Randomized placebo-controlled trial of isotretinoin in chemoprevention of bronchial squamous metaplasia.

Purpose: Retinoids have proven chemopreventive efficacy in both preclinical and clinical studies. This trial was designed to confirm the finding of an earlier uncontrolled trial that the synthetic retinoid etretinate had major activity in reversing squamous metaplasia found in the bronchial epithelium of chronic smokers.

Patients And Methods: We prospectively evaluated 152 smokers with bronchoscopy and obtained biopsies from six sites.

Squamous metaplasia of the bronchial mucosa and its relationship to smoking.

We performed flexible fiberoptic bronchoscopy (FFB) on 106 heavy cigarette smokers. Six bronchial biopsy specimens, obtained from the carina and five major bronchi, were screened for squamous metaplasia. Individual biopsy specimens were sectioned into 4-microns sections, and a metaplasia index (MI), or percentage of sections containing squamous metaplasia, was determined.

Radiation-induced malignant pleural mesothelioma.

Malignant pleural mesothelioma is a rare and usually fatal disease. Its association with asbestosis is well recognized. The authors report a case of malignant pleural mesothelioma that developed 30 years after the patient underwent radiotherapy for breast cancer.

Morphologic and immunocytochemical evaluation of 220 fine needle aspirates of malignant lymphoma and lymphoid hyperplasia.

A total of 220 fine needle aspiration (FNA) specimens from 212 patients with clinically suspected or previously histologically confirmed lymphoma were evaluated by cytology in conjunction with immunophenotyping analysis of the aspirate; the results were compared with the histologic diagnosis made on previous or current accessions of lymph node or extranodal tissue. Smears of the aspirates were stained with the Diff-Quik and Papanicolaou stains while immunoperoxidase staining using antibodies against kappa and lambda immunoglobulin light chains and Leu-4 was routinely performed on Cytospin preparations. Where indicated, additional marker studies (including T-200, Leu-1, Leu-2a, Leu-3a + 3b, Leu-M1, B1, Leu-12, IgM, CALLA and TdT) were performed.

Lung cancer classification: the relationship of disease extent and cell type to survival in a clinical trials population.

The staging and histologic cell type of patients in the Lung Cancer Study Group (LCSG) clinical trials program are reviewed and confirmed or resolved at the reference center for anatomic and pathologic classification of lung cancer. A high level of consistency in classification has been achieved through the use of criteria that minimize intraobserver variability. The data obtained from the review project have been used to characterize the relationship of disease extent and cell type to survival in the clinical trials population.

Drug and radiation sensitivity measurements of successful primary monolayer culturing of human tumor cells using cell-adhesive matrix and supplemented medium.

The limitations of the agar suspension culture method for primary culturing of human tumor cells prompted development of a monolayer system optimized for cell adhesion and growth. This method grew 83% of fresh human tumor cell biopsy specimens, cultured and not contaminated, from a heterogeneous group of 396 tumors including lung cancer (93 of 114, 82%); melanoma (54 of 72, 75%); sarcoma (46 of 59, 78%); breast cancer (35 of 39, 90%); ovarian cancer (16 of 21, 76%); and a miscellaneous group consisting of gastrointestinal, genitourinary, mesothelioma, and unknown primaries (78 of 91, 86%). Cell growth was characterized morphologically with Papanicolaoustained coverslip cultures and cytogenetically with Giemsastained metaphase spreads.

Prognostic factors in patients with resected stage I non-small cell lung cancer. A report from the Lung Cancer Study Group.

The authors present prognostic information on recurrence and survival for resected Stage I lung cancer patients with squamous cell carcinoma, adenocarcinoma or large cell carcinoma. The data derive from 392 carefully staged patients and include results from the history and physical examination, preoperative laboratory tests, nature of the surgery, complications, initial pathologic findings following surgical resection, and final pathologic review. A simple multivariate model of recurrence, which is used to classify patients into low, intermediate, and high-risk groups, is based on tumor size and location (T1, T2), histologic type (squamous, nonsquamous/mixed) and nodal status (N0, N1).

Superior vena cava obstruction in small cell bronchogenic carcinoma. Clinical parameters and survival.

A clinical pathologic review with analysis of prognostic factors was conducted in 56 patients who were seen at the University of Texas M. D. Anderson Hospital and Tumor Institute between 1969 and 1980 with the syndrome of superior vena cava (SVC) obstruction secondary to small cell bronchogenic carcinoma.

