It is important to predict the prognosis of patient with cancer. Well known parameters predicting the prognosis are staged and degree of differentiation. Recently, the prognostic and diagnostic significance of silver-stained nucleolar organizer regions(Ag-NORs) and flow cytometric DNA analysis are introduced. This study aims to detect the diagnostic significance of Ag-NORs in breast lesions, and to correlate the number of Ag-NORs and cellular ploidies in breast carcinoma. In addition, the existence of heterogeneity according to the sample in the same patient is studied Sixty six paraffin blocks(two primary lesions and the two metastatic lymph nodes in 13 patients, and one primary lesion and one metastatic lymph node I 10 patients) of breast carcinoma, 30 paraffin blocks of fibroadenoma and 23 paraffin blocks of normal breast are studied. The numbe of Ag-NORs increase from normal breast(mean 1.45) through fibroadenoma(mean 1.60) to carcinoma(mean 2.43). It was significantly different between each lsions(P<0.0005). The number of Ag-NORs increased in the aneuploidy carcinoma than that in the euploidy one(P<0.05). But, there was difference between the number of Ag-NORs and DNA index according to the sample area in the same patient with carcinoma. In conclusion, the number of Ag-NORs is diagnostically significant in breast lesions and is correlated with cellular ploidies in breast carcinoma. In addition, Ag-NORs and cellular ploidies are heterogenous in the same patient.
Neoplasm Metastasis

No abstract available.
Neoplasm Metastasis*

No abstract available.
Neoplasm Metastasis*

Gastrointestinal stromal tumors are notorious for their unpredictable clinical behavior. To assess the cellular proliferating activities, four different methods were used: mitotic count, nucleolar organizer region(AgNOR) staining, immunostaining of proliferating cell nuclear antigen (PCNA) and DNA ploidy were used on 39 cases of gastrointestinal stromal tumors. Additionally, we analysed cellularity, cellular atypism and necrosis. Among 39 cases of gastrointestinal stromal tumors, 11 cases were diagnosed as benign lesions according to clinicopathologic findings. Malignant lesions were arbitrarily classified into low grade(n=ll) and high grade(n=17) on the basis of absence or presence of recurrence, metastasis or tumor-related death during the follow-up period. Numbers of mitosis, AgNORs, PCNA index and DNA ploidy were correlated with grades of tumor and prognosis. Among them, AgNORs counting appeared to be the most useful in predicting prognosis. Numbers of mitosis, PCNA index and DNA ploidy showed varying degrees of overlap among the 3 groups. Among the histological parameters, cellular atypia showed some relationship with the prognosis that others did not reveal.
Neoplasm Metastasis

Seventy five cases of squamous cell carcinoma of the uterine cervix, invasion depth of which was less than 5 mm from the basement membrane, were reviewed during a period of 9 years from 1975 to 1983 at SNUH and investigated clinicopathologically by the following items; 1) lymphnode metastasis 2) vascular invasion 3) recurrence 4) pattern of invasion 5) cell type. Following results were obtained. 1) Lmyphnode metastasis was demonstrated in 4 out of 75 cases (5.3%). One of them had stromal invasion to 1.3 mm and the other three to a depth of 3.1 to 5.0 mm. 2) Vascular invasion was seen in 5 among the cases (6.7%) and well related to the depth of invasion. Vascular invasion did not occur in tumors with 3 mm depth of stromal invasion. 3) Three patients were with recurrence, treated by postoperative radiation. The depth of stromal invasion was over 2 mm in all of them. 4) The pattern of invasion was confluent in 26 out of 28 cases (92%) whose stromal invasion were over 2 mm depth, while only 3 confluency of 27 cases (11%) invaded less than 1 mm depth. 5) There was no good relationship between the tumor cell type and the depth of stromal invasion. Based on the above results, it is concluded that diagnostic criteria of microinvasive squamous cell carcinoma of the uterine cervix is stromal invasion not exceeding a depth of 3 mm from basement membrane of surface or glandular epithelium.
Neoplasm Metastasis

Tumor angiogenesis(TA) refers to the growth of new vessels toward and within a tumor. TA is necessary both at the beginning and at the end of the metastatic cascade of events. Recently, experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis. To investigate how tumor angiogenesis correlates with metastases in breast carcinoma, the microvessels were counted (per 200 / field) in the most active areas of neovas-cularization by two investigators. The microvessels within breast carcinoma were highlighted by in imunohistochemical staining for factor VIII-related antigen. Microvessel count(MVC) in node-positive carcinoma(59.66=35) was significantly higher than in node-negative carcinoma(44.76=17)(p=0.009). MVC was also statistically correlated with tumor size and stage, but not with histologic grading, DNA ploidy, or hormonal receptors(estro-gen and progesterone). MVC in invasive breast carcinoma may be one of many prognostic predictors of node-positive breast carcinoma. Assessment of tumor angiogenesis may therefore be valuable in selecting patients with early breast carcinoma for aggressive therapy.
Neoplasm Metastasis

Synovial sarcoma is one of the most common malignant soft tissue tumors in paraarticular regions. However, it is very rare to occur without any apparent relationship to synovial or articular structures. We report a case of synovial sarcoma manifested as a subcutaneous nodule in the upper lip. A 12-year-old boy complained of a palpable tender mass in the upper lip for several months. Under the impression of a benign soft tissue neoplasm, surgical excision was done. The mass, 1.5 cm in maximum diameter, was easily separated from surrounding tissues. Microscopically, this tumor showed a characteristic biphasic pattern of synovial sarcoma. On immunohistochemical and ultrastructural studies, the tumor cells showed evidence of epithelial differentiation. There was no evidence of joint-related, primary lesions or metastatic foci. This report describes a case of synovial sarcoma arising in very unusual location and size for histologically typical synovial sarcoma.
Neoplasm Metastasis

Fine needle aspiration cytologic findings of four cases of chondrosarcoma were described. The cases consisted of one primary scapular tumor, two recurrent shoulder masses, and right upper quadrant mass which developed after an A-K amputation for an unknown tumor. The aspirates characteristically revealed cell-rich smears containing clusters and isolated cells having abundant cyanophilic cytoplasm and round to oval or elongated vesicular nuclei. The cytoplasm was occasionally foamy. The nuclei were usually small but prominent. Nuclear atypism and pleomorphism were frequently associated. The last case showed epithelioid sheets of polygonal cells, possibly representing chondroblasts, and a well differentiated chondroid element. The fine needle aspiration could be a good diagnostic tool for primary, recurrent, and metastatic chondrosarcomas.
Neoplasm Metastasis

Fine needle aspiration cytologic findings of four cases of chondrosarcoma were described. The cases consisted of one primary scapular tumor, two recurrent shoulder masses, and right upper quadrant mass which developed after an A-K amputation for an unknown tumor. The aspirates characteristically revealed cell-rich smears containing clusters and isolated cells having abundant cyanophilic cytoplasm and round to oval or elongated vesicular nuclei. The cytoplasm was occasionally foamy. The nuclei were usually small but prominent. Nuclear atypism and pleomorphism were frequently associated. The last case showed epithelioid sheets of polygonal cells, possibly representing chondroblasts, and a well differentiated chondroid element. The fine needle aspiration could be a good diagnostic tool for primary, recurrent, and metastatic chondrosarcomas.
Neoplasm Metastasis

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis