[An autopsy case of extramural malignant leiomyoblastoma of the stomach with ovarian cancer: an immunohistochemical study].

The subject was an 85-year-old woman, who had been diagnosed as having an ovarian cancer and carcinomatous peritonitis and had been treated conservatively. She subsequently died from respiratory and renal insufficiency, and the autopsy that followed revealed that her pelvic cavity had been filled by a tumorous mass that size of a child's head. Histologically, the tumor was a serous cystadenocarcinoma of the ovary. Moreover another tumor, also the approximate size of a child's head, was found sited extramurally, beneath the posterior wall mucosa of the stomach body. Histological inspection of this tumor revealed a proliferation of round oval, and spindle-shaped tumor cells. A vacuolation of the cytoplasms and karyomitosis to the extent of 10/50 HPF also were observed. Based on the findings of being positive for Vimentin and a negative EMA, this tumor was diagnosed as being a malignant leiomyoblastoma of the stomach smooth muscle. The leioblastoma is a relatively uncommon neoplasm, and recent advances in immunohistochemical staining have indicated that some of these tumors are not only of smooth muscle derivation but also of nerve origin. Therefore, this tumor, given its morphological characteristics, had been generalized in this case as a gastric stromal tumor, and with negative findings for Desmin and S-100 protein, as well as positive for Vimentin.

Human type VI collagen: isolation and characterization of alpha 1 and alpha 2 chains by two-dimensional preparative gel electrophoresis.

Two 140 kDa collagenous glycoproteins were isolated from 5 M guanidinium chloride extracts of human uterine leiomyoma by two-dimensional preparative gel electrophoresis. The glycoproteins represented the major concanavalin A binding fraction of the extract and were also present in adult human skin. On two-dimensional gel electrophoresis the glycoproteins appeared as elongated spots, indicating variations of their isoelectric points from 5 to 6. These glycoproteins were disulfide-bonded components of high molecular mass protein and, after reduction, became sensitive to collagenase treatment that generated peptides corresponding in size to those of the noncollagenous domains of type VI collagen. Antisera raised against these purified glycoproteins reacted with either pepsin-derived alpha 1(VI) or pepsin-derived alpha 2(VI) chains but not with alpha 3(VI) chain of human type VI collagen. Reciprocally, these glycoproteins reacted with monoclonal antibodies against type VI collagen. These results indicate that the glycoproteins represent the integral alpha 1 and alpha 2 chains of type VI collagen. The globular domains of alpha 1(VI) and alpha 2(VI) chains remaining after collagenase treatment appeared on two-dimensional gel electrophoresis as elongated spots, suggesting that the noncollagenous portions determine the well known microheterogeneity of the molecule. The differences in isoelectric points between and within alpha chains may facilitate the formation of microfibrillar network.

Antígeno prostático específico como marcador tumoral prostático: análisis de resultados en 206 pacientes / Prostatic specific antigen as tumoral prostatic marker: analysis of results in 206 patients

Se presentan los resultados encontrados en 206 pacientes a los que se les hizo determinación de Antígeno Prostático Específico (APE), como parte de una evaluación Prostática. De ellos se obtuvo estudio histológico en 109, haciéndose una correlación de los resultados de la biopsia con los hallazgos de APE. Hubo 57 pacientes con Hiperplasia Prostática Benigna (HPB), 36 pacientes con Adenocarcinoma de la próstata (ADC); 15 casos con diagnóstico de Prostatitis, y en un paciente se hizo el diagnóstico de Leiomioma. Cuando el APE arroja valores entre 0 y 10 ng/ml, no es posible utilizarlo como elemento de diagnóstico diferencial entre HPB y ADC, por no haber diferencias importantes en estos valores. No así cuando las cifras están por encima de 15ng/ml, cuando se hacen evidentemente mayores en los pacientes con ADC. Los enfermos con HPB, portadores de sonda permanente presentan valores de APE muy elevados que pueden confundir con la presencia de un ADC. El APE es de gran utilidad en el manejo de pre y post operatorio de los pacientes de Prostatectomia Radical. Consideramos que es un procedimiento de gran utilidad en el dignóstico y tratamiento del ADC de próstata, pero de ninguna manera como medio único, sino en conjunto con los demas procedimientos existentes

Endocrine profile associated with estrogen and progesterone receptors in leiomyoma and normal myometrium.

