National Cancer Institute®
Last Modified: April 1, 2002
UI - 11686037
AU - Verweij J
TI - Sarcomas.
SO - Cancer Chemother Biol Response Modif 2001;19():639-51
AD - Department of Medical Oncology, Rotterdam Cancer Institute (Daniel den Hoed Kliniek), University Hospital, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands.
UI - 11781522
AU - Toki T; Shimizu M; Takagi Y; Ashida T; Konishi I
TI - CD10 is a marker for normal and neoplastic endometrial stromal cells.
SO - Int J Gynecol Pathol 2002 Jan;21(1):41-7
AD - Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Asahi, Matsumoto, Japan.
Using the immunohistochemical technique, we investigated the expression of CD10 in normal female genital tissues, chorionic villi and decidua of early gestation, endometriotic lesions, and uterine mesenchymal tumors. The cytoplasm of normal endometrial stromal cells was consistently positive for CD10. During early gestation, decidualized endometrial stromal cells were negative or only focally positive for CD10, whereas nondecidualized stromal cells were diffusely positive. Syncytiotrophoblast was positive for CD10 on the apical surface, whereas chorionic mesenchymal cells were diffusely positive within the cytoplasm. Cytotrophoblast and intermediate trophoblast were negative for CD10. Groups of stromal cells surrounding cervical glands were often positive for CD10. Myometrium, endometrial and cervical glands, cervical squamous epithelia, and tubal epithelia and stroma exhibited no reactivity for CD10. In endometriosis and adenomyosis, ectopic endometrial stromal cells were usually positive for CD10. Endometrial stromal tumors, including undifferentiated uterine sarcomas, mostly showed diffuse immunoreactivity for CD10. Leiomyomas and leiomyosarcomas were negative or focally (< 5% of cells staining) positive (8/12 leiomyomas and 4/8 leiomyosarcomas) for CD10, except for 1 myxoid leiomyosarcoma that showed CD10 staining in the myxoid areas. These data suggest that diffuse CD10 staining is characteristic of normal and neoplastic endometrial stromal cells, unless they are decidualized.
UI - 11042567
AU - Jager PL; Hoekstra HJ; Leeuw J; van Der Graaf WT; de Vries EG; Piers D
TI - Routine bone scintigraphy in primary staging of soft tissue sarcoma; Is it worthwhile?
SO - Cancer 2000 Oct 15;89(8):1726-31
AD - Department of Nuclear Medicine, University Hospital Groningen, Groningen, The Netherlands. firstname.lastname@example.org
BACKGROUND: The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients. METHODS: Preoperative bone scans were evaluated retrospectively in 109 consecutive patients (median age, 44 years; range, 1-86) with intermediate or high grade STS. Scans were scored in 3 categories: 1, metastases very likely; 2, equivocal; and 3, normal or benign lesions. RESULTS: Category 1 scans were found in 8 of 109 patients (7%); in all 8 patients, bone metastases were confirmed. Six of these eight patients reported pain, and all had additional lung, bone marrow, or lymph node metastases. The highest rate (17%) was found in the rhabdomyosarcoma subgroup (n = 18). Category 2 (equivocal) scans were present in 12 of 109 patients (11%), in all of which bone metastases were excluded through additional investigations. Category 3 (normal) scans were found in 81%. Bone metastases were at least as frequent as lung metastases (4%) and were the single site of systemic disease in 4%. The rate of bone metastases was 55% in patients with bone pain versus 2% in patients without pain. CONCLUSIONS: Bone metastases in primary STS patients are rare (7%) yet in this study at least as frequent as lung metastases. The low rate in asymptomatic patients versus the high rate in symptomatic patients supports the use of bone scanning in symptomatic patients only. The yield of routine bone scanning is low. Copyright 2000 American Cancer Society.
UI - 11760565
AU - Demetri GD; Delaney T; NCCN Sarcoma Practice Guidelines Panel
TI - NCCN: Sarcoma.
SO - Cancer Control 2001 Nov-Dec;8(6 Suppl 2):94-101
AD - Dana-Farber Cancer Institute, USA.
UI - 11857563
AU - Carney JA; Stratakis CA
TI - Familial paraganglioma and gastric stromal sarcoma: a new syndrome distinct from the Carney triad.
SO - Am J Med Genet 2002 Mar 1;108(2):132-9
AD - Department of Laboratory Medicine and Pathology (Emeritus member), Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. email@example.com
Paragangliomas may be inherited in an autosomal dominant manner either alone (as in PGL1, PGL2, and PGL3 syndromes) or as a component of a multiple tumor syndrome (as in von Hippel-Lindau disease and neurofibromatosis type 1). In this article, we describe 12 patients (7 male and 5 female) with an average age of 23 years from five unrelated families that manifested paraganglioma and gastric stromal sarcoma; the tumors were inherited in an apparent autosomal dominant manner, with incomplete penetrance. Seven patients had paraganglioma, four had paraganglioma and gastric stromal sarcoma, and one had gastric stromal sarcoma. The paraganglioma was multicentric and the gastric stromal sarcoma multifocal. Because of the rarity of gastric stromal sarcoma and its multifocality, the young age of the patients, and the unlikelihood of coincidental co-occurrence of paragangliomas and gastric stromal sarcomas, we suggest that a new syndrome exists with these two main components, a condition that is familial and distinct from the Carney triad. Published 2002 Wiley-Liss, Inc.
