Pulmonary vein myxoid leiomyosarcoma.

A case of myxoid leiomyosarcoma located in the right pulmonary veins is presented. The patient complained of progressive dyspnea, orthopnea, sputum cruentum and right chest pain. Angiography revealed an obliteration of right pulmonary veins by a tumor mass that expanded into the left atrium. Histologically, the lesion contained densely packed fusiform cell areas that alternated with other much less cellular and richer in interstitial myxoid matrix. The tumor cells showed specific immunoreactivity to desmin antibodies and contained abundant thin filaments with focal densities and micropinocytic vesicles.

Nuclear planimetry in renal-cell tumors.

A morphometric study using conventional planimetry was carried out in 73 renal-cell tumors (64 adenocarcinomas and 9 adenomas) in order to correlate the objective nuclear measurements with some histologic and clinical data believed to have prognostic value. The use of a discriminant function to correctly separate adenomas and low-grade adenocarcinomas was also investigated. There was a strong association between the nuclear grade and the following parameters: nuclear area, nuclear major diameter and nuclear elongation. There was also a relationship between an adverse outcome and the major nuclear diameter and nuclear elongation. In a univariate survival analysis, only the clinicopathologic stage, the nuclear grade and the histologic presence of a pseudosarcomatous cell population had predictive value. Multivariate survival analysis using Cox models showed that the clinicopathologic stage, major nuclear diameter, presence of anaplastic cells and nuclear area had predictive value. Although the minor nuclear diameter reached a significant level, a discriminant function that would correctly separate adenomas and low-grade renal-cell carcinomas could not be formulated.

Cytophotometric DNA measurements in medullary thyroid carcinoma.

The prognostic significance of objectively measured karyometric variables (ploidy pattern, nuclear roundness, area, elongation, chromatin texture, and nearest nucleus distance) was investigated in relation to clinical (stage and type of disease) and morphologic (histologic patterns) variables in 27 patients with the diagnosis of medullary thyroid carcinoma (MTC). The DNA and karyometric measurements of Feulgen-stained nuclei were made with a video cytometry system. The five-year and ten-year adjusted survival rates were 74.4 +/- 10.1% and 59.5 +/- 15.6%, respectively. Cox's survival analysis for mortality showed that only stage, age, sex, and 5N exceeding rate had predictive value (overall P = 0.0012) in decreasing order. Patients with the best prognosis were young females with clinical Stage I disease and low 5N exceeding rate tumors. When karyometric and histometric variables were considered by themselves survival correlates with the standard deviation (SD) of the nearest nuclear distance and nuclear elongation; that is, patients with crowded, high cellularity tumors and elongated cells had the worst prognosis. In univariate analyses only clinical stage correlated with adjusted survival rate. Multivariate survival analysis for morbidity showed that patients in Stages greater than or equal to II and high SD of ploidy values were free of symptoms for short intervals. When morphometric data were considered alone, patients with high variance in the chromatin texture and highly variable nuclear areas had shorter asymptomatic intervals.

Lectin histochemistry of the thyroid gland.

The authors carried out a histochemical study with lectins (Ulex europaeus agglutinin-I [UEA-I], Triticum vulgaris [WGA], Glycine max [SBA], Dolichos biflorus [DBA], and Arachis hypogaea [PNA]) in different thyroid gland conditions (17 benign nodular goiters, three diffuse hyperplasias, five Hashimoto's thyroiditis, 20 follicular adenomas, 14 well-differentiated papillary carcinomas, five well-differentiated follicular carcinomas, and 30 normal thyroids) in order to determine if specific lectin patterns are developed during neoplastic transformation. The results showed that (1) in normal thyroid glands, the lectin, UEA-I, is able to discriminate between follicular cells and C-cells; (2) pathologic follicular epithelium had an increased expression of UEA-I, SBA, and WGA receptors; (3) no lectin or group of lectins allow a distinction between follicular carcinoma and papillary carcinoma; (4) when benign and malignant tumors are compared for UEA-I affinity there is a significantly greater frequency of malignant tumour with UEA-I receptor; and (5) although all investigated lectins have shown receptors in endothelial cells at least in one case, the most constant findings have been obtained with UEA-I and WGA. These findings suggest that lectins are not useful in routine diagnostic pathologic examination; however, in particular cases of follicular carcinoma, UEA-I may be a useful tool for the recognition of small vessels invaded by tumoral cells and the demonstration of fucose residues in malignant tumor cells.