This study aimed at assessing the usefulness of paraffin wax sections for demonstration of ER(estrogen receptor) and PR(progesterone receptor), using brief microwave processing rather than proteolytic predigestion. The receptor status of a breast cancer is often into consideration when planning treatment nowadays. As biochemical receptor assays require large amount of fresh tumor tissue and are not always available for all tumors, pathologists are now increasingly asked to provide a service for the assessment of the receptor status in tissue routine sections. Until recently, immunohistochemical demonstration of receptors was used in frozen sections. Therefore, routinely processed paraffin wax sections of 25 cases of breast carcinoma with known ER and PR concentrations, estimated by the standard DCC(dextran-coated charcoal) biochemical assay, were examined using the ABC immunoperoxidase technique. The results were assessed semiquantitably, using a five grade scoring system. Of the 25 cases examined, with DCC cutoff point being <10 fmol,71% and 75% in positivity of each ER, PR receptor is concordant. Statistic analysis demonstrates high relationship between scoring system of IH method and DCC value in ER (R=0.6061, p=0.001) and PR (R=0.5832, p=0.001). The IH method can provide easily assessed reliable positive information about ER, PR status of breast carcinoma using routinely processed paraffin wax sections.
Breast Neoplasms

Pulmonary tumors exhibiting neuroendocrine differentiation are classified as typical carcinoid, atypical carcinoid, and small cell lung carcinoma(SCLC). Travis et al. proposed a fourth category of large cell neuroendocrine carcinoma, which is characterized by light microscopic neuroendocrine appearance, cells of large size, polygonal shape, low nuclear cytoplasmic ratio, coarse nuclear chromatin, with prominent nucleoli high mitotic rate and frequent necrosis; and neuroendocrine features by immunohistochemistry or electron microscopy. High grade neuroendocrine carcinoma (LCAC-NE) revealed aggressive clinical course. We report two cases of neuroendocrine tumors of the lung characterized by a trabecular pattern of large pleomorphic cells with frequent mitoses and wide necrosis. The frequent metastatic sites of atypical carcinoid were liver, bone and brain. One of our case is presented, at first, as an ovarian mass, which shows multifocal rosettes and revealed metastasis from lung. Both cases expressed neuroendocrine differentiation by light microscopy and immunohistochemistry. However clinical neuroendocrine symptom were not present.
Brain ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Chromatin ; Cytoplasm ; Female ; Immunohistochemistry ; Liver ; Lung* ; Microscopy ; Microscopy, Electron ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Ovary

The occurrence of sqamous cell carcinoma arising from epidermal cyst is unusual. A 54-year-old man with soft tissue mass on the back for 25 years presented an infiltrating squamous cell carcinoma within the wall of epidermal cyst. All tissue excised deserved to be examined to be axamined carefully in longterm epidermal cyst.
Male ; Humans ; Cysts

Synovial sarcoma most commonly affects the extremities, especially the lower thigh and knee region. However, a smaller number develops in a central or axial distribution, an area which encompasses the trunk, orofacial, cervical and parapharyngeal regions. The retroperitoneum is an extremely unusual site and has never been recorded in the literature as primary a site for synovial sarcoma. We investigated a case of retroperitoneal synovial sarcoma in a 40-year-old woman. The specimen consisted of fragmented large bulky multinodular masses separated by slit-like spaces. The tumor was 130 gm in weight. Microscopically, the tumor was composed of nests of plump ovoid to polygonal shaped cells and bundles of spindle shaped cells, which had vesicular nuclei and a small amount of cytoplasm. In some areas, there were cleft like spaces and pseudoglandular structures lined by flat or cuboidal cells. Myxoid change, collagen deposition, foci of calcification and osseous metaplasia were also present. Immunohistochemically, the polygonal cells and some of the spindle cells reacted positively for keratin. The spindle cells, especially in the perivascular area were positive for vimentin. S-100 protein and GFAP were negative in both type of cells.
Female ; Humans

