An acquired giant vascular tumour of the breast

We present a rare case of an acquired giant vascular tumour of the breast that was diagnosed as angiomatosis. It was characterised by the mixture of blood-filled haemangiomatous, and apparently empty lymphangiomatous, vascular channels. The breast remnant returned to a normal configuration and contour without breast reduction.     

Preoperative diagnosis of soft tissue tumours

Summary Over a period of 3 years in Southern Sweden 35 patients were seen with deep-seated limb sarcomas without metastases, 30 of whom were referred before any operation had been carried out. Thirty seven patients with deep-seated benign lesions were referred during the same period because of suspected malignancy. A preoperative diagnosis considered sufficient for a definitive operation was made from the clinical findings, aspiration cytology and radiographic examination, but without open biopsy, in 59 of these 67 cases. The differentiation between a benign and a malignant tumour was correct in all but one. The extent of excision necessary to achieve adequate margins for a soft-tissue sarcoma can often be reduced if open biopsy is avoided, with preservation of function. We conclude that treatment without open biopsy is possible in the great majority of patients with soft-tissue sarcoma.

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Résumé En l'espace de trois ans, en Suède méridonale, on a rassemblé 35 malades porteurs de sarcomes profonds des membres, sans métastases. Trente d'entre eux ont été adressées avant toute intervention. Pendant la même période 37 patients présentant des tumeurs bénignes profondément situées ont été adressés pour suspicion de malignité. Dans 59 de ces 67 cas, un diagnostic pré-opératoire, suffisant pour déterminer le type d'intervention à réaliser, a été obtenu grâce à l'examen clinique, à l'examen radiologique et à la cytologie par ponction biopsie, mais sans biopsie opératoire. La distinction entre tumeur bénigne et maligne s'est révélée exacte dans tous les cas sauf un. L'étendue de l'excision nécessaire pour délimiter correctement un sarcome des parties molles peut souvent être réduite si la biopsie pré-opératoire a été évitée, permettant la conservation de la fonction. Les auteurs concluent que le traitement des malades porteurs de sarcomes des parties molles est possible dans la grande majorité des cas sans qu'il faille recourir à la biopsie chirurgicale.

     

Beitrag zur Klinik des Hämangiopericytoms

Zusammenfassung Nach Darstellung der pathologisch-anatomischen und histologischen Befunde des Hämangiopericytoms werden 276 Fälle der Literatur und 5 Fälle aus der Chirurgischen Univ.-Klinik Heidelberg hinsichtlich ihrer Geschlechts-, Alters- und Organverteilung, ihrer Symptomatik, Rezidiv-und Malignitätsrate untersucht. Die 65 kindlichen Fälle dieser Übersicht werden getrennt auf ihre Besonderheiten hin analysiert. Der Tumor kann grundsätzlich überall da auftreten, wo Capillaren vorkommen. Die verschiedenen Körperregionen sind fast gleichmäßig betroffen. Das weibliche Geschlecht überwiegt (55%). Die Symptomatik ist uncharakteristisch und abhängig von der Lokalisation. Ein hoher Prozentsatz der Tumoren entwickelt sich symptomlos.Nur 15% der Fälle verliefen innerhalb des Beobachtungszeitraumes gutartig, bei 41% war der Verlauf maligne. Bei 53 Patienten (37%) wurden Rezidive beobachtet.Bei den Hämangiopericytomen des Kindesalters ist das männliche Geschlecht stärker betroffen, im 1. Lebensjahr stehen 13 Fällen beim Knaben nur 4 beim Mädchen gegenüber. Die Zahl der malignen Hämangiopericytome ist um das 10. Lebensjahr am größten. Die Malignitätsrate ist bei Kindern mit 50% etwas höher als beim Erwachsenen. Bei der hohen Rezidiv- und Malignitätsrate ist das radikale chirurgische Vorgehen das Mittel der Wahl.

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Hemangiopericytoma — A clinical study

Summary After a presentation of the pathological, anatomical and histological findings in hemangiopericytoma, 276 cases from the literature and 5 from the Surgical University Hospital in Heidelberg were studied with reference to sex, age and organ distribution, symptoms, relapse and mortality rate. The 65 cases in children in this review were analysed separately according to their characteristics. Fundamentally, the tumour may appear wherever there are capillaries. The different regions of the body are almost equally affected. It is more frequent in females (55%). The symptoms are not characteristic and depend on the localisation. A high percentage of the tumors develop without symptoms.Only 15% of the cases within the period of observation were benign, and the course was malignant in 41%. In 53 Patients (37%) recurrence was observed. In childhood, hemangiopericytoma occurs more frequently in males, in the first year of life there were 13 cases in boys and only 4 in girls. The number of malignant hemangiopericytomas is greatest at about the age of 10. The malignancy rate of 50% in children is somewhat higher than in adults. Because of the high relapse and malignancy rates, radical surgery is the treatment of choice.

