A morphologic analysis of the cells of ductal carcinoma of the breast and of adenocarcinoma of the ovary in pleural and abdominal effusions

The cells in serous effusions from 14 cases of histologically proven ductal adenocarcinoma of the breast and from an equal number of proven adenocarcinomas of the ovary were morphologically analyzed, with quantitative values assigned to various cell parameters. The resulting data were then subjected to stepwise discriminant analysis. The presence of coarse chromatin proved to be the most significant discriminating factor, resulting in a correct classification of 100% of the mammary carcinomas (14 of 14) and 71.4% (10 of 14) of the ovarian carcinomas, for an overall rate of 85.7% correct classifications. When combined with other cell parameters, such as the presence of polygonal cells, multiple nucleoli and an isolated cell arrangement, the accuracy rate increased to 92.9% correct classifications. Ovarian carcinoma was more likely to have coarse chromatin and to occur in three-dimensional cell groups, in contrast to mammary carcinoma, which tended to have fine chromatin and more polygonal cell shapes and to occur more commonly in syncytial cell groups and as isolated cells.

Chemotherapy of drug-resistant ovarian cancer: a Southwest Oncology Group Study

We present a final analysis, including pathology review, of a cooperative group study of drug-resistant ovarian cancer. Of 200 patients registered, 112 were eligible and evaluable, with a response rate of 26% and median survival of 7 months. Because these results are poorer than those reported in the preliminary and interim analyses of this study, we scrutinized the 88 excluded patients, most of whom failed to meet our strict pathologic criteria for a diagnosis of ovarian cancer of epithelial type, and who, as a heterogeneous group, fared better than patients who did meet the eligibility criteria. We believe this analysis provides insight into the spectrum of diseases that are frequently called ovarian cancer, but might be more properly labeled abdominal carcinomatosis.

Gas-liquid chromatographic analysis of fluoropyrimidine nucleosides and fluorouracil in plasma and urine

A gas-liquid chromatographic method employing on-column alkylation and a nitrogen-sensitive detector was developed for the analysis of 5-fluoro-2'-deoxyuridine, 5-fluorouridine, and 5-fluorouracil in plasma and urine. Samples (0.72 ml) containing the fluoropyrimidine and internal standard (5-chloro-2'-deoxyuridine for nucleoside analyses and 6-methyluracil for 5-fluorouracil analyses) were prepared for gas-liquid chromatography by sequential cation-exchange and anion-exchange column chromatography. Recoveries of fluoropyrimidines were 71-95% over the concentration ranges studied. The dried eluate from the anion-exchange column was dissolved in p-tolyltrimethylammonium hydroxide in methanol before gas-liquid chromatographic analysis. Columns packed with either 3% SP-2100 on Supelcoport or 3% OV-1 on Gas-Chrom Q were suitable for nucleoside analyses; a column packed with 0.75% Carbowax 20M-5% KOH on Chromsorb G was used for 5-fluorouracil analyses. The fluoropyrimidine nucleosides were well separated from each other and from the potentially interfering endogenous compounds 2'-deoxyuridine and uridine; 5-fluorouracil was well separated from uracil. Linear standard curves (peak area ratio method) were obtained for plasma containing 0.025 to 20 micrograms FdUrd (0.1 to 81 microM) or 0.05 to 1.0 microgram FUrd (0.2 to 3.8 microM), and for urine containing 0.2 to 1.0 microgram (0.8 to about 4 microM) of the nucleosides. Standard curves for 5-fluorouracil (1.5 to 7.9 microM) and 2'-deoxyuridine (0.9 to 4.4 microM) were also linear. A measurable amount of 5-fluorouracil, equivalent to 4 to 7% of the 5-fluoro-2'-deoxyuridine injected, was formed from the nucleoside on the gas-liquid chromatographic column, requiring correction of 5-fluorouracil concentrations measured in the presence of 5-fluoro-2'-deoxyuridine.

Inferior vena caval replacement after resection of left renal tumor in canine model

An animal model simulating the necessity of replacing the inferior vena cava (IVC) with a prosthetic graft is described. Six dogs underwent replacement of the IVC with an expanded polytetrafluoroethylene (E-PTFE) graft using an interrupted-suture technique. Three dogs served as controls, undergoing resection and autograft of the native IVC. Distal side-to-side femoral arteriovenous fistulas were constructed in each case and allowed to remain for six weeks. Subcutaneous heparin and prophylactic antibiotics were administered in the early postoperative period. All grafts were patent at six months, indicating a potentially successful technique for reconstruction of the IVC involved in disease or trauma.

