Expansive Growth Pattern Research Articles

Hepatocellular carcinoma: efficacy of transcatheter oily chemoembolization in relation to macroscopic and microscopic patterns of tumor growth among 100 patients with partial hepatectomy.

To evaluate the efficacy of transcatheter oily chemoembolization (TOCE) for hepatocellular carcinoma (HCC) on the basis of microscopic and macroscopic findings postembolization. HCCs ranging in size from 0.5 to 13 cm (mean 3.6 cm) were obtained from partial hepatectomies of 100 consecutive patients who had undergone TOCE between 20 and 246 days (mean 59.5 days) prior to surgery. The efficacy of TOCE was assessed on the basis of the necrotic to live cell ratio of the tumors. The microscopic pattern of tumor growth was grouped into expanding type (complete capsule formation) and replacing type (incomplete or no capsule). There were five types of macroscopic groupings: single nodule, single nodule with extranodular growth (SNE), contiguous and noncontiguous multinodular, and massive growth type. Among 79 cases with the expanding type, 29 (37%) had 100% HCC necrosis, but none with 100% necrosis were in the replacing type. By macroscopic grouping, the efficacy of TOCE decreased from the single nodule type (50% of patients had 100% necrosis) to the SNE type (21%), and the other types (9%). TOCE appears to be most efficacious for HCC with the expanding growth pattern and HCC forming single nodules. Poor results are to be expected in HCC of replacing growth type and multinodular or massive growth types.

Expression of laminin, collagen IV, fibronectin, and type IV collagenase in gastric carcinoma

This study attempted to determine if there is a pattern of matrix/matrix-degrading-enzyme immunoreactivity related to the morphologic types of gastric carcinoma or to their invasiveness. The authors performed an immunohistochemical study of the basement membrane antigens laminin and collagen IV, fibronectin, and Type IV collagenase in a series of 87 gastric carcinomas and their respective nodal metastases (n = 329). Laminin expression was observed almost exclusively in carcinomas of the intestinal type. The expression of collagen IV was significantly higher in intestinal (52%) and atypical (44%) carcinomas than in diffuse (10%) carcinomas; collagen IV expression also was significantly correlated with lymphatic invasion and aneuploidy. Ninety percent of the carcinomas expressed fibronectin, mostly in the connective tissue at the invading edge of the tumors; fibronectin expression was significantly related to the expanding growth pattern of the neoplasms. Eighty-six percent of the tumors expressed Type IV collagenase, regardless of the histologic type or invasive properties. No relationship was observed between the expression of any of the antigens and the S-phase fraction of the tumors. No significant differences were found between the immunohistochemical profile of the primary tumors and their metastases. The authors conclude that the expression of basement membrane antigens is related to the type of gastric carcinomas, rather than the cell differentiation or proliferative activity of the tumors. The putative prognostic meaning of the relationship between collagen IV immunoreactivity and aneuploidy and lymphatic invasiveness of the carcinomas remains to be clarified.

Dermoid cyst of the floor of the mouth

Sublingual dermoid cysts are uncommon in the head and neck region. They are most often seen in young adults and can become unusually large with few symptoms. A case is presented to demonstrate the slow, expansive growth pattern and relatively painless swelling in the floor of the mouth that occurred over a 9-year period.

Morphometric analysis of colorectal cancer

Thirteen nuclear and cellular morphometric variables were measured in 312 cases of colorectal adenocarcinoma. All variables, except nuclear shape factors, differed significantly (P < 0.001) between normal colorectal and tumor tissue. In adenocarcinomas, epithelial nuclei in well-differentiated mucosa tended to be elliptic, while those in poorly differentiated mucosa were more spheric. Increasing values of maximum nuclear and elliptic diameter were associated with progression from none to simple tubule configuration (P < 0.001), none to easily discerned nuclear polarity (P < 0.001), and expanding growth pattern (P < 0.001). Univariate survival analysis revealed that none of the morphometric variables was significantly related to patient survival. Multivariate regression analysis showed that no morphometric variable could add significantly to a model containing the variables of patient age, Dukes stage, and tumor differentiation. Morphometry may be useful in distinguishing malignant from normal tissue and degrees of differentiation, but it is of little prognostic value in colorectal adenocarcinoma.

エナメル上皮しゅの臨床的・病理組織学的検索 歯そう部症例について

Since the occurrence of ameloblastoma in the alveolar region is rare, little is known about its properties. We experienced 6 such cases in 24 years.Patients' ages at first visit ranged from 9 to 53 years old. Five cases were found in the mandible and one in the maxilla. Five of 6 patients complained of an enlargement of the alveolus whose size ranged from the tip of the little finger to that of the thumb. In 4 cases, the teeth which had been related to the tumor had been extracted and in one child, the tumor-related tooth germ was not evident.Radiographic examinations revealed that 3 cases had unilocular appearance, 1 had large multilocular, and 2 had honeycomb appearance. Unilocular and multilocular cases had well defined peripheral margins with radiopaque figures, but the honeycomb cases had poorly definable margins. It was interesting to note that the former cases preferentially located in the molar edenturous region expanded to the mandibular body, while the latter in the anterior denturous portion.Histological examination revealed that the unilocular or multilocular tumors were surrounded by connective tissues and showed an expansive growth pattern, while the honeycomb tumors infiltrated the interspace of bone trabecules and destroyed these structures.The above findings suggested a possibility that the histological growth pattern of ameloblastoma was destined by the condition of bone trabecules in the alveolus.