Multiple myeloma and oat cell carcinoma.

An association linking multiple myeloma with a higher incidence of carcinomatous tumours has been reported. The following case report describes a man diagnosed as having bronchogenic carcinoma found also to have myelomatosis. Aspects of this association are discussed.     

Spindle cell carcinoma of the larynx

The clinicopathological features of 14 laryngeal neoplasms consisting of spindle-shaped cells are presented. Light microscopy showed a variety of morphological patterns from that of pleomorphic sarcoma and fibrosarcoma to more loose vascular patterns. Immunohistochemistry revealed that the spindle-shaped cells had a positive keratin immunoreactivity in 8 of 14 cases, and also that some cases had a dual expression of keratin and vimentin filaments. Electron microscopy showed that spindle-shaped cells had epithelial ultrastructures. The results support the hypothesis that the spindle cell carcinomas are true carcinomas with mesenchymal metaplasia and that the spindle-shaped cells are part of the neoplasm and not benign, reactive fibroblasts. These lesions occurred mainly on the true vocal cords in elderly patients. The neoplasms were nearly all polypoid, and many also ulcerated. There is no significant difference in clinical behaviour between laryngeal spindle cell carcinomas and ordinary squamous cell carcinomas of the larynx, and the same treatment policy is therefore advocated. Being polypoid and therefore able to be surgically removed with relative ease, they may even present a more favourable clinical course.     

Acinous cell carcinoma of the larynx

Adenocarcinomas of the larynx are an unusual type of lesion that arise in the minor salivary glands. An acinous cell carcinoma that arose in a supraglottic minor salivary gland closely resembled an oncocytic adenocarcinoma on light microscopy; but on electron microscopy, the neoplasm clearly was serous in origin. Contrary to the behavior of most acinous cell carcinomas, but similar to the majority of laryngeal adenocarcinomas, the neoplasm herein discussed was extremely aggressive and developed widespread metastases, which led to the patient's death.     

Adenoid squamous cell carcinoma of the larynx: an uncommon histological variant of squamous cell carcinoma

Adenoid squamous cell carcinoma (ASCC) or acantholytic squamous cell carcinoma is a well-recognized variant of squamous cell carcinoma. ASCC commonly occurs in the sun-exposed areas of the skin and has only rarely been observed in mucosal sites. We report a case of ASCC in the larynx of a 75-year-old man with a history of odynophagia and dysphonia of 3 months' duration that presented as an exophytic lesion on the right vocal cord. Biopsy was performed and the histological diagnosis was squamous cell carcinoma. Treatment consisted of total laryngectomy and radical neck dissection. Microscopically, the tumor showed a prominent alveolar pattern with cystic degeneration of the neoplastic epithelium and formation of pseudoglandular structures. In the lumina there were acantholytic cells. Transition areas from conventional squamous cell carcinoma to adenoid pattern were found. To the best of our knowledge this is only the third case of ASCC reported in the larynx. We reviewed the nine mucosal ASCCs of the upper aerodigestive tract reported. The assertion that these tumors are associated with an aggressive behavior and poor prognosis cannot be estimated in this review as the number of cases is small and the tumors are located in different places.     

Dual differentiation in small cell carcinoma (oat cell carcinoma) of the lung

Two cases of small cell “undifferentiated” carcinoma (oat cell carcinoma) of the lung with dual neurosecretory and squamous differentiation are reported. One was treated with various regimens of chemotherapy and radiotherapy; the other was untreated at the time of biopsy. By electron microscopy, the same tumor cells showed membrane-bound, dense-core, neurosecretory-type granules and bundles of tonofibrils denoting squamous differentiation. This dual differentiation underlies the difficulty of ascribing an exclusively neural histogenesis to small cell carcinomas with neurosecretory-type granules. It is possible that entoderm-associated neuroectodermal tumors develop features of autochthonous entodermal tumors as a result of microenvironmental influences. An alternative hypothesis would be that small cell tumors are derived from basal reserve bronchoepithelial cells with pluripotentialities.     

Small cell (oat cell) carcinoma of the breast

A case of small cell (oat cell) carcinoma, which represents both the most dlstlnctlve and the least common type of mast carcinoma wtth neuroendocrine dlfterentiation and usually shows the most aggressive behavior, is described. Radlcal mastectomy was performed on a Wyearold female for a 10 cm tumor located in the outer part of the right breast with cutaneous ulceration Microscoplcally, the tumor predominantly consisted of a diffuse proliteration of small, round to ovoid cells with hyperchromatlc nuclei and ill-defined, scant cytoplasm that was reminiscent of oat cell carclnoma of the lung. There were foci of invasive ductal carcinoma and ductal carcinoma in situ . Small cell carcinoma areas constituted approximately 90% of the neoplasm. The patlent had axlllary lymph node metastasis. The small tumor cells were argyrophlllc and positive for CAM5.2, carclnoembryonic antigen, neuron-specific enolase, Leu-7, chromogranln A and synaptophysin. Flow cytometric analysis showed an aneuplold DNA content. The patient was alive and well without disease 4 years after surgery. Small cell carcinomas of the breast may exhibkt a spectrum of malignancy that is comparable to similar tumors at better known primary sites.     

