Metastatic Pulmonary Carcinoma Research Articles

Flow cytometric DNA content analysis in neuroendocrine carcinoma of the lung. Correlation with survival and histologic subtype.

The DNA content of 53 primary and locally metastatic pulmonary neuroendocrine carcinomas was retrospectively determined by flow cytometric analysis of nuclei released from paraffin-embedded tissues and compared with histologic subtypes and clinical survival. Forty-one percent (9 of 22) of tumors classified as well-differentiated neuroendocrine carcinoma (WDNC) were aneuploid. In contrast, 85% (17 of 20) of small cell neuroendocrine carcinoma (SCNC), and 73% (8 of 11) of intermediate cell neuroendocrine carcinoma (ICNC) were aneuploid. DNA content was not a significant independent predictor of patient survival within each histologic subtype (P greater than 0.05 for all subtypes). Yet, when all cases were examined as a single group, diploid cases showed better clinical survival than cases with DNA aneuploidy (P less than 0.02). However, the survival advantage for diploid DNA content did not quite achieve statistical significance when only cases of limited stage disease were analyzed (0.10 greater than P greater than 0.05). Histologic subtype was also a prognostic indicator, with WDNC cases showing a significantly longer survival than either SCNC (P less than 0.05) or ICNC (P less than 0.02), for those cases with limited-stage disease. These results indicate information on clinical staging and the histologic subtype are important parameters to compare with DNA content analysis in determining independent prognostic factors in neuroendocrine or small cell carcinoma of the lung.

脳と舌への転移をみた肺癌の１剖検例

A rare case of metastasis to the brain and the tongue from carcinoma of the lung is presented.Case report: A 72-year-old Japanese male was admitted with complaints of the hemiplegia and the impediment in speech. Radiologic examinations revealed the multiple low density areas of the brain and the shadow of the lower lobe of right lung. Metastatic pulmonary carcinoma to the brain was supported. Chemotherapy was treated but the tumorous lesion appeared in lateral and basal regions of the tongue. A biopsy specimen showed adenocarcinoma. He died for cardiac insufficiency 1 month after the discovery of the tongue metastasis. Postmortem examination showed primary adenocarcinoma in the lower lobe of right lung invading into the pleura, and metastatic adenocarcinomas in the brain, the tongue, the kidney and the adrenal glands.

Placental protein 10 levels in benign and malignant ovarian cyst fluids and pleural exudates

Placental protein 10 (PP10) was measured in benign (n = 47) and malignant (n = 10) ovarian cyst fluids and in pleural fluid specimens from 19 patients with pleural metastases of various carcinomas (n = 15) or infectious pleurisy (n = 4). PP10 was found in 9 out of 18 follicular or luteal cyst fluids (range 2.0-42.0 micrograms/l) and in 24 out of 29 benign ovarian tumours (range 2.6-38.0 micrograms/l). Nine out of ten malignant ovarian cyst fluids contained detectable PP10 (range 4.0-55.2 micrograms/l). PP10 was found in all the pleural fluids from 15 patients with metastatic bronchial, pulmonary, breast or pancreatic carcinomas (range 5.1-100.2 micrograms/l), as well as from four patients with pleurisy (range 5.0-28.6 micrograms/l). Our results indicate that PP10 is tumour-associated, but not tumour-specific.

Pulmonary Resection in Metastatic Carcinoma

Resection of pulmonary metastases in osteogenic sarcoma has been reported by us to result in a five-year survival rate of 27 percent. A later report of surgical management of pulmonary metastases from all types of sarcomas showed a five-year survival rate of 26%. This report reviews the experience with 188 patients treated surgically for pulmonary metastasis from a variety of carcinomas, demonstrating that a similar rate of survival is obtainable by surgical excision of these metastases. A total of 188 patients underwent 242 thoractomies for metastatic pulmonary carcinomas. The most frequent sites of origin were the colon, melanoma, breast, and testicular carcinoma. Surgical treatment of these metastases is justified when the following criteria are adhered to: (1) primary site controlled or controllable; (2) no extrapulmonary metastatic sites demonstrable; (3) good surgical risk; and (4) no effective treatment available by nonsurgical means.

