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PubMed1993

Lung cancer histologic types and family history of cancer. Analysis of histologic subtypes of 872 patients with primary lung cancer.

BACKGROUND: Previous research has demonstrated that there is clustering of cancer among relatives of patients with lung cancer and that women may be at a greater risk than men, regardless of their smoking histories. METHODS: The authors conducted a study to test the hypotheses that this predisposition varies by the histologic type of tumor and that women with particular histologic types will report more first-degree relatives with cancer than will men with the same cell type. The analyses were based on 872 patients with histologically confirmed lung cancer who had been admitted to Roswell Park Cancer Institute, Buffalo, New York, between 1982 and 1987. RESULTS: More patients with squamous and large cell carcinomas reported two or more relatives with cancer, and overall, women reported more family history of cancer. Among patients with squamous cell carcinoma, this difference between men and women was significant (P < 0.05). Among patients younger than 57 years, those with squamous cell were the most likely to report a family history of cancer (P < 0.01). A similar trend was observed for smoking. Persons with small cell and squamous cell carcinomas who were nonsmokers or had smoked 1-20 years had three times the risk of a family history of cancer than did those with large cell and adenocarcinomas (odds ratio [OR] = 3.01; confidence interval [ci] = 1.38-6.63), in contrast to those who had smoked more than 20 years (OR = 0.85; ci = 0.62-1.62). CONCLUSIONS: Squamous cell carcinoma is most associated with familial clustering of cancer, particularly among women, persons younger than 57 years, and individuals who smoked for fewer than 20 years.

Adenocarcinoma↗
PubMed1989

Histological changes of the liver by treatment of chronic non-A, non-B hepatitis with recombinant leukocyte interferon alpha. Comparison with histological changes in chronic hepatitis B.

We have treated 17 patients with non-A, non-B chronic hepatitis by recombinant interferon alpha (0.3-9 megaunits for 4-28 weeks). In six patients, serum aminotransferase levels fell to normal or near-normal range during treatment. The mean levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in 17 patients fell from 156 +/- 80 (mean +/- SD) and 213 +/- 135 at the beginning of treatment to 94 +/- 49 and 112 +/- 71, respectively, at the end of treatment. In 12 patients, liver biopsies were performed before and after (or during) the treatment, and histological activity indices (HAI) were blindly examined by two independent observers. For comparison, we examined histological changes of pre- and posttreatment liver biopsies of 19 patients who were treated by recombinant interferon for chronic hepatitis B. Mean HAI scores improved from 10.0 to 5.4 after treatment in non-A, non-B chronic hepatitis. The most marked reduction was noted in scores of portal inflammation and hepatocellular degeneration and/or necrosis. No such reduction was observed in B-viral chronic hepatitis. These data indicated that rapid biochemical resolution by the treatment was related to histological improvement of the liver in our patients with non-A, non-B hepatitis.

Adult↗
PubMed2005

Histological-hemodynamic correlation in cirrhosis-a histological classification of the severity of cirrhosis.

BACKGROUND/AIMS: While the definitive diagnosis of cirrhosis is histological, it is the degree of portal hypertension, as determined by the hepatic venous pressure gradient (HVPG), that is an important determinant of the severity of cirrhosis. An HVPG > or =10 mmHg (termed clinically significant portal hypertension or CSPH) is predictive of the development of complications of cirrhosis, including death. This study aimed to determine the relationship between specific histological parameters and HVPG in cirrhosis. METHODS: Forty-three patients with biopsy-proven cirrhosis and HVPG measurements within 6 months of the biopsy were included in the study. The following parameters were scored semiquantitatively and without knowledge of HVPG results: sinusoidal fibrosis, septal thickness, loss of portal tracts and central veins, nodule size, inflammation, steatosis, and iron. RESULTS: Septal thickness (p=0.03), small nodularity (p=0.003), loss of portal tracts (p=0.01), inflammation (p=0.04) and alcoholic etiology (p=0.01) correlated with the presence of CSPH. However, small nodularity and septal thickness were the only parameters independently predictive of CSPH (r=0.658, p<0.05). CONCLUSIONS: We describe a subclassification of histological cirrhosis based on the severity of portal hypertension that consists of a combination of nodule size and septal thickness, with small nodularity and thick septa being independent predictors of the presence of CSPH.