Thymic carcinoid tumor with Cushing's syndrome. Report of a case with electron microscopic and immunoperoxidase studies for neuron-specific enolase and corticotropin

A partially encapsulated, 11-cm-diameter anterior mediastinal mass was resected from a 26-year-old man who appeared with signs and symptoms of Cushing's syndrome. Electron microscopic study disclosed cytoplasmic neurosecretory granules and positive immunoperoxidase reactions for neuron-specific enolase and corticotropin in the tumor cells. A lymph node metastasis was detected 11/2 years after the operation. It appears that a thymic carcinoid tumor is a specific entity.

Muscular hamartoma of the breast. An electron microscopic study

A rare case of muscular hamartoma of the breast was presented. An electron microscopic study confirmed that the proliferating spindle cells were of smooth muscle cell origin.

The primary hamster kidney cell rabies vaccine: adaptation of viral strain, production of vaccine, and pre- and postexposure treatment

The hamster kidney cell rabies vaccine was investigated as a substitute for classical nervous tissue rabies vaccine. The Beijing strain of fixed rabies virus was adapted to primary hamster kidney cells (PHKCs), and four types of rabies vaccine (plain, adjuvant, concentrated, and concentrated adjuvant vaccines) were developed for human use. The potencies of the vaccines met the requirements of the World Health Organization, and these vaccines elicited rather satisfactory antibody responses in volunteers. The postexposure use of vaccine was evaluated in 301 individuals, 97 of whom had been bitten by proven rabid animals. None of the individuals contracted rabies during the observation period. After several years of field trials with both pre- and postexposure vaccines, the evidence indicates that the PHKC rabies vaccines are effective and safe for human use.

Studies of a human mesothelioma

Abdominal fluid from a patient with mesothelioma was cultured in vitro, and a cell line designated JMN was established. This cell line has undergone more than 100 passages. Electron microscopic, karyotypic, and heterotransplantation studies as well as the capability of collagen synthesis by this cell line indicated that it is of malignant mesothelial origin. The cell line has proved very useful for the isolation of human pathogenic viruses.

Computed tomographic mammography using a conventional body scanner

The technique for computed tomographic (CT) examination of the breasts using a conventional body scanner is described, and experience with 67 patients is reported. In the diagnosis of both malignant and benign breast lesions, the results with a body scanner were equal to those of a dedicated CT/M mammographic unit. Although the CT study of the breast cannot replace conventional mammography in screening or in routine diagnostic workup, the unique capability of demonstrating both anatomic changes and increased iodide concentration in a cancer provides many advantages over conventional mammography. CT mammography appears to have the capability to detect breast cancers that are occult to other methods. Indications for a CT study of the breasts are: (1) clinically suspected breast cancer, especially with a mammographically occult lesion; (2) questionable mammographic findings, including microcalcifications, tumor shape, architectural distortion, and uncertain lesion location; and (3) evaluation of postbiopsy or postlumpectomy breast cancers when a primary irradiation therapy is contemplated. Breast CT also appears to be a valuable diagnostic tool in searching for a second primary breast cancer, follow-up study of postirradiation of breast cancer, followup study for postmastectomy patients, and screening procedure for genetically high-risk patients, especially those with dense breasts.

The variable manifestations of extraarticular synovial chondromatosis

Clinically, patients with extraarticular synovial chondromatosis are seen with a juxtaarticular mass due to metaplasia of synovial cells and subsequent formation of cartilaginous nodules. Three patients are described to illustrate the varied clinical and radiographic features of this disease. One patient had involvement of the knee and wrist while another had involvement of the knee along with presumed intraarticular synovial chondromatosis of the elbow. The third patient had a solitary finger lesion. Routine radiographs in extraarticular synovial chondromatosis demonstrate either solitary or multiple calcified juxtaarticular masses with chondroid matrix. Bone scintigraphy reveals intense radionuclide uptake within the calcified masses. Computed tomography clearly defines the extent of the lesion. Arthrography can evaluate for intraarticular extension.

Cytologic diagnosis of gliomatosis cerebri

Malignant cells were found in the cerebrospinal fluid of an elderly woman with a clinically confusing neurologic disease that was recognized as gliomatosis cerebri at autopsy. The usefulness of cerebrospinal fluid cytology in the antemortem diagnosis of this unusual brain tumor is discussed.

Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast

If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.