Study of immunohistochemical expression of insulin-like growth factor I and proliferating cell nuclear antigen in thyroid gland papillary carcinoma and its metastasis.

BACKGROUND: Several tumor factors are associated with papillary thyroid cancer. Most studies do not compare the expressions of these factors in the primary tumors and in their associated cervical metastasis. METHODS: Paraffin sections of 20 patients with papillary carcinoma of the thyroid gland with lymph node metastasis were studied. The presence and distribution of insulin-like growth factor I (IGF-I) and proliferating cell nuclear antigen (PCNA) was analyzed, through immunohistochemical technique, in both primaries and lymph node metastasis. The results were correlated with clinical-pathologic data (sex, age, size of primary, multicentricity, thyroid capsule invasion, lymphatic and blood vessels invasion, development of distant metastasis, and associated thyroid diseases). RESULTS: The qualitative analysis showed the reaction for IGF-I was present in more than 90% of the neoplastic cells in both primaries and lymph node metastasis. No correlation with the clinical-pathological features was observed. Regarding the PCNA, the mean percentage of nuclei stained showed no statistical difference between primaries and metastasis (p = 0.598). Except for age, clinicopathologic data had no influence on the mean percentage of nuclei stained. A correlation was verified between the percentage of cells stained by PCNA in primary tumors and the patients' age (p < 0. 01). CONCLUSIONS: The expressions of these tumor factors are equally intense for both primary and metastatic tissue in papillary thyroid cancer. Despite the small size of the sample, the expressions of IGF-I and PCNA could not be associated to clinical-pathologic features, except for the age. As patients over 40 years old had higher expression of PCNA, this marker may have prognostic significance for patients with papillary thyroid cancer.

p53 in epidermoid cancer of the esophagus.

BACKGROUND/AIMS: Wild type p53 protein has an inhibitory effect on cell proliferation and transformation. Mutation or deletion of the p53 gene can be the first point of malignancy. Abnormalities of the p53 protein gene have been linked with tumors of the esophagus. METHODOLOGY: In this study, we investigated the expression of the p53 gene in epidermoid carcinoma of the esophagus as well as in the basal layer near the tumor. We studied the expression of p53 in 24 esophageal tumors and in normal esophageal tissue near the tumor in 16 cases, using an immunohistochemical reaction. RESULTS: p53 was positive in 18 esophageal tumors (75%) and in 15 of the 16 (94%) normal samples of esophageal tissue. There was no correlation between expression of the p53 gene and age, sex, tobacco intake, alcoholism, and familiar history of cancer or clinical stage of the disease. The mean survival of the p53 patients (negative or positive) was similar. CONCLUSIONS: p53 accumulation was found in most cases of esophageal cancer as well as in samples of normal tissue close to the tumor. The positivity of p53 seems to be independent of clinical or pathological parameters and was not of any use in predicting prognosis in our study.

How should PCNA be assessed? Total of stained cells or only the most intensely stained ones?

OBJECTIVE: This study aimed to analyse whether a marker of proliferative activity (PCNA) could provide a prognosis of tumor evolution and to determine whether different interpretation criteria could alter the results. METHOD: The presence of PCNA in 59 patients of state II (T2 N0.1 M0) mammary carcinoma was determined. RESULT: Numerical proportions of total and intensely stained cells were established. These data were compared with anatomopathological parameters. A significant association between higher cyclin values and worse histological and nuclear grading was encountered, particularly in patients with a "negative axilla" using the PCNA index. Cyclin values were not significant in relation to any parameters when indices from the intensely stained cells were considered exclusively. CONCLUSION: Higher nuclear (NG3) and histological (HGIII) grading, associated with a high PCNA index (> 50), distinguish high-risk patients, and it is more appropriate considering all the stained cells as representative of PCNA indices, thus reflecting tumor aggressiveness.

Granulocytic sarcoma presented as a reactivation of chronic myeloid leukemia after allogenic marrow transplantation.

The authors report the case of a chronic myeloid leukemia (CML) patient submitted to allogenic bone marrow transplantation, who had probably never entered complete remission. The disease was reactivated as a granulocytic sarcoma, next to a platinum plate installed to correct a tibia fracture 11 years earlier. Its final event was a myeloid Ph1 + blastic crisis that was unsuccessfully treated with high doses of sc interferon and citarabine.

