Biomedical subjects

S Korourian

Publications and source records attributed to S Korourian.

35 records · Page 2Linked to original sources

PubMed1998

Carcinoid tumor metastatic to the breast.

Breast metastases from nonmammary malignant neoplasms are uncommon, accounting for approximately 2% of breast tumors. There are 13 cases reported in the literature of carcinoid tumor metastatic to the breast, and more than half of these cases were misdiagnosed pathologically and treated as primary breast carcinoma, even in cases with a medical record of carcinoid tumor. We describe a patient with a history of asthma and diarrhea who presented to the University of Arkansas for Medical Sciences, Little Rock, with an exacerbation of the asthma. The results of routine physical examination revealed a mass in the left breast. A diagnosis of carcinoid tumor metastatic to the breast was made after a partial mastectomy was performed. The differential diagnosis between primary carcinoid tumor of the breast and carcinoid tumor metastatic to the breast is often controversial in surgical pathology. Diagnoses need to be made correlating clinical and histological examination in difficult cases in which there is not a diagnosis of carcinoid tumor elsewhere. Accurate diagnosis of breast metastases is important to avoid unnecessary treatment.

Aged↗

PubMed1998

Use of touch preps for intraoperative diagnosis of sentinel lymph node metastases in breast cancer.

BACKGROUND: Intraoperative touch prep (TP) is highly accurate for determining positive breast cancer margins and thereby reducing the need for second surgeries. It also may be useful in determining the status of the sentinel lymph node (SLN) during the initial surgical resection. The objective of this study was to test the ability of intraoperative TP to predict metastatic disease and, thus, the necessity for axillary lymph node dissection (ALND) at the time of SLN biopsy. METHODS: Fifty-five patients with invasive breast cancer were entered in the SLN biopsy protocol. The SLN was identified by gamma probe, dissected, and sent to pathology for TP and permanent sections. Level I and II ALND was then performed. Any radiolabeled LN in the lymphadenectomy specimen also was sent for TP and permanent sections. RESULTS: A total of 124 radiolabeled lymph nodes (LNs) were submitted for TP; of these, 93 (75%) were SLNs. Pathologic diagnosis by TP was correct compared with permanent sections for 99.2% of the nodes. There were no false positives. There was one (0.8%) false negative. The positive predictive value was 100% and the negative predictive value was 99%. Sensitivity was 95.7% and specificity was 100%. CONCLUSIONS: TP is a simple, quick, and accurate method for detecting metastatic disease in the SLN and, when used intraoperatively, enables the surgeon to determine whether or not an ALND is necessary at the time of the initial surgery.

Adult↗

PubMed1998

Sentinel lymph node biopsy for staging breast cancer.

BACKGROUND: Determination of axillary nodal status is essential for the staging of breast cancer since nodal status is one of the most important predictors of survival. The objective of this study was to test the hypothesis that the histology of the first draining lymph node (LN) accurately predicts the histology of the rest of the axillary LNs. METHODS: Fifty-five patients with operable invasive breast carcinoma and clinically negative axillary lymph nodes were studied. Patients were injected with Technetium-99 (99Tc) sulfur colloid around the primary tumor. A hand-held gamma detector probe was used to identify the sentinel LN (SLN). After the SLN was identified and removed, a level I and II lymphadenectomy was performed. RESULTS: The SLN was identified in 53 (96.3%) of the 55 patients entered into the trial. The sensitivity was 88.2% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value was 94.6%. The accuracy of the study was 96.2%. CONCLUSIONS: The SLN biopsy for breast cancer staging is highly accurate in our hands and has the potential to decrease the morbidity and cost of managing patients with breast cancer without compromise of staging.

Adult↗

PubMed1998

Trophoblasts are the preferential target for human papilloma virus infection in spontaneously aborted products of conception.

In a recent study it has been shown that human papillomavirus (HPV) infection was threefold more prevalent in spontaneous abortion specimens compared with elective specimens (60% [15 of 25] v 20% [3 of 15], respectively) as analyzed by broad-spectrum HPV polymerase chain reaction (PCR) amplification and dot-blot hybridization with an HPV-16 probe. In this study, archival paraffin-embedded tissue from a subset of previously analyzed spontaneous abortion cases were reanalyzed by in situ PCR amplification so that the specific cells infected by HPV could be identified. In the current study, using a new PCR primer set for HPV-16 E6, the status of six previously analyzed cases were verified (five HPV-positive and one negative). Furthermore, syncytiotrophoblasts were identified as the predominant cellular target of HPV (HPV-16 or a related type). Finally, four of four third-trimester placentas similarly analyzed gave no HPV-positive signal. Trophoblasts are the cell type that maintains placental contact with maternal tissue and through which nutrient exchange occurs. This knowledge prompts the hypothesis that HPV-infected trophoblasts may have altered characteristics, which may lead to a compromised gestation.