UI - 11905413
AU - Essary LR; Vargas SO; Fletcher CD
TI - Primary pleuropulmonary synovial sarcoma: reappraisal of a recently described anatomic subset.
SO - Cancer 2002 Jan 15;94(2):459-69
AD - Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
BACKGROUND: Primary pleuropulmonary synovial sarcoma (SS) is a rare neoplasm and a recently recognized anatomic subset. Its clinicopathologic attributes are not yet well defined. METHODS: In this study, the clinical and histopathologic features of 12 SS arising in the lung and/or pleura were analyzed. RESULTS: The neoplasms occurred in 7 men and 5 women, 20-72 years old (median, 31 years), were well circumscribed with a mean size of 7.2 cm, and involved either lung (9 cases), pleura (2 cases), or both (1 case). All the tumors were of monophasic type. Nine showed a classic spindle cell pattern, and three showed predominantly poorly differentiated features. All but one case showed at least focal positivity for epithelial membrane antigen (EMA), a finding characteristic of this tumor. The lack of EMA staining in one case, proven by electron microscopy to be SS, was attributed to the scarcity of material available for immunohistochemical stains. The diagnosis was proven cytogenetically in three cases. Within 2 years, local recurrence developed in 8 patients (75%), 3 of whom developed metastasis (25%). Five patients died of their disease within 2.5 years, 4 of them from uncontrolled local disease. CONCLUSIONS: The authors conclude that pleuropulmonary SS, although rare, represents a distinct anatomic subset having pathologic features similar to those of its soft tissue counterpart. Its clinical behavior appears more aggressive, perhaps because of relatively later presentation combined with the difficulty in obtaining a wide surgical margin.
UI - 11900234
AU - Rossi CR; Foletto M; Mocellin S; Pilati P; De SM; Deraco M; Cavaliere F;
TI - Palatini P; Guasti F; Scalerta R; Lise M Hyperthermic intraoperative intraperitoneal chemotherapy with cisplatin and doxorubicin in patients who undergo cytoreductive surgery for peritoneal carcinomatosis and sarcomatosis: phase I study.
SO - Cancer 2002 Jan 15;94(2):492-9
AD - Dipartimento di Scienze Oncologiche e Chirurgiche, Sezione Clinica Chirurgica Generale II, Universita' di Padova, Italy. firstname.lastname@example.org
BACKGROUND: Hyperthermic intraperitoneal intraoperative chemotherapy (HIIC) combined with cytoreductive surgery (CS) has been proposed as a new multimodal treatment mainly for carcinomatosis of gastrointestinal origin. To evaluate whether this regimen could be used for other tumor types, the authors conducted a Phase I study on HIIC with doxorubicin and cisplatin in patients with peritoneal carcinomatosis or sarcomatosis. PATIENTS AND METHODS: Thirty-one patients with peritoneal carcinomatosis or sarcomatosis (PCS) were enrolled for the study. After completion of CS, HIIC was administered with drug doses that were increased for each consecutive cohort following a three-patient cohort scheme. Thereafter, the accrual was stopped when Grade 4 locoregional or systemic toxicity was observed. The maximum tolerated dose (MTD) was considered the dose in the previous triplet. Drug pharmacokinetics and procedure costs also were analyzed. RESULTS: After CS, residual tumors were not present or measured less than or equal to 3 mm (in dimension) in all cases. Maximum tolerated dose was 15.25 and 43.00 mg L(-1) for doxorubicin and cisplatin, respectively. The perfusate/plasma area under the curve ratios were favorable for both drugs, at 162+/-113 and 20.6+/-6.0, respectively, for doxorubicin and cisplatin. Doxorubicin levels in the peritoneum were higher than in tumor or normal tissue samples. There were no postoperative deaths. Surgery-related complications were observed in 25% of cases. Findings at cost analysis showed that the length of stay in the operation room and intensive care unit were the major cost drivers. CONCLUSIONS: Cytoreductive surgery combined with HIIC is an expensive but feasible therapeutic approach for locally advanced abdominal tumors. Because our preliminary findings for local disease control are encouraging, a Phase II study is now advisable to verify the activity of this promising treatment.
UI - 11917581
AU - Shimizu K; Korematsu M
TI - Phyllodes tumor of the breast. A cytomorphologic approach based on evaluation of epithelial cluster architecture.
SO - Acta Cytol 2002 Mar-Apr;46(2):332-6
AD - Department of Anatomic and Diagnostic Pathology, Dokkyo University School of Medicine, 880, Mibu, Tochigi, 321-0293, Japan.