Biopsy↗
PubMed2000

Secondary neoplasms of the bladder are histological mimics of nontransitional cell primary tumours: clinicopathological and histological features of 282 cases.

AIMS: The incidence, anatomical localization and histological appearances of secondary neoplasms of the urinary bladder are described, with emphasis on the points of distinction from primary tumours. METHODS AND RESULTS: A retrospective study of cases at the Royal Hospitals Trust yielded a total of 282 secondary bladder neoplasms, representing 2.3% of all malignant bladder tumours in surgical specimens. The commonest primary sites were the colon (21% of secondary neoplasms), prostate (19%), rectum (12%) and cervix (11%). Most tumours from these sites reached the bladder by direct spread. The most common sites of origin of tumours metastatic to the bladder were stomach (4.3% of all secondary bladder neoplasms), skin (3.9%), lung (2.8%), and breast (2.5%). Secondary tumour deposits were almost always solitary (96.7%), and 54% were located in the bladder neck or trigone. Histologically, 54% of secondary tumours were adenocarcinomas. Immunohistochemical staining patterns with prostate-specific acid phosphatase, prostate-specific antigen, carcinoembryonic antigen, chromogranin and neurone-specific enolase were similar in primary vesical and urachal adenocarcinomas and secondary adenocarcinomas from the gastrointestinal tract. CONCLUSIONS: The incidence of secondary bladder tumours is comparable to that of nontransitional cell primary tumours. Few secondary tumours have distinctive histological features, hence knowledge of the history and clinical investigations are particularly important in their diagnosis.

Adenocarcinoma↗
PubMed1987

A comparison of histological and non-histological indices of atresia and follicular function.

Histological indices of atresia for bovine follicles greater than or equal to 5 mm in diameter were compared with potential non-histological indices of atresia such as opaqueness of the exposed surface of non-excised follicles, concentrations of steroids in follicular fluid (FF) and specific binding of gonadotropins by granulosal cells. Each non-excised follicle was classified as clear (n=86), intermediate (n=79), or opaque (n=115), on the basis of the appearance of its exposed surface. A section of tissue from each follicle was evaluated histologically for atresia and assigned to one of the following categories: non-atretic, intermediately atretic, strongly atretic, or luteinized-atretic. Concentrations of estradiol (E), progesterone (P), and testosterone (T) and capacity of granulosal cells to bind radioactive ovine follicle-stimulating hormone (oFSH) and human chorionic gonadotropin (hCG) were determined for each follicle. Overall incidence of atresia was similar for clear (n=66%), intermediate (60%), and opaque (72%) follicles. Opaque follicles, however, were more likely to be strongly atretic (42%) than were clear (21%) or intermediate (23%) follicles. Non-atretic and intermediately atretic follicles had similar concentrations of E, P, and T and similar capacities to bind gonadotropins. Strongly atretic and luteinized-atretic follicles contained a higher concentration of P, lower E, and a reduced capacity of granulosal cells to bind oFSH than non-atretic and intermediately atretic follicles. A ratio of P:E in FF greater than or equal to 10 usually (greater than 90%) indicated that a follicle was atretic. However, lesser ratios of P:E did not accurately indicate whether follicles were atretic.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

A clinical and histological study of urticaria pigmentosa: relationships between mast cell proliferation and the clinical and histological manifestations.

