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Detection of the plasmin system in human mammary pathology using immunofluorescence.

The presence and localization of the plasmin system components urokinase (UPA), tissue type plasminogen activator (TPA), plasminogen (PG), a neoantigen expressed by the plasmin-alpha 2-antiplasmin complex, and plasmin inhibitors alpha 2-antiplasmin (AP) and alpha 2-macroglobulin (MG) have been tested by immunofluorescence on sections of 11 benign and 40 malignant lesions of the breast in an attempt to apply a morphological approach to the problem of tumor invasion in vivo. In benign lesions, TPA was seen in secretions of mammary glands and MG was seen in edematous zones. In one involuting lactating adenoma, UPA, TPA, PG, PAP, and AP were associated with glandular cells. UPA was detected in 11 carcinomas, TPA in 22, PG in 31, PAP in 12, AP in 23, and MG in all 40. All these components were essentially present in invasive territories, with a cellular labeling for UPA and TPA and a fluorescent staining frequently at the periphery of tumoral foci for PG and PAP. AP was more closely associated with cancer cells than MG, which was present in the stroma. Intraductal proliferations were rarely positive and there was no correlation between the localization of PG and the distribution of a basement membrane glycoprotein laminin. These data argue strongly for the involvement of the plasmin system in the infiltrating process of the stroma. This system seems to play a limited role in the breakdown of basement membrane in breast carcinomas in vivo.

Adenofibroma↗

[Suprapubic ultrasonic diagnosis of the prostate].

100 patients, 60 affected by prostatic pathology and 40 normal, underwent ultrasonography using a transabdominal suprapubic approach, with a diagnostic accuracy of 88% and no instances of false negatives. The advantages of transabdominal approach are discussed and the various sonographic appearances are explained and correlated to histological findings.

Adenocarcinoma↗

Eccrine syringofibroadenoma. Immunohistological study of a new case.

Eccrine syringofibroadenoma is a rare tumor considered to originate from the excretory portion of the eccrine sweat gland. A new case of this lesion, whose acrosyringeal differentiation was underlined by an immunohistological study using antibodies to keratin and involucrin, is reported herein.

Adenofibroma↗

Estrogen staining in breast carcinoma by PAP methods compared to CEA and ferritin staining.

The aims of this paper are to demonstrate the stainability of estrogen, CEA, and ferritin in breast carcinomas, fibroadenomas, and fibrocystic diseases; to examine whether the findings of endogenous estrogen using the immunohistochemical detection method are related to estrogen receptor (ER) assays; and to determine whether the stainability of estrogen, CEA, and ferritin were related to the prognosis of breast carcinomas. In breast cancer, the stainability of estrogen using the peroxidase-antiperoxidase (PAP) method was positively correlated with the dextran-coated charcoal (DCC) assay for ER. In breast cancers, the percentage of positive staining was 46% for estrogen, 48% for CEA, and 47% for ferritin. With all three stains, significant differences were observed between cancer and benign diseases. Cases that were both positive for estrogen staining and negative for CEA showed a good prognosis after the recurrence of disease. Our data suggest that the immunohistochemical staining of estrogen, CEA, and ferritin might predict the biological behavior of breast carcinomas and be a prognostically useful indicator of breast cancer patients.

Adenofibroma↗

Fine needle aspiration of palpable breast lesions. Results obtained with cytocentrifuge preparation of aspirates.

The use of cytocentrifugation in the preparation of fine needle aspiration (FNA) specimens from the breast was evaluated. A total of 174 fine needle aspirates of breast masses were flushed into cytospin Collection Fluid, from which Papanicolaou-stained Cytospin preparations were made in the laboratory. Comparison of these preparations to conventional smears of aspirates showed no significant differences in the number or morphology of the cells. In 148 cases, the FNA cytologic study was followed up by excisional biopsy, Tru-Cut biopsy and/or a combination of mammography and clinical follow-up of two to nine months. Of 36 verified carcinomas, 31 (86%) were correctly diagnosed, with a zero false-positive rate. Among the 74 cytologically benign aspirates, 2 carcinomas were found on open biopsy, giving a false-negative rate of 3%. Lipomas were not diagnosable with this technique. This technique should be considered in institutions with a high turnover of junior staff members, which frequently results in a higher number of poorly smeared specimens or in poorly fixed/air-dried specimens that give suboptimal results with the Papanicolaou stain. With this method, there is less risk of creation of potentially hazardous aerosols and further preparations for additional studies may be made if required.

