[Primary apudomas of the liver]. / Pervichnye apudomy pecheni.

The literature data on primary liver apudomas with the discussion of their histogenesis, structure, endocrine activity and immunohistochemistry, 36 hepato- and cholangiocarcinomas are studied among which a group of poorly differentiated "atypical" tumours (9 cases) is distinguished. Large areas of endocrine-cell differentiation represented by solid, trabecular and alveolar structures consisting of small lymphocytoid cells or big cells with eosinophil cytoplasm and numerous sinusoid vessels were observed in these tumours. Cytoplasm of these cells contained argyrophylic granules in variable quantity. It is suggested that a certain part of primary liver apudomas is mistaking considered as poorly differentiated "atypical" hepato- or cholangiocarcinomas.

[Primary neuroendocrine carcinoma of the skin: histologic, immunohistochemical and ultrastructural study of a case with highly aggressive biological behavior]. / Carcinoma neuroendocrino primitivo della cute: studio istologico, immunoistochimico ed ultrastrutturale di un caso a comportamento biologico altamente aggressivo.

We report a histological, immunohistochemical and ultrastructural study of a case of neuroendocrine carcinoma of the skin, which occurred in a 52 years old woman in the dermal, subcutis and soft tissues of the left buttock. Clinically this neoplasm, which was related to intramuscular injections and a to a following abscess, had rapidly reached unusual dimension compared with other cases of neuroendocrine carcinoma of the skin reported in the literature. The patient died three months after presentation with distant metastases. A variable percentage of the neoplastic cells was positive for low molecular weight cytokeratins (CK), neurofilaments (NF), neuron specific enolase (NSE) and occasionally for vaso-intestinal polypeptide (VIP). Ultrastructural investigations showed two types of neoplastic cells, identified for some features of the nucleus and of the cytoplasm; these two groups of cells are, in our opinion, related to different stages of cellular development. Our results, in agreement with some observations reported in the literature, give evidence of a possible origin of neuroendocrine carcinoma of the skin from an undifferentiated cell which is capable of neuroendocrine or ectodermal differentiation.

[C-cells (parafollicular) and medullary cancer of the thyroid gland]. / C-kletki (parafollikuliarnye) i medulliarnyi rak shchitovidnoi zhelezy.

In the human thyroid gland, less than 1% of the cell mass of the organ parenchyma is comprised of C-cells, the typical feature of which is the capacity of produce and accumulate a hypocalcemic hormone, calcitonin. Because of their function, these cells play an important role in the maintenance of homeostasis. Neoplastic proliferation of C-cells results in medullary carcinoma represented by the classical forms and non-medullary apudomas. Morphological, histochemical, and electron microscopic studies demonstrated cytological and histological inhomogeneity of thyroid apudomas and allowed the differential diagnosis criteria for their identification to be outlined.

The diffuse neuroendocrine (APUD) system.

The bulk of experimental evidence indicates that the APUD series of cells is a distinct system based upon common pathophysiological features. The diffuse nature of this system with elements in the central and peripheral nervous system suggests a more complex interaction of the body's homeostasis than has been established. It is probable that as radioimmunological and radioenzymatic assays become more widely available and standardized, other apudomas will be described. Finally, an understanding of the APUD concept, with its peculiar pluripotential for the production of biogenic amines and peptides, the multicentric nature of the disease and the possibility of multiple cell involvement, is of key importance in managing patients. Studies of the apudomas will also advance the understanding of the normal physiologic interrelationships of the APUD cells.

[Cutaneous symptoms of carcinoid tumours of the small bowel (author's transl)]. / Les manifestations cutanées des carcinoïdes du grêle.

Cutaneous symptoms of carcinoid tumours are classified in 4 groups: --Acute type: flusch and vasomotor signs (the caracters of which are described). --Chronic type: telangiectasia, hyperpigmentation, sclerodermia-like, cutaneous maetastasis. --Rare type with non-diagnostic sign. --Types in association with other dermatological conditions either unrelated disease or with a likely related disease such as phacomatosis. Dermatological diagnosis is generally easy as cutaneous symptoms is concomitant with metastatic tumours and increased levels of serotonin and 5-H.I.A. The carcinoid syndrom may take place in the concept of the tumours of the A.P.U.D. system on clinical, embryological, histological and biochemical basis.