A Controlled Clinical Trial of Streptokinase and Heparin in the Treatment of Major Pulmonary Embolism

Treatment with streptokinase or heparin was allocated randomly to 20 patients with major pulmonary embolism verified by angiography. In addition, 4 patients treated with streptokinase and 1 patient treated with heparin were included in the trial prior to the start of treatment. Streptokinase of heparin was given for 72 hours and pulmonary angiography was repeated. The angiographic evidence of thrombolysis was significantly greater (p less than 0.01) in the 14 patients treated with streptokinase than in the 11 treated with heparin. In the heparin group, 1 patient died from massive embolism 15 hours after the start of treatment. In another patient who died 4 weeks later from cerebral glibolastoma, persistent massive embolism contributed to the fatal outcome. In the streptokinase group, 1 patient with a metastatic pulmonary carcinoma died 3 weeks after the start of treatment from gangrene of both legs following thrombotic occlusion of the inferior vena cava. Bleeding was more common after treatment with streptokinase than with heparin, but was not a serious problem in any patient. It is concluded that patients with life-threatening pulmonary embolism should be offered the benefits of streptokinase.

Stimulation of alpha and beta polypeptide chain synthesis in cultured human marrow by erythropoietin.

Erythropoietin (ESF) acts on erythroid progenitor cells inducing their differentiation into definitive erythroblasts (1, 2). Associated with this ESF effect there is, in many species, an increase in the rate of heme synthesis (2–5). In addition, in lower mammals, both in vivo and in vitro, the hormone has been shown to increase the rate of globin synthesis (6). There is also evidence that ESF stimulates globin formation in cultured human marrow cells (7,8). Further studies on the mechanism of action of ESF have shown that in cultured rodent marrow cells the increase of hemoglobin synthesis by ESF is preceded by an increase in the formation of 9S RNA which may represent globin polypeptide messenger (9). Indirect support for these results has been the increase in production of alpha, beta and gamma globin polypeptide chains by ESF in cultured neonatal calf marrow cells (10). The present studies were undertaken to define further the mechanism of action of ESF on human marrow cells growing in primary culture. The data obtained indicate that associated with the increase in the rate of heme and globin synthesis (8) ESF causes a comparable increase in the rate of synthesis of both the alpha and beta polypeptide chains of globin in these cultured marrow cells. Materials and Method. Culture of bone marrow cells. Human bone marrow cells were obtained by sternal aspiration in patients undergoing this procedure as part of an evaluation for possible metastatic pulmonary carcinoma. Only morphologically normal aspirates were used. The aspirated marrow cells were immediately placed in cold NCTC 109 solution and cultured by the method of Krantz (4). In brief, bone marrow cells were washed twice with cold NCTC 109 solution and then suspended in an incubation medium consisting of 60% NCTC 109 solution, 40% heat-inactivated human plasma of AB type and 50 units/ml of penicillin so as to obtain a cell concentration of 2000 nucleated cells (approx 25% erythroid)/mm of medium.

Primary and Metastatic Bronchiolo-Alveolar Carcinoma

A study of 215 cases of metastatic pulmonary carcinoma revealed 34 (15.8 per cent) instances in which the histologic features were compatible with the diagnosis of primary bronchiolo-alveolar carcinoma. The metastatic bronchiolo-alveolar tumors were found chiefly in cases of carcinoma of the pancreas, colon, breast, stomach, and kidney, respectively. Bronchiolo-alveolar carcinoma is not a specific entity, but a histologic pattern of malignant epithelial proliferation occurring both in primary and metastatic lung cancer. The distinctive glandular appearance is dependent on the anatomic structure of the lung parenchyma which provides an alveolar stroma along which the malignant cells can propagate. The histologic differentiation between primary and metastatic bronchiolo-alveolar carcinoma presents a diagnostic challenge in the absence of necropsy.

Cavernous Metastatic Pulmonary Carcinoma

Metastatic carcinoma has been scarcely mentioned as a cause of pulmonary cavitation in the texts and articles on this subject.’.2 The purpose of this report is to review the literature and to describe the clinical, roentgen and pathological findings in two cases of cavernous metastatic carcinoma of the lungs. In one of these, spontaneous pneumothorax was an associated finding. Articles pertaining to the roentgen diagnosis of pulmonary metastases stress the classical pictures of nodular, miliary, infiltrative, and massive types. In a 10 year survey of 78 autopsied cases of metastatic pulmonary disease, Farrell3 reported one with multiple cavities in the lungs due to metastatic sarcoma. Minor4 reported four with cavernous lesions in a series of 312 cases of metastatic pulmonary carcinoma. The detailed roentgen and pathological findings were not described in these articles. Five cases of spontaneous pneumothorax associated with metastatic sarcoma have been reported; three by Lodmell and Capps,5 and two by Thornton and Bigelow.6