Metastatic disease in the breast from nonmammary neoplasms.

Breast cancer is the leading cause of death from cancer in women. The metastatic involvement of the breast from nonmammary neoplasms is a relatively rare condition. Female patients are affected five to six times more frequently than male patients. We present seven patients with metastasis in the breast from extramammary tumors. Females seemed to be more frequently affected (6 women and 1 man) and included a wide range of ages (17-70 years old). All female patients had suspicious-looking abnormalities (B1-RADS 4) or lesions highly suspicious of malignancy (BI-RADS 5) in the mammography, without a confirmative fine needle aspiration cytology. The primary malignancies were equally distributed between non-hematological (1 renal adenocarcinoma, 1 melanoma, 1 leiomyosarcoma) and hematological (1 non-Hodgkin's, 2 Hodgkin's lymphomas and 1 leukemia). Treatment is therefore modified, taking into consideration the treatment and prognosis of the primary disease.

Altered leukocyte delivery to specific and nonspecific inflammatory skin lesions following burn injury.

This study assessed the effect of burn trauma on the in vivo leukocyte cell delivery during the first 24 hr of the delayed type hypersensitivity (DTH) skin test reaction and a bacterial skin abscess. Inbred male Lewis rats sensitized to keyhole limpet hemocyanin (KLH) were given a 30% scald burn or sham burn. Three days later the animals were injected intradermally, at different sites, with 0.3 mg of KLH, 10(8) organisms of S. aureus 502A, and 0.1 cc of saline, at 2 to 24 hr. Leukocytes labelled with Indium111 oxine(leu111) were injected intravenously. In sham rats the peak leu111 influx in the DTH reaction occurred at 2-4 hr while in the abscess it was biphasic with peaks at 3 hr and 6-8 hr. In burn trauma rats there was a markedly increased leu111 peak at 2 hr in both the DTH and abscess reactions followed by a significantly lower than normal leu111 delivery in the late (6-24) hours. This marked early leukocyte influx in burned rats was paralleled by a reduced DTH skin test lesion (8.2 +/- 1.1 mm to 4.2 +/- 1.1 mm) and an increased bacterial abscess (5.1 +/- 1.1 mm to 8.1 +/- 0.9 mm) post burn. There was a direct correlation between leukocyte cell delivery to a DTH reaction and a bacterial abscess (r8 = 0.69, Spearman rank; p less than 0.001). We conclude that burn trauma results in altered leukocyte delivery to inflammatory lesions and the DTH response can be used to assess the ability of a burn trauma host to recruit leukocytes at a site of infection.

The influence of long-term protein deprivation on in vivo phagocytic cell delivery to inflammatory lesions.

The effect of long-term protein deprivation and refeeding was assessed on the in vivo delivery of phagocytic leukocytes (PHAGS) to delayed-type hypersensitivity (DTH) reaction and a bacterial abscess. Male inbred Lewis rats sensitized to keyhole limpet hemocyanin (KLH) were fed either a normal diet or a 2% protein diet for 1, 6, and 10 weeks. Two additional groups were fed a 2% protein diet for 10 weeks but were refed with a normal diet for 1 or 4 weeks. At the end of each diet period rats were injected intradermally with KLH, Staphylococcus aureus 502A, and saline solution at different sites at from 1 to 24 hours. Technetium-99m-colloid labeled PHAGS (99PHAG) were injected intravenously and used to assess in vivo PHAG cell delivery. In normally fed rats the peak influx of 99PHAG was at 2 to 4 hours. After 1 week of protein-deficient diet there was a significant drop in early (2 to 4 hours) 99PHAG influx to both the DTH and bacterial reactions. After 10 weeks of protein deprivation (severe malnutrition) there was a further drop and a delay in the peak 99PHAG influx (from 2 to 4 hours, to 8 hours). A return to normal 99PHAG influx occurred only after 4 weeks of refeeding, and it coincided with a return to normal body weight and a normal DTH reaction. There was a direct correlation between total 99PHAG delivery to a DTH reaction and a bacterial abscess (rs = 0.87, Spearman rank; p less than 0.001). We conclude that both moderate and severe protein deprivation is associated with reduced in vivo phagocytic cell delivery to both a DTH reaction and a bacterial skin abscess, which can be restored with refeeding.