Abnormal regulation of coagulation/fibrinolysis in small cell carcinoma of the lung

Article Abstract:

The progression of a tumor is a complex process involving many different components. In the case of small cell carcinoma of the lung (SCCL), progression seems to involve the coagulation of blood. Fibrin, the clot material, may surround the tumor and form a favorable matrix for the development of new blood vessels which help feed the growing tumor. The administration of anticoagulants to patients with SCCL prolongs survival and increases tumor regression, but the mechanisms behind this phenomenon are not clear. Also uncertain are the reasons for the activation of the clotting mechanisms, and the reasons why normal mechanisms do not work to dissolve the tumor-associated clot. In order to provide more data about the mechanisms at work, histological staining was performed on autopsy specimens from six patients with SCCL. Specific immunological stains were used to localize within the tumor various components of the blood coagulation process. Tissue factor, a protein which is capable of activating coagulation, was present within some, but not all, of the tumor cells. Fibrin, the fibrous protein resulting from the coagulation process, was found at the border between the tumor and the host tissue. This indicates that the enzyme thrombin had acted upon the fibrinogen within the tumor tissue, but the mechanism of thrombin formation was not apparent. In addition, urokinase and tissue plasminogen activator, which are responsible for dissolving clots under normal conditions, were found around the blood vessels, but not in the tumor itself. These data suggest that the coagulation is probably controlled by the tumor cells themselves, and indicate why the anticoagulant warfarin has beneficial effects on patients with SCCL. But since the inhibition of the clot-forming thrombin by warfarin is not complete, it may be possible to improve treatment by using other factors which reduce coagulation, such as tissue plasminogen activator. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Physiological aspects, Anticoagulants (Medicine), Anticoagulants, Cancer, Blood coagulation factors, Lung cancer, Small cell, Small cell lung cancer

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The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma

Article Abstract:

Pathology normally comes to the attention of the physician in the form of illness. Occasionally, however, pathological changes are identified at autopsy and reveal diseases for which there were no clinical symptoms. This may be especially true of pathology of the thyroid gland, which generally gets little attention at postmortem examination. To determine the incidence of thyroid pathology in patients who had no evidence of thyroid disease, 300 whole thyroids were obtained sequentially at autopsy; the only selection characteristic being no clinical evidence of thyroid disease. The patients ranged from 13 to 82 years of age; 75.8 percent were between their fourth and seventh decade. Males outnumbered females two to one in this sample. The glands were fixed in formalin and subjected to routine histological analysis. In 6.6 percent there was some sort of thyroid tumor evident. A total of seven malignancies were identified, representing 2.3 percent of the sample; five of these seven were seen in otherwise normal thyroid glands. Less than half (42.3 percent) of the thyroid glands were normal. Colloid goiter and thyroiditis were the most frequently observed conditions. Clearly, an apparently normal thyroid gland not only may have hidden pathology, but is indeed likely to have hidden pathology. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Thyroid diseases, Thyroiditis

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Small cell carcinoma of the esophagus: the Memorial Hospital experience 1970 to 1987

Article Abstract:

Esophageal small cell carcinoma (SCC) is a rare cancer, with under a hundred cases ever reported in the English language medical literature. Surgery or radiation has generally been used as treatment, but the high prevalence of metastases (spread of tumor from original site) seems to justify the use of chemotherapy. The outcome of chemotherapeutic treatment of SCC is reported. Eleven patients with SCC were treated; they represented 1.1 percent of all esophageal cancer cases. Eight of 11 patients had extensive disease; the average survival rate was 7.5 months, with a range from 1 to 21 months. The longest survivor received chemotherapy followed by radiation to the esophagus as well as whole-brain radiation. One patient remains free of disease after surgical treatment and chemotherapy, and is alive 8 months following diagnosis. The poor survival rate is associated with the widespread tumor occurrence found during diagnosis of SCC. Patients with limited small cell carcinoma have a better prognosis, and the study suggests that chemotherapy followed by surgery and/or radiation is appropriate treatment for these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Esophageal cancer

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