OBJECTIVE: To develop more useful criteria for differentiating benign phyllodes tumor (BPT) from fibroadenoma (FA) of the breast on fine needle aspiration cytology (FNAC), with a focus on architectural features of epithelial clusters. STUDY DESIGN: The smears of 18 cases obtained by preoperative FNAC, each with tissue-proven BPT, were compared to those of 25 cases of FA. Several features of epithelial clusters in both groups were studied, with histologic correlation. RESULTS: BPT exhibited large epithelial clusters longer than 1 mm, with a wavy or folded shape, that could be distinguished from the small or medium-sized clusters with tubular, blunt-branching or monolayered contours in FA. This appearance of BPT was equivalent to the characteristic phyllodes pattern of its histology. CONCLUSION: The size and shape of epithelial clusters are important diagnostic clues in addition to several findings that have been described as differentiating BPT from FA on FNAC.
UI - 11788902
AU - Tsujimura A; Kawamura N; Ichimura T; Honda K; Ishiko O; Ogita S
TI - Telomerase activity in needle biopsied uterine myoma-like tumors: differential diagnosis between uterine sarcomas and leiomyomas.
SO - Int J Oncol 2002 Feb;20(2):361-5
AD - Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Preoperative differential diagnoses between uterine sarcomas and leiomyomas are difficult. As telomerase activation is thought to be essential for the immortality of malignant cells, it is considered a potentially useful diagnostic marker. The aim of the present study was to evaluate the potential diagnostic use of measuring telomerase activity in needle biopsy samples to distinguish uterine sarcoma from leiomyoma. Sixty-two patients with suspected uterine sarcomas based on clinical findings or magnetic resonance imaging findings, and who were scheduled for surgery, underwent transcervical ultrasound-guided needle biopsy. Three samples were obtained per patient for histopathological examination and telomerase activity measurement. Telomerase activity was measured using the telomeric repeat amplification protocol and correlated with final histopathological findings of surgical specimens. Of the 62 patients, 6 leiomyosarcomas and 1 endometrial stromal sarcoma (high grade) were diagnosed by histopathology. In 6 of the 7 samples from uterine sarcomas, relatively high telomerase activity (22-102 units) was detected, whereas only low telomerase activity (11-18 units) existed in 3 of the remaining 55 samples from benign or borderline uterine smooth muscle tumors. At a cut-off value of 20 units, sensitivity, specificity, positive predictive, and negative predictive values for detecting uterine sarcoma were 86% (95% confidence interval, 59-100%), 100% (94-100%), 100% (54-100%) and 98% (95-100%), respectively. The results indicated that telomerase activity in needle biopsy samples is a useful diagnostic marker to distinguish uterine sarcoma from leiomyoma.
UI - 11866525
AU - Mayo K; Vana ML; McDermott J; Huseby D; Leis J; Barklis E
TI - Analysis of Rous sarcoma virus capsid protein variants assembled on lipid monolayers.
SO - J Mol Biol 2002 Feb 22;316(3):667-78
AD - Vollum Institute and Department of Microbiology, Oregon Health & Science University, Portland, OR 97201-3098, USA.
During assembly and morphogenesis of Rous sarcoma virus (RSV), proteolytic processing of the structural precursor (Pr76Gag) protein generates three capsid (CA) protein variants, CA476, CA479, and CA488. The proteins share identical N-terminal domains (NTDs), but are truncated at residues corresponding to gag codons 476, 479, and 488 in their CA C-terminal domains (CTDs). To characterize oligomeric forms of the RSV CA variants, we examined 2D crystals of the capsid proteins, assembled on lipid monolayers. Using electron microscopy and image analysis approaches, the CA proteins were observed to organize in hexagonal (p6) arrangements, where rings of membrane-proximal NTD hexamers were spaced at 95 A intervals. Differences between the oligomeric structures of the CA variants were most evident in membrane-distal regions, where apparent CTDs interconnect hexamer rings. In this region, CA488 connections were observed readily, while CA476 and CA479 contacts were resolved poorly, suggesting that in vivo processing of CA488 to the shorter forms may permit virions to adopt a dissembly-competent conformation. In addition to crystalline arrays, the CA479 and CA488 proteins formed small spherical particles with diameters of 165-175 A. The spheres appear to be arranged from hexamer or hexamer plus pentamer ring subunits that are related to the 2D crystal forms. Our results implicate RSV CA hexamer rings as basic elements in the assembly of RSV virus cores. Copyright 2002 Elsevier Science Ltd.
UI - 11870176
AU - Lopez M; Vici P; Di Lauro L; Carpano S
TI - Increasing single epirubicin doses in advanced soft tissue sarcomas.