Abortion, Spontaneous↗

PubMed1998

Seprase, a membrane-bound protease, is overexpressed by invasive ductal carcinoma cells of human breast cancers.

The increased cell surface expression of the serine integral membrane protease, seprase, has been associated with the invasive behavior of human melanoma cell lines in vitro. The present study investigates the expression of seprase in malignant, premalignant, benign, and normal human breast tissues. The 170-kDa gelatinase activity of seprase was identified in extracts of infiltrating ductal carcinomas (IDC). Protein bands corresponding to the proteolytically active 170-kDa seprase dimer and its 97-kDa seprase subunit protein were identified by immunoblot analysis of IDC extracts using an antiserum elicited against immunoaffinity-purified seprase. Immunohistochemical analysis of seprase expression in 41 formalin-fixed and paraffin-embedded specimens of human breast tissue revealed preferential immunoreactivity with the malignant cells of IDC (27 cases). Within individual IDC specimens, the stromal cells or morphologically normal epithelium revealed low labeling that was always significantly less than the labeling of neoplastic cells. Lymph node metastases of IDC cells were also strongly positive, but the lymphoid tissue in affected nodes was not stained. Neoplastic cells in DC in situ (5 cases) exhibited variable levels of staining. Epithelial cells of benign fibroadenoma specimens (2 cases) and benign proliferative breast disease (5 cases) exhibited little or no immunoreactivity. Epithelial cells of normal breast tissue (1 case) were not stained. The overexpression of seprase by DC cells is consistent with seprase having a role in facilitating invasion and metastasis of IDC of the breast. The cell surface localization of seprase could be used to target therapeutic agents to malignant breast cells.

Adult↗

PubMed1997

Diagnostic pitfalls of aspiration cytology of salivary duct carcinoma.

BACKGROUND: Salivary duct carcinoma (SDC) is a highly aggressive primary salivary gland neoplasm that resembles intraductal and infiltrating breast carcinoma histologically. The purpose of this study was to review the cytologic features of histologically proven salivary duct carcinomas and to identify the potential pitfalls in cytologic diagnosis. METHODS: Fine-needle aspiration cytology of nine histologically proven salivary duct carcinomas was reviewed. RESULTS: The patients' age ranged from 62 to 89 years (median, 69 years). There were eight males and one female. The cytologic diagnoses of these cases were as follows: pleomorphic adenoma (PA) (three cases), high grade carcinoma, not otherwise specified (three cases), mucoepidermoid carcinoma (MEC) (two cases), and atypical cytology with differential diagnosis including MEC, oncocytoma, and acinic cell carcinoma (one case). The spectrum of cytologic findings included broad flat sheets and three-dimensional clusters. There was mild to severe cellular pleomorphism and nuclear atypia. Papillary clusters and cribriforming occasionally were identified. Bland cytologic features and prominent hyaline stroma, shown to represent the dense fibrosis on histologic sections, were identified in three cases cytologically interpreted as PA. CONCLUSIONS: Fine-needle aspiration of SDC may be difficult to interpret accurately, and bland cytomorphologic features in some cases may lead to a false-negative interpretation; several clinically important pitfalls are demonstrated in our series.

Adenoma↗

PubMed1997

Cytology of germ cell tumors: extragonadal, extracranial masses and intraoperative problems.

BACKGROUND: Germ cell tumors (GCTs) and their metastases may be found in numerous sites that are accessible to cytologic sampling, and many are responsive to chemotherapy. METHODS: The authors reviewed 20 examples of GCT cytology from 16 males and 3 females ranging in age from 1.5 to 61 years (median, 34 years). With two exceptions, one benign cystic ovarian teratoma in which intraoperative cytology was used to diagnose an associated adult-type carcinoma and one undescended testis in which seminoma presented as an abdominal mass, the material reviewed included no examples of primary gonadal GCT. RESULTS: The authors studied 7 primary and 13 metastatic GCTs; these studies were based on 13 in vivo aspirations, 4 intraoperative preparations, and 3 samples of body cavity fluids. All samples were correctly interpreted as malignant, and only one was incorrectly classified as a non-GCT malignancy. CONCLUSIONS: Clinical and cytologic findings are useful in the diagnosis of GCTs and their metastases. Incorrect interpretation of these neoplasms as poorly differentiated malignancies of other types may deprive the patient of effective chemotherapy. Air-dried, Romanowsky-stained smear material and cell block sections may contribute to the resolution of diagnostic dilemmas.

