Cytokeratins and lung carcinomas.

Background: Recently, cytokeratins (CK) were studied as tumor markers for many carcinomas. In lung cancer they appeared to be useful in distinguishing primary from secondary tumors, in histological typing as well as in evaluating patient's prognosis. However, the results have yet to be conclusive.

Expression of cyclin D1, Ki-67 and PCNA in non-small cell lung cancer: prognostic significance and comparison with p53 and bcl-2.

Uncontrolled cell proliferation is the hallmark of malignant tumours. Thus, the proliferative potential of tumour cells is an important prognostic factor. However, evaluation of the prognostic significance of the expression of proteins involved in regulation of cell proliferation remains controversial.

[Expression of p53, p21 and bcl-2 in prognosis of lung carcinomas].

Expression of suppressor genes 53 and bcl-2 as well as of protein p21 (partly induced by p53 gene) was analyzed in a group of 77 resection specimens and bronchial excision of lung carcinomas (of all basic histological types--squamous cell, neuroendocrine, adenocarcinoma, undifferentiated). Simultaneously the relation of tumor immunophenotype and level of differentiation, cell death and 2-year-survival of patients was evaluated. Gene p53 showed non-only an expected strong expression in squamous cell carcinomas but especially in adenocarcinomas, which were newly characterized by exceptional hyper-expression of p53 in lowly differentiated variants.

[Expression of the nm 23 gene in pulmonary carcinomas].

Gene nm 23 may have an antimetastatic function but relevant data in the literature are ambiguous even in the same types of malignant tumors. In a group of 77 lung carcinomas there was not found any relation of gene nm 23 expression to the histologic type of tumor or the level of its differentiation and to the finding of metastases in resected lung materials either. Adenocarcinomas showed a negative relation of nm 23 expression to later occurrence of metastases and to a decreased survival of patients which squamous, neuroendocrine and undifferentiated carcinomas did not.

[A large metastasis of colorectal carcinoma--case report].

The authors present the case-history of a female patient four years after a low resection on account of carcinoma of the rectum who developed a large secondary in the abdominal wall. After its radical resection the patient is free from systemic or local manifestations of the basic disease and free from complaints.

[Sarcomatous hepatocellular carcinoma].

Atypical variants of liver carcinomas may represent diagnostic pitfalls when compared with classical types. We described two cases of unusual hepatocellular carcinoma with sarcomatoid pattern. Both were large tumors in elderly people.

[Clinicopathologic correlation of interstitial pulmonary processes].

"Not-specified interstitial" lesions represented mostly cryptogenic fibrous alveolitis, extrinsic allergic bronchioloalveolitis prevailed among "disseminated" lesions, "infiltrative" lesions were proved to be extrinsic alveolitis or disseminated carcinoma. Among more definitely formulated suppositions of the clinician, cryptogenic alveolitis was proved in more then 50% of cases often modified by extensive fibrosis, organized pneumonia, cholesterol pneumonia or minute desquamative pattern. A similar relation of diagnostic correctness was found in allergic bronchioloalveolitis suprisingly often modified again by fibrosis and cholesterol pneumonia.

Medulloepithelioma in a cat.

Castrated male of European cat, bastard, 16 month-old suffered from a grayish-pink tumour in the anterior chamber of the right eyeball in the course of last six months. After enucleation, the eye was examined by histology, immunohistochemistry (NSE, NPF, S-100 protein) and electronmicroscopy. The tumour was classified as malignant medulloepithelioma.

[Visceral and cutaneous leishmaniasis].

Two cases of kala azar and 5 cases of cutaneous leishmaniasis were found in bioptic files from previous 50 years in Hlava Institute of Pathology in Prague, 4 of them were cumulated in 1994 and 1995. All cases followed short stays in Mediterranean or Caribbean area. The latest kala azar was identified from bone marrow trephine biopsy and subsequently, leishmanias were also found in an inapparent hepatopathy.

[Lectins in pulmonary adenocarcinomas].

A relatively specific binding of lectins to various glycids enabled authors to evaluate the exosecretion characteristic of lung carcinomas closer than by HE, investigation of mucins and immunohistochemical epithelial markers. The main subtypes of lung adenocarcinomas (usual of acinar, tubulopillary cubocellular or cylindrocellular, solid with mucus production), pseudosarcoma, large cell and undifferentiated carcinomas from 9 bioptical samples were therefore compared as to binding of 5 lectins with preferential affinity to glucose/mannose (CON A), acetylglucosamin (WGA) and acetylgalactosamin (PNA, RCA, HPA). All the subtypes of adenocarcinoma as well as undifferentiated carcinoma showed a strong binding of bean lectin (CON A) and a slighter binding of ricinus (RCA) and wheat germ (WGA) lectins.

[Toxic manifestations in the treatment of leukemias and malignant lymphomas].

Toxic effect of chemotherapy was found in 13 dead patients suffering from myeloic leukaemia, Hodgkin disease and malignant lymphoma during past 18 months. Drugs with known toxicity from various sorts of antineoplastic treatment were administered simultaneously or successively what did not allow to differentiate their effects. Clinical symptomatology of the patients comprised respiratory distress syndrome or heart failure which could not be otherwise explained.