SO - J Clin Oncol 2002 Mar 1;20(5):1329-34
AD - Division of Medical Oncology B, Regina Elena Institute for Cancer Research, Rome, Italy. email@example.com
PURPOSE: To evaluate the maximum-tolerated dose and the clinical efficacy of epirubicin in patients with advanced soft tissue sarcoma. PATIENTS AND METHODS: Sixty-one patients were treated at three different epirubicin dose levels: 140 mg/m(2) (six patients), 160 mg/m(2) (52 patients), and 180 mg/m(2) (three patients). Cycles were repeated every 3 weeks for a maximum of eight cycles. The first two dose levels proved to be feasible and safe without dose-limiting toxicity (DLT). Because the first three patients entering the third dose level experienced DLT, subsequent patients received the next lower dose level. RESULTS: The overall response rate was 44% (95% confidence interval, +/- 12%), with six complete (10%) and 21 partial (34%) responses. Responses seemed related to epirubicin dose level, because the response rate was 17%, 44%, and 100% for the three dose levels (chi(2) test for trend, P =.02). Median response duration, median time to progression, and median overall survival were 10, 8, and 15 months, respectively. Myelosuppression was the most frequent side effect, with grade 3 or 4 neutropenia occurring in 79% of the patients; 31% of patients were febrile. Nonhematologic toxicity was mainly grades 1 and 2. The mean epirubicin dose-intensity was 49 mg/m(2) per week. CONCLUSION: The third epirubicin dose level (180 mg/m(2)) was the maximum-tolerated dose. The recommended drug dose for clinical use is 160 mg/m(2) every 3 weeks with hematopoietic support. Single high-dose epirubicin is effective as first-line treatment and should be preferentially used whenever a high response rate is important to allow the resection of an otherwise unresectable disease or whenever it might result in a significant symptomatic benefit.
UI - 11873080
AU - Parisi SG; Sarmati L; Pappagallo M; Mazzi R; Carolo G; Farchi F;
TI - Nicastri E; Concia E; Rezza G; Andreoni M Prevalence trend and correlates of HHV-8 infection in HIV-infected patients.
SO - J Acquir Immune Defic Syndr 2002 Mar 1;29(3):295-9
AD - Institute of Immunology and Infectious Diseases, University of Verona, Italy.
To assess the circulation of human herpesvirus (HHV)-8 infection over the years, two seroprevalence surveys were conducted, which tested sera from HIV-infected individuals recruited 10 years apart (206 individuals from 1986 to 1988 and 177 individuals from 1997 to 1998). For all patients, antibodies to hepatitis C virus (HCV), hepatitis B virus (HBV), and HHV-8 lytic and latent antigens were evaluated.HHV-8 seroprevalence was higher among individuals recruited in the 1990s (31.6% for anti-lytic, 8.5% for anti-latent antibodies) compared with similar findings in those seen in the late 1980s (14.6% and 3.4% for anti-lytic and anti-latent antibodies, respectively), with a twofold increase of the risk of HHV-8 infection. However, the increase was observed only among injecting drug users, whereas seroprevalence tended to slightly increase among those infected by sexual contact. At univariate analysis, time of recruitment and being homosexual men were factors associated with HHV-8 infection, an association that remained after adjusting for age. HBV infection was significantly associated with HHV-8 infection (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.3-3.6), whereas those infected with HCV had a lower probability of having HHV-8 antibodies (OR, 0.3; 95% CI, 0.20-0.6). After controlling for age and gender, time of recruitment remained independently associated with HHV-8 infection among injecting drug users.In conclusion, HHV-8 seroprevalence appears to be increased during 10 years among HIV-infected injection drug users but not among homosexual men, who remain those at the highest risk of infection.
UI - 11762815
AU - Ruka W; Rutkowski P; Kaminska J; Rysinska A; Steffen J
TI - Alterations of routine blood tests in adult patients with soft tissue sarcomas: relationships to cytokine serum levels and prognostic significance.
SO - Ann Oncol 2001 Oct;12(10):1423-32
AD - Department of Soft Tissue/Bone Sarcomas, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Warsaw, Poland.
BACKGROUND: It has been reported that malignancy is often accompanied by hematological alterations and that such alterations may correlate with poor prognosis. It has also been demonstrated that several cytokines may be synthesized by many malignant tumors and that elevated serum levels of some cytokines are associated with changes in blood cell counts in cancer patients. However, so far little is known about the prognostic significance and mechanism of hematological changes in soft tissue sarcomas. The aim of the study was to evaluate the routine blood tests of disturbances in patients with malignant soft-tissue tumors prior to treatment and to correlate these results with selected cytokine serum levels, clinicopathological features of the tumors and patient survival. PATIENTS AND METHODS: 145 patients (75 males, 70 females; mean age 49.97 +/- 16.9 yrs) with histologically confirmed soft tissue sarcomas before treatment were enrolled into the study. In all these patients we evaluated routine blood tests (hemoglobin level HGB, white blood cell count WBC, platelet count PLT, white blood cell differential count-neutrocyte count NE, lymphocyte count LY, monocyte count MN, eosinophile count EO) and serum levels of 13 cytokines and soluble cytokine receptors (IL-6, IL-8, IL-10, TNFalpha, G-CSF, M-CSF, bFGF, VEGF, IL-1ra, sIL-2R. sIL-6R. TNF RI, TNF RII)--ELISA method. Peripheral blood samples from 50 healthy volunteers served as control. Statistical analysis was performed using Kolmogorov-Smirnov and Mann-Whitney U-tests, chi2 test (P < 0.05), where appropriate. For survival analysis the Kaplan-Meier method, log-rank test and multivariate Cox analysis were applied. RESULTS: Alterations of at least one of the standard blood tests were found in 43.4% of all cases. The most frequent alterations were: neutrophilia (28.3% of cases), leukocytosis (27.6%), decreased HGB (25.5%), monocytosis (19.3%) and thrombocytosis (14.5%); they correlated strongly with elevated serum levels of several cytokines and soluble cytokine receptors (particularly: sIL-2R, IL-6, IL-8, M-CSF, VEGF, TNF RI, TNF RII) (P < 0.001). Lymphocytopenia (LY < 1.0) found in 10.3% of patients correlated strongly with increased serum levels of IL-6, sIL-2R, TNF RI. In parallel, we found a significant difference in serum levels of 11 of 13 cytokines (IL-1ra. sIL-2R, IL-6, IL-8, IL-10, TNF RI, TNF RII, TNFalpha, M-CSF, bFGF, VEGF) (P < 0.001) in soft tissue sarcoma patients compared to healthy controls. Hematological alterations were significantly more frequent in patients with advanced tumors. In multivariate analysis we found no prognostic significance of any of the routine blood tests in soft tissue sarcoma patients. CONCLUSION: The results of this study demonstrate that hematological alterations, which occur in over 40% of soft tissue sarcoma cases, are found more frequently in patients with advanced tumors. Strong correlations between the occurrence of hematological abnormalities and elevated serum levels of several cytokines and soluble cytokine receptors, suggest that the former may develop as a result of cytokine misbalance frequently detected in soft tissue sarcoma patients. However, the results of routine blood tests alone are no independent prognostic factor for survival of soft-tissue sarcoma patients.