Adolescent↗

PubMed1997

Hepsin, a cell surface serine protease identified in hepatoma cells, is overexpressed in ovarian cancer.

Extracellular proteases mediate the digestion of neighboring extracellular matrix components in initial tumor growth, allow shedding or desquamation of tumor cells into the surrounding environment, provide the basis for invasion of basement membranes in target metastatic organs, and are required for release and activation of many growth and angiogenic factors. We identified overexpression of the serine protease hepsin gene in ovarian carcinomas and investigated the expression of this gene in 44 ovarian tumors (12 low malignant potential tumors and 32 carcinomas) and 10 normal ovaries. Quantitative PCR was used to determine the relative expression of hepsin compared to that of beta-tubulin. The mRNA expression levels of hepsin were significantly elevated in 7 of 12 low malignant potential tumors and in 27 of 32 carcinomas. On Northern blot analysis, the hepsin transcript was abundant in carcinoma but was almost never expressed in normal adult tissue, including normal ovary. Our results suggest that hepsin is frequently overexpressed in ovarian tumors and therefore may be a candidate protease in the invasive process and growth capacity of ovarian tumor cells.

Carcinoma, Hepatocellular↗

PubMed1997

Basal cell carcinoma metastatic to the salivary glands: differential diagnosis in fine-needle aspiration cytology.

A disparate group of salivary gland neoplasms is characterized by small, uniform, hyperchromatic, basaloid cells. This "small blue cell" pattern is most common in non-Warthin's types of monomorphic adenoma, or in adenoid cystic carcinoma. Small cell anaplastic carcinoma (primary or metastatic), metastatic basaloid squamous cell carcinoma, basal cell adenocarcinoma, and metastatic nasopharyngeal carcinoma are rarely encountered but may present a cytologically similar appearance. We report one female and two male patients (median age = 84 yr) with cutaneous-type basal cell carcinoma (BCC) aspirated from metastatic deposits in the parotid (2 cases) or the submandibular (1 case) gland. One was correctly classified at the time of aspiration, based on a previous history of multiple facial BCC. One was interpreted as carcinoma, the previous history being unavailable at the time of FNA. Smears in these two cases show necrosis and rare keratotic cells. The third cases was mistaken for pleomorphic adenoma (PA); the smears showed metachromatic fragments of collagenous tumor stroma that were misinterpreted as the matrix material typical PA. Similar material was identified in the other two cases. When the "small blue cell" pattern is encountered in salivary bland cytology, one should consider BCC, especially if necrosis is identified. The desmoplastic tumor stroma of BCC may mimic the chondroid matrix of PA. Careful consideration of previous history is very important.

Aged↗

PubMed1996

Effects of diet and ethanol treatment on azoxymethane-induced liver and gastrointestinal neoplasia of male rats.

Epidemiological and animal studies have shown that diet and excessive alcohol consumption are major risk factors for liver and gastrointestinal cancers. This study investigated the effects of diet and alcohol consumption on azoxymethane (AOM)-induced liver and gastrointestinal neoplasia in male rats. Rats were infused intragastrically with control or ethanol-containing diets. After 35 days of dietary acclimatization, all rats received two intragastric infusions of AOM (15 mg/kg) separated by 1 week and then were maintained on standard rat food for 26 weeks. Results suggest that liver and duodenum are the major target organs when AOM is given orally and ethanol pre-exposure potentiates the AOM-induced hepatic and duodenal dysplasia.

Alcohol Drinking↗

PubMed1996

Effects of diet and ethanol on the expression and localization of cytochromes P450 2E1 and P450 2C7 in the colon of male rats.

