A Case of Hamartomatous Adiposity--A Rare Type of Goiter

A rare case of hamartomatous adiposity of the thyroid occurringin a 4-year-old Japanese boy was studied by light and electronmicroscopy. This tumor-like disorder was composed of predominantlyadipose tissue and fibrous connective tissue with muscle fibersbut only a small amount of thyroid follicles at the periphery.The ultrastructural appearance showed corresponding featuresof mature fat cells, fibroblasts and other mesenhymal cellsin various grades of differentiation, and especially of striatedmuscle cells with myofilaments having electron-dense Z-lines.The findings suggest that this tumor is a hamartomatous or heterotopicdisorder caused by histogenetic malformation during embryonaldevelopment rather than a true neoplasm.     

Blood Vessel Invasion in the Primary Site and Involved Lymph Nodes of Breast Cancer: Its Significance to Hematogenous Metastases

One hundred sixty-nine patients who had had radical mastectomywere investigated for blood vessel invasion in the primary tumorsites (TBVI); and 72 of these patients with regional lymph nodemetastasis were examined for blood vessel invasion within andin the vicinity of the involved lymph node (NBVI). Although distant metastases occurred more frequently in thepatients with blood vessel invasion in the tumor than in thosewith no blood vessel invasion, the differences were rather smallwithin respective negative and positive node metastasis subgroups. Analysis of blood vessel invasion in the involved lymph nodeshowed higher incidences of distant metastases in the subgroupswith positive blood vessel invasion in the lymph node than inthe subgroups with no such invasion; 42.1% 5s. 9.5% (negativeTBVI subgroup) and 47.4% 5s. 15.4% (positive TBVI subgroup). ^* This work was supported by a grant-in-aid for cancer researchfrom the Ministry of Health and Welfare.     

Breast Carcinoma Arising in Cystosarcoma Phyllodes: Report of a Case with a Review of the Literature

An extremely rare case of coexistent carcinoma arising in acystosarcoma phyllodes of the breast is reported. A 41-year-oldJapanese woman was referred with a lump in the right breast.A tumor measuring 5.6x3.6x3.2 cm was removed by local excision.Histological examination revealed foci of papillo-tubular carcinomawithin the benign cystosarcoma phyllodes. Radical mastectomywas performed and the axillary lymph nodes showed no metastasis.While 22 cases of coexistent carcinoma and cystosarcoma phyllodesin the same breast have been reported, in only nine of thosecases, the carcinomas including this case have developed withinthe cystosarcoma phyllodes.     

A Study of Estrogen and Progesterone Receptors in Human Breast Cancer by Sucrose Gradient Centrifugation

Estrogen receptors (ER) and progesterone receptors (PgR) weremeasured by sucrose gradient centrifugation in a series of 109breast cancers, 22 benign mammary tumors and 10 normal mammarytissues. About 45% of the breast cancers were ER + and about 20% werePgR +. In the 39 cases examined for both ER and PgR, all 8 PgR+ cases were also ER +, and there was a close relationship betweenER and PgR status. There was no marked difference between premenopausaland postmenopausal patients in the positive rates or in thelevels (the number of binding sites) of ER and PgR. The relationshipbetween ER or PgR status and clinical response to endocrinetherapy was examined in 21 cases. Close relationships betweenthem were observed and the presence of PgR increased the predictiveindex of ER.     

T-Lymphocyte Subsets in Primary Lung Cancer

T-cell subsets in the peripheral blood of 63 primary lung cancerpatients (23 with adenocarcinoma, 23 with squamous cell carcinomaand 17 with small cell carcinoma) and 24 normal healthy controlswere determined by indirect im-munofluorescence, using the monoclonalantibody reagents OKT3, OKT4 and OKT8. Correlations betweenT-lymphocyte subset values and stages or cell types of diseasewere sought. Total lymphocytes in the patient group were decreased.However, no significant difference from controls was seen inthe percentage of OKT3-positive cells (Pan T-cells) in the cancerpatients. The percentage of OKT8-positive cells (cytotoxic/suppressor)was increased in the early stage of disease whereas the percentageof OKT4 positive cells (inducer/helper) remained at the controllevel throughout all stages. The ratio of OKT4-positive to OKT8-positiveT-cells (OKT4/OKT8), reflecting the balance of immunoregula-toryT-cells, was, therefore, significantly decreased in patientswith stage I–II lung cancer (P < 0.05), especiallyin squamous cell lung cancer (P < 0.05), whereas in stagesIII or IV, this T4/T8 ratio returned to the control level. Insmall cell carcinoma, the T4/T8 ratio was significantly decreasedin stage III (P < 0.01) and returned to the control levelin stage IV.     

