Unilateral balsalazide-induced eosinophilic pneumonia in an ulcerative colitis patient.

We report a case of unilateral eosinophilic pneumonia secondary to balsalazide monotherapy for ulcerative colitis. After commencing balsalazide, the patient presented with a history of cough, progressive dyspnoea and lethargy. Blood counts revealed peripheral eosinophilia. Her chest radiograph showed left-sided infiltration, and high-resolution computerised tomography demonstrated widespread nodular shadowing and ground glass opacifiction in the left lung. The right lung was normal. Transbronchial lung biopsy confirmed eosinophilic pneumonia. There was rapid clinical and radiological improvement after with-drawing balsalazide. Drug-induced eosinophilic pneumonia has been described with mesalazine and sulfasalazine, but no case reports of balsalazide-induced eosinophilic pneumonitis have been found.

Fibrosarcoma arising in an ovarian mucinous tumor: a case report.

A case of an ovarian mucinous tumor with a mural nodule is reported. The mucinous tumor was solid and cystic and contained benign, borderline and malignant elements. Within the solid area a nodule representing fibrosarcoma was identified. Mucocoele of the appendix was the other finding in this case. To the best of our knowledge this is the first description of fibrosarcoma arising in an ovarian cystadenocarcinoma.

Heterogeneity of oestrogen receptor expression in normal and malignant breast tissue.

The heterogeneity of oestrogen receptor (ER) expression has been examined in both normal and malignant breast tissue using an immunohistochemical assay. In both instances the ER status and cellular ER negativity were influenced by the patients' menopausal status, with tissues removed from premenopausal women being more often ER-negative, and when ER-positive, containing a high proportion of apparently ER-negative cells. Since the breast is normally regarded as hormone sensitive and since tumour cell ER negativity is apparently under a degree of hormonal regulation, our results suggest that the proportion of breast cancer cells that are ER-negative should be viewed with a degree of caution.

Lack of expression of P-glycoprotein in 7 small cell lung cancer cell lines established both from untreated and from treated patients.

The establishment and characterisation of 7 small cell lung cancer cell lines is described. Four cell lines were established from biopsies taken from untreated patients and one of these was from primary tumour taken via the fibreoptic bronchoscope. The other three were from biopsies taken from patients who had relapsed after chemotherapy. All grow as non-adherent aggregates of cell and express a range of neuroendocrine and epithelial features characteristics of small cell lung cancer cell lines. No relationship was observed between the characteristics of the cell line in vitro and the treatment status of the patient from whom the biopsy was taken. Furthermore, none of the cell lines expressed p-glycoprotein even though 3 were derived from relapse biopsies where chemotherapy included drugs associated with the multidrug resistance phenotype.

Influence of the antioestrogen tamoxifen on normal breast tissue.

Immunohistochemical assays have been employed to study the expression of ER, PgR, EGFR and Ki67 immunostaining in normal breast tissue (n = 76). The expression of ER and PgR was highly variable in both pre and postmenopausal women and was characterised by large numbers of apparently negative cells. This was most evident for ER-ICA staining in tissues removed from premenopausal women. PgR levels were highest in the ducts of premenopausal women, while EGFR expression was elevated in both ducts and lobules. Ki67 expression was observed in less than 10% of all normal cells and was suppressed by the menopause in lobular tissue. Tamoxifen therapy (40 mg d-1) did not influence the expression of PgR, EGFR or Ki67 immunostaining in cancer associated normal tissue (n = 17). A significant increase, however, was observed in the mean percentage ER positivity in ductal tissue. No effect of duration of tamoxifen therapy was observed on the expression of the antigens studied.

Genesis of breast cancer is in the premenopause.

In Britain and other high-risk countries, about a third of patients with breast cancer are premenopausal at diagnosis. In the remainder, tumour initiation might have occurred in the premenopause, even though the clinical presentation was late in life. This possibility has important implications for breast cancer prevention and screening. The relations between the patient's age and tumour kinetics, prognosis, oestrogen receptors, and environmental X-ray carcinogenesis were studied, together with the age-related protection afforded by pregnancy. The findings support the hypothesis that breast cancer is initiated in the premenopause.

Combined plasmacytoma and squamous cell carcinoma.

A 63-year-old man was admitted to the Cardiothoracic Department of Glasgow Royal Infirmary for surgical treatment of a left suprahilar opacity. A left pneumonectomy was required to deal with an extensive upper lobe tumor. Histopathological examination, in addition to a moderately well-differentiated squamous cell carcinoma, revealed the presence of a band-like infiltrate of plasma cells and lymphoplasmacytoid cells at the main bronchial resection margin. Immunohistochemical studies confirmed this to be an extramedullary plasmacytoma by showing IgA and kappa positive monotypic cells. No paraprotein was detected in the serum. The value of immunohistochemistry in the differential diagnosis has been emphasized.

Immunocytochemical demonstration and significance of p21 ras family oncogene product in benign and malignant breast disease.

It has been suggested that the immunocytochemical demonstration of the p21 ras oncogene product is a useful marker of malignancy in breast disease. We have studied the reactivity of a series of specimens of benign and malignant breast disease with the anti ras p21 monoclonal antibody Y13-259, and shown widespread positive staining in both benign and malignant (including metastatic) disease as well as in adjacent 'normal' epithelium. In addition some staining of stromal cells as well as nerve fibres was observed. Our results suggest that the presence of ras p21 protein as demonstrated by this antibody is not a useful marker of malignancy or of proliferating epithelium but is rather a normal feature of certain cell types.

A critical investigation of the Oxford tumour marker Ca1 in the histological diagnosis of breast cancer and pre-cancer.

Ca1 antibody reacted focally with all of the 20 cancers examined, but also with 12 out of 13 fibroadenomata and with each of 20 normal breasts. These observations indicate that there are severe limitations to the use of Ca1 antibody for defining benign versus malignant processes. Ca1 is most specific in terms of the cytoplasmic staining of tumours versus normal tissues. If a hierarchy of maximal staining is drawn up, cancers and fibroadenomata appear at the top, with normal tissue found in various types of breast in the middle, and non-neoplastic lesion such as epitheliosis, hyperplasia and apocrine change at the bottom of the hierarchy. There is a growing list of non-cancerous tissues which show reactivity to Ca1. In July 1983 this list numbered about 15. The designation 'Ca' is inappropriate.