[Combined small cell and "adenoid cystic" carcinoma of the uterine cervix].

Cervical carcinoma in a 49-year-old woman was resected and found to spread into parametrium. It consisted of a unique combination of adenoid cystic, squamous and small cell neuroendocrine structures. Small celled part revealed positivity with chromogranin A and neuron-specific enolase, neuroendocrine granules were argyrophilic and about 130 nm in diameter.

[Relapsing polychondritis--ultrastructure in 2 additional cases].

A 37-year-old woman and a 74-year-old man with typical clinical history of relapsing polychondritis enabled electron microscopical analysis of various cartilages (ear, nasal septum, rib). Apoptotic lesion and degradation of chondrocytes combined not always with changes of their lacunae prevailed in both patients, fragmentation of elastic tissue in the man. Lesions of chondrocytes, a bit varied and asynchronous in intensity were observed as everywhere in a single cartilage as in cartilages from different sites.

[Genodermatoses in fetal skin biopsies].

The risk of serious genodermatoses, i. e. mainly of bullous epidermolyses and keratinization lesions, can be verified only by a prenatal ultrastructural diagnosis.

Possible relationship between abnormal melanosome structure and cytotoxic phenomena in malignant melanoma.

Melanogenesis has been regarded as a hazard for pigment cells which are endangered by reactive quinones and semiquinones generated by this process. Normally the potentially cytotoxic species are confined to melanosomes by a limiting membrane and thus separated from the rest of the cell. Our electron microscopic investigation has demonstrated the presence of abnormal and incomplete melanosomes in human melanomas from epidermal and mucosal sites, in melanoma metastases, and in B16 mouse melanoma.

The ultrastructure of respiratory tract tumours.

The study presents the author's experience of 15 years of electron microscopic study of 339 resected respiratory tract tumours, an unusually large group. A dual purpose was pursued: a) to present a systematic analysis of carcinomas which prevailed in the material, and b) to interpret some of the unusual or poorly studied phenomena found in some tumours. The author has been using electron microscopy to study carcinomas since 1973 as a corrective factor giving more precision to routine classification (according to WHO, 1981), on which modern diversified therapy depends.

[The so-called sclerosing hemangioma of the lungs].

A 12-year old girl had a focal density in the lung found by checking CT. Structural features were those of the so called sclerosing hemangioma. Analysis of structure in various methods and of references supported authors' interpretation that lesion represented a late consequence of pecul a obliterative mainly venous process with prevailing plasmacytic feature.

[Bizarre cells in pseudotumors of the digestive tract].

Aneuploid cells were studied in the mucous stroma in 10 bioptic excisions of the tongue, gums, stomach, colon, rectum and anus. These bizarre cells corresponded most probably to fibroblasts, macrophages and endotheliomas strangely proliferating in inflammatory polyps, granular tissue and hyperplastic stroma. Significance of repeated mechanical irritation for pathogenesis of this reactive phenomena in projecting pseudo-tumours is stressed.

[Ultrastructural evaluation of pulmonary adenocarcinoma. II. Phenotype heterogeneity and classification].

A phenotypical heterogeneity was observed in 45 tumours (45 per cent) from a group of 102 carcinomas with ultrastructural features of exocrine differentiation. Double heterogeneity was found in 36 tumours and a triple one in 8 tumours; a case with quadruple heterogeneity was presented analogy of which has been lacking in literature. A combination of different exocrine phenotypes occurred in 12 tumours, exocrine and endocrine phenotypes combined in 18 tumours, exocrine cells and keratinocytes were found in 21 tumours.

[Ultrastructural evaluation of pulmonary adenocarcinoma. I. Cytologically homogeneous phenotypes].

A group of 102 lung carcinomas with an ultrastructural evidence of exocrine features comprised 88 adenocarcinomas and 2 adenosquamous carcinomas classified correctly according to the WHO histological typing as well as 12 other carcinomas which had to be re-classified after electron microscopy. Microvilli and secretory granules served as exocrine markers. The microvilli were more specific than granules because of being missing in 15 less differentiated tumours and granules in 45 cases.

Benign hypergammaglobulinemic purpura in a patient with ulcerative colitis and peripheric arthritis.

A 32-year-old patient is described presenting with ulcerative colitis and oligoarthritis who later developed benign hypergammaglobulinemic purpura. This diagnosis was confirmed by clinical investigation, immunological findings as well as by histological and immunofluorescent examination. He was successfully treated with steroids and azathioprin.

Histogenesis of benign pleomorphic mesenchymal tumours.

Benign pleomorphic mesenchymal tumours (lipoma, fibroblastoma) are defined by large cells with multiple peripheral nuclei reminding of florets. Similar cells were previously detected by Mirejovský as a reactive phenomenon in polypous processes. We assume that these cells may occur not only in pseudotumours but also in tumours with stromal conditions similar to those in polyps.