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Abramson Cancer CenterNCI CANCERLIT® Search: Soft Tissue Sarcoma/Rhabdomyosarcoma - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 11686037
AU - Verweij J
TI -
Sarcomas.
SO - Cancer Chemother Biol Response Modif 2001;19():639-51
AD - Department of Medical Oncology, Rotterdam Cancer Institute (Daniel den
Hoed Kliniek), University Hospital, Groene Hilledijk 301, 3075 EA
Rotterdam, The Netherlands.
2
UI - 11781522
AU - Toki T; Shimizu M; Takagi Y; Ashida T; Konishi I
TI -
CD10 is a marker for normal and neoplastic endometrial stromal cells.
SO - Int J Gynecol Pathol 2002 Jan;21(1):41-7
AD - Department of Obstetrics and Gynecology, Shinshu University School of
Medicine, Asahi, Matsumoto, Japan.
Using the immunohistochemical technique, we investigated the expression
of CD10 in normal female genital tissues, chorionic villi and decidua of
early gestation, endometriotic lesions, and uterine mesenchymal tumors.
The cytoplasm of normal endometrial stromal cells was consistently
positive for CD10. During early gestation, decidualized endometrial
stromal cells were negative or only focally positive for CD10, whereas
nondecidualized stromal cells were diffusely positive.
Syncytiotrophoblast was positive for CD10 on the apical surface, whereas
chorionic mesenchymal cells were diffusely positive within the
cytoplasm. Cytotrophoblast and intermediate trophoblast were negative
for CD10. Groups of stromal cells surrounding cervical glands were often
positive for CD10. Myometrium, endometrial and cervical glands, cervical
squamous epithelia, and tubal epithelia and stroma exhibited no
reactivity for CD10. In endometriosis and adenomyosis, ectopic
endometrial stromal cells were usually positive for CD10. Endometrial
stromal tumors, including undifferentiated uterine sarcomas, mostly
showed diffuse immunoreactivity for CD10. Leiomyomas and leiomyosarcomas
were negative or focally (< 5% of cells staining) positive (8/12
leiomyomas and 4/8 leiomyosarcomas) for CD10, except for 1 myxoid
leiomyosarcoma that showed CD10 staining in the myxoid areas. These data
suggest that diffuse CD10 staining is characteristic of normal and
neoplastic endometrial stromal cells, unless they are decidualized.
3
UI - 11042567
AU - Jager PL; Hoekstra HJ; Leeuw J; van Der Graaf WT; de Vries EG; Piers D
TI -
Routine bone scintigraphy in primary staging of soft tissue sarcoma; Is
it worthwhile?
SO - Cancer 2000 Oct 15;89(8):1726-31
AD - Department of Nuclear Medicine, University Hospital Groningen,
Groningen, The Netherlands. p.l.jager@nucl.azg.nl
BACKGROUND: The incidence of bone metastases in soft tissue sarcoma
(STS) patients seems to be low but has not been studied separately. In
this study, the authors aimed to determine the value of routine
radionuclide bone scanning in preoperative staging of STS patients.
METHODS: Preoperative bone scans were evaluated retrospectively in 109
consecutive patients (median age, 44 years; range, 1-86) with
intermediate or high grade STS. Scans were scored in 3 categories: 1,
metastases very likely; 2, equivocal; and 3, normal or benign lesions.
RESULTS: Category 1 scans were found in 8 of 109 patients (7%); in all 8
patients, bone metastases were confirmed. Six of these eight patients
reported pain, and all had additional lung, bone marrow, or lymph node
metastases. The highest rate (17%) was found in the rhabdomyosarcoma
subgroup (n = 18). Category 2 (equivocal) scans were present in 12 of
109 patients (11%), in all of which bone metastases were excluded
through additional investigations. Category 3 (normal) scans were found
in 81%. Bone metastases were at least as frequent as lung metastases
(4%) and were the single site of systemic disease in 4%. The rate of
bone metastases was 55% in patients with bone pain versus 2% in patients
without pain. CONCLUSIONS: Bone metastases in primary STS patients are
rare (7%) yet in this study at least as frequent as lung metastases. The
low rate in asymptomatic patients versus the high rate in symptomatic
patients supports the use of bone scanning in symptomatic patients only.
The yield of routine bone scanning is low. Copyright 2000 American
Cancer Society.
4
UI - 11760565
AU - Demetri GD; Delaney T; NCCN Sarcoma Practice Guidelines Panel
TI -
NCCN: Sarcoma.
SO - Cancer Control 2001 Nov-Dec;8(6 Suppl 2):94-101
AD - Dana-Farber Cancer Institute, USA.
5
UI - 11857563
AU - Carney JA; Stratakis CA
TI -
Familial paraganglioma and gastric stromal sarcoma: a new syndrome
distinct from the Carney triad.
SO - Am J Med Genet 2002 Mar 1;108(2):132-9
AD - Department of Laboratory Medicine and Pathology (Emeritus member), Mayo
Clinic and Foundation, Rochester, Minnesota 55905, USA.
carney.aidan@mayo.edu
Paragangliomas may be inherited in an autosomal dominant manner either
alone (as in PGL1, PGL2, and PGL3 syndromes) or as a component of a
multiple tumor syndrome (as in von Hippel-Lindau disease and
neurofibromatosis type 1). In this article, we describe 12 patients (7
male and 5 female) with an average age of 23 years from five unrelated
families that manifested paraganglioma and gastric stromal sarcoma; the
tumors were inherited in an apparent autosomal dominant manner, with
incomplete penetrance. Seven patients had paraganglioma, four had
paraganglioma and gastric stromal sarcoma, and one had gastric stromal
sarcoma. The paraganglioma was multicentric and the gastric stromal
sarcoma multifocal. Because of the rarity of gastric stromal sarcoma and
its multifocality, the young age of the patients, and the unlikelihood
of coincidental co-occurrence of paragangliomas and gastric stromal
sarcomas, we suggest that a new syndrome exists with these two main
components, a condition that is familial and distinct from the Carney
triad. Published 2002 Wiley-Liss, Inc.