Local activation of procarcinogens in target tissues such as the colon by cytochrome P450-dependent microsomal monooxygenases is considered to be an important factor in the etiology of cancer. Diet and alcohol consumption are considered risk factors in colon cancer, and the cytochrome P450 isozymes CYP2E1 and CYP2C7 have been implicated in the biochemical mechanisms underlying colon cancer. The current study was conducted to determine the effects of diet and ethanol consumption on colonic and hepatic expression of these two enzymes. Adult male rat Sprague-Dawley rats were fed rat chow ad lib. or were infused intragastrically with control or ethanol-containing diets. Our results indicate that CYP2E1 is present in colonic epithelial cells, and expression of colonic and hepatic microsomal CYP2E1 and CYP2C7 was increased by chronic ethanol intake. As compared with rats having ad lib. access to standard rat food, rats receiving total enteral nutrition had significant (P < 0.01) reductions of CYP2C7 and slight, but not statistically significant, reductions in the expression of CYP2E1 in colon. Diet and ethanol differentially regulated CYP2E1 and CYP2C7 in a tissue-specific manner such that the ethanol induced CYP2E1 and CYP2C7 in the colon and liver, and the intragastric diet alone had a tendency to induce these isozymes in the liver and reduce them in the colon. These results may provide a partial explanation for the mechanism underlying effects of diet and ethanol on colon cancer.

Animals↗

PubMed1996

Sialolithiasis. Differential diagnostic problems in fine-needle aspiration cytology.

Sialolithiasis with obstruction of major salivary gland ducts can lead to clinical tumefaction related to cystic dilatation. In addition to mucus accumulation, these pseudoneoplasms feature hyperplasia and squamous metaplasia of the ductal lining epithelium, with varying degrees of inflammation. The authors report five examples of this lesion aspirated from two males and three females ranging in age from 45 to 80 years (median 65 years). Three were in the submaxillary gland, and two were in the parotid. In three cases, stone fragments were identified, and diagnoses of sialolithiasis were rendered; two of these patients underwent surgical excision. The remaining two cases showed prominent foam cells and metaplastic squamous cells in a mucoid background that mimicked low grade mucoepidermoid carcinoma. Stone fragments were not identified and a differential diagnoses of sialolithiasis versus low grade mucoepidermoid carcinoma were suggested. Surgical excision revealed sialolithiasis in both instances. When stone fragments are identified in aspirated material, these cases pose little diagnostic difficulty. However, when this material is not present, epithelial changes and mucus accumulation may be difficult to distinguish from low grade mucoepidermoid carcinoma. Cautious interpretation is suggested in this setting.

Adolescent↗

PubMed1996

Cytologic findings in thyroglossal duct carcinoma.

Approximately 150 cases of thyroglossal duct carcinoma, predominantly of the papillary type, have been reported, but the preoperative fine-needle aspiration (FNA) diagnosis of such neoplasms has rarely been cited. The authors describe FNA findings in four samples obtained from three patients who were 29, 50, and 83 years of age, histologically diagnosed as papillary (n = 2) and squamous (n = 1) thyroglossal duct carcinomas. Atypia and squamous cell carcinoma were the FNA diagnoses in the patients with papillary carcinomas. The remaining case was correctly diagnosed as keratinizing squamous cell carcinoma. Cellularity was scant in two cases and moderate in one, and all displayed a cystic background. The authors also reviewed FNA features in 11 papillary and 2 Hurthle cell carcinomas from the English language literature; diagnostic findings were present in less than one third of the cases. In conclusion, familiarity with the FNA findings of thyroglossal duct carcinoma is limited by its rarity. The presence of large, atypical squamous cells, or psammoma bodies, in the FNA material of a midline anterior cystic neck mass should suggest papillary thyroglossal duct carcinoma.

Adult↗

PubMed1995

Mycoses of the breast: diagnosis by fine-needle aspiration.

Fungal infections of the breast are unusual and may clinically mimic carcinoma. When studied by fine-needle aspiration (FNA), such masses may yield necrosis, granulomatous inflammation, reactive histiocytes, and atypical epithelial cells. Cohesive groups of atypical epithelial cells featured nuclear enlargement and overlapping, as well as prominent nucleoli. The organisms may be widely scattered, so that careful evaluation was required for their identification. In concert with provocative clinical findings, these features may lead to an erroneous diagnosis of malignancy. We describe three women with mycotic masses of the breast initially studied by FNA. The first patient presented at age 31 with a large, firm breast mass, chest wall extension, and radiographic evidence of vertebral bone involvement. FNA was requested to confirm the clinical diagnosis of advanced breast carcinoma. In addition to the atypia described above, the smears showed yeast forms indicative of blastomycosis surrounded by neutrophils. She remains well, following antifungal treatment. The second case of Blastomycosis was diagnosed by FNA of a breast mass in a 64-yr-old woman, who also responded to treatment. The third patient's preoperative needle aspiration showed granulomas, but no organisms were identified, even with special stains; silver stains of surgically excised tissue showed histoplasmosis.

