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From July 1, 1989, through June 30, 1991, 1,218 preoperative wire-localization breast biopsies were performed at one institution. In this group, 254 (21%) of the abnormalities were fibroadenomas, 26 of which had enlarged or developed in the interval between routine or short-interval follow-up mammography. This interval growth was noted in 21 premenopausal women and in five who were postmenopausal and receiving oral estrogen supplementation.
The authors describe mammographic and pathologic evidence of the growth of a fibroadenoma in an 82-year-old obese woman, 44 years after menopause, who had never been treated with hormone therapy. The patient's obesity is hypothesized as the causal factor for increased estrogen levels leading to growth of the fibroadenoma.
PURPOSE: To subjectively and semiquantitatively evaluate color Doppler signals on images of breast lesions. MATERIALS AND METHODS: A 5-MHz ultrasound (US) system was used to examine 210 new breast lesions. Signals were evaluated subjectively with an analog scale. A semiquantitative scoring system involved analysis of the average number of vessels per square centimeter and average density of color pixels. RESULTS: Vessels were detected in 57 of 58 cancers (mean, 0.11 vessels per square centimeter, occupying 1.76% of the scan area). Color Doppler scores had no correlation with conventional prognostic indicators such as lymph node status or survival. Fewer vessels per square centimeter (mean, 0.06) occupying a smaller area (mean, 0.41%) were detected in the five fibroadenomas (n = 36) that showed color Doppler signals. Most cases (99 of 104 [96%]) of benign breast changes had no color Doppler signals. CONCLUSION: Color Doppler signals in a lesion otherwise thought to be benign should prompt a biopsy, while the absence of signals in an indeterminate lesion is reassuring.
PURPOSE: To describe the sonographic features of paraovarian cystadenomas. MATERIALS AND METHODS: We searched the computerized pathology and radiology databases for cases of histopathologically proved paraovarian cystadenomas from January 1993 through December 1996 in which preoperative sonography had also been performed. Fourteen paraovarian cystadenomas or cystadenofibromas were identified in 14 patients aged 20-57 years. Sonographic and pathologic findings were correlated. RESULTS: Three of the masses appeared as simple cysts sonographically. Of the remaining 11 masses, nine had solid nodular areas within the cyst; three had septations; and four had a thick wall, an irregular wall, or both at sonography. At sonography, four masses were thought to arise outside the ovary, four were erroneously thought to arise in the ovary, and the location was uncertain in six. CONCLUSION: Paraovarian cystadenomas are cystic masses that usually contain one or more small solid nodules and occasionally contain septations.
A patient from Thailand presented with symptoms suggestive of peptic ulceration. Radiology showed an ulcerated duodenal stricture, a pancreaticoduodenal mass and extensive retroperitoneal lymphadenopathy suggestive of metastatic carcinoma. Tuberculosis was diagnosed only at laparotomy. The incidence of tuberculosis is increasing, and alimentary tuberculosis should be considered in patients from populations at risk presenting with obscure abdominal complaints or unexplained radiologic findings.
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Histochemical studies of human breast tumors were performed with particular emphasis on the activity of alkaline phosphatase (AIP), acid phosphatase (AcP) and glucose-6-phosphate dehydrogenase (G6PDH). Enzyme activities in benign and malignant lesions were compared. AIP was prominent in normal mammary epithelium, limited to the myoepithelial layer in benign tumors and was absent in cords of malignant cells. AcP activity was faintly detected in normal mammary epithelium, increased in canalicular epithelium of fibroadenomas and was marked in malignant cells. G6PDH exhibited marked activity in neoplastic epithelium and the stroma of nearly all carcinomas studied, whereas in benign tumors, G6PDH activity was strictly limited to the connective tissue. The study suggests a strong correlation between G6PDH activity and malignancy. The different results obtained by various workers in this field are critically reviewed, and discussed in the light of the results of the present study.
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GP 48 989 causes regression of DMBA-induced mammary carcinomas of spayed ("hormone-independent"), non spayed (approximately 5% "hormone-dependent") rats and of tumors which had become refractory to estradiol treatment. Since no binding to the cytoplasmic estradiol receptor after prolonged intramuscular treatment was found, the compound does not act as a classical anti-estrogen.