6
UI - 11905413
AU - Essary LR; Vargas SO; Fletcher CD
TI -
Primary pleuropulmonary synovial sarcoma: reappraisal of a recently
described anatomic subset.
SO - Cancer 2002 Jan 15;94(2):459-69
AD - Department of Pathology, Brigham and Women's Hospital and Harvard
Medical School, Boston, Massachusetts 02115, USA.
BACKGROUND: Primary pleuropulmonary synovial sarcoma (SS) is a rare
neoplasm and a recently recognized anatomic subset. Its
clinicopathologic attributes are not yet well defined. METHODS: In this
study, the clinical and histopathologic features of 12 SS arising in the
lung and/or pleura were analyzed. RESULTS: The neoplasms occurred in 7
men and 5 women, 20-72 years old (median, 31 years), were well
circumscribed with a mean size of 7.2 cm, and involved either lung (9
cases), pleura (2 cases), or both (1 case). All the tumors were of
monophasic type. Nine showed a classic spindle cell pattern, and three
showed predominantly poorly differentiated features. All but one case
showed at least focal positivity for epithelial membrane antigen (EMA),
a finding characteristic of this tumor. The lack of EMA staining in one
case, proven by electron microscopy to be SS, was attributed to the
scarcity of material available for immunohistochemical stains. The
diagnosis was proven cytogenetically in three cases. Within 2 years,
local recurrence developed in 8 patients (75%), 3 of whom developed
metastasis (25%). Five patients died of their disease within 2.5 years,
4 of them from uncontrolled local disease. CONCLUSIONS: The authors
conclude that pleuropulmonary SS, although rare, represents a distinct
anatomic subset having pathologic features similar to those of its soft
tissue counterpart. Its clinical behavior appears more aggressive,
perhaps because of relatively later presentation combined with the
difficulty in obtaining a wide surgical margin.
7
UI - 11900234
AU - Rossi CR; Foletto M; Mocellin S; Pilati P; De SM; Deraco M; Cavaliere F;
TI -
Palatini P; Guasti F; Scalerta R; Lise M
Hyperthermic intraoperative intraperitoneal chemotherapy with cisplatin
and doxorubicin in patients who undergo cytoreductive surgery for
peritoneal carcinomatosis and sarcomatosis: phase I study.
SO - Cancer 2002 Jan 15;94(2):492-9
AD - Dipartimento di Scienze Oncologiche e Chirurgiche, Sezione Clinica
Chirurgica Generale II, Universita' di Padova, Italy.
carlor.rossi@unipd.it
BACKGROUND: Hyperthermic intraperitoneal intraoperative chemotherapy
(HIIC) combined with cytoreductive surgery (CS) has been proposed as a
new multimodal treatment mainly for carcinomatosis of gastrointestinal
origin. To evaluate whether this regimen could be used for other tumor
types, the authors conducted a Phase I study on HIIC with doxorubicin
and cisplatin in patients with peritoneal carcinomatosis or
sarcomatosis. PATIENTS AND METHODS: Thirty-one patients with peritoneal
carcinomatosis or sarcomatosis (PCS) were enrolled for the study. After
completion of CS, HIIC was administered with drug doses that were
increased for each consecutive cohort following a three-patient cohort
scheme. Thereafter, the accrual was stopped when Grade 4 locoregional or
systemic toxicity was observed. The maximum tolerated dose (MTD) was
considered the dose in the previous triplet. Drug pharmacokinetics and
procedure costs also were analyzed. RESULTS: After CS, residual tumors
were not present or measured less than or equal to 3 mm (in dimension)
in all cases. Maximum tolerated dose was 15.25 and 43.00 mg L(-1) for
doxorubicin and cisplatin, respectively. The perfusate/plasma area under
the curve ratios were favorable for both drugs, at 162+/-113 and
20.6+/-6.0, respectively, for doxorubicin and cisplatin. Doxorubicin
levels in the peritoneum were higher than in tumor or normal tissue
samples. There were no postoperative deaths. Surgery-related
complications were observed in 25% of cases. Findings at cost analysis
showed that the length of stay in the operation room and intensive care
unit were the major cost drivers. CONCLUSIONS: Cytoreductive surgery
combined with HIIC is an expensive but feasible therapeutic approach for
locally advanced abdominal tumors. Because our preliminary findings for
local disease control are encouraging, a Phase II study is now advisable
to verify the activity of this promising treatment.
8
UI - 11917581
AU - Shimizu K; Korematsu M
TI -
Phyllodes tumor of the breast. A cytomorphologic approach based on
evaluation of epithelial cluster architecture.
SO - Acta Cytol 2002 Mar-Apr;46(2):332-6
AD - Department of Anatomic and Diagnostic Pathology, Dokkyo University
School of Medicine, 880, Mibu, Tochigi, 321-0293, Japan.
