. It can thus be concluded that immunocytochemical analysis in conjunction with cytomorphology on fine-needle aspirates will allow the identification of neuroendocrine carcinoma of the skin and its differentiation from other small-cell neoplasias of the skin.

Aged↗
PubMed1990

Immunocytochemical analysis of receptors for estrogen and progesterone in fine-needle aspirates from human breast carcinomas.

Monoclonal antibodies were used for a preoperative analysis of estrogen receptors (ERs) and progesterone receptors (PgRs) in fine-needle aspirates from 44 primary human breast carcinomas. The semiquantitative receptor values obtained in cytologic specimens correlated well with those from enzyme immunoassay analysis on surgically removed tumor tissue (r = 0.74 for PgR; r = 0.75 for ER). Cytologic smears showed a heterogenous tumor cell distribution of ER and PgR in 29 and 23 cases, respectively. The results suggest that measurement of the ER and PgR in cytologic smears is an accurate and reliable technique that can be performed on a minimum amount of tissue.

Aged↗
PubMed1990

Fine-needle aspiration of fibroadenomas of the breast with atypia: a spectrum including cases that cytologically mimic carcinoma.

We herein report the cytologic and histologic findings in 11 cases of cytologically atypical fibroadenoma (FA). These ranged from cases recognizable as FA but showing epithelial atypia to cases that, even on review, completely mimicked the needle aspiration picture of ductal breast carcinoma. A retrospective review of 45 cases of previously excised FA showed that focal atypia is common (27%). Possible physiologic explanations for atypia in FA, along with strategies for avoiding false diagnoses of malignancy in aspiration smears, are discussed.

Adenofibroma↗
PubMed1990

Genomic alterations in human breast carcinomas.

All human chromosomes were screened in 52 human breast carcinomas for the occurrence of allele losses, in order to identify genomic alterations involved in initiation and progression of the disease. Loss of chromosome 22 alleles was detected in 6 out of 8 lobular carcinomas, while chromosome 17 losses were most frequent in ductal carcinomas. Furthermore, patients who developed advanced disease after many years of mild clinical course showed significantly higher frequencies of allele losses in their primary tumors, compared to patients with a persistently mild disease course. Finally, in one case, molecular examination suggested a translocation t(10;17) with coamplification of the ERBB2 oncogene and chromosome 10 sequences present in the two tumors from this patient, consistent with one of the tumors being a metastasis originating from a subclone of cells in the other tumor.

Adenocarcinoma, Mucinous↗
PubMed1990

Preoperative immunocytochemical analysis of the estradiol receptor in nonpalpable human breast tumors.

An immunocytochemical technique employing a monoclonal antibody to the estrogen receptor was used to analyze the receptor content in tumor biopsy material from nonpalpable breast carcinomas. Fine needle biopsies were obtained from 12 such tumors using a stereotaxic biopsy technique. The smears were used for cytomorphological diagnosis and receptor analysis. The results show that estrogen receptor status can be determined preoperatively in nonpalpable human breast tumors.

Aged↗
PubMed1989

Dietary habits and prognostic factors in breast cancer.

The relationship between dietary habits and prognostic factors for breast cancer was studied in 240 women aged 50-65 years who had surgery for breast cancer between 1983 and 1986. A dietary history interview was conducted within the 4 months following resection of the primary tumor. In the stepwise multivariate analysis, the multiple-odds ratio (OR) for having a tumor greater than or equal to 20 mm in diameter was 0.95 (95% confidence interval, 0.91-0.99) for each 1-g increase in fiber intake per 10 MJ of energy intake. Compared with patients having tumors poor in estrogen receptor (ER), those having ER-rich tumors (greater than or equal to 0.10 fmol/microgram of DNA) were older (P less than .01) and reported carbohydrate intake yielding higher E% (percentage of total energy intake) (P less than .01) and higher retinol intake per 10 MJ (P less than .05). The OR for having an ER-rich tumor was 1.58 (95% confidence interval, 1.08-2.31) for each 1-mg increase in retinol intake per 10 MJ; 1.09 (95% confidence interval, 1.02-1.16) for each additional year of age; and 1.08 (95% confidence interval, 1.02-1.13) for each 1% increment in E% from carbohydrates. These results suggest that the dietary patterns of the western world (e.g., high fat intake and low intake of carbohydrates and fiber) affect certain prognostic factors in breast cancer, such as tumor size and ER content of the tumor.

