A subset of cell clusters with malignant features in morphologically normal-appearing and hyperplastic tissues.

Background: The development of human breast cancer may be a multistep process, sequentially undergoing normal, hyperplastic, in situ, invasive, and metastatic stages.

Methods: Our previous and current studies have revealed that a subset of morphologically normal-appearing and hyperplastic breast tissues adjacent to or distant from malignant breast lesions contained cell clusters that showed malignancy-associated immunohistochemical and cytological alterations.

Results: Compared to their morphologically similar counterparts within the same lesion, these cell clusters exhibited several unique features: (1) a significantly increased frequency of focal disruptions in surrounding myoepithelial cell layers and the loss of estrogen receptor expression, (2) signs of stromal and vascular invasion, (3) distinct alterations in the cytoplasmic-nuclear ratio and nuclear shape, size, and polarity, (4) the expression of multiple malignancy-associated biomarkers, and (5) malignancy-associated nuclear changes in benign-appearing cells.

A subset of in situ breast tumor cell clusters lacks expression of proliferation and progression related markers but shows signs of stromal and vascular invasion.

Background: Our previous studies in pre-invasive mammary tumors revealed that estrogen receptor negative cell clusters (ER NCC) overlying focally disrupted myoepithelial (ME) cell layers showed a significantly higher rate of genetic abnormalities and cell proliferation than adjacent cells without ME cell layer disruptions. A subset of these ER NCC, however, completely lacked expression of Ki-67, a most commonly used marker for cell proliferation. The purpose of this study was to further elucidate the immunohistochemical and morphological profiles of these ER NCC.

A decision support system to detect morphologic changes of chromatin arrangement in normal-appearing cells.

Several studies have described malignancy-associated changes (MACs) of chromatin arrangement in the nuclei of apparently normal cells adjacent to and distant from an invasive cancer area. MAC assessment is a hard task, since it requires a deep knowledge of morphologic features of chromatin arrangement. The aim of this work is to verify the reproducibility of the subjective evaluation of the expert on the basis of a decision support system (DSS) that automatically and objectively reproduces MAC diagnosis.

Relationship between the in vitro colony growth of human tumors and cytologic diagnosis.

The cytologic examinations and cloning efficiencies of 47 human tumor specimens (19 ovarian carcinomas, 6 sarcomas, 5 lung carcinomas, and 17 miscellaneous tumors) were compared to evaluate the predictability of clonogenecity by cytologic diagnosis. Cytologic examination preceding clonogenic assay identified the 50% to 60% of all specimens that failed to yield in vitro chemotherapy sensitivity by this assay, with a false-negative rate of 10%. The frequency of cytologically identifiable tumor cells in the plating suspension was independent of the histologic type of tumor (ovarian carcinoma or others) and the nature of the specimen (solid tumor or malignant effusion).

Problems in the diagnosis of small cell carcinoma of the lungs by fiberoptic bronchoscopy.

Fiberoptic bronchoscopy (FOB) with the aid of endoscopic biopsies and brush cytology is recognized as a valuable approach in the diagnosis of lung cancer. However, histologic classification of lung cancer based on tiny specimens obtained from FOB can be difficult. Correct identification of small cell carcinoma of the lung is especially important because its recognition usually precludes surgery.

The place of fine needle biopsy in the diagnosis of nodules of the thyroid.

Fine needle aspiration cytology with an accuracy rate of 90.2 per cent confirmed by surgical specimens was found to be a useful adjunct in the diagnosis of tumors of the thyroid but did not replace large needle core biopsy. Both methods offered information complementary to each other, and our data indicated that, when possible, they should be used together.

Pulmonary tumorlets in cases of "tuberculoma" of the lung with malignant cells in brush biopsy.

Two cases of pulmonary nodules associated with Mycobacterium intracellulare infection were initially interpreted as carcinomas of the lung after brush cytology specimens were reported to contain malignant epithelial cells. In both instances, the cells observed in the cytology specimens exhibited marked cytologic atypia. These cells were identical to those present in tumorlets adjacent to the granulomatous lesion.

The cytologic basis for classification of lung tumors.

Nuclear changes in cells of bronchial biopsies and surgical specimens were studied in relation to nuclear structures of cells at various mitotic phases. Cell structures comparable to early and late G1 and G2 phases were correlated with histologic types of lung tumors according to the 1981 WHO classification. The evolved cellular classification added another parameter for diagnosis of histologic alterations and for interpretation of cellular changes in cytologic specimens.

Metastatic nonfunctioning parathyroid carcinoma: ultrastructural evidence of secretory granules and response to chemotherapy.

A 69-year-old woman was admitted to the hospital because of recurrent cervical nodules, a large anterior mediastinal mass, and malignant left pleural effusion. Light and electron microscopy of the resected cervical nodules and cytology of the pleural fluid showed findings consistent with parathyroid carcinoma. There was no evidence of hyperparathyroidism on clinical evaluation, multiple serum calcium and phosphorus determinations, skeletal survey, intravenous pyelogram, or radioimmunoassay of intact and carboxy-terminal parathyroid hormones in the serum.

Carcinoma of the prostate: lymph node aspiration for staging.

Percutaneous fine-needle aspiration biopsy of suspect nodes was used for histologic staging in 33 patients with clinically localized carcinoma of the prostate after an abnormal or suspicious lymphogram. A total of 66 nodes was biopsied, and positive cytology for metastatic carcinoma was obtained from 29 nodes in 20 patients indicating the presence of stage D disease. Thus, staging lymphadenectomy and radical treatment by radiation or surgery were avoided.

Flexible fiberoptic bronchoscopy in the diagnosis of pulmonary complication of lymphoma.

Patients with known lymphoma frequently present with pulmonary abnormalities that require prompt diagnosis. The usual chest radiograph and bacteriologic studies often fail to be of diagnostic value. Since February 1973, we have performed flexible fiberoptic bronchoscopies on 76 patients with Hodgkin and non-Hodgkin lymphoma who presented with pulmonary abnormalities.

Post-lymphangiography fine needle aspiration lymph node biopsy in staging carcinoma of the prostate: preliminary report.

Five cases of clinical stage B carcinoma of the prostate are reported. Bipedal lymphangiography showed unequivocal involvement of the pelvic nodes in 3 patients and was equivocal in the other 2. Percutaneous transabdominal fine needle aspiration biopsy of abnormal or suspicious iliac nodes was performed and a positive cytolocal diagnosis of metastasis was obtained in all 5 patients.

Flexible bronchoscopy in nonvisualized carcinoma of the lung.

Of 1,000 consecutive patients undergoing fiberoptic bronchoscopy, 331 eventually were proven to have primary lung cancer. Of the 331 carcinomas, 253 were beyond the visual range of the flexible bronchoscope. However, under fluoroscopic guidance, the diagnosis of carcinoma was established in 194 (76.