OBJECTIVE: To develop more useful criteria for differentiating benign
phyllodes tumor (BPT) from fibroadenoma (FA) of the breast on fine
needle aspiration cytology (FNAC), with a focus on architectural
features of epithelial clusters. STUDY DESIGN: The smears of 18 cases
obtained by preoperative FNAC, each with tissue-proven BPT, were
compared to those of 25 cases of FA. Several features of epithelial
clusters in both groups were studied, with histologic correlation.
RESULTS: BPT exhibited large epithelial clusters longer than 1 mm, with
a wavy or folded shape, that could be distinguished from the small or
medium-sized clusters with tubular, blunt-branching or monolayered
contours in FA. This appearance of BPT was equivalent to the
characteristic phyllodes pattern of its histology. CONCLUSION: The size
and shape of epithelial clusters are important diagnostic clues in
addition to several findings that have been described as differentiating
BPT from FA on FNAC.
9
UI - 11788902
AU - Tsujimura A; Kawamura N; Ichimura T; Honda K; Ishiko O; Ogita S
TI -
Telomerase activity in needle biopsied uterine myoma-like tumors:
differential diagnosis between uterine sarcomas and leiomyomas.
SO - Int J Oncol 2002 Feb;20(2):361-5
AD - Department of Obstetrics and Gynecology, Osaka City University Graduate
School of Medicine, Osaka, Japan.
Preoperative differential diagnoses between uterine sarcomas and
leiomyomas are difficult. As telomerase activation is thought to be
essential for the immortality of malignant cells, it is considered a
potentially useful diagnostic marker. The aim of the present study was
to evaluate the potential diagnostic use of measuring telomerase
activity in needle biopsy samples to distinguish uterine sarcoma from
leiomyoma. Sixty-two patients with suspected uterine sarcomas based on
clinical findings or magnetic resonance imaging findings, and who were
scheduled for surgery, underwent transcervical ultrasound-guided needle
biopsy. Three samples were obtained per patient for histopathological
examination and telomerase activity measurement. Telomerase activity was
measured using the telomeric repeat amplification protocol and
correlated with final histopathological findings of surgical specimens.
Of the 62 patients, 6 leiomyosarcomas and 1 endometrial stromal sarcoma
(high grade) were diagnosed by histopathology. In 6 of the 7 samples
from uterine sarcomas, relatively high telomerase activity (22-102
units) was detected, whereas only low telomerase activity (11-18 units)
existed in 3 of the remaining 55 samples from benign or borderline
uterine smooth muscle tumors. At a cut-off value of 20 units,
sensitivity, specificity, positive predictive, and negative predictive
values for detecting uterine sarcoma were 86% (95% confidence interval,
59-100%), 100% (94-100%), 100% (54-100%) and 98% (95-100%),
respectively. The results indicated that telomerase activity in needle
biopsy samples is a useful diagnostic marker to distinguish uterine
sarcoma from leiomyoma.
10
UI - 11866525
AU - Mayo K; Vana ML; McDermott J; Huseby D; Leis J; Barklis E
TI -
Analysis of Rous sarcoma virus capsid protein variants assembled on
lipid monolayers.
SO - J Mol Biol 2002 Feb 22;316(3):667-78
AD - Vollum Institute and Department of Microbiology, Oregon Health & Science
University, Portland, OR 97201-3098, USA.
During assembly and morphogenesis of Rous sarcoma virus (RSV),
proteolytic processing of the structural precursor (Pr76Gag) protein
generates three capsid (CA) protein variants, CA476, CA479, and CA488.
The proteins share identical N-terminal domains (NTDs), but are
truncated at residues corresponding to gag codons 476, 479, and 488 in
their CA C-terminal domains (CTDs). To characterize oligomeric forms of
the RSV CA variants, we examined 2D crystals of the capsid proteins,
assembled on lipid monolayers. Using electron microscopy and image
analysis approaches, the CA proteins were observed to organize in
hexagonal (p6) arrangements, where rings of membrane-proximal NTD
hexamers were spaced at 95 A intervals. Differences between the
oligomeric structures of the CA variants were most evident in
membrane-distal regions, where apparent CTDs interconnect hexamer rings.
In this region, CA488 connections were observed readily, while CA476 and
CA479 contacts were resolved poorly, suggesting that in vivo processing
of CA488 to the shorter forms may permit virions to adopt a
dissembly-competent conformation. In addition to crystalline arrays, the
CA479 and CA488 proteins formed small spherical particles with diameters
of 165-175 A. The spheres appear to be arranged from hexamer or hexamer
plus pentamer ring subunits that are related to the 2D crystal forms.
Our results implicate RSV CA hexamer rings as basic elements in the
assembly of RSV virus cores. Copyright 2002 Elsevier Science Ltd.
11
UI - 11870176
AU - Lopez M; Vici P; Di Lauro L; Carpano S
TI -
Increasing single epirubicin doses in advanced soft tissue sarcomas.
SO - J Clin Oncol 2002 Mar 1;20(5):1329-34
AD - Division of Medical Oncology B, Regina Elena Institute for Cancer
Research, Rome, Italy. lopez@ifo.it
PURPOSE: To evaluate the maximum-tolerated dose and the clinical
efficacy of epirubicin in patients with advanced soft tissue sarcoma.