In leiomyoma and normal myometrium estrogen receptors act independently at low or high levels of the normal serum steroid range in the menstrual cycle. It might be an inherent characteristic of leiomyomas, which results in their progressive growth in the absence of any abnormal stimulation. In the secretory phase of the menstrual cycle, serum progesterone suppresses estrogen receptor concentrations in leiomyoma. In the present study serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) showed direct as well as inverse correlations with estrogen and progesterone receptors in different phases of the menstrual cycle.

Decreased beta-carotene tissue levels in uterine leiomyomas and cancers of reproductive and nonreproductive organs.

The dietary importance of beta-carotene as a factor in health maintenance has recently attracted considerable interest. Previously, total carotene content was estimated in a limited number of human tissues by means of spectrophotometric methods. In this study the levels of beta-carotene were measured by high-pressure liquid chromatography in tissue samples of uterine leiomyomas and adjacent normal myometrium obtained at hysterectomy from uteri of 18 patients. beta-Carotene concentration was significantly (p = 0.0013) lower in fibroid tissue than in normal myometrium. In addition, levels of beta-carotene were assayed in tissue samples of cancers of the cervix, endometrium, ovary, breast, colon, lung, liver, and rectum and were compared with levels of respective adjacent normal sites. The concentrations of beta-carotene were found to be lower in all cancer tissues. The decreased levels of beta-carotene suggest that beta-carotene deficiency may have a role in the cause and/or pathogenesis of leiomyomas and cancers of the organs that were investigated. The mechanism of action, however, remains unknown.

Myofibromatosis in adults (adult counterpart of infantile myofibromatosis).

Five solitary, benign, soft-tissue tumors histologically resembling infantile myofibromatosis but which occurred in adults were found among more than 5,000 benign soft-tissue tumors from a tumor registry. The tumors clinically presented as superficial, painless, and slowly enlarging nodules, usually of more than 10 years' duration, that occurred in the upper (two cases) and lower (two cases) extremities or the buccal mucosa (one case). They developed in the dermis and subcutis as well-circumscribed nodules with an average diameter of 1.2 cm. They were composed of discrete and confluent fibrous tissue with a mixture of bundles of smooth muscle-like cells and a hemangiopericytoma-like area of immature mesenchymal cells. Immunostaining for actin and intermediate filaments revealed the myofibroblastic nature of the tumor cells. The tumors were surgically excised, and there has been no recurrence. Clinicians and pathologists should note that the lesion of infantile myofibromatosis can and does occur in adults.

[Hypertrophy of the myometrial cells in women with myoma]. / Gipertrofiia kletok miometriia zhenshchin pri miome.

A rapid growth of the uterus myoma results from the cell hypertrophy, which involves essential ultrastructural changes in the cytoplasm and the nucleus, thus suggesting the intensification cell functions. The increase in the cell volume and intensification of secretion is followed by the enlargement of the interface between the nucleus and the cytoplasm resulting in formation of numerous invaginations of the nuclear membrane. The autoradiographical data demonstrate a considerable DNA synthesis in the peripheral zone of the myoma, unlike the situation seen in the centre of the myoma and the unchanged myometrium, where DNA synthesis is not considerable. The cytospectrophotometric analysis confirms the above data showing the highest content of DNA in the peripheral zone of the myoma.

A comparative study of the estrogen receptor ratio in myometrium and uterine leiomyomas.

Estrogen receptor (ER) content in myoma and myometrium was determined by radio-receptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e. the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be hither than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (P less than 0.05). These results suggest that myoma contains more ER positive cells to obtain estrogen effects than myometrium.

Immunohistologic detection of estrogen and progesterone receptors in disseminated peritoneal leiomyomatosis.