In 21 cases of urticaria pigmentosa (UP), clinical and histological observations and evaluation of mast cell (MC) volume density in the lesions using a morphometric point counting method were performed. The mutual correlations between clinical and histological findings were statistically assessed by a method of multiple regression analysis. Clinical items employed in the analyses were as follows: sex, the age of onset, the age of biopsy, the biopsy, the duration of lesions, the type of skin lesions, sites involved, the presence or absence of Darier's sign of Darier's sign and symptoms, and serum histamine level. Histological items included the localization and infiltration pattern of MC, the level of basal melanosis, the presence or absence of inflammatory cell infiltration, and the MC volume density in the lesions. Statistical significance of the partial regression coefficients was obtained for 6 pairs of the criteria (p = 0.05), including the age of onset and the age of biopsy, the age of onset and the level of basal melanosis, the duration of lesions and the level of basal melanosis, and the type of skin lesions and the level of basal melanosis. No significant correlations were observed between the MC volume density in the lesions and any of the other items. These results suggest that the basal melanosis in a UP lesion may not be a direct reaction to the transitory massive infiltration of MC, but rather be due to a relatively long-term effect of MC infiltration. Furthermore, the MC volume density in the lesion is not likely to be an important factor in determining the clinical manifestations of a UP lesion.

Adolescent↗
PubMed1998

Helicobacter pylori infection and gastric neoplasia: correlations with histological gastritis and tumor histology.

OBJECTIVE: Several authors have reported an association between Helicobacter pylori (H. pylori) and gastric carcinoma, but the data are conflicting. Atrophic gastritis and intestinal metaplasia (IM) have also been linked to gastric carcinoma, especially the intestinal tumor type. We investigated the relationship between H. pylori infection, gastric neoplasms, and histological gastritis. METHODS: A total of 105 patients with gastric carcinoma, 36 patients with gastric adenoma, and 105 age- and sex-matched control subjects were examined for H. pylori infection and histological gastritis. H. pylori status was evaluated by Giemsa staining and IgG serology. Mucosal inflammation, atrophy, and IM were evaluated in biopsy specimens from antrum and corpus. RESULTS: H. pylori seroprevalence was higher in patients with gastric carcinoma (98 of 105, 93%) and adenoma (34 of 36, 94%) than in control subjects (82 of 105, 71%, p < 0.05). H. pylori was more prevalent in patients with noncardia (OR, 5.67; 95% CI, 2.25-14.44) than cardia (OR, 5.20; 95% CI, 0.65-41.68) tumors. Histologic types and tumor stage (early; OR, 6.60; 95% CI, 2.23-19.69, advanced; OR, 4.27; 95% CI, 1.21-15.03) showed no difference in H. pylori prevalence. Atrophy and IM scores were higher in patients with the intestinal- but not diffuse-type of carcinoma and adenoma than in H. pylori-positive control subjects. Smoking was associated with gastric carcinoma (OR, 3.05; 95% CI, 1.58-5.93) but not alcohol or coffee use, blood group A, or a family history of gastric cancer. CONCLUSIONS: Our results confirm a strong association between H. pylori and gastric carcinoma and adenoma. The intestinal-type gastric carcinoma is associated with atrophic gastritis and IM.

Adenoma↗
PubMed1985

The histological variance of malignant melanoma: the interrelationship of histological subtype, neoplastic progression, and biological behaviour.

Histological variance within premalignant melanocytic dysplasias and melanomas reflects the biological progression of neoplasia. In general, the more severe cytological atypia, the more advanced the stage of neoplasia, and the more likely true melanomatous transformation (vertical growth or level III invasion) will be present. Histological variance may be seen in disparity between the cytology of the premalignant precursor and the vertical growth component and in the expression of normally latent phenotypic options such as desmoplasia and neurotropism. The pattern of superficial spreading melanoma (severe atypism, large epithelioid cells in pagetoid growth) is universal and qualifies as the common final pathway. Breslow's criteria of measurement are useful in formulating therapy in melanomas showing the common final pathway but may not accurately relate to the biological potential of minimal deviation variants i.e. those with mild to moderate melanocytic atypia. Examples of such variants are lentigo maligna melanoma, melanomas arising in pigmented spindle cell nevus, Spitz nevus, cellular blue nevus, dermal nevus and melanomas histologically resembling halo nevus.