PATIENTS AND METHODS: Sixty-one patients were treated at three different
epirubicin dose levels: 140 mg/m(2) (six patients), 160 mg/m(2) (52
patients), and 180 mg/m(2) (three patients). Cycles were repeated every
3 weeks for a maximum of eight cycles. The first two dose levels proved
to be feasible and safe without dose-limiting toxicity (DLT). Because
the first three patients entering the third dose level experienced DLT,
subsequent patients received the next lower dose level. RESULTS: The
overall response rate was 44% (95% confidence interval, +/- 12%), with
six complete (10%) and 21 partial (34%) responses. Responses seemed
related to epirubicin dose level, because the response rate was 17%,
44%, and 100% for the three dose levels (chi(2) test for trend, P =.02).
Median response duration, median time to progression, and median overall
survival were 10, 8, and 15 months, respectively. Myelosuppression was
the most frequent side effect, with grade 3 or 4 neutropenia occurring
in 79% of the patients; 31% of patients were febrile. Nonhematologic
toxicity was mainly grades 1 and 2. The mean epirubicin dose-intensity
was 49 mg/m(2) per week. CONCLUSION: The third epirubicin dose level
(180 mg/m(2)) was the maximum-tolerated dose. The recommended drug dose
for clinical use is 160 mg/m(2) every 3 weeks with hematopoietic
support. Single high-dose epirubicin is effective as first-line
treatment and should be preferentially used whenever a high response
rate is important to allow the resection of an otherwise unresectable
disease or whenever it might result in a significant symptomatic
benefit.
12
UI - 11873080
AU - Parisi SG; Sarmati L; Pappagallo M; Mazzi R; Carolo G; Farchi F;
TI -
Nicastri E; Concia E; Rezza G; Andreoni M
Prevalence trend and correlates of HHV-8 infection in HIV-infected
patients.
SO - J Acquir Immune Defic Syndr 2002 Mar 1;29(3):295-9
AD - Institute of Immunology and Infectious Diseases, University of Verona,
Italy.
To assess the circulation of human herpesvirus (HHV)-8 infection over
the years, two seroprevalence surveys were conducted, which tested sera
from HIV-infected individuals recruited 10 years apart (206 individuals
from 1986 to 1988 and 177 individuals from 1997 to 1998). For all
patients, antibodies to hepatitis C virus (HCV), hepatitis B virus
(HBV), and HHV-8 lytic and latent antigens were evaluated.HHV-8
seroprevalence was higher among individuals recruited in the 1990s
(31.6% for anti-lytic, 8.5% for anti-latent antibodies) compared with
similar findings in those seen in the late 1980s (14.6% and 3.4% for
anti-lytic and anti-latent antibodies, respectively), with a twofold
increase of the risk of HHV-8 infection. However, the increase was
observed only among injecting drug users, whereas seroprevalence tended
to slightly increase among those infected by sexual contact. At
univariate analysis, time of recruitment and being homosexual men were
factors associated with HHV-8 infection, an association that remained
after adjusting for age. HBV infection was significantly associated with
HHV-8 infection (odds ratio [OR], 2.2; 95% confidence interval [CI],
1.3-3.6), whereas those infected with HCV had a lower probability of
having HHV-8 antibodies (OR, 0.3; 95% CI, 0.20-0.6). After controlling
for age and gender, time of recruitment remained independently
associated with HHV-8 infection among injecting drug users.In
conclusion, HHV-8 seroprevalence appears to be increased during 10 years
among HIV-infected injection drug users but not among homosexual men,
who remain those at the highest risk of infection.
13
UI - 11762815
AU - Ruka W; Rutkowski P; Kaminska J; Rysinska A; Steffen J
TI -
Alterations of routine blood tests in adult patients with soft tissue
sarcomas: relationships to cytokine serum levels and prognostic
significance.
SO - Ann Oncol 2001 Oct;12(10):1423-32
AD - Department of Soft Tissue/Bone Sarcomas, M. Sklodowska-Curie Memorial
Cancer Center and Institute of Oncology Warsaw, Poland.
BACKGROUND: It has been reported that malignancy is often accompanied by
hematological alterations and that such alterations may correlate with
poor prognosis. It has also been demonstrated that several cytokines may
be synthesized by many malignant tumors and that elevated serum levels
of some cytokines are associated with changes in blood cell counts in
cancer patients. However, so far little is known about the prognostic
significance and mechanism of hematological changes in soft tissue
sarcomas. The aim of the study was to evaluate the routine blood tests
of disturbances in patients with malignant soft-tissue tumors prior to
treatment and to correlate these results with selected cytokine serum
levels, clinicopathological features of the tumors and patient survival.