UI - 11918915
AU - Wurl P; Kappler M; Meye A; Bartel F; Kohler T; Lautenschlager C; Bache
TI - M; Schmidt H; Taubert H Co-expression of survivin and TERT and risk of tumour-related death in patients with soft-tissue sarcoma.
SO - Lancet 2002 Mar 16;359(9310):943-5
Increased expression of survivin has been shown to be a negative predictor of survival in patients with soft-tissue sarcoma. We investigated 89 adults with soft-tissue sarcomas to ascertain the relation between co-expression of survivin and human telomerase reverse transcriptase (TERT) transcripts and prognosis. We quantified mRNA expression of survivin and TERT transcripts. Cox's proportional-hazards regression model showed co-expression of both genes to be a significant negative prognostic factor for patients with stage I to stage IV tumours (p=0 small middle dot0004; relative risk 20 small middle dot1, 95% CI 3 small middle dot8-106 small middle dot4) and for those at stage II and III (p=0 small middle dot0002; 42 small middle dot1, 6 small middle dot0-294 small middle dot9) compared with low expression of both genes. Co-expression of survivin and TERT transcripts identifies patients at high risk of tumour-related death.
UI - 11920533
AU - Kawamura N; Ichimura T; Ito F; Shibata S; Takahashi K; Tsujimura A;
TI - Ishiko O; Haba T; Wakasa K; Ogita S Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma.
SO - Cancer 2002 Mar 15;94(6):1713-20
AD - Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan. firstname.lastname@example.org
BACKGROUND: The clinical differential diagnosis between uterine sarcoma and benign leiomyoma is difficult even with magnetic resonance imaging (MRI). Therefore, a considerable number of patients have undergone hysterectomies due to an indication of "suspected malignancy" based on tumor size alone. However, approximately 80% of these hysterectomies have been judged to have been recommended inappropriately. In such situations, reliable preoperative diagnostic tests are required. The authors have evaluated the accuracy of needle biopsy for uterine myoma-like tumors, a procedure that to the authors' knowledge has been performed infrequently. METHODS: Transcervical needle biopsy was performed in 435 patients with uterine myoma-like tumors. The biopsy specimens were scored for degree of malignancy according to the histopathologic criteria proposed by Bell et al. Histopathologic evaluation of surgical specimens and clinical outcome after 2 years of follow-up were used as the reference standards. RESULTS: Of 435 patients, 7 had uterine sarcomas, 4 of which were scored as > or = 4 points and were diagnosed as "sarcoma" by needle biopsy alone. No sarcoma cases were included in the group of patients with a score of 0. The cutoff score combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was 2; sensitivity, specificity, and positive and negative predictive values were 100%, 98.6%, 58%, and 100.0%, respectively. CONCLUSIONS: Transcervical needle biopsy using histopathologic scoring is a reliable diagnostic test for the differential diagnosis between uterine sarcoma and leiomyoma. This diagnostic method, combined with MRI screening, could reduce the number of patients currently undergoing unnecessary surgery. Copyright 2002 American Cancer Society.
UI - 11920510
AU - Wang J; Weiss LM; Chang KL; Slovak ML; Gaal K; Forman SJ; Arber DA
TI - Diagnostic utility of bilateral bone marrow examination: significance of morphologic and ancillary technique study in malignant.
SO - Cancer 2002 Mar 1;94(5):1522-31
AD - Division of Pathology, City of Hope National Medical Center, Duarte, California 91010, USA.