Age Factors↗
PubMed1989

Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers.

The frequency of new primary cancers was studied in 1846 postmenopausal patients included in a randomised trial of tamoxifen as an adjunct to primary surgery for early breast cancer. The median follow-up was 4.5 years (range 0.5-10.5 years). The number of new cancers in the tamoxifen group (n = 57) did not differ significantly from that in the control group (n = 70). However, in tamoxifen patients second breast cancers occurred less often and endometrial cancer occurred more often than in the controls. The increase in endometrial cancers was probably related to the agonistic oestrogenic effects of tamoxifen and was most pronounced in those treated for over 2 years.

Adenocarcinoma↗
PubMed1989

Metaplastic carcinoma of the breast: fine-needle aspiration cytology of seven cases.

We describe the cytomorphology of seven cases of metaplastic carcinoma of the breast studied by fine-needle aspiration cytology and by histology. All seven cases contained foci of ductual adenocarcinoma. This finding was combined with heterologous mesenchymal elements in four cases, a spindle-cell pattern of growth in one case, and extensive squamous-cell metaplasia in two cases. Both carcinomatous and metaplastic components were present on smears in four cases (57%). Thus in three cases (43%), the diagnosis was not possible on smear material alone. Differential diagnostic considerations are discussed.

Adenocarcinoma↗
PubMed1989

Cystosarcoma phyllodes of the breast: a cytologic and clinicopathologic study of 23 cases.

Twenty-three cases of cystosarcoma phyllodes of the breast were studied clinically and by fine-needle aspiration (FNA) cytology as well as by tumor histology. The median patient age was 52 yr. The total actuarial survival at 5 yr was 90%, and the recurrence-free survival was 70%. A combination of stromal elements (tissue fragments and/or single spindle cells) and epithelial tissue was required to make the diagnosis on smear material. In FNA smears, stromal elements were absent in two cases, and ductal elements were not seen in three. Thus, the dimorphic pattern essential to this diagnosis was not present in five (22%) cases. An evaluation of tumor factors reported to be of prognostic significance was performed on histologic sections of resected tumors. Comparison of these data with FNA results indicates that little prognostic information can be obtained from FNA alone in most cases.

Adolescent↗
PubMed1989

Mucinous breast carcinoma and mixed mucinous-infiltrating ductal carcinoma: a comparative cytologic study.

In its pure form, mucinous breast carcinoma (MC) has a much better prognosis than infiltrating ductal carcinoma (IDC). Mixed MC-IDC has the prognosis of IDC. We compared the fine-needle aspiration (FNA) cytology and histology of nine cases of pure MC with 13 cases of mixed MC-IDC. While typical of pure MC, abundant mucin (3+/3+) was noted in smears from three cases of mixed tumor and is thus necessary but not sufficient for a diagnosis of pure MC. Cellular pleomorphism has been said not to be a feature of MC; however, we found occasional large cells markedly different from the typical small uniform cells of MC in four pure and seven mixed tumors. Cytologic features indicative of a mixed tumor include one or more smears totally without mucin, scantly amounts of mucin, or necrosis. A combination of features indicative of pure mucinous carcinoma in FNA included abundant mucin on all smears, no pleomorphism, and no necrosis. Many cases will have smear patterns that are not typical of either profile and should probably be designated as carcinoma with a mucinous component.

Adenocarcinoma, Mucinous↗
PubMed1989

Prognostic value of nuclear DNA content in breast cancer in relation to tumor size, nodal status, and estrogen receptor content.