Disseminated peritoneal leiomyomatosis (DPL) is a rare clinicopathologic entity typically observed in women during pregnancy or immediately postpartum. Immunohistologic examinations of frozen as well as paraffin sections in three cases of DPL confirmed the myocytic character of the lesion and substantiated the hormonal influence on growth and regression of DPL nodules by detection of estrogen and progesterone receptors in the tumor cells. Implications of functional aspects as well as the benign clinical and morphologic feature of DPL are discussed in order to avoid inappropriate therapeutic measures.

Estrogen and progesterone receptors in uterine leiomyomas.

The purpose of our study was to evaluate the contrasting data between estrogen receptors (ER) and progesterone receptors (PgR) in uterine leiomyomas, endometrium and myometrium. Uteri were obtained from 30 women undergoing hysterectomy for uterine leiomyomas (24 premenopausal and 6 postmenopausal patients). Cytosolic and nuclear ER and PgR were analysed in uterine tissues by the method of single saturation point assay at a final concentration 5 nM of [3H-17 beta]estradiol and [3H]ORG-2058. Our results confirm that leiomyomas undergo changes similar to those observed in other uterine tissues during the menstrual cycle. The ER levels show decreased values during the postovulatory phase. After subdividing leiomyomas according to their topographic criteria, as submucous or subserosal, we observed that ER and PgR are significantly more numerous in submucous than in subserosal myomas, both in proliferative and in the secretive phase of the cycle. These results agree with the hypothesis that leiomyomas have a different etiology and may explain why some myomas decrease after progestin therapy (submucous), while others (subserosal) remain unchanged.

[Determination of cell nuclear DNA content in leiomyoma and leiomyosarcoma of gastro-intestinal tract (G-I)].

Nuclear DNA content was measured by microspectrophotometry in 15 biopsy specimens from patients with G-I smooth muscle tumors (3 leiomyomas and 12 leiomyosarcomas subdivided into 3 groups with 4 cases to each). The mean DNA value increased steadily as follows: leiomyomas (14.39 +/- 0.62 Au); leiomyosarcoma Grade I (19.78 +/- 2.39 Au); Leiomyosarcoma Grade II (26.39 +/- 1.60 Au); leiomyosarcoma Grade III (30.66 +/- 2.39 Au). The difference of DNA value in the 4 groups had statistical significance (P less than 0.05-0.01). These results suggest that microspectrophotometric measurement of nuclear DNA content may serve as an objective quantitative method for diagnosis of G-I tract smooth muscle tumors and classification of leiomyosarcoma.

Estrogen and progesterone receptors in leiomyomas and normal uterine tissues during reproductive life.

Estrogen and progesterone receptors (ER, PR) were measured in leiomyomas and normal uterine tissues. Estrogen receptors concentration was higher in endometrium than in leiomyomas, lowest in normal myometrium. In the case of progesterone receptors, the concentrations in endometrium and leiomyomas were similar whereas that of myometrium was lower. ER and PR concentration were similar in leiomyomas of the uterine fundus, body and isthmus and steroid receptor content in the inner parts of large myomas was the same as in the outer parts. ER and PR concentrations in tumor-bearing myometrium were not different from those in myometrium of a control group.

Alpha smooth muscle actin (alpha-SM actin) in normal human ovaries, in ovarian stromal hyperplasia and in ovarian neoplasms.