Cell Division↗
PubMed2000

Use of the Cornier pipelle as the only means of presurgical histologic diagnosis in endometrial carcinoma: agreement between initial and final histology.

OBJECTIVE: To test the reliability of the Cornier pipelle as a diagnostic tool for submitting endometrial carcinoma patients directly to surgery, without the additional performance of dilatation and curettage. METHODS: In this prospective study, 56 consecutive patients with the presumptive diagnosis of endometrial carcinoma, based on the analysis of material sampled by means of microcurettage using the Cornier pipelle, were submitted to hysterectomy. The findings of the final pathological report were compared with those of the previous microcurettage. Both were analysed at the same Pathology laboratory throughout the study. The presence of endometrial carcinoma was confirmed intraoperatively in all cases, and, as a consequence, a staging laparotomy was completed in all of them. RESULTS: Although the initial diagnosis of carcinoma was confirmed in every case (100% sensitivity), the final pathological report revealed discordant histological subtypes in 6 out of the 56 cases (10.7%). Only two, however, represented higher histological risk than initially stated. Discrepant grading values were also found in 3 out of 41 (7.3%) cases of the endometrioid subtype for which tumor grade been established in the microcurettage specimen. Not performing dilatation and curettage under general anesthesia prior to surgery resulted in a significant saving, both in hospitalization costs and bed occupation. CONCLUSION: When endometrial sampling by means of the Cornier pipelle yields the diagnosis of carcinoma, it can be confidently relied upon. However, some high-risk cases can be missed due to discordance between initial and final histology, and this could eventually lead to the choice of an inadequate surgical strategy.

Biopsy↗
PubMed1984

Clinical and histological evaluation of synovial needle-biopsies in patients suffering from rheumatoid arthritis. I. Relationship between clinical activity and histological pattern.

In 50 patients suffering for 1-15 years from rheumatoid arthritis, needle-biopsy of the synovial membrane was carried out. The finding correlated with the general clinical activity of the disease. Each type of histological change was evaluated with regard to its diagnostic value in assessing clinical activity. Among the histological changes, oedema, synovial cell proliferation, lymphocyte-plasma cell proliferation and necrotic vasculitis showed a negative correlation with clinical activity, while a positive correlation was observed between clinical activity and the presence of fibrin (fresh and old), fibrinoid, fibrinoid basophilia, fibroblast proliferation, synovial cell desquamation, concentric perivascular sclerosis, fibrosis and hyalinosis. Vascular changes of the synovial membrane such as oedema, fresh fibrin exudate, necrotic vasculitis showed a negative correlation with clinical activity while hyalinization and concentric sclerosis and clinical activity were found to be in positive correlation. It is concluded that in the course of rheumatoid arthritis the histological changes do not necessarily run parallel with the clinical activity of the disease.

Arthritis, Rheumatoid↗
PubMed1998

Renal histology in ureteropelvic junction obstruction: are histological changes a consequence of hyperfiltration?