PATIENTS AND METHODS: 145 patients (75 males, 70 females; mean age 49.97
+/- 16.9 yrs) with histologically confirmed soft tissue sarcomas before
treatment were enrolled into the study. In all these patients we
evaluated routine blood tests (hemoglobin level HGB, white blood cell
count WBC, platelet count PLT, white blood cell differential
count-neutrocyte count NE, lymphocyte count LY, monocyte count MN,
eosinophile count EO) and serum levels of 13 cytokines and soluble
cytokine receptors (IL-6, IL-8, IL-10, TNFalpha, G-CSF, M-CSF, bFGF,
VEGF, IL-1ra, sIL-2R. sIL-6R. TNF RI, TNF RII)--ELISA method. Peripheral
blood samples from 50 healthy volunteers served as control. Statistical
analysis was performed using Kolmogorov-Smirnov and Mann-Whitney
U-tests, chi2 test (P < 0.05), where appropriate. For survival analysis
the Kaplan-Meier method, log-rank test and multivariate Cox analysis
were applied. RESULTS: Alterations of at least one of the standard blood
tests were found in 43.4% of all cases. The most frequent alterations
were: neutrophilia (28.3% of cases), leukocytosis (27.6%), decreased HGB
(25.5%), monocytosis (19.3%) and thrombocytosis (14.5%); they correlated
strongly with elevated serum levels of several cytokines and soluble
cytokine receptors (particularly: sIL-2R, IL-6, IL-8, M-CSF, VEGF, TNF
RI, TNF RII) (P < 0.001). Lymphocytopenia (LY < 1.0) found in 10.3% of
patients correlated strongly with increased serum levels of IL-6,
sIL-2R, TNF RI. In parallel, we found a significant difference in serum
levels of 11 of 13 cytokines (IL-1ra. sIL-2R, IL-6, IL-8, IL-10, TNF RI,
TNF RII, TNFalpha, M-CSF, bFGF, VEGF) (P < 0.001) in soft tissue sarcoma
patients compared to healthy controls. Hematological alterations were
significantly more frequent in patients with advanced tumors. In
multivariate analysis we found no prognostic significance of any of the
routine blood tests in soft tissue sarcoma patients. CONCLUSION: The
results of this study demonstrate that hematological alterations, which
occur in over 40% of soft tissue sarcoma cases, are found more
frequently in patients with advanced tumors. Strong correlations between
the occurrence of hematological abnormalities and elevated serum levels
of several cytokines and soluble cytokine receptors, suggest that the
former may develop as a result of cytokine misbalance frequently
detected in soft tissue sarcoma patients. However, the results of
routine blood tests alone are no independent prognostic factor for
survival of soft-tissue sarcoma patients.
14
UI - 11918915
AU - Wurl P; Kappler M; Meye A; Bartel F; Kohler T; Lautenschlager C; Bache
TI -
M; Schmidt H; Taubert H
Co-expression of survivin and TERT and risk of tumour-related death in
patients with soft-tissue sarcoma.
SO - Lancet 2002 Mar 16;359(9310):943-5
Increased expression of survivin has been shown to be a negative
predictor of survival in patients with soft-tissue sarcoma. We
investigated 89 adults with soft-tissue sarcomas to ascertain the
relation between co-expression of survivin and human telomerase reverse
transcriptase (TERT) transcripts and prognosis. We quantified mRNA
expression of survivin and TERT transcripts. Cox's proportional-hazards
regression model showed co-expression of both genes to be a significant
negative prognostic factor for patients with stage I to stage IV tumours
(p=0 small middle dot0004; relative risk 20 small middle dot1, 95% CI 3
small middle dot8-106 small middle dot4) and for those at stage II and
III (p=0 small middle dot0002; 42 small middle dot1, 6 small middle
dot0-294 small middle dot9) compared with low expression of both genes.
Co-expression of survivin and TERT transcripts identifies patients at
high risk of tumour-related death.
15
UI - 11920533
AU - Kawamura N; Ichimura T; Ito F; Shibata S; Takahashi K; Tsujimura A;
TI -
Ishiko O; Haba T; Wakasa K; Ogita S
Transcervical needle biopsy for the differential diagnosis between
uterine sarcoma and leiomyoma.
SO - Cancer 2002 Mar 15;94(6):1713-20
AD - Department of Obstetrics and Gynecology, Osaka City University Graduate
School of Medicine, Osaka, Japan. kawamuraog@med.osaka-cu.ac.jp
BACKGROUND: The clinical differential diagnosis between uterine sarcoma
and benign leiomyoma is difficult even with magnetic resonance imaging
(MRI). Therefore, a considerable number of patients have undergone
hysterectomies due to an indication of "suspected malignancy" based on
tumor size alone. However, approximately 80% of these hysterectomies
have been judged to have been recommended inappropriately. In such
situations, reliable preoperative diagnostic tests are required. The
authors have evaluated the accuracy of needle biopsy for uterine
myoma-like tumors, a procedure that to the authors' knowledge has been
performed infrequently. METHODS: Transcervical needle biopsy was
performed in 435 patients with uterine myoma-like tumors. The biopsy
specimens were scored for degree of malignancy according to the
histopathologic criteria proposed by Bell et al. Histopathologic
evaluation of surgical specimens and clinical outcome after 2 years of
follow-up were used as the reference standards. RESULTS: Of 435
patients, 7 had uterine sarcomas, 4 of which were scored as > or = 4
points and were diagnosed as "sarcoma" by needle biopsy alone. No
sarcoma cases were included in the group of patients with a score of 0.
The cutoff score combining the highest sensitivity and specificity with
respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma
was 2; sensitivity, specificity, and positive and negative predictive
values were 100%, 98.6%, 58%, and 100.0%, respectively. CONCLUSIONS:
Transcervical needle biopsy using histopathologic scoring is a reliable
diagnostic test for the differential diagnosis between uterine sarcoma
and leiomyoma. This diagnostic method, combined with MRI screening,
could reduce the number of patients currently undergoing unnecessary
surgery. Copyright 2002 American Cancer Society.
16
UI - 11920510
AU - Wang J; Weiss LM; Chang KL; Slovak ML; Gaal K; Forman SJ; Arber DA
TI -
Diagnostic utility of bilateral bone marrow examination: significance of
morphologic and ancillary technique study in malignant.
SO - Cancer 2002 Mar 1;94(5):1522-31
AD - Division of Pathology, City of Hope National Medical Center, Duarte,
California 91010, USA.
