Aneurysmal bone cyst secondary to other osseous lesions. Report of 57 cases.

Fifty-seven aneurysmal bone cysts which were associated with or secondary to other lesions of bone are reported. The most common associations were with solitary or unicameral bone cyst, and with osteoclastoma. Other associated lesions included osteosarcoma, nonosteogenic fibroma, osteoblastoma, hemangioendothelioma, and hemangioma of bone. Five aneurysmal bone cysts were secondary to fracture or other bone trauma.

Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases.

Radiological findings in 75 cases of aneurysmal bone cyst were analyzed. Sixty-five per cent were primary or simple and 35% were secondary, the aneurysmal bone cyst being combined with other osseous lesions. A primary aneurysmal bone cyst can be diagnosed with a high degree of certainty, but only 20% of secondary forms had the radiological appearance of aneurysmal bone cyst; in the other 80% the associated lesion dominated the radiological picture, particularly when it was malignant. In the secondary form a small biopsy specimen may show the features of aneurysmal bone cyst only; without radiological assistance a concomitant malignant lesion may be missed. Therefore, there must be close collaboration between the radiologist and and the pathologist.

Immunostaining for carcinoembryonic antigen does not discriminate for early recurrence in breast cancer. The ECOG experience.

Carcinoembryonic antigen (CEA) immunohistochemistry was evaluated by 11 surgical pathologists with sections from 147 postmenopausal women with node-positive breast cancer. Carcinoembryonic antigen staining in breast cancer tissues has been correlated with a worse prognosis. This association was studied with a clinically characterized population of Eastern Cooperative Oncology Group (ECOG) patients using precisely the peroxidase-antiperoxidase methodology which had been employed in another published study. In 50% of the cases, the study pathologists were uncertain whether CEA was or was not present in the cancers. Various groupings of the pathologists' interpretation were compared with the observed disease-free intervals in the patients. These analyses suggested no association of perceived CEA staining with the biological course of the cancers. Two reference pathologists who examined the sections in a similar way also gave non-prognostic interpretations. There is no convincing evidence that pathologists can reliably interpret the CEA content in the same breast cancer tissue sections. There is no observed correlation between immunohistochemical evidence of CEA in a breast cancer tissue section and the biological behavior of that cancer.

Interobserver reproducibility of histopathological features in stage II breast cancer. An ECOG study.

Eleven surgical pathologists studied microscopic sections from 45 mastectomy specimens of node positive breast cancer patients who had been entered into ECOG clinical trials. Inter-observer reproducibility for histoprognostic features was examined as a prerequisite before a subsequent evaluation of their possible clinical applicability could be undertaken. Histological type, nuclear grade, tubular formation, and lymphoid reactions were studied in the cancerous tissues. Lymph nodal responses (follicular and pulp prominence, sinus histiocytosis) were also examined in a manner that stimulated slide review in routine surgical pathology practice. Numerous two-way comparisons of the pathologists' findings resulted in low levels of agreement (usually much less than 90%). The degree of inter-observer reliability is clinically unacceptable using customary slide review analysis. New ways of examining breast cancer tissues need to be explored in the search for prognostic features which can be applied to the clinical management of breast cancer patients.