PURPOSE: There are few reports of pathological kidney findings in ureteropelvic junction obstruction in pediatric patients. The role of hyperfiltration in the genesis and progression of these changes has been a matter of debate. We determine whether segmental sclerosis is evidence of hyperfiltration and renal damage in children who underwent surgery for ureteropelvic junction obstruction. MATERIALS AND METHODS: We retrospectively analyzed the clinical records of 38 children with a mean age of 4.4 years with ureteropelvic junction obstruction. Histological changes in biopsies (39 renal units) and nephrectomy specimens (2 renal units) were compared with clinical history, imaging studies and urinary protein excretion. RESULTS: Renal histology was essentially normal in 75% of the biopsies. Focal dilatation of Bowman's space and occasionally of the collecting tubules was noted in a third of this group. Abnormal changes consistent with renal damage were present in 25% of the biopsies, including variable degrees of interstitial chronic inflammation, eosinophilic acellular material within Bowman's space and focal concentric glomerulosclerosis. Severe changes, chronic interstitial fibrosis and inflammation, and diffuse glomerulosclerosis were only found in nephrectomy specimens, while eosinophilic acellular material and glomerulosclerosis were observed in 7 biopsies. In all of these renal units there was evidence of hyperfiltration with bilateral or unilateral ureteropelvic junction obstruction with a contralateral multicystic dysplastic kidney. Urinary protein excretion in 19 patients was increased in obstructed compared with normal contralateral kidneys (p < 0.05). CONCLUSIONS: Hyperfiltration should be considered a mechanism involved in the progression of histological changes in kidneys with ureteropelvic junction obstruction. We suggest that early surgical correction be considered in obstructed kidneys at risk for hyperfiltration.

Child↗
PubMed1991

HistoLogical, a computer atlas and drill of histology.

An educational program has been developed to aid the instruction of Histology, a required course for the first year medical student. The program was developed using SuperCard on an Apple Macintosh IIci computer. It incorporates high quality color images with a hypermedia format, i.e. the student can jump from topic to topic as he/she wishes. The program has an "atlas," which provides information about each image and topic being discussed, and a "drill," which presents to the student a question about an image and provides feedback tailored to the student's answer. In the drill, the student is asked to type in responses to the questions; the answer is judged by text recognition. For each question, feedback is written for the correct answer, incorrect answer, and up to 10 "accessory answers" (answers which might be expected although they are not correct). The faculty of the UMMS Histology course has encouraged the use of this program in this years' course, and evaluation received from faculty and students has been quite positive.

Computer Graphics↗
PubMed1989

[Long-term experiences with histologic control of the incision margin (3-D histology)].

In order to make sure that malignant tumors of the skin are excised completely, excisional margin control has been performed in our department for 8 years. For this purpose, tissue is excised, fixed in formalin and embedded in paraffin. The tumor and the excisional margins are examined separately. A total of 2016 basal cell carcinomas have been followed up for up to 4 years. If histological examination of the excised margins still show evidence of the tumor, re-excision is performed until the excised margins are free of the lesion. This procedure has proven to be very successful, with a recurrence rate of only 0.35%. The tissue is processed in a routine histology laboratory according to standard procedures.

Basal Cell Carcinoma↗
PubMed2006

Maternal vasculopathy and histologic diagnosis of preeclampsia: poor correlation of histologic changes and clinical manifestation.

OBJECTIVE: The purpose of this study was to evaluate the frequency of maternal vasculopathy and to determine the usefulness of placental examination in correlation with clinical manifestation of pregnancy-induced hypertension. STUDY DESIGN: We investigated 350 pregnancy-induced hypertension placentas over a 2.5-year period (January 2002-June 2004) to identify the potential usefulness of the maternal vasculopathy in histologic diagnosis and corroboration of clinical preeclampsia. This study was carried out at West Virginia University Ruby Memorial Hospital, where 1271 placentas were examined macroscopically and microscopically for the period. The presence or absence of vascular changes, infarctions, thrombosis, abruption, chorangiosis, and chorioamnionitis were investigated for each placenta with the clinical diagnosis of preeclampsia or pregnancy-induced hypertension. RESULTS: Two types of vascular changes that are characteristic of pregnancy-induced hypertension, namely maternal atherosis and fibrinoid medial necrosis, were found in 21.4% of the placentas (75/350 placentas). These vascular changes were found mainly in the decidua capsularis of the membrane rolls, not on the decidua basalis of the maternal floor. There were more placental infarctions within these placentas (32.3%; 113/350 placentas). Intervillous thrombosis was 18.9% (66/350 placentas); microscopic abruption was 6.3% (22/350 placentas); chorangiosis was 10.9% (38/350 placentas), and chorioamnionitis was 8.6% (30/350 placentas). CONCLUSION: These findings demonstrate that the maternal vascular changes that are characteristic of pregnancy-induced hypertension are found in approximately 1 of 5 pregnancy-induced hypertension placentas. Examination of pregnancy-induced hypertension placentas should be based on a combination of a number of histologic changes. Furthermore, the decidua capsularis of the fetal membrane roll, rather than the decidua basalis of the maternal floor, of the placenta should be examined for these maternal vascular changes.