BACKGROUND: To retrospectively evaluate the significance of morphologic
examination and ancillary studies performed on bilateral bone marrow
biopsy specimens, 1864 bone marrow samples were studied. METHODS:
Bilateral bone marrow biopsy specimens included 883 specimens that were
evaluated for involvement by non-Hodgkin lymphoma (NHL); 381 specimens
that were evaluated for involvement by carcinoma (CA); 362 specimens
that were evaluated for involvement by Hodgkin disease (HD); 94
specimens that were evaluated for involvement by sarcoma (SA); 56
specimens that were evaluated for involvement by multiple myeloma (MM);
53 specimens that were evaluated for involvement by acute and chronic
leukemia, myelodysplasia, and/or myeloproliferative disorders (LEUK);
and 35 specimens that were evaluated for other reasons. RESULTS: Of all
1864 specimens, 410 samples (22.0%) were positive for disease, including
77% of MM samples, 58% of LEUK samples, 29.6% of NHL samples, 14% of SA
samples, 9.9% of HD samples, and 6.8% of CA samples. A discrepancy
between the left and right sides was identified in 48 specimens (11.7%
of positive samples). The discrepancy rate was 39% for HD samples, 29%
for SA samples, 23% for CA samples, and 9.2% for NHL samples. No
morphologic discrepancies between bilateral samples were found in MM
samples or LEUK samples. Bilateral flow cytometric studies (n = 113
samples) were positive in 11 samples (9.7%; all morphologically
positive), with two discrepancies detected between bilateral samples.
Bilateral cytogenetic studies (n = 74 samples) were positive in 5
samples (7%), and there were no discrepancies. Bilateral molecular
studies (n = 16 samples) were positive in 7 samples (44%), and there
were 3 discrepancies. CONCLUSIONS: Bilateral morphologic evaluation is
useful in the evaluation of patients with NHL, HD, CA, and SA and is not
indicated for patients with acute or chronic leukemia, myelodysplasia,
MM, and other diseases. Bilateral flow cytometric or cytogenetic studies
of bone marrow did not provide additional information in this population
to justify bilateral samples. The role of bilateral molecular analysis
needs to be defined further, but pooled samples for molecular studies
may be adequate. Copyright 2002 American Cancer Society.
17
UI - 11920514
AU - Kettelhack C; Wickede M; Vogl T; Schneider U; Hohenberger P
TI -
31Phosphorus-magnetic resonance spectroscopy to assess histologic tumor
response noninvasively after isolated limb perfusion for soft tissue
tumors.
SO - Cancer 2002 Mar 1;94(5):1557-64
AD - Division of Surgery and Surgical Oncology, Robert Roessle Hospital and
Tumor Institute at the Max Delbruck Center for Molecular Medicine,
Charite, Campus Berlin-Buch, Humboldt University at Berlin, Berlin,
Germany.
BACKGROUND: In patients with unresectable soft tissue sarcoma of the
extremities, isolated limb perfusion (ILP) has been reported to result
in significant tumor regression enabling limb-sparing resection in the
majority of patients. However, clinical tumor response as evaluated by
imaging and histopathology (extent of tumor necrosis) often differ
significantly. The current study was initiated to evaluate prospectively
the role of 31phosphorus-magnetic resonance spectroscopy (31P-MRS) in
the noninvasive assessment of histologic response in patients treated
with ILP. METHODS: Thirty-two patients with locally advanced and
unresectable soft tissue tumors (sarcoma in 28 patients and bulky
melanoma in 4 patients) were treated by ILP with recombinant human tumor
necrosis factor-alpha and melphalan or with cytostatics. 31P-MRS was
performed prior to treatment and at regular intervals after ILP until
definite tumor resection. Clinical response parameters according to the
World Health Organization as well as the histopathologic necrosis rate
of the resection specimen were correlated with changes in the
energy-rich phosphorous metabolites phosphocreatine (PCR); alpha-,
beta-, gamma-adenosine triphosphate (ATP); phosphomonoesters (PME); and
inorganic phosphate (Pi). RESULTS: Clinically, 15 of 32 patients
(response rate [RR] of 47%) demonstrated a partial response (PR). The
ratios of PME/PCR and PME/beta-ATP decreased significantly after ILP in
comparison with preoperative values (P < 0.001). The changes in the
PME/beta-ATP ratio were significantly different between clinical
responders and nonresponders (P < 0.02) in contrast with the PME/PCR
ratios (P < 0.09). Histologic necrosis of > 90% (pathologic (p) PR) was
present in 17 resection specimens, 7 of which demonstrated no clinical
response. Seven tumors demonstrated a pathologic complete response
(pCR). When combining PR, pPR, and pCR (RR of 68%), 31P-MRS was able to
predict response with a specificity of 94% and a sensitivity of 68% (P <
0.006, by the chi-square test). CONCLUSIONS: The considerable difference
between clinical and pathologic RR after ILP underlines the shortcomings
of established response criteria. Utilizing changes in PME/beta-ATP
ratios, 31P-MRS is a highly specific tool with which to predict
histologic response in this setting. This finding may be of major value
in those patients in whom the decision to perform a major resection or
amputation must be made for local tumor control. Copyright 2002 American
Cancer Society.
18
UI - 11844053
AU - Samaratunga H; Clarke B; Owen L; Bryson G; Swanson C
TI -
Phyllodes tumors of the breast: correlation of nucleolar organizer
regions with histopathological malignancy grading, flow cytometric DNA
analysis and clinical outcome.
