Medullary carcinoma with lymphocytic infiltration of the stomach: clinicopathologic study of 27 cases and immunohistochemical analysis of the subpopulations of infiltrating lymphocytes in the tumor
Article Abstract:
One of the possible histopathological observations that might be made on a tumor specimen is the infiltration of numerous lymphocytes into the tumor mass. In some tumors, such as breast cancer, increased infiltration of lymphocytes is associated with an improved prognosis. Although most stomach cancers show some degree of lymphocyte infiltration, a few cases show marked infiltration. The highest degree of lymphocyte infiltration is sufficiently striking that many authorities have given such cancers a distinct name. Unfortunately, this has resulted in different names in different research papers. The authors of this study have chosen the term gastric medullary carcinoma with lymphocyte infiltration (MCLI) to describe this type of tumor. In an examination of tissue specimens from 867 cases of stomach cancer, 27 cases of MCLI were identified. The cases were more common among men by a ratio of 2.3 to 1. Using immunohistochemical techniques, it was possible to observe that the majority of infiltrating lymphocytes were T cells; this is consistent with observations of T cell infiltration in other types of cancers. The five-year survival rate of patients with MCLI was consistently better than that of patients with more common gastric cancers, but the difference was statistically significant only when advanced cancer cases were considered. Of the 12 cases of MCLI in which cancer invasion was limited to the uppermost tissue layers, five-year survival was 100 percent. For tumors that had invaded the subserosal layer and the serosa, five-year survival among patients with MCLI was 73.3 percent, in contrast with the 60.9 percent survival seen for most stomach cancers. It is tempting to speculate that the T cells present in the tumor may have some antitumor activity that is beneficial to the patient. However, until more is known about the nature of these lymphocytes, no conclusions can be drawn. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Papillary-cystic neoplasm of the pancreas: a clinicopathologic study concerning the tumor aging and malignancy of nine cases
Article Abstract:
Pancreatic tumors are uncommon in children and young adults. Furthermore, the pancreatic cancers seen in children have a characteristic primitive appearance which distinguishes them from the pancreatic tumors occurring in young adults. Recently, the tumor designated by some researchers as the papillary-cystic neoplasm (PCN) of the pancreas is coming to be recognized as a distinct clinical entity. It also appears that PCN, which is found predominantly in young adult women, has a favorable prognosis. Since the histopathological and clinical features of this particular tumor have not been thoroughly described, data from nine patients were reviewed. PCN is usually a large encapsulated tumor. The tumor is intermingled with solid and cystic necrotic areas; the solid areas have a pseudoglandular arrangement of cells. Of the nine patients seen, only two were over the age of 24; these two were also the only patients who died. In both of the patients who died, their cancer had apparently been growing for many years. Immunohistochemical study of tumor sections using antibodies for specific pancreatic substances suggested that the PCN does not develop from one particular type of pancreatic cell. Rather, the tumor seems to result from the growth of a totipotent primitive cell. This "all-powerful" cell, like the primitive cells of the embryo, is capable of differentiating into many different adult cell types. The histogenesis of the papillary-cystic neoplasm of the pancreas is therefore similar to embryonic development. Thus the PCN resembles a pancreaticoblastoma, the most common pancreatic cancer of children. PCN may be considered to be a pancreaticoblastoma with delayed onset occurring in young adults. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Mantle zone lymphoma: a clinicopathologic study of 22 cases
Article Abstract:
Mantle zone lymphoma is a cancer of the lymphatic system, characterized by the overgrowth of cancerous lymphoid cells in wide layers, or mantles. These mantles develop around benign germinal centers, regions of tissue located in the center of lymphatic nodules of the spleen, tonsils, and lymph nodes. Among 22 cases of mantle zone lymphoma, 18 were of the intermediate lymphocytic type, and four cases were of the small lymphocytic type. The immunological features of the tumors were characterized, and were similar to normal lymphoid tissue in some respects. Most patients were about 63 years old, and more men than women were affected. Symptoms of weight loss, night sweats, and fever developed in 55 percent of the patients. Other symptoms included enlargement of the spleen (81 percent); lymphocytosis, an excess of lymph cells (13 percent); and bone marrow disorders (67 percent). Patients were assessed according to the progression of the disease, which was classified into stages. Sixty-four percent of the patients were in the most advanced stage of the disease. All patients were given some form of treatment, with 73 percent receiving treatment with multiple anticancer agents. Complete remission was achieved in 11 patients, and overall survival was 88 months. Survival was adversely affected by increased numbers of lymphocytes, a type of white blood cell; decreased numbers of platelets, cells involved in blood clotting; male sex; a high rate of cell division and multiplication; and the presence of large lymphoid cells. Survival was favorably affected by the development of complete remission. Based on these findings, it was suggested that mantle zone lymphoma is a type of non-Hodgkin's lymphoma. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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