Endoscopic cytology and biopsy diagnosis of esophageal carcinoma.

We examined 107 cytology and biopsy specimens taken simultaneously from 103 patients to determine the efficacy of cytologic esophageal brushing in the diagnosis of esophageal carcinoma. After review of all material, cytology was positive in 84% of cases, biopsy in 86%, and combined specimens (cytology and biopsy) in 94%. However, agreement as to histologic type was reached in only 53 of the 63 specimens originally reported as positive by both cytology and biopsy.

Spontaneous regression of breast carcinoma: follow-up report and literature review.

A case of spontaneous complete regression of metastatic breast carcinoma (malignant pleural effusion and bone metastases) with previously reported from M. D. Anderson Hospital and Tumor Institute.

Fibrous histiocytoma of lung--a clinicopathological study of two cases.

Two cases of fibrohistiocytic tumours of the lung are presented and histogenesis of this group of this group of tumours is discussed. An essentially biphasic pattern of histiocytes and fibroblasts, and the presence of myofibroblasts and undifferentiated mesenchymal cells is similar to the fibro histiocytic neoplasms in other locations.

Diagnosis of eosinophilic granuloma of bone by cytology, histology, and electron microscopy of transcutaneous bone-aspiration biopsy.

The cytological, histological, and ultrastructural morphology of transcutaneous bone aspirates from five patients with eosinophilic granuloma of bone were studied. Use of this combined approach enabled us to make a definitive diagnosis of eosinophilic granuloma from a small quantity of tissue without having to resort to open biopsy. By light microscopy, eosinophilic granuloma is composed of a polymorphous infiltrate of characteristic lobulated histiocytes, eosinophils, polymorphonuclear leukocytes, and giant cells.

The comparative diagnostic accuracy of cancer-cell detection obtained with Ficoll-Hypaque gradient separation and standard centrifugation technics on body-cavity fluids.

Ninety-two consecutive samples of body-cavity fluids from patients with confirmed or suspected cancer were compared for accuracy of diagnosis using a Ficoll gradient test and a standard centrifugation test. The percentage of positive test results was 76% (70/92) with the Ficoll test and 64% (59/92) with the routine test. The Ficoll and routine tests also gave a significant difference in the classification of malignancy, with the latter test giving a significantly higher proportion of negative or inconclusive test results.

Oncocytic carcinoid tumor of the lung.

A case of bronchial carcinoid tumor is reported in which a marked degree of transformation to mitochondrion-rich cells (oncocytes) was present. Ultrastructural observations demonstrated a transition between the two cell types, and revealed an alteration in mitochondria suggestive of a degenerative change in these organelles.

Fine-needle aspiration biopsy of the liver.

Percutaneous fine-needle aspiration biopsy of focal liver lesions was performed in 36 patients. Of the biopsies, 83% yielded enough cytologic material for a correct diagnosis, without significant complications. The primary indication for the biopsy was to document the presence of malignancy and avoid a diagnostic laparotomy.

Spontaneous regression of breast carcinoma.

Spontaneous regression of breast carcinoma occurred in a patient with a malignant pleural effusion and bone metastases. The patient did not receive any form of hormonal manipulation or systemic chemotherapy. It is postulated that the spontaneous regression of the carcinoma may have been caused by immunological factors.

Percutaneous needle biopsy of bone in the cancer patient.

Needle biopsy of skeletal lesions is easily accomplished by the percutaneous technique. Although this approach has been utilized for many years, the frequency has definitely increased of the 91 cases performed at M. D.

Fine needle aspiration biopsy of retroperitoneal lymph nodes and abdominal masses: an updated report.

Percutaneous fine needle aspiration biopsy of retroperitoneal lymph nodes and abdominal masses was performed in 109 patients. Eighty-five per cent of the aspiration biopsies yielded sufficient cytologic material for a correct diagnosis. Indications include confirmation of lymphangiographic findings and the establishment of a histologic diagnosis in lieu of surgery.

Aspiration biopsy of discrete pulmonary lesions using a new thin needle. Results in the first 100 cases.

The authors describe their initial experience with a new thin spinal-type needle for aspiration biopsy of the lung. One hundred patients with discrete pulmonary lesions were studied. Diagnosis was possible in 87% of cases, and no significant complications were encountered.