Prognostic implications of DNA histogram, DNA content, and histological changes of regional lymph nodes in patients with lung cancer

Article Abstract:

As is the case with many forms of cancer, patients with lung cancer generally survive longer if cancerous cells have not spread to the lymph nodes. In the case of lung cancer specifically, superior survival may also be achieved if the spread of cancer cells is limited to the lymph nodes. However, it is abundantly clear that some patients with early stage disease without lymph node spread still die early, and some patients with metastatic disease in their lymph nodes survive longer than predicted. There are prognostic factors that have not yet been elucidated. It is also clear that some lymph nodes that are observed to be swollen on physical examination, and therefore presumed to harbor cancerous cells, actually contain no malignant cells when examined microscopically. The swelling is apparently due to the reactive changes mounted by the immune system of the patient. While it is thought that such reactive hyperplasia (abnormal degree of cell proliferation) of the lymph nodes may benefit the patient and therefore be a good signs, it is difficult to quantify lymph node swelling in a useful fashion. For this reason, an attempt was made to utilize flow cytometry in the quantitative evaluation of lymph nodes from patients with lung cancer. In flow cytometry, the cells from a tissue specimen are fluorescently labelled and automatically dropped past a sensitive detector; the result is a histogram representing the distribution of DNA contents of the individual cells in the sample. If the lymph nodes of the lung cancer patients are indeed reactive, there should be evidence of more cells actively synthesizing DNA. A total of 46 lung cancer cases were retrospectively analyzed; 20 cases were Stage I or II disease and 26 cases were Stage III (stages indicate extent of cancer spread, with Stage I as the least amount and Stage IV as the greatest amount). Eighteen of the 46 patients (10 in an early stage and 8 in Stage III) had longer survival than expected. It was found that these patients had more hyperplasia of the lymph nodes visible microscopically. For patients with Stage III disease who had a better outcome, flow cytometry revealed that the lymph nodes also had significantly higher DNA synthesis activity and cell proliferation. Overall, hyperplasia of the paracortical region of the lymph nodes was an indicator of better prognosis, and for more advanced disease stages, DNA histograms from flow cytometry may be useful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Prognosis, Cancer invasiveness, Lung cancer, Lymph nodes

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Primary cerebral ganglioneurocytoma in an adult

Article Abstract:

Neuronal or nerve-associated tumors of the central nervous system are rare and can be classified into various types. These tumors commonly develop in children and young adults and vary in their physical characteristics. Because neuronal tumors are difficult to diagnose and vary widely in their physical features, the classification and description of this group of tumors remains unclear. A case is described of a 30-year-old woman with a neuronal tumor in the cerebrum, the largest part of the brain. The tumor was marked by definite boundaries or margins, and occupied specific areas of the cerebrum, including the septum pellucidum, genu of corpus callosum, and right frontal lobe. It was composed of small round cells and ganglionic tissue, which is a mass of nervous tissue composed of nerve cell bodies. These two types of cancer cells appeared to be at an advanced stage of nerve development. Consequently, the tumor was described as a ganglioneurocytoma. Problems associated with the classification, description, and development of neuronal tumors are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Brain tumors, Nervous system tumors

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