Hypersensitivity to thimerosal: the sensitizing moiety

There has been increasing interest in characterizing the sensitizing moiety of thimerosal [TIM]. following the finding that patients with photosensitivity to piroxicam arc allergic to the thiosalicylic acid [TIO] moiety of TIM. For this purpose, the authors have conducted 2 studies in TIM-sensitive patients. In the 1st. of 175 patients tested with TIO and ammoniated mercuric chloride [HGAM|, 45.7% reacted only to TIM, whereas 45. 7%. reacted also to TIO and 17.7%. also to HGAM: 9.1% reacted to both TIO and HGAM. In the 2nd. of 47 patients tested with TIO and ethylmercuric chloride [F.THG], 87.2% reacted to ETHG. 44.7% to TIO and 31.9% reacted to both. None of the patients reacted only to TIM. The authors conclude that thimerosal allergy is due either to the mercuric moiety or to thiosalicylic acid, with no cases of sensitivity only to the whole molecule of TIM. TIM-sensitive patients are mainly allergic to the mercuric moiety. but among them there are a large number of TIO-sensitive patients, and these should be advised to avoid piroxicam.     

Mucinous carcinoma of the breast: A pathologic study of 82 cases

A series of 82 consecutive cases of mucinous carcinomas of the female breast was investigated for their clinical, morphological, and histochemical features and for the influence of some tumor characteristics on its prognosis. Two groups, a “pure” subtype (n=58) and a “mixed” subtype (n=24), were considered, according to the absence or the presence of concomitant areas with typical infiltrating ductal carcinoma. Eighty patients were followed with an average of 7.4 years. The actuarial survival was 58.5% at 10 years. The group of pure mucinous carcinomas showed a statistically significant better prognosis (P=0.0007) than that of the group of mixed tumors, as well as a lower percentage of axillary nodal metastasis. Tumor dimension of both pure and mixed mucinous carcinomas influenced the prognosis, since patients with T1 tumors had longer survival than those with T2 tumors (P=0.05) and the latter showed less mortality than T3 tumor cases (P=0.036). Node-negative patients also had a more favorable outcome with lower mortality than node positive patients (P=0.007). None of the T1 pure mucinous carcinomas had axillary metastasis, which may have implications for the surgical protocols. The evaluation of quantitative and qualitative content in mucosubstances did not correlate with the prognosis. However, sulfomucins were demonstrated in 30.5% of cases; this fact points to add breast carcinoma to the group of neoplasms that may present as a metastatic sulfomucin-producing adenocarcinoma. © 1995 Wiley-Liss, Inc.     

Predictors of positive axillary lymph nodes in breast cancer patients with metastatic sentinel lymph node

INTRODUCTION: Breast cancer with metastatic sentinel lymph nodes (SLN) may have clinico-pathologic factors associated with the presence of positive non-sentinel axillary nodes (NSLN). The aim of the present study was to determine factors that predict involvement of NSLN in breast cancer patients with positive SLN. MATERIAL AND METHODS: A prospective database search identified 80 patients who underwent SLN biopsy for invasive breast cancer between January 1999 and August 2002. Clinico-pathologic data was analyzed to determine factors that predicted additional positive axillary nodes. RESULTS: A total of 23 patients had positive SLN and underwent conventional axillary lymph node dissection. Statistical analysis revealed that lympho-vascular invasion (p~0.00000), SLN metastasis >2 mm (p=0.002), and the presence of extra-nodal involvement (p=0.002), were positive predictors of the metastatic involvement of NSLN. CONCLUSIONS: The likelihood of positive NSLN correlates with pathologic parameters such as the presence of lympho-vascular invasion, size of the SLN metastasis, and extra-nodal involvement. These data may be helpful with the regard to the decision to undertake axillary dissection in breast cancer patients with metastatic sentinel lymph nodes.     

Allergic contact dermatitis from Dittrichia viscosa (L.) Greuter

9 cases of contact sensitivity to Dittrichia viscosa, mainly with an airborne pattern, are described. All patients reacted to the fresh leaf of the plant and to its ethereal extracts at 1 and 0.5% pet., and some of them also to that at 0.1% pet. Positive reactions to Frullania dilatata, Laurus nobilis, some other members of the Compositae, and helenin were observed, suggesting the diagnosis of a sesquiterpene-lactone-induced allergic contact dermatitis.     

Evaluation of ERBB2 gene status and chromosome 17 anomalies in male breast cancer

Male breast cancer (MBC) is an uncommon neoplasm that shares several biologic characteristics with its female counterpart. In the latter, abnormalities in the expression and/or copy number of the ERBB2 gene are present in 10% to 30% of invasive carcinoma and behave as poor prognostic markers. ERBB2 abnormalities have also been reported in MBC, yet at lower frequency, but their prognostic significance remains controversial. Furthermore, no study has addressed the impact of chromosome 17 abnormalities in MBC survival. In this study, the ERBB2-gene status (overexpression and amplification) and chromosome 17 numerical abnormalities were investigated in a series of 50 archival cases of MBC. The results, together with patient's age, histologic grade, pathologic stage, and estrogen receptor status were correlated with overall survival. ERBB2-protein overexpression was present in 7 cases (14%), ERBB2-gene amplification in 4 (8%), and aneuploidy of chromosome 17 in 12 cases (33.3%). The pathologic stage, ERBB2 overexpression and ERBB2 amplification were significantly correlated with overall survival (P=0.002, 0.016, and 0.009, respectively). No correlation was observed between chromosome 17 aneuploidy and overall survival. Therefore, despite their low incidence in MBC, expression abnormalities of ERBB2 behave, together with the pathologic stage of the tumor, as predictors of overall survival, akin to what has been reported for its female counterpart.