Squamous cell carcinoma of the larynx in young adults

Clinical and pathologic features of squamous cell carcinoma in 33 young adults (19 to 34 years) are presented. The most important difference between these patients and older subjects with squamous cell carcinoma of the larynx is the female preponderance in the young. Sixty percent were smokers but no other predisposing factors were uncovered. Histologic grade of malignancy had no impact on prognosis but, as it is with any head and neck site, the most important prognostic predictor is clinical stage.     

喉大细胞神经内分泌癌

目的：探讨喉大细胞神经内分泌癌的临床及病理特征。方法：复习2例患者的临床病史，肿瘤组织的病理形态和免疫表型及相关文献。结果：2例患者均为男性，以声音嘶哑、喉部不适为主要表现；病变均位于声门上，以具有丰富嗜酸性胞质，巢状排列为肿瘤细胞的形态特征，免疫组化表达神经内分泌肿瘤标志物。2例均因短期内发生肿瘤广泛转移而死亡，结论：喉大细胞神经内分泌癌属于高度恶性的肿瘤。形态上需与低分化鳞癌，甲状腺样癌，肺神经内分泌癌，副神经节瘤和无色素性黑色素瘤等相鉴别。     

Electrical excitability of oat cell carcinoma.

Cultured tumour cells from two oat cell carcinomas of the lung were demonstrated to generate all-or-nothing, short-duration action potentials similar to those previously reported in neurones, in bronchial carcinoid cells, and in a number of endocrine cells of proven or proposed neural ancestry. This observation provides new evidence to establish oat cell carcinomas and carcinoids as closely related tumours distinct from other pulmonary neoplasms, and raises the possibility of treating these tumours by manipulation of hormonal agents.     

Primary clear cell carcinoma of the larynx.

The clinical and pathological findings in three patients with clear cell carcinoma of the larynx are described. This type of neoplasm in the larynx is extremely rare. The aggressiveness of the tumour and its high biological malignancy are stressed.     

Small-cell (oat cell) carcinoma of the endometrium

We report a case of small-cell (oat cell) carcinoma of the endometrium in a 59-year-old woman. The tumor was confined to a portion of an adenomatous polyp. It exhibited argyrophilia with Grimelius' stain and dense-core endocrine-type granules by electron microscopy. The patient was alive and well one year later. To our knowledge, this is the fourth reported case of a small-cell carcinoma of the endometrium exhibiting endocrine differentiation.     

Oat cell carcinoma of the urinary bladder with ectopic adrenocorticotropic hormone production

A case of primary oat cell carcinoma of the urinary bladder with ectopic adrenocorticotropic hormone (ACTH) secretion in a 55-year-old woman is reported. Cystoscopy revealed a large necrotic tumor in the bladder; the tumor was partially electroresected. At autopsy, a large residual tumor infiltrating the wall of the bladder was found. It had metastasized to the lymph nodes, left ovary, liver, spinal canal, bone marrow, and hypophysis. Bilateral adrenocortical hyperplasia was found. Microscopically, the tumor was identical morphologically to oat cell carcinoma, and the cells contained argyrophilic hormone granules and immunohistochemically demonstrable ACTH. Apparently, oat cell carcinomas with endocrinologic activity have not been reported previously in the urinary bladder.     

Squamous cell carcinoma of the larynx in a Pekingese dog

This is a report of an unusual multicentric squamous cell carcinoma in the larynx of a Pekingese dog. A 5-year-old female Pekingese dog with a 1-month history of unexplained pain localized to an asymmetrical swelling of the neck together with lethargy and poor appetite was referred to the Veterinary Clinic of Shiraz University. Plain radiographs of the neck revealed ventral displacement of the trachea, with the space between the trachea and spine occupied by a soft tissue mass. Histopathology of the mass affirmed squamous cell carcinoma that affected the larynx. According to the history, clinical signs, radiology, necropsy findings, and histopathological examination, the case was diagnosed as laryngeal squamous cell carcinoma.     

