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Effects of X-irradiation on N-methyl-N-nitrosourea-induced multi-organ carcinogenesis in rats.

The effects of X-irradiation on N-methyl-N-nitrosourea (MNU)-induced multi-organ carcinogenesis were examined in both sexes of ACI/N rats. At 6 weeks of age, rats in groups 1 (25 males, 25 females) and 3 (24 males, 23 females) received a single i.p. injection of MNU (25 mg/kg body weight), while those in groups 2 (25 males, 26 females) and 4 (25 males, 25 females) were administered the carcinogen at a dose of 50 mg/kg body weight. At 10 weeks of age, groups 3 and 4 were X-irradiated at a dose of 3 Gy. Group 5 (24 males, 24 females) received X-irradiation alone. Group 6 (21 males, 21 females) served as an untreated control. As a result, neoplasms developed mainly in the digestive tract, kidney, uterus, and hematopoietic organ in groups 1-5. The incidences of adenocarcinoma in small and large intestines of male rats of group 4 (50 mg/kg MNU and X-irradiation) (small intestine: 48%, large intestine: 32%) were significantly higher than those of group 2 (50 mg/kg MNU) (small intestine: 17%, P < 0.05; large intestine: 8%, P < 0.05), and also the frequency of adenocarcinoma in the large intestine of males of group 3 (25 mg/kg MNU and X-irradiation) (22%) was significantly greater than that of group 1 (25 mg/kg MNU) (0%, P < 0.05). These results indicated that X-irradiation enhanced the development of intestinal neoplasms induced by MNU in male ACI/N rats.

Adenocarcinoma↗

Epitheliotropism in high-grade lymphomas of mucosa-associated lymphoid tissue.

Low-grade lymphomas of mucosa-associated lymphoid tissue (MALT) characteristically show centrocyte-like cells, plasmacytic differentiation, follicular colonization and lymphoepithelial lesions (epitheliotropism). High-grade lymphomas of MALT are thought to lack these features and can only be identified as MALT lymphomas with confidence if they are admixed with residual low-grade tumours. We studied 23 cases of MALT lymphoma of the thyroid. Six were predominantly low-grade, 12 were predominantly high-grade, and five contained both low- and high-grade areas. All cases were stained for cytokeratin, epithelial membrane antigen and laminin using an immunoperoxidase technique. The low-grade lymphomas all contained lymphoepithelial lesions, generally in the form of clusters of intra-acinar centrocyte-like cells. Eleven of the 12 high-grade MALT lymphomas of the thyroid also showed lymphoepithelial lesions. These appeared in three forms: follicles or clusters of epithelial cells infiltrated by groups of centrocyte-like cells, intra-acinar clusters of blast cells, or irregular invasion of islands of epithelial cells by blast cells. The first pattern presumably represented residual low-grade tumour over-run by high-grade lymphoma. The second two patterns indicated that the factors that result in epitheliotropism in low-grade MALT lymphomas are also present in high-grade tumours. Following this study we identified epitheliotropism in single examples of high-grade MALT lymphomas of the bronchus and small intestine. Previous failure to recognize epitheliotropism in high-grade MALT lymphomas of the gastrointestinal tract may be due to loss of the affected epithelium. The localization and relatively good prognosis of high-grade MALT lymphomas may be related to retention of MALT characteristics including epitheliotropism.

Epithelium↗

Morphology and histochemistry of large intestinal polyps.

In order to assess the progress of the growth of large intestinal polyps into cancer, the epithelial height and the size of the epithelial nuclei were measured. Mucin histochemistry was also carried out. The increase of the histologic grade was based on the extent of epithelial pseudostratification; epithelial height became greater and epithelial nuclei increased in size. The histochemical mucin values were as follows: the total amount of murin in a given area increased in grade I epithelia in comparison with its behaviour in normal ones, and then decreased gradually with the increase in histologic grade. Neutral mucin became more conspicuous with the increase of epithelial pseudostratification. The amount of sulphated mucin decreased with the increase in histologic grade. In normal epithelia, sialomucin was rarely seen, but in grade I and II epithelia which did not show nuclear stratification the amount of sialomucin increased strikingly. It then decreased in amount with the increase in histologic grade. The noticeable increase of the amount of sialomucin in grade I and II epithelia can be thought of as a temporary pheomenon which appears in an early stage of carcinogenic process. The large intestinal polyps go through several stages before turning into cancer.

Adenocarcinoma↗

Hepatocellular carcinoma with unusual metastasis to the small intestine.

An autopsy case of a hepatocellular carcinoma (HCC) with unusual metastasis to the mucosa of the small intestine is reported. The patient was a 73 year old female. At autopsy, the liver weighed 970 g, and an ovoid and necrotic 6 x 5 cm sized tumor was found in the right posterior lobe with many daughter tumors within the cirrhotic liver. The tumor embolus in the portal vein was not found. Extrahepatically the tumor metastasized to the lungs, sacral bone and hepatohillar and para-aortic lymph nodes. Additionally, many sessile and pedunculated polyps up to 2 cm in diameter were found sporadically in the small intestine. These seemed to be primary adenomatous polyps but histologically they were HCC metastasis. To the best of the authors' knowledge, many polypoid involvements of the small intestine by a hepatocellular carcinoma have not been reported until now.

Aged↗

Bowel haemorrhage and perforation from metastatic lung cancer. Report of three cases and a review of the literature.

Surgical emergencies caused by bowel metastases from carcinoma of the lung are very rare. A search of the English literature revealed less than 10 cases of bowel perforation and no case of haemorrhage. In this report, we describe three patients with both bowel perforation due to metastases from primary lung tumours (one epidermoid; two adenocarcinoma). In two of these, bleeding occurred several days before perforation, suggesting that bowel haemorrhage may be a warning of impending rupture. It may be reasonable to consider early laparotomy to control haemorrhage and prevent perforation even in such patients despite the presence of disseminated malignant disease.

Adenocarcinoma↗

A histochemical method of differentiating lower gastrointestinal tract mucin from other mucins in primary or metastatic tumours.

Epithelial mucins of the normal terminal ileum, caecum, colon, and rectum of man are unique in that they alone exhibit staining following the periodate-borohydride/KOH/PAS technique. Application of this technique enables one to differentiate those mucin-producting metastases arising from adenocarcinoma of the lower gastrointestinal tract from those arising elsewhere, and may occasionally be useful in determining the site of the primary tumour when it is in doubt. Furthermore, it was found to be especially useful in distinguishing between primary adenocarcinoma of the lung and metastases in the lung from adenocarcinoma of the lower gastrointestinal tract.

Adenocarcinoma↗

Small intestinal metastasis from small cell lung cancer.

A 71-year-old man who had small cell lung cancer was referred to our institution. Before starting chemotherapy, anemia progressed and stool examination was positive for occult blood. An abdominal computed tomography scan with contrast medium enhancement of the gastrointestinal tract disclosed a small intestinal tumor. Histological examination after the surgery confirmed that the tumor was metastasis of lung cancer. The patient survived for 3 years after the resection. Although clinically apparent metastases of lung cancer to the small intestine are rare and are reported to have a poor prognosis, early detection and intervention might enhance the chance of survival.

Aged↗