E. C. White

Thyroid carcinoma—Biologic behavior and mortality: Postmortem findings in 42 cases, including 27 in which the disease was fatal

Thirty‐three autopsy cases of clinical thyroid carcinoma were studied as to types, precursor changes and biologic behavior of the tumors. Eleven carcinomas were of the solid type; 13 were spindle and giant cell and the remainder were papillary, follicular or both. The findings indicate that spindle and giant cell carcinomas arise from the papillary and follicular type. No precursor changes were found in the other tumors or in 9 occult carcinomas found at autopsy. The biologic behavior of all types, other than the spindle and giant cell, is unpredictable; survivals vary from a few months to 20 years or longer. The mortality rate is much higher than commonly is believed: Among the 554 patients treated, it was 19%. The treatment for all thyroid carcinomas is total thyroidectomy.

REPRODUCIBILITY OF THE TECHNIC OF MAMMOGRAPHY (EGAN) FOR CANCER OF THE BREAST.

Summary The findings of the reproducibility study indicate that the technic of mammography developed by Egan can be learned by other radiologists, that films of acceptable quality can be produced, and that the interpretations provide information which is useful in the clinical management of breast disease.

Evaluation of irradiation of the peripheral lymphatics in conjunction with radical mastectomy for cancer of the breast

From 1948 through 1964, 978 patients with cancer of the breast were treated by radical mastectomy alone or in conjunction with pre‐ or postoperative irradiation of the peripheral lymphatics. Since 1954 with increasing availability of skin‐sparing beams (60Co, 137Cs and electron beam), the dose to the supraclavicular and internal mammary chain nodes has been increased. This paper reviews over‐all survival rates, survival rates related to the location of the tumor within the breast and the incidence of recurrences in the regional lymphatics and the chest wall. The analysis shows a very low incidence of supraclavicular disease and a negligible incidence of parasternal recurrences. Since 1955 chest wall recurrences have also been few. It seems that one can draw the conclusion that irradiation of the peripheral lymphatics in conjunction with radical mastectomy is worthwhile except for small tumors located in the outer quadrants with the axillary nodes negative in the surgical specimen.

Hepatic tissue tolerance to thio-TEPA administered by the isolation-perfusion technique.

Summary An isolation technique is described which allows for perfusion of the intact canine liver with the minimum of leakage from the perfusion circuit into the general circulation. With this low leakage the maximum dosage of Thio-TEPA tolerated by the normal hepatic cells in dogs was 0.3 mg./kg.

Chondrosarcoma. Immune reactions of a patient to autologous tumor

Chondrosarcoma cells obtained from the tumor of one patient were established in culture. The tumor cells contained filamentous structures resembling viral ribonucleoprotein strands. Autologous small lymphocytes reacted immediately with cultured tumor cells and inhibited the growth of the culture. Destruction of tumor cells by lymphocytes was seen; autologous fibroblasts were not damaged. Small lymphocytes of another patient with chondrosarcoma also reacted immediately with cultured allogeneic tumor cells and inhibited growth. Lymphocytes of normal donors reacted both with cultured fibroblastic and neoplastic cells of the patient but only after several days of co‐cultivation; blastic transformation of lymphocytes was evident during co‐cultivation. It is proposed that patients with chondrosarcoma circulate presensitized small “executor” lymphocytes committed to a tumor antigen. The patients serum reacted with cytoplasmic antigens of the autologous tumor cells in an indirect fluorescent antibody test.