Adenofibroma↗

[An immunohistologic study of reactive lymphocytes in breast tissue].

A series of T-cell specific monoclonal antibodies (Leu-4; CD-3, OKT-4; CD-4, OKT8; CD-8) and a B-cell specific monoclonal antibody (Leu-12; CD-19) were used to detect the localization and intensity of lymphocytes in breast tissue. Frozen sections of 12 fibrocystic diseases, 11 fibroadenomas and 17 carcinomas of the breast were examined during this study. CD-3 and CD-8 positive lymphocytes predominated in and around the ducts of the fibrocystic disease and the fibroadenoma. Similarly, almost all of the reactive lymphocytes around the cancerous tissue also were CD-3 and CD-8 positive suppressor/cytotoxic cells.

Adenofibroma↗

The cytokeratin profiles of ovarian common "epithelial" tumors.

An improved immunohistochemical determination of the cytokeratin profiles of epithelia and their neoplasms is possible using monoclonal antibodies that will either identify all 19 cytokeratins (AE1/3) or delineate specific subsets (35 beta H11, 34 beta E12, 34 beta B4 and Cam 5.2). Ovarian common "epithelial" tumors (CET) contain cytokeratin filaments. To determine the nature and differences in the cytokeratin profiles of ovarian CET, eight benign Brenner tumors, four serous cystadenofibromas, 28 mucinous tumors, 27 serous tumors and six endometrioid, five clear cell and five undifferentiated carcinomas, as well as nine normal ovaries were immunostained with the above five antibodies. AE1/3 staining was predominant, while Cam 5.2 and 35 beta H11 displayed the most frequent staining thereafter. Statistically significant staining differences were found between a number of tumor groups using the antibodies 35 beta H11, 34 beta E12 and Cam 5.2. In this study, all ovarian CET, except the benign Brenner tumors, displayed a predominantly low molecular weight cytokeratin profile. The same profile in the normal surface epithelium lends credence to the belief that these tumors are derived from this epithelium. A significant staining difference between some of the tumor types using some of the antibodies suggests a possible ancillary, diagnostic role of cytokeratin profiling in situations where exact tumor typing is difficult.

Adenocarcinoma↗

[Carcinoma and fibroadenoma of the breast].

Eight cases of breast carcinoma coexisting with fibroadenoma were retrieved from the files of the Division of Pathology from 1957 to 1987. In 3 patients (Group I) the lesion was within the fibroadenoma and in the remaining 5 patients, adjacent to it (Group II: synchronic carcinomas). All patients were females. During the same period, 987 fibroadenomas and 2004 carcinomas were diagnosed: 0.30% of the fibroadenomas developed carcinoma within the epithelial component and 0.15% of the carcinomas originated in the fibroadenoma's epithelium. The mean age was 39 years for in situ lesions and 45.5 years for infiltrating carcinoma with a general mean age of 43.3 years, 20 years older than the peak age of fibroadenoma. In Group I, there were 3 in situ lesions, 1 lobular and 3 ductal (Table 1). Two of the three patients had another coexisting gynecologic malignancy. In Group II all cases had infiltrating carcinomas, one lobular, 3 ductal and 1 mixed lobular and ductal (Table 1). The adjacent breast tissue showed associated pathology in all cases: multiple fibroadenomas, fibrocystic diseases, sclerosing adenosis, infiltrating ductal carcinoma and/or lobular hyperplasia. Different hypotheses from the literature were analysed concerning an association between carcinoma and fibroadenoma. A casual association is suggested by the low percentage of carcinomas developing in fibroadenomas as well as the low percentage of carcinomas originating from fibroadenomas.

Adenofibroma↗

DNA ploidy in fibroadenomas (abstract).