SO - Pathol Int 2001 Nov;51(11):866-73
AD - Department of Anatomical Pathology, Royal Brisbane Hospital, Queensland,
Australia. hemamali_samaratunga@snp.com.au
To examine whether nucleolar organizer regions detected by argyrophilia
(Ag-NOR counts) can be used as a prognostic indicator in phyllodes
tumors of the breast, and to compare its usefulness with that of DNA
flow cytometric analysis, 28 cases of breast phyllodes tumors (including
15 benign, two borderline and 11 malignant tumors) were subjected to
Ag-NOR staining and counting as well as DNA flow cytometric analysis.
S-phase fraction and DNA ploidy analysis showed useful trends for
improving outcome predictions in malignant phyllodes tumors. However,
high Ag-NOR counts were significant in predicting survival status (P =
0.013) and reached near statistical significance in predicting survival
times (P = 0.07). In predicting survival status, results for Ag-NOR
counts were significantly better than those for ploidy analysis (P =
0.02) and S-phase fraction (P < 0.01). Only S-phase fraction was
significantly predictive of survival times (P = 0.025). It is concluded
that Ag-NOR counts and DNA flow cytometric analysis, easily performed
using paraffin sections, give information that can improve predictions
made by histopathological classification. Ag-NOR counts are significant
in predicting survival in the presence of histopathological features of
malignancy.
19
UI - 11844066
AU - Yavuz E; Gulluoglu MG; Akbas N; Tuzlali S; Ilhan R; Iplikci A; Akhan SE
TI -
The values of intratumoral mast cell count and Ki-67 immunoreactivity
index in differential diagnosis of uterine smooth muscle neoplasms.
SO - Pathol Int 2001 Dec;51(12):938-41
AD - Department of Pathology, Gynecologic Pathology Division, Istanbul
Medical Faculty, Istanbul University, Turkey. ekremyavuz@ixir.com
In this study, the role of the count of intratumoral mast cells was
examined and compared with the proliferative activity exhibited by Ki-67
indices in the differential diagnosis of uterine smooth muscle tumors.
Sixteen cases of leiomyosarcoma, nine cases of atypical leiomyoma and 16
cases of ordinary leiomyoma were included. The pathological features of
the cases were determined by reviewing the archive materials including
the patient records and hematoxylin-eosin-stained sections. Toluidine
blue stain was used to highlight the intratumoral mast cells and they
were counted in at least 40 high power fields. A standard
streptavidin-biotin method was applied to the sections to highlight the
Ki-67 immunoreactive tumor cell nuclei. These proliferative cells were
counted in at least 10 high-power fields. Atypical leiomyomas tended to
have a higher quantity of intratumoral mast cells than leiomyosarcomas
and ordinary leiomyomas (P = 0.027 and P = 0.021, respectively).
Leiomyosarcomas tended to have higher Ki-67 immunoreactivity rates than
atypical leiomyomas, although the difference was not statistically
significant (P = 0.82). We concluded that the quantity of intratumoral
mast cells is useful in the differential diagnosis between
leiomyosarcomas and atypical leiomyomas, while the cell proliferation
rate expressed by Ki-67 immunoreactivity has a limited value.
20
UI - 11782672
AU - Salwa-Zurawska W; Biczysko W; Wozniak A; Janicka-Jedynska M; Trejster E
TI -
Usefulness of immunohistochemical testing and electron microscopy in the
diagnosis of embryonal rhabdomyosarcoma.
SO - Med Sci Monit 2002 Jan;8(1):BR39-46
AD - Department of Clinical Pathomorphology, Medical University, Poznan,
Poland.
BACKGROUND: This article presents the results of histological,
immunohistochemical, and ultrastructural examinations of embryonal
rhabdomyosarcoma. MATERIAL/METHODS: 20 tumors were tested
histologically, 13 immunohistochemically, and 5 under electron
microscopy. RESULTS: We found that in cases when the entire tumor or
large specimens were obtained for estimation, it was possible by
examining many areas of the neoplasm to establish a diagnosis on the
basis of testing paraffined sections, routinely HE stained. Our
evaluation of the value of certain additional histological methods
indicated only slight diagnostic usefulness for tumors of this kind.
Among the immunohistochemical methods we evaluated, the desmin assay had
the greatest practical applicability, due to the fact that this antigen
is also expressed in highly immature cells; in second place was
myoglobin. Differences are pointed out in the results obtained by
assaying myoglobin using DAB and the DAKO kit. Ultrastructural
examinations revealed myofilaments of myosin and actin in all types of
cells, including immature cells. Particular attention is drawn to the
possibility of using material fixed in formalin for ultrastructural
examination. The preservation of intact myofilaments in material
prepared in this way constitutes an essential diagnostic aid.
CONCLUSIONS: In diagnosing embryonal rhabdomyosarcoma the most useful
examination, apart from histological examination, is electron
microscopy, followed by immunomorphological examination.
21
UI - 11882765
AU - Stojadinovic A; Leung DH; Hoos A; Jaques DP; Lewis JJ; Brennan MF
TI -
Analysis of the prognostic significance of microscopic margins in 2,084
localized primary adult soft tissue sarcomas.
SO - Ann Surg 2002 Mar;235(3):424-34
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA.
OBJECTIVE: To define the significance of positive microscopic resection
margins in a large cohort treated for soft tissue sarcoma. METHODS: The
authors analyzed 2,084 patients with localized primary soft tissue
sarcoma (all anatomic sites) treated from 1982 to 2000.