Female↗
PubMed1975

Structural patterns and histological behaviour of experimental sarcomas. I. General considerations, histology and histochemistry.

Methylcholanthrene-induced rat sarcomas were used as a model for the examination of morphological and cytological differentiations in tumours of the connective tissue. Particular attention was paid to the question how far these sarcomas are comparable to human connective tissue tumours. The histological examination yields a broad spectrum of mesenchymal differentiations ranging from undifferentiated anaplastic sarcomas over less differentiated fibrosarcomas and malignant fibrous histocytomas to well-differentiated fibrosarcomas, myosarcomas and haemangiopericytomas. It is worth mentioning that different histological structures can be encountered with one and the same tumour.

Animals↗
PubMed1999

Histologic and morphometric analysis of the choroid, Bruch's membrane, and retinal pigment epithelium in postmortem eyes with age-related macular degeneration and histologic examination of surgically excised choroidal neovascular membranes.

OBJECTIVE: Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in industrialized countries. Different risk factors have been associated with AMD. We performed a histopathologic and morphometric study to compare eyes with different stages of AMD to age-matched eyes. This study aimed to investigate the correlation among morphometric characteristics of choroidal vessels, the retinal pigment epithelium, and Bruch's membrane, to study the association between these characteristics and the presence and type of AMD, and to identify morphologic risk factors for exudative AMD. Furthermore, we histologically analyzed surgically removed choroidal neovascular membranes secondary to underlying diseases other than AMD to discern whether the cellular and extracellular components of the membranes of eyes with AMD are similar to those with diseases other than AMD. METHODS: We analyzed 51 eye bank eyes (Georgia Eye Bank, Atlanta, GA) from 40 donors with different stages of AMD and compared them with 40 age-matched controls. The eyes were processed for light microscopy. The degree of calcification of Bruch's membrane, fragmentation of Bruch's membrane, number and types of drusen, basal laminar deposit, and seven morphometric variables of the choroid were assessed in the macular and extramacular regions. Surgically excised subfoveal membranes were processed and evaluated by light and transmission electron microscopy. RESULTS: There were no statistically significant differences observed between eyes with neovascular and non-neovascular AMD. The single most important difference between eyes with and without AMD was the amount of basal laminar deposit (P < 0.001). Eyes with AMD displayed fewer large choroidal vessels in the submacular choroid than eyes without AMD (mean density values of all choroidal vessels [arteries and veins] were 3.5 +/- 1.5 mm(-1) and 5.7 +/- 1.6 mm(-1), P < 0.001, respectively). The submacular choriocapillaris density was higher in eyes with AMD (mean density, 0.62 +/- 0.06) than in eyes without AMD (mean density, 0.51 +/- 0.08 [P < 0.001]). The diameter of the larger choroidal vessels in the peripheral choroid was higher in eyes with AMD (mean diameter, 30 +/- 8 microm) than in eyes without AMD (mean diameter, 21.4 +/- 6.2 microm [P < 0.001]). The peripheral choriocapillaris density displayed the same pattern as the macular region in eyes with and without AMD. There was a statistically significant difference observed in the degree of calcification and fragmentation of Bruch's membrane in eyes with exudative AMD (mean degree of calcification, 1.6; median number of breaks in Bruch's membrane, five) as compared with controls (mean degree of calcification, 0.8; median number of breaks in Bruch's membrane, zero). The difference for these two variables between eyes with nonexudative AMD (mean degree of calcification, 0.8; median number of breaks in Bruch's membrane, one) and controls (mean degree of calcification, 0.8; median number of breaks in Bruch's membrane, zero) failed to reach statistical significance. Eyes with AMD displayed significantly more soft, diffuse, and large drusen, as well as basal laminar deposit, in the macular area than controls. CONCLUSION: Combining our data with data from the literature, we conclude that AMD can be interpreted as a dynamic process with early proliferation and subsequent atrophy of capillaries of the choriocapillaris. Calcification and fragmentation of Bruch's membrane; soft, diffuse, and large drusen; and basal laminar deposit, but not hard drusen, strongly correlate with the histologic presence of AMD. The degree of calcification and fragmentation of Bruch's membrane is prominent in eyes with exudative AMD. The formation of choroidal neovascular membranes represents a stereotypic, nonspecific wound repair response independent of the underlying disease.