There is now a considerable body of literature reporting DNA quantification in a variety of malignancies. There have been few reports, however, of such measurements in benign lesions.

Adenofibroma↗

Phenotypic variability of chemically induced primary rat mammary tumors.

Rat mammary tumors induced by DMBA (7,12-dimethylbenz(a)anthracene) or MNU (N-methyl-N-nitrosourea) were compared for frequency of histological types. Total tumor incidence in 50-day-old rats (Groups 3, 4, 5) was about 100% independently of the rat strain and carcinogen. There were found no distinct histological tumor types between DMBA and MNU carcinogenesis, although the distribution of fibroadenomas, adenocarcinomas and sarcomas varied markedly among rat groups. In 300-day-old female Wistar rats (Group 1) treated with DMBA, fibroadenomas and adenocarcinomas showed an incidence of 58% and 42% respectively. In 50-day-old rats (Group 3) the proportion of adenocarcinomas increased up to 72% of total DMBA tumors. MNU carcinogenesis induced adenocarcinomas in 98% of total tumors in the Lewis rat strain (Group 5), while only 53% in Wistar rats (Group 4). The rest of tumors were sarcomas occurring in opposite ratio to adenocarcinomas. The relatively high susceptibility of connective tissue to MNU as compared with mammary epithelium was due to the mode of MNU administration and seemed to be strain dependent. Both DMBA and MNU carcinogenic systems are valuable experimental models of mammary tumor. The cell phenotypes of the resulting tumors can be predicted with high probability by the choice of dose regimen of carcinogen and the route of its application.

9,10-Dimethyl-1,2-benzanthracene↗

Effect of n-3 and n-6 fatty acids on 7,12 dimethylbenz (a) anthracene-induced mammary tumorigenesis.

Numerous studies have consistently shown that vegetable oils containing linoleic acid enhance mammary tumorigenesis more effectively than fish oils containing eicosapentaenoic and docohexaenoic acids. The purpose of this investigation was to study these and additional n-3 and n-6 PUFA, e.g., a-linolenic (a-LN) (18:3 n-3) and gamma-linolenic (GLA) (18:3 n-6) acid. Different oils were used as dietary sources of fatty acids: corn (CO) (61% LA); blackcurrant (BCO) (44% LA, 18% GLA and 16% a-LN); fish oil (FO) (mixed with corn oil, 12% LA and 24% EPA + DPA + DHA). Thirty-five-day-old female Sprague-Dawley rats were divided into 5 dietary treatment groups and were allowed to feed ab libitum on one of the test diets: I. BCO (23.5%); II. CO (23.5%); III. BCO (15.5%) + FO (8%); IV. FO (20.5%) + CO (3%); and V. BCO (20.5%) + FO (3%). From 48 to 52 days of age, rats in all five groups were fed rat chow. At 50 days of age, all rats were given 5 mg DMBA by oral intubation, and 2 days later the test diets were resumed until termination of the experiment. Analysis of tumor incidence, and multiplicity data for 5 diet groups indicated that rats fed 23.5% CO (II) exhibited enhanced mammary tumor yields when compared to animals on the remaining 4 diets in the order II greater than I, III, V greater than IV. Since the level of fat (23.5% w/w) was similar in all 5 diets, and body weight gain was in the order IV greater than II greater than I, the results of this study indicate that differences in tumor yields were related to fatty acid composition of diets. In support of this conclusion, fatty acid profiles of RBC and tumor phosphoglycerides reflected dietary fatty acid composition. In groups I and II, even though tumor levels of LA were similar, the levels of GLA, DHLA (20:3 n-6) and a-LN were higher in I compared to II, suggesting that these differences may be associated with lower yields of DMBA-induced mammary tumors in group I. Incorporation of marine type n-3 PUFA (EPA, DPA and DHA) in tumor PL was greater in Group IV compared to plant type n-3 PUFA (a-LN) in Groups I, III, and V. Since tumor yields were the lowest in Group IV, these results suggest that incorporation of marine type n-3 PUFA into cell membranes does not favor development of DMBA-induced mammary tumors.