Pseudosarcomatous Fasciitis of the Breast Simulating a Malignant Neoplasm: A Case Report and Ultrastructural Study

A rare case of pseudosarcomatous fasciitis of the breast simulatingbreast cancer in clinical and gross features was studied bylight and electron microscopy. The pseudo-tumor was located in the right breast of a 59-year-oldJapanese woman, who underwent a radical mastectomy. The tumorcells were mainly composed of fibroblast-like cells within fibrousstroma and appeared to infiltrate into the subcutaneous fattytissue. Normal or atrophic lobules and ductules of the mammarygland were also found with occasional microcalcification. The ultrastructure of the tumor cells showed poorly developedrough endo-plasmic reticula, and abundant intracytoplasmic microfilaments.This finding suggests that the pseudotumor cells were proliferativefibroblasts derived from the superficial fascia of the breast.     

Inter-Site Variation of Estrogen Receptors in Human Breast Cancers

Estrogen recepter (ER) assays in multiple sites within largetumors of breast cancer were performed by sucrose gradient centrifugation,and the ER status and the number of binding sites were determinedand compared with the cell-strornal ratio. In eight of 21 cases,inter-site variation in the number of binding sites within atumor was shown. Of these, six cases having relatively low ERlevels even showed differences in their ER status. These resultssuggest it is possible for a single assay in a small part ofa large tumor to be misleading concerning the ER status. ERassays of a mixture of cytosols from multiple sites of the tumorand of the tissue slice at the largest cross section showedthat the ER value of the tissue slice was the same as the averagewithin the tumor. In comparing the ER status and the cell-stromalratio, some correlation between the two factors was demonstrated.     

2{alpha},3{alpha}-Epithio-5{alpha}-androstan-17{beta}-yl 1-Methoxycyclopentyl Ether in the Treatment of Advanced Breast Cancer --A Preliminary Clinical Trial--

A new orally active anti-estrogenic steroid, 2,3-epithio-5-androstan-17ß-yl1-methoxycyclopentyl ether (10364-S) was given to 41 advancedbreast cancer patients. Most patients were given a daily doseof 20 mg. The study was preliminary and not a controlled trialusing an already proven androgenic steroid. The remission rateon giving this compound to advanced breast cancer was 11/41or 26.8% and the average duration of the remission was 10.5months. Hoarseness (8/41, 19.5%) and hirsutism (5/41, 12.2%) were relativelyoften seen as virilizing side effects. No unfavorable effectson the hematopoietic organs, the liver or on calcium metabolismwere recognized in the study.     

Significance of Blood Vessel Invasion in the Involved Lymph Node as a Predictor of Blood-Borne Metastases in Breast Cancer--Further Report

Two hundred fifty-six patients who had a radical mastectomywere investigated for blood vessel invasion in the primary tumor(TBVI); and 106 of these patients with regional lymph node metastasiswere examined for blood vessel invasion within and in the vicinityof the involved lymph node (NBVI). Patients with positive TBVI showed a higher incidence of blood-bornedistant metastases, particularly those associated with regionalnode metastases. Further analysis of NBVI among 106 patientswith lymph node metastases indicated higher incidences of distantmetastases in the subgroup with positive NBVI than in the subgroupwith negative NBVI; 40.9% vs. 6.1% in negative TBVI group and48.6% vs. 12.5% in positive TBVI group. Dividing the patientswith positive NBVI into three subgroups relating to the gradeof invasion, the incidence of blood-borne distant metastasesincreased according to the grade of the NBVI. The above results suggest that blood vessel invasion, especiallythe finding in the involved nodes, is important as a predictorof postoperative distant metastases, and adjuvant anticancerchemotherapy is recommended.