[A case of disseminated intravascular coagulation--a paraneoplastic manifestation of a borderline ovarian tumor]. / Consideratii asupra unui caz de coagulare intravasculara diseminata (CID)--manifestare paraneoplazica a unei tumori ovariene de granita.

A 24-year-old-woman was admitted because of disseminated intravascular coagulation (DIC), menometrorrhagia and galactorrhea. The investigations performed showed a right adnexal tumor after the equilibration of DIC with plasma substitution, we performed a right adnexectomy with limited excision of peritoneal. The pathologic examination showed a focus of endometriosis on the right ovary who had a polycystic look and a right adnexal fibromyxoma (premalignant lesion). The post operative evolution was good, with the loss of entire onco-hemato-endocrinologic picture. We describe the interrelation between DIC (paraneoplastic syndrome), menometrorrhagia and galactorrhea, the pathologic hypothesis and the treatment of DIC.

Esophageal tumor with an unusual histological appearance: a case report.

An unusual esophageal tumor in a 58-year-old man complaining of dysphagia and weight loss is herein described. Esophageal radioscopy and endoscopy visualized a huge polypoid tumor which was occluding the esophagus. After esophageal resection, the histological examination revealed miscellaneous benign cells (squamous, columnar fat cells, cartilaginous cells, and glandular structures) and two different malignant areas (spindler sarcomatous cells and squamous cells). There was no malignant invasion in the stalk, in the adjacent esophageal wall, or in the periesophageal tissue, and there were no malignant adenopathies. The postoperative course was favorable for one year, until the patient developed pain in the right superior back. A sarcomatous relapse was diagnosed by fine-needle biopsy under CT guidance, and the patient subsequently received radiation therapy.

Glutathione S-transferase activity in human breast tumors.

The level of total glutathione S-transferase (GST) activity was examined in forty-three breast carcinomas (forty tumors from previously untreated patients and three tumors from patients previously treated by chemotherapy), and thirteen benign breast tumors. Cytosolic GST activity was determined according to a spectrophotometric method. Using Student's t-test, significant differences were found between GST levels in these two groups of tumors (p < 0.01). The higher values were found in malignant tumors. The range of values in both malignant and benign tumors was very wide. The relationship between GST activity and hormone receptor status was examined in thirty-three cases for estrogen receptor (ER) status, and thirty-one cases for progesterone receptor (PR) status. The level of hormonal receptors was determined according to the dextran-charcoal technique. No significant difference between the mean levels of GST activity in ER+ and ER-tumors was found (p > 0.4), but the difference corresponding to PR+ and PR-tumors approximated the 1% level of significance. The relationship between total GST activity and clinical or pathological parameters was also studied. Significant difference was found between the mean levels of GST activity corresponding to the groups of patients with non-involved nodes, and those having one or more involved nodes, respectively (p < 0.05). No correlation was found with respect to age (p > 0.2), tumor size (p > 0.2), or tumor grade (p > 0.4). Increased levels of GST activity were found in PR-tumors and in tumors with involved axillary nodes. Both groups of tumors are known to have a poorer prognosis. It was concluded that the significance of GST activity as an additional marker of prognosis must be taken into consideration.

[The criteria and place of limited surgery in treating breast cancer]. / Criteriile si locul chirurgiei limitate în tratamentul cancerului mamar.

The evolution of conceptions regarding the treatment of "operable" mammary cancer has balanced during the past 25 years between amputation of the mamma and non-mutilating treatments. The main achievements concerning the evolution of this site of cancer, as well as the selection criteria for a limited operation, such as they result from the literature and from the studies performed by the authors, are pointed out. These criteria, although numerous, should be very rigorously observed. The cooperation surgeon-radiotherapist-anatomo-pathologist is absolutely compulsory. Authors report 16 cases of women with mammary cancer, in 9 of whom the criteria were carried out. The results obtained are for the time being favourable but as the group is very small, definitive conclusions cannot be drawn.

Relationships of steroid hormone receptors, age and histological characteristics in human breast cancer.

A number of 178 human primary mammary carcinomas were evaluated for estradiol receptor (ER) content, patients' age, histologic type, tumor histological grade of differentiation and content of elastosis. For a subset of 78 cases progesterone receptor (PR) was also assayed. ER positivity was significantly elevated in patients over 50 years while PR positivity rate was increased in patients under 50; ER-positive-PR-positive (ER + PR +) cases were evenly distributed among age groups. Correlations of ER and PR with histological features revealed that: a) high levels of ER were found in lobular, cribriform and colloid carcinomas; b) ER+ cases but not PR+ tumors were more frequent in well differentiated tumors; c) ER+, PR+ and ER+ +PR+ tumors were strongly related to the presence of elastosis; d) contrasting with ER-PR+ tumors, ER+ PR+ cases were associated with features indicative of a favorable prognosis. It is concluded that the determination of ER and PR in mammary malignant tumors brings information regarding the evolution of breast cancer in human patients and the biology of malignant mammary cells.

