Barbara F. Banner

Should flow cytometric DNA analysis precede definitive surgery for colon carcinoma

Conventional prognostic parameters for colon carcinoma are predominantly determined after resection and have limited predictive value. For an evaluation of the significance of flow cytometric (FCM) DNA analysis in colon carcinoma, 56 invasive colon carcinomas were prospectively studied to compare DNA ploidy with established prognostic parameters obtained from pathologic examination of resected specimens. Objective parameters, i.e., depth of invasion and node status, were strongly linked to DNA ploidy; diploid tumors tended to be Astler-Coller stage A or B and nondiploid tumors stage C or D. Diploid and nondiploid tumors did not differ according to subjective criteria such as histologic grade and microscopic invasion of vessels and nerves. These results suggest that FCM DNA analysis may be a valuable tool in managing patients with colon carcinoma, since analysis of biopsies could indicate the likelihood of tumor spread before surgery.

Primary adenocarcinomas of the human urinary bladder: Histochemical, immunological and ultrastructural studies

Neoplastic and non-neoplastic tissue specimens from ten patients with primary adenocarcinoma of the urinary bladder were examined. Most of these tumors were associated with either foci of transitional cell carcinoma and/or with glandular metaplasia of the bladder epithelium. The mucin produced by the neoplastic cells was PAS, alcian blue, mucicarmine, PB/KOH/PAS, and RPB/KOH/PAS-positive. ABH isoantigens of these tumors were not always deleted. Ultrastructurally, the neoplastic cells resembled goblet cells. Their plasma membrane had numerous microvilli with prominent glycocalyx. Proliferation and attenuation of tight junctions were noted. The gap junctions were few and small. Two types of desmosomes were found. The ultrastructural features of the neoplastic cells were attributed in part to the malignant transformation and in part to the direction of their differentiation. We have not observed any distinctive morphologic, histochemical, immunologic or ultrastructural features that might be diagnostic for these adenocarcinomas.

Alterations of intercellular junctions in acinic cell carcinoma of the canine pancreas.

SummaryIntercellular junctions in spontaneous canine pancreatic acinic cell adenocarcinomas were compared to those in control canine pancreas. The neoplastic cells displayed proliferation and fragmentation of tight junctions and reduction in size and number of gap junctions. Marked decrease in desmosomal density was observed only in the poorly differentiated carcinoma. In the well differentiated carcinomas a few of the desmosomes were characteristic of those found in squamous cells. No quantitative or qualitative differences in cell junctions were noted between primary and metastatic tumor.

Carcinoma with Multidirectional Differentiation Arising in Barrett's Esophagus

Four cases of esophageal carcinoma arising in metaplastic Barretts epithelium are presented in which multidirectional differentiation was demonstrated by light and/or electron microscopy and immunohistochemistry. All tumors and adjacent mucosa produced both neutral and acidic mucins, as well as one or more hormones indigenous to the gut, including gastrin, bombesin, substance P, somatostatin, and serotonin. Gastrin and somatostatin were the peptides most frequently identified in the tumors, while somatostatin and serotonin predominated in Barretts epithelium. Ultrastructurally, neurosecretory-type granules, 80-250 nm in diameter, were present in 2 cases; squamous features also were present in one of these cases. One patient displayed hypertrophic osteoarthropathy, which disappeared after the tumor was resected. These cases represent the majority of the Barrett-associated carcinomas in our material. Compared to the pure esophageal adenocarcinomas not included in this report, these tumors behaved more aggressively, with wider local involvement and nodal and systemic metastases at the time of presentation. The incidence of multidifferentiation in esophageal carcinomas is not known nor is its possible significance, particularly with regard to tumors arising in metaplastic epithelium. This group may merit further study to detect true differences, if any, between these esophageal carcinomas and their apparently more common counterparts.