Treatment of advanced dermatofibrosarcoma protuberans with imatinib mesylate with or without surgical resection.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma of the skin characterized by the presence of specific COL1A1-PDGFB fusion protein, which appears as a consequence of the t(17;22) (q22;q13) translocation. OBJECTIVE: The aim of the study was to perform an analysis of patients with advanced DFSP treated with imatinib, with or without surgery, in clinical practice outside trials. PATIENTS AND METHODS: We analysed the data of 15 patients (6 male, 9 female; median age 56 years) with locally advanced/initially inoperable and/or metastatic DFSP treated with imatinib 400-800 mg daily between 12/2004 and 06/2009. All diagnoses were ascertained cytogenetically (fluorescent in situ hybridization). Median follow-up time was 16 months (range: 4-81). RESULTS: Metastases were present in six cases (two lungs, two soft tissue, two lymph nodes). Fibrosarcomatous transformation (FS-DFSP) was confirmed in seven patients (47%). A 2-year progression-free survival (PFS) rate was 60%, and a 2-year overall survival (OS) rate was 78% (median time for PFS/OS was not reached). The best overall responses were: 10 partial responses (67%, including 5 FS-DFSP-1 progressed during the follow-up), 2 stable diseases (13%) and 3 progressive diseases (20%). Seven patients (47%) underwent resection of residual disease and remained free of disease. CONCLUSIONS: We have confirmed the profound anti-tumour effect of imatinib in DFSP harbouring t(17;22) with long-term responses. Imatinib therapy may in some cases lead to tumour resectability of lesser disfiguration.

Clonal chromosome aberrations with monosomy of chromosome 8 in a case of grade III chondrosarcoma.

We report cytogenetic findings in a case of grade III chondrosarcoma. Complex clonal chromosome aberrations including monosomy of chromosomes 4, 8, 13, and a consistent t(5;14)(q23;p12) were observed in all cells. There were no structural or numerical anomalies involving chromosome 12. The complexity of the chromosome aberrations reflect the advanced stage of this chondrosarcoma; we suggest a possible involvement of the EXT1 gene located on chromosome 8.

Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in reactive and neoplastic lymphoid cells.

We have studied the expression of gelatinase A, gelatinase B, interstitial collagenase, tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 in reactive lymphoid cells, as well as in a series of cell lines derived from neoplasms of B- and T-cell lineage. Using both Northern blot analysis and zymography, gelatinase B activity was detected by zymography in two Burkitt cell lines and in a tonsillar cell suspension, while gelatinase A and interstitial collagenase activities were not detected by either method. TIMP-1 expression was demonstrated by Northern blot analysis in the multipotential neoplastic K-562 cell line, the high grade Burkitt's B-cell lymphoma lines, isolated tonsillar B cells and at low levels in peripheral blood T cells, but was not expressed in any of the neoplastic T-cell lines or isolated peripheral blood B cells. In contrast, TIMP-2 expression was restricted to tissues containing cells of T-cell lineage with high levels being observed in the neoplastic T-cell lines and lower levels in normal peripheral blood T cells and hyperplastic tonsil. Expression of TIMP-1 and TIMP-2 was confirmed at the protein level by reverse zymography and immunofluorescence assays using antihuman TIMP polyclonal antibodies. Expression of gelatinase B by the high grade B-cell Burkitt's lymphoma cell lines is consistent with previous findings in large cell immunoblastic lymphomas and indicates that this enzyme may play an important role in high grade non-Hodgkin's lymphomas. TIMP expression correlated with cell lineage in that TIMP-1 was primarily observed in B cells and TIMP-2 was restricted to T cells.

Upper airway obstruction in a woman with AIDS-related laryngeal Kaposi's sarcoma.

Kaposi's sarcoma rarely causes upper airway obstruction. In the only two previously reported cases, both patients were men who died of hemorrhage shortly after tracheostomy. We describe a 45-year-old woman with AIDS who presented with stridor secondary to Kaposi's sarcoma of the larynx. To our knowledge, this is the first report of this presentation in a woman and the first reported patient with Kaposi's sarcoma to survive tracheostomy.