Adult↗

PubMedDate not supplied

Use of touch preps for diagnosis and evaluation of surgical margins in breast cancer.

BACKGROUND: The best cosmetic results with conservative breast surgery are obtained at the time of initial excisional biopsy. The usefulness of the touch prep (TP) technique was evaluated for accuracy in diagnosis as well as in evaluation of margins at the time of original breast biopsy. METHODS: Four hundred twenty-eight consecutive patients with breast masses seen from January 1993 to December 1994 were evaluated prospectively using TP. RESULTS: Three hundred forty-five benign and 83 malignant tumors were evaluated. Tumors ranged in size from microscopic to 8 cm. Pathologic diagnosis was correct as compared to permanent section in 99.3%. The three carcinomas missed on TP were focal and in situ. Sensitivity was 96.39%, and specificity was 100%. Positive predictive value was 100%, and negative predictive value was 99.3%. For margin evaluation, the sensitivity and specificity were both estimated to be 100%. CONCLUSIONS: TP has the advantage of being a simple, quick (2 to 3 minutes), safe (no loss of diagnostic material), and accurate method for diagnosis and estimation of tumor margins at the time of the original surgery.

Adult↗

PubMedDate not supplied

Is glutathione-S-transferase-pi expression a reliable predictor of chemoradiation response in cancer of the head and neck?

PURPOSE: Concurrent radiation and chemotherapy is being evaluated as an alternative treatment to surgery for patients with advanced squamous cell carcinoma of the head and neck, because organ preservation maybe possible without compromising survival. However, the response to concurrent chemoradiation treatment varies from patient to patient, and there is currently no available molecular predictor of response for this particular treatment modality. There is some evidence to indicate that glutathione S-transferase-pi (GST-pi), which is one of the drug detoxifying enzymes, may decrease the effectiveness of platinum-based chemotherapy in the treatment of a variety of tumor types. This study was performed to investigate whether GST-pi expression was correlated with response to concurrent chemotherapy and radiotherapy in patients with advanced squamous cell carcinoma of the head and neck. MATERIALS AND METHODS: Diagnostic biopsy specimens of 36 patients who underwent concurrent chemoradiotherapy for the treatment of advanced squamous cell carcinoma of the head and neck were examined for GST-pi expression by using immunohistochemistry with polyclonal antihuman GST-pi antibodies. GST-pi expression scores were compared among responders and nonresponders. RESULTS: Although the staining rate with antiGST-pi was slightly lower in the responder group in comparison with the nonresponders (82% vs 100%), the difference was not statistically significant. CONCLUSION: GST-pi expression is unlikely to be a valuable predictor of response to concurrent chemotherapy and radiation treatment in patients with advanced squamous cell carcinoma of the head and neck.

Adult↗

PubMedDate not supplied

p16 overexpression: a potential early indicator of transformation in ovarian carcinoma.

OBJECTIVE: The recently cloned gene p16 (MST1) has been identified as a putative tumor suppressor gene that binds to CDK4 and CDK6 (cyclin-dependent kinases), preventing their interaction with cyclin D1 and thereby preventing cell cycle progression at the G1 stage. In addition, the p16 gene has been shown to have a high frequency of mutation in some tumor cell lines; however, it has also been shown that a much lower frequency of mutation occurs in primary tumors. This study investigated the mRNA expression level and mutation status of the p16 gene in ovarian tumors. METHODS: We performed quantitative polymerase chain reaction and direct cDNA sequencing analysis. To confirm the p16 protein level in ovarian tumors, Western blotting and immunohistochemical staining were performed. Expression levels of mRNA for the p16 gene relative to the beta-tubulin gene were examined in 32 ovarian tumors (24 carcinomas, six low malignant potential tumors, and two benign tumors) and six normal ovaries. RESULTS: The mRNA expression level of p16 was significantly elevated in 28 ovarian tumors (22 carcinomas, five low malignant potential tumors, and one benign tumor) compared with that of normal ovaries. Western blotting analysis and immunohistochemical staining confirmed elevated p16 protein levels in ovarian tumor samples. Among 32 ovarian tumors, cDNA sequencing of the p16 gene showed no p16 mutation resulting in a coding error, although one silent mutation and three polymorphisms were found. CONCLUSIONS: Although p16 is seldom mutated in ovarian tumors, the overexpression of p16 in most ovarian tumor cases indicates a dysfunction in the regulatory complex for G1 arrest. Therefore, overexpression of p16 may be an important early event in the neoplastic transformation of the ovarian epithelium.

Biomarkers, Tumor↗