Aged↗
PubMed1984

[Surgical treatment of cervix cancer. Treatment results and data on the postoperative course over a minimum of 5 years following uniform surgery and standardized histological examination of the histological material of 1092 patients at 4 university gynecology clinics].

Treatment results of 1092 patients with operated cervical carcinoma were evaluated and assessed on the basis of data supplied by four University Clinics of gynaecology. Surgical treatment and histological processing of all surgical specimens were uniform. Indication for postoperative radiation was determined differently at the individual clinics. The treatment results obtained can be compared with one another not on the basis of clinical stage assessment; the only criterion is the histologically proven extension of the tumour, ascertained via an examination of the surgically obtained specimen. With continuous tumour growth in accordance with stage Ib, the 5-year survival rate after surgery alone was 90.5%, after additional radiation 95.6%. In case of continuous tumour growth in accordance with stage II, the 5-year survival rate after operation alone was 79.5%, after operation and radiation 83.1%. The differences in the 5-year survival rates are statistically not significant. Taking into consideration a discontinuous metastatic tumour growth in the region of the parametric tissue, the 5-year survival rate after operation alone was 72.7%, after subsequent radiation 75%, in case of metastases in the region of the lymph nodes 77.8% and 60.5%, respectively. These differences in survival rates were not statistically verifiable. Furthermore, if individual tumour parameters were tested and statistical pairing was performed, it became evident that prognosis of patients with infaust tumour criteria could not be influenced by postoperative radiation.

Combined Modality Therapy↗
PubMed1992

Hemangiomas of the breast with atypical histological features. Further analysis of histological subtypes confirming their benign character.

Eighteen patients with vascular tumors of the breast that exhibited characteristics raising the question of but not qualifying for a diagnosis of low-grade angiosarcoma were reviewed. We had previously referred to these lesions as "atypical" hemangiomas because of concern regarding the diagnosis and the risk of the later development of angiosarcoma. Significant features, variably present, included small size (less than 2.0 cm), relative circumscription, broadly anastomosing vascular channels, and endothelial hyperplasia. Destructive invasion, solid areas, and hemorrhage or necrosis unrelated to a needle localization procedure were absent. Four distinct histological patterns were observed: cavernous, compact capillary, capillary budding, and a combined cavernous and compact capillary type. The age of the patients varied from 19 to 82 years (mean 60 years). Eleven tumors were detected mammographically. The size of the lesion ranged from 0.4 to 2.0 (mean 0.9) cm. The diagnostic biopsy was the only treatment in nine (50%) cases. Reexcision was performed in seven and mastectomy was done in two cases. Follow-up ranged from 1 to 140 (mean 44) months. There have been no local or systemic recurrences. Hemangiomas with diverse histological patterns have been detected clinically with the increasingly widespread use of mammography. Further follow-up indicates that the lesions originally referred to as "atypical" are benign and not associated with an appreciable risk of the development of angiosarcoma. Complete excision alone is recommended to treat these tumors, which may be diagnosed as hemangiomas and subclassified according to growth pattern.

Adult↗