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Various rat mammary tumors were analyzed for the presence of a milk-specific Ca2+-stimulated RNase (Ca2+-RNase). When crude extracts of some differentiated tumors--adenocarcinomas of MT/W9, MT/W9a, R3230AC, DMBA-1, DMBA-8, and DMBA-14 and 3MN squamous cell carcinoma--were assayed for RNase activity under various ionic conditions, it was always highest in the presence of Ca2+/EDTA than under any other ionic condition. The opposite was true in invasive MT/W449a and 13762 adenocarcinomas, poorly differentiated SMT/2A carcinomas, MAMF2/TC fibrosarcoma, and MT/A fibroadenoma. Sephacryl S-200 chromatography separation of tumor extracts confirmed the presence of Ca2+-RNase in those differentiated tumors and absence of the enzyme from other tumors. Expressing the activity as a ratio of Ca2+/EDTA to either Mg2+/EDTA or EDTA alone to more clearly represent the relative level of Ca2+-RNase activity further illustrates the distinct differences between tumor classes. Thus Ca2+-RNase is a sensitive marker for use in the characterization of rat tumors with respect to differentiated mammary functions.
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OBJECTIVE: We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. MATERIALS AND METHODS: The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. RESULTS: All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2-dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. CONCLUSION: Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.
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The low incidence of breast cancer among women under the age of 25 years may not justify the routine excision biopsy of breast lumps in this age group. A policy of conservative management has been tested in 70 women between the ages of 17 and 25 years. Excision biopsy was eventually performed in 23 women - fewer than half of those with a palpable mass. No cancerous lesions were found; a high proportion of lumps removed were fibroadenomas. The accuracy of clinical diagnosis was high and, of 31 breast lumps diagnosed as benign mammary dysplasia, more than three-quarters resolved without surgical intervention. Indications for surgery are defined. Because breast cancer does occasionally occur in this age group, accurate clinical diagnosis and review are essential components of conservative management.
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Ultrasound has become increasingly important in the management of benign breast disease. The main reasons are its ability to distinguish between cystic and solid lesions, its special advantages in examining the dense breast, and the absence of potential radiation hazard. This paper evaluates the specificity of automated ultrasound in the diagnosis of benign lesions. The usefulness of the signs established for the diagnosis of benign masses is analyzed. Atypical lesions are discussed and the role of ultrasonography in the differential diagnosis of benign lesions is reviewed.
By use of accepted criteria, all masses anterior to the splenic vein are thought to arise from the pancreas, whereas all masses posterior to the vein are attributed to other retroperitoneal organs. Three patients with pancreatic masses are presented. Since the mass was posterior to the splenic vein in these cases, a pancreatic origin did not originally suggest itself.
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Hand-held sonomammography was used intraoperatively to localize 52 masses in 45 women in an out patient operating suite. All but five women had a positive X-ray mammogram. The ultrasound mammogram was able to identify all lesions. In 42 women studied by a preoperative ultrasound examination before the operating room procedure, all the masses were successfully identified. Precise localization was successfully performed in the operating room before sterile preparation in less than 10 minutes. Relocalization after incision in the sterile operating field was necessary in two cases. This technique requires no ionizing radiation and expedites outpatient surgical removal of the lesion. Of the 52 masses, there were 32 fibroadenomas, three carcinomas, three cysts, six cases of focal fibrous mastitis, and eight patients with focal fibrocystic disease. In patients with positive sonograms for nonpalpable masses, ultrasound localization is a fast, accurate alternative to X-ray needle placement.
Ultrasound examinations of solid breast masses were reviewed retrospectively to determine whether quantitative data of their dimensions could distinguish benign from malignant tumors. Forty-nine fibroadenomas and 30 carcinomas with cytologic or histologic proof were identified. No significant difference was found between carcinomas and fibroadenomas when comparing the average ratio of length to anteroposterior (L/AP) diameter or the mean ratio of anteroposterior diameter to transverse diameter (AP/T). In this limited series, quantification of the degree of mass elongation along the natural breast tissue planes had low sensitivity in distinguishing malignant from benign tumors.
Our objective was to characterize the properties of an intravascular ultrasonographic contrast agent in examination of adnexal masses and to compare contrast agent properties between benign and malignant adnexal tumors. Fifty-eight consecutively examined women with suspected ovarian tumors were examined preoperatively by power Doppler ultrasonography, first without and then with contrast agent enhancement (Levovist). Fourteen women had ovarian cancer, 3 had borderline ovarian tumors, 18 had benign ovarian neoplasms, and 23 had functional adnexal cystic masses or endometriomas. The effect of the contrast agent was evaluated visually and by using computerized power Doppler signal intensity measurements. In visual evaluation, the brightness of the power Doppler signal and the amount of recognizable vascular areas increased in each tumor after contrast agent administration. The number of vessels in power Doppler ultrasonograms, both before and after contrast agent enhancement, was significantly higher in malignant than in benign adnexal masses, as also was the increase in the number of recognizable vessels after contrast agent administration. Contrast agent uptake time was significantly shorter in malignant than in benign tumors. No significant differences were found in the power Doppler signal intensities or their changes between benign and malignant tumors. In conclusion, use of sonographic contrast agent facilitates imaging of tumor vessels. For differentiation of benign and malignant tumors, the kinetic properties of the contrast agent, such as uptake and washout times, may have more potential than the use of the contrast agent in anatomic imaging of the tumor vessels.
OBJECTIVE: To describe the sonographic characteristics of ovarian cystadenofibromas. METHODS: We conducted a retrospective study of 23 ovarian tumors histopathologically confirmed as ovarian cystadenofibromas that were preoperatively evaluated by transvaginal color Doppler sonography. RESULTS: In all cases the mass was predominantly cystic. Septations appeared in 30.4% of the tumors. Papillary projections or solid nodules appeared in 56.5% of the cases. The most frequent appearance was a unilocular complex cystic mass. In 47.8% of the tumors, vascularization was detected, having a typical pattern of peripheral vascularization with scattered vessels of high blood flow impedance. CONCLUSIONS: We have described the sonographic spectrum of findings of ovarian cystadenofibromas. The most frequent appearance was a unilocular cystic mass with gross papillary projections or solid nodules. In almost half of the tumors, vascularization could be detected.