Completion thyroidectomy for thyroid carcinoma.

We have reviewed the charts of 149 patients who underwent completion thyroidectomies for cancer of the thyroid. The purpose of the study was to evaluate extent of residual disease in the thyroid, and morbidity and mortality of the operation. Residual cancer was found in 58% of the cases, the morbidity was low, and there was no operative mortality.

Natural killer activity and NK cytotoxic factors in peripheral blood and lymph node cells from non-Hodgkin's lymphoma patients.

Natural killer (NK) activity and natural killer cytotoxic factors (NKCF) were found to be depressed in large granular lymphocytes (LGL) from the peripheral blood and lymph node lymphocytes (LNL) from untreated non-Hodgkin's lymphoma (NHL) patients. The LGL number was also reduced in NHL patients as compared to the normal subjects. The depression in all the activities mentioned above showed a correlation with the clinical status of the patients. Exogenous interferon-alpha (IFN-alpha) treatment of the effector cells could augment the NK activity to a comparable extent in normal as well as patient's LNL. The results indicate that the production of interferon may be affected in cases of NHL and therefore it would be worthwhile to test the tolerance and efficacy of IFN-alpha in these patients.

Mucin histochemistry of the upper gastrointestinal tract.

Histochemically differentiated mucins have been studied in the mucosal lining of the esophagus and the stomach. Acid mucin was differentiated from neutral mucin by the alcian blue/PAS technique and sulphomucin by the high iron diamine/alcian blue technique. Neutral mucin secreted normally by the stomach mucosa was replaced by acid mucin in 17 of the 19 mucin secreting adenocarcinomas involving the lower third of the esophagus, and in 24 of the 28 mucin secreting gastric adenocarcinomas studied. The intestinal metaplasia (IM) seen in the gastric mucosa associated with adenocarcinoma, chronic gastric ulcer and chronic gastritis was classified according to the type of mucin secreted by the goblet cells. IM secreting sulphomucins was seen to be associated with gastric adenocarcinoma.

Mucin histochemistry of the lower gastrointestinal tract.

Variations in the mucin secretion pattern in the mucosal lining of the colon and rectum have been studied. Mucins have been differentiated histochemically as neutral mucins, sialomucins and sulphomucins, using alcian blue/PAS and HID/alcian blue techniques. In the normal colonic mucosa, the goblet cells secrete predominantly sulphomucins with small amounts of sialomucins. Twenty one cases with benign lesions showed varying patterns of mucin secretion. In the 35 cases with adenocarcinoma studied, the transitional mucosa adjacent to the lesion showed a reversal of mucin secretion pattern, with an increase in sialomucins and a marked decrease in sulphomucins, suggesting a reaction to neoplasia.

Lectin binding in colorectal mucosa.

Lectin binding of goblet cell mucin in human colonic mucosa was studied in patients with irritable bowel syndrome, colorectal malignancy and ulcerative colitis using plant lectins, Dolichos biflorus agglutinin (DBA) and peanut agglutinin (PNA). Normal colonic mucosa demonstrated a strong binding with DBA (100%) but did not bind to PNA at all. Colonic carcinomas showed strong PNA binding (7 of 15 biopsies) while DBA binding was absent in 14 of 15 biopsies. The transitional mucosa showed reduced or absent DBA binding in 6 and positive PNA binding in 2 of 15 biopsies. During the active phase of ulcerative colitis, there was a loss of DBA binding in 10 of 15 biopsies, which was restored during remission in all. One biopsy with severe dysplasia showed PNA binding. It is concluded that normal colorectal mucosa binds DBA strongly but not PNA. Malignant tissue and transitional mucosa reveal PNA binding often, with decreased DBA binding. In ulcerative colitis DBA binding decreases during phases of activity.

Secondary carcinoma of testis--a clinicopathologic study of 10 cases.

Ten cases of metastatic carcinomas to the testis are recorded in the last 17 years from Tata Memorial Hospital (TMH). There were two from kidney and four each from prostate and gastrointestinal tract carcinomas. The age of the patients ranged from 40 to 82 years with a mean of 57 years. The disease was unilateral in eight cases and bilateral in two. The testicular mass preceded the symptomatology of the primary lesion in a single case. The disease was an incidental finding in three prostatic carcinomas, where bilateral orchidectomy was performed as a therapeutic procedure. Hydrocele was associated in three cases. Grossly the tumour deposits were nodular or diffuse. Microscopically involvement of the interstitial parenchyma, with sparing of the tubular structures of the testis, epididymis and retetestis and special stains for mucin were helpful in the diagnosis. Lymphatic emboli were present in six cases and vascular emboli in three. The spermatic cord was involved in two cases.