An immunohistochemical investigation of alpha-smooth muscle actin (alpha-SM actin) using the monoclonal anti-alpha-SM-1 antibody was carried out in 15 normal ovaries, in three ovaries with stromal hyperplasia and in 27 neoplastic ovaries. In selected cases the pattern of actin isoforms was examined by means of 2 D-gel electrophoresis. In addition, the tissues were stained for vimentin and desmin. In normal ovaries alpha-SM actin was found in the inner cortex and in the theca externa. In ovarian stromal hyperplasia expression of alpha-SM actin was minimal or absent. In primary and metastatic epithelial tumors there was positive stromal staining for alpha-SM actin, especially in the vicinity of epithelial elements. This tended to be more widespread in malignant neoplasms. Thecomas did not express alpha-SM-actin and could thus be differentiated from leiomyomas which stained intensely for alpha-SM actin. Only focal stromal staining of alpha-SM actin was observed in granulosa and germ cell tumors. In all the tissues studied blood vessels were strongly positive for alpha-SM actin. Desmin, although present in the stroma of most of the specimens, was less abundant than alpha-SM actin. We concluded that alpha-SM actin is a component of the normal human ovary where it may contribute to the contractility of its stroma. Its absence in the normal outer cortex and theca interna, and in stromal hyperplasia and thecoma implies that sex hormones do not constitute a stimulus for alpha-SM actin production in the ovary. Among neoplasms it is most widely represented in the stroma of epithelial tumors in which it may reflect stromal stimulation mediated by neoplastic epithelium.

Ethnic variation in estrogen and progesterone receptor concentration in leiomyoma and normal myometrium.

The total content of 17-beta estradiol and progesterone receptors in human uterine leiomyoma and normal myometrium in a Caucasian population was determined. Estrogen receptor concentrations in leiomyoma and myometrium were not significantly different (p = 0.1401). The concentration of progesterone receptors in leiomyoma was higher than in myometrium (p = 0.0303). Negroid and Caucasian ethnic groups did not differ with respect to estrogen (p = 0.7040) or progesterone (p = 0.8494) receptor concentrations in leiomyoma, but estrogen (p less than 0.005) and progesterone (p less than 0.005) receptor concentrations in normal myometrium were significantly higher in Caucasian than in negroid patients. Leiomyoma in negroid and Caucasian patients appears to be histologically similar, but the biochemical pathway of its pathogenesis seems to differ. Genetic predisposition probably acts as an initiation factor in the myometrium of both ethnic groups, then estrogen receptor levels in negroids and alterations in steroid metabolism in Caucasians promote the growth of leiomyoma.

[A comparison of radioreceptor assay and immunocytochemical staining for estrogen receptor in leiomyoma and myometrium].

Estrogen receptor (ER) content in myoma and myometrium was determined by radioreceptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e., the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be higher than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (p less than 0.05). These results suggest that myoma contains more ER positive cells and more efficiently absorbs estrogen than myometrium.

Physicochemical characterization and functional activity of fibroid prolactin produced in cell culture.

Evidence from our laboratory with the use of cultured (primary and passaged) cells has extended our initial observation that human uterine fibroid is an extrapituitary source of prolactin. Fibroid prolactin antigen in conditioned medium reacted specifically in radioimmunoassay for human pituitary prolactin. Control experiments demonstrated that the radioimmunoassay results were not spurious due to degradation of tracer 125I-labeled prolactin. Immunoparallel dilution curves indicated antigenic relatedness of pituitary and fibroid prolactin. In a calibrated Sephadex G-100 column, fibroid prolactin eluted in the same region (20.3 to 20.9 kd) as purified pituitary prolactin. Glycosylated prolactin, detected by concanavalin A affinity column chromatography, appeared to constitute only a small percentage of fibroid prolactin made in culture. The ratio of fibroid prolactin bioactivity (lactogen Nb2 lymphoma bioassay) to antigen (radioimmunoassay) was 0.77. These data indicate that human uterine fibroid tissue produces a molecule similar to or, perhaps, identical with pituitary prolactin.

Leiomyoma and neurilemoma: report of two unusual non-epithelial tumours of the thyroid gland.

Two primary spindle cell tumours of the thyroid are described showing light microscopic features of leiomyoma and neurilemoma respectively. The origin from smooth muscle and nerve sheath was confirmed by both immunohistochemical reactions and ultrastructural findings. Review of the literature reveals only one case of leiomyoma and three cases of neurilemoma reported as developing within the thyroid gland. Our observations further support the view that leiomyoma and neurilemoma may occur at this unusual site and are recognizable entities.