Cytoenzymologic investigations on carcinomas of the cervix uteri.

A study was carried out on 85 patients with lesions of the cervix uteri: 45 carcinomas and 40 dysplasias. A large battery of cytoenzymatic tests was used to determine their potential value in the diagnosis of carcinomas. An increase of LDH, G6PDH, 6PGDH and NADH2-TR activities and a loss of alpha-GP-ase I activity were demonstrated in malignant cells. It is suggested that the cytoenzymologic techniques may offer help in the distinction between normal, dyskaryotic and malignant cells of vaginal fluid. In individual patients these techniques are useful in understanding the evolution of dysplastic lesions and in the diagnosis of carcinoma. These techniques, however, cannot be used as a general screening test for malignancy.

Histochemical patterns in human breast tumours.

Histochemical investigations carried out on 104 breast tumours (10 benign proliferations and 94 carcinomas) showed that breast carcinomas were characterized by various enzymological equipments in relation to tumour differentiation degree, histogenesis, functional stage, site of tumour cells in the carcinomatous islands or cords and to hormonal factors. Tumour cells -- stroma interrelationships study pointed out that high glycolysis (high LDH, NADPH2-TR, NADH2-TR activities) and an intense LEPA-activity of tumour cells seem to be favourable for proliferation and local tumour cells migration.

Morphological study of the thymus of Jensen tumor-bearing rats after tumoral, non-tumoral antigens and thiamine diphosphate administration.

The morphological changes produced in the thymus of Jensen tumor-bearing rats after specific immune stimulation (glycoprotein 8 obtained from Jensen tumor, bovine serumalbumin (BSA), tuberculoprotein, gylcoprotein 5 from normal rat blood) and after non-specific one (thiamine diphosphate (TDP)) were studied. The changes produced by associating the antigenic action and TDP were reviewed, too. Morphological investigations were preformed 24 hours and 7 days after beginning of treatments. Twenty-four hours and 7 days after specific (tuberculoprotein and BSA) or non-specific (TDP) stimulation, similar morphologic changes were observed in the thymus: vasodilatation, thymocyte agglomeration in perivascular sheaths and their intravascular migration. When TDP was associated with gylcoprotein 8 or tuberculin - PPD more pronounced morphological modifications were observed 24 hours after treatment, while associating it with glycoprotein 5 or BSA obvious changes have been produced after 7 days. Gylcoprotein 5 and 8 did not induced any modifications in the thymus structure.

Histochemical manifestations of early and late changes induced by Aflatoxin in rats.

Wistar rats were intraperitoneally treated with different doses of Aflatoxin B1 (5 and 7 mg/kg body weight) and sacrificed after various periods (6, 24, 48, 72 h, 5, 6, 7, 8, 9, 10 days and 86, 96, 97 weeks) in an attempt to detect liver, lung, intestine, spleen, mesenteric lymph nodes alterations. There are histochemical indications to suggest early liver changes for both doses in carbohydrates metabolism (decreasing of: polysaccharides, acid and neutral mucopolysaccharides, LD activity diffusely distributed through the all lobule). After 86, 96, 97 weeks from Aflatoxin administration, hepatocytes alterations rendered evident by fat accumulations, depletion or loss of polysaccharides, acid and neutral mucopolysaccharides, loss of cytoplasmic enzymes activities, altered pattern of surface ATP-ase are associated with diffuse fibrosis. The findings are suggestive that liver alterations are depending on dose and duration of exposure and could be detected by histochemical methods before significant morphological changes appear.

Morphological study of rat thymus after tumoral, non-tumoral antigens and thiamine pyrophosphate administration.

The study was performed on 60 Wistar white rats sacrificed 24 hours and 7 days after administration of glycoprotein 8 (extracted from Jensen rat tumors), glycoprotein 5 (from normal rat blood), bovine albumin, tuberculin (PPD), and a complex of strychnine, picrotoxin and TPP administered alone or together with the above-mentioned antigens. In order to study thymus morphological changes, methods of quantitative morphology and current histological techniques were used. The thymus responds morphologically to the antigenic administration - (glycoprotein 8, bovine albumin and PPD) - by cortico-medullary ratio modification, expressed by decrease of cortical surface and increase of medullary one, thymocytes agglomeration in the perivascular sheaths and their deliverance in the blood flow. Under other conditions (strychnine, picrotoxin and TPP administration) thymus responds only by thymocytes agglomeration in the perivascular sheaths. Glycoprotein 5 does not induce any modifications in thymus structure.