9,10-Dimethyl-1,2-benzanthracene↗

[Sonographic diagnosis of breast carcinoma by a 7.5 MHz high-resolution electronic linear array transducer].

The diagnostic quality with 7.5 MHz real-time, transducer was evaluated in 175 cases of breast lesions including 106 carcinoma. All cases were histologically confirmed by surgery or excisional biopsy. In the prospective study, accuracy in carcinoma was 84.6% with true positive ratio of 86.8%. There were 14 false negative cases with carcinoma and 13 false positive cases. Five "early" breast carcinoma within 1 cm in diameter were misdiagnosed as benign breast lesions. The false positive cases were composed of 7 degenerated fibroadenomas, 2 mastopathies and 4 inflammatory changes. In the retrospective study, accuracy in carcinoma was 83.4% with true positive ratio of 93.4%. Compared with the prospective study, false negative cases decreased and false positive cases increased in retrospect. The predictive value of positive results with carcinoma were about 80% in each malignant findings on the criterion of breast carcinoma. The 7.5 MHz electronic, linear-array transducer has several advantages over the 7.5 MHz polymer transducer in detection and also precise observation of the breast lesions.

Adenocarcinoma, Mucinous↗

[X-ray morphologic characteristics of microcalcination in benign processes and cancer of the breast].

Mammographic and morphologic examination was carried out in 136 females bearing microcalcinates in breast tissue. Morphologic examination identified benign tumors (mostly fibrous cysts) in 72.1% and cancer (mostly ductal and lobular carcinoma in situ or initial signs of invasion) in 27.9% of cases. Calcinates occurred mainly in the epithelium and incipient cancer complexes. The analysis of the data showed shape, structure and distinctness of contours of calcinates to be instrumental in differentiating between malignant and benign lesions.

Adenofibroma↗

Expression of HLA-A, -B, -C, -DR, -DP, -DQ, and of HLA-D-associated invariant chain (Ii) in non-neoplastic mammary epithelium, fibroadenoma, adenoma, and carcinoma of the breast.

Non-neoplastic mammary gland, 20 benign tumors and 206 carcinomas of the breast were immunohistochemically examined for expression of HLA-A, -B, -C, HLA-DR, -DP, and -DQ molecules and the HLA-D associated invariant chain (Ii). In contrast to cells from benign lesions, tumor cells of 51.2% of carcinomas had an abnormally low content of HLA-A, -B, and -C determinants ranging from reduction of antigenic density per cell (28.8%) over an incomplete (15.6%) to complete loss of antigens (6.8%). Associated with lymphohistiocytic stromal infiltrates, HLA-D/Ii determinants were found to be induced in benign duct and acinar epithelium after the order Ii greater than or equal to HLA-DR greater than or equal to HLA-DP greater than or equal to HLA-DQ. These antigens were also expressed, mostly noncoordinately, in 55.5% of carcinomas, and in 98 cases according to the above order. In 28.6%, Ii expression clearly exceeded HLA-D antigen expression; conversely, 6.2% contained HLA-DR+/Ii- tumor cell subsets. In breast carcinoma, the association of reduced HLA-A, -B, and -C expression and a noninduction of HLA-DR was highly significant (P less than 0.0009), suggesting an abnormal signal acting down-regulating on the expression of both classes of antigens. Because the modality of HLA-A, -B, and -C and HLA-D/Ii expression correlated with neither tumor type nor grade, it might be an independent parameter.

Adenofibroma↗

Sex chromatin in female breast tumour.

The incidence of sex chromatin in tumour cell nuclei was estimated in twenty five cases each of carcinoma and fibroadenoma breast using haematoxylin and eosin, thionine, aceto-orcein and Papanicolaou's stains on imprint-smears. The sex chromatin incidence in fibroadenoma was found similar to that of normal breast tissue but the incidence markedly decreased in carcinoma breast. Undifferentiated tumours with histologic grade III, nuclear grade I, no lymphocytic infiltrate and involvement of overlying skin, nipple and areola were more often associated with low sex chromatin incidence. No relationship was observed between sex chromatin incidence and tumour size or axillary lymph node metastasis.

Adenofibroma↗