[Cases of granular cell tumor (myoblastoma) in the larynx]. / W sprawie granular cell tumor (myoblastoma) krtani.

Two patients suffering from very rare granular cell tumor of the larynx were observed at the ENT Department of Medical School in Szczecin in the period 1986 to 1990. In one case the tumor located in the intra-arythenoid region was treated by tyreotomy. In the second case the tumor contained comisura anterior and cricothyreoidea region and was resected by subglottic laryngectomy. The functional results of the treatment were satisfactory.

[Molecular-genetic evaluation of translocation of bcl-2 gene and locus bcl-1 in selected lymphoproliferative changes]. / Molekularno-genetyczna ocena przemieszczen genu bcl-2 i locus bcl-1 w wybranych zmianach limfoproliferacyjnych.

In the work it has been decided to evaluate the occurrence of locus bcl-1 rearrangement in type B chronic lymphatic leukemia and that of gene bcl-2 in non-Hodgkin's lymphoma with diffuse morphology, as well as in reactive lymph nodes. The study material comprised DNA isolated from fragments of lymph nodes sent for routine diagnostic examinations at the Institute of Pathology--Pomeranian Medical Academy. Southern's method was used to examine DNA having been cut with restrictive enzymes, estimating the distribution of gene bcl-2 and locus bcl-1. Resorting to Polymerase Chain Reaction (PCR) translocation t (14;18) was assessed by means of short nucleotides hybridizing with 14 and 18 chromosome sequences restricting this translocation. The amplification product was subsequently studied by Southern's method with probe bcl-2. In 1 out of 18 examined cases of type B chronic lymphocyte leukemia it was disclosed that locus bcl-1 had been rearranged. In 45 cases of non-Hodgkin's lymphoma with diffuse morphology the gen bcl-2 was found to display germline arrangement. Germline position of gen bcl-2 was also revealed in 60 cases of reactive lymph nodes.

Germ line configuration of the BCL-2 major breakpoint region in hyperplastic lymph nodes.

The configuration of the BCL-2 major breakpoint region was analyzed by Southern blot hybridization and polymerase chain reaction amplification in DNA derived from 44 benign hyperplastic lymph nodes with follicular overgrowth. None of the cases exhibited translocation of the BCL-2 gene at the major breakpoint region of chromosome 18. The potential usefulness of molecular genetic detection of BCL-2 translocation in the differential diagnosis between hyperplastic lymph nodes and lymphomas is suggested.

[Evaluation of rearrangement of immunoglobulin genes and T cell receptors in determining low numbers of leukemic in children with acute lymphoblastic leukemia]. / Ocena przemieszczen genów immunoglobulinowych i receptorów limfocytów T w wykrywaniu sladowej liczby komórek nowotworowych u dzieci z ostra bialaczka limfoblastyczna.

The samples from blood and/or bone marrow were analysed in 7 children at the time of initial diagnosis or relapse and in 9 children with clinical and hematologic remission of ALL. Molecular genetic methods were more sensitive than morphologic ones in leukemic cells detection: 5 children in remission of ALL demonstrated gene rearrangements. Clinical significance of the presence of low numbers of leukemic cells in remissions is still unknown.

Gene rearrangements detected by nonradioactive digoxigenin-labeled DNA probes.

The configurations of immunoglobulin, T-cell receptor beta chain and bcl-2 genes were analyzed in lympho-proliferative disorders using nonradioactive digoxigenin-labeled probes. The studies demonstrated the reliability of digoxigenin-labeled probes for the detection of single-copy genes after Southern blotting of genomic DNA: 1 microgram and sometimes even 0.2 microgram of restriction endonuclease-digested DNA could be detected either by JH, C beta or bcl-2 probes. The intensity of the signal was consistently satisfactory, and there was no background problem. Control experiments showed neither false-positive nor false-negative results caused by the use of the nonradioactive detection system.