BACKGROUND: To retrospectively evaluate the significance of morphologic examination and ancillary studies performed on bilateral bone marrow biopsy specimens, 1864 bone marrow samples were studied. METHODS: Bilateral bone marrow biopsy specimens included 883 specimens that were evaluated for involvement by non-Hodgkin lymphoma (NHL); 381 specimens that were evaluated for involvement by carcinoma (CA); 362 specimens that were evaluated for involvement by Hodgkin disease (HD); 94 specimens that were evaluated for involvement by sarcoma (SA); 56 specimens that were evaluated for involvement by multiple myeloma (MM); 53 specimens that were evaluated for involvement by acute and chronic leukemia, myelodysplasia, and/or myeloproliferative disorders (LEUK); and 35 specimens that were evaluated for other reasons. RESULTS: Of all 1864 specimens, 410 samples (22.0%) were positive for disease, including 77% of MM samples, 58% of LEUK samples, 29.6% of NHL samples, 14% of SA samples, 9.9% of HD samples, and 6.8% of CA samples. A discrepancy between the left and right sides was identified in 48 specimens (11.7% of positive samples). The discrepancy rate was 39% for HD samples, 29% for SA samples, 23% for CA samples, and 9.2% for NHL samples. No morphologic discrepancies between bilateral samples were found in MM samples or LEUK samples. Bilateral flow cytometric studies (n = 113 samples) were positive in 11 samples (9.7%; all morphologically positive), with two discrepancies detected between bilateral samples. Bilateral cytogenetic studies (n = 74 samples) were positive in 5 samples (7%), and there were no discrepancies. Bilateral molecular studies (n = 16 samples) were positive in 7 samples (44%), and there were 3 discrepancies. CONCLUSIONS: Bilateral morphologic evaluation is useful in the evaluation of patients with NHL, HD, CA, and SA and is not indicated for patients with acute or chronic leukemia, myelodysplasia, MM, and other diseases. Bilateral flow cytometric or cytogenetic studies of bone marrow did not provide additional information in this population to justify bilateral samples. The role of bilateral molecular analysis needs to be defined further, but pooled samples for molecular studies may be adequate. Copyright 2002 American Cancer Society.
UI - 11920514
AU - Kettelhack C; Wickede M; Vogl T; Schneider U; Hohenberger P
TI - 31Phosphorus-magnetic resonance spectroscopy to assess histologic tumor response noninvasively after isolated limb perfusion for soft tissue tumors.
SO - Cancer 2002 Mar 1;94(5):1557-64
AD - Division of Surgery and Surgical Oncology, Robert Roessle Hospital and Tumor Institute at the Max Delbruck Center for Molecular Medicine, Charite, Campus Berlin-Buch, Humboldt University at Berlin, Berlin, Germany.
BACKGROUND: In patients with unresectable soft tissue sarcoma of the extremities, isolated limb perfusion (ILP) has been reported to result in significant tumor regression enabling limb-sparing resection in the majority of patients. However, clinical tumor response as evaluated by imaging and histopathology (extent of tumor necrosis) often differ significantly. The current study was initiated to evaluate prospectively the role of 31phosphorus-magnetic resonance spectroscopy (31P-MRS) in the noninvasive assessment of histologic response in patients treated with ILP. METHODS: Thirty-two patients with locally advanced and unresectable soft tissue tumors (sarcoma in 28 patients and bulky melanoma in 4 patients) were treated by ILP with recombinant human tumor necrosis factor-alpha and melphalan or with cytostatics. 31P-MRS was performed prior to treatment and at regular intervals after ILP until definite tumor resection. Clinical response parameters according to the World Health Organization as well as the histopathologic necrosis rate of the resection specimen were correlated with changes in the energy-rich phosphorous metabolites phosphocreatine (PCR); alpha-, beta-, gamma-adenosine triphosphate (ATP); phosphomonoesters (PME); and inorganic phosphate (Pi). RESULTS: Clinically, 15 of 32 patients (response rate [RR] of 47%) demonstrated a partial response (PR). The ratios of PME/PCR and PME/beta-ATP decreased significantly after ILP in comparison with preoperative values (P < 0.001). The changes in the PME/beta-ATP ratio were significantly different between clinical responders and nonresponders (P < 0.02) in contrast with the PME/PCR ratios (P < 0.09). Histologic necrosis of > 90% (pathologic (p) PR) was present in 17 resection specimens, 7 of which demonstrated no clinical response. Seven tumors demonstrated a pathologic complete response (pCR). When combining PR, pPR, and pCR (RR of 68%), 31P-MRS was able to predict response with a specificity of 94% and a sensitivity of 68% (P < 0.006, by the chi-square test). CONCLUSIONS: The considerable difference between clinical and pathologic RR after ILP underlines the shortcomings of established response criteria. Utilizing changes in PME/beta-ATP ratios, 31P-MRS is a highly specific tool with which to predict histologic response in this setting. This finding may be of major value in those patients in whom the decision to perform a major resection or amputation must be made for local tumor control. Copyright 2002 American Cancer Society.
UI - 11844053
AU - Samaratunga H; Clarke B; Owen L; Bryson G; Swanson C
TI - Phyllodes tumors of the breast: correlation of nucleolar organizer regions with histopathological malignancy grading, flow cytometric DNA analysis and clinical outcome.