The prognostic value of nuclear DNA distribution pattern in relation to tumor size, axillary lymph node status, and estrogen receptor (ER) content was studied in 464 patients with primary, operable mammary adenocarcinoma. The median follow-up time was 3 1/2 years. Slide cytophotometric DNA analysis was performed on morphologically identified Feulgen-stained tumor cells. The tumors were classified into four subgroups according to their DNA histogram type. DNA content was significantly related to tumor size and ER level but not to nodal status. When all variables were stimultaneously introduced into Cox's proportional hazards model, tumor size, nodal status, and DNA profile remained as significant predictors of recurrence. Restricting the analysis to node-negative patients, both DNA profile and tumor size showed a significant prognostic value. DNA did not contribute significant prognostic information in node-positive patients. However, the trends in recurrence-free survival were similar to those in the node-negative subgroup: patients with aneuploid tumors tended to fare worse than those with euploid carcinomas.

Biomarkers, Tumor↗
PubMed1989

Fine-needle aspiration cytology and immunocytochemistry of malignant non-Hodgkin's lymphoma in the oral cavity.

Fine-needle aspirates from 12 cases of malignant non-Hodgkin's lymphoma of the oral cavity were cytologically classified according to the Kiel classification. Ten lymphomas were high-grade and two were classified as being low-grade malignancies. Immunocytologic characterization on cytospin material showed that all cases were B-cell derived with monoclonal expression of immunoglobulin light chains. Surgical biopsy material was available for histologic diagnosis in 8 of 12 cases. In 5 of these, the cytomorphologic and the histologic diagnoses were in agreement. With respect to the other 3, one case was histologically classified as an unspecified malignancy and one as a centroblastic/centrocytic lymphoma, and in one case no malignant lesion could be found. The three cases were cytologically classified as large-cell centrocytic, centroblastic, and lymphoblastic lymphoma, respectively. We conclude that fine-needle aspiration cytology in conjunction with immunocytochemistry is a rapid, feasible, and atraumatic technique that is useful for diagnosing malignant lymphoma in the oral cavity.

Adolescent↗
PubMed1989

Estrogen receptors in fine-needle aspirates from metastatic lesions of gynecologic tumors.

The estrogen receptor content in metastases of gynecological tumors was analyzed with an immunocytochemical technique in material obtained by fine-needle aspiration. Eighteen patients with metastasis from ovarian (10 cases), endometrial (4 cases), and uterine cervical (4 cases) carcinomas were studied. Three metastases showed specific nuclear staining for estrogen receptors and they originated from primary tumors in the ovary, the cervix, and the endometrium. Thus needle aspirates can be used for cytomorphologic diagnosis as well as determination of estrogen receptors and their use has potential value when a decision must be made between hormonal therapy or chemotherapy in patients with generalized gynecological carcinomas.

Abdominal Neoplasms↗
PubMed1989

Prognostic value of DNA ploidy and S-phase fraction in relation to estrogen receptor content and clinicopathological variables in primary breast cancer.

Tumors from 472 women with primary breast cancer were analyzed by flow cytometry. Divided into four categories, DNA ploidy showed significant association with disease recurrence and mortality. When allowance was made for its correlation with nodal status and estrogen receptor (ER) content, DNA ploidy did not add prognostic information. S-phase fraction was estimated in 290 DNA histograms. In contrast, it was significantly related to recurrence and mortality when controlling for nodal status, tumor size and ER content. When the follow-up was divided into two periods DNA ploidy and S-phase fraction showed association with disease recurrence in the first period only (less than 2.5 years), while the association with mortality was valid for both periods. Light scatter was measured in 234 samples. A low light scatter variability for the stemline nuclei was related to a high recurrence rate during the early follow-up period. In conclusion, DNA flow cytometry adds prognostic information concerning breast cancer patients.

Aged↗