Clinicopathologic variables studied included tumor site, size, depth,
histologic type, grade, and resection margin status. Treatment other
than resection was not analyzed. Study endpoints included local and
distant recurrence-free and disease-specific survival rates, estimated
by the Kaplan-Meier method. Univariate and multivariate analyses were
performed using the log-rank test and the Cox proportional hazards
model. RESULTS: Median follow-up was 50 months. After primary resection,
1,624 (78%) patients had negative and 460 (22%) had positive resection
margins. Having positive margins nearly doubled the risk of local
recurrence and increased the risk of distant recurrence and
disease-related death. Seventy-two percent of patients with positive
margins had no recurrence. Resection margin did not predict local
control for retroperitoneal sarcomas or fibrosarcomas. Resection margin
remained significantly associated with distant recurrence-free survival
and disease-specific survival across all subsets after adjusting for
other prognostic variables. The overall 5-year disease-specific survival
rates for negative and positive margins were 83% and 75%. CONCLUSIONS:
Positive microscopic resection margins significantly decrease the local
recurrence-free survival rate for other-than-primary fibrosarcoma and
retroperitoneal sarcomas, and independently predict distant
recurrence-free survival rates and disease-specific survival rates for
all patient subsets. Adjuvant therapy should be considered in the
management of soft tissue sarcoma to increase local control. Because 72%
of positive margins did not equate with inevitable local recurrence,
considerable clinical judgment is required in considering additional
treatment. Microscopic resection margins should be considered for
inclusion in staging systems and treatment algorithms that address local
recurrence.
22
UI - 11895494
AU - Saito T; Oda Y; Sakamoto A; Tamiya S; Iwamoto Y; Tsuneyoshi M
TI -
Matrix metalloproteinase-2 expression correlates with morphological and
immunohistochemical epithelial characteristics in synovial sarcoma.
SO - Histopathology 2002 Mar;40(3):279-85
AD - Department of Anatomic Pathology, Kyushu University, Graduate School of
Medical Sciences, Fukuoka, Japan.
AIMS: Synovial sarcoma is a unique mesenchymal tumour characterized by
the presence of epithelial differentiation, although the mechanism
involved in the epithelial morphology is still unclear. The aim of this
study was to evaluate the function of matrix metalloproteinase-2 (MMP-2)
in synovial sarcoma, in order to assess whether MMP-2 expression plays
an important role in epithelial differentiation, or whether it
contributes to a poor clinical outcome. METHODS AND RESULTS:
Immunohistochemical stainings for MMP-2, cytokeratins (CKs) 7, 8, 18 and
19, and E-cadherin were performed for 58 (44 monophasic and 14 biphasic)
cases of synovial sarcoma, and we compared the expression of these
proteins with the histological and clinical findings. MMP-2 and
E-cadherin expression was observed in 43 cases (74.1%) and in 18 cases
(31.0%), respectively. Expression of these proteins was preferentially
observed in the glandular components of biphasic tumours or the
epithelioid areas of monophasic tumours. Statistically significant
correlations were recognized between MMP-2 expression and E-cadherin
expression of biphasic subtype. Moreover, there were statistically
significant correlations between monophasic tumours with epithelioid
areas and MMP-2 expression or E-cadherin expression. MMP-2 expression
was correlated with epithelial differentiation as assessed by CK
immunoreactivity. The expression of MMP-2 did not affect the overall
survival rate in synovial sarcoma. CONCLUSIONS: MMP-2 expression seemed
to have an important role to play in the epithelial differentiation of
tumour cells in synovial sarcoma, through remodelling of the
extracellular matrix and by changing the cytoskeletal interaction
between the extracellular matrix and tumour cells.
23
UI - 11906888
AU - Torreggiani WC; Al-Ismail K; Munk PL; Nicolaou S; O'Connell JX; Knowling
TI -
MA
Dermatofibrosarcoma protuberans: MR imaging features.
SO - AJR Am J Roentgenol 2002 Apr;178(4):989-93
AD - Department of Radiology, Vancouver General Hospital, University of
British Columbia, 899 W. 12th Ave., Vancouver, B. C., V5Z 1M9 Canada.
OBJECTIVE: The objective of our study was to describe the MR imaging
features of 10 cases of histologically confirmed dermatofibrosarcoma
protuberans. CONCLUSION: MR imaging is useful in identifying the extent
and location of dermatofibrosarcoma protuberans. Although most cases of
this tumor are superficial and well defined, we have shown three cases
in which the tumor was in a deep location and one case in which the
tumor was ill defined in appearance. Knowledge of the variable MR
imaging appearances of these tumors may aid in the diagnosis of
difficult or atypical cases.
24
UI - 11699563
AU - Montesinos-Rongen M; Hans VH; Eis-Hubinger AM; Prinz M; Schaller C; Van
TI -
Roost D; Aguzzi A; Wiestler OD; Deckert M
Human herpes virus-8 is not associated with primary central nervous
system lymphoma in HIV-negative patients.
SO - Acta Neuropathol (Berl) 2001 Nov;102(5):489-95
AD - Abteilung fur Neuropathologie, Universitatsklinikum Koln, Germany.
neuropatho@uni-koeln.de
Primary central nervous system lymphomas (PCNSL) are derived from
germinal center B cells. Recent molecular studies indicate that the
tumor cells or their precursors have experienced antigenic stimulation.
Attractive candidates for such antigens are pathogens with the capacity
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