Immunohistochemical demonstration of insulin-like growth factor I (IGF-1) in normal and pathological human pituitary glands.

The authors have studied the presence and distribution of Insulin-Like-Growth-Factor-1 (IGF-1) in 5 autopsied normal and 20 surgically removed human pituitary adenomas, employing a peroxidase-anti-peroxidase method. IGF-1 could be demonstrated in all cases, with variation of cells immunostaining from 60% in normal pituitary gland to 100% in corticotroph cell adenoma.

[Primary brain neoplasms associated with vascular malformations: anatomo-pathologic study of 2 cases]. / Neoplasias cerebrais primárias associadas a malformações vasculares: estudo anatomopatológico de dois casos.

The association of intracerebral vascular malformations and primary cerebral neoplasm is rare. The most commonly found vascular malformation with neoplasm is intracranial arterial aneurysm. We describe two cases of vascular malformations associated with primary cerebral neoplasms, with histologic and immunohistochemical studies.

Human papillomavirus DNA in respiratory papillomatosis detected by in situ hybridization and the polymerase chain reaction.

The authors have demonstrated the presence of human papillomavirus (HPV) types 6 and 11 in 10 of 13 (77%) juvenile laryngeal papillomatosis by in situ DNA hybridization using as probes the radiolabeled DNAs of HPVs 6, 11, 16, and 18. Of six specimens from adult laryngeal papillomatosis assayed by the same technique, only 33% were positive. Immunohistochemistry to detect HPV capsid antigens performed on serial sections gave positive signals in 44% (8 of 18) of the specimens, all from juvenile lesions. These results were in agreement with in situ hybridization, except in two cases. When both series (juvenile and adult) were analysed by amplification of a 450-bp fragment corresponding to the L1 ORF of the HPV genomes directed by the polymerase chain reaction, the frequency of positive specimens rose to 100%. Our data agree with the concept that HPV is implicated in the etiology of laryngeal papillomatosis.

[Relation of hepatitis B virus markers in the serum and hepatic tissue in chronic carriers of HBsAg]. / Relação entre marcadores do vírus da hepatite B (VHB) no soro e no tecido hepático em pacientes portadores crônicos do HBsAg.

The authors studied 23 chronic carriers of HBsAg, to classify them in terms of serology, histopathologic findings and behaviour of markers HBsAg and HBcAg in hepatic tissue. Immunohistochemical techniques were used to establish possible relations between these parameters. Among patients with positive HBeAg found all exhibited HBcAg in hepatic tissue, but in 16 patients in which HBeAg was negative, liver HBcAg was positive in 3 cases (18.7%). No correlation was found between the HBeAg system/anti-HBe and histopathologic findings because chronic active hepatitis was observed in 6/8 anti-HBe positive patients (75%). These findings suggest that, the evaluation of chronic carriers of HBsAg, requires a histologic analysis of the liver, including a tissue research for the virus in addition to a complete serologic study of HBV.

Lymphoplasmacytic lymphoma. A clinicopathologic study of a previously unrecognized composite variant.

Six cases are reported of a previously undescribed unusual composite variant of lymphoplasmacytic lymphoma that is not readily classifiable by either the Rappaport or the Lukes and Collins classifications, or by the recently proposed Working Formulation. These cases are characterized by a partly nodular, partly diffuse proliferation of lymphoid cells surrounded by a separate, zonally distinct proliferation of large plasmacytoid cells. The latter cells are located in medullary and paracortical areas in lymph nodes and in the marginal zone of the white pulp and in the red pulp in the spleen. This distinct zonal characteristic was noted in the small bowel as well in one case. Five of our six patients were male, and their ages ranged from 46 to 68 years. Three had a monoclonal serum IgM and one had hyperglobulinemia that was not further characterized. Three had evidence of an altered immune state. In all cases, monoclonal IgM was demonstrated in involved tissues by an immunoperoxidase technique. These cases are unusual because of the unique topographic segregation of the varying types of tumor cells in all cases, and because of the association of paraproteinemia with nodular lymphoma in three. The resemblance of this tumor to the plasma cell variant of giant lymph node hyperplasia with which two cases were originally confused, and to lymph nodes in patients with autoimmune diseases, may be responsible for its lack of recognition.