Serum samples from patients with primary breast carcinoma, breast carcinoma with metastases, chronic mastitis and fibroadenoma, and healthy individuals, were treated with hydrochloric acid and urea and analysed by polyacrylamide disc gel cationic electrophoresis. The discrete and highly reproducible patterns received showed variations from individual to individual. The frequencies of the presence and of the color intensity of every protein band were compared and profound differences were found for several bands between the four groups of patients and the healthy controls studied. The results suggest that a correlation exists between the electrophoretic profiles of partially hydrolysed serum cationic proteins and occurrence of disease, possibly useful for the early diagnosis of preneoplastic states.
Carcinoma of the breast is now the most common malignant disease of females in Europe and North America. The most critical single factor in determining the success or failure of treatment is the extent of the disease at diagnosis. A sensitive immunoperoxidase technique was utilized to (1) detect the presence in normal human serum of antibody directed against breast carcinoma cells (anti-T antibody), and (2) determine whether this antibody could be used to discriminate between benign and malignant breast epithelium in sections of formalin-fixed, paraffin-embedded tissue. A total of 11 benign and 11 malignant breast lesions were examined for evidence of binding of human immunoglobulin, before and after application of purified anti-T antibody or normal human AB serum (containing anti-T antibody). Malignant cells showed significant binding of human immunoglobulin (anti-T); benign or normal cells did not. Clear immunohistological separation of benign and malignant breast lesions appears to be potentially feasible by this method.
A single dose of the carcinogen 7,12-dimethylbenz(a)-anthracene (DMBA) when administered to 55-day-old female Holtzman rats did not produce any change in the pattern or amount of oestradiol receptors in the breast tissues, when compared to age-matched control animals. The period of observation extended up to 280 days of age. Following DMBA administration to 102 animals, only 60% developed carcinomas of the breast, of which 59 and 50% were ER- an PgR-positive, respectively. This lower yield of steroid receptor-positive tumours in this strain of rats was also reflected in a very low incidence of regression of tumours to ovariectomy. Plausible explanations for both these findings have been offered.
Oestrogen receptor content, lactoferrin, hexokinase, and glucose-6-phosphate dehydrogenase levels were measured in cytosol from 25 primary breast cancers and 3 fibroadenomas. Both hexokinase and glucose-6-phosphate dehydrogenase activity were higher in malignant tissue as compared to benign breast lesions. Oestrogen receptor concentration and lactoferrin content failed to predict the development of metastatic disease, while glucose-6-phosphate dehydrogenase activity was significantly higher in cytosol from those tumours which subsequently metastasized compared to those which remained localized.
A case of mucinous adenocarcinoma probably originating in the renal pelvis of an ectopic pyelic kidney with infiltration of the adjacent urinary bladder is reported. Review of the literature shows that this is the 42nd case of such a tumor, the second one reported in the pelvis of an ectopic pyelic kidney, and the first infiltrating the urinary bladder.
To establish appropriate indications for endoscopic treatment of submucosal invasive gastric carcinoma, we investigated clinicopathologic features and proliferating cell nuclear antigen (PCNA) expression at the deepest invasive portion of 192 differentiated submucosal invasive gastric carcinomas that had been surgically resected. Lymph node metastasis was demonstrated in 30 (15.6%) of 192 lesions. Histologic heterogeneity (based on differentiation at the deepest invasive portion) was demonstrated in 36 (18.8%) of the 192 lesions. In 159 lesions, excluding 33 undifferentiated lesions at the deepest invasive portion, the depth of invasion, histologic grade, lymph vessel involvement, infiltrative growth pattern (INF) and existence of an ulceration were all significantly correlated with the incidence of lymph node metastasis. The lesions with both well-differentiated adenocarcinoma (WELL) and minimal submucosal invasion (sm1) showed no lymph node metastasis. PCNA expression was estimated in 59 good stained lesions. The mean PCNA labeling index (LI) was 50.9 +/- 7.2% in lesions with lymph node metastasis and 43.7 +/- 9.3% in those without lymph node metastasis (p < 0.05). In addition, PCNA-LI also correlated significantly with the histologic grade, depth of invasion, INF and lymph vessel involvement. These results indicate that the submucosal invasive gastric carcinoma with both WELL and sm1, which shows no other risk factors, can be considered as the appropriate indication for curative endoscopic treatment. The PCNA-LI at the deepest invasive portion is useful in understanding the biology of lymph node metastasis in submucosal invasive gastric carcinoma.
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