Small cell neuroendocrine (oat cell) carcinoma of the male breast

Summary A case of small cell neuroendocrine (oat cell) carcinoma of the breast in a 52-year old male is presented. Oat cell carcinomas have been reported in various extrapulmonary sites, but this is the second case of a primary oat cell carcinoma of the breast and the first one to have been documented in a male. The tumor was investigated histologically, immunocytochemically and ultrastructurally. The relationship to so-called carcinoid mammary tumors is discussed.Dedicated to Prof. Dr. J. Kracht on the occasion of his 60th birthday     

Primary oat cell (neuroendocrine) carcinoma of the breast

Summary Four cases of oat cell (neuroendocrine) carcinoma of the breast are reported. Three patients died within 15 months of the diagnosis and the fourth patient is alive after 44 months. Histochemical, ultrastructural and mRNA markers of endocrine differentiation were present in three cases. These tumours show histological similarities to breast metastases of bronchial oat cell carcinoma, but a distinguishing feature is the presence of in situ ductal lesions. It appears that the breast is a further site which has to be added to the long list of extrapulmonary oat cell carcinomas.     

Small cell carcinoma of the ovary with hypercalcemia and ectopic parathyroid hormone production

Small cell carcinoma of the ovary is a rare malignant tumor of the ovary. It is the most common undifferentiated ovarian carcinoma in young women. Approximately two thirds of patients with ovarian small cell carcinoma have hypercalcemia. The mechanism of development of hypercalcemia is unclear, although parathyroid hormone-related protein has been found in some of the cases. Parathormone expression in tumor cells, rarely reported, was seen in this case, suggesting that ectopic parathyroid hormone production by the tumor cells may be the cause of hypercalcemia.     

Placental metastasis from maternal bronchial oat cell carcinoma

We describe the case of a young pregnant woman with oat cell carcinoma diagnosed by immunohistochemical reactions and ultrastructural study of a mediastinal biopsy specimen. A neonate was delivered by a cesarean section without evidence of carcinoma, but a thorough pathologic examination of the placenta showed intervillous metastasis of the maternal oat cell carcinoma. This case is interesting, since placental metastases from solid tumors are rare (38 reported cases with pathologic examination of the placenta), and 39% of them arise from maternal melanomas.     

Unique karyotypic abnormalities in a squamous cell carcinoma of the larynx

We have cytogenetically examined short-term cultures from a squamous cell carcinoma of the larynx, a type of carcinoma in which chromosome aberrations have hitherto not been reported. The tumor karyotype was 46,XY,inv(2)(p22q24),t(9;13)(q34;q12),t(11;18)(q23;q21). None of these abnormalities have been described in carcinomas before.     

Host-tumor cellular junctions: an ultrastructural study of hepatic metastases of bronchogenic oat cell carcinoma

A light and electron microscopic study of a metastatic oat cell carcinoma of the lung in the liver of an elderly male is presented. In addition to the finding of a few desmosomes between the tumor cells, desmosomes were also found between the tumor cells and adjacent hepatocytes. The latter feature does not appear to have been reported previously in man.     

Nonrandom pattern of cytogenetic abnormalities in squamous cell carcinoma of the larynx

Cytogenetic analysis of short-term cultures from 105 squamous cell carcinomas of the larynx (LSCC) revealed clonal chromosome aberrations in 56 tumors. Simple karyotypic changes (less than four aberrations per clone) were found in 24 cases, and the remaining 32 tumors had complex karyotypes with multiple numerical as well as unbalanced structural rearrangements. Extensive intratumor heterogeneity, in the form of multiple related subclones or unrelated clones, was observed in a large fraction of the tumors. The structural changes most often affected chromosomes 3, 1, 11, 7, 2, 15, 5, 4, 8, and 12, with rearrangements in the centromeric regions, i.e., the centromeric bands p10 and q10 and the juxtacentromeric bands p11 and q11, accounting for 43% of the total breakpoints. The most common imbalances brought about by numerical and unbalanced structural rearrangements were loss of chromosomal region 3p21-pter, chromosome arms 4p, 6q, 8p, 10p, 13p, 14p, 15p, and 17p, and gain of chromosomal regions 3q21-qter, 7q31-pter, and 8q. Among 17 recurrent aberrations identified, the most common were i(8q), hsr(11)(q13), i(3q), i(5p), and del(3)(p11). No statistically significant association was found between major karyotypic features and histological differentiation or TNM stage. The karyotypic features of the LSCC were also compared with previously published oral SCC, a subgroup of SCC that has been more extensively characterized cytogenetically. No clear-cut karyotypic differences were found between LSCC and oral SCC, with the exception that i(8q) was significantly more frequent among the latter.