A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

Fifty-four adenocarcinomas of stomach were investigated to assess the expression of p21 and p53 using an immunohistochemical method. The relationship between p21 and p53 expression and the clinicopathologic parameters were analysed. The staining pattern of p21/p53 were: p21+/p53+, p21-/p53+, p21+/p53-, and p21-/p53- in 30, 12, 8, and 4 cases, respectively. Loss of p21 expression was observed in 16 of 54 tumor tissues (29%). p21 expression, however, had an inverse correlation with vascular invasion and depth of tumor invasion. The p21 and p53 protein expression showed intratumoral heterogeneity. In 63% of the adenocarcinoma, a proportional relationship was found between p21 and p53 immunostaining. The present results suggest that p53 independent induction of p21 expression may be involved in the molecular mechanism of these tumors, and expression of p21 protein may be related to a favorable prognosis in gastric adenocarcinomas.
Adenocarcinoma* ; Immunohistochemistry ; Population Characteristics ; Prognosis ; Stomach

Monoclonal antibody(TCM-9) against human thyroid cancers have been studied by screening with human thyroid cancers, normal and benign thyroid tissue, and normal human serum protein. A monoclonal antibody(TCM-9) that is known to have strong specificity for human thyroid cancer but not for Graves' disease, adenoma or normal thyroid does not bind to native or mature human thyroglobulin(Tg). We used to TCM-9 antibody by immunohistochemical staining on 5 follicular cancer, 2 follicular adenoma, 1 follicular neoplasm with suspicious invasion, 2 papillary cancer to ascer- tain being of help in differentiation between follicular carcinoma and adenoma. Reactivity of TCM-9 was observed in follicular carcinoma and papillary carcinoma but not observed in follicular adenoma. Thus TCM-9 is a novel monoclonal antibody against the thyroid cancer.
Adenoma ; Carcinoma, Papillary ; Graves Disease ; Humans ; Mass Screening ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms

A 25-year-old 7 month pregnant woman with mitral stenosis was hospitalized because of life threatening hemoptysis dispite intensive medical treatment. Emergency mitral commissurotomy resulted in prompt cessation of hemorrhage and at nine months follows-up, the hemoptysis has not recurred. Mitral valve surgery appears to be consitently associated with rapid and sustained cessation of hemoptysis. Therefore, surgery should be considered in hemoptysis due to mitral stenosis, particulary when the danger of asphyxiation exists.
Adult ; Emergencies* ; Female ; Hemoptysis* ; Hemorrhage ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Pregnant Women

PURPOSE: To determine whether the expression of DNA topoisomerase II and P-glycoprotein are of prognostic value. MATERIALS AND METHODS: We evaluated the expression of DNA topoisomerase II and P-glycoprotein immunohistochemically in a retrospective study of samples from 44 patients with breast cancer. Thirty two among 44 patients (72.7%) received chemotherapeutic treatments (CMF or FAC protocol) and/or tamoxifen postoperatively. RESULTS: P-glycoprotein was detected in the 27 samples of 44 patients (61.3%). The expression of P-glycoprotein was increased in the patients older than 50 years, with distant metastases, and with death on follow-up. DNA topoisomerase II was detected in the 34 samples of 44 patients (77.2%). The expression of topoisomerase II was increased in the patients younger than 50 years, with recurrent tumor, with distant metastases, and with death on follow-up. The expression of P-glycoprotein and topoisomerase II was not correlated with other clinico-pathological factors including the size of primary tumor, involvement of lymph node, histologic grade, and clinical stage. The correlation between expression of P-glycoprotein and topoisomerase II was not significant. CONCLUSION: The immunohistochemical evaluation of P-glycoprotein and topoisomerase II before treatment in breast cancer has little clinical prognostic value.
Breast Neoplasms* ; Breast* ; DNA Topoisomerases, Type I* ; DNA Topoisomerases, Type II* ; DNA* ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; P-Glycoprotein* ; Retrospective Studies ; Tamoxifen

Coronary artery steonosis can be effectively treated by non-operative percutaneous tansluminal coronaryangioplasty(PTCA). We performed PTCA in three patients with coronary artery stenosis, who were referred to thedepartment of radiology, from January to Dec. in 1985. The results were as follows; 1. The locations of coronaryartery stenosis were the proximal anterior descending branch of left coronary artery. 2. The number of stenoticlesions was single without calcium plaque in all three cases. 3. The extent of coronary artery disease is focal,under 2cm in length. 4. PTCA was performed successfully with satisfactory post-dilatation results in all cases. 5.Severe complications such as arterial intimal dissection, acute myocardial infarction, did not occurred. PTCA hasmany advantages over vascular surgery on surgical, economical, and psychological aspects.
Angioplasty, Balloon, Coronary ; Calcium ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Myocardial Infarction