     

Tumour of Wagner-Meissner touch corpuscles*

Summary Two benign tumours composed mainly or exclusively of Wagner-Meissner corpuscles are described. In the first case the touch corpuscles are composed of closely piled laminar cells and surrounded by argyrophilic fibres. In the second case some Schwann cells are observed in between the tactile corpuscles. The light microscopic, electron-microscopic and immunohistochemical results demonstrate that these corpuscles are comparable with the tactile end organs of the skin. Immunohistochemically, neuron-specific enolase, vimentin and protein S-100 could be demonstrated in the tactile corpuscles. Neural processes present in normal Meissner corpuscles are absent and immunohistochemically no nerve fibres or nerve endings can be demonstrated using antibodies to neurofilaments as they are observed in normal touch corpuscles of the skin.Tumours which consist mainly of multiple touch corpuscles have not been described in the literature. It is suggested to call these tumours Wagner-Meissner neurilemmoma.Dedicated to Professor Dr. Dr. h.c. K. Lennert in honor of his 65th birthday     

The Evaluation of Thoracic Paraspinal Neurogenic Tumours The Role of Magnetic Resonance Imaging

Paraspinal neurogenic tumours may have associated intraspinal tumour extension. It is important that such extension be accurately defined preoperatively in order that an appropriate surgical approach may be planned. It has been suggested in the literature that MRI (where available) should replace myelography and post myelographic CT in the preoperative evaluation of these patients. The literature is reviewed and the potential role of MRI is illustrated in three cases.     

Fine structural localisation of acid phosphatase in neural tumours induced by N-ethyl-N-nitrosourea in rats

Summary A single intravenous injection of 30 mg of N-ethyl-N-nitrosourea per kg of body weight was administered to pregnant BD-IX rats on the 15th day of gestation. The neural tumours which developed in 97.5% of the offspring were gliomas and schwannomas. The demonstration of acid phosphatase in the neoplastic and reacting cells of these tumours was carried out at fine structural level. The enzyme activity was localised in lysosomes and in the innermost cisternae of the Golgi complexes. High acid phosphatase activity was related not only to degeneration, necrosis and phagocytosis but also to cellular differentiation and anaplasia.     

Reciprocity between membranous and nuclear expression of β-catenin in colorectal tumours

 β-Catenin has a central role not only in linking the cadherin-mediated cell adhesion system but also in the intercellular signalling pathway. To investigate alterations of β-catenin in the development of colorectal carcinoma, the pattern of β-catenin expression was studied using immunohistochemistry in 74 sporadic colorectal adenomas, in histologically normal mucosa adjacent to 65 of these adenomas, and in 52 carcinomas arising in adenomas. All normal epithelia displayed cell boundary staining for β-catenin. Adenomas and carcinomas showed varying degrees of membranous staining. However, some tumours also showed nuclear staining of β-catenin protein. Decreased membranous and increased nuclear β-catenin staining were associated with increasing degrees of dysplasia in adenomas (P < 0.005, P < 0.05, respectively). Carcinomas manifested significantly reduced membranous, but enhanced nuclear β-catenin expression compared with their associated adenomas (P < 0.001, P < 0.005, respectively). An inverse correlation was found between decreased membranous and increased nuclear staining of β-catenin in both adenomas and carcinomas (P < 0.025, P < 0.05, respectively). The data confirm that reduced membranous and increased nuclear expression of β-catenin is associated with the progression of colorectal adenomas to carcinomas. Our results also suggest that decreased membranous expression of β-catenin may result from aberrant localisation of the protein in the cell nucleus. Received: 1 January 1997 / Accepted: 26 February 1997     

Pregnancy specific β1-glycoprotein and α2-pregnancy associated globulin in tumours of the female genital tract

Summary Tumour tissues obtained from 35 patients with malignancies of the female genital tract were investigated for production of pregnancy specific ₁-glycoprotein (PS₁G) and ₂-pregnancy associated globulin (₂-PAG). PS₁G was found in all five trophoblastic tumours studied and in 10 of the 30 non-trophoblastic cancers. ₂-PAG was not detected in any of the neoplastic tissues.In 18 of the patients with non-trophoblastic tumours PS₁G and ₂-PAG serum concentrations were also determined. No correlation between serum and tissue findings were noted. Thus, PS₁G does not seem to be a valuable serum indicator for monitoring the extent or variation of tumour mass in non-trophoblastic gynecological malignancies. Likewise, ₂-PAG is unlikely to serve as a clinical useful tumour marker in various gynecological cancers.     

Acinar Phenotypes in Salivary Pleomorphic Adenoma: Unusual Differentiation or Disordered Functional Activity?

To explain the occurrence in salivary pleomorphic adenoma of structures with an arrangement and appearance of tumour cells resembling acini, two tumours showing such structures and, for comparison, a tumour showing goblet cells were examined with the use of histochemistry and immunocytochemistry for constituents of the salivary secretory process. One tumour consisted mainly of slightly granular cells with an acinar arrangement, which contained neutral and carboxylated glycoproteins, -SH groups and cytoplasmic epithelial membrane antigen. The second tumour showed a minor component of structures resembling mucous acini, which contained neutral and carboxylated glycoproteins, -SS- groups and fucoglycoconjugates. The goblet cells of the third tumour contained sulphated glycoproteins and were associated with cystic lumina. Acinar phenotypes in salivary pleomorphic adenoma could reflect either an unusual line of differentiation or luminal cells with increased synthesis and/or retention of variably mature glycoproteins different from those of goblet cells. Disordered secretion and externalization of glycoproteins are possible factors influencing phenotypes in this tumour.