SO - Pathol Int 2001 Nov;51(11):866-73
AD - Department of Anatomical Pathology, Royal Brisbane Hospital, Queensland, Australia. email@example.com
To examine whether nucleolar organizer regions detected by argyrophilia (Ag-NOR counts) can be used as a prognostic indicator in phyllodes tumors of the breast, and to compare its usefulness with that of DNA flow cytometric analysis, 28 cases of breast phyllodes tumors (including 15 benign, two borderline and 11 malignant tumors) were subjected to Ag-NOR staining and counting as well as DNA flow cytometric analysis. S-phase fraction and DNA ploidy analysis showed useful trends for improving outcome predictions in malignant phyllodes tumors. However, high Ag-NOR counts were significant in predicting survival status (P = 0.013) and reached near statistical significance in predicting survival times (P = 0.07). In predicting survival status, results for Ag-NOR counts were significantly better than those for ploidy analysis (P = 0.02) and S-phase fraction (P < 0.01). Only S-phase fraction was significantly predictive of survival times (P = 0.025). It is concluded that Ag-NOR counts and DNA flow cytometric analysis, easily performed using paraffin sections, give information that can improve predictions made by histopathological classification. Ag-NOR counts are significant in predicting survival in the presence of histopathological features of malignancy.
UI - 11844066
AU - Yavuz E; Gulluoglu MG; Akbas N; Tuzlali S; Ilhan R; Iplikci A; Akhan SE
TI - The values of intratumoral mast cell count and Ki-67 immunoreactivity index in differential diagnosis of uterine smooth muscle neoplasms.
SO - Pathol Int 2001 Dec;51(12):938-41
AD - Department of Pathology, Gynecologic Pathology Division, Istanbul Medical Faculty, Istanbul University, Turkey. firstname.lastname@example.org
In this study, the role of the count of intratumoral mast cells was examined and compared with the proliferative activity exhibited by Ki-67 indices in the differential diagnosis of uterine smooth muscle tumors. Sixteen cases of leiomyosarcoma, nine cases of atypical leiomyoma and 16 cases of ordinary leiomyoma were included. The pathological features of the cases were determined by reviewing the archive materials including the patient records and hematoxylin-eosin-stained sections. Toluidine blue stain was used to highlight the intratumoral mast cells and they were counted in at least 40 high power fields. A standard streptavidin-biotin method was applied to the sections to highlight the Ki-67 immunoreactive tumor cell nuclei. These proliferative cells were counted in at least 10 high-power fields. Atypical leiomyomas tended to have a higher quantity of intratumoral mast cells than leiomyosarcomas and ordinary leiomyomas (P = 0.027 and P = 0.021, respectively). Leiomyosarcomas tended to have higher Ki-67 immunoreactivity rates than atypical leiomyomas, although the difference was not statistically significant (P = 0.82). We concluded that the quantity of intratumoral mast cells is useful in the differential diagnosis between leiomyosarcomas and atypical leiomyomas, while the cell proliferation rate expressed by Ki-67 immunoreactivity has a limited value.
UI - 11782672
AU - Salwa-Zurawska W; Biczysko W; Wozniak A; Janicka-Jedynska M; Trejster E
TI - Usefulness of immunohistochemical testing and electron microscopy in the diagnosis of embryonal rhabdomyosarcoma.
SO - Med Sci Monit 2002 Jan;8(1):BR39-46
AD - Department of Clinical Pathomorphology, Medical University, Poznan, Poland.
BACKGROUND: This article presents the results of histological, immunohistochemical, and ultrastructural examinations of embryonal rhabdomyosarcoma. MATERIAL/METHODS: 20 tumors were tested histologically, 13 immunohistochemically, and 5 under electron microscopy. RESULTS: We found that in cases when the entire tumor or large specimens were obtained for estimation, it was possible by examining many areas of the neoplasm to establish a diagnosis on the basis of testing paraffined sections, routinely HE stained. Our evaluation of the value of certain additional histological methods indicated only slight diagnostic usefulness for tumors of this kind. Among the immunohistochemical methods we evaluated, the desmin assay had the greatest practical applicability, due to the fact that this antigen is also expressed in highly immature cells; in second place was myoglobin. Differences are pointed out in the results obtained by assaying myoglobin using DAB and the DAKO kit. Ultrastructural examinations revealed myofilaments of myosin and actin in all types of cells, including immature cells. Particular attention is drawn to the possibility of using material fixed in formalin for ultrastructural examination. The preservation of intact myofilaments in material prepared in this way constitutes an essential diagnostic aid. CONCLUSIONS: In diagnosing embryonal rhabdomyosarcoma the most useful examination, apart from histological examination, is electron microscopy, followed by immunomorphological examination.
UI - 11882765
AU - Stojadinovic A; Leung DH; Hoos A; Jaques DP; Lewis JJ; Brennan MF
TI - Analysis of the prognostic significance of microscopic margins in 2,084 localized primary adult soft tissue sarcomas.
SO - Ann Surg 2002 Mar;235(3):424-34
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
OBJECTIVE: To define the significance of positive microscopic resection margins in a large cohort treated for soft tissue sarcoma. METHODS: The authors analyzed 2,084 patients with localized primary soft tissue sarcoma (all anatomic sites) treated from 1982 to 2000. Clinicopathologic variables studied included tumor site, size, depth, histologic type, grade, and resection margin status. Treatment other than resection was not analyzed. Study endpoints included local and distant recurrence-free and disease-specific survival rates, estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed using the log-rank test and the Cox proportional hazards model. RESULTS: Median follow-up was 50 months. After primary resection, 1,624 (78%) patients had negative and 460 (22%) had positive resection margins. Having positive margins nearly doubled the risk of local recurrence and increased the risk of distant recurrence and disease-related death. Seventy-two percent of patients with positive margins had no recurrence. Resection margin did not predict local control for retroperitoneal sarcomas or fibrosarcomas. Resection margin remained significantly associated with distant recurrence-free survival and disease-specific survival across all subsets after adjusting for other prognostic variables. The overall 5-year disease-specific survival rates for negative and positive margins were 83% and 75%. CONCLUSIONS: Positive microscopic resection margins significantly decrease the local recurrence-free survival rate for other-than-primary fibrosarcoma and retroperitoneal sarcomas, and independently predict distant recurrence-free survival rates and disease-specific survival rates for all patient subsets. Adjuvant therapy should be considered in the management of soft tissue sarcoma to increase local control. Because 72% of positive margins did not equate with inevitable local recurrence, considerable clinical judgment is required in considering additional treatment. Microscopic resection margins should be considered for inclusion in staging systems and treatment algorithms that address local recurrence.
UI - 11895494
AU - Saito T; Oda Y; Sakamoto A; Tamiya S; Iwamoto Y; Tsuneyoshi M
TI - Matrix metalloproteinase-2 expression correlates with morphological and immunohistochemical epithelial characteristics in synovial sarcoma.
SO - Histopathology 2002 Mar;40(3):279-85
AD - Department of Anatomic Pathology, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan.
AIMS: Synovial sarcoma is a unique mesenchymal tumour characterized by the presence of epithelial differentiation, although the mechanism involved in the epithelial morphology is still unclear. The aim of this study was to evaluate the function of matrix metalloproteinase-2 (MMP-2) in synovial sarcoma, in order to assess whether MMP-2 expression plays an important role in epithelial differentiation, or whether it contributes to a poor clinical outcome. METHODS AND RESULTS: Immunohistochemical stainings for MMP-2, cytokeratins (CKs) 7, 8, 18 and 19, and E-cadherin were performed for 58 (44 monophasic and 14 biphasic) cases of synovial sarcoma, and we compared the expression of these proteins with the histological and clinical findings. MMP-2 and E-cadherin expression was observed in 43 cases (74.1%) and in 18 cases (31.0%), respectively. Expression of these proteins was preferentially observed in the glandular components of biphasic tumours or the epithelioid areas of monophasic tumours. Statistically significant correlations were recognized between MMP-2 expression and E-cadherin expression of biphasic subtype. Moreover, there were statistically significant correlations between monophasic tumours with epithelioid areas and MMP-2 expression or E-cadherin expression. MMP-2 expression was correlated with epithelial differentiation as assessed by CK immunoreactivity. The expression of MMP-2 did not affect the overall survival rate in synovial sarcoma. CONCLUSIONS: MMP-2 expression seemed to have an important role to play in the epithelial differentiation of tumour cells in synovial sarcoma, through remodelling of the extracellular matrix and by changing the cytoskeletal interaction between the extracellular matrix and tumour cells.
UI - 11906888
AU - Torreggiani WC; Al-Ismail K; Munk PL; Nicolaou S; O'Connell JX; Knowling
TI - MA Dermatofibrosarcoma protuberans: MR imaging features.
SO - AJR Am J Roentgenol 2002 Apr;178(4):989-93
AD - Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W. 12th Ave., Vancouver, B. C., V5Z 1M9 Canada.
OBJECTIVE: The objective of our study was to describe the MR imaging features of 10 cases of histologically confirmed dermatofibrosarcoma protuberans. CONCLUSION: MR imaging is useful in identifying the extent and location of dermatofibrosarcoma protuberans. Although most cases of this tumor are superficial and well defined, we have shown three cases in which the tumor was in a deep location and one case in which the tumor was ill defined in appearance. Knowledge of the variable MR imaging appearances of these tumors may aid in the diagnosis of difficult or atypical cases.
UI - 11699563
AU - Montesinos-Rongen M; Hans VH; Eis-Hubinger AM; Prinz M; Schaller C; Van
TI - Roost D; Aguzzi A; Wiestler OD; Deckert M Human herpes virus-8 is not associated with primary central nervous system lymphoma in HIV-negative patients.
SO - Acta Neuropathol (Berl) 2001 Nov;102(5):489-95
AD - Abteilung fur Neuropathologie, Universitatsklinikum Koln, Germany. email@example.com
Primary central nervous system lymphomas (PCNSL) are derived from germinal center B cells. Recent molecular studies indicate that the tumor cells or their precursors have experienced antigenic stimulation. Attractive candidates for such antigens are pathogens with the capacity