Bo Hainau

Bone-marrow examination in the staging of small-cell anaplastic carcinoma of the lung with special reference to subtyping. An evaluation of 203 consecutive patients.

Histologic examination of bone‐marrow from the posterior iliac crest was routinely done as a pretreatment staging procedure in 203 consecutive patients with small‐cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 27.8% with “fusiform” cell type (WHO II,1), 28.3% with “polygonal” cell type (WHO II,2), 42.8% with “lymphocyte‐like” cell type (WHO II,3), and 1.1% with mixed types (WHO II,4). Bone‐marrow involvement was found in 17.2%. No significant difference was observed among the histological subtypes with regard to bone‐marrow involvement. A comparison of bone‐marrow biopsy and aspiration in patients investigated with both procedures showed that aspiration alone was diagnostic in nine of 24 (38%) positive patients as compared with two of 24 (8%) with biopsy alone, while in the remaining 13 patients (54%) both procedures were positive. Of the 35 patients with positive bone‐marrow examination, 77% had no other evidence of distant metastatic disease if liver metastases identified by peritoneoscopy and liver biopsy are excluded as a staging procedure. With the exception of thrombocytopenia which was observed in six patients, with bone‐marrow metastases, hematological findings were of little value in detecting bone‐marrow involvement.

Peritoneoscopy in the staging of 190 patients with small‐cell anaplastic carcinoma of the lung with special reference to subtyping

Peritoneoscopy with liver biopsy was routinely done as a pretreatment staging procedure in 190 patients with small‐cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 28.3% with fusiform cell type (WHO II,1), 28.9% with polygonal cell type (WHO II, 2), 41.5% with lymphocytelike cell type (WHO II, 3) and 1.3% with mixed types (WHO II, 4). Liver metastases were found in 21% of the patients with adequate liver biopsy. In addition macroscopic signs of liver metastases were observed in 9%. No significant differences were observed among the histological subtypes. Liver function tests, such as alkaline phosphatase, LDH and GOT, were of little value in excluding liver metastases. On the other hand, 2 of 3 abnormal liver function tests were highly indicative of liver metastases. In patients with positive liver biopsy, 41% had liver metastases alone and 76% had no other evidence of distant metastatic disease if bone‐marrow involvement identified with bone marrow examination is excluded as a staging procedure.

Electron microscopy of ultrasound-guided fine-needle biopsy specimens

A prospective 3-year study was undertaken in order to assess the value of electron microscopy (EM) as a supplement to routine light microscopy (LM) in ultrasound-guided fine-needle biopsy of suspected abdominal and retroperitoneal tumours. Eight-six of the 899 ultrasound-guided fine-needle biopsies performed during this period were supplemented with EM using the following indications: metastatic lesions with unknown primary tumour, primary retroperitoneal tumours, tumours with atypical clinical histories and where the primary LM evaluation was unable to determine tumour cell type. Two methods of obtaining material for EM were tested, namely, fine-needle aspiration and fine-needle histological biopsy (Surecut). Both methods yielded suitable material for EM evaluation in approximately 80% of the 76 cases where tumour cells were identified by LM. However, it was technically easier to process material for EM when obtained by fine-needle histological biopsy. The results of the 62 cases where suitable material for EM was obtained were grouped according to the histopathological and clinical value of the diagnosis. In 23 cases (37%) EM was without additional diagnostic value. In 12 cases (19%), EM supplied a more precise histopathological diagnosis, but the diagnostic gain was without clinical significance. In 27 cases (44%) EM was of significant clinical value, as the diagnosis by itself was enough to change the investigative procedure and/or the treatment of the patient.

Punktion retroperitonealer Tumoren

Retroperitoneal konnen Primartumoren aber auch Metastasen lokalisiert sein. Bei den primaren Tumoren handelt es sich um Sarkome, Karzinome oder benigne Tumoren oder um Lasionen im Rahmen einer Erkrankung des lymphoretikularen Systems, das die retroperitonealen Lymphknoten einschliest. Bei den sekundaren Tumoren handelt es sich um Lymphknotenmetastasen verschiedener Primartumoren.

Elektronenmikroskopie und sonographisch kontrollierte Feinnadelbiopsie

Die Elektronenmikroskopie (EM) wird in der Pathologie als Erganzung zur Lichtmikroskopie (LM) zur Klassifizierung von Tumoren verwendet. In diesem Zusammenhang hat die EM gelegentlich entscheidende Bedeutung fur die Therapie, z.B. zur Indikationsstellung einer Operation oder eines Chemotherapieschemas.

Puncture of retroperitoneal mass lesions

Retroperitoneal masses are either primary or secondary. Primary lesions are sarcomas, carcinomas or benign neoplasms or lesions due to diseases of the lymphoreticular system involving the retroperitoneal nodes. Secondary tumors are metastases to the lymph nodes from a wide variety of primary sites.

Electron microscopy of ultrasound guided fine needle biopsies

Diagnostic electron microscopy (EM) is used in surgical pathology as a supplementary procedure to light microscopy (LM) in the classification of certain tumors. In this context EM can be of decisive importance to the correct clinical approach, be it the choice of operative procedure